It was with great enthusiasm tempered by sadness that I read Geoff Ibbotson's description of his experiences in Nepal1 as I prepared to head home to Nepal this year. The beginning of February is a good time to take a peek at the Himalayas, as the skies become clearer and the white snow melts on the mountains. But the colour characterizing the mountains this year was red. The whole country has been caught up in a cycle of violence since the beginning of the Maoist insurgency, which has claimed over 10 000 lives and has now reached the capital city of Kathmandu.
We are all aware of the deplorable level of health care available in Nepal, but few, including me (a Nepalese native), are aware that the system can also offer good care at an affordable cost. Yet, as Ibbotson describes and as I experienced during my recent trip home, such affordable care is possible.
While in Nepal, I had the opportunity to visit some of the medical facilities in Kathmandu, and I was surprised at the speed and efficiency with which an elderly woman with congestive heart failure was managed at a government-run cardiac care hospital in Kathmandu. She had initially been treated for myocardial infarction at a regional hospital a few weeks before. On arrival at the cardiac hospital, the necessary investigations, including electrolyte measurement, radiography and echocardiography, were done and the patient was transferred to the intensive care unit. She was evaluated by a cardiologist and started on angiotensin-converting enzyme inhibitors, spironolactone and cardioselective β-blockers. She made an uneventful recovery the following week and was discharged to follow-up. The cost of her entire hospital stay? Less than US$200!
Although my experience was limited to the city of Kathmandu, I am sure that the picture at many locations in the remote hills is not much different from what Ibbotson1 portrays.
Now, as I sit back in the comfort of my living room in the United States, I try to convince myself that the sun has not entirely set on “the roof of the world.” A little help from the more fortunate ones and some reprieve from the cycle of fear and violence could go a long way toward improving the health care situation in Nepal.
Sonal Singh Unity Health System Rochester, NY
Reference
- 1.↵