Turkey

Reacting to the monotonous shifts and the busy schedule, I one day got very frustrated with the huge shift in work-life balance and as a reactionary rather than a reasonary, i decided i would go on a vacation.

The short- list was already short owing to the tremendous weight my passport holds when it comes to travelling abroad.  

I 

   Mid August, I was in Australia to visit my fiancé and was abruptly called to visit the German embassy here in Kathmandu. I booked tickets the next day and arrived but hey that’s another story.

   Upon my arrival on the 29th of Sep 2018, a move that I had been working on for a couple of years owing to the fact that learning the German language was needed to tick the very first box of requirements to pursue a career in Medicine in Germany. 

My very first move, a train ride from Dusseldorf to Osnabruck was a mishap, I boarded the wrong train, travelled on it for a good 2 hours before realising that I was moving in the wrong direction.  ---    -Phew. 

   My initial days were spent waiting for a work permit, during which I was not allowed to work and therefore not paid. During this time Hon. Prof. Dr. med. Dieter Lüttje, yes that’s what was written outside his door, head of the department had agreed to support me with 1000 Euros per month which was roughly what I needed to sustain myself.

    Initially I felt a little amused, because I was free to visit anywhere and was given no work, 
the only instructions I was handed out were, Ask Questions. Everyone smiled at me and life was good. 
  After a few days when the amusement sank in and reality crept in is when I started drawing parallels with the health system to which I was accustomed to and that’s where I wish to take you all.

   After a few days I began to meander into deeper questions like how the system worked and there I stumbled across a few other questions. 

 As a junior doctor and just like other juniors, I, dreaded making diagnoses, firstly, because of the complexity of it and secondly this was Germany.  A few days later I realised that everyone was already diagnosed when they were at the hospital(Krankenhaus). 

Part of my job initially, was to take patient history and inside this file was a sheet with everything that I required, but mainly the diagnosis. I knew beforehand the condition the patient had. Led me to ask who the good samaritan was,who did this tidy work? Where do patients come from? Where is the OPD(outpatient dept). I later realised that each patient has a GP and it is this GP that was the first line of contact. The OPD- system is bypassed, so when people stop paying the doctors for OPD visits then the whole system is flipped on its head. Why don't we do that in Nepal was an obvious query.

I soon began to accompany the Prof. with his rounds and with each passing day I felt I gained a little more of his as well as my confidence. 

My Prof. was a seasoned practitioner in 60’s and always carried a smile . He made it a point to have breakfast with the whole team in the mornings and bought breakfast. Most importantly, he was our first line of defence.*

   Days passed by and I encountered patients, my german got better, slangs began to make sense. 

 Most inmates at the hospital were largely alone, No 'Kuruwas' (attendants), in fact the children only came to know when the hospital informed them about it. 

Months passed by and things began to normalise, the daily calls back home and  phone topics like what I ate and what I did at the hospital turned scarce. 

One of the most striking features and contrary to what I was accustomed to was the way the hospital ran. All the work from feeding, washing, medication, was done by the hospital. 

I was informed that to make it simpler, the whole system is same in all of Germany, in all the hospitals. The shape of the ward, where the mobile charger are placed, the bathrooms, the computer programmes, the app used to treat and dosage was uniform throughout the land. This made sense as unlike in Nepal, Germany had a system whereas anyone could come in and the level of care and the treatment would be the same. This lead me to another very important difference between how docs work in Deutschland(Germany) and here in Nepal.

  Different World - Tho whole system is a light years away from what we have here, while we in Nepal are struggling for primary health, people in Germany are gifted with a GP each, the GP is the 1st point of contact and decides when and where people go for treatment. 

 Depth of Care: The system even caters to the daily needs of these elderly. You have people who can’t cook, wash or carry out regular hour chores and for such people there are specialized services whereby people ‘pflegedienst’(nurses) come in depending on the needs of the person,usualy elderly. Once, twice, thrice, four times a day everyday to cater to these people.
The ward even had a social worker who arranged these social errands for the needy. To such depth ran the system, that there was once a staff who taught the elderly, on how many pieces and what sized pieces to cut a ‘bratwurst’(sausage) so as to be the most energy efficient. 

