Himalaya Watch

People, issues. Debates, perspectives. Details, nuances. A crisp view from the top.

Visit the new professional website of Jiwan Kshetry

Sunday, May 31, 2015

Why the MBBS docs are thinking twice about serving in earthquake zone

Guest post by

(First carried in his blog; republished here with his permission.) 

The truth
I know a doctor here in Nepal who once spent a month trekking from village to village in his district, working with every VDC, to examine women and find the ones who could benefit from a specialized surgical camp set up by a German charity group.  And for every doctor and nurse in Nepal, going on a “health camp” to a rural area is part of normal practice.
The sacrament of the goddess: Book by Niemczura

The innuendo
On May 26th, there was a short article in Republica newspaper bemoaning the fact that 300 doctors are needed in the earthquake-affected areas of Nepal,  and only about 19 responded to the government’s call to work in the earthquake zone. The writer was heaping shame on the young doctors of Nepal.

The response
I wrote a quick response, since the volunteer project I do here in Nepal involves working with those very same doctors, at the beginning of their career.
Today on Twitter I see that the original article has been retweeted more than a hundred times, and seemingly refuses to die. I replied to the retweets offering to give more info as to why young docs might be reluctant but – the writer of the original article did not call me.

Don’t pay  attention to Twitter?
I am aware that Twitter is a bit shadowy. Many of these people who tweet are seeking sensational stories and false outrage. Any twelve-year-old with a mobile can tweet. We don’t know who is “serious” – so, often it’s best to ignore them.

But this time I will be a bit more direct.

Here is what the young doctors are being asked to do, from what it sounds like.

1) go to work in a recent earthquake zone where the houses, schools and health posts have been destroyed.

2) live in the same kind of temporary structure that the people they serve are living in, just as exposed to the elements as the others;

3) Use a temporary structure as a clinic, just like the one that they are living in. There will be no guarantee of a recordkeeping system, no X-ray equipment, no lab equipment, not even a microscope. Not necessarily an examining table, no medical supplies accumulated from the past. There will be no way to dispense drugs if they write a prescription. If there were supplies at that location in the past, they now lie in a heap under rubble that used to be a health post.

4) there is no security personnel. There are reports that the aid now being delivered gets hijacked by village strongmen. Even before the earthquake, there has been a problem with aggressive behavior toward doctors when things don’t go well; the problem with “thrashing” has not gone away and will most likely get worse – the doctor’s physical safety is in doubt.

5) there will be no guarantee of a senior doctor of any kind to supervise or provide advice.

6) In many cases, the young doctor has never lived in a village – they grew up in Kathmandu.

Does this list help? Do you get the picture?

You can’t provide the kind of medical care you were trained to provide, on a picnic. You need tools.
You can’t do it while you are on a two-year’s long camping trip. How does the doctor get food and water and laundry?

The young doctors who signed a commitment to serve and repay loans, could not have known they would be asked to serve in an earthquake zone. Not even Albert Schweitzer would work under these conditions. Many of these young doctors are the same ones who rushed to the affected areas to provide immediate relief in the first weeks. They are not lacking in patriotism. In fact, a few of them did grow up in a village setting. In my teaching I met one  young doc from Makwanpur who was expert at handling oxen when it was time to plant paddy. But for most? Kathmandu.

The doctors need equipment, a roof over their head, and  somebody to prepare rice while they work.
The Nepal Army is in the affected area, doing the backbreaking work to help the residents prepare for monsoon. But while the Army guys were doing physical training everyday and camping while on maneuvers, the young doctors were in the library. All of a sudden, for all intents and purposes, they are asked to join the Army on deployment.

The government needs to  work on these issues and make an effective plan. The article in Republica resorts to shaming and namecalling. This is not the time to browbeat the twentytwo-year-old MBBS graduates, nor is it time to shame the Nepal Medical Council for bringing up the elements of an effective plan.  With a few more questions  the journalist could have gotten to the other issues and provided a service to the reader.
Alas, he did not.

No comments:

विजय कुमारको खुशी पढेपछि

जीवन, खुशी अहंकार

जीवनमा अफ्ठ्यारा घुम्तीहरुमा हिंडिरहँदा मैले कुनै क्षणमा पलायनलाई एउटा विकल्पको रुपमा कल्पना गरेको थिएँ, त्यसलाई यथार्थमा बदल्ने आँट गरिनँ, त्यो बेग्लै कुरा हो त्यसबेला लाग्थ्योः मेरा समग्र दुखहरुको कारण मेरो वरपरको वातावरण हो, यसबाट साहसपूर्वक बाहिरिएँ भने नयाँ दुख आउलान् तर तत्क्षणका दुरुह दुखहरु गायब भएर जानेछन् कति गलत थिएँ !

Read more from Dashain Issue

Debating partition of India: culpability and consequences

Read the whole story here

Why I write...

I do not know why I often tend to view people rather grimly: they usually are not as benevolent, well-intentioned and capable or strong as they appear to be. This assumption is founded on my own self-assessment, though I don’t have a clue as to whether it is justifiable to generalize an observation made in one individual. This being the fact, my views of writers as ‘capable’ people are not that encouraging: I tend to see them as people who intend to create really great and world-changing writings but most of the times end up producing parochial pieces. Also, given the fact that the society where we grow and learn is full of dishonesty, treachery, deceit and above else, mundanity, it is rather unrealistic to expect an entirely reinvigorating work of writing from every other person who scribbles words in paper.

On life's challenges

Somebody has said: “I was born intelligent but education ruined me”. I was born a mere child, as everyone is, and grew up as an ordinary teenager eventually landing up in youth and then adulthood. The extent to which formal education helped me to learn about the world may be debatable but it definitely did not ruin me. There were, however, things that nearly ruined me. There came moments when I contemplated some difficult choices. And there came and passed periods when I underwent through an apparently everlasting spell of agony. There came bends in life from which it was very tempting to move straight ahead instead of following the zigzag course.

Read more