Odisha Visit from Citta Nepal

Background:

During Michael Daube’s visit to Nepal in January 2012, we discussed Citta’s projects in Nepal and India in the health and education sectors. Since both projects have the same mission, the necessity to meet, and study and share the experiences between the teams is important.

After requesting that Michael make arrangements for the Citta Nepal team to visit the project in Odisha. Dr. Yeshe Lodoe Lama, President/ Medical Director and Sanjeev KC, Managing Director of Citta Nepal, planned the visit.

Objective:

The main objective of the visit was to learn more about the Odisha project and share experiences and information between Citta’s two project sites in India and Nepal.

Journey:

The trip was planned for April 10-19, 2012 and on April 10, We flew on Indian Airlines to Calcutta. The journey was exciting as we were getting the opportunity, for the first time since the establishment of the organization, to visit the Citta site in India. Indeed, Sanjeev was even more excited as this was his first visit to India and his first train ride as well.

After one night’s stay in Calcutta, we headed to Bhubaneswar the next evening on an eight-hour train journey. Govinda met us in Bhubaneswar and it was great sightseeing on our way to Juanga.

Major Observations :

In spite of the poor living standards similar to those in Humla, Odisha has an advantage— easy access via a road. Because of this, more doctors and surgeons have been attracted to provide services to the Odisha project. We met the entire Odisha team and shared our activities. Govinda is doing a great job overseeing all of the project’s activities almost full time. Manu and Sarat are two nice guys, energetic and dedicated to helping Govinda maintain the project. They are doing a great job! We were impressed at the efficiency of the OT and the surgical patients who have been successfully helped. This was one of the purposes of our visit—to learn more about how the OT is functioning in Odisha. It was found to be more efficient  with respect to the equipment and instruments provided as well as the surgeries scheduled on a regular basis.

In comparison to Odisha, Humla has the advantage of more space in our OT, postoperative room and surgical ward. Patients and attendants are getting quick service from two private pharmacies near the hospital’s premises. Even a small lab and the housekeeping staff are doing a good job, too.

Staff quarters are perfect with adequate space but we need to make these operational soon so as to attract more doctors and health care professionals.

 Technical Discussion with the Doctors:

Dr. Yeshe and the duty doctors shared their experiences on the most common cases, treatment patterns, medicines prescribed, and much more. Dr. Yeshe suggested using coding for the various diseases and recording the information about each patient and their particular illness. This information would help us generate statistics for patients and diseases in the area. Sanjeev has discussed with Manu the various managerial aspects of bookkeeping, accounting and tracking records and reports. He has advised Manu to slightly change the budget format by using  appropriate headings such as Operational Cost and Capital Cost.

Most of the progress in the projects was encouraging except for frequent power outages and lack of adequate space and proper layout.

More services could be rendered, if we can come up with the following:

1. X- ray and ultrasound machines

2. Separate birthing/ delivery room

3. New budget format on Google docs with proper budget headings

4. IEC materials for health awareness

5. Patient bus

Govinda also took us to the school but unfortunately we could not meet the teachers and students as it was a public holiday. We were amazed to see the newly painted Jonathan Sheffer High School and the positive results of the latest student exam.

Moreover, the school’s provision of tiffin or lunch is really encouraging the students to attend regularly. We gained a lot of information on the project and its management, and our visit has provided us a great opportunity to bring the Odisha and Humla teams together under one  umbrella. After the school visit, we headed to Puri to visit Jagannath Temple and the beach and we really enjoyed this. After spending two days there, we retuned to Calcutta and did a bit of sightseeing there before returning to Kathmandu on the 19^th.

This slideshow requires JavaScript.

 

 

 

 

 

 

 

Surgical Camp Planned at Dr. Christopher Barley Hospital

Humla, Nepal

The year 2012 is another exciting year for us as there are lots of activities planned with the aim to make Citta’s hospital services in Humla accessible to most of the people in this mountainous region.

There will be a surgical camp for the entire month of September, and Marta Miquel Faig from Spain is working with great effort to make all of the arrangements. A six-member team will conduct the camp with Dr. Jose Maria Ferrendo as General Surgeon, Marta herself, an anthesiologist, a surgical nurse, and an intensivist (specialist in critical or intensive care).

The final list of equipment and instruments, disposables and medicines has been completed. The purchase order has been given to the supplier in Kathmandu for the purchase and shipment of these supplies to Humla, the latter of which will be made by the end of July.

We have so far received € 8000 from Marta for the procurement of the items on the list and £1800 from Irmgard for medicines.

The equipment list comprises most of the vital equipment such as a respirator, ECG machine, oxygen concentrator, autoclave, suction machine, cuttery machine, cardiac monitor, trolley, and others. We are very pleased to get all of this equipment for setting up our newly established operating theatre.

We will start advertising on social media for this surgical camp as this will be the first ever surgical camp in this region.

There are a lot of patients unable to have necessary surgery as they do not have the finances to fly to Nepalgunj or Kathmandu and we hope that our efforts will make a great difference against indifference and help the mountain people of Humla .

 

A Report on Urmila Bhandari

Background:

Urmila Bhandari, 12 year-old resident of Thehe VDC, Humla, fell four years ago and broke her right wrist.

