http://www.rannepal.org
Medical volunteers in Nepal
Thank you very much for your interest to volunteer in Nepal. RAN works with doctors and local nurses at the following hospitals and healthposts where you would be very welcome to help.
RAN works with Nepalese doctors in hospitals that can offer assistance to volunteers in exchange for their time and help. RAN doesn't charge any fee - volunteers pay for their food and lodging directly to the hospital or host/hotel where their stay. Obviously if volunteers want to donate anything, they are most welcome to do this either via RAN or directly with the hospital where they are volunteering.
Hospitals
In general, doing OPD at hospitals can be a problem unless there is staff available to translate. In particular, training is very valuable at all levels. The hospitals make a nominal charge to medical students (75$/month) that goes to the Hospital Development Fund to subsidize medicines and treatment for poor patients.
Gulmi District Hospital
Gulmi District Hospital is a government 15-bed hospital a few hours by road west of Pokhara, with the Annapurnas to the north. Two Nepalese doctors, sponsored by the American Nick Simon Institute (NSI) are helping raise standards of medical care here. Over a hundred patients are seen a day, with two or three deliveries and one or two operations a day performed by Dr Kashim Shah, one of the two NSI MDs here. He can supervise elective students and doctors volunteering here. There’s every chance to be involved in a wide range of procedures, obstetrics, possibly a visit to healthposts, and in return training staff is very much appreciated.
Gulmi District Hospital although a government hospital, receives good support from NSI not only in terms of trained and skilled staff, but in additional resources.
Accommodation is available either in a simple hotel a few minutes’ from the hospital, or at the home of one of the staff nearby. It takes 8-10 hours by to reach Tamghas by bus.
Tamekoshi Cooperative Hospital http://tss.com.np/menu_07_tamakoshi%20hospital.html
In Ramechapp district in eastern Nepal, this cooperative hospital is in Manthali, the district headquarters. Run by Dr Suman Karmacharya, it is a hospital funded from savings and credit schemes and local people. It also provides medical camps and outreach work, and has a number of specialists visiting at different times throughout the year. Here Dr Suman welcomes doctors, nurses, medical students - in fact anyone with something to contribute. For the non-medic, local schools are always in need of assistance teaching English.
Tamekoshi Cooperative Hospital works with the government health system but does not receive any financial support, instead relying on support by the local community. RAN and HEXN (UK) are providing some support for medicines as well as sending medical volunteers to this hospital that uses their skills to good effect.
Accommodation is at the hospital and there is a small canteen where you can get your meals. Buses leave the Old Bus Park in Kathmandu at 7am and 9am every morning and it takes about 6-7 hours to Manthali.
Sub-healthposts/clinics
Usually there are no doctors working in healthposts and there will be typically there are one or two ANMs (Auxiliary Nurse Midwives) or CMAs (Community Health Assistants) who see patients. Help is useful in treating patients, but more importantly, providing one-to-one training in diagnosis skills to the nurses. Usually open between 10am and 2-3pm Sunday to Friday, healthposts see from 12 to 40-60 patients a day on average. Most nurses speak some English and are usually fairly competent with medical English, even if weaker on conversational English. Patients do not generally speak any English, but often understand Hindi.
Friendship Clinic, Megauli, Chitwan
This community clinic is supported by a British charity and provides a range of services to the local community. About 12-15 patients are seen per day (Sun-Fri, 9am-5pm). Doctors from a hospital a few hours by road come on some days for a few hours. Otherwise the clinic is run by nurses. Accommodation is at a lodge next to the hospital.
To reach Megauli, take a bus to Chitwan (Naranghat - 5 hours) and a local bus (2 hours). Megauli is close to Chitwan National Park.
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Further information
Nepal has been 'in transition' for the past six years, following the decade long Maoist insurgency that ended when the king abdicated. Since then, the government has been unstable, but other than the inconvenience of strikes from time to time, the country has been peaceful. For most of the past year there have not been any major strikes (as at January 2013), but the constitution is still not completed, the politicians continue to argue and so the country is still unstable. However, though strikes very inconvenient as transport grinds to a standstill across the country, as long as you can allow some flexibility in your travel plans (reach Kathmandu a day or two earlier than your flight home for example), then there should not be any problem. Hospitals usually can get around the worst of problems as they have ambulances which can be used in emergencies other than the medical variety!
Accommodation
Kathmandu: RAN has a discounted rate at the Tibet Guest House, a good hotel in Thamel that offer free airport pick up and good standard quality rooms (14$ single or 18$ double inc. taxes). This hotel comes recommended. Cheaper hotels are available, though usually you have to pay extras like tax (10% service + 13% VAT) and the taxi from the airport. Taxis from the airport to Thamel normally should cost around £3-4, though you will invariably be asked for more.
While volunteering: At Gulmi Hospital, accommodation is available at the hospital or in homes nearby. For family accommodation, budget on £6-8/day and if you have to stay in a hotel, expect to pay a bit more, around £7-9. Food at hospital canteens is very cheap.
At Tamekoshi Cooprative Hospital they have accommodation and a canteen, though if you are out a medical cmapor healthpost, you may stay at family homes. Budget on around £6 for your accommodation and food.
Food
Many volunteers succumb to stomach upsets at some point during their stay. Hygiene is not a priority in many kitchens, so at least to start with, exercise caution with where you eat. It's a good idea to come prepared with rehydration salts and emergency Immodium just in case.
