Friends of tansen 2012 1
A note from the hospital director 3 Anaesthesia training: benefitting Nepal 4 A Christmas gift 5 A journey from Ukraine to Tansen 6 A glance at the library 7 What makes Tansen special 8 Life dependent on 0 2 9 Now I see 10 Rajan s story: We serve, Jesus heals 11 Toys can make a difference 12 A successful twins delivery 13 Facts and figures 14 To give 15 Snapshots from 2011 16 Welcome to another edition of Friends of Tansen. Thank you for your prayers and support over the past year. In this edition, there are stories which illustrate different aspects of work and life here. This year has brought its own joys and challenges. The hospital has continued to provide medical care and pastoral support to our patients, and our Community Health Department has been active in promoting health in the communities in which they work. There have also been many trainees passing through the hospital, and we added a year-long Anesthesia Assistant Course this year. We also added a diabetes clinic to our out patient work. In an effort to promote good relations, we held our first Open Day for the press and local community - an event that was well-received. We did not have a major building programme this year, but many parts of the hospital have had a face lift; the surgical ward, in one of the oldest buildings, is now bright and clean after renovation and painting. The next challenge involves electricity. Several hours each day, the hospital is without mains electricity. Power A note from the hospital director surges and drops are common and can damage sensitive medical equipment. The hospital s electrical wiring also needs sorting out. In addition to these electrical challenges, the dry season presents the hospital with significant water shortages. This year seemed to be marked by goodbyes. We said goodbye to the John family, who had been part of the team here for 11 years. Sunil is a pediatrician, and Jeena an engineer who supervised most of the recent building work. We also farewelled Tanuja and Wayne Martin and their family, after seven years service. They are general practitioners who were in charge of the medical ward. Our personnel manager, Nirmal Rana, also retired after 35 years. We are thankful for their many years of service and grateful to God that he sends the people we need at the right time. Maybe you are one of them? Thank you for being part of the team and sharing with us as Friends of Tansen. Dr. Rachel Karrach Hospital Director Editors: Dr. Roshan Kharel, Beth Beels, Dr. Ana Pickering and Dr. Rachel Karrach 2 Friends of tansen 2012 Friends of tansen 2012 3
Anesthesia Training: Benefitting Nepal A Christmas Gift United Mission Hospital, Tansen (UMHT) has been conducting surgery for over 50 years. To have safe surgery you need safe anesthesia, but for the majority of those years, there has been no anesthesia doctor in Tansen. However this service has been faithfully provided by other allied health workers such as nurses and health assistants, who have been given on-thejob training to do so. Nowadays in Tansen, there are five permanent anesthesia staff who have many years of experience between them, and who can provide excellent anesthesia services 24 hours a day, every day of the year. The vast experience and skills of this great team, working with patients of all sizes and ages, and alongside surgeons from Nepal and all over the world, are now also benefiting students of anesthesia. Tansen is one of only four hospitals in Nepal that trains AAs (anesthesia assistants.) AAs are men and women from a nursing or health assistant background who, on completion of their training, will return to their own hospitals to help with the provision of anesthetic care for Anesthetic trainee from Mission hospital in Western Nepal Dr. Steve during Anesthesia training surgical patients. We are currently training three AA students in Tansen, part of the first batch in the country to undergo this new one-year AA training course. Another step forward for anesthesia in Tansen is the presence of a Nepali anesthesia doctor. Our first Nepali anesthesia doctor completed more than a year of work in UMHT recently. Now we have a new Nepali anesthetist who joined us recently to help supervise the AA training, further update the skills of our permanent staff, and share in the 24/7 provision of good quality services. It is encouraging to think that not only have the patients around Tansen benefited from the anesthesia skills of UMHT, but that through the provision of long term training and short term up-skilling placements, patients in distant areas of Nepal can also benefit. Dr. Steve Pickering Chief of Anesthesia Prem was found lying in the street in Tansen. Some people called the hospital and told us about Prem s condition. The police brought Prem to the Emergency Department and admitted him with the diagnosis of mental psychosis. Prem was very weak and was thin and skinny. His weight was only 30 kg at admission. In the midst of all the busy-ness in the medical ward, our doctors, nurses and pastoral care staff gave him full supportive care. Staff gave him a bath, changed his clothes, fed him and gave him medication. He needed as much care as a baby! Staff