My name is Anja Ebker-White and I spent three weeks in April volunteering with Nurse Teach Reach (NTR) at BPKM Cancer hospital (BPKMCH). BPKMCH is a large teaching cancer hospital located in the Chitwan District of Nepal, approximately 5 hours travel from Kathmandu. I am a fourth year registered nurse from Sydney and volunteering as a nurse overseas has always been something I have wanted to do. I lived in Nepal as a baby so coming back felt very special and familiar in a strange way. Funnily many actually thought I was Nepali! Strange as my skin could not be any paler if I tried! Maybe it was my nose-stud called a ‘phuli’ (little flower) in Nepali.
My nursing background is mainly surgical, having worked for a short period on haematology then permanently on the colorectal ward at Royal Prince Alfred Hospital. Just before commencing this trip I had the opportunity to work as a stomal therapy nurse, which came in great use for my volunteering with NTR.
At the beginning of my time with NTR I met up with Lucy, Peta, Nikki and Lexi in Kathmandu where they had already been working at both Patan and Grande hospital implementing ICU programs. As I don’t have an ICU background, we decided my time would be best spent at BPKMCH working on the GI and urology wards. BPHMCH was already affliated with NTR having been the first hospital where NTR volunteers worked.
After a fun weekend celebrating Neaplese New year in Bhaktapur with the NTR girls, Lucy and I took the windy bus ride to Bharatpur where I met the lovely host family I was to live with. This area of Nepal sees few tourists and therefore I stood out like a sore thumb, from kids to grandparents who would point, smile and wave at me. It was the dry hot season so the temperature often reached above 40 degrees.
Left: CVC dressing with large, tough adhesive dressing
Image 3: Typical dressing kit.
Stomal therapy was another area I focused on as once I mentioned my background the nurses ‘promoted’ me to stomal therapy nurse. I enjoyed this role and after their initially skepticism that I was too young to know anything (my average age over there was 17-20 not 25!), they recognized my skills and were eager to receive education. I enjoyed spending time with the ostomy patients as they where all very grateful and interested to learn. Mostly patients and their family members spoke no English and as “ma ali-ali Nepali bolchu” (I speak a little Nepali) at best, a nurse usually helped translate.
At the same time however I also found stomal therapy challenging because unlike teaching clinical assessments etc, stomal therapy care is very dependent on having sufficient supplies. They receive most of their appliances donated from the US and their supply room was a shamble. This meant bags were not changed when back home they would have been, patients went home with insufficient supplies and urosotmy bags where placed on colostomies and visa versa.
I thought often that at least they didn’t have the issue of obesity in Nepal so stomas generally were easier to manage, not requiring the extensive belts, pastes, convexity etc to prevent leakage. I had the opportunity to do an in-service on ‘Basic Stoma Care’ and was surprised when over 20 nurses turned up. I was very nervous however it was a great experience and I felt like I taught them some new and relevant information. I focused on some basic stoma cares that I felt could be implemented separate from the lack of supplies issue.
My time in Chitwan was defiantly not all work, most evenings I spend at one of the nurses home until the heat of 40 + degrees lessened and I could ride home. I saw some beautiful local sights and hung out with a Melbourne girl called Siobhan. A friend inKathmandu gave me her number and it was nice to have someone there as support and who could understand the ups and downs of Nepalese life. We found a local hotel pool where we could swim and drink tea (or Nescafe if I was desperate for coffee), which was lovely and a great way to relax after work.
The weekend before leaving back to Kathmandu, Nikki came down to visit and we spend two nights at Chitwan National Park. We had so much fun and it was exciting that on our walking safari we saw rhinos, deer’s, crocodiles, elephants, beautiful birds and even glimpsed a leopard. Our guide Gopal provided a running commentary that kept us utterly entertained. He showed us how to climb trees to view rhinos and took us on a jeep safari.
I am eternally thankful to all the friendly and hard-working Nepali nurses who made my trip so amazing and I h ope to return in the near future to continue the great work that NTR does. A special thank you to Janaki and Khem for being like a second family to me for those three weeks.
Till next time,