In April 2023 the Nepal International Elective took place with 16 UU PA students attending. This month-long elective in Nepal includes the western Annapurna circuit, village health and teaching, rural and urban clinical work, introductory language skills, service projects, and exposure to the culture and history of Nepal. The faculty and clinical team consisted of Richard Backman MD, medical director of the UU PA Program and director global electives; Scott Brown PA, adjunct faculty and urgent care PA at the U; Shelley Moore MD an emergency medicine physician/medical director of multiple urgent care facilities in Fort Collins, CO; and Krissa Wright a PA in urgent care at the U. Both Scott and Krissa are graduates of our PA Program.
The elective location for the first part is Pokhara, Nepal. PA student rotations occurred in collaboration with a local hospital, Gandaki Medical Center and Teaching Hospital. Afternoon introductory Nepali language classes were held for the students and faculty. The second half of the elective involved the Annapurna Conservation Area village of Gandruk that has a rural health post.
The team facilitated outreach health camps and screenings in the villages surrounding Gandruk. Six clinic camps were held with 3 in Ghandruk and 3 in the surrounding communities of Udu, Kimchi and Dliew. It is estimated that 200-300 patients were seen during this time. Child Fluoride treatments were offered. Menstrual kits were distributed. To get to the surrounding communities, the team traversed the “rock stair master” - steep slate steps that stretch for miles and miles village to village. Villagers maintain the steps where teams of donkeys, goats, an occasional water buffalo and locals laden with frequently heavy items, firewood, or other staples journeyed alongside the UU team.
The team had a multi-day trek to complete the Annapurna circuit arriving at Gorepani. Those interested climbed Poon Hill in the very early hours before heading back to Pokhara. A breathtaking twelve mountain peaks 19,000 to 26,00 feet can be seen from this hill station. Afterward, the students spent a few days in the capital city Katmandu for cultural education before their return home.
A former student’s reflections on her time spent on the Nepal Elective:
"..For the next month, I have the privilege of continuing to work with rural healthcare – this time in rural Utah on the Navajo reservation. Health statistics on the reservation (life expectancy, rates of certain diseases, etc.) are often compared to similar rates of mortality and morbidity in developing countries, so there are a lot of medical parallels with my last rotation in Nepal.
Much like Nepal, the scenery coming down here is spectacular (though red rock monoliths and endless blue sky have replaced the lush green and white mountains of the Annapurna). Also much like Nepal, my accommodations are humble – I am living out of my tent at the Monument Valley Tipi Village, which is adorable! There is a central kitchen (with a fridge!), and a HOT shower anytime I want it (so, actually, even more glamorous than Nepal!). Another similarity to last month is the diversity of the community around me. From Navajo to French to German to Swiss to Hindi, the myriad languages I hear each evening at the campground is a lot like traveling internationally. Transiting back to clinic was a bit difficult on the first day. Though I learned a lot about what to do with little to no resources in Nepal, it took me a few patients to remember all that we have available in the States! Even in a place as comparatively remote as Monument Valley, we still have the luxury of a lot of point-of-care lab testing (or the ability to send it out for a patient, without sending the patient themselves to the nearest city). I had to re-learn to change my default thinking from, “that’s not available here,” to “that’s something we can do!”
The biggest lesson from Nepal, however, is still true here: these patients have given up hours of their days to travel long distances to come to this clinic. In the US, where we put such a high priority on getting patients in and out quickly, I’m grateful to my time in Nepal to remember to put myself in the patient’s shoes. I still need to be efficient, but not at the expense of giving the patient enough time to be heard and honored for the effort that they put into coming to see me for care.”
article by Kathy Pedersen, PA-C