Each year I travel to Kathmandu in Nepal to work at a local hospital on the outskirts in one of
the suburbs of Kathmandu called Kirtipur. The team of plastic surgeons there number 5
attendings and 4-5 trainees. They are supported by a hand therapy unit and a burns
intensive care unit. They do great work there under very difficult financial conditions.
The majority of the work is currently burns, acute burns management and the sequelae of that, hand injuries and a cleft lip and palate service. They have a mixed ward currently but are soon to have a new paediatric ward. Each morning, six days a week, they meet at 8 am for an update as to the activity on the previous day, what cases are to be operated on that day and then a teaching period that includes lectures, either from the resident staff or from visiting staff, and usually a journal club provided for by the trainees. After this one tends to carry out ward rounds of the department and then theatre normally starts at about 9.30 am. The days are often long and as Kirtipur is a charity hospital, they often end up having patients that cannot afford to pay the fees charged for their care.
I find the experience each year to be immensely rewarding, both teaching in the lecture room and teaching in theatre, the consultants of tomorrow in Nepal. They are a very eager group of young men and women, keen to learn, very knowledgeable and extremely hard working.
I try to bring out as many dressings and as much theatre equipment as I can and this is a tremendous help for them and their ability to deliver the care they so wish to do. Many of the cases that I see and am involved with are heart breaking in terms of the delays that can occur because of poor transportation routes into the hospital, patients often taking many days to get from the rural areas of Nepal to the hospital in Kirtipur. The patients and their relatives I find incredibly brave and my heart goes out to them during what is often a very bad burn to a young member of their family.
David R Gateley Director DRG Plastic Surgery Ltd