I just got back from a week-long visit to Tansen for a work orientation. It was great to finally see the place and to meet the people I'll be working with in a couple months. It's a 10-hour bus ride to get there, which is why I haven't visited until now. The hospital has a vehicle, known as the Buck (half bus, half truck) that travels once a week between Kathmandu and Tansen. We took the Buck there and then flew back (the closest airport is about 1 1/2 hours from Tansen along a very windy mountain road that makes you motion sick pretty quickly). After having been there and seen how beautiful it is (SO much nicer than dirty, noisy, smelly Kathmandu!), and spent a bit of time in the hospital, I'm starting to get excited about moving there and starting work. There will definitely be a steep learning curve at the beginning, but that is to be expected. Burns are very common there and all but the most superficial burns usually require some form of surgical intervention. In Canada this is usually done by plastic surgeons, but there is no plastic surgery department at Tansen. What else did I see during my one day of rounds? There was a baby a few days old with spina bifida and an open spinal cord defect (probably not much that can be done for her, but the surgical team is caring for the wound for the time being). There were a few people with TB-related pleural effusions (fluid around the lungs) requiring chest tube drainage. There was a guy with alcoholic cirrhosis (alcohol abuse is a big problem here) with badly infected fluid in his belly...not too much that can be done for him here. There was the usual mix of gallbladders, hernias, appendixes, and other more "typical" general surgery cases.
I was interested to find out that the hospital does have mesh that they can use to repair hernias with. It's expensive so it's used sparingly, but it's good that they have it. That's the gold standard for most hernia repairs in the west, but I wasn't expecting to have that option here. There is a laparoscopic set-up, as well. It's pretty basic, and the picture quality isn't great...but hey, at least they have something. They do try to do their gallbladders laparoscopically if they can, which is great...both for the patients (when it is successful) and for someone like me who wants to keep up her laparoscopic skills if possible. I helped another surgeon with a gallbladder the other day. We started laparoscopically, but it was a pretty inflamed gallbladder, and we were both visiting surgeons and weren't too familiar with the equipment, etc, so we ended up converting to an open procedure, which was the safest thing to do at that point.
Tansen is right in the Himalayan foothills, and the town itself is built into the side of a fairly steep hill. You are almost never walking on level ground. Water supply is a huge problem, and so people walk quite a distance with buckets to get the water they need for daily life. It's less of a problem on the hospital compound, but you still have to use water sparingly.
In other (more important) news, as many of you already know, I have recently gotten engaged to be married to a guy named Paul!! No, we didn't meet in Nepal - we've actually been friends for 8 years now, but it's taken this long for the relationship to develop into more. He was just here for a visit (during which we got engaged on a little 18-seater plane, right in front of Mount Everest!), and he was able to come and see Tansen with me, which is great, since he will also be living there after we get married. We also had a chance to spend a weekend at the children's home, where all the kids have already started calling him the Nepali word for "Brother-in-law" (older sister's husband, to be precise). They were all very excited to meet him, and we had a wonderful weekend there. He is off to Africa now for 6 months (sigh) to finish up a building project there. We plan to get married in Canada in October, and then come back to Nepal together as a couple in December. We're very happy (obviously), and everyone - both here in Nepal and back home - has been so great and supportive. People here are excited to have us in Tansen as a couple, and he had a chance to meet some people he may end up working with when he comes back. These next 6 months will be challenging for us, especially since a long-distance relationship between Nepal and Africa isn't the most straight-forward. We're just praying for good phone networks and internet connections so that we can stay in touch as best we can. We did manage to plan the majority of our wedding while we were together, so that was a bonus!
I'm off on Friday to Pokhara (a tourist town about 5-6 hours from here) for a weekend of touristy things with a couple other language students. Then on Monday we head to the village for our 2-week village stay. I don't expect to have internet access there...or showers, for that matter!
