Medicine & Healthcare, Physiotherapist in Nepal by Nanda Pindoria
My name is Nanda Pindoria and I am 21 years old and live in London. I have been studying for the past 3 years at Coventry University and achieved my Physiotherapist qualification in July 2012, after which I went to Nepal to volunteer as a physiotherapist.
My work involves helping people to restore movement and function when they are affected by illness, injury or disability. This is done by using exercise or manual therapy such as massage to treat the problem area.
Motivation to volunteer abroad
I chose to be a volunteer because I wanted to experience working as a physiotherapist in a different and challenging environment to the one that you get in the western world. I had a desire to meet new people and go out of my comfort zone. I chose Nepal because I have always wanted to see the Himalayas, and it looked like a beautiful country to visit. Furthermore, I am a Hindu and have not been brought up with strict religious beliefs, so I also wanted to go to Nepal to learn more about my religion and experience the culture.
I worked at Chitwan Medical College Teaching hospital in Bharatpur, the hospital requires patients to pay for services such as physiotherapy and seeing a general doctor, but it is cheaper than other hospitals, so a lot of people come to this hospital for treatment, if they can afford it.
The physiotherapy department is very small and has 3 physiotherapists who treat many patients a day and it can become very busy. They need volunteers to take the pressure off the physiotherapists so that they have more time to spend on each patient. They have never been taught western physiotherapy so they love learning new techniques from us and are always welcome to new ideas.
As I was qualified in physiotherapy, I worked as an independent Physiotherapist and had my own patients. When I first got there, physiotherapy was only given to those who came into the outpatient department with fractures, muscle pains, back pains etc. In the western world, physiotherapy is given to most wards in the hospital including general surgery and ICU (Intensive Care Unit), because it has been proven that helping patients stay active instