Happy Easter from Nepal!

April 5, 2015

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So after the Kala Patthar post, I thought I should write a more general post about what we do at the Himalayan Rescue Association clinic in Pheriche, because up until now, all I’ve shown you is my little adventures in the field. We actually do work too!

The author doing Nepalese Ebola Training.  Actually, I'm just wearing the bag from a new down comforter donated by the Australian Embassy, and using the EKG probes to harass people!

The author doing Nepalese Ebola Training. Actually, I’m just wearing the bag from a new down comforter donated by the Australian Embassy, and using the EKG probes to harass people!

There are three doctors at the Pheriche Clinic. Renee Salas is a Wilderness Medicine Fellowship at Mass General Hospital in Boston. We have known each other since we were both in a Wilderness Medicine Institute “Medicine in the Wild” course in 2009. Katie Williams is a general practice doctor from the UK, who is also a Diploma in Mountain Medicine graduate. She has been to the Himalayas multiple times, including working at a different clinic in Machermo last fall. Her fiancée is Reuben, who is a professional photographer who is starting to orient his career more towards wilderness and expedition photography. Katie and Reuben are planning on getting married 3 weeks after we leave Nepal.

We opened the clinic on March 15, although the patients couldn’t wait and we saw four patients on March 14th. To date, we have seen 124 patients in the past 23 days. We have evacuated evacuate 13 patients, or over 10%, mostly for High Altitude Pulmonary Edema, but have also seen High Altitude Cerebral Edema, an Upper GI bleed, and a pancreatitis patient.

Renee ultrasounding a patient

Renee ultrasounding a patient

Using our old-fashioned "suction cup" EKG machine on a patient.

Using our old-fashioned “suction cup” EKG machine on a patient.

Katie testing a patient's neurological functioning

Katie testing a patient’s neurological functioning

We do an altitude talk every day at 3pm, and thus far have given the talk to 229 trekkers and climbers. Renee is also running a research study looking at using Ibuprofen versus an anti-nausea medicine to help people with altitude symptoms. Since my research study has ground to a halt due to a malfunctioning ultrasound machine, and because the Nepal Health Research Council has not bothered to approve it yet, I have been helping her with her study. She also has a medical student who has been working over in Dingboche, the community next to Pheriche. So far we have enrolled 25 participants, with a goal of enrolling 200.

The author giving an Altitude Talk to trekkers and climbers on their way towards Everest.

The author giving an Altitude Talk to trekkers and climbers on their way towards Everest.

Evacuating patients by helicopter is often a big deal around here, and the helicopter services use it as a reason to send goods, food, or people up to Pheriche, as well as taking patients down.   The helicopters used here are used for general purposes, and are not specifically for medical usage, they have no medical crew or medical equipment.

Escorting a patient to the helipad.

Escorting a patient to the helipad.

Reuben and Gobi waiting for a helicopter.

Reuben and Gobi watching a helicopter to land.

Getting the patient secured in the back of the helicopter.

Getting the patient secured in the back of the helicopter.

A helicopter on approach with a box full of Easter goodies.

A helicopter on approach with a box full of Easter goodies.

Easter goodies landing at Pheriche.

Easter goodies landing at Pheriche, with Ama Dablam in the background.

A panorama of Pheriche and Ama Dablam from the helipad.

A panorama of Pheriche and Ama Dablam from the helipad.

Of course Easter here is business as usual, and the closest church is probably in Kathmandu, but we did find ways to enjoy the day. Reuben and Katie brought out Cadbury Eggs for each of us, and I broke out some Archer Farms (Target brand) Carmel flavored coffee, which was pretty good. We even had enough time to play a little Cricket with Jeet and Tan. It was my first time playing, so needless to say I was pretty awful.

A pretty great backdrop for a cricket match.  Katie pitches with Jeet at the bat.

A pretty great backdrop for a cricket match. Katie pitches with Jeet at the bat.

Our three puppies, Grizzly Bear, Black Bear, and Brown Bear, respectively.

Our three puppies, Grizzly Bear, Black Bear, and Brown Bear, respectively.

Katie playing with puppies.

Katie playing with puppies.

Luanne Freer, founder of the Everest ER, playing with puppies.

Luanne Freer, founder of the Everest ER, playing with puppies.

Puppies taking shelter from the snow.

Puppies taking shelter from the snow.

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