EAR CENTRE - GREEN PASTURES HOSPITAL - SEPTEMBER 2019


SUNDAR GAIRE

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Sundar Gaire (32 years) is from Waling-3, Syangja, one of the adjoining districts of Kaski. It takes two hour by drive to reach there from Pokhara.He lives with his wife, father, mother and two daughters (7 years and 3 years). He studied up to tenth grade.
Sundar works in Dubai as a foreign employee. While working there he often went to swim in the swimming pool in order to tackle the heat. Unfortunately, one day water entered into his left ear. As the days passed, he began to realise that his listening power was diminishing day by day. Afterwards he went to the hospital in Dubai and started treatment. But his problem couldn’t be healed. After sometime he returned back to Nepal.

In Nepal, one of his relatives suggested him to visit ear centre in Green Pastures Hospital. So he visited there three months ago. He was diagnosed with chronic suppurative otitis media (CSOM) with left osteoma. Therefore, he was admitted in the hospital and his vital signs were taken and recorded. His hair trimming was done. Next day he was planned for left ear revision mastoid surgery under general anaesthesia. So he underwent small atticotomy with Tympanoplasty, canaloplasty and osteoma removal, an intermediate ear surgery. Beside this he also received laboratory services including biochemistry and serology test, blood test and urinal test, ECG and Pure tome audiometry. After surgery, while examining facial nerve, mouth couldn’t stretch to the left side. Nystagmus on the left side and facial nerve palsy was seen on left. Then physiotherapy for facial palsy was provided as well as vital signs were taken and medicine was provided to him. After staying in the hospital for four days, he was discharged.

After nearly three months, Sundar was back in the hospital for the follow-up. This time he came for the treatment of facial nerve palsy and underwent left revision mastoid exploration under general anaesthesia. He received medical charity support from the ear centre for his treatment.

Sundar and his relatives are happy that Sundar’s hearing has improved and he is much better and also he has received the medical charity support from the hospital, which has reduced some economic burden. Moreover they are glad to see the friendly and clean environment of the hospital.



BURTIBANG - APRIL 2019

SAPANA RASAILY

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Sapana Rasaily (name changed for anonymity) is a 25- year-old woman from Baglung district and she is farmer and a housewife. She lives in a joint family along with her 2 sons.

When she was 6 years of age she developed a wound in her right ear with regular discharge of pus. During that time in her village there were no proper heath facilities and there were very few vehicles. On top of this she belonged to a poor family and could not afford to go far for treatment. She tried home remedies for her ear and after some time her wound healed. Although the wound was healed she gradually started to lose her hearing and she didn’t expect this, but there was nothing she could do. From 24th- 26th April, Green Pastures Hospital conducted a three-day ear outreach camp in Burtibang of Dhorpatan Rural Municipality (RM). She, being a neighbouring resident of Burtibang RM, heard about the ear camp. In the hope of hearing again, she decided to consult the doctor in the camp and did so. In the camp the doctor, after examining her case, suggested she visit the Green Pastures Hospital as her treatment was not possible in the camp.

Following the doctor’s suggestion she visited GPH and she was recommended for surgery and after the agreement with the patient, the doctors operated on her right ear. The doctors also suggested for surgery on left ear as well, after she had recovered from the first operation. Due to hearing deficiency she had left school when she was in grade 4. After surgery she feels lightness in her life and is able to hear much better than before. She is hopeful that in the near future she will be able to hear clearly once the operation on her left ear is done. Previously due to her low hearing she could not communicate easily with other people and even her family members, which used to make her life difficult.

She is very thankful to GPH for conducting ear outreach camps near her home. “If there hadn’t been the ear outreach camp, I might never have been able to correct my hearing deficiency,” says Mrs. Rasaily.



MARCH 2019 - POKHARA

RITA’S STORY
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Rita Kishan (name changed for anonymity), a 23 year old girl is from an extremely poor and backward family. She is from Baglung and lives with her father, mother, elder brother and sister in law. She also has a 3-year-old son. Her husband left her when she was pregnant. She, her father and mother work on a daily wage basis to support the family.

When she was 9 year old she developed a big swelling behind her right ear. During the day she used to feel normal but during the night she used to have severe pain in her ear. After some days blood and puss was released from the wound and the pain also vanished but she developed a hearing problem. She was attending school at that time but she could not understand what the teacher was saying and after a few years she left the school. She was bullied in school because of her hearing problem but her family could not afford her an ear check-up. After dropping out of school at the early age of 14 she started working with her father and mother as a labourer on a daily wage basis in order to help support her family.

