Hospital on a hill

This is the distractingly beautiful view from the operating theatre at the newly opened Kirtipur hospital. Throughout the week, half the plastics team works here and the other half at Model Hospital. The plan is to eventually move all the services here, but at the moment most of the burns are operated on here while the clefts and more complex procedures happen at Model hospital.

There's one particular patient I should tell you about but I'll keep it vague for confidentiality reasons. A couple of posts back I mentioned that I had assisted in a 36% burns surgery - the last couple of days I've been able to see how they're doing and help with the dressing changes. This patient was burned in a house fire and unusually attended the hospital pretty soon after the incident. This seems to be one of the issues here; often patients cannot seek appropriate medical help immediately and often will go for long periods of time without any treatment. Sometimes to the extent that they only visit the hospital 10 or more years after the event.

So this patient attended early, had the surgical debridement early and has been fighting off infections and a host of other physiological insults that happen after major burns like this. I'm happy to say that most of the newly grafted skin has now taken, and slowly the 36% of their body surface area that was affected by the burn is healing.

One of their next important steps in treatment is to maintain adequate calorie intake. In the UK doctors and nutritionists will happily scribble on the patients notes for regular fresubin (high energy protein drinks) to bulk up the daily intake. But since this is expensive stuff, the schedule here is lots of milk, eggs and Dhal Bhat "to the max" to quote the senior doctor from today:

 Sounds good to me!