Description of the service in Kathmandu:
About 250—300 procedures are done annually. These include tumor, trauma, infection, and congenital—both cranial and spinal. No epilepsy surgery and minimal peripheral nerve surgery. Neurosurgery ward is primarily for cranial cases with a separate spinal ward. There is a general ICU and a SICU. Latter usually is filled with neuro patients. Operating theater is modern with Zeiss Contravas microscope, Midas Rex and Anspach drills, 3m craniotome, bipolar cautery, and complete sets of cranial and spinal instruments. The hospital has spiral CT and MRI scanners. Arteriography is limited but MRI angiography is available.
The Tribhuvan University Teaching Hospital (TUTH) has 400 beds and is the primary hospital for the associated medical school on the same campus. The Kanti Childrens Hospital is adjacent and refers neurosurgical patients to TUTH. Both medical students and general surgery residents rotate on the neurosurgical service. There are two fulltime Nepali neurosurgeons. They are general surgeons who spent an additional five years in neurosurgical training. Each passed the USMLE and spent 30 months doing clinical neurosurgery in the USA. They are Dr. Sushil K. Shilpakar (chief) and Dr. Mohan R. Sharma. A neurosurgical residency program is planned.
Role of the volunteer in Nepal
Volunteer will not be the primary surgeon unless it is a technique not ordinarily done by the Nepalese neurosurgeons. A senior neurosurgeon should like to teach on the wards, in the operating theater, and the outpatient department. This is a good opportunity for someone interested in seeing how neurosurgery is done
in a poor country without any health insurance and generally limited resources. A resident will be an active participant in all aspects of the neurosurgical service.
A volunteer practicing neurosurgeon should plan for at least one month and a resident for at least
two months, if possible. |
