Navin Leanage

I was originally planning on taking my medical elective with a group of friends from university – we had planned to go to overseas without the help of an organisation, but it had all fallen through quite last minute.

At this point I didn’t have the time to organise another elective by myself, and so started looking around for organisations that could lend a hand. At this point I recalled hearing about Work the World at a conference, who came across as a lot more professional than the other companies my friends had decided to go with.

As soon as I arrived in Kathmandu I was picked up by the team, and then promptly fell asleep once we arrived at the Work the World house after a friendly hello and welcoming meal as I’d arrived quite late in the day.

Then the next day was my city and hospital orientation, which was fantastic. I was taken out, had some traditional food, and was shown places in the city I’d likely return to. The information I got covered everything, and made things familiar when I went out on my own in the following days.

Before starting my placement in Kathmandu’s hospital, I was pretty nervous. I didn’t know what it was going to be like. The experience was totally different from going to a hospital in England that you hadn’t worked in before, as in Nepal I had no prior experience of the healthcare system. I soon discovered how nice the staff were, meeting the head of the department right away. He asked me what I wanted to achieve, and suggested a whole host of ideas for my placement I hadn’t considered.

I was given regular opportunities to enhance my practical skills (obviously under supervision) so that was exciting for me. I made the effort to get stuck in straight away and I was very proactive, making sure I was asking questions and getting the most out of my time. One thing that really helped was the fact that one of the consultants had trained in England, so he knew what information would be particularly helpful to me. 

I was in A&E for my whole six-week placement, and so saw many things that I simply wouldn’t have done in the UK. One particular case was a severe rhino attack on a child, who suffered multiple injuries. It was incredibly sad to see. The family had travelled from the countryside — it took them 24 hours to get to the hospital. Because of this, the wounds were completely infected. You just don’t see this sort of thing in England. Everyone in A&E tried their upmost to help this child.

Another thing that stuck me about many of the cases that came through A&E was the fact that the family are so involved with the care. This is because there’s so much bed pressure – often a patient will be left down in A&E for a long time, and so the family will have to help care for them. If doctors decide to intubate the patient, the family will have to mechanically ventilate them. It must be incredibly tough on the family – I don’t know how they do it.

In terms of practical experience, I got to brush up on my cannulation skills. Cannulation is so simple, but when the family can only afford one cannula, there’s really no room for error. Now in England, if you miss the cannula you can just go straight to the store room and get another one. If you miss it in Nepal, you have to charge the family for another one, which often families can’t afford. Learning how to cannulate difficult people in high pressure environments is definitely a skill I’ve been able to take back home.

I also helped to insert chest drains, and learnt to read the tell-tale signs of certain ailments. Because you just don’t have the investigative technology available to you, there’s a lot of going back to these basics, which are very valuable.

On weekends, I did as much travelling as I could! Sean the Programme Manager was so helpful with all of this; there’s a noticeboard in the Work the World house with ideas and details for extra travel.

I decided to go to the smaller city of Pokhara one weekend, which I would strongly recommend. Pokhara was so different from Kathmandu, and well worth visiting for the contrast. Kathmandu is a bustling Asian city — busy traffic, lots of winding lanes and hidden temples and craft markets —whereas the pace in Pokhara is totally different. It’s green, mountainous and peaceful. You’ve also got all the extreme sports there too, so I went paragliding and white water rafting! It was incredible.

I also went on a weekend hike which in a neighbouring village not too far from Kathmandu. The weather and scenery were incredible; I’d recommend going for at least one hike. I also went on a jungle safari, where I got to see elephants, and went to a local village and see how they made their food.  

Life at the Work the World house was incredible. The food was just so good. When I got there I was mentally preparing to lose weight, but Uma – another member of staff – told me that most people end up putting it on, instead! I didn’t believe her at the time, but soon did…

There’s also the weekly BBQ night every Wednesday – a great time to be social. The house was also well situated, walking distance from hospital, very easy to find, and had lots of balconies where we often enjoyed a few drinks, and amazing views.

I’ll admit I’m probably a bit bias, but I genuinely do not believe that any of the other programmes are anywhere near as good as Kathmandu! Sean goes above and beyond for every student.

When I was in Kathmandu I really enjoyed exploring within the city. There’s just so many heritage sites and religious monuments: you’ll never be bored. As a Buddhist, there was an incredible amount of cultural history to explore. This was very enriching for me. The scenery is incredible. Even if you’re not going for the country and are there just for the placement, it still ticks all the boxes. It’s a struggling health system, it’s got doctors that are probably better than the one’s you’ve got in England at times, and who will work to the same level with less resources. There’s just so much you can learn and take home. 

I strongly recommend it. If I went back in time, there’s no way I would change my choice.  Perhaps when I’m a registrar I can take some time off and come back to take a professional placement!