Just 2 months ago she again developed swelling but this time it was in the ear canal. The swelling was so big that it hanged outside the canal and was clearly visible by everyone. After consulting with the doctor in her hometown she started some medicine but that did not work at all. She also felt unbearable pain but due to her financial problem she could not go to a better place for her treatment. Then the secretary of her local ward gave her a letter stating her poor economic situation and recommended her to the GP hospital. In GP, surgery was performed to heal her disease. After surgery she is in a very good condition. Now she says she feels very easy and the burden and pain in her ear has disappeared and now she is also able to hear clearly. She is very thankful to the hospital for treating her illness. She loves the hospital management, caring nurses, polite doctors and other supporting staff. Now she hopes she can work more effectively than before and support her family. In future she is committed in providing quality education to her son so that they can get out of poverty.



SEPTEMBER 2018

Shante Pariyar

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Shante Pariyar (14, M) is from Myagdi District, one of the rural districts in Western Nepal. He recently underwent his right ear surgery at the Ear Centre.

Shante had problems in his both ears, his right ear more severe, since he was nine year old. There used to constant discharge of water and often blood from his both ears. Shante couldn’t even hear properly since then. Because of the hearing problem, Shante discontinued his study after grade four. His family took him to nearby health post and later to one of the leading private hospital in Pokhara. Shante received his first surgery in the private hospital five years ago. The problem got relapsed during this period with development of an external wound behind the right ear.

Shante’s aunt visited Pokhara and got to hear about the Ear Centre. She told Shante’s mother to take him for the treatment. The family had no money even for travelling to Pokhara. Shante’s neighbors and relatives supported them travel fare. After proper assessment, Shante underwent surgery of his right ear. His cost has been covered through the hospital’s Medical Charity Fund.

The Pariyar family are thankful to receive the support from the hospital.




POKHARA JUNE 2018

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Dipika Sapkota (12 years) had pain in her left ear for the last one year. He mother took her to nearby chemists shop and prescribed with pain relief medicines. This didn’t help Dipika. Gradually redness on back of her ear started to appear with some discharge of mucus. Dipika’s mother heard about INF’s Ear Centre through radio jingle. She immediately took her daughter to the centre. Dipika underwent surgery. As per telephone conversation with Dipika’s mother, Dipika’s condition has become better now. She thanked INF’s Ear Centre for making her daughter well and her ear painless.

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Hari Chandra Silwal (18 years) is from Lamjung but currently stays with his sister in Pokhara for his education. He had problem in his right ear with constant discharge of mucus. Hari Chandra’s family couldn’t find the right treatment for him until they heard about the Ear Centre. His sister brought him to the centre with hope to make his brother relief from pain. Hari Chandra underwent surgery and his condition now is better. He has been visiting the hospital for more than twice for follow-up. Hari Chandra and his family including his sister are happy and grateful towards INF’s Ear Centre for all the support and care.



PALPA 2017

Delighted Sinjali family!!

Raymond Sinjali (14) from Palpa District was born as a healthy child. Regrettably with his growing age, Raymond’s hearing ability started degrading. Unknown of the condition, Raymond parents could not pay much attention to it. Consequently, Raymond lost his hearing ability, particularly the left one.

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Raymond’s family could do nothing to help him due to their economic condition The money sent by the family’s elder son from abroad was just enough for their basic requirements. This restricted the family from seeking treatment for their child.

Raymond’s school teachers took initiative to help him. They searched for every possible means. One of the teachers contacted a child development center in Pokhara for help. Without any delay, the center contacted INF to solve the little boys hearing problem, as they aware of the commendable service provided by the Green Pastures Hospital Ear Service Centre.

Raymond underwent a successful ear surgery at the centre. His sister-in-law taking care of Raymond post-surgery said, ‘we were rather angry at ourselves than sad because we were unable to do anything for our child. It was painful to see him not able to hear. We are very thankful to the centre for providing us with this immense help; hopefully our little boy will be able to hear completely like other kids”.

Written by Sunita Bhandari, an Intern at GPH


OUTREACH PROGRAMME - EAR CAMP NOVEMBER 2015

Puskar Shaahi

Puskar was one of the first patients at the new Ear Hospital and Training Centre. He was dropped off by an uncle on the first day of the hospital opening, having been referred by INF doctor Shirley Heywood from the Surkhet Clinic. Puskar, 14, had experienced pain and deafness in his ear since early childhood. At the official opening ceremony on 3 November 2015, the day after the hospital opened to the public, Puskar had already had an operation on his right ear, and watched the proceedings from beneath his hooded sweatshirt, which was hiding the bandage around his head. Puskar had traveled a long way to Pokhara for the operation and had nowhere to stay for the week, he therefore was offered a bed in the male ward. At the end of the week patients are requested to return for a check up, bandage change and post-operative care advice. Over the week Puskar became a familiar face to all the staff and volunteers as he wandered the grounds during the week between operation and check up, usually with a smile on his face. Puskar was well cared for by the staff at EHTC who took time to talk with him, play cards and keep him somewhat entertained between their duties. Puskar even received some special visits from INF volunteers and their family, to keep him amused, adding to his joy that he now has his hearing restored and has no more pain. He was however, very much looking forward to returning to his family and friends so he can play football and cricket again.

