A day at Kunde hospital

50 years of health care

A day at Kunde Hospital

Dr Mingmar believes Sir Ed would be very happy if he was able to see how the hospital is operating today. “This is what Sir Ed wanted; we have our own hospital with our own doctors.”

As we arrive at the hospital, there’s a late winter dusting of snow covering Kunde and the neighbouring Khumjung village just down the valley.

It’s 9.30am on a Thursday morning and 10 people are waiting on the benches outside the small clinic. Dr Kami Temba, the doctor-in-charge at the hospital, is in Kathmandu for a few days so we meet Dr Mingmar Tshering Sherpa, 29, who is managing the clinic in his absence.

The hospital operates all year round in the Khumbu area, and it services up to 8,000 local people, plus the thousands of trekkers that pass through the region during the climbing seasons. Sundays are usually the busiest day of the week with up to 35 patients passing through the door; the average is about 20 patients per day.

Kunde hospital was built by the Himalayan Trust in 1966.

Kunde hospital was built by the Himalayan Trust in 1966. The hospital was the first in the Khumbu region.

Built by the Himalayan Trust

The Kunde hospital was built in 1966 by Sir Ed Hillary and the friends and volunteers he persuaded to help him. From 1966 until 2002, Sir Ed recruited volunteer doctors, mostly from New Zealand and Canada to help run the hospital.

In 2002, Dr Kami became the first Sherpa doctor to take over the full management of the hospital. Today, the hospital is fully staffed by Nepali medical professionals and funded by the Sir Edmund Hillary Foundation of Canada.

A steep climb

Dr Mingma treats Bemba Doma for a chest infection at his clinic at the Kunde Hospital.

Dr Mingma treats Bemba Doma for a chest infection at his clinic at the Kunde Hospital.

Among the patients is Bemba Doma, age 10, who has made the steep climb from Namche Bazaar to the hospital with her two siblings. All three are suffering with chest infections. During Bemba’s checkup, Dr Mingma also finds evidence of a heart condition, which requires treatment in Kathmandu. Her mother tells Dr Mingma that her daughter has had episodes of passing out and turning blue. As lodge workers in Namche Bazaar, Bemba’s parents will have to work hard to save the funds to afford to take her for treatment in Kathmandu. Today, all three children take away a treatment of antibiotics.

After they leave, Dr Mingma tells us: “I have advised them that as soon as possible they need to go to Kathmandu, but they’re not sure how long it will take to arrange enough money. All three children have respiratory infections most likely due to poor living conditions and lack of insulation.”

The ailments of the other patients that morning included mild altitude sickness, winter chest infections, jaundice, backaches, and a young woman requesting a pregnancy test.

Rural and isolated

Dr Mingmar, from the nearby village of Thame, received the Mingma Norbu Scholarship and graduated from Kathmandu Medical University in 2012. He is now completing a two-year placement at Kunde Hospital and says not only is it good to be working close to his home and family, but it’s also very good medical training to be working in an isolated, rural hospital.

“Working in a rural setting on my own is very challenging, but Dr Kami has supervised me. My placement in the emergency ward in Kathmandu before starting at Kunde was essential experience to prepare me.

“We see a lot of life-threatening cases here and the major challenge is the limited diagnostic facilities. We have a new digital X-ray now so we don’t have to use the dark room anymore and in some surgical cases we can now access the internet to consult with medical professionals in Kathmandu.”

Dr Mingmar says technology, particularly cellphone coverage, has made a significant difference to the service of the hospital: “patients can now call ahead and we can prepare for their arrival or give medical advice over the phone’.

Local care

Fifty years on, Dr Mingmar says he believes Sir Ed would be very happy if he was able to see how the hospital was operating today.

“This is what Sir Ed wanted; we have our own hospital with our own doctors.”

The hospital provides an essential service for expectant mothers. The delivery room and ultrasound facilities are the only option outside of traditional birthing attendants for pregnant women in the area. Dr Mingmar, who was taught to operate the ultrasound by Dr Kami, examines Dawa Jangmoo, 27, and confirms she has just over four weeks to go until her delivery date.

Dawa and her husband Mingmar Sherpa are staying at the 15-bed long-stay facility attached to the hospital. They are both farmers from Thame village, about three hours walk from Kunde. This is their first baby and Dawa said she worries a little bit about the birth and she didn’t want to leave it too late to come to the hospital, so they have arrived quite early to be close to the doctors.

Mingma Temba and Phura Doma

Left to right: Mingma Themba, health assistant; Tsering Thendu, Lab technician; Dr Mingma Tshering Sherpa, and Nurse Phura Doma.

Left to right: Mingma Themba, health assistant; Tsering Thendu, Lab technician; Dr Mingma Tshering Sherpa, and Nurse Phura Doma.

The other staff in the hospital that day included Mingmar Temba, who for 34 years has been an essential assistant, administrator and account-keeper at the hospital. His daughter is currently working in Patan Hospital in Kathmandu and will be the doctor taking over from Dr Mingmar next year.

The nurse on duty was Phura Doma, 25, who was a recipient of a Himalayan Trust education scholarship from Khumjung School. She went on to complete her Bachelor of Nursing in India and is happy to be able to have returned home to practice nursing: “It is very good experience for me here now, so far I’ve already helped deliver six babies.” Phura hopes to complete her Master of Nursing in the near future.

Young lab technician, Tsering Tendu, 21, described by Mingmar Temba as ‘very good in the lab’ was also a Himalayan Trust scholarship recipient from Khumjung School.

Dr Mingmar added: “Kunde Hospital has been running for 50 years this year and providing the same level of care until now. As far as I know, this is the best functioning rural hospital in Nepal.”

By Janna Hamilton, February 2016.