My name is Yile Li. I am 20 years old and am a university student in America.
I am a premed and economics major. I was in Nepal for two months, spending the majority of my time in the village of Trisuli volunteering at the local medical clinic. I also spent time at different government hospitals in Trisuli and around Kathmandu. Coming to Kathmandu from America is one shock but living in Trisuli is a completely new experience in itself.
Trisuli Bazaar, Nuwakot District
The medical clinic is located in the Trisuli Bazaar, which is the main road with different small shops and guest houses on both sides. It is located right next to the Trisuli River. Getting to Trisuli from Kathmandu is done either by bus or microbus. It is a 70km distance but takes about 4 to 5 hours by bus with a half an hour stop in the middle for food and a 3 hour ride by micro with a similar stop.
The first time I went to Trisuli, I rode on the top of the bus which is probably not recommended but the view was spectacular. The road winds through terraced mountains and are filled with rice patties, wheat fields and little houses spotting the hillside.
Upon arriving in Trisuli I stayed with Raju and his family in their government quarters. Raju is the owner of the medical clinic. His house is located about a 15-minute walk up from the bazaar. The house had a living room which was used as a bedroom, a separate bedroom, a dining room and a small kitchen. There is electricity in the house though at times there are power shortages. Raju also has a television which kept some of the nights entertaining because there were four channels in English. There was no running water but there were three buckets outside that collected water that came from a hose. I never found the other end of the hose but I think it came from a well.
Showers are basically taking a bucket of water to the backyard with a smaller bucket. Though there isn't much privacy, there are only a few neighbors and all the locals wash the same way. The bathroom is a small room with a squat toilet and a bucket of water. I would recommend bringing toilet paper though you can go to the bazaar to buy some.
Depending on what month you are in Trisuli, mosquitoes can be a problem but can be easily resolved by a net. There are a few other little critters that I cohabited with but nothing dangerous. The worst creatures are not inside the house but outside at night. As in Kathmandu where the night is drowned by the howling and barking of the street dogs, Trisuli nights are orchestrated by hundreds of crows and some foxes. I got used to them after a few sleepless nights but after working at the clinic for a day, I was pretty tired and found sleep pretty easily.
The medical clinic in Trisuli Bazaar
The medical clinic is a combination of a pharmacy, two checkup rooms, a small "operating room" and a pathology lab. There are generally three people who work at the clinic. Raju is a pharmacist-paramedic, Gokarna is the pathologist and Laxmi is a nurse. At the clinic, all check-ups are free and the only thing patients pay for are medications and any supplies (bandages, casts, etc).
As I was still in university, I didn't have much medical experience except from what little I knew from previous volunteering and jobs in hospitals, but I was able to learn much. Raju explained to me all the diagnoses and treatment methods and Gokarna would show me and the other volunteers any abnormal results on the blood tests. After being familiarized with the routine, I helped in taking the patients' blood pressures and blood samples. I also was asked to help on some of the small operations that took place at the clinic. Because of the size of the clinic and the lack of equipment, we were only able to do small procedures like removal of abscesses, fixing fractured bones and bandages. If a patient came in needing a procedure that we were unable to do, we would send them to the local government hospital which is about a 15-minute walk from the clinic, or if it was really serious, to a hospital in Kathmandu.
The problem with health care in Nepal is that everything is based on one's ability to pay. When a patient goes to the hospital, if they do not have enough money for the service or treatment, they won't be able to get it. There is no health insurance or government funding to aid in paying for the fees. Many times while working in the hospitals, I paid for some of the patient's treatments because generally it was immensely cheaper than back in the states, essentially a couple of dollars to help a child have his arm checked and casted.
Saturdays at the clinic are an exceptionally busy day. Raju pays for doctors from Kathmandu to come to the clinic to examine patients. Every other Saturday he has either a gynecologist, an orthopedic surgeon, a general physician, a radiologist or a physical therapist. These services are also provided free of charge to the patients. Generally between the hours of 10am and 2pm there are about 40 or 50 patients at the clinic. It is literally just a clump of people waiting to see the doctors but it's great to be busy.
One necessity of working at the clinic is being able to slow your life down. Most people are used to a 9-5 job, working as fast as possible for 8 hours and then just going home. But in Nepal, it's a lot different. All the shops are open for at least 12 or 13 hours a day because the longer it's open the more of a chance of doing business there is. The clinic may seem unbearable at times when there are no patients but once you slow your life down, it’s really enjoyable to have some free time to just walk around the bazaar or go visit people. Most days I had a routine of going down to the Buddhist monastery and just spend an hour talking with the monk about everything, from his story of becoming a monk to where he sees Nepal being in a hundred years. The greatest part was he spoke immaculate English.
Most people in Trisuli speak a little English, usually enough to make a sale or something but everyone is always so eager to practice their English with a foreigner so there is no shortage of opportunity to speak with people. It's a great way to get to know people and hear about their lives, by a mix of broken English and bad Nepali.
At the end of my two months in Nepal, I became extremely close to many people I met, Raju's family, many of the doctors who I worked with and all the other volunteers back in Kathmandu. I've heard from a friend who's traveled all over the world and he said that Nepali people were the nicest people he's met anywhere, and it's true.