Hi from Jodi Wright and Marie Ellis, 3rd year North Island College nursing students. We came to Nepal to gain insight into different cultures in hopes that it will help us in our future as nurses.
The two of us are currently doing our practicum at Hospice Nepal in Lagankhel, Lalipur. The staff at this facility provides palliative care for patients with advanced cancer. http://www.hospicenepal.org.np/ . It is currently an 8 bed unit with round the clock nursing care. However, nursing care looks different than back home, as the family tends to almost all personal needs including washing, feeding, toileting, and emotional support. This organization provides nursing service and doctor consultations free of charge. It is expected that patients will pay for medications, lodging, and food, if they are unable to pay, then it is also free of charge. In Nepal, many health services are NGO funded, but Nepalese run. Hospice Nepal is one of them, and relies on donations to stay running. Hospice Nepal utilizes the information suggested and provided on the World Health Organization (WHO) website for palliative care and pain management.
The idea of Hospice in Nepal is a very new concept and is met with hesitation and resistance from health care workers as well as the Nepalese people. This is partially due to the cultural influences surrounding illness and death. For example, it is not an unusual occurrence for the patient to be unaware of their current disease and prognosis. It is the family’s decision on how much a patient is told. At the same time, they will talk about the illness around them, somehow presuming they do not understand.
So far, our experience at Hospice Nepal has been different than expected, as the workload and priorities are much different than in Canada. We have learned a lot from the nurse we have been following as he is full of experiences, insight, and cultural information. He seems to be taking on a lot within the organization as he is also the primary home care nurse.
We have been lucky to have him as our primary preceptor because of the vast experiences he is able to share with us, including the home care visits that we have been able to partake in. Although home care is relatively new, it is not that much different from back home, and focuses a lot on the relational practice aspects of care. The nurse listens to the patients and family’s needs and concerns, and then works with their resources to attain a more suitable and client focused care plan. Home care has taken us to areas of communities we may have never seen otherwise, and are rarely visited by tourists. It has opened our eyes, in the sense that we are able to put faces to the places we see. As it is one thing to see a picture of hardship, it is another to get to know the person behind the face, and begin to gain insight into how they manage to get to where they are in the world in which they live.
After an exciting and scary river rafting experience down the Bhote Kosi River that originates in the Himalayan Mountains of Tibet, we are back in the Kathmandu Valley and ready to start back into our school routine. The rafting showed us aspects of Nepal that you can only see from the river, the children swimming, garbage and sewage dumping in from the houses above, people fishing with homemade rods, elders resting, 
water buffalo bathing, farmers working their fields, farmers herding yaks or goats, monkeys climbing on the cliffs, bees nesting and building honey comb in the rock, and cremations on the river bank. It was an experience of a lifetime.
The two of us are currently doing our practicum at Hospice Nepal in Lagankhel, Lalipur. The staff at this facility provides palliative care for patients with advanced cancer. http://www.hospicenepal.org.np/ . It is currently an 8 bed unit with round the clock nursing care. However, nursing care looks different than back home, as the family tends to almost all personal needs including washing, feeding, toileting, and emotional support. This organization provides nursing service and doctor consultations free of charge. It is expected that patients will pay for medications, lodging, and food, if they are unable to pay, then it is also free of charge. In Nepal, many health services are NGO funded, but Nepalese run. Hospice Nepal is one of them, and relies on donations to stay running. Hospice Nepal utilizes the information suggested and provided on the World Health Organization (WHO) website for palliative care and pain management.
The idea of Hospice in Nepal is a very new concept and is met with hesitation and resistance from health care workers as well as the Nepalese people. This is partially due to the cultural influences surrounding illness and death. For example, it is not an unusual occurrence for the patient to be unaware of their current disease and prognosis. It is the family’s decision on how much a patient is told. At the same time, they will talk about the illness around them, somehow presuming they do not understand.
So far, our experience at Hospice Nepal has been different than expected, as the workload and priorities are much different than in Canada. We have learned a lot from the nurse we have been following as he is full of experiences, insight, and cultural information. He seems to be taking on a lot within the organization as he is also the primary home care nurse.
We have been lucky to have him as our primary preceptor because of the vast experiences he is able to share with us, including the home care visits that we have been able to partake in. Although home care is relatively new, it is not that much different from back home, and focuses a lot on the relational practice aspects of care. The nurse listens to the patients and family’s needs and concerns, and then works with their resources to attain a more suitable and client focused care plan. Home care has taken us to areas of communities we may have never seen otherwise, and are rarely visited by tourists. It has opened our eyes, in the sense that we are able to put faces to the places we see. As it is one thing to see a picture of hardship, it is another to get to know the person behind the face, and begin to gain insight into how they manage to get to where they are in the world in which they live.
After an exciting and scary river rafting experience down the Bhote Kosi River that originates in the Himalayan Mountains of Tibet, we are back in the Kathmandu Valley and ready to start back into our school routine. The rafting showed us aspects of Nepal that you can only see from the river, the children swimming, garbage and sewage dumping in from the houses above, people fishing with homemade rods, elders resting, 
water buffalo bathing, farmers working their fields, farmers herding yaks or goats, monkeys climbing on the cliffs, bees nesting and building honey comb in the rock, and cremations on the river bank. It was an experience of a lifetime.
We have visited one elder care facility, where Cathy and the two of us gave out toothbrushes, toothpaste, bananas, watermelon, and candy to the 35 residents. While there we visited with residents, listened to a few people’s lungs, and looked around. Traditionally, elders are held with high regard and respected and cared for by family and communities. Old age is considered a time for relaxation, prayer, and meditation. Hopefully by the time we do our next posting, we will have had a little more of a chance to visit and learn about other elder care facilities in the Kathmandu Valley.Even with the current political situation here in Nepal, that leaves the country without a government, we are all well, safe, happy, and having a great experience.
Till next time
~ Marie and Jodi
~ Marie and Jodi
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