Nepal has been a changing experience. A lot of this has been the conversations that I have had with the doctors especially one doctor in particular, the general surgeon. He taught me a lot including stories and information about being a surgeon in a rural hospital, which is my goal, as well as the challenges of American med school. However, the most inspiring things he taught and showed me weren’t about America but about Nepal. Here in Nepal families take care of each other in a different way than in the U.S. because here there is a family member who is always with the patient and this family member is the one getting the food and supplying other tasks that need to be done. This is a cultural difference that while it shows greater care for family it also puts more strain on the family when there is a hospital stay. Then at all times there is at least two family members in the hospital a helper and the patient and when the patient isn’t a peds patient this often means two sources of income are no longer producing. This is one reason that hospital stays are more draining here than in the U.S. 

Another issue that is faced here is cost of care. While the hospital does it’s best to be affordable and cuts the costs for patients as much as possible there are times when the cost of care is too much for them. I saw a patient that was going to die. There was a procedure that had the potential to save them however it was nowhere near a guarantee. To afford this procedure the patient would have to sell his land reducing his family’s income after his passing. This was not a risk that he could take and so the only thing to be done was pain management for end-of-life care. This story struck a chord in me as it is heartbreaking to know that money keeps people from being cured. Another story the surgeon told me though was of a patient who needed there arm amputated but couldn’t afford the procedure anywhere. Anywhere except at the united missions hospital. The procedure was done and the patient was all smiles and joy. This was not the typical response and when asked about why the patient was smiling after such a life altering procedure the patient responded by saying that he was saved from the burden of his arm without burdening his family. After this story I realized something there is a difference between providing medical care and serving people. The hospital we were visiting is full of stories of service and it is inspiring me in my future serve people rather than only provide medical care. 

Another great example of service in the hospital is a pediatric nurse who saw an injustice being practiced and changed it. The main practice was to change burn dressings on pediatric patients with no pain killers or distractions and it was done in a very painful way. This nurse developed a course to teach the other nurses how to distract keeps during these painful times. Now instead of screams and cries it is much calmer and kids will laugh and smile during these painful experiences. I got to see this in action on the pediatric ward and I saw kids with brutal wounds smiling and laughing while playing with nurses’ balloons, bubbles, and stuffed animals. While before the practice was providing adequate care it has changed to serving the patients in such a marvelous way. 

             Another way I saw real service was in comparison between Lambini Medical College and United Missions Hospital. In both hospitals I witnessed a discussion among doctors about the possibility of adding another medical wing. This wing would provide more expensive care and both of the doctors I shadowed said no to the wings but for different reasons. At Lambini the doctor said no because the hospital couldn’t make money off of the wing. Their guiding principle it then seems is money and not the patient. At United Missions Hospital the doctor I shadowed said they weren’t adding the into because it would force the hospital to charge patients more. That means less patients would need medical care without the means to pay can be served. So while it would help the hospital it would hurt the patients and that wasn’t a trade off the doctor was willing to make. This further showed me the hospital and doctors at United Missions Hospital wanted to serve their patients as much as possible. 

               After seeing this service on display at the hospital it has inspired me to want that in my career moving forward. I hope and pray that I can have the impact on patients like the impact that I saw here in Tansen. The impact where they get the medical care that they need and they get all the other help and consideration they need plus more.