Introducing Raj Kumar!

Raj Kumar is a seventeen-year old boy who is studying in Class 8. He comes from a poor farming family who live in the district of Lalitpur, south of Kathmandu. He was admitted to NHEDF in April 2017 accidentally – his brother presented for surgery following a head injury and Samrat, NHEDF’s Director, discovered that Raj had been badly burned as a baby when a kerosene lamp fell on him and caught alight. He experienced significant burns to his left arm, back, torso and needed surgical intervention due to significant burns contractures which were distorting what was left of his arm, his neck, his face and the left side of his body and causing significant loss of function and pain.

Raj underwent two operations in May and June of 2017 and an amputation of his left arm during his time at NHEDF in 2017 but needed a third surgery before a prosthetic arm could be fitted. This will be done as soon as funding is secured.

Meet Goma…

Goma was a patient at NHEDF for two months. She had a breast abscess – no one knows why. She came to Kathmandu for treatment armed with NPR 25,000 (approximately $300). She is a single mother who lives in a shack with her young son and because she is so poor, her village municipality gave her $60. She also used all her savings of $210.

The hospital admitted her as a day case only, and she had her wound debrided and dressed. She was then discharged the same day with nowhere to go to. She was told to present for daily dressings which she did.  She slept in the hospital lobby for three days until one of the hospital cleaners who rented a single room outside the hospital became aware of her situation and invited her to stay. She shared her room with her for a week until all Goma’s money was gone on dressing supplies and medications (pain-killers and antibiotics).

She said she begged the hospital one hundred times to treat her for free, but nobody listened. She begged for help from strangers from whoever came near her, but no one would listen.

One of NHEDF’s patient’s caretakers who had taken another patient to hospital found her crying outside the hospital. She called NHEDF and explained the situation and after talking to Goma, NHEDF accepted her into the NHEDF family. Goma’s wound required complex dressings as not only was the abscess large, but it had a deep sinus. It took two months to heal. When she was ready for discharge NHEDF provided Goma with some money to get home and a thank you letter to the village office so that the municipality who gave her the small amount of funding knew she had received treatment and why.

NHEDF is not just an organization but a home for many people like Goma. Good bye Goma. We wish you good luck ……

How to make your photography subjects smile in Nepal!

During her trip to Nepal in February, one of NHEDF’s patients gave Virginia a great tip! In Nepal many people look so serious when they have their photo taken. Goma suggested saying ‘dhat dhekinus’ which in Nepalese means ‘Please show your teeth’!

It was enough to make everyone smile or howl with laughter!

Thank you Goma! I will never forget your advice or your smile!

Wish Sandeep luck….

Thirteen year old Sandeep who sustained multiple internal injuries in the earthquake is having major surgery tomorrow to try to resect the stricture that is giving him so many problems ranging from incontinence to kidney damage. It is going to be very tricky surgery because of the location of the stricture. We are thinking of you Sandeep and we wish you good luck for the operation and we hope so much it is successful for you! You deserve it and then you can go back to school and we hope you will be like you used to be before the earthquake… take care and thinking of you!

NHEDF has a new patient who needs your support

Himal B.K is a six-year-old boy from the province of Aacham in the west of Nepal. His father Jay Bahadur B.K is all he has left.

Like many of NHEDF’s patients, Himal’s parents were poor and they were working in India as laborers. Home was a little wooden hut provided by their employee. Unfortunately, one night, an electrical short circuit set the house alight and everyone was killed except for Himal and Jay. Himal and Jay lost their mother/wife along with Jays brother, sister-in-law and their child.

They were taken to hospital in India with dreadful burns. Jay had burns to both legs and Himal had terrible facial burns as well as burns to his arms and back. Medical care was not free in India and eventually they ran out of money so the hospital discharged them. They decided to return to Nepal and like many of NHEDF’s patients, they could not afford medical treatment. Thanks to financial support from their community they were admitted to a local hospital, but it had few facilities and only basic treatment for burns injuries.

For two weeks the hospital did not charge them for the care they received and some of the hospital staff generously paid their medical bills. They were then discovered by a nurse who had volunteered for NHEDF after the earthquake and was doing her Bachelor in Nursing at the hospital where they had been admitted. She contacted NHEDF and arrangements were made for Himal and Jay to be brought to Kathmandu. They were admitted to NHEDF on April 12th.