from the Pastoral Care department gave him love and moral support regularly. We prayed for him and asked our friends to lift him up in prayer. For the first few weeks, Prem did not communicate with anyone, so it was difficult to know his name and his address. However, after staff had spent some special time with him, he started talking. Gradually, he came out of this physical weakness. After a few months, he weighed 50 kg. Earlier he was unable to control his stool and urine, but now he is able to control it. Spending time with him, we discovered that Prem had been rejected from another hospital that he had been taken to for treatment. I built a relationship with him, and he confided in me his home address. Just recently, I took him to his home, which is located in the western part Prem during admission Prem before discharge of Nepal. Prem s family thought he was dead, as he has been out of contact with them for the last five years. When they saw Prem, they were completely surprised and all of them, including the community there, shed many tears, tears of joy. It was a miracle for them to be able to embrace him. Prem became special Christmas gift to his family. United Mission Hospital, Tansen took him in and gave him the care that Jesus would have given. Our hospital motto is: We serve, Jesus Heals. Indeed, Jesus healed Prem. In Nepali language, Prem means love. Jesus is at work through the staff of United Mission Hospital, Tansen. It was a unique experience for me to witness this joy. I feel that it is a privilege to be able to work and serve at the hospital. I am thankful to all my dear staff at the hospital for their patience and love towards Prem. Please pray for his further journey, that one day he will be able to share the love that he received at Tansen with others. As this story was going to press, we had just been able to take Prem back to his family in their village. Soon afterwards, his mother died. His sister said that his mother was so thankful that she was able to be with him! And we are thankful for God s perfect timing, in bringing the family back together, before his mother s death. Vishnu Bahadur Pandey Chaplain 4 Friends of tansen 2012 Friends of tansen 2012 5
A Journey from Ukraine to Tansen A glance at the Library of the United Mission Hospital, Tansen Everything in this world keeps changing, and this makes life in this world competitive and challenging. My parents sent me to the Ukraine to study dentistry in 1993, when Nepal had only one medical school and no dental schools. During my six years in the Ukraine, I not only learnt about dentistry in the Russian language, but I also had the opportunity to experience the love and grace of Christ on the cross. During my dental practice in Kathmandu, where my parents live, I discovered that Kathmandu had many dentists, but I needed to go to a place where people needed my profession the most. Low and behold, I heard about the need for a Nepali dentist in United Mission Hospital, Tansen. I visited there and applied for the post, was successful and joined the staff as a dentist from 2001. For a few years, I worked at the clinic in the hospital, and also worked in the community, teaching village health care workers about oral health and simple dental procedures. Unlike in Kathmandu, in Tansen I could feel that I was needed in this community. After my first few months in Tansen, the Lord graciously provided me with my life partner, Esther, who was then a nursing student at Tansen Nursing School. She worked as a nurse in the maternity ward at United Mission Hospital, Tansen for six years, and now she is training nurses at Tansen Nursing School. We For the past few years, I have been working in Donor Relations for the hospital. I interact with many people and many different organisations. It is a great joy to know that many people in Nepal and around the world pray for our work here in Tansen. It is a heart-touching experience for me to acknowledge gifts from those retired people who share their savings for the treatment of poor and marginalised patients. Thank you, Friends of Tansen, for your faithful prayers and generous giving for the work of this hospital. Your partnership in our ministry has enabled many lives to be changed, physically and spiritually. This is my 11th year in United Mission Hospital, Tansen. People ask me, What keeps you in Tansen hospital? My answer is that the vision and values of this hospital have been holding me to this place thus far. Reflecting on my past, my journey from the Ukraine to Tansen has never been a loss; it has always has been win-win in all aspects of life. I am reminded of this promise in the Bible: No eyes have seen, no ear has heard, no mind has conceived what God has prepared for those who love him. I Corinthians 2:9 (NIV) Dr. Roshan Kharel Chief of Dental Department My name is Urmila, and I have been working at the United Mission Hospital, Tansen for the last 10 years. I started as a cashier for three years, and after that I was assigned to be a librarian and secretary for the training programme. I had seen many libraries in schools and colleges, but I had never visited any libraries in medical institutions. Medical terms made my job quite