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The first thing that hits you as you stagger out the airport is the people. Lots of them. And for some reason, they all want to carry your bags. My colleagues and I later found out that it was one way of earning money: ask foreigners for loose change in exchange for carrying their bags to the cars. Since the exchange rate was so poor in the countries favour, practically any currency would triple its amount in rupees. In the case of the Australian dollar, it would give exactly 56 times its value. For my two colleagues and I, that was the beginning of our six week elective in Nepal.
As we meandered through the streets at the neck breaking speed of 30km/h, the mind can’t help but contrast the pot-hole ridden, narrow roads which seem to wear garbage as a second skin with their utopian relatives in Australia. Indeed, Nepal was a country which was at great contrasts with Australia and the roads were only the beginning...
My first day at hospital was spent accepting that a giant building which looked like it had been painted in dust was, in fact, a hospital. The wards were literally steel frame beds where patients hunkered against the cold below blankets that had seen better days. Occasionally, you would have one that had an oxygen cylinder beside it. Air conditioning, monitoring equipment and “remember to wash your hands” signs were nowhere to be seen. Scrubbing in for theatre literally involved washing your hands with soap; no povidine solution or chlorhexidine in sight. At least they had sterile gloves. In fact, it was the only place in the hospital that had them; everywhere else used the ones from surgery that had been used and washed.
Even the patient population and common diseases were very different. Surprisingly, for people so thin, diabetes was also a growing epidemic over there, along with COPD. The latter came as no surprise considering 85% of their population were smokers. As a student from Australia, my list of differential diagnoses for any condition was almost useless. When asked what my thoughts were on a middle aged man who presented with microscopic haematuria, my differentials of nephrotic syndrome, UTI or prostate problems were quickly brushed aside by the physician. When I asked what his differentials were he exclaimed, “obviously, it’s TB cystitis!” As I mentioned above, my differentials were a world apart.
Majority of the population in Nepal subscribe to the Hindu religion in Nepal. This presented itself in quite a stark contrast to modern day Australia, where many are Atheists, Agnostic or, at best, Spiritual. Most people were in some way devout, going to the temples to pray on a regular basis. The main concern to me, however, was the subsequent absence of beef (more accurately, steak) at any given restaurant. Cows are considered sacred by the Hindu people; hence devouring them is seen as an act of sacrilege. Their close cousins, the buffalo, sadly are not covered under the same religious veil and can be quite commonly found on menus as “buff”.
Australia, being a first world country, is concerned with laws, policies, efficiency and the use of the tax-payers dollar. The concern of the Nepalese government seems slightly at odds with ours. Mass culling of the previous monarchy by the prince-heir left the entire nation shocked and only now is the government coming to terms and trying to restructure against thousands of years of tradition. Due to this, laws seem more like “guidelines” and the state of the roads and facilities really does make one wonder just where the tax-payers money is being spent. Or at least, if there are any tax payers at all. The relative inefficiency of just about everything from going shopping to sitting in an out-patient clinic leaves you with a feeling of strange restlessness and with the desire to stand up and yell “if you just combined this (metaphorical) step with that (metaphorical) step in this process, you would be about 300% more efficient!” or “Does anyone, let alone a doctor, need a coffee break every 20 minutes?!” Sadly, the aforementioned statements were not over-exaggerations.
In light of all this negativity, I had one of the best rotations of my medical life so far in Nepal. This is due to the first thing I noticed when I arrived: its people. Initially, as mentioned above, the general consensus was that they were just trying to cheat tourists. However, the more I got to know the people, the more they seemed genuinely friendly. Not only that, they were lacking that emptiness and the growing restlessness that exists in the inhabitants of many first world countries, where abundance and luxury leave you with a lack of purpose and a need for the next big thing. Instead, the Nepalese people seemed quite content with the very fact that they were alive. Survival was a very real goal for the entire nation, and as long as they did, every one of them seemed content. That very stress made them seem completely at ease most of the time. Their stresses seemed natural, coming from not having enough money for food or electricity (question of survival), not from trivial “What do I wear tonight?” or “What does that boy/girl really think of me?” Sure, such conundrums did exist, but they seemed almost immune to the existential crisis that one can see here on any given day.
So at the end of the day, what did I think of Nepal? In one word: awesome! The streets were a mess, law was a fictional word and efficiency a concept in fairy tales, but it was the people that lived there that made everything worthwhile. They hadn’t lost focus on what mattered; it wasn’t the money or the clothes that motivated them, it was spending time with each other, which brings me to my last point. This “essay” is obviously not one that is typical of the genre, though my previously defined objectives of exploring the culture, history, structure and spirituality are covered in the paragraphs above. After experience such an atypical country, I hope it can be understood why this atypical format seemed far more apt for the purpose of this essay. I hope you agree.
1 comment:
we did indeed spend '6 weeks' there raffy! Of course.....
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