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Deafness is the commonest single disability in Nepal. The Britain Nepal Otology Service (BRINOS) was established in 1988 with the aim of reaching out to people living far away from the nearest ear surgery in Kathmandu.
Since November 2012, I have been volunteering with BRINOS and working in a surgical ear camp in Nepalgunj, Nepal. The camps take place several times a year and aid Nepalese ENT surgeons in providing expert treatment to those suffering from ear disease in the town and surrounding areas.
BRINOS volunteers also assist in the training of Nepalese doctors making a career in ENT surgery; raise vital funds for instruments and to send highly qualified people to take part in the ear camps; and serve to advance Primary Ear Care as a means of reaching out to the greatest possible number of ear disease sufferers. The ultimate goal is to reach a point where there are sufficient surgeons and associated healthcare professionals to staff the Regional and Zonal Hospitals across the country.
In countries such as Nepal, antibiotics are in short supply meaning that infections can often go untreated. If a patient has an infection in the ear, they may not be able to work. Children may be excluded from school which means they can miss their education. A simple operation can therefore make the world of difference but unfortunately, Nepal is not yet equipped to offer treatment to every patient they encounter. The volunteers at BRINOS ear camps make every effort to treat as many patients as possible during the time they are there.
When I first visited Nepal, our operating theatre was set up in a disused house. Old equipment, donated from the UK, was assembled in the front room, whilst ‘operating’ tables were propped up on bricks. It was makeshift, to say the least, but within the week we operated on over 100 patients who were suffering with ear disease.
During my latest visit, it was great to see how the ear camp had developed and BRINOS have recently established a new, purpose-built ear care centre providing a base for ear health for the region. The formal opening of the centre occurred during my visit this time. It provides modern facilities for ear surgery for the visiting doctors, such as myself, and the Nepalese ear surgeons. Sound–proofed audiology rooms and dedicated outpatient facilities allow for accurate assessment of patients whilst a ward provides patients with a place to recuperate following surgery. The operating area is spacious and well-lit allowing for three operating tables to run at the same time.
The pathology we encounter in Nepal is often much more complex than we are used to here in the UK – the ear drum perforations are huge and a surgical challenge. There is usually associated hearing loss. As such, our work is vital and with so many people suffering from the disease, we try to treat the patients as best as we can under the working conditions available to us.
We receive follow up results a year after the work so we can assess how successful the ear camps are. While the success rate of the surgeries taking place in Nepal may not always be as high as here in the UK, they are still excellent and must be considered in the circumstances of where the surgery was performed.
My time in Nepal has been eye-opening. It is tough work but hugely rewarding and opportunities like this are one of the reasons I wanted to become a doctor. It really feels like we’re making a big difference and watching the Nepalese staff improve makes all our hard work feel worthwhile. BRINOS has come so far since it was established in 1988 and I’m looking forward to seeing further changes on my next visit.
Finally, thank you to The Tinnitus Clinic for their support and sponsorship of my work in Nepal.
An important part of my mission at The Tinnitus Clinic is to share our knowledge of tinnitus; its causes, how to prevent it and what to do if you are suffering from the condition. This blog will go some way in achieving this aim.