challenging at first. However, I had immense support from the library supervisor, doctors, nurses and hospital administration. For a small town, the library facility here is surprisingly well equipped. It is situated in a quiet place and has adequate light. It has medical books, CDs and DVDs. The latest journals of different kinds from various countries are also available. We are trying to keep up-to-date with modern information technology, and as a result we have a few computers, a scanner, a printer and internet services. These services have been very useful for our medical and nonmedical staff, helping them to update their skills and meet their academic requirements. Many of our staff are able to study while they are working. They can use our library to complete their thesis work and other academic projects. Working in the library has benefited me personally. Just by reading and by providing assistance to the staff, my knowledge in the medical field has broadened. I have got to know many Nepali and international healthcare workers. I am thankful to all those people who have asked me for help, because I have benefited just as much as they have. I belong to Tansen and I am always proud to be a staff member of United Mission Hospital, Tansen. I have gained a lot from this hospital. And not only I, but also the community in Tansen and Nepal has benefited greatly from this hospital. Urmila Rana Librarian are blessed with a son and a daughter. 6 Friends of tansen 2012 Friends of tansen 2012 7
What makes Tansen special Life dependent on 0 2 During a recent visit to Tansen, three experiences stood out for me as a summary of the uniqueness of our work here. The first was a get-together of team members in the guesthouse. As ever, the atmosphere was one of friendship and fellowship, and a wide variety of accents and even languages merged together in the buzz of conversation. I counted up how many nationalities were represented there that evening and came to 11. There cannot be many places in the world were we have the privilege to serve alongside 10 nationalities other than our own. The United aspect of the United Mission Hospital, Tansen was brought home to me by that experience. The next day, I had the privilege of sharing a time of fellowship with the pastoral care team. This dedicated group of staff meets together to pray and fellowship and read God s Word before they go out and minister to the patients throughout the hospital. Once again the uniqueness of Tansen was brought home to me, and the holistic and compassionate nature of the care provided there. The third experience was during a brief visit to the children s ward. Despite Liz, my wife, being a doctor, I am not one who greatly enjoys visiting hospitals. But the children s ward at Tansen is an exception, and I was keen for my own children to meet some of the children in the hospital. Two of them remain in my mind. The first was a little girl of perhaps three years old who had both her legs lifted up above her in traction. Despite this she smiled and gurgled happily at us. The second was a boy of 10 who had fallen out of a tree while cutting fodder for his animals. He had also broken an arm quite badly and as he smiled, it became clear that he had lost his front teeth as well! He joked that now he was like an old man! There are not many hospitals in Nepal in which these kids (and many hundreds every year like them) would have received the loving and professional care that they received in Tansen. But that of course is what makes Tansen so special. This is truly a place where many have served and continue to serve, and Jesus continues to heal. Mark Galpin UMN Executive Director At United Mission Hospital, Tansen, we aim to give our patients holistic care. Renuka s story illustrates this. Renuka suffered from severe bronchitis and heart failure. She was admitted 24 times during her final three years of life. Renuka s husband had been working in India for many years, her four sons all live far away, and her only daughter has family problems of her own, so Renuka used to rely on her own parents for help when she was ill. The family is very poor. Last year, we made a home visit and our staff discovered that the family had taken a big loan to cover her medical bills. Renuka was severely disabled by her breathing problems and so was unable to earn any money herself. Therefore she received support from our Medical Assistance Fund. Her doctors advised home oxygen, and the Pastoral Care team was investigating how to provide an oxygen concentrator machine for her to use at home, and had also contacted the local administration about connecting electricity to her home, as it had no power supply. Unfortunately this proved unnecessary. Her last admission lasted 39 days, and it was clear she did not have long to live. At the time of discharge from hospital, even though she was terminally Pastoral care staff ill, she was happy. During her time in hospital, she had accepted Jesus as Saviour. She realised how much our staff cared for her. She had been suffering for three years, and in the last year she had experienced some improvement, but now she felt weak and very unwell. She was totally dependent on oxygen and initially