Since then Himal has had five surgeries and Jay has had two.  We have felt that the photos of Himal when he arrived at NHEDF were too distressing to be shown and despite wonderful nursing care from NHEDF’s nurses, even recent photos are enough to make some people turn away.

Jay’s skin grafts have taken and his wounds are well healed. Himal is a different story due to the extent of his burns. The road to rehabilitation for Himal will be very long and both may require long-term medical care to minimize their disabilities from burns contractures and help them deal with the trauma they experienced. If you would like to support Jay and Himal’s ongoing medical care, please contact us.

Have a look and see what Manis is getting!

Manis had a left femoral artery aneurysm which resulted in the loss of the blood supply to his leg. He required a left above knee amputation. Two weeks post-surgery a he was sent back to his village. His wound got infected, so he returned to hospital and was there for 3 months before being referred to NHEDF for ongoing wound management of both a groin incision and a difficult stump wound, as well as physiotherapy.

Finally, his wounds are now healed and he has had a prosthesis fitted and when this is finally made he will be able to return home to the remote village of Baitadi in western Nepal. He is really excited!

Anjeela, NHEDF’s physio is a legend at stump bandages! Improper stump bandaging can cause irreversible damage whilst proper stump bandaging results in shrinking and shaping the stump and is a major key to successful prosthetic fitting.

Karna is NHEDF’s longest staying patient… read his story here

Karna was 27 years old when he was admitted to NHEDF. He is not married and has two brothers. He had been to university and had done a sociology degree and used to work as a Red Cross worker. He comes from Rolpa in the far mid- west of Nepal 280km from 

Kathmandu.

When the first earthquake happened, Karna was crushed by a falling wall and was in hospital for many months. By the time he was discharged from NHEDF in March 2018 he had undergone thirteen surgeries. These included the ongoing insertion of external fixators because as each fracture healed the fixator was removed but further surgery was required to fix the next fracture, and this involved an operation to apply another fixator because only one fracture could be fixed at a time. Karna ended up having three fixators – the first for two months, the second for nine months and the third fixator for eight months. 

Fixators require daily dressings to prevent infection and regular adjustment and medical review. Karna also needed daily physiotherapy support, as well as regular hospital follow ups and X-rays to assess progress.

Karna was eventually discharged home in March 2018 after a bout of osteomyelitis and has now been employed by NHEDF as a field worker visiting two hospitals a week in Rolpa and finding patients for NHEDF. He assesses the eligibility of patients for NHEDF and coordinates their transfer to the Shelter and monitors their progress when they return.

We wish Karna all the luck in the world after almost three years of hospitals and an epic journey along the road to rehabilitation. Take care Karna!

 

 

 

This is Keshar’s story

Keshar is 17 and comes from a place called Udhayapur in the east of Nepal. He was admitted to NHEDF in mid December 2017 and was discharged in late February 2018.

Keshar comes from a poor family, and when he was 13  he broke his right leg. His family brought him to Kathmandu for medical treatment and he had surgery but they could not afford for him to stay in hospital for long, so the limb was plastered and Keshar was sent home. He went on to develop osteomyelitis and was left with severe rigidity or stiffness in his right leg which made mobility difficult .

In 2015, as bad luck would have it, Keshar was injured in the earthquake whilst running away in an attempt to seek safety. This time he sustained a fracture of his other femur (thigh) and was again brought to Kathmandu for treatment. He was operated on and sent back home with his leg in plaster and instructions to have the plaster removed  after 3 – 4 months. During this time he became unable to move his leg but his family could not afford any further treatment. Eventually however he was brought to Kathmandu with a wound requiring debridement, and a diagnosis of chronic osteomyelitis was made  with ankylosis (severe stiffness) due to injury and infection . He was transferred to NHEDF for nursing care and physiotherapy and whilst further surgery was suggested, it was going to cost about $10,000  At that time NHEDF was unable to help Keshar so he returned to his village.

In 2017, two years after the earthquake, Keshar re-presented to the Shelter with severe pain in his left leg and a number of consultations were sought. By late February consensus was that Keshar should not have a bilateral hip replacements now due to the high risk of  complications and the likelihood that this surgery would not be successful.

Keshar was advised to contact NHEDF if he experiences increased pain and there is a possibility that simpler surgery could possibly be performed or a decision will be made to perform hip and knee replacements as required, should funding be available.

