Picture it: a hospital without heat. Patients bringing their own blankets. Women delivering babies side by side with little more than a curtain separating them. No public ambulances.
This is the glimpse of Third World health care that UNH students witnessed on a trip to Nepal during UNH’s 2015 January term. Gene Harkless, associate professor of nursing and chair of the nursing department, led the group as they attended lectures and toured various urban and rural health care facilities in Kathmandu, Pokhara, Chitwan and Dhulikhel.
“The whole experience was so eye-opening,” says Kristen Kirkpatrick ’17. “Electricity and heat are an issue. The water isn’t always safe to drink. Transportation is one of the biggest problems. People have to get to the hospital or clinic on their own. Here everything is so fast, so efficient.”
The students — most, like Kirkpatrick, are nursing majors — visited a leprosy clinic, a cancer hospital, a birthing center, a rehabilitation hospital for the disabled, a tropical and infectious disease hospital and several clinics. They got to witness a live birth and a cremation, later learning that the father of the newborn was the nephew of the man being cremated.
“Here was this really ancient ritual and there was the dad showing pictures — he was so proud of his baby daughter — then going back to help feed the fire,” Harkless says.
“It was an honor to witness the cremation ceremony,” adds Olivia Lovenstein ’16. “We were able to stand close by and speak to some of the family members and people who were working at the cremation temples. There was a strong sense of family involvement. This experience was a reminder that no matter what the culture, humans deeply value life.”
Lovenstein, an ROTC student who will be an Army nurse when she graduates next year, has traveled abroad before. She thought she was prepared for the difference in culture that she would find in Nepal. But the country that is among the poorest in the world — roughly half the people live in poverty — was like nothing she had ever seen.
“I’d never traveled to a Third World country. I’d never been anywhere that didn’t have running water,” Lovenstein says. “There were contrasts everywhere. We saw people on the street corners trading goats while, in the hospital next door, they were doing C-sections.”
Resources in Nepal are scarce but the compassion and concern shown by doctors and nurses was impressive, the students say. Family members are charged with daily tasks like bathing and helping patients in and out of bed. Many of the facilities don’t have kitchens; relatives bring in food. The cancer hospital — the most Americanized of the places students’ toured — required a family member be present at all times.
“The whole system relies on families as caregivers,” Harkless says. “They don’t have professional staffs to cook meals, bathe patients, get them water. They don’t have the resources that we do, but there are things they do better, such as end-of-life care. And they manage stress through prayer and meditation. I think it helps moderate the poverty.”
She describes the “Global Health and Culture” class as a focused study tour that provided students with a “very personal connection.” All along the way, they were given the opportunity to ask questions.
“The places we went were very open to us as observers. It brought things alive. There weren’t a lot of barriers in what we were seeing and learning,” Harkless says.
That lack of barriers gave students a greater sense of the Nepali people than they might otherwise have gained. Doctors and nurses were very well educated. They were compassionate. Patient care was paramount.
“It was very basic but it was a good standard of care. The nurses took the time to explain to patients what was going on,” says Kirkpatrick, who is interested in being a traveling nurse. “And, people were happy. I thought maybe in a country so poor, people would be more down or sad, but they were so happy.”
Lovenstein agrees. “I was impressed with how simply people live. They go their whole life and never see a doctor. Here, it’s ‘Take this; have this test.’ I was amazed to see how simply and happily they live.”