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Puskar on the final day, awaiting for assessment, re-bandage and discharge



Sheetal Sharma

Sheetal came to the Ear Camp with hope for a future with hearing. Sheetal Sharma, nicknamed “Aggrim”, came with his parents from Parwat District looking for a cure for Sheetal’s deafness. At nearly five years old, his parents had taken Sheetal to see various ENT doctors in Nepal and he was given a hearing aid in a past consultation. With limited hearing Sheetal can repeat a few sounds, but his hearing is diminishing and his well-researched parents had been advised that the answer for their only son might be a cochlear implant. Unfortunately an implant is a highly specialised and expensive procedure; one which the facilities (and budget) at EHTC don’t provide. Time is running out for Sheetal’s hope for hearing – at nearly five years old it may already be too late for surgery that is just out of reach. So, what hope is there for Sheetal’s future without hearing? One option is a cochlea implant at Kathmandu Teaching hospital; however this is very expensive and would require trips for follow up. What education potential is there? He may try a school for hearing impaired. However, there is ongoing stigmatization associated with being deaf in Nepal and this would further associate him with having a disability.

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Sheetal and his parents, following his assessment at the Ear Hospital



Bhim Bahadur Thakuri

Bhim Bahadur Thakuri had a different reason to most to be excited about the opening of the ear hospital. Bhim is a former leprosy patient of Green Pastures Hospital and Rehabilitation Centre (GPHRC) and, despite having had surgery on his hands, feet and right eye in the past, he requires special attention in his daily routine to care for his hands and feet. His hands are insensitive because of his condition and he needs to check them every hour for signs of damage. To care for them, he soaks them in water and regularly applies ointment. He also needs to wear special shoes for his foot deformity. Because of the complications of his condition, Bhim has not had employment for several years. His wife herds buffaloes on the GP farm to earn some money to help keep their family of four. His son and daughter, having failed their school leaving certificates, stay at home and look after their goats; they cut grass and work in the fields to earn extra income. Bhim was assessed for a cleaning job at the hospital. He proved to be very thorough, followed all the instructions, and so has acquired a job cleaning the toilets and facilities. Bhim is delighted to have some employment and is performing his job with vigour and pride.

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Bhim Bahadur Thakuri with his certificate received for participation in the Ear Outreach Programme



Guma Devi Baniya

Guma Devi Baniay, 61, lives a village life, not far from the GPHRC complex in Pokhara. She works in the fields near her home and looks after buffalo, oxen and her pet dog. Guma Devi has never married, but is close to her younger sister who has three children. For a year prior to the Ear Camp, Guma Devi had been experiencing headaches and pain in her ear. She heard about the camp and attended with her sister. Although hearing problems were not known in her families’ history, a medical examination diagnosed chronic suppurative otitis media (CSOM), a chronic inflammation of the middle ear and mastoid cavity, which through perforation of the ear drum results in hearing loss of varying severity. The medical team operated to close the perforation (myringoplasty) and Guma Devi looks forward to returning to her simple life, without headaches and pain.


JUMLA EAR CAMP DECEMBER 2014

Jumla 12/2014

Family with infections and hearing loss in mother (25) and daughter (5), and profound loss in her son (8).

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This delightful family shocked us with their hearing problems. Mum Asa (which means hope) was 25 years old. She has moderately severe nerve deafness in both ears and for that reason had not been able to go to school. Her young daughter Sonam aged 5 years not only had a similar hearing loss from birth but also had a history of frequent episodes of ear discharge on both sides, starting in infancy. Her older brother Sunil, aged 8 years was in a worse state, he appeared to have no hearing at all in either ear from birth and similarly also suffered regular attacks of otitis media and discharge. His only speech was the word ‘mummy’. For him we could only recommend a deaf school, but we could see that the family would not have the resources for the travel and boarding that would be needed. They came with Grandad, who had good hearing for his age, and dad was off in India working, we were told that he could hear. We were able to fit Asa and Sonam with hearing aids, at first Asa was reluctant to be fitted, as even in remote Nepali mountain villages, girls do worry about their appearance! But seeing her daughter’s response she asked to have an aid herself. The children were a delight to watch playing. We gave them some knitted teddy-bear toys and they immediately strapped them on their backs as the locals do when carrying their babies to the fields. There was a lot of laughter and giggling, we just wished we could do more.


