July 16, 2013- Patle Village Clinic

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July 17, 2013 - Chyangba – Community Health Worker Education Program day 1

Number of survivors: 8

The day started off with the opening of the Chyangba Beauty Salon run by the Stanford Medical Team. Two sisters came in this morning to get treated for lice in their hair. After a few of us massaged their scalps with cream, Jackie and Erin (the expert hair braiders in the group) braided their hair. We saw them again tonight to wash off the cream with shampoo, courtesy of Yak and Yeti.

In clinic today, we saw patients with more serious medical problems than those from the previous three days. We had to triage patients because there were so many patients we could not have seen them all in the one day we had left. Understandably, quite a few middle aged individuals were upset because they were unable to be seen—luckily for them, Kamding has a community health worker who can treat chronic knee and back pains, which are very common, with ibuprofen!

The most serious problem I had was presented by an elderly woman who had chronic obstructive pulmonary disease, congestive heart failure, edema, and cyanosis. With a low oxygen saturation of 82%, we suggested that she move to a lower altitude. I was surprised that quite a few patients had medical problems that were a result of being overweight. However, most of the elderly in Nepal are healthier than their American counterparts with all the exercise they do going up and down mountains.

Quick Kim interlude:  I had two of the sickest patients today.  My first patient was an older woman who had to come in carried by her family.  She was emaciated and hadn’t been able to eat for days.  Kelly gave her two liters of IV and sent her to the hospital.  He thinks she has cancer.  It was hard to see it all unfold.

The second very sick patient I had was a woman who came in talking about an ear infection.  She entered the room with flies around her head and a musty, clinging scent.  She presented with a wound behind her ear and swelling in her face, so much so that she couldn’t close her eye when she blinked.  Kelly explained that her wound had sat for so long that it was necrotized.  The flies were attracted to the dead tissue, and the infection has spread into her face and also towards her head.  If she had been in America, she would have been in the operating room already, but all we could do is give her antibiotics and recommend her on to the hospital.  It was hard.  Finish Kim interlude.

After clinic, we all gathered for tea and a few of us were able to try butter tea, a popular drink in Chyangba that consists of black tea, butter, salt, flour, and milk. Jackie, Andrew, Lisa, and Kim tried it and described it as salty milk. The rest of us were too worried about diarrhea to drink it… Four hours and a delicious buffalo pasta dinner later, no upset stomachs yet! Lots of love from all of us in Nepal!

written byAlda