April 2018 Update: six-minute CNN video about the Burn Center in Kirtipur
March 12 2018 update: Today’s Nepal news is a plane that veered off the runway while landing and burst into flames. Two dozen victims survived and were brought to hospitals in Kathmandu. I am sending the victims good karma and also praying for God to guide the hands of the doctors and nurses. In the meantime, in such an accident there is a high proportion of burn injuries. And so, I am re-posting this blog entry for people who wish to learn more about the health care system of Nepal.
Oct 2017 update – thrilled to report that “Burn Care in Nepal” is the “untold Global Health Story of the Year” for 2017 – go to: https://www.globalhealthnow.org/2017-10/reconstructing-hope-surgeons-mission-help-nepals-burn-patients to read the first of a three-part series.
In January 2016, I wrote a piece about burn care on my other blog, titled “Bride Burning” in Nepal and Burn Injuries http://wp.me/p3b3md-e1
The blog focused on the prevalence of burn injuries and the gender imbalance among victims. I wanted western readers to learn about the issue.
(oh, and you can buy my book at https://www.amazon.com/Hospital-at-End-World/dp/1935514288 )
This summer in Nepal I had the serendipitous chance to teach my course at Kirtipur Hospital, home of the Nepal Burn Center.
Kirtipur is an ancient town in the Kathmandu valley, home of a large campus of T.U., and southwest of the center of the city, outside the ring road.
And below the photo is a video from a few years back that features Dr Shankar Rai, a reconstructive surgeon.
The hospital is presently administered by Kathmandu Model Hospital. They freed up thirty staff to attend the CCNEPal three-day course.
There is a wonderful nurse from Australia who is working through PHECT, named Tina Bryce McKay.
I did not think i would teach in Kathmandu Valley, but when the schedule changed and I got some time, Tina got me the invite to train staff at Kirtipur.
They gave me a tour of the place.
close-up of dressing cart
and another view:
Here is the waiting area outside the HDU, where patients are admitted when they have the most extensive burns. In Nepal, the family is expected to be nearby. In many cases, they donate skin to the victim.
In the area where the HDU is, the Operating Theatre has a room designated specifically for grafting and debridement.
The HDU is a highly specialized Intensive Care Unit. When extensive burns occur, the victim inhales hot gas and can burn the upper airway. Inhalation burns are extremely serious.
The percent of burns is an important point. For years it has been an axiom in Nepal that >60% burns is not survivable.
The physical plant of the hospital is only part of the story. In this case, Dr Rai – the main doctor behind the establishment of the hospital – is also a faculty member of NAMS, the National Academy for Medical Science, the oldest site for Post-Graduate Medical Education in Nepal. Along with other surgeons from NAMS, they have built a nationwide network to educate for best practices in burn care. Course have been held in many regions of Nepal, and local educators have been trained. They work with Nepal Burn Society; with Interplast; and with ReSurge International.
Here is a video from only two years ago that updates Dr Rai since the earlier one above. It was made just as Nepal Burn Center was being built.
Another piece of the medical system needed for effective burn treatment is to have a skin donor bank. – http://setopati.net/society/1073/
The website for Kirtipur is http://www.nepalcleftandburncenter.org/
The hospital at Kirtipur serves a critical need in Nepal to upgrade the level of burn care. Their efforts go beyond the construction of a physical building – they are also creating a nationwide network for burn education and care. They partner with international NGOs to advance the practice. Burn care is intense, and it’s inevitable that they will have staff turnover. They need to continue to train their staff, and I think they could benefit from partnering with NGOs that will send future nursing specialists in Burn ICU.
My own efforts to educate nurses and doctors in advanced life support have paralleled the approach adopted by the Nepal Burn Society, I am impressed by their success.