Scott’s Elective – Satellite Clinic

At the end of last week I had the opportunity to join a team of staff from Anandaban Hospital as they travelled to Butwal to run a satellite clinic. This clinic runs monthly, and provides care for leprosy affected patients across the west of Nepal, and even some patients from northern India.

The 13 members of the team included doctors, nurses, physios, laboratory and administrative staff, and of course the bus driver. As well as the team themselves, they must also bring all the equipment they require. This included patient notes, assessment tools and sterile equipment to allow samples to be taken from patients and transported back to the hospital for analysis. To say this requires a lot of planning is an understatement. Furthermore, the clinic operates from a single room (in Lumbini hospital). This means that there could be up to ten patients, plus their families, plus all the team in the one room. While it appeared chaotic, it was amazing to see so many patients assessed by multiple staff in such a short time.

The journey from Anandaban to Butwal take approximately 9 hours (including a short lunch break and a couples of toilet stops). Therefore to run the clinic for just one day, the trip takes a full 3 days. Thursday and Saturday are allocated to travelling there and back, and the clinic takes place on Friday. This is a major undertaking for such a small hospital, as there are only around 120 staff at Anandaban in total. However, they have been running this clinic for over 6 years and regularly see approximately 70 patient each month. Many of these patients are known to the staff, and attend for regular reviews and to collect ongoing medication. Although, they frequently make new diagnosis, and on occasion will admit a patient to Anandaban for reconstructive surgery.

It was a privilege and a joy to be part of this trip. Firstly to see the planning and coordination that goes into organising such a clinic. But, also to see their passion and desire to ensure patients all across Nepal are treated and followed up for Leprosy. On this occasion, 68 patients attended, many of whom travelled far to be seen. On Friday morning, we experienced a large thunderstorm. At the time, I was not concerned as it was early in the morning and cleared up before breakfast. However, when speaking with one of the doctors, they were very concerned that this would leave patients unable to travel to the clinic. They explained that poor weather conditions can make the journey impossible for some patients. This really struck me. As if a patient could not attend, they would have to wait another month until the next clinic.

I thoroughly enjoyed the trip – despite how long and warm the bus was. It almost felt like a school trip. With the younger staff excitable and playing lots of Nepali pop music, and the older members of staff napped and tried to ignore the singing. It was fascinating to experience other parts of the country. As Butwal is at a lower altitude than Kathmandu and Anandaban, it was much warmer, commonly reaching 40degrees Celsius. The drive was also an incredible opportunity to see the mountainous landscape and forrests that cover much of Nepal.

It was truly a unique experience to see this clinic and I am grateful for my opportunity to observe. I am sure this is something that will continue to run for many more years, to serve hundreds of patients affected by leprosy.

(I have not been able to upload photos from the clinic itself, and I shall add these when possible)

Lumbini Hospital who allocate a room for the team to run the clinic from.

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9th May 2019

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Opinions are the authors own and not necessarily those of The Leprosy Mission Scotland.