July 25th 2018 Time to stop and smell the incense in #Kathmandu

So the last teaching session for 2018 finished yesterday.

Final tally: 

sessions: 19

total certificates: 583. These are easy to quantify.

Nursing consultations: many.  Not so easy to quantify, perhaps priceless! Valerie Aikman, RN, BSN is an experienced and qualified nursing administrator and critical care manager who collaborated with administrators at every host agency. I expect that she will share her perspective in future guest blogs on this site. She brought a unique skill set to Nepal.


Valerie Aikman, R,N, B. S was my colleague this summer. Here she is with Anupama Karnajeet, RN, B Sc who first took my course five years back. Ms. Karnajeet is a critical care specialist in her own right. Her assistance was invaluable.

Last session, back in Kathmandu

We taught 24 nurses from CIWEC hospital. This one was arranged through a former CCNEPal participant now working there, Anupama Karnajeet. CIWEC is located in Lazimpat, convenient to the big hotels and near the former royal palace.  I usually focus on hospitals in other parts of Kathmandu.

Calling Doctor Rajasthani

This training does not use PowerPoint. We do not own expensive manikins. We do not have long periods of lecture. we are hands-on and practical.

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Just a small number of costume items makes training more fun. Doctor Rajasthani is a recurring character in the drama…..

CCNEPal tends to work in Terai these days with only short periods in Kathmandu. They were having construction at the hospital so the venue was the meeting hall of the Himalayan Rescue Association nearby.


Himalayan Rescue Association has a nice space for class size of thirty.


CIWEC  Hospital has an unusual history. It was originally a Canadian project,since 1982. They cater to travel medicine, about 80% of their admissions are foreign tourists. They are busiest during trekking season, spring and fall. Here is a 15 minute YouTube video (Nepali with English subtitles). The two doctors in the video also speak excellent English for those who care.


Everest route. If you trek to Everest Base Camp and develop frostbite or HAPE, you will most likely be evacuated to CIWEC. The Tourist Association of Nepal has a system to help injured travelers.

They are famous for treatment of diarrhea, a tourist plague; CIWEC participates in research on this illness.

CIWEC gets patients with frostbite, a problem among climbers. Among the expatriate community of Kathmandu, they are the most highly recommended of any Nepali hospital.


Poster in the OPD area. Nobody is downplaying the seriousness of diarrhea, but it’s nice to retain perspective.

Th physical plant is the closest thing to a western hospital, in the country. The mineral content of water here seems to easily corrode plumbing, for example, making faucets difficult to operate. CIWEC does not have this problem. The hospital was remarkably clean and reminded me of my own doctor’s office back in Tampa.

The rooms were nice.


Most of the inpatient rooms at CIWEC are single-occupancy but some are double. Bright and airy.  The closest to a USA hospital room of any place.

Obviously I just spent three days with the nursing staff. They all were multilingual and spoke good English, as advertised. Many studied or worked overseas.


The course ” Assistants”for this batch. One of the classroom management techniques I use is to delegate running the megacode drills to people who speak better Nepali than I do!


brushing up on ecg rhythms. I teach the six step method, the international standard. the class was attentive and sked good questions.

Many previously took either BLS or ACLS and worked in critical care in other hospitals prior to joining CIWEC. The hospital is able to recruit and retain the best.


part of the three-bed ICU.

Emergency Room at CIWEC

The ER consists of two well-equipped single-stretcher rooms.

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each ER room has’s own ambulance door and an inner door. They have a “minor Operating Theater” adjacent to the ER as well as a larger O.T upstairs. They can do endoscopy.

I wrote relatively little this summer on this blog, I was busy teaching. I expect to backtrack over the fall and fill in the gaps. This will include ideas about summer 2019.


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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1 Response to July 25th 2018 Time to stop and smell the incense in #Kathmandu

  1. Martha Asher says:

    Always find your posts fascinating!

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