felt depressed and hopeless. We provided food, gave encouragement, care, and grief counseling. We also prayed with them whenever we met. Her husband never missed a chapel service. Even in these difficult circumstances, we could see brightness in his face. We helped the doctors break the news of her poor prognosis, and the couple was able to come to terms with her approaching death. Her husband told us, If this hospital had not helped my wife, she would not have lived until today, so I am very thankful for the Godly care and love given. The family sent a message a few days after her discharge, that she had died. We hope we will see her one day in heaven, transformed and healthy. I have been working here for 21 years, and it is a joy for me to be a part of the Pastoral Care team. Please remember us in your prayers, as we relate to the many patients in the hospital and the increasing numbers of poor patients needing financial support. You too are the part of this ministry. Thank you! Pun Narayan Shrestha Chief of Pastoral Care 8 Friends of tansen 2012 Friends of tansen 2012 9
Now I see Rajan s story: We serve, Jesus heals Sangita, a 14 year old girl, was admitted to a hospital on the Terai (the flat southern part of the country), about five hours away from here. Her admission diagnosis was meningitis, but she developed a rare complication, called ARDS (acute respiratory distress syndrome), a condition that is often fatal, even in a sophisticated environment. She was promptly transferred to their ICU and placed on a ventilator. After a day the family asked to take her home. It is not clear whether that was because they had given up hope, or because they realised that the expense of staying there would be prohibitive. Her breathing tube was removed and they took her home. After a day, they changed their mind and brought her to our hospital, where we do not have the facility for long-term ventilatory support. She was critically ill, febrile and had very low blood pressure. She was admitted to our critical care unit (which really is a general ward next to the nursing station) and treated with antibiotics for the previously documented meningitis, and maximum oxygen and blood pressure support. The evening of Day 3, I was on call, and even though it was not yet 9:00 pm, many patients were asleep. Relatives were scattered on the floor, sleeping on blankets. The nurse told me that Sangita had not produced urine since 3:00 pm. I went to check on her and found her restless, fighting for every breath. Her father and mother were sitting next to her with anguish on their faces, holding her hand and stroking her sweat-covered face. Usually, I do a pretty good job of separating myself emotionally from patient s suffering, but this night it did not work. I sat down with them and checked what I needed to check, and after I had fought back the tears, I asked permission to pray for healing in the name of Jesus, which was granted. I had the day the next day off, but the intern wrote: Doing better than previously, sitting herself, eating food. We referred her to Pastoral Care for ongoing prayer and family support. Eight days after admission, Sangita was discharged Sangita on the medical ward with a smile on her face! I said goodbye with the words: Prahbule timilai niko parnubaeko chha! The Lord has healed you! I cannot prove that all of this was not coincidence. The blind man said after his healing: One thing I do know. I was blind but now I see. (John 9:25) One thing I know: Sangita was on the brink of death. Now she is walking home. Praise the Lord! Dr. Theo D Beels Chief of Medicine Friends of Tansen is also available in pdf format on our website. If you would rather not receive a paper copy of our magazine or you have changed your address please email Dr. Roshan Kharel on drkharel@gmail.com. Thank you. Five-year-old Rajan was curled up next to his grandmother when he woke very early one morning, crying and pointing to his right hand. His granny noted two little bite marks, and in an area where snakebites are common, immediately knew what had happened. They found a metre-long black and white striped snake in the room a krait, one of the most poisonous snakes around. His family rushed Rajan to our hospital, but during the two hours it took them to get here, he lost consciousness and stopped breathing very close to the hospital. On arrival in the Emergency Department, he was intubated, mechanical ventilation was commenced, and he was given snake antivenom. We see many patients with snakebites every year during the warm, wet monsoon, and only a few of them need mechanical ventilation because of paralysis of their respiratory muscles. Most of them do well, but a few months before Rajan was admitted, a 15-year-old boy had died after a snakebite. What made Rajan Rajan a little more unusual was the fact that he is a very small boy, and had been bitten twice by a very large, very poisonous snake. His mother and grandmother were at his bedside in our ICU continuously over the next ten days, as we tried to save his life. Because he was totally paralyzed, it was impossible to know how much he knew of what was going on around him, or whether he was in pain or uncomfortable. After