I will be traveling to rural Nepal at a remote hospital called Bayalpata Hospital where we will conduct three important trainings for local providers and community. First, we will design and run a disaster drill for the community and hospital. The area is heavily prone to earthquakes and the need for disaster response training is high in the area. Second, we will conduct a week long ultrasound workshop to teach healthcare workers how to diagnose upper extremity fractures, identify emergent conditions and treat them with the aid of Ultrasound. Third, we will provide ultrasound education to cover other trauma and emergnecy care (EFAST, RUSH). These three activities will make a significant impact to local population when it comes to disaster readiness and daignosis and treatment of common emergent conditions. Given lack of other imaging and high tech modalities in this rural area, both of these training programs will serve to benefit the local population.
The people served will be rural Nepali population who otherwise don't have access to health care. The nearest facility with CT imaging availability in this region is 12 hours away, and the use of ultrasound has shown to save lives here. This population was chosen due to my personal experiences over the last 5 years where I have collaborated with the local hospital to conduct various programming and improve prehospital and in-hospital care at this facility. Furthermore, physicians and other healthcare providers in this region will also benefit immensely from this project.
The expected impact of this trip will be two fold: 1) we will have better equipped the local hospital in this disaster prone region to be able to respond to future disasters and mass casulty events 2) we also expect the hospital and providers to have the adequate skills to use ultrasound for diagnosis of emergent condition and use it as aid to treat these conditions as well .The learnings done during this trip will be followed by virtual meetings monthly with the local leaders at Bayalpata and with necessary virtual trainings. Additionally, I will return to the site in November to conduct a refresher training. With trained workforce at this hospital, future trainings will be led by the local staff.
We partnered with the staff of Bayalpata for the research for which we made this trip. These staff, made up of one physician and several health officers, welcomed us completely and worked tirelessly toward the success of the program. Bayalpata Hospital serves a massive geographic area, often with patient's traveling over 8 hours to arrive at the hospital. It is also the only location with an x-ray machine for a great distance. This research project is attempting to show that with sufficient education, the health officers are able to diagnose certain fractures with high specificity and sensitivity. Given their low cost relative to x-ray machines, ultrasound machines could then be used in more rural areas for these diagnosis. This prevents unnecessary transfers that can take days, and cost money that the local people simply do not have. This program also helps to improve the local competence and confidence of providers with ultrasound, leading to a further teaching opportunities in the future and improvement of patient care.