Their records with audio results:

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DEAF AND DUMB MAN WITH EAR INFECTIONS

Basanti Nepali

At the ear camp in Jumla in November we saw a 21 year old man, Basanti Nepali, who had suffered with ear discharge and deteriorating hearing since the age of 5 years. His hearing became so poor that he had to leave school after the 7th grade, aged 12, as he was unable to manage in class. His hearing loss was of great concern to his family who were unable to afford medical care. He was teased at school and in the local neighbourhood and would be in trouble for throwing stones at his tormentors. His profound hearing loss led to deterioration in his speech and his family would resort to sign language to communicate. In addition to his hearing loss he suffered with repeated ear infections which led to chronic disease in the mastoid bone. These infections have the potential to be life threatening and certainly contributed to Basanti’s hearing loss.

The family had in the past sought medical help in Nepalgunj but the hearing aid that was provided was not effective and so discarded.

Jumla is a remote small town in west Nepal. Although it has a small hospital that is bigger and more advanced that found in may other districts, access to some specialised medical care such as ENT is poor. The INF ear camp is able to provide the specialist ear care that Basanti Nepali desperately needed. With his brother and mother he walked for 2 hours to be seen at the ear camp. It was clear that he needed surgery to both ears to prevent the infections that he suffered with causing a real threat to his health. It was only possible to offer surgery to one ear at a time and Basanti underwent his first mastoid surgery and reconstruction of his hearing bones. We can be confident that this surgery will reduce his infections but will not know whether the surgery has led to an improvement in his hearing for a number of weeks and unless Basanti is able to travel to a subsequent ear camp in another area, may never know.

In the developed world, patients with such ear disease would require multiple hospital visits and surgical interventions. It remains a challenge to explain to our patients, that with one intervention, our priority has to be to make the ear safe of infections and whilst we will make every effort to improve the hearing that this is not always possible, though a hearing aid may then be more effective than before.


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POKHARA EAR CAMP NOVEMBER 2013

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Osim Pariya is a five-year old boy who is deaf and has no understandable speech. Osim had a severe infection when he was one. Local doctors inserted grommets that unfortunately did nothing to improve his hearing. Osim’s grandfather, Biri Pariya brought him to the Pokhara Camp. Biri had been a trekking guide until his leg was amputated. He was rehabilitated at the Green Pastures Hospital where he heard about the Ear Camp. Biri now looks after Osim full-time as he has not been able to find any work since the amputation.
Biri himself has a large cyst behind his left ear which would be easy to remove but he declined the offer as his wife thought it would be unlucky to lose it.

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Osim was seen by the Swiss team of audiologists who gave him excellent hearing aids so that he was able to hear something for the first time. As he now needs to learn to utilise his residual hearing, Eka Dev suggested a special school in Pokhara where Osim could flourish.

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Nam Acharya Bikas
 is 27 years old and from Pokhara. Although he was born with severe hearing loss, he can lip read even in English! Nam’s mother is a widow who is now a teacher. She has a daughter who had polio as a child and is handicapped but she managed to cope and become a nurse. In spite of the tremendous difficulties faced by the family, Nam is studying to become an electrical engineer.

Eight years ago, Nam was given a large hearing aid that did not work for him and he gave up using it. He then had an operation in Kathmandu that was unsuccessful in improving hearing. At this camp, he was given two new hearing aids and Nam was able to hear more clearly for the very first time in his life. He left the Camp smiling broadly, clutching the prayer that Indra gave him and with the promise of a new future.

Parmila Gharti Mangal is twenty-five and took two days to reach the camp. Clutching her small child in her arms, she trekked for a whole day then took a long bus journey to reach the Ear Camp from her home.

Parmila had an infection in her right ear when she was small and had an operation but it did not stop the infection. She had a lot of pus coming out of both ears. She can hear a little on both sides and lip reads. She heard about the camp on FM radio and is hoping to be operated on.


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Nana Gurung 
is 84 and comes from Machhapuchare VDC (Village Development Committee) which is 25 km from Pokhara. She has some hearing loss and hopes to get a hearing aid.




Sagar Gurung is four. He is an only child who lives in Lamjung, 28 km from Pokhara with his father, a farm labourer. Sagar has been a deaf mute since birth. In spite of his handicap, his father said he is a clever boy keen to learn. It was felt that he would not benefit from a surgical procedure so he was taken to the audio department where he was given a hearing aid. Immediately afterwards, Sagar responded to snapping fingers and he beamed with delight. It will take about 6 months for Sagar to relate the sound to speech but hopefully, his brain will make the right connections while he is still just young enough to learn spoken language. The video clip shows him leaving the Camp and is a testament to the life-changing effect the Team had on the life of a small boy.

