Three Cups of Tea in Kathmandu Nepal

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Daybreak sounds of urban Nepal

In the sleepy mornings of Jawalekhel, somebody about a block away meditates each day using a base drum and another instrument that chips away rhythmically with a hollow almost-Cuban sound like claves. I cock my head to discern to hear whether they are also  chanting. If they are it doesn’t carry quite as well; some mysteries are best left unsolved. I tell myself of course they chant. Milarepa Tsok puja, no doubt. Or Green Tara Puja.

I also tell myself I’m pretty sure they are Buddhist not Hindu……. For forty minutes it’s relentless and I suppose others would be annoyed since it starts at daybreak. I like the sound  though – I am already awake and it reminds me where I am. 

The Norway-Nepal connection.

 So LNC has indicated they need to upgrade their medical mannikins, as does everybody else here. What we’ve had in Nepal nursing schools is  a situation where the Fundamentals courses start with a  minimum of lab time, and students go directly to basic clinical practice for OJT.  There is a lot of incentive to change this, especially if more B Sc programs get off the ground.

Problem: getting mannikins to Nepal is not like hauling used textbooks to Nepal. Nobody has mannikins to donate free. They are too bulky to ship in quantity. No, Ma’am, this one involves raising cash money and paying for things. So, a quick websearch on the Laerdal site revealed that there is one authorized dealer in Nepal – Prudent Medical, Inc. Located in Kamaladi, close to the palace of the former King.

Took the bus to Ratna Park and walked past Rani Pokari using my map, to the Clock Tower. In this neighborhood, a large mosque.  Confused when I got nearby,  so the company  sent somebody to come get me the last hundred meters.  The lift in their building was broken so we  walked up the six flights.

First Cup of Tea

A  cordial meeting with the principal of the company was next, over a cup of instant coffee. (What is it they say  about three cups of tea…..)  and he filled me in on his view of simulation and the role it will play here. He started to show me the Laerdal catalog but I waved him off…. It’s not about the products but about the related issues. Shipping, logistics etc.

“There is no market for the high end simulators here”, he stated flatly. He’s been in business since 1993.

Laerdal created the mannikin business worldwide and is Number One. Their stuff is nice. If you have taken CPR since 1960 you have used their product. Every nurse in USA has used their stuff.

A Chinese company now also makes mannikins.  Chinese mannikins do not stand up well to the wear and tear, though they are cheaper. UH uses Laerdal, and yes they are nice and last a long time. If we bought mannikins, they would be in use here for the next fifty years.

Laerdal does not give a Low Income Country discount; Laerdal has two plants, one in Norway and one in USA. From this meeting I gleaned all kinds of tidbits. He knows he is poised on a boom of demand, and that Laerdal has a worldwide reputation for quality. (It’s true if you ask me).

I thought this company was good, they obviously know what they are about and they know just about everyone in the health professions education industry here. They are involved in training childbirth attendants here as well as docs and paramedics (!). 

They have plans to open up their very own simulation center right here in Central Kathmandu, and to bring in the American Heart Association to develop ACLS courses here. He gave me the names of groups now using simulation, prominent among them is the Red Cross which trains police and Army, but not nurses. There is nobody focusing on nurses per se.

I gave him two  tips: one was how to set up a FB fan page so that your FB contacts don’t clog up your personal profile; the other was about getting donated textbooks from USA inexpensively via his contacts.

Then we got out his laptop and I helped him find this WordPress blog and my other URLs. He  laughed when he saw the titles to my entries. I said “My topic is mostly boring but people will still peek at it if you hint about romance or sex in the title” – with a wry smile  he replied “I see you have studied marketing”.

Urban Hiking through Lazimpat

In May when I first arrived in KTM, the Campus Chief of Tribuwhan University Teaching Hospital (TUTH) phoned me, but we never did meet. Til yesterday. I phoned; she was there; she would meet me at 1:30.  Found it on the map and set out on foot north on Kanti Path through Lazimpat to Maharajganj.

Here was a neighborhood through I rarely go. Embassies behind gated walls with broken glass on the tops, and upscale tourist hotels. The shops here that sell Nepali items are subtly organized to appeal to the kind of traveller who might stay at such a place – you can get a Pashmina or a singing bowl or prayer flags without seeing the beggars and vagabonds of Thamel six blocks away. The shops outside each hotel gate  reminded me of the shops on the ground floors of hotels in Waikiki. No bargains here; but convenience and a sort of insulation, offering Buddha statues but probably no haggling…….


This area is in contrast to the dust, clutter and crowds of Patan….the term would be “gentrified”….the way old-time Boston got gentrified….  Will all of urban Nepal be like Lazimpat some day? Is that goal? Should it even be the goal? As I thought of this the road sloped gently uphill and  I noticed a rice paddy, with lentils planted on the dike, in an undeveloped spot. How long before a shop goes there?

 Passed the International Friendship Children’s Hospital on my way – a nondescript arch proclaims the mission then opens up into a brick courtyard shielded from the street as if it were a hotel in Thamel. Two of my students work here – save the tour for another day.

Past the Army barracks and on to TUTH. Here the gateway opens to an acre of  unpaved dust, a corral of a hundred motorcycles, not many trees; ambulances and the Ausadhi Paisal with a crowd awating their prescription refill. The families awaiting ER care spill out on to the walkway. A chowkidar is stationed at the steel grill, of course. The nursing school on site has it’s own adjacent complex of buildings and houses 280 students in two four-story hostels. The hostel grounds are planted with a vegetable garden to supplement the cafeteria.

 Second Cup of Tea

 The Campus Chief was delightful and said she’d seen me out of the corner of her eye on her trip to Bhairawa as part of a Visiting Committee a few weeks ago. More chiya. I will return here Friday and meet 18 M.N. students to guest lecture on Advanced Nursing for two hours. Just a getting-to-know-you then she arranged a tour for me and was off to her meeting at W.H.O. Downtown.

 Naturally the tour included the library here, not as uptodate as LNC if you ask me.

A Trail of Bread Crumbs?

And another different faculty member led me on a tour of TUTH hospital.  As astounding maze of buildings with niches of patient care. Special attention to ICU and CCU and pediatrics. Fascinating. As always, I think to my first USA nursing job at Boston City Hospital in the old Dowling Building – – the open-ward plan is similar,as in the jumble of buildings that cover more than a city block. Florence Nightingale would be at home here. By this time, the “typical Nepali hospital” is very familiar to me. Mission Hospital is a small scale version of this.  Go to my FB site, find the Mission Hospital photos, and scale them up to about ten times the number of patients.  That’ s a small taste of TUTH. 

 Third Cup of Tea?

 Not a chance. Even one cup keeps me awake. At the end I thanked my guide and got on the bus to Jawalekhel. Got some groceries in my neighborhood and had spaghetti and meat for dinner.

Got to design a certificate for the upcoming class……



About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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One Response to Three Cups of Tea in Kathmandu Nepal

  1. Just a short view of the TUTH nursing collection building complex


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