Namaste!
December was a busy month for Initiative
Outdoor. From December 15-17 we ran a WFA course with 8 students only to turn
around on the 19th and start a 5-day AWFA with 11 students. Both
courses were taught at the Kakani
Center for International
Training. The classroom was set up on a mountaintop overlooking the Kathmandu Valley
on one side and the Himalayas on the other
side. During lunch breaks the students, most of whom are guides, would identify
the separate mountain ranges (Langtang, Manaslu, and on crisp days the Annapurna Range and Machapuchare). Despite being
the middle of the winter, it was warm and sunny during the day, which made the
outdoor classroom a perfect venue.
While most of the students in
the AWFA work as guides for the DAV Summit Club, two students work for SIT
Nepal, and one is a professional mountain biker. All but one of the students spoke
varying degrees English, so the course was taught half in Nepali and half in
English. As with the previous courses here, simplifying the medical terms was the
biggest hurdle. Words like “laryngospasm” needed to be dissected (spasm of the
larynx) and redescribed (a closing of the tube leading to the lungs) to make
the material clear. In addition to the challenge of memorizing and utilizing
these terms, the students have the task of remembering acronyms that are based
on English words. For example, AMPLE history is a great tool if you are
familiar with the definition and spelling of “ample,” but if you don't know
what ample means, the acronym has no significance.
Despite these hurdles, the
class had a great sense of humor. Every time a helicopter was called for an
evacuation the call was placed to Washington D.C. because all of the helicopters in Nepal were busy. We were assured that the
response time from the States would be approximately 5 minutes.
Both courses have been
slightly amended to fit the scenarios most likely to be encountered in Nepal, so a lot of time was spent perfecting
splints, practicing with a Gamow bag, and clearing the spine for ease of
transport.
Some lectures demonstrated
marked differences between life in the States and that in Nepal. One Western assumption that stands out
the most came up when teaching about lightning and safe places to go during a
thunderstorm. The course teaches that it is always safe to go into a house, but
two of the students had stories of families being killed by lightning strikes
to their homes. The difference being that the image of a house in the West is
of one that would protect you from lightning. In the examples that they referenced
the houses had dirt floors, wooden sides, and no means for safely grounding the
lightning. Of course that isn't a safe place during a thunderstorm.
Another dramatic difference
between medical care in Nepal
and in the West is response time. Kathmandu remains the only place in the
entire country where one can receive the shots for rabies, yet many of the
areas with the highest risk for rabies are days away from Kathmandu. Imagine
the only resource for the rabies vaccine in the United
States being located in Missouri and the only way to get there is by
driving. Recognizing and addressing the challenges to accessing healthcare in
Nepal is both an integral part of these courses and the impetus behind encouraging
both guides and urban residents to become certified in wilderness medicine.
Initiative Outdoor is
currently advertising a WFR for late February and is gauging interest for more
AWFA and WFA courses for the spring.
Pheri Betola,
Chandra Ale and Initiative
Outdoor
Initiative Outdoor, PO Box 23023, 3/336 Gyanmandala, Jhamsikhel 3, Lalitpur, Nepal
P:+977-(0)1-2111505
E:info@initiativeoutdoor.com
W:http://www.initiativeoutdoor.com
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