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Susmita Gautam
 is a nineteen year old student from Pokhara who hopes to be a doctor. She lives 18 km from Pokhara with her doting parents who accompanied her. In 2005, she was treated locally for an ear infection. Unfortunately, she thinks that the doctor she saw punctured her left ear drum by mistake, starting an infection. She has a perforation in that left ear that will be operated on at this Camp.

Eight years ago, when Susmita had a severe infection, she said that Mike Smith saved her from meningitis. Susmita now insisted on seeing him as she believed he is the best doctor in the world! She said this as she had travelled elsewhere and had not been satisfied.

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Subas Bikram Rana
 is an orphan aged 19. He comes from Miruwa near Pokhara. He left school in Grade 9 and is out of work as he cannot hear and has an obvious physical impairment, a congenital deformity where his ear canal is incomplete and the external ear deformed. He had enquired about an operation in China but it was too expensive and he heard that the infection rate there is very high. An INF employee told him about the Camp. Ideally, he would like to have cosmetic surgery as no one will employ him in his current state. His job prospects would be dramatically better if he could hear well.

Subas underwent a complex operation and should recover completely in the next six months. He was also given a hearing aid. Hopefully his treatment will ensure he is able to find employment. He will get regular follow up by the team in Pokhara and at the next ear camp.

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Girthaman Tamman
 is a twelve year-old boy from Pokhara who has been deaf in his right ear for three years following an ear infection. Girthaman has been in pain for the past three years and after his three hour operation took a long time to come round from the anaesthetic and sedation. The accompanying family members were hungry and anxious to leave but could not until he awoke, so they were given chocolates to ensure they stayed until Girthaman recovered!

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Girthaman surrounded by his family in the recovery area.

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The Patients' Stories displayed above were all related to Linda Falter,
mostly through interpreters, at the Ear Camp in Pokhara in November 2013.
Patients have all given their consent to the information being displayed.




CHAINPUR, BHAJANG, APRIL 2013

1 - Durga Lal Thapa

A 50 year old female had never been to school. She is a farmer and housewife and spends her time cooking, cleaning and sleeping. She has three sons who live with her and her husband, but cannot communicate with any of them due to her hearing loss, so just cooks and cleans and sleeps. She was accompanied by 3 younger women from her home near Dhangadi, called Chisopani in Karnali. She travelled on the night bus leaving at 6 pm and arriving at 10 AM. They are staying in the hotel.
She had surgery on the right and a bone conductor hearing aid on the left.
She greeted Peggy with a Christian greeting.
She felt the hearing aid helped her immediately and is very very happy because it will stop her being so isolated.
The young women with her were very surprised that they did not have to shout anymore to be heard.

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Amma (mother)

Works by cutting grass, carrying wood in baskets and feeding the buffalo. Her niece accompanied her and says that a hearing aid is not suitable for her type of work, but Amma herself wants it.
She lives 15-20 minutes away by bus in a big village with 3-4000 people.

Amma has come to live permanently in her mother’s house because her husband has another wife. Her husband lives a 7-hour walk away.
Four years ago her hearing started to deteriorate slowly.
Her speaking is affected and her niece shouts. She is isolated and goes to sleep while the family chats.

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Mandara Sayar

Is a 40 year old Chettri man. He has had hearing loss since he was a small boy. He is from Dhangadi 8 ward, which is a 2-hour bus ride from Chainpur. Eighty people live in the village and the guardian calls it a big village. There is no electricity in his house.
His parents came from that village but are both dead now.
He went to school but only to one class because of his hearing loss. He works as a ‘mystery man’ doing plumbing, electrical, ‘DIY’ and farming. He is the village dharmi (shaman or witchdoctor). He has never cut his hair.

He doesn't know what is happening or going on around him because of his hearing loss. There are no other people in his family with hearing loss. He is married with 3 boys and 1 girl.
He does not feel there are problems at home because of his hearing. He can listen on his mobile.

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Two 7-year-old girls

Both had extensive bilateral cholesteatoma disease in their ears.
One Tibetan extraction girl had both sides operated 3 days apart, then ear dressings changed with a short anaesthetic on the last camp day.
The other girl had one side mastoidectomy and her parents plan to attend our next ear camp in Pokhara in 7 months time to have the other ear operated. In all these operations the intention was to clear disease but also reconstruct the hearing with ossiculoplasties.

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