The Accident at Tashi Lapsa Pass – Part Nine: Treatment in Kathmandu

I have lived in Nepal for eight years and one of my worst fears has always been that I would get suddenly ill or have an accident serious enough to need to go to a Nepali hospital.

Hospitals in Nepal don’t have a particularly good reputation and there are only a few in Kathmandu that offer anything close to world class quality health care. Rumors are that many hospitals are understaffed, particularly with specialist doctors; diagnoses are sometimes completely incorrect; drugs are overprescribed and post-operative infection rates are high.

Most foreigners who get ill in Nepal, whether foreign expats or short term travelers, choose to visit the high quality CIWEC travel clinic if they have medical problems that are reasonably straight-forward to treat. CIWEC is well-staffed with both foreign and Nepali GP’s and visiting specialists. They have laboratory, ultrasound, and x-ray facilities. There is in-patient capacity for a small number of patients and the clinic has upgraded to include both a High Dependency Unit and an Intensive CU. It handles medical complaints ranging from traveler’s diarrhoea, to altitude sickness, to tropical diseases, to frost-bite. Currently, however, it does not have capacity for more complex surgical procedures. Travelers with more complex medical problems are either referred to other hospitals in Kathmandu, or are medically evacuated out of the country to Bangkok or Singapore.

Going to CIWEC for treatment was not an option because, being a compound fracture, the injury was almost certainly going to require surgery. We were given the choice of nominating any hospital we liked to go to that evening but since we had little knowledge of what were the best options outside of CIWEC, we had no real preference. Basundhara Hospital was a relatively new private hospital and we were told that the facilities and medical care there was good by Kathmandu standards, so we agreed to go there.

Arriving at the Basundhara Emergency Department, the ambulance was met by what seemed – to me – a large number of people who immediately started milling around when the ambulance door was opened. Some were dressed in hospital attire, but many were dressed in street clothes. Someone had a wheelchair for me. Willing hands stretched forward to help me out of the ambulance but I fought them off. Once again I was terrified that in the process of being moved out of the ambulance my leg would not be adequately supported and I would be caused unnecessary pain. One junior doctor suggested that I simply step out of the ambulance into the wheelchair!  I said, “if I could do that I wouldn’t even be in an ambulance!”

It was 5:45pm when we arrived: eight hours since the accident. Apart from the makeshift splint, I still had not received any medical treatment or painkillers. Up until then I had been more or less emotionally controlled, but in the back of that ambulance I lost it and flatly refused to let anyone touch me. I had been holding my leg together since the accident and didn’t trust anyone else with this responsibility, not even hospital staff. My husband told the group that only the relevant staff with experience in moving injured patients should be there to help.

I finally allowed myself to be assisted into the wheelchair but once again my injured leg was wrenched causing a cry of pain from me and my distressed little daughter to again burst into anguished tears.

About Louise Currie

Originally from Australia, although I have been living in Nepal since 2005. I worked for a long time for an international aid agency in Kathmandu. I am interested in community development and having adventures in remote places. I am married with one daughter.

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