Dental Elective in Nepal

The first week in Dhulikhel surpassed all my expectations.

The sheer heat was brutal and the accommodation was basic at best. It served well as somewhere to escape the heat; that is, until I had to climb into the mosquito net that I had very inexpertly hung.  After moving into Dhulikhel Guest House, we quickly left to explore Dhulikhel city to search for an alternative place to stay. Little did we know that the guest house would become our favourite place, our Nepali haven.

We returned to the guest house to voices with northern English accents. After less than a minute it became clear that the voices belonged to two medical students at Newcastle University. One of the students introduced us to all the other people staying at the guest house. Those people became friends for life.

Dhulikhel Guest House cost 800 Nepali Rupees a night (£4.50) and an extra Rs150 for dinner, each dinner outshining the last. Money well spent. The guest house provided free transport to the hospital, albeit in a seven-seater car holding nine. The hospital was a twenty-minute walk away across some very busy dirt roads, which became quite treacherous during rain. For context, our elective was at the epicentre of Nepal’s monsoon season. A cagoule (and spare toilet roll) became our most prized possessions.

Queues of patients lining up to receive treatment became a daily sight, something we all became used to. The same could not be said for the commute to the dental department, which is only 400 metres away from the main hospital entrance. The main hospital is built at the edge of a valley, and the dental department, was built at the bottom. The commute never grew old, the endless steps back up towards the canteen, littered with rubbish and home to well-fed rats will haunt me for a long time.

During the first week of the elective, I met a patient who was receiving reconstructive treatment after being attacked by a bear in his Yak farm.  I also saw many surgical extractions, and orthodontic appliance placements and adjustments. I was fortunate enough to complete dental treatment of my own, including a simple extraction.  The hospital, as a rule, does not give anaesthesia for many dental procedures. We were shocked by the lack of anaesthesia but thankfully the patients tolerated it well. In true elective form, we experienced many power cuts during treatment and had to resort to using our mobile phone flashlights. It was incredible.

For our second week the journey to Charikot was a bumpy four-hour drive through forests, up mountain paths and over a small waterfall.

The hospital was beautiful, perched on a cliff edge to the Himalayas, miles of green mountains and blue skies. We saw less than three dental patients a day as Charikot is miles from any nearby village. The hotel had comfortable double beds, a true luxury, costing £6 a night. Food was at a hut nearby, run by a lovely family who felt intertwined with the hospital’s core. 

On the second day we visited Shree Kalika Secondary School where we ended up performing over 100 check-ups with only a pack of disposable tongue depressors and a hand torch. We learnt basic Nepali phrases to communicate with the children.  We also provided some demonstrations and formed treatment plans for all individual children. It was a hard day and very upsetting to see so many young children with such extensive caries but very rewarding. We all felt like we made a difference that day.

Nepal was always somewhere I wanted to visit.

The culture, the Himalayas and the plethora of vegetarian and vegan food quickly highlighted it as the country I wanted to do my elective in. I would recommend Nepal to anyone who is doing an elective, despite the gruelling heat. It was by far the best trip I have ever been on.

Hari Patel

Stage 5 Dental Student.