four days, he started moving his foot, and gradually over the next few days he was able to open his eyes. During all this time, his mother and grandmother talked to him, explaining what was happening, and comforting him. Somehow that was enough for him to tolerate the discomfort, pain and fear associated with being paralyzed with a tube down his throat, and being connected to various other lines and tubes. He made a good recovery, despite developing a collapsed lung and pneumonia, and after two weeks in hospital, he was able to go home still very weak, but walking and with no other neurological damage. We rejoice with his family that this little boy is alive, and we are filled with gratitude towards Jesus who heals and brings life. Rajan continues to receive follow-up at our outpatient clinic, and we continue to pray that he and his family may come to know and understand the love of Christ, who not only heals, but also forgives and gives eternal life Dr. Ansie van Rensburg Cheif of Pedicatrics 10 Friends of tansen 2012 Friends of tansen 2012 11
Toys can make a difference A successful twins delivery Being admitted in a hospital is a scary experience for a child. Not only is adapting to the new environment difficult, but children also have to undergo painful procedures such as blood tests and IV placement. To change this scary experience, toys and balloons are given to the children. An official play therapy ministry was started about 11 years ago, by a missionary nurse, Anne Hoyal. Now I am working as a play therapist. My days in the wards begin by distributing toys. Bedside games, stories, crafts and visits are much appreciated by children and their visitors. The Pediatric Ward has a playroom where there are many, toys such as puzzles, dolls, carrom boards, card games etc. For some children, it is quite a novelty and very exciting. During my work, I develop relationships with these children. Many children are Pediatric nurse helping distract a child afraid of health care workers in white coats because of the painful procedures that they perform. However, the children are friendly with me because I give toys and play with them. These toys often comfort the children during their time of pain. I give dolls, cars and other toys to the children staying for a long time (for example those with burns, in traction, and with malnutrition). On discharge, they may take these toys home. Krishna is an eight-year-old girl who was admitted to the burn ward due to an electric burn. This led to her having her arm amputated. Obviously, she was sad because of being admitted to the hospital and losing her arm. During her stay, I noticed that there was no family with her - only one of her neighbours, of whom she seemed afraid. I gave her toys and replaced these every day. One particular day, she had a Barbie doll, which she did not want to give up. She slept with that doll all the time. On one occasion, I spoke to her and found out that her mother had died a few years ago, and that her father works as a driver. He has to leave her alone at home most of the time. One day, while playing unsupervised on the neighbour s roof, Krishna received the injury that brought her to hospital. Krishna said that the long black hair of the Barbie doll reminded her of her mother and her family. That s why she did not want to exchange it, and always slept with it. Barbie was her friend throughout her stay in the hospital. The playroom and toys gave joy to Krishna, and we gave her the Barbie doll and other toys when she was discharged to go home. Sita Gurung Pastoral Care Department Uma is a 17-year-old girl from a remote western part of the Palpa District. She is married, and her husband lives and works in India. Geographically it is very difficult to reach Uma s village, which is quite far from Tansen. There are nine members in Uma s family. Uma was in her first pregnancy. She was encouraged by her motherin-law to have regular checkups by health professionals, and as a result, Uma visited the village health care centre and United Mission Hospital, Tansen (UMHT) several times. Apparently, Uma s mother-inlaw attended Women s Health Group meetings organised by the hospital s Community Health Department. UMHT staff found Uma s mother-inlaw to be a very attentive and active participant in discussions on women s health issues. As a result of her involvement in the Women s Health Group, her whole family benefited. Uma is blessed to have such support from her family. Uma experienced both physical and emotional hardship during this, her first pregnancy. Later on, she was also surprised to find she was having twins! After her visit to UMHT, an ultrasound revealed that the babies were in a difficult position for a normal delivery, and this information was draining for her emotionally. However, with the support Mothers group training of her family, she prepared herself for the delivery. As time passed by, before the expected delivery date, Uma experienced intense, ongoing abdominal pain. She came to the Emergency Department, and after examination she was found to be in premature labour. Soon after, Uma safely gave birth to a baby boy and a girl. The babies were small, and were therefore admitted