So in a way the govt. looks at the person from all angles. Diseased go the hospitals, the crippled to the rehabs, and those who can’t live alone go to the old age homes. Astounding, is the number of people who live in these old age “alter heim/pflegeheim” despite the fact that they are married have children or even wives for that matter who can care for them.

There are sad parts to this well drilled engine as well. Because of the fact that most of the people are independent and mostly decide how they want to live, they take work very seriously and are very good with time management.  Even when someone is sick and in the hospital and have their daughters/ sons come visit them once a week for merely an hour, these patients are so happy and I have sometimes seen then dress up and put on make up to look pretty while they come. Chances are that, they only see their kids once a year or maybe haven’t seen them for years.  I have sometimes during the early morning round seen first hand of how happy they are because someone is coming to visit them today or during the weekend.

Another strong difference and something that I really appreciated is how females choose to own their own identity , even words, nouns are variable eg. arzt-doctor, arztin -female doc, pflege- male nurse ,pflegerin- female nurse and the list is endless.

From short hair, jeans worn by most women/girls looks like they are built to be fast, efficient and may be better than their male counterparts.

They are very vocal and unusually loud, sit with a confident demeanour and you cannot difference between a male or a female.

Lastly, they are used to such high standards that I want to recall an event

-- It’s interesting how they say he(a 92 years old patient)was reanimated 2 months ago without a pause to acknowledge it, as if it's that easy to do that. reanimated means revive

I was stationed in the Geriatric ward. A few notes I wrote in the initial days.

: The amount of patients that receive dialysis and have end stage kidney disease is staggering.

: Fractures that may have something with sunlight vitamin D(prob due to low sun


light exposure)

: Doctors smoke openly, sisters, health care professionals , without an iota of shame, smoke openly under the hospital. What is comic is that sometimes even patients are seen about smoking, some come with intravenous (cannulas inserted inside your vien) drips hanging and some come with wheel chairs. Thank god I haven’t seen anyone with the whole bed asking to be taken to the smoking area

: The amount of respect patients have for doctors is enormous

:Coffee eatable water for tea or candy is readily available at the front desk coffee didn’t taste the best but its good.

: what also stands out is number of people of people the hospital has been able to retain. 60 year olds, 65 and they say they have been working here for the last 30 years. The dedication and ethic over the years has remained as strong as ever.

: The Deutschen(Germans) make it a point to greet each one with a guten tag(good-morning), hallo, morgen(morning), while walking through the corridor. This would /could be good in the morning but when you are tired towards the evening and then to greet every person at 4 pm could be quiet tiresome and sometimes irritating.

*for those who are not accustomed to the medical world, here everyone tries to bring you down, grossly evident during cross speciality meetings and seminars, which almost felt like war-zones, where it’s common to denigrate a fellow medico and to use this to climb a rung higher.

My identity card 

My problems with German are clearly evident. 

An exhibition about Nepal inside the hospital premises.

Me

Saw this on my way back home everyday and everyday I would look at it and dream of buying it for my wife as a wedding gift.  

WITHOUT-- SUGAR

   

                                                    WITHOUT SUGAR 


     I  once drank*, it tasted, just like,
                       My Heart.
 
    I, now regulary drink,
    because it continues to taste, just like,
                       My Heart

    I think i will, always, drink,
    because, it continues to taste just like,
                       My Heart

    I advise you all to drink because,
    who knows it might taste like,
                   Your Heart

* coffee


god knows where i got the inspiration from
written on the 10th Sep 2019

#basatapur dabalee ko sanjha ko kura ho..

ramri NANI aiee..ani khaie rako churungi lai bhurrraaaaa udaie 

“ NANI timi sanga ako KETA (boifren) lai ta bike le hirkaye cha ni uhhhhhhh tyaaaa

horaaaaa bhandai NANI ni udera gai.."

#koi ali dhilo udey>> pachi po thaha bhayo ta ti ta bairo po rahechan

#koi udnai sakenan>> pachi po thaha bhayo ta..ti ta buda pakha po raiachan

#koi bami sari uta  gaye >> pachi po thaha bhayo ti ta baccha po rahechan

#koi k bhayo sari twalla pari here>> pacho po thaha bhayo..launa bhaktapur ko pauna po rahechan

#koi balla balla udey>>> pachi po thaha bhayo ta langado po rahechan

#NANI afno KETA sanga pharkera aien..

