2010 spring camp, by the chairwoman

This year's spring camp, from 3 to 24 April, was a very special one:

What a warm welcome we were given in the new villages in Dhading.

What a lively team spirit was present in all of the teams.

What fun it was with the trainee gynaecologists.

What a sophisticated digital recording system we had on the small laptops.

What good and enthusiastic contacts we had with many Nepalese.

And what a weird end: we were stuck for more than a week in Kathmandu due to a volcanic eruption.

The report

Field team I spent the first week in two new villages and a follow up village, in the Dhading district (Jyemrung, Salyantar, Naubise). In Dhading, RHEST, our permanent counterpart, worked together with a local NGO, Global Health Society Nepal.

A great start: after a long journey over the well-known rough roads, we arrived in a beautiful valley near Salyantar. We were given a very friendly welcome at a farm, situated on a hill with a magnificent view. After a good night's sleep, we discovered that our hosts had slept outside after given us their sleeping places. Such touching hospitality.

It was very busy in the school, and the next days in the local Health Centre. A truck even arrived, from which the women in their red dresses almost tumbled out.

The local team of aid workers worked as hard as they could. The cooperation and the enthusiasm of everyone was heart warming and very encouraging. As a result we managed to examine and treat about 1000 women in the first week. We had insufficient materials for such large numbers. In particular we ran out of rings. We had to place an urgent order in the Netherlands. Luckily our gynaecologists and the second field team arrived a week later. They were accompanied by very heavy bags.

Salyantar

In week two, we had two field teams and four gynaecologists at work.

The field teams were occupied in various locations with follow-up examinations and seeing new patients. We visited the villages of Mecche, Narayanstan, Thulo Parsel, Bhakundebesi and Shaktikor.

Field team II led by gynaecologist Loes Harmsen introduced a new digital registration system. Using mini laptops, the women's details were quickly entered by enthusiastic volunteer Henne van Egteren supported by Joke Stevens who also helped in the clinic. The software was written by Hans Lammers together with Henne, who both work in Deventer Hospital. What a great effort.

Henne and Joke

In addition to the fieldwork, Loes worked in the Dhulikhel hospital, where together with the local gynaecologists she operated on a number of patients who had complications after previous surgery. This improved the competency of the local gynaecologists somewhat.

The other team cooperated in week two with the Karuna Foundation in the Timal region.

Meanwhile, gynaecologists Jan Vonk and Astrid Vollebregt were working enthusiastically in the Scheer Memorial Hospital. They supervised two trainee gynaecologists, who had hardly developed any surgical skills.

Ashika and Astrid

Mark Vierhout had his own programme at the gynaecology department of the Maternity Hospital. Here he performed operations and provided training.
Mark Vierhout and Molly Verdegaal gave a presentation at the annual congress of the Nepalese gynaecologists association. Mark's presentation addressed the limitations of the use of mats in pelvic floor surgery. Molly held a presentation, in part together with Mark, addressing the use of rings in Nepal and the experience that Women for Women has had with this treatment.
In addition to two general practitioners, in total four young Nepalese trainee gynaecologists from the academic Maternity hospital in Kathmandu worked with the teams. They were very enthusiastic and told us that they had learnt a lot.
Nepalese nurses also worked in the teams. Here, the previous training given in our field clinics bore a lot of fruit. In particular our junior nurses Bimala and Yamuna worked almost like fully trained doctors.
The local health workers were now trained in a very structured way and with a great deal of verve.
The morning started with a theory class followed by practice. So many health workers attended the training sessions that sometimes we did not see the patient between the "uniforms". This required some action to be taken. Certainly a point where we can improve. In addition, privacy and how the patient is approached requires continual attention and correction.
A very enthusiastic intern from the Netherlands, Gabrielle van Ommeren, also worked hard. Within the context of her scientific internship, she carried out follow-up research, holding in-depth interviews with a number of women.
What is also nice to mention is that a Canadian documentary maker accompanied us for a day to film our work. A documentary concerning “Reproductive Health in Nepal" is on its way.
The organisation by Rhest, our local partner, went smoothly. But still, there are always unexpected situations and problems. For instance, the response in Thulo Parsel was very low. The cause seems to lie in a variety of things. In Naubise, the second day was not very busy and the National Immunisation Day kept the health workers busy. National holidays including New Year and Mothers' Day also did not help. In Timal, the logistics wasn't always that well arranged. In Naubise, our sleeping accommodation was extraordinarily miserable.
Lots of discussions were held with local partners and the government to improve the structure and cooperation. We are also looking into further research opportunities on the request of the Nepalese authorities. Here our new Nepalese representative Deepti Khakurel has an important task.

We finally managed to see almost 1700 women in the two weeks and about 50 had surgery. We trained many health workers in the health posts.

And then… after all this work, we wanted to go home. No way: a volcano in Iceland spoilt the fun. All air transport was cancelled. The gynaecologists performed some more operations, we investigated Rhest's financial accounts, we hung around airline offices and walked in the mountains. After being forced to wait for eight days, finally everyone could go home.
All of the team members and assistants: did a great job, with a lot of enthusiasm and without complaining about the sometimes very difficult circumstances. Fantastic. On behalf of the women of Nepal: many thanks.

Molly Verdegaal