The Need for Medical Doctors in the Remote Areas.

Dr. Kshitiz Paudel with the patient

On September 12th, along with another volunteer at Medication for Nepal (MFN) I went to Ampipal Community Hospital in Gorkha to shadow a doctor. Little did I know I would come back so inspired. The journey from Kathmandu took us a total of 7 hours in the muddy rural roads that gives you a feel of elephant ride. We chose Ampipal hospital as the subject of the business case study we were developing at MFN. And we surely found a lot of inspiring stories and people in that hospital.

This particular hospital is situated in the midst of lush green hilly region of Gorkha District. It is situated at the foothills of Manaslu Himalayan Range. This place is surrounded by hills, red mud and all green forests, fields where lots of plantations happen. It is a heaven for people living in the polluted Kathmandu city, but it had its own set of problems very different than Kathmandu. The vast majority of the people living around this place and the nearby districts are subsistence farmers who live in poverty according to Nepal MEd’s website – its charity sponsor. People at Ampipal seems to have a really hard life. Around the area there is only one school that has buildings that stand and not leaky (this is my definition of well-equipped in remote Nepal, forget the internet access, bus service access to gym or any other thing you might associate with the term). The students as young as 3 or 4 walk about 2-4 hours daily to get to and from the school. There is no proper road, and the level of health knowledge is very poor from my observation. Women with OB-GYN problems don’t want to get treated, men with severe COPD will not stop smoking, or they just don’t know their health is made up of health services from providers but their good health starts first from their own initiative.  I also saw massive problems with alcoholism – men seems to drink all the time. I met drunk men even in the early morning. There were many cases in the hospital related to alcohol abuse. I did not see any rehab center there, I doubt it exists.

Amidst all these problems, I saw a beacon of hope. That was Ampipal hospital along with their dedicated staff. We went to research, interview and shadow Dr. Kshitiz Poudel – the only general physician in the hospital to develop a leadership case. He has been serving in the hospital for 3 years.

 

The hospital treats about 50 patients per day. For all the patient there is only one doctor. He has to juggle through different departments every day, he has to go through different medical cases from surgery to delivery to treating the patient with critical health related problems. There are no other trained medical doctors besides him. Looking at him and his dedication towards his work and his service to the patient was indeed really inspiring for me. The way he has managed to pull himself up from every challenging scenarios in this field gives some peace to the heart and eyes for anyone who sees it – that someone cares very much (at least it was for me and the volunteer who was with me including the staffs at the hospital).

There was a day where the doctor had to do 4 surgical procedure and there were patients lined up at the Out Patient Department to get treated and because he is the only doctor there the patients had to wait for a long time to get checked and the doctor didn’t get time to take rest or even eat his lunch. To fulfill the need of Ampipal people he didn’t want to waste time on his lunch time and kept on doing his work. Sometimes as they say you have to expect the unexpected. A sudden death of his staff’s grandfather really had confused and disappointed him but he continued on his work rather than sit and think about the patient he had just lost. “You cannot dwell on the cases that don’t make it. Yes I get vulnerable and insecure by these cases but I have to commit and dedicate my work to the people who are seeking your service and time” he said and continued on the work.

He is always worried about the place the people and the hospital.” What will happen if I leave this place?” This is the question that arises in his mind every day and every time. Though, Ampipal Hospital proves that with the system in the right hand a rural hospital can also provide people with the best facility. The communities it has served, the families and patients it has served is worth praising. The continuous devotion from the staffs to serve the patients of Ampipal is unexplainable. With every increasing challenges operational, financial, human resource their work and commitment for sustaining this hospital couldn’t be more important today and tomorrow. But, with the lack of well trained and well experienced doctors the hospital cannot reach its full potential. We need doctors and well trained health workers to go to places like these and to go to more remote areas of Nepal to serve our people. We need more people like the doctor and the staffs at Ampipal to selflessly serve our people. We need more people who can understand the current scenario of the rural hospitals in Nepal and work together to eradicate the problems these hospitals are going through and the way that we can do this is to deploy massive amount of health workers (doctors, nurses, lab workers and more) to these areas of Nepal fight the problem and give a quality health service.

There’s nothing more heartwarming than seeing people get healthy and experience the selfless service that people are capable of. I went to research and interview Dr. Paudel, but I came back so much more enriched, inspired and understanding of remote Nepal. There is much to do and much to work for.

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