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A Retired GP in Nepal

Most doctors, when they start at Medical School, have a sense of vocation. I always felt it was a privilege to be a doctor, even as I approached retirement, but the increased pressure on General Practitioners, in recent years, made me feel like the red queen. However hard I ran, I could not keep up and provide patients with the quality of care that they wanted, and that I felt they should have. So I retired. I had a pension and no longer needed to earn a living, but what about my vocation? For two years I prayed for God's guidance and he appeared to say, 'Go and practise any skills you have, not for money but for the love of God in the mission field. I felt totally inadequate. I had no surgical skills - I could not do a Caesarean section. I had no useful foreign language and with a frail and elderly father did not feel I could offer more than two months. It seemed hopeless. However, I attended the Residential Refresher Course held at Oak Hill and while there was invited to go to Nepal as the GP to the missionary families of INF (International Nepal Fellowship) at their headquarters at Pokhara.

Worship and Work
Normally new missionaries spend the first three months in language study and orientation. I could have done with the orientation! It is very rude to show people the soles of your feet, but in a Nepali church you sit cross legged on the floor. With arthritis of the hip this is impossible, so I sat with my legs straight out and for the next two hours insulted about two hundred people.

My job was to be GP and most of the work was treating upper respiratory tract infections, abdominal upsets, arthritic joints - the usual GP problems. I was also required to do 'medicals' on school children, missionaries over 50, folks going home, and immunisations.

The Conference
The highlight of the INF year is conference'. This is a time when all 180'INFers', if possible, come to Pokhara for a week of worship, business and fun and of course injections! The nurse in charge of the schedule is extremely efficient and on the notice board each day was a list for everyone and comments that Pooh bear would have made! Injections are needed for DPT, Polio, Measles, Rubella, Mumps, Typhoid, TB, Rabies, Meningitis and Japanese Encephalitis. I think we gave about 180 injections each. It was quite trying having so many small children, on three or four consecutive days. The kids were fantastic, but by the end of the week they were feeling less brave and the one year olds of course didn't know they were supposed to be brave!

I also offered 'medicals' to the people coming in from the villages. It takes two or three days walking to get to Pokhara from some of the outlying camps, so they don't just pop into the surgery for every little thing. Quite a lot of people, usually families, took up the offer. Over the two months I saw two thirds of the people there. The surgery was a little hut about ten foot square at the edge of the lawn of the main compound. The waiting room was under the trees and very pleasant in February and March, but I do wonder how they are doing now that the monsoon has arrived! We kept a few drugs in the surgery; antibiotics, pain relievers and of course ketokonazole for the dreaded giardia For anything else I wrote a letter to the pharmacist in the local bazaar, who in his ten foot by six shop, kept a remarkably sophisticated variety of drugs. Most drugs were manufactured in India. There were a few which were just unavailable anywhere. The ones I missed most were Fluconazole and PVC Ring Pessaries.

My Colleague
Elsie was the nurse. She was Indian and had worked with INF since the days of the Shining Hospital, built in 1953 and named because it was built of aluminium which shone in the sun.

Her husband was an elder of one of the local churches and in quiet spells we had many a fascinating conversation about the Nepali church; the cast system, the rejection of Christians by their families, the poverty. Every morning Elsie held a surgery and saw the Nepalis from the compound. For one week she went back to the hospital for a refresher course and I took over her surgery. I was trying to work my way through basic Nepali for beginners and could manage 'dishaa laageko chha'- 'does he have diarrhoea, or stomach ache or headache?' - but important words like 'have you been coughing blood or had pleurisy?' just weren't in the book. I had to find the nearest experienced 'INFer' to act as interpreter, or resort to mime, which led to much hilarity but little comprehension.

On Call and Off Duty
I lived on the compound and was on call most of the time, but did feel free to take the odd weekend or half day off. There was only one night call. A visitor knocked on my door early one morning saying, 'I feel awful, I'm being sick'. There was one person whom I visited. I set off on the back of a motorbike but it was another lovely day, so I continued on foot. I visited the General Hospital, where the INF has three surgeons, a pharmacist, several nurses and technicians working for the Government, and the Leprosy Hospital. The General Hospital is tremendously busy and apparently chaotic, but the milling crowds that passed through the entrance hall at 9 a.m. had all disappeared by 1 p.m. I was very impressed by the ability of the staff to work cheerfully and effectively, in spite of the innumerable interruptions. Green Pastures, in contrast, was beautiful and peaceful. I was impressed by the appliance room where they were making artificial limbs out of drain pipes and bicycle hubs; light, efficient and thoroughly practical.

I went to Nepal to give, but I received so much more than I gave. The memories; beautiful people, love, laughter and caring , beautiful country, those incredible mountains, the crimson flowered trees and the orchids and the depth of the worship, especially during conference and a complete reassessment of priorities.

I will lift up mine eyes to the mountains.…
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