University of Adelaide 2017

Medical, Nepal Pokhara

My journey to Pokhara for my medical placement with Work the World was an eventful one including a storm delaying our entry into Kathmandu by a couple of hours; I was lucky that I could still make my flight to Pokhara and was met at the airport by one of the Work the World team members. My first impression of Pokhara was that it was hot, closely followed by my admiration of all the lush greenery and colour at every turn!

Alice Terrett

We took a brief taxi ride to the beautiful house, located in Damside, where I met my friend who had arrived for their own placement a few days earlier, and the other girls who were also beginning placement that week. After meeting our (amazing) Assistant Program Manager, we headed out to explore Pokhara, visiting local temples, boating on the lake and experiencing the local food for the first time.

As an Australian medical student, I had the opportunity to access an OS-HELP loan to help fund my placement in Nepal. This made planning for the trip much easier, and the personalised MyTrip WtW placement planner was also valuable in planning my costs for the month I was away. I found the calendar function on MyTrip a valuable resource, as it meant I was always on top of the next task I needed to complete (whether this is visas or payment of fees), and nothing was left until the last minute.

I chose Pokhara as I have always wanted to travel to Nepal and I fell in love with the picturesque lakeside area when I was researching my destinations.

I am also a keen hiker, and the proximity of Pokhara to the Annapurna circuit was a hugely appealing factor for me, as I could combine a trek and my placement into one trip, allowing me to immerse myself completely into the culture and country.

While in Pokhara, we made the most of our weekends and afternoons off, and as we were also visiting during a major Nepali festival, we were able to use some of the festival days to complete other activities. We made the most of the adventure sports opportunities in Nepal, going paragliding, experiencing sunrise yoga, white water rafting and canyoning (abseiling), as well as using every moment we could to see the beautiful Annapurna Mountain range. This included an overnight stay at Sarangkot and a 4-day trek to Poon Hill, both of which were very hot and steep but rewarded us with some of the best views of our lives. As a group in the Work the World house, we did many afternoon walks to the World Peace Pagoda and the Powerhouse (a small water area near the house) to show new friends the views.

Alice Terrett

Due to my compact university timetable, I was unable to extend my trip before or after my placement, but the Work the World staff and other students made sure I was able to see the most of Nepal, even organizing a tour of Kathmandu for our last weekend prior to flying home!

My placement was largely in Pediatrics, but the staff at the hospital were very flexible and allowed us to spend days in other areas which also interested us. This meant I was able to visit the Emergency Department, Obstetrics and Gynecology wards and the operating theatres. I saw many interesting cases as a result, including multiple cases of omphalitis, tuberculosis, extremely premature infants and many cases of pertussis. Perhaps one of the more interesting cases I saw was the delivery of an infant with a complete unilateral cleft lip and palate. I was curious as to the prognosis of this baby, and what resources are available in Nepal for such a condition, and was informed that in Kathmandu there is a craniofacial unit funded by international charities which provides free correctional procedures and equipment for infants with a cleft lip and palate.

Alice Terrett

Along with these interesting cases, I saw many cases of viral respiratory and gastrointestinal infections. Care of these differed to care back in Australia, as almost all were given antibiotics to treat these viral infections.

Perhaps one of the hardest cases I saw was the delivery of a stillborn infant and the difference in care and counselling after the event compared to that given in Australia. This case highlighted the difficulties in follow up management in a low resource setting.

The care in Nepal was definitely different from what is delivered in Australia. Noticeably, all patients have to pay for equipment used which results in fewer hygiene precautions as these are not government funded. I expected differences in care but what I noticed was that there was a significant difference in the attitude of the health professionals and the care delivered is very paternalistic with minimal input or questioning from the patients.

Alice Terrett

Our accommodation for the month was the wonderful Work the World house! It is located in Damside and is easy to travel to both the hospital and Lakeside (the main part of town). The rooftop area is another great opportunity to see the mountains on a clear day. The downstairs area has a kitchen and communal area which was where most of us hung out each day to relax with others and debrief about placement and what we saw at the hospital that day.

It was a great experience to live with so many different students who are studying different courses and from different countries – the majority of our fellow housemates were from the UK or Australia, but we also had housemates from Spain, the Netherlands and the USA during our stay.

Living with a group of like-minded people was a fantastic experience, and helped cement friendships from day one.

The main social events of our day were breakfast and dinner – the house had a wonderful chef who would cook these meals for us and they were definitely a highlight of the day with the delicious food and wonderful company! Once a week we would have a rooftop barbecue, which meant we could look out over Pokhara until the sunset, before eating dinner.

We were also provided with twice-weekly language lessons, which were helpful in learning a few key phrases used to break the ice at the hospital. The lessons are a fantastic resource, and when combined with the videos on the MyTrip page, meaning you can get the most out of your placement and time abroad!

Through our language instructor, a small group of us also had the opportunity to visit a local English school during the festival time and make papier-mache with the group of children there, adding another unique experience to our trip.

Alice Terrett

To those considering a placement with Work the World – do it! It was one of the most challenging and rewarding experiences of my final year of medical school, but most definitely worth it. My top two pieces of advice for those going on a Work the World placement are to keep an open mind, and remember you aren’t there to change the world, but to experience it and develop yourself personally and professionally.

The one thing that will stick in my mind forever after this trip is the friends I made; both in the house and while travelling on weekends or breaks. They made the experiences I had so much richer and gave me a host of stories to tell and remember for many years to come.

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