On Tuesday, we had the graduation program for our 9th batch of MLP (Mid Level Practicum) students. This is a course that takes government health post workers (paramedicals) for 3 months at a time and reviews with them the basic skills of history-taking and physical examination, diagnosing the 20 most common problems seen in health posts, and doing the 10 most common procedures. There are 6 to 8 participants in each batch, sent by the Ministry of Health. They are mostly bright, dedicated health workers living in very remote areas and working alone. Every batch has started out reluctantly, thinking that they already know a lot. But by the time they graduate, they have learned a lot of things: clinical knowledge they had forgotten since they first went to school as well as an awareness of the need to continue studying during their entire career. The course includes some time in the classroom, but most of the time is spent in the clinics working together with our own staff, who act as mentors. We had a final practical test for our participants on Monday. This kind of training is one of the things I (Les) enjoy most here in Tansen.
These MLP courses were started under the auspices of the Nick Simons Institute (NSI). Although we had always tried to have training as an important part of our work here in Tansen, it did not really take off until after we became involved with NSI. The Simons family established NSI in memory of their son Nick, who loved Nepal and was planning to train in medicine and come to Nepal to work until he was tragically killed in a swimming accident. Directed by our good friend Mark Zimmerman, NSI developed the vision of assisting government hospitals and health posts in Nepal by training staff and building up facilities in remote areas. Because it has been difficult to get doctors to stay in the villages, NSI has put a lot of focus on training paramedical staff, who tend to stay in their local area.
As one of their partners, we are a training site for MLP. Other trainings we do in partnership with NSI are the Skilled Birth Attendant (SBA) course for midwives and the Anesthesia Assistant Course (AAC) for anesthetists. We continue to have resident and intern doctors we train, and we are the site for most of the practical rotations for the nursing students from the Tansen Nursing School. We have started to work on developing a laboratory technician school that will be based in our hospital, also.
Of course we continue to treat patients who come to us, but through training we can multiply what we do. Now the effects of what we do go outside the four walls of the hospital, even beyond the boundaries of our district and last longer than the years we ourselves can stay here and work. Not everyone we train stays in remote Nepal. In fact, a discouragingly large number of our former residents and interns are now living and working in Western countries! We can’t be angry with them; it is only natural that bright, promising young Nepali people should try to get a better life for themselves and their families. But each person who stays in Nepal and serves the people here gives us great encouragement to continue what we do.