Khumbu healthcare system

Finally having good internet connection! A bit about my experience last week…

On my first day at Kunde Hospital, I was faced with a patient carried on a stretcher. The patient was being carried from a nearby village, which is about 2 hours walk for me (mainly uphill). My heart sank when I saw the stretcher from afar as the other doctor wasn’t on site that afternoon and it was my 1^st day!!! (I found out today that the stretcher used was the one we had donated)

Thankfully, I was with the hospital assistants who were amazing. She was carried in, writhing in pain, mainly around the abdomen and back. With the electronic machine, her pressure measured 70/35. Immediately the intravenous fluids went up. However, a repeat reading on the traditional manual machine was slightly reassuring at 90/50. The young lady turned out to have pyelonephritis (UTI leading to infection of the kidneys). I admitted her to the inpatient ward and she recovered well with intravenous antibiotics. Her blood pressure remained low thoughout though.  I found out from the local doctor that people of their races tend to have lower blood pressures. Right.. enough of medical anecdotes and a bit about the Kunde Hospital! 

About Kunde

Sir Edmund Hillary set up Kunde Hospital in 1966. It was inititally run by volunteer doctors from overseas for periods of 2 years. Eventually, a local doctor from the village nearby took over and he has been in charge for many years. 2 doctors, a healthcare assistant, a lab technician, a midwife, a cook and helper run the hospital. It is still funded by the Edmund Hillary Fund.

At the hospital, we can do simple blood tests and x-rays. Simple minor surgery can be done too (such as toilet and suture). Major surgical cases are flown out to Kathmandu on a helicopter. (Which costs a bomb for the locals). However, the rate of appendicitis and emergency caesarean section is low and has not been a problem.

Located at an altitude of 3840m 

View from the hospital

One of the bigger problems is gastritis. Last night we had another patient brought in on a stretcher from a village 3 hours walk away with haematemesis (vomiting blood). I did find out from the doctor that the incidence of H. Pylori is high even among the young people.

Kunde Hospital has been very successful with their immunization, family planning, antenatal and iodine therapy programs.  The main mode of family planning is the depot- most have 2-3 children. I haven’t seen any goiters and most ladies who need an elective caesarean head down to Kathmandu early in the pregnancy.

Partial thickness burn on the face. Ideally, he should immediately be transferred to a Burns Unit. But we don't have such luxury here. We have been dressing the wound and preventing it from being infected. He has done well.

The problem- It is the only hospital that covers a large area though. The furthest village is about 5 hours walk away (full of upslopes and downslopes) I find it hard enough carrying myself on these slope. I don’t know how they manage to carry the patient on a stretcher on this terrain!!!

Each village has a health post, which is run by a health worker, who does very basic medical care.  We have been helping to train these health care workers and promote health education, such as simple first aid, safe delivery at home, maternal health and children health and hygiene.

While at Kunde, I had the chance to learn more about the healthcare system in the Khumbu region. Working with the local doctor, I had a chance to understand more about the common medical ailments, the people’s attitude towards healthcare and areas of health education that lack in the villages.

From Kunde, I walked over to Thame (about 3 hrs walk West of Kunde). There I had a chance to meet their health worker and stay in the local doctor’s lodge. However, I forgot to visit Tenzing Norgay’s house!!!

View from the monastery of Thame Valley

Thame Valley- near the passes to Tibet 

I’m back in Phortse, where I’ll continue running the clinic and promote health education among the villagers. I will be heading to the nearby village of Pangboche in a couple of days.