It is hard for NHEDF who are so committed to helping when patients cannot be helped because the risks are too great, or the operation is simply too expensive. Reflect how lucky we are in a place like Australia where we can have whatever surgery we need in a public hospital at no cost to ourselves…Sure, we may have to wait a while, but there is a system in place to facilitate appropriate timely surgery for those that need it….and it is free under Medicare.

 

 

Read Bikram’s story here

Bikram Bogati is a 17 year old boy who comes from a poor family. He has the most beautiful smile! He comes from the province of Accham close to the Indian border in the north west of Nepal. Life is very difficult for many Nepalis living in remote regions like this, and when it comes to health and medical care, because what exists where he lives is beyond the imagination of many.

Until the age of nine, Bikram’s problems were not unlike anyone else’s in the village. Life changed when Bikram’s father walked out on the family leaving his mother responsible for Bikram and his two siblings only to return, completely out of the blue ten years later, but with no money.

Things for Bikram also changed dramatically when a small corn developed on his foot. It grew bigger and bigger, and he then started to have problems walking due to pain. In 2015 he had surgery in India, but when he returned home his mobility became worse and a few months later he was bed-ridden. People thought it had something to do with the surgery, and Bikram’s life then became even more difficult because his mother was working all day and was not able to take care of him. He was no longer able to attend school.

Luckily for Bikram, humanity in his village is not dead. Some students from the region who knew Bikram and had heard about NHEDF brought him to the Shelter in July 2017. It took months for doctors to work out what was wrong with Bikram and finally a genetic disease called Friedreich’s ataxia was diagnosed. This is an autosomal recessive inherited disease that causes progressive damage to the nervous system and manifests initially with symptoms of poor coordination such as gait disturbance. It does not affect cognitive function.

Bikram cannot be cured. He can only be helped to manage his disability. Whilst regular physiotherapy did not improve his mobility it was important to prevent contractures and maintain muscle tone. He has now been provided with a wheelchair as he cannot walk without support. Now Bikram has a decision to make. He can go back to his village and return to school. The other option is for NHEDF to arrange admission to a hostel where he can also continue his education in Kathmandu. Bikram will be wheel-chair bound for the rest of his life, and NHEDF would also like his siblings to be tested for the same disorder.

It is hard for everyone when patients cannot be cured. Bikram hit rock bottom for a while, refused to eat, and became very depressed. Thanks especially to Manish, a fellow patient, and the supportive environment at the Shelter, Bikram’s beautiful smile returned and he feels life is worth living again.

Bikram was eventually discharged from NHEDF with a diagnosis (and a wheelchair) in March 2018 with plans to return to school and finish his education. Luckily there is a straight road between his home and his school and he can be  independent again. NHEDF is trying to obtain screening for Bikram’s sister to determine whether she is afflicted with the same genetic condition as Bikram.

 

Read Sandeep’s story here

Sandeep is one of six children. His family are very poor and farm a small parcel of land. His home was badly damaged in the earthquake in 2015 when a wall collapsed on him and he suffered serious internal injuries requiring major abdominal surgery. After his surgery he had to have a permanent indwelling urinary catheter. He was eventually referred to NHEDF who organised investigations and the insertion of a supra-pubic catheter and in March 2017 he had a number of urethral dilations for a urethral stricture. Eventually he was able to pass urine normally and his supra-public catheter was removed. He was finally discharged on April 4th, 2017.

In January 2018, Sandeep was re-admitted to NHEDF with abdominal and pelvic pain. He had a retrograde ureterogram which showed an obstruction causing backflow of urine into his kidney (hydronephrosis). He had a ureteroscopy and surgery to stent this and prevent kidney damage. He then went on to develop an infection requiring re-hospitalisation and intravenous antibiotics. Further investigations showed a 0.5cm stricture at the bulbo-membranous junction which sits almost at the opening into the urethra. Whilst further radical surgery was contemplated it was eventually decided not to proceed because of the location of the stricture which is so close to the urethral sphincter muscle, which if damaged, could cause complete incontinence. Sandeep instead, had a series of urethral dilatations and so far has had no more problems passing urine. He was discharged from NHEDF in May 2018.

Sandeep is happy. He is back at school and no one teases him anymore. He does not smell of urine and does not have to carry a catheter bag wherever he goes. He is in class 5 and we really hope everything goes well for him and that is the end of all his medical problems. Good luck Sandeep!