Patan Academy of Health Sciences (PAHS), Patan (Nepal)


Impressions of Nepal

Elizabeth Harrop – medical student from Sydney Medical School, undertook an Elective with Patan Academy of Health Sciences, Nepal in 2011–12

I recently spent my 8 week elective at Patan Hospital in Nepal. It was an amazing experience and I would particularly recommend it to anyone interested in global health. I found out just how frustrating it is when you don’t have the resources necessary to diagnose or treat a patient and how hard it is to see a patient go home because they cannot afford the necessary investigations or treatment. It has given me some insight into the issues they face with healthcare in Nepal and what some of the barriers are that need to be overcome to improve the situation.

I also saw some of the effects of Nepal’s massive shortage of rural doctors. One woman had travelled for 3 days to reach the ED with a severely mangled hand from a crush injury. The delay meant she would likely have permanent nerve damage as a result. And of course, there are many more, sicker patients, who will not make the trip to hospital. PAHS is a medical school set up with the aim of working towards improving the rural doctor shortage and it was great to get a chance to meet people involved with it and hear how they are going about doing this.

Patients would present with much more advanced disease than we generally see in Australia, which gave me the opportunity to examine patients with very pronounced pathology. Also, as a result of the lack of resources, the doctors had amazing clinical skills. It was good experience to have to try and think more and base decisions on clinical signs rather than investigations, as they were often unavailable.

Nepal is also a great place to spend time. Nepali people are such lovely, warm people and I met some truly amazing people while there. Not speaking the language was a bit of a problem as the majority of the consultations and discussions between doctors were in Nepali so there were times when it was difficult to understand what was going on. However that’s definitely not a reason to not go. The doctors all speak perfect English and the clinical notes are written in English too so you are always able to find out what is happening with a particular patient. The doctors were all happy to answer any questions and explain things to me.

Overall my time at Patan Hospital was an incredible experience and I will definitely be returning to Nepal in the future.

Aruna Shivam - medical student from Sydney Medical School, undertook an ILA at the Patan Academy of Health Sciences in Nepal in 2010–11

"I spent my time at Patan hospital in the Emergency department. The department runs on few resources and has a high throughput of patients. The doctors and nurses that I worked alongside were inspiring and wonderful teachers to me. I watched as they patiently tried to address problems of their patients in a culture where hospitals and western medicine are not fully trusted. As a result patients often presented at very late stages of disease. This exposed me to a range of cases that I just don’t think we would get exposure to in Australia.

The clinicians I worked with were patient and very willing to allow me to get involved. I practised a range of techniques including suturing, ECG and basic venepuncture, which we don’t usually get to do very much in Sydney; particularly on real patients. They would call me every time there was an interesting case and encouraged me to get involved in as many procedures as I could from basic life support to intubation and tracheotomies.

I highly recommend Patan hospital and in particular, the emergency department to any future students. If you are interested in seeing a broad range of cases and willing to get involved and learn, you will find this placement invaluable. My list of great experiences and learning is endless!"