 #maafi malai hoina NANI churungi lai maga

#sani chara ko pani satto ta udi halcha

#niyali hera NANI usko ko pani euta sanu MANN chai huncha

Nepal-Lippe unterwegs

Es war ein kalter Novemberabend, als Dr. Satish, ein renommierter Radiologe in Nepal, der jetzt in Deutschland arbeitet und der auch meines Vaters Freund ist, mich anrief und fragte, ob ich ihn besuchen könnte. Ich ging sofort ins Haus von Dr. Satish. Hier treffe ich mit Dr.Tract und Mr.Heinz, zwei Veteranen in den späten 60ern und einen orthopädischen Surgeon Dr Titos.

 Verpackung bevor wir nach Charikot fahren.

Wir hatten eine einstündige  lange Konversation 

sicher in Deutsch, und zusammenfassend ich hat verstanden, dass sie (wahrscheinlich die besten Freunde) nach Nepal in den späten 60er Jahren als Touristen kamen und sich später in das Land und leute verliebten haben und danach sehr oft sie hierher gekommen sind. "Wenn ich raten musste, vielleicht 40 mal in Nepal" sagt Dr. Tract.

Ich fühlte mich wie ein König

  Dieses Mal hatten sie Geld aus Deutschland gesammelt und wollten den Leuten hier dienen und mir wurde das Privileg gegeben, neben zu ihnen.

Dr. Tract, ein Kinderarzt war mit der Mission Hospital in Okhaldhunga für 3 Jahre in der
 Mitte der 80er Jahre, seine größte Stint in Nepal 
beteiligt, und seit macht regelmäßige kurze Besuche von 4-8 Wochen pro Jahr nach Nepal. Während Herr Heinz in den 80er Jahren für den Bau der Trisuli-Autobahn arbeitete und interessanterweise sogar hier in Gorkha den traditionellen nepalesischen Weg heiratetet

abends in Kalinchowk

Es war letztes Jahr, dass Herr Heinz hatte schmerzen in seine hand und das führte ihn zu Dr.Titos zum treffen, der ein Orthopädischer Chirurg ist und er hat eine privatKlinik in Deutschland zu treffen. Im Laufe seiner Behandlung teilte Herr Heinz seine Geschichte mit dem Chirurgen und jetzt war er auch interessiert, um in Nepal zu dienen und damit die 3 Deutschen in Nepal landete im November.

Ihr Auftrag war, Gesundheit Lager in den entlegenen Gebieten von Nepal,
Letztes Jahr nach dem Erdbeben waren die beiden nach Charikot und Lamjung gefahren.
Nach einer kurzen Planung trafen wir uns
eines Morgens und gingen nach Kalinchowk, Dolakha. Wir hatten zwei Tage im Gesundheitslager
 Kalinchowk. 3 anstrengende Tage und wir sind in der Lage, insgesamt 420 Personen zu dienen. Wir verließen das Gefühl sehr stolz auf uns selbst.

Schule in Lamjung

Auf unserem Weg zurück nach Kathmandu
planten wir unsere nächste Reise nach
Lamjung und 10 Tage später trafen wir uns
 wieder und fuhren nach Ghamar Chowk,
einem Gurung Dorf in Lamjung. Unsere
 Ankunft war sehr spektakulär. 15 Erwachsene
 bauen eine Straße, nur für uns, arbeiten
 begeistert. Bei der Ankunft wurde uns
 gesagt, dass dies der erste Jeep nach
Ghamarchowk in diesem Jahr kommen.
Bisher konnten nur Traktoren hier sein.


Wir wurden von alle leute in dem Dorf begrüßt. Später wurde mir mitgeteilt, dass Dr. Tract und Herr Heinz im vergangenen Jahr nach dem Erdbeben hier waren und ein Gesundheitslager

guten morgen aus Kalinchowk.

 geführt hatten. Sie hatten den Dorfbewohnern
mit Baustoffen und eine mutter mit finanzieller
Hilfe geholfen die gerade zwilingen  die gerade
zwei Zwillinge geboren hatte und nun die beiden
 Jungen herumlaufen sah, muss den beiden so viel
 Zufriedenheit gebracht haben. Um die lange Liste
 der guten Arbeit, die die beiden getan hatten,
hinzuzufügen, hatten sie auch vereinbart, einen
 Jungen Kumar Gurung, nach Deutschland zu
nehmen und ihm Ausbildung und einen neuen
Anfang zu seinem Berufsleben zu geben

Dr. tract nahm eine Prinzessin "Kanchi" von Bal Mandir, (ein Waisenhaus in Naxal), wenn sie nur 3 Monate alt war. Kanchi ist jetzt in Deutschland und arbeitet als Neurochirurg. Dr. Kanchi war hier im Model Hospital, Kathmandu im letzten Jahr und verbrachte einige Zeit serviert .

ein guter mann

In Lamjung arbeiten wir für 3 Tage und mindestens 320 Personen helfen.
Während der letzten zwei Tage hatten wir das Glück, eine Gurung hochzeitzeremonie zu haben, Kumars älterer Bruder heiratete und wir wurden eingeladen, mehr als funf Hundert Menschen hatten kommen und ganze Nacht tanzen und trinken Pa (lokaler Alkohol), war ein Anblick.



Wir kommen nach zuruck in ein woche zurück und wie im vergangenen Jahr haben Herr Heinz und Dr.Tract einige finanzielle Unterstützung für die örtlichen Vereine geleistet und versprochen, ein besser Trinkwassersystem im Dorf in den kommenden Tagen zu bauen.



Letzte Woche hat das "Tourism Board" aus Nepal Herrn Heinz als seinen Markenbotschafter in Deutschland aufgrund seiner langjährigen Hingabe und Liebe gegenüber Nepal ernannt.


Ich möchte Dr. Tract, Herrn Heinz, Dr.Titos für ihre Arbeit in Nepal danken. Ich sehe foward zum Haben viel mehr solcher Abenteuer in der Zukunft. Im Namen des Teams bedanke ich mich auch bei CWIN (Kinderhilfe in Nepal) für ihre logistische Unterstützung und danke Herrn Bisnu, der die Dinge so gut organisiert hat.

Ich weiß, einige der Leute, die dies lesen könnte dies ein wenig langweilig, aber ich glaube, waren unsere Erfahrungen in diesen 2 Wochen war nichts weniger als spektakulär und ich habe noch so viele Erinnerungen zu teilen. So viele kleine Geschichten blieben noch ungeklärt wie die Straßensperre, die wir dem ersten Tag begegneten, der uns vor Charikot und dem alltäglichen Wifi-Hotspot-Spezialisten in ihnen stoppen ließ. Ich hoffe, wir treffen uns eines Tages und ich bin mehr als glücklich, eine andere Reise wie diese zu tun.

PROST!!!

Tanzen 

It was a cold November evening when Dr. Satish, a renowned radiologist in Nepal but currently working in Germany, and who also happens to be my dad’s friend, called me up and asked if I could visit him at his place. I obliged immediately and rushed over. It was here that I met Dr.Tract and Mr.Heinz, two veterans in their late 60s I guess.( I know Dr.tract is smiling,because he’s 70..something) 

  We had an hour long conversation in Deutsch 
obviously, and to sum it up I understood that 
they (probably best friends) came to Nepal in
 the late 60’s as tourists and later fell in love 
with the country and its people and since then
 they seems to have lost track of the number
 of times they came here. If I were to guess,

gute Aussicht, Charikot.

 maybe 40times, says Dr. Tract.

 This time round they had collected some

 funds from Germany and wanted to serve 

the people here and I was given the privilege 

of serving alongside.

Dr. Tract, a pediatrician was involved with the Mission hospital in Okhaldhunga for 3 years in the mid 80’s, his largest stint in Nepal, and since makes regular short visits of 4-8 weeks every year to Nepal.  Whereas Mr. Heinz worked to construct the Trisuli highway way back in the 80’s and more interestingly he even married here in Gorkha the traditional Nepali way. 

