Nothing makes you feel small like standing in a bustling five-story developing world hospital, holding your toolkit and wondering where to start fixing things. Even though this is my third trip with Engineering World Health, I still feel the same nervousness and anticipation as I did on my first day in Rwanda; every successful repair, every unsolvable software error or warranty violation, and every moment of connection with another person brings the same wide array of highs and lows. The immersion into a new culture is overwhelming and exhilarating; learning about a new way of life, meeting our homestay family and being integrated into the community, and working in the local hospital all are incredible ways to know Nepal a little bit better each day.
Some things about Nepal are very reminiscent of Rwanda. For example, streets are incredibly chaotic and overcrowded, and horns are constantly blaring all throughout Kathmandu. Dogs wander the streets and cars simply swerve around them; cows (holy animals in Nepal) are also given free reign of the road, and they pay no heed to rush hour traffic. The pulse of the city is lively, and people are constantly on the move during the daylight hours. When darkness begins to fall, the streets thin out and the chaos begins to slow down. Smog from the evening’s rush hour slowly dissipates until the horizon is clear again, and the stars come out.
Other things, however, are more foreign than anything I have ever experienced. The strong rooting of Buddhism and Hinduism in Nepali culture means that the baseline of norms, behaviors, and moral codes in society are different than those I grew up with. There is a strong belief in caste systems (as opposed to the American idea of personal equality), a six-day work week (only Saturdays off), and a completely new and confusing set of national holidays. Not to mention, both the Nepali language and script are completely foreign to me; I know polite phrases like “namaste” (hello) and “dhanyabad” (thank you) and “mero naam Reece ho” (my name is Reece), but if the conversation goes any deeper than that, you’re getting a blank stare from me.
Also, tea is everywhere; we drink milk tea, black tea, masala tea, and anything in between, and we will drink it any time of the day. Do you have a quick 15 minute meeting with the director of the hospital? Prepare for tea. Meeting the head of a ward for the first time? Before we even sit down, tea. After a while, I’ve grown to really love this tradition– it gives you extra time to sit and enjoy a moment with your host, and it opens doors to conversations that otherwise wouldn’t have happened. And of course, Nepali people make some really great tea!
This adventure wouldn’t be possible without a great team. The people who are on this trip with me are some of the most brilliant, motivated, and kind-hearted people I have ever met, and my homestay group in particular has made adjusting to Nepal and our working schedule much easier. There are two hospital groups staying at our homestay in Kathmandu (totaling 5 people), and we all are able to encourage each other (and pick fun at each other) as we figure out how to perform basic tasks like buying water, finding taxis, and testing how much current our power strip can pull from the single backup outlet in our house. It’s a good thing, too, because our work in the hospital is a challenge.
We are the first groups to work in Nepal for EWH, and as a result we are testing the waters of our hospitals and laying the foundation for future summer and winter institute programs here. This consists of a lot of trial and error; we entered our hospital assignments with very little prior knowledge of the staff and working conditions, and a lot of our job here has been improvised based on what we observe. The first hospital to which we were assigned was a five-story behemoth in the heart of Kathmandu: Bir Hospital.
Bir is a bustling central public referral hospital for Nepal, and it serves a huge portion of the population. It’s the biggest and oldest hospital in Nepal, and as a result, it seemed the natural place to begin placing engineers for our program. After spending six working days at the hospital, however, it became apparent that the hospital maintenance department was extremely competent and didn’t feel like we were necessary. It was a difficult transition coming from my experience in Rwanda; I was used to people wanting any fix possible to get equipment back on the floor and into use, no matter how unconventional. At Bir, the attitude was directly opposite; they wanted to wait for spare parts to ship since there were enough devices that backups could be used. We found ourselves working on incredibly complex pieces of equipment that inevitably had a missing spare part or required a manufacturer code to repair, and after our first week came to a close we decided that we needed to find another hospital to send students to for the coming summer.
And thus began our evaluation of multiple different hospital sites, an adventure that we are still currently undertaking (and which I will write more about in the coming days). We’ve spent a lot of hours in bumpy Jeep rides, seen some truly beautiful sights, and are slowly building contacts and relationships with hospitals in more rural areas of Nepal. We’ve spent time at Bhaktapur District Hospital near Kathmandu, Phaplu District Hospital at the foot of the Himalayas, and now are finishing out our time at a mission hospital in the village of Okhaldhunga. In the process of all of this, I’ve had the privilege to see hospitals across the country and talk to some of the brilliant minds that are trying to change the face of developing world healthcare for the better. More than any other Engineering World Health trip before, I feel like I am reaching the crossroads where I realize that the crazy ideas that we have to make the world a better place can actually become a reality; even more than that, I am realizing that we have an obligation to see them through to reality.