University of Otago School of Medicine student Kerry
Short, based at the Christchurch campus, was one of two
recipients of the Queenstown-based Pat Farry Rural Health
Education Trust Travelling Scholarship last year. The
23-year-old, originally from Matamata, wraps up today her
front-line experience of rural medicine in Nepal from
November 19 to December 23. She summarises her encounters
while working in Zambia, from January 3 to February 18, later
next month for the Queenstown Times.
Wow! Nepal has been quite the experience and a true
introduction into medicine in a Third World country.
As I am keen to follow a career in rural medicine, I chose to
do my elective in developing countries and in resource
limited areas. I wanted to challenge myself and gain
experience in clinical decision-making in difficult
situations with or without the resources to which we are so
In Nepal, I've been based at Scheer Memorial Hospital in
Banepa, doing a three-and-a-half-week rotation working in
internal/emergency medicine, obstetrics and gynaecology and
It's a small mission hospital serving a large rural
population, situated 30km, or a two-hour bus trip, from the
edge of Kathmandu. Patients can travel for up five to six
hours in order to see us, whether that is by bus or walking
down from the hillside villages.
The standard of health care in Nepal is hard to compare to
that delivered in New Zealand. While the doctors at Scheer
Memorial Hospital are well trained and have experience from
many institutions from around the world, they are working in
very different conditions.
Patients here must pay a fee to see the doctor. We then
review the patient and write a list of equipment,
investigations and medicines we need.
This list is given to the patient's family who then must
purchase the items at the pharmacy/lab/X-ray and bring it
back to us before we can ''treat'' the patient. This occurs
for patients whether they are in the clinic or the emergency
It is hard to deliver the health care you want when patients
cannot afford what we have prescribed. It is then a matter of
negotiating, prioritising and finding a balance between need
I think in many ways it has forced me to consider more
carefully and to justify each decision about tests needed. I
believe this experience will be incredibly useful in New
Zealand, as health-care costs are increasing and some of the
burden is on clinicians to be utilising our resources in a
I also went to visit a small health post which provides
primary care to a collection of small villages.
That was a fantastic experience, as it demonstrated how to
''work with what you have''. We only had a set listof 25 free
medications/lotions we could prescribe.
In five weeks in Nepal I have seen so many conditions I had
only read about in textbooks. It has been a wonderful
learning opportunity to see, diagnose and treat these
diseases and has broadened my medical knowledge base.
In both placings, thanks to my Pat Farry Trust Scholarship,
I've had the funds to provide equipment such as an automatic
blood-pressure machine, a blood-glucose monitor and testing
strips, thermometers, gloves, batteries, bandages, scissors
and basic first-aid kits to the Scheer Memorial Hospital
Obstetric Department and the Chitwan health centre.
This equipment was very much appreciated as they need all the
help they can get.
As I wrote to my family and friends, Nepal, thank you for an
amazing five weeks. You have taught me to relax and do things
on Nepali time, shown me humanity at its best and worst,
engulfed my senses at every opportunity and opened my eyes to
medicine at its rawest. I will miss you.
• For more information visit www.patfarrytrust.co.nz.