Where do Nepali doctors come from? This week I (Les) got more insight into how the process happens in modern-day Nepal. The truly gifted students (those who can perform exceptionally well on national tests) can compete for scholarship seats at the national university. Those who are only above-average compete for the private medical college seats in Nepal (which are quite expensive for here in Nepal). Those who are not accepted there (if they are from wealthy [for Nepal] families) can attend medical schools outside of Nepal (which is even more expensive). After medical school, students must complete an internship to be eligible for a medical council certificate (ie. medical license). These internships must be completed at the medical college where they studied (if they did medical school in Nepal).
So, when we interviewed for interns here at Tansen Hospital the other day, all five of our applicants were graduates from foreign (not Nepali) medical schools. One had not been accepted the last time we interviewed for interns and had spent the last 5 months working without pay as a pre-intern to improve his clinical skills. He had come a long way and was accepted this time as a full intern. Two of the other candidates had already started an internship in KTM at government hospitals, but after 3 months were not happy with their level of training and had heard that Tansen was a good place to intern, so they applied here. Only one of those was accepted. It is discouraging to see how far people can get in their medical training with such huge deficiencies in their basic understanding of medicine.
Of the two remaining applicants, one was accepted and the other was offered to do a pre-internship to improve his skills with the option to interview again for an internship in 4 – 5 months. This last young man actually was in a Sunday school class that Debbie and I taught many years ago during our last time in Nepal. He is very personable and we hope he will take the opportunity to learn from the experienced doctors here in Tansen and not be discouraged. (Both of his parents are on staff here in Tansen – so they were able to finance his education.) Right now in Nepal, if a student is from a very poor family, unless he or she is a genius, they really have no chance to try to become a physician.
When we first came to Tansen hospital in 1990, there were 9 – 10 doctors (mostly missionaries from other countries) to keep the hospital running. Now, there are about 37 doctors when you include the interns and residents currently working and learning at Tansen mission hospital. That is good in the sense that these young people are getting an excellent level of training and experience and will become fine physicians after their time here. The down side is that after having such good training, many of these bright, talented young people are leaving Nepal for better opportunities in the west. The goal is to train Nepali physicians so that the level of care for people in Nepal will increase, but it is difficult to keep the well-trained doctors here as there is little compensation or opportunities for them in rural Nepal.
Today is the 2nd day of Bhadra in Nepal – the year is 2069. Our calendars here are 2 different months – the western months, and the Nepali ones. The Nepali month generally begins about the 15th or 16th of the western month. (And you thought it was hard to keep track of dates in the west!!)
On the night of the 32nd of Shrawan (August 16), Les was on call at the hospital. The nurses phoned from the maternity ward around 11:30 pm. A woman had come in earlier in the day with symptoms of toxemia, so was admitted to be induced. She had had an ultrasound at an outside clinic and was told there was one baby. After the baby was delivered, however, it was discovered that there was still another one inside! At that point, they phoned Les. He went to assist, and the second baby was delivered safely – after midnight! So, the twin boys were born not only on different days, but also in different months! Shrawan 32, and Bhadra 1. One of the nurses quipped that the second baby was a month later than the first! Both boys and mom are doing well.
UPDATE! Many of you have asked about the tiny quadruplet. I saw her today! We were a bit discouraged a couple of weeks ago, as her mom took her out of the hospital because she was needing to be home to care for her other child and didn’t feel able to stay in the hospital any longer. So – against medical advice, she took this tiny baby (still on oxygen and being fed by a tube) home! She was back for a check with the baby this morning and I got to see this amazing strong little baby girl – growing more beautiful each day! She weighs around 800 grams now – we could hardly see her in the mass of blankets wrapped around her! Please keep praying for mom and baby. We know her life is a miracle and have told the mom that many are praying.
Scenes from monsoon:
Beautiful clouds over green hills…
Snake in the grass…