January 26, 2015
Villages visited 2014: Betang - Langu - Parchhyang - Sarsiu - Jibajibe
The bi-annual medical camp held in the Rasuwa District, Nepal is organized by High Himalayan Trekking and Expedition and is held to service the most remote communities who have no medical services in their villages.
In October/November of 2014, the visiting French medical team camped in the villages of Betang, Langu, Parchhyang and Sarsiu to offer their professional services. The people of these villages must trek for many hours to obtain medical help, and even this help, if sought, can be very limited with its services.
The French medical team for 2014 consisted of 1 doctor, 1 nurse, 1 physiotherapist and 6 osteopaths, with the addition of 1 administration assistant from Australia.
In total over 320 patients throughout remote Nepal participated in this free service.
Data on each patient was collated both in French and English, with the French team taking their data back to their home country for future record. The collated English data will be entered onto a High Himalayan Trekking and Expedition’s database for future use in patient records, remote health analysis and feedback for both the Rasuwa District Health Department and the Nepal Ministry of Health Department, and will also be available for any further responsible health concern groups of Nepal. It will also help to assist future medical trips with past knowledge of previous client’s diagnosis and treatment, whilst also giving upfront information on generalized presenting conditions in these remote areas.
As to the medical side of the data collated, models emerged which indicate the result of hardships and patterns of their lifestyle, and poor hygiene.
Many patients presented with lower back and knee problems which are a result of the incredibly heavy loads they carry on a daily basis around the mountains. The adults generally carry about 50-60kg and the children from a very young age are carrying 15kg and up. This may also be affecting their height as the children are carrying loads on their foreheads, necks and backs before their bones have finished growing and their height appears to be shorter than the children that are based in Kathmandu. This may also be due to malnutrition.
Ear infections were also reasonably common in younger children as many have running noses, the children don't blow their nose to clear the nasal passage and this fluid flows to the ear canal and collates there. The running noses may be caused by common colds brought on by lack of hygiene in the washing of their food utensils and the lack of bodily immunity in the cooler months due to wearing clothing that is not sufficient for the temperatures.
Many patients have chronic dental problems which require basic education in dental hygiene, more so now that they have discovered sugar and consume copious amounts of sugar in their tea. As we did not have a dentist in the team there was no advice given in this area.
Eye problems highlighted a Vitamin A deficiency proving their balanced dietary needs are not being met. Good sources of Vitamin A are carrots, pumpkin and tomatoes which are able to be grown in these areas although for the villagers it is just not a consideration. Many patients also presented with cataracts and therefore a need for cataract operations. This could also be attributed to a dietary result with a lack of Vitamin C in their dietary intake. Therefore further education is needed in their need for a well-balanced diet. Their eye problems could also be exacerbated by the daily work and home conditions, out with the dust in the fields during the day, not washing at the end of the day and then moving into enclosed smoke filled kitchen for the evening meal.
Many patients presented with gastritis which is most probably a result of drinking tea early in the morning on an empty stomach with tea having an effect on the body of raising the acidity. They then have their first meal of the day about 9-10:00am that is incredibly hot and spicy. This hot spicy food that they eat is having an impact on the lining of their stomachs causing inflammation of the stomach lining, or gastritis, and in some cases burning through the lining and also causing ulcers which may produce a little blood in their vomit or stools. With the spicy food intake it is a double edged sword, as for many of the families their food storage and preparation is completely unhygienic and the heavy spices they are using is killing the bacteria on the food. If they ate this food without the heavy spices they could well end up with many more bacterial problems.
There were also presenting cases of tuberculosis which the doctor advised these patients to go to a hospital to have tests for correct diagnosis and treatment. Apparently it is reasonably common for this area of Nepal and patients are treated in Jibajibe free of charge by the Nepali government.
Other various bacterial infection problems presented due to lack of bodily hygiene as they rarely wash, and for the elderly perhaps never wash at all.
Supplies most in demand for the doctor and nurse were saline solution for eyes and wound cleaning, antibiotic cream for eye infections, children antibiotics and vitamin A tablets.
In summary, the remote Nepali villages people are very trusting of a doctor and nurse although remain skeptical of alternative methods of treatment with the physiotherapy and osteopathy. They do have “blind faith” in the powers of shamanism, and in some instances there should be a place for this age-old tradition in their communities, although there is also certainly a need for these people to recognize the benefits of modern medicine. Some of the conditions that presented to the medical team have been something moderately simple that modern medicine could have fixed with ease, although because they have been left for such long periods trying to heal with shamanism, the condition of the patients had been quite appalling.
Furthermore, currently the remote village people must go to Kathmandu for something as simple as getting a broken bone x-rayed and re-set, therefore they opt to live with their injury rather than incur the expense of visiting a hospital in Kathmandu. This is a service many of the families could never afford.
High Himalayan Trekking and Expedition would like to say heartfelt thanks to all Medical volunteers and Community members of the Rasuwa district for their generous support.
High Himalayan Trekking and Expedition Pvt. Ltd.