We are very grateful to the large number of ENT surgeons who have joined the camps over the years, some have returned many times. We are particularly keen to have specialists in ear disease and ear surgery. We all share the outpatient and surgical work. Both are fascinating, there is a very large amount of ear disease and most patients have significant problems, many difficult diagnostic dilemmas and treatment decisions. The opportunity to examine out patients together and discuss the treatment options is invaluable. We have to take into account the particular needs of people living tough rural agricultural lives, often with limited education and little access to any on-going health care. On some camps we may be supported by a GP to help with OPD. Two of our operating microscopes have video screens attached, so we can see each other’s procedures. We see many patients two or three times as they return after ear syringing, audiometry or perhaps a couple of day’s medication. Most patients will have walked several hours and some for several days in order to see you. We want to offer the best quality advice and surgery that we can to each one.

surgery 2

All patients are reviewed on the last day of the camp. They receive written information and medicines. We explain in detail how to use the medicines and what to expect. With long experience working in Nepal both full time and over many ear camps it is clear that regular follow up is not as necessary as we assume in developed countries. Surgical techniques must be appropriate to the situation since many patients will not have any opportunity to see an ear specialist again. (E.g. large meatoplasties are essential, staged procedures are rarely appropriate). We frequently see post-op patients from previous camps and have found that the results of surgery have been very good and certainly as good as we see with regular checks in the west. We always leave instructions at the DGH that if there are any complications that cannot be dealt with locally they may send the patient to our HQ in Pokhara for treatment and we will cover all costs. Patients are all given our Nepal office contact details.

We take a good range of medicines for treating ear diseases and other common general ailments. Our camps co-ordinator worked in a large hospital pharmacy for some years and he and a colleague act as camps pharmacists, expaining dosages to the patients. We give out simple advice leaflets in Nepali language, such as how to keep water out of the ears.

Volunteers are given a camps formulary list and have a review of the local medications available on arrival.