There were no proper treatment facilities in her VDC so her parents treated her at home with the prevailing method of treatment but there was no improvement. After a few days, the parents took Urmila to the district hospital for treatment but she was only able to get relief from the pain and her wrist was still deformed. There was no treatment available there in Humla and the doctor suggested taking her to Nepalgunj or Kathmandu for further treatment.

But due to their poor financial condition, the parents could not afford this and they returned to their village with Urmila. This is the most common problem in most of the hilly mountainous regions of this area. Urmila was now living with the social stigma of being disabled yet she was bright and successful in her studies.

In the meantime, Urmila met with Dr. Yeshe Lodoe Lama (Medical Director/President of Citta Nepal) while he was running Citta’s regular village health program in Thehe.  Dr. Yeshe understood Urmila’s parents’ poor financial situation and began searching for people who could help Urmila.  Luckily, Canadian citizens, Dr. Stephen Aaron and his wife Hannah, offered to provide the financial means for Urmila’s treatment.

Treatment Arrangement:

The estimated budget for Urmila’s treatment was calculated and the total cost was $3000, which was donated in full by Dr. and Mrs. Aaron. Citta Nepal arranged for Urmila’s treatment at the Hospital and Rehabilitation Center for Disabled Children (HRDC) in Banepa.

Treatment:

Urmila and her guardian came from Humla to Kathmandu and a staff member at Citta Nepal in the Kathmandu office was assigned to look after them.

After consultation in OPD, the doctor advised that he needed to admit Urmila to the hospital and make a plaster cast 15 times, every 3 days, to straighten her wrist. Also, she needed physiotherapy under regular supervision for around 3 weeks. According to the doctor, since Urmila still had feeling in her fingers and wrist, surgery might not be needed.

Urmila has now completed her 15 plasters and 3 weeks of physiotherapy and significant progress has been made. Her wrist is now straight and she can move it as well as her fingers much better than before. However, she does need to continue the physiotherapy for the next 6 months to increase her strength. A follow-up has been scheduled after the 6 months and she is now staying with her guardian in one of the hotels in Kathmandu.

Next Plan:

The travel cost to and from Humla is very high. Again, Urmila needs a follow-up after the next 6 months of physiotherapy and she needs additional follow-ups every year for the next 5 years. The situation with Urmila is very difficult as her parents are quite busy with work and there is little parental supervision and support for her.

As Urmila is bright and now has more hope for her future since her wrist has been repaired, Citta Nepal has asked Dr. and Mrs. Aaron if they might support her academic studies. Dr. and Mrs. Aaron were positive on this and Urmila has joined Cambridge Boarding School at Kathmandu.

This slideshow requires JavaScript.

 

Story of Binita Bohara

This slideshow requires JavaScript.

In the first week of September 2011, Binita Bohara, a 1 ½ year-old girl from Thehe village, was brought to Christopher Barley Hospital in Humla for the treatment.  Dr. Yeshe and two volunteers from the USA, Dr. Trudy and Kat Bogacz immediately diagnosed that she was suffering from Kwashiorkor.

Kwashiorkor is an acute form of childhood protein-energy malnutrition characterized by edema, irritability, anorexia, ulcerating dermatitis, and an enlarged liver with fatty infiltrates. The presence of edema, specifically pedal edema or the swelling of the feet, caused by poor nutrition defines Kwashiorkor in a malnourished child. Other signs include a distended abdomen, thinning hair, loss of teeth, and skin pigmentation.

Binita was in such serious condition, and since we don’t have a malnutrition rehabilitation center in Humla, we advised her parents to take her to Nepalgunj for treatment. However, her family is very poor and unable to pay for the treatment and transportation charges of the plane, So, by the generous support of Kat Bogacz and Dr. Trudy, we were able to sent her to Nepalgunj Medical College for treatment. Binita and her mother were in Nepalgunj for one month and all the expenses were paid by Citta’s volunteers, Kat Bogacz and Dr. Trudy.

Now, Binita has returned back to Humla after her treatment and she is doing very well under the supervision of Christopher Barley Hospital for her medical care. Her mum heartily thanks Citta’s Christopher Barley Hospital and Kat Bogacz and Dr.Trudy for saving her daughter’s life. Citta’s Christopher Barley Hospital has saved many other children’s lives in the Humla region. Citta is really making a difference against indifference!

Happy New Year

Citta Nepal CB hospital Humla (winter pictures)

Man with Broken Arm Sent to Nepalgunj for Treatment

While Roshi Joan Halifax’s team was working hard during the two day medical camp at Citta Hospital, Humla, we received a patient with serious multiple fractures to his arm. While working in his village fields, the man had fallen from a terrace and was in a considerable amount of pain.

After suffering through seven days without care, he journeyed three days from his villiage, Muchu, to our clinic. It became clear after several doctors examined him that he was in need of resources for treatment that we would be unable to provide at the hospital.

Through contributions, we were able to cover the cost of six days of medical care and recovery in Nepalgunj as well as travel expenses to and from Simikot.

As you can see by the photos, the patient looks much improved!