What’s the need?
Nepal is a long thin country stretching across the Himalayas North East of India, sandwiched between India and China. It has a population of 31 million of which 1.4 million live in Kathmandu where many people use mopeds as their primary mode of travel. Here the traffic rarely gets up to high speeds but isolated limb injuries are common.
Many areas are remote with long and difficult journeys needed to reach any medical facilities. There are basic government health services and a government health insurance scheme is being developed. People with broken bones and an overlying wound are often very delayed in getting to an appropriate hospital which results in an increased risk of deep infection and potentially amputation.
Leprosy is still present, spinal cord injuries are common from falling out of trees while harvesting mangos or the fresh leaves desirable for feeding the livestock. Open fires are used for heating and cooking so burns are common and often not treated as quickly as would be needed for the best outcome.
Life expectancy is 68 for men and 70 for women.
BFIRST connected with the team at Kirtipur, which is near Kathmandu in Nepal after the Earthquake in 2015. Sarah Tucker had previously lived in Nepal while working at a hospital in Pokhara and had met the team so she has led the BFIRST connection with them.
Previous Visits
2015
Scoping visit following the Earthquake. Four lower limb Microsurgical reconstruction cases done. Following this the Nepali team identified lower limb reconstruction as an area they would like further training in.
2017
Four surgeons from Nepal came to the UK for further training in microsurgical techniques.
2018
Visit with an orthopaedic surgeon to demonstrate the benefit of orthoplastic collaboration.
2019
Visit to Kathmandu and on to Pokhara to meet a new Plastic Surgeon setting up service there.
2020
Further visit to Kathmandu and Pokhara to provide further training in complex limb reconstruction and speak at the National Orthopaedic annual conference.
2023
Visit to Pokhara, Kathmandu and Kirtipur - click here to read the trip report
Here are some of the team:
Bishal Karki
Bishal was a BFIRST microsurgical fellow to Taiwan where he received a whole year of training in microsurgical techniques.
He has co-hosted a webinar on surgical techniques of microsurgical reconstruction with Sarah Tucker (ALT Flap).
Kiran Nakarmi
Kiran Nakarmi is a senior surgeon who has been a co-host of hand surgery and microsurgery webinars.
Future Plans
The team have asked for a global fellowship in Burns which we are hoping to facilitate for them.
The next visit will probably be in April 2023 and we are hoping to support them to become one of our training units for other global partners.