Restaurants in Kathmandu offer a variety of food, from Thai, Indian, Chinese, ‘Continental’, French, to Tibetan, Nepalese and so on and tend to e fairly safe. Once outside of the city however, food tends to be much more limited in choice (and cleanliness). Dal bhat (rice with dal soup and vegetable curry, (sometimes meat) is generally eaten twice a day at around 10am and 8pm, with a light snack meal around 3-4pm. Chicken, mutton (goat) and pork is usually eaten, with fish being a rarity unless you are close to a river or lake.
Nepali tea is served everywhere and is sweet – the sugar is added with the milk and tea and ‘cooked’ so if you don’t want it sweet, this will usually mean a longer wait as it will have to be made specially.
Water is unsafe virtually everywhere you go. Best is to drink boiled water (which is easy enough at the hospitals). Mineral water in bottles is available in some places though the plastic bottles and the purity of the bottled water are problems. Ideally, if you have a filter, or can treat water with iodine, this should minimize the risk. When water is said to be filtered, don’t trust it, as this won’t have removed some of the more serious water-borne nasties.
Transport
Travelling in Nepal is invariably on buses and very cheap and afive-six hour bus journey won't cost more than about five pounds.
Journeys tend to be long and slow and the roads everywhere (except a short stretch near Kathmandu) are usually in a terrible condition. This is even worse during the summer months when the monsoon can lead to landslides and mud that slows if not stops the progress of buses in the more remote areas.
The road to Tamghas, district headquartersof Gulmi and where the district hospital is located is blacktopped, but narrow and winding. Microbuses go to Gulmi and take a bit less time than the big buses. They can be easily booked in advance by Dr Kashim Shah from the hospital and they leave at 5:30am from Sundhara, which is handy as it is near to Thamel.
Buses east to Manthali, district headquarters of Ramechapp leave from the Old Bus Park at 7am and 9am every day.
Weather
If you have the choice, the monsoon is the time to avoid (mid June – mid September) particularly if you plan on going trekking. This is when it is quite wet and can be in some places very hot and humid (Chitwan is very hot). Trekking is not impossible during the summer however, only be prepared for a bit of rain and maybe leeches in the lower elevations; once high however, it can be very pleasant (the rain is falling below you) and less crowded.
During the autumn (mid September –November), the weather is dry and mild, getting colder through to December till February when it starts to get warmer. It stays generally dry throughout from October to April, though May tends to be hot and humid as it starts to build up to the monsoon.
During the winter months, it is generally quite cold though Gulmi is generally colder than Manthali which is a bit milder in winter. The worst of the cold is mainly due to concrete buildings with no central heating. It is sunny during the day however, and can get quite warm (18-20 degrees C).
Money
Outside of Kathmandu, there are very few ATMs. It is recommended to take all the cash you need with you. Like anywhere, you need to be careful, but Nepal is probably less dangerous than most countries in the world (whatever you might read in the Lonely Planet). Even if the small towns outside Kathmandu have banks, they generally find it all but impossible to exchange foreign currency, so it really is best to change money before you leave Kathmandu (or Pokhara).
Outside of Kathmandu, no one will usually accept US dollars for payment though Indian currency can be accepted, especially in the south (Terai) and in Kathmandu.
Ideally, change as many large 1000Rs notes into smaller notes as everywhere has a problem with small change. In Kathmandu they invariably ask if you have smaller change, but don't give in - they can generally get it easily enough in the city, but outside it’s much more of a real problem.
Visa
You can get a Tourist Visa on entry to Nepal whether at the airport or at land entry points. You need a passport sized photo and you complete the forms on arrival.
Thirty and ninety day visas are available at 40$ and 100$, payable in your own currency. NOTE Indian Rupees are NOT acceptable. This will invariably be cheaper than getting the visa in advance at the Nepalese embassy abroad, and a lot quicker.
However to renew your visa (Kathmandu or Pokhara), you pay in Nepal Rupees, and not in hard currency.
Be careful at Immigration wherever you come in or extend your visa that you to clearly state you are a tourist, as in theory, volunteers are not supposed to work on Tourist Visas. However, since there is no longer a Volunteer Visa, this cannot be avoided and it accepted. However Immigration could use it as an excuse to be difficult and they are very corrupt.
Dangers and annoyances
Nepal is perhaps one of the safer countries left in the world, especially away from the main towns. However, you need to be careful, as robberies do occasionally occur. Don’t leave valuables in a bus unattended and in Kathmandu, be careful in crowded places as there are a few pickpockets around.
Don’t trek alone. There have been some reports of a few people going missing or meeting with an accident in the past few years.
Nepal is classified as a low risk malarial country, though reports vary depending on where they come from. Malaria was officially eradicated in the 1950s, but there are still occasional occurrences. These are usually from people who have come back from India, where the problem is still bad in some areas. Other than in Bardiya and Megauli, there are few mosquitoes (the worse time is during the monsoon months) and during the months of October to February, even here, there are very few mosquitoes.
There is some risk of dengue fever and Japanese Encephalitis where the best cure is prevention, whether by repellent or mosquito nets.
Rabies is prevalent. In general the street dogs are not particularly vicious but be careful of cats, as they often tend to be semi-feral and often will bite! They can carry rabies too.
Beware the beggars in Thamel, more often than not are from India. Often carrying a baby, they ask you buy expensive powdered milk, which invariably they then sell back to the shopkeeper.
Trekking
If you are interested in trekking, RAN can put you in contact with local guides from some of the villages where RAN is working. RAN works with a school and healthpost in the lower foothills of the Everest area and also has contacts very familiar with the Annapurna area and other trekking regions. It is much cheaper to book your trek from Kathmandu. RAN advises strongly that you take at least a porter or guide as accidents do occur, especially when going to any altitude.
Application
If you would like to volunteer, please let RAN know the following information: