My Eye-Opening Medical Placement in Nepal

Dominic Lowe is a fourth-year medical student from the University of Manchester. He recently travelled to Nepal on a six-week medical elective to see the differences between healthcare in the UK and in the developing world. Below, he gives us an insight into these differences and also provides us with a taste of what you can do for fun in South Asia…

Pokhara is a wonderful place, bursting with culture and full of friendly people. The city is built around the beautiful Phewa Lake and close to the start of many trekking routes that lead into the Himalayas. I arrived in Pokhara by plane, and someone from Work the World (the organisation that planned my elective) was there waiting to take me to the shared house that I’d be living in.

My clinical placement

For the placement itself, I spent six weeks in a hospital in northern Pokhara. I divided my time between the emergency department and anaesthetics. As a medical student, I initially took on a primarily observational role. But as time went on, and as I built rapport with the medical staff, they asked me to help out in procedures more and more.

This included assisting with an intubation and carrying out chest compressions. Although the science of medicine is the same in Nepal, the cultural settings and resources surrounding it vary greatly from that of the UK.

Patients often presented with diseases much further advanced than they would be in the UK. And they seemed to complain very little, even with conditions such as (alarmingly large) pleural effusions or dramatic fractures.

The facilities in the emergency department were not modern. There were no computers, only some beds had working monitoring equipment and most of the beds lacked curtains.

Families often accompanied patients arriving in the emergency department. There were up to 15 family members per patient. These ‘patient parties’, as they were sometimes referred to, were heavily involved in decision-making, and responsible for covering the cost of investigations and procedures.

In some cases, treatment had to be stopped, as many families weren’t able to pay for continued treatment. This was quite challenging for me to observe.

While spending time with the anaesthetics team, I witnessed many different techniques and operations including laparoscopic surgeries and many C-sections. Local doctors were great teachers — I was in awe of their knowledge and ability to provide medical care with limited resources. The patients, who persevered through incredibly severe conditions, also inspired me.

Travelling in Nepal

The weekends provided opportunities to explore Nepal. We went on many adventures as a group of housemates.

One of my favourite adventures was a trek up Poon Hill to see the sunrise above the Himalayas. Another was a weekend in Chitwan National Park where we saw lots of wildlife and joined in with some pretty spectacular traditional dancing.

There were many great activities to do in and around Pokhara itself. Paragliding and relaxing boat rides on the lake were popular choices, making it a fantastic place to call home for six weeks.

I loved my time in Nepal. I had some challenging days in the hospital, but it was certainly an eye-opening experience. It made me appreciate how much we have available to us in the UK.

I made some great friends, went on awesome adventures and learned valuable lessons that will make me a better clinician.