It was last year that Mr. Heinz had some issues regarding his hand and that led him to meet Dr. Titos who is a orthopedic surgeon and runs his private clinic in Germany. During the course of his treatment Mr. Heinz shared his story with the surgeon and now he too was impressed and interested to serve in Nepal and hence the 3 Germans landed in Nepal this November. 

Thamichagu - Abschied.

Their mission was to conduct health camps in remote areas of Nepal, 

Last year in the aftermath of the earthquake the two had served in Charikot and Lamjung and thus this year they were keen to see the progress made in the villages.

 After some brief planning, we met one morning and headed to Kalinchowk, Dolakha where we conducted a health camp for 2 days before rambling across to the next village about 45 minutes down south to Thamichagu where we set camp and conducted a day long camp. 3 exhausting days and we were able to serve a total of 420 people. We left with huge hearts and the team was proud

Waghalsige Brücke- Daredevil Bridge.

 of itself.

 During our way back to Kathmandu we 
planned our next trip to Lamjung and 10 days
 later we met again and headed for Ghamar
 Chowk, a Gurung village in Lamjung. Our 
arrival was nothing short of spectacular. 
15 adults building a road just for us, working
 enthusiastically to cobble the streets. Upon 
arrival we were told that this was the 1st jeep
 to come to Ghamarchowk this year. Until now
 only tractors could make it here. 

Moving on we were welcomed by the whole 
village.I was later informed that Dr. Tract and
 Mr. Heinz were here last year after the 
earthquake and had conducted a health camp, 
donated tin sheets as shelter and financially
 aided  some of the villagers in particular a
 mother who had just give birth to two twins and 
now  seeing the two boys run around must have
 brought so much satisfaction to the two. To add

Dr Titos, der gute Lehrer.

 to the long list of the good work the two had
 done,they had also agreed to take a boy Kumar
 Gurung, in his late teens to Germany and to 
give him education and a new start to his 
professional life.

Dr tract by the way adopted a girl "Kanchi" from
 Bal Mandir,(an orphanage in Naxal) when she 
was merely 3 months old. Kanchi is currently in
 Germany and works as a neurosurgeon. 
Dr.Kanchi was here at the Model Hospital,
Kathmandu last year and spent some time serving.

In Lamjung we carried out a camp for 3 
days and served a minimum of 320 people. 

During the last two days we were lucky 
enough to have witnessed a Gurung marriage
 , Kumar’s  elder brother was getting married 
and we were invited, Hundreds of people 
dancing all night with the unlimited 
Pa(local alcohol) was some sight. 

We returned  after a week long stay and
 like last year Mr. Heinz and Dr.Tract made 

some financial aid to the local clubs and 
promised to fund to build a  clean drinking
 water system in the village in the coming days.  

Last week the Nepal Tourism Board appointed Mr.Heinz as their brand ambassador in Germany as a result of his long standing dedication and love towards Nepal.

abschied

I would like to thank Dr Tract , Mr Heinz ,
 Dr Titos for their work in Nepal. I look 
foward to having many more such adventures 
in the future. On behalf of the team I would 
also like to thank CWIN (child welfare in Nepal) 
for their logistic support and special thanks to 
Mr. Bisnu who arranged things so effortlessly.

Das frisch verheiratete Paar

I know some of the people who read this might
 find this a little boring but trust  me, our 
experiences encountered in these 2 weeks 
was nothing short of spectacular and I still
 have so many memories to share.  So many 
small stories still left untold like the road-block 
we encountered the very first day which caused 
us to stop before Charikot and the everyday 
wifi-hotspot specialist in them. I hope we meet
 someday and I am more than happy to do 

mein freund und ich mit traditionelle Gurung kleidung

another trip like this one.

To the team I would like to say a final “PROST”

No Caption needed- Kein Titel erforderlich - Charikot.

Selroti essen 

Prinz Harry aus Großbritannien baute die Schule

Vorbereitungen für das Hochzeitsessen

mein geschenk aus Lamjung

frauen in Thamichagu

Männer bei der Arbeit

abends in Kalinchowk

prost dr titos.

"peperoni munchies"

ich vergesse , was ist passiert, enshuldigung!

ein kinderbett

unser haus

der chef

morgens in Lamjung

abend essen mit dem Hand

mt manasulu 

hochzeit