December 2nd 2017. It was a chilly Saturday morning and I stood in line at Gatwick, along with hundreds of other travellers bound for Delhi, wondering what I had got myself into. I was about to travel thousands of miles across the world to a country I had never visited before, hoping that some of my 20+ years of experience within the NHS would be of benefit to the healthcare workers I would be living and working with in rural Nepal.
By the time I had made my way to Kathmandu I was exhausted but also excited to find myself in such a bustling and vibrant, if dusty, city! People were really friendly and the hotel (Kathmandu Guest house) was gorgeous, with a leafy garden and lots of space to relax despite it being in the city centre.
Later that week, after a few days sightseeing and a visit to the PHASE Nepal Office, I set out for the village with Suna, a recently qualified Auxiliary Nurse Midwife (ANM). It was a long journey that began with a seven-hour car ride, four hours of which were on dirt roads. Loc was the most skilful driver I had ever met, dodging the potholes and rutted tracks in and out of diff lock with such finesse I am sure he would put the Top Gear team to shame! I had really enjoyed my first few days in Kathmandu, but it was nice to leave the dusty city basin behind and get out into some countryside. We arrived in Soti in the mid-afternoon. At the end of the road we were surrounded by ladies carrying heavy baskets of wood and asking for a lift into town.
Chandra, a local farmer, who was acting as my porter, didn’t bat an eyelid when my massive rucksack was lifted out of the car. My four-season sleeping back took up most of it, the rest jam packed with treats for the ANMs I would be working with (hand cream, lip balm, chocolate, and even nail varnish!) The start of the walk up the mountain was over a stunning gorge with a suspension bridge across the river, which was a dramatic start to the next stage of the journey. A group of older women took me under their wing as I puffed and panted upwards and tried to get me to hand over my meagre day pack for them to carry. The rest of my belongings were being transported up the mountain with ease by Chandra, who hadn’t even broken into a sweat! We saw glimpses of Manaslu through the trees on the way up, and it felt like a real treat to find myself within sight of the Himalayas!
Before long it became dark and the rest of the walk was an uphill slog without a view to distract me. When we arrived in Manbu, Sangita and Lok were waiting to welcome us and soon had us settled in with some Daal Bhat. The next morning, I woke to this view…
The clinic building in Manbu had just opened, having been newly built and relocated following the earthquake. The floors and walls still hadn’t been laid or plastered so there was dust everywhere. The drugs and equipment were well organised, which was amazing in such a chaotic environment. In fact, everything was well ordered at the clinic, from the documentation of consultations to the disinfection of equipment and the incineration of rubbish. Sangita ran a tight ship!
When the clinic started I instantly felt more at ease. The past few days had been spent in a whirlwind of new experiences but as the patients trickled in I was surrounded by cases I was very used to from British General Practice – some familiarity at last! Over the following days I did alternate day clinics and community educational sessions with young mothers and the local school children who were putting on a health-based drama for the local community. There were also home visits with some amazing views.
We also had a clinic day trip to a neighbouring village which involved a stunning walk into the next valley with time for a quick selfie on the way!
I taught whenever I could – in clinic during surgeries and quiet periods, and in the evenings back at our accommodation. One evening another PHASE Nepal worker, who was travelling back down the mountain, stayed with us overnight and attended my evening tutorial. I only found out later that I had been teaching ‘common skin conditions in primary care’ to a civil engineer!
Our down time involved playing Perudo, showing each other photos of our families, painting our nails and, on the last night treating ourselves to a tiny M&S Christmas cake that poor Chandra had carried up the mountain!
All too soon it was time to start my long journey back to Kathmandu. Back to the luxury of running water, a toilet, and a beer!
What an experience!
Mary Martin, GP volunteer, 2018
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