to the Pediatric Ward for observation, and also so that Uma could receive nutritional education. A few days later, they were safely discharged. The Community Health Department conducts a community-based safe motherhood programme in various villages in the Palpa district. We are thankful to our donors for their support in providing a four-wheeldrive vehicle, so we can travel on difficult roads to access remote villages. This has made our community outreach very smooth, and as a result, we are able to conduct community work more efficiently. In addition to this, we also air safe motherhood and other health-related radio programmes through local radio stations. Because of this, people like Uma are able to deliver their babies normally and safely. It gives me and the whole team great satisfaction to witness positive safe mother and child (children!) outcomes. Parvati Gautam Chief of Community Health Department 12 Friends of tansen 2012 Friends of tansen 2012 13
Facts and figures To give It has been a busy year in the hospital as you can see from the figures below: Patients seen in our clinics Emergency cases treated This year Last year 12,891 12,987 Babies delivered 1,808 2,116 Patients admitted 11,352 11,201 Surgeries performed 7,274 7,624 Bed occupancy rate 77.85% 78.86% Town clinic visits made 7,193 8,759 Thanks to your donations we were able to: Give free patient care to over 2000 patients, totaling NRS 9,248,504 (USD 124,000); Buy two incubators and phototherapy lights for our premature babies; Continue our training focus, offering courses for internal and external medical staff; Start a diabetes clinic; and Expand our lab services again by adding coulter counter. Future projects - can you help? 1. The Medical assistance Fund (MAF) provides charity to the poorest patients. Each year we are seeing more and more patients in need of assistance, so donations to this are always welcome. 2. We hope to purchase the following muchneeded items of equipment: Spin dryer for laundry Oxygen concentrators Mobile x-ray machine Image intensifier Cardiac monitors Generator 3. We are still looking for funding to build an additional large water tank to store more rainwater so that we have sufficient reserves for the dry season. 4. We are still in need of long term medical personnel and an IT specialist. If you feel that God may be leading you to serve here, please get in touch. Our website has more details. Thank you again for all your generous giving that allows us to further enhance the level of service we offer. When donating to United Mission Hospital, Tansen please send us a letter or email tansen@umn.org.np (and copy to fin@umn.org.np) giving the following details: 1.Your name 2.Your address 3.The amount 4.The date of the transaction 5.The account number it was paid into (if by money transfer); and 6.What area the gift has been given for. e.g. for general use, training, pastoral care fund, etc. Please also state clearly that the funds are for United Mission Hospital, Tansen. The above details make the tracking and allocation of donations that much easier. Thank you. There are three main ways you can give financially: Money transfer Set up a payment or monthly standing order to transfer funds. UK & EUROPEAN CURRENCIES Pay to: United Mission to Nepal Sort code: 60-91-99 Account Number: 10078177 (Sterling account) 10615512 (Euro account) USD & NEPAL CURRENCIES Transfer or wire to: Standard Chartered Bank Nepal Ltd. PO Box 3990 Kathmandu, Nepal Account name: United Mission Hospital Tansen, Palpa Account number: 01-1565281-01 Swift Code: SCBL NP KA Alternative Account: Standard Chartered Bank Nepal Ltd. PO Box 3990 Kathmandu, Nepal Account Name: United Mission to Nepal Account number: Swift Code: SCBLNPKA 01-0488798-51 (USDaccount) 01-0488798-01 (Nepali NRS account) * All undesignated gifts will be used as needed DONATE ONLINE www.umn.org.np Give via credit or debit card from anywhere in the world. For UK donors, this site offers tax efficient giving. MAIL DONATIONS The other alternative is to send a cheque made payable to United Mission Hospital, Tansen and post to: United Mission Hospital, Tansen c/o United Mission to Nepal P.O. Box 126, Kathmandu, Nepal Again, please advise us that you have posted the cheque so we can ensure it arrives safely and contact you again if it is not received. Another safer option would be to send the cheque with someone visiting Tansen from your own country. If you contact us we can let you know details of anyone that may be traveling back to Tansen in the near future. All donations made will receive a letter of acknowledgement and thanks. other options For help or advice about giving please contact tansen@umn.org.np or look at our website: www.tansenhospital.org. np/support/support-money.html 14 Friends of tansen 2012 Friends of tansen 2012 15
Snapshots from 2011 For more information, please contact: United Mission Hospital, Tansen United Mission to Nepal PO Box 126, Kathmandu, Nepal Tel: (977 75) 520489 Fax: (977 75) 520039 tansen@umn.org.np www.tansenhospital.org.np Produced by Communications Team, United Mission to Nepal Design: Ramesh Man Maharjan Photos: Pernilla Ardeby, Dr. Tom Sun and Vince Ng UMN 2011 16 Friends of tansen 2012