Kanti Children's Hospital

Today Yan and I walked then took tuk tuk to the hospital (costs about 10p!). In the hospital I was greeted by Bishop Joshi, who works for KCH in what I understand to be managing the trust fund for oncology patients who cannot afford to pay - KCH Oncology Fund.  Although I had a short amount of time to see one outpatient first, we then spend the remainder of the day listening as he described the history of the hospital. For those of you interested, I will summarize it below:

Kanti Hospital was founded in 1963 by the then USSR, and during this time many students, including medical, went to Russia for their studies. The Russians left the hospital in the 70's, leaving behind much equipment but not always the means to maintain it. At this time, it was a general hospital, although it had 10 beds for children. Around this time, the Nepalese government built the existing red brick building, expanding the hospital to about 150 beds, and it became a children's hospital, KCH. Many doctors and other professionals trained in the UK at this time, including Dr Kailash who trained in India and the Alder Hay Hospital in Liverpool, whereas the other oncology consultant, Dr Prakash trained in the USA.

Nepal started it's first medical school in 1978, in the Institute of Medicine. The first intake took 20 students from healthcare backgrounds and 20 from science backgrounds, which the MBBS curriculum similar to the UK.

In the 80's, the hospital received some equipment such as incubators from Stuttgart, Germany, which replaced some of the old Russian equipment which had fallen into disrepair. They also started a 2-bed Neonatal ICU (although interestingly only about 20% of Nepalese give birth in medical facilities).

Around 1983 the Japanese, under the influence of the late Prime Minister Hashimoto, built a white concrete extension to the hospital, and increased the number of beds to 300. They also gave many grants for further equipment. Sadly the lack of facilities to maintain the equipment is demonstrated by their oxygen plant, which they have not been able to use for the past 6 years due to lack of parts, and have therefore been buying in oxygen instead. More recently, in 2002 an extra 50 beds were added, including a specialist cardiac facility.

Corridor leading to Oncology ward

The hospital has both 'free' and 'paying' beds, separated by wards and barriers. The free beds provide free care, food, etc, where as the paying beds range from about 100-900 NRp (113 NRp to the pound) a night, plus extra for investigations such as X-rays and medication. An outpatient appointment with a doctor typically costs about 20 NRp. To put this in context, apparently doctors earn about 260 USD pcm (once the values start getting higher, they seem to change currency!), although I am unsure of an 'average' wage, if such a thing exists. Evidently the vast majority cannot afford the paying beds, nevertheless.

The patients in the hospital range from those within Kathmandu valley to those many days travel away. Some have moved away from Kathmandu, but 'hills look good from far, but far from good'.

Queue to get an outpatients ticket

From 1997 Carmel Dersch, Bianca Mathesius, Samantha Jefferson and others from Alder Hay have contribued towards the establishment of the KCH oncology fund, which was started by Bishop Joshi (Bishop is his name, not title!). Since then the fund has been maintained in part due to the generous donations of the above and others, and also through charging medical students such as myself. Currently this costs 50 USD per week.

Anyway, changing topic, I have arranged a two day trek out of Kathmandu this weekend with Yan - more of that to follow!