Health and Sanitation Program in Nepal

- Practical abilities I was able to learn or to improve at the hospital:

1. Daily:

Taking vitals: Blood pressure, Respiration Rate, Temperature, Heart rate, SpO2
12 ECG
Cannulization/opening veins/put an intravenous access
Preparing I.v.-Systems
Setting up Nebulizer
Assisting with Dressing Wounds/Stitching
Drawing medication

2. Sometimes:

Catheterization
Dressing Wounds
Stitching Wounds (once)
Removing stitches (once)
Giving rectal Enema
Assisting with delivery and the examination of the newborns
Fetal Heart Rate

- Interaction with the staff and the patients:

1. Staff:

The staff at the hospital welcomed me warmhearted, open and kind. On the first day Bhagawan (head of We Volunteer Nepal) accompanied me to the hospital, where he introduced me to the manager, who then introduced me to the staff at the emergency unit.

From then on the nurses and doctors took care of me. The manager also checked in sometimes.

After I had introduced myself, the sister in charge showed me around the hospital. No matter, which department we went to, I was welcomed with a smile and a happy "Namaste".

However as my volunteering went on, I as the volunteer was always the one who introduced myself to "new" staff first. They would not come up to me first. Which is totally understandable - I am the new one, so I will introduce myself. So do not be shy about going up to them and be confident: Hey, I am new, this is me, this is what I am doing here, let me know when you need help with anything.

Show interest and they will start to trust you more and more.

The human interaction with them was more beautiful than everything, I have ever experienced at hospitals. They always shared their tea and coffee with me, always asked me if I was fine, provided food for me, when I wanted to. They always let me try their local food. I ate breakfast together with them sometimes, one time we prepared local food together and the whole team gathered together, to enjoy it. It was very special for me, to eat a ton of rice at 10am in the morning.

They always offered me a chair, when there was nothing to do, even though there were not enough chairs for everyone. Mostly we even shared chairs with a second person, in case it was needed.

As I never really understood anything, when the doctors and nurses examined the patients, I always tried to ask even more questions about the case, once they where finished examining. To find out, what they did, what their diagnosis was, how they would continue the treatment and so on.

Some of them were very open and detailed, some others were rather closed. My favorite doctors and nurses always tried to immediately translate and explain everything to me. I was always very thankful for that, but you definitely cant expect all of the staff to do that. Mostly you as the volunteer need to be very active, need to show interest and be motivated. You cannot be to shy to ask questions or to ask, if you can draw the medicine/do the I.v. or any other practical things. Especially at the beginning they were very cautious about what they would let me do. They would always show me everything 10 times, before they allowed me to do it. I did my first i.v. after one week. They want you to observe a lot before doing practical things.

All the notes that doctors and nurses write down in the files are english, so that was also always a good possibility to catch up on the case (if I was able to read all the messy handwriting haha).

The staff was incredibly patient and kind every time I made a mistake. They never got mad, they just told me - practice makes perfect, don't worry and so on. The next time they showed me how to do it again and then I was allowed to try again.

All in all every single staff member was a warmhearted and nice person.

2. Patients:

The interaction with the patients was quite difficult for me. I often felt lost, because the majority of patients does not speak English. So I tried to explain, what I was doing with hands and feet, but often I felt like a robot, not being able to have proper interactions with the patients and just putting a needle in their arms. It takes away one of the things, people in the medical field love the most: The social part, the communication with the people.

That was one of the things, I missed the most during this volunteering experience. Of course that is exactly, what makes you grow the most: How you handle these situations in a foreign country without knowing the language.

Whenever there were patients with english knowledge, I spoke to them even more and every single one of them was super kind, open and curious about my history. They asked a ton of questions and were super happy, that I treated them. In general almost every patient was able to ask the one question: Where are you from? And they always smiled, when I told them that I was a volunteer from Germany.

I also tried to learn and talk Nepali, which was very difficult.

But whenever I tried to talk to the patients in their language, they laughed at me and reacted very kind. Same as for the staff: They taught me new words and whenever I would practice with them, they would all burst out in laughter and encourage me to go on.

3. My advice: 

Confidence is key. Don't be afraid of making mistakes, don't be shy to pepper them with questions. Don't hesitate to ask if you can do practical things. Always be active, show interest, be motivated, open, kind and always have a smile on your face. Always admit when you've made a mistake to build trust, always ask twice if you're not sure about something.

Just try to see it from the staff's perspective: They want you to have a great experience and they are all super happy to teach you.

And at the end your always there to help. You only have good intentions and everyone knows that.

Trust the process. Of course it is difficult to be in a foreign country alone with an unknown language, strange people, different types of treatment and other medical supplies. Give yourself time to get to know everything, to get confident and to grow with it. Sooner or later you will feel confident in the same hospital that seemed so overwhelming at the beginning.

And again: Don't be shy to ask for help. I've done a thousands ECGs before I arrived in Nepal, so I told them that I know how to do it. When I saw the ECG for the first time it looked a bit different. So I asked them to do it together for the first time and they were happy to show me how they use it.

Just be honest with yourself and the staff and you will have a great experience and a huge opportunity to grow.

Also: If you have the opportunity to do so, try to learn a bit of Nepali before you visit the country. It will make the start of your journey a bit easier and also it makes every single local person happy - I promise!

- My way to work: 

As my host family lived quite far away from the hospital, it took me about an hour per day to get to work. That was always an experience itself. No matter if I used the bicycle, the scooter or the bus.

First of all: No matter which type of transportation I used, the way was amazing every time. It was exactly like you would imagine your way to work in a small village in Nepal. It started with going through huge rice fields and bumpy small paths. I passed a lot of people, who were sitting outside eating rice for breakfast, worked in the fields, were  cleaning or completing other tasks around the house. I always saw buffalos, chicken, goats and dogs. And a beautiful mountain range as soon as the sky cleared up (which was rather rare though).

It continued on a bumpy highway with a lot of terrifying, crazy traffic, which then led through a small forest. I always saw a big sign "Careful of tigers and deer". My hopes were up - unfortunately I never saw any ;)

Using the scooter or the bicycle was an amazing, horrifying and daredevil experience at the same time. The traffic was straight up crazy and the first time, I rode the scooter, I thought, I had just signed my death certification. There were so many big trucks, who passed by super closely, people going in all different directions, bumpy roads, who shook my whole body, and just no structure at all. Well - no structure - is what you think at the beginning. The more often I used these roads, the more I realized how this mess works. There was structure in being unstructured. I have no idea, how it works, but somehow it does. At the end of my stay I ended up being the crazy driver who just always went for it. And - what should I say, I am still here. I always said Nepali roundabouts are like Russian roulette: You just drive into it and hope you are not being run over.

I always loved to use the scooter because it just defines Nepal for me.

I always loved to use the cycle, because then I was always able to move my body, before I went to work. As it got closer to monsoon season every day, I always arrived at the hospital super sweaty and hot, which was not as great - but the hospital luckily has good air conditioning. Later in the season I couldn't use the bike as often anymore, as it was about 40 degrees in the noon sun, when I returned from the hospital.

Let's talk about Nepali busses. I loved that experience.

It took me 20 minutes, to walk to the bus station from my home, which I enjoyed, because it makes you take life a bit slower. You just walk through the village and start the day slowly.

When I arrived at the bus station, there was always a Nepali guy, who asked me, where I wanted to go and let me hop on the bus. So even at the beginning I didn't struggle, to find the right way. The bus was always full of locals and played super loud Nepali music. Sometimes a blessing, sometimes a nightmare at 7am in the morning. ;)

Taking the bus took quite a while because the locals just stood on the side of the highway, waving at the bus, so it stopped almost every two minutes. It continued along the bumpy highway. No air condition so it was incredibly hot. Then I changed busses to a tiny bus-car called magic. Sometimes I sat on a small stool in the middle, sometimes on a normal seat and sometimes even in on the stick shift platform. They always try to make the bus as full as possible so be prepared for some cuddles. :)

And then they dropped me off 5 minutes away from the hospital and the crazy journey came to an end. I loved it because it is just a pure local experience. You always chat with the other people on the bus an are a real part of the local life.

- Activities besides working at the hospital:

You need to be aware of the fact that Parsa (the town where I lived with my host family) is quite a small town. So it is a bit difficult to do activities after work during the week.
When I was there (April-July) it got hotter everyday so mostly it was too hot to really do anything after work anyways.
Sometimes I felt a bit bored and lonely, especially because I was the only volunteer at that time. I finished work at 2pm, had lunch and went home afterwards. I usually arrived there at 4-5pm and mostly spend the evenings at home. So, if you go to Chitwan, you should settle in for a slow and relaxed life. I think the experience can be a lot different if there is other volunteers as well though!
I mostly used the weekends to explore the areas around my place.
I bought a second hand bicycle, because I wanted to be a bit more flexible and that was a very good decision. I cycled a lot during my stay, because, as Parsa is quite remote, it always took a while to reach the places I wanted to visit. Usually I cycled at least 1-1,5 hours per way.
That was always very hot and exhausting, but very rewarding at the end.
There's two amazing waterfalls around Chitwan called Shaktikor and Jalbire.
I visited each one twice. In Jalbire you can do amazing Canyoning which I can really recommend.

Other than that there's the Chitwan national park, where you can do Safaris and Jungle tours. You start in Sauraha, which is like 45-60mins away from the homestay.
Staying in Chitwan for 3 months - looking back I think I actually wouldn't have needed the Safari.

I often stayed in Sauraha and saw crocodiles in the distance swimming in the river.

I saw elephants while I was riding my bike.

One time some guys on elephants even rode through the river and past me.

My favorite spot on that same river was always crowded by buffalos bathing in the sun and the river. Sometimes I saw a rhino in the distance on the other riverside.
One time even a snake suddenly appeared next to my scooter.

So the nature and wildlife really is amazing in Chitwan.

Other than that there's small shops near Parsa, where you can do some shopping or buy things you need. They also have a drug store, a pharmacy and all the important stores.

If you volunteer in Nepal, I can definitely recommend, to add some time at the end of your stay to explore the rest of the country, do trekking and live a travellers life! It was quite interesting for me to see both perspectives.

- Support from We Volunteer Nepal/ especially from Bhagawan (head of We Volunteer Nepal):

Bhagawan is super flexible and open. He lets you have the opportunity to get to know Nepal outside of work.
I spoke to him about visiting the next big city and he made arrangements with the hospital and got me one week of holiday.
This holiday allowed me to go trekking for a week which was an incredible experience. If you go to Nepal, it is a must to do a trek in these amazing mountains.
I booked my trek privately as I didn't know that Bhagawan also offers to organize a trek for you.
So I can't make any particular statements about it but if you consider going trekking in Nepal after/during Volunteering I am sure Bhagawan is the right one to ask for arrangements.
He always helped me with advice, booked my bus to the next big city, made sure I was okey and so on.
Whenever I felt alone or lost in Nepal, because I had no idea, which bus to take, when to start or where to go, Bhagawan kindly helped me out.
No matter which question I asked, he always replied immediately when I texted or called him.
I've also done some Volunteering in South Africa before I came to Nepal and I can tell you: Bhagawans commitment for the volunteers is very special and not self-evident at all! The amount of effort he makes to make sure you're comfortable and safe really made me feel well taken care of.
He fetched me up from the bus stations, when there were no other possibilities of transport, fetched my luggage as it was super heavy and always helped out whenever there was help needed.
I am so grateful for getting to spend my time here in Nepal with him and his family. And I appreciate every single thing he has done for me.
Especially when you're travelling to a foreign country with different cultures and traditions, it is very nice to have someone, you know you can trust and who is always there for you.

- Summary:
All in all a day at the hospital was always a crazy and exciting experience. Some days were slow, some days were incredibly busy.

The whole package was a wholesome experience; starting with leaving the house, using crazy transportation, learning a lot and helping out at the hospital, using crazy transportation and returning home again.

I was a part of the local life and that was a once in a lifetime opportunity I will always be thankful for.

As said by Maite Bitterlich

As a medical student, I worked in the emergency department at Narayami Community Hospital, a private hospital in Bharatpur. The medical staff was very welcoming, and friendly. My work was suited to my medical level, and I could easily go to other departments. It was really interesting to compare the way the patients are treated and managed in Nepal with the way I am used to. This program is a valuable practical experience, adapted to my professional project. However, I didn't feel so useful, and would have prefered to help people who can't afford medical care. My host family was wonderful and I was so glad to be immersed in Nepalese culture. The program director and his staff were reactive, reliable, caring and everything was well organised.