Pilgrim to Nepal
17 Nov 11
Ian at a camp in Rolpa District
Ian Bissett will be one of three surgeons who will join two anæsthetists, general practitioners, an ultrasonographer, nurses, an interpreter and ten Nepali INF staff on an INF surgical camp in Nepal's remote Achham District at the end of this month.
Ian is Associate Professor in Surgery at the University of Auckland's Faculty of Medical and Health Sciences and has made an annual trip like this to Nepal for the last seven years. His love for Nepal goes back to his medical elective in Nepal's Gorkha District during his final year of medical studies at Auckland in 1978. Ian says: 'Back then one of the things that struck me was how much you could do as a surgeon in that setting, how many conditions were curable with surgery and how not being able to do surgery would hamper what you were able to do.'
In 1987 he returned to Nepal as a qualified surgeon with a young family to work with INF at the government's Western Regional Hospital in Pokhara. He comments: 'I was on call every second or third night as well as working during the day for many years. I had to take Tuesdays off, I could not keep going. But for my Nepali colleagues there was an internal rhythm, an ebb and flow, which eased the burden of work so one didn't completely collapse into leisure time as people would in New Zealand.
Ian worked at the Western Regional Hospital for eleven years with a wide range of general surgical conditions, training young doctors. He says: 'It was a privilege to be there for a length of time; to have people come relatively junior and leave as competent surgeons.'
When Ian and the other members of the INF camps team go to Achham this month they will need to fly west from Kathmandu then drive for two days, taking all their equipment with them. The camp will take place in the local hospital, lasting for two weeks of long working days.
Patients often walk long distances to come to INF camps after they hear radio advertisements, as Ian explains: 'One day is normal, walking for three days is quite common. One year a man walked five days to have a kidney stone removal by open surgery and then walked five days home. It's important that the camps are in remote areas, otherwise people come from big cities where there is already a surgical service, because we do the treatment for less than NZ$1. The worst time is the first day. People often arrive and start queueing the night before. We might get 500 or 600 people arriving on day one, then between 800 and 1,400 over the next ten days. There is triage and we operate on 100 or 150: hernias, gallstones, kidney stones, a whole array of general and broad surgical conditions. In the last days we generally do the minor procedures so that the people who have had more major surgeries are getting ready to go home. By the time we leave everyone has been discharged.'
According to Ian, the health situation in Nepal has improved markedly: 'If you look back on what it was like thirty or forty years ago things have changed hugely and that is demonstrated in increases in life expectancy. A lot of that has to do with improvement in maternal death rates.'
Ian finds it hard to contemplate what his life might have been like if he had not had his experiences in Nepal: 'I take a different view of life. I've met a lot of brave people who, while suffering a huge amount, just continue with their everyday life, and very committed professional people on minimal incomes. I've experienced the importance of community and relationships. The richness of the people of Nepal compared with the spiritual poverty of New Zealand is quite marked. It is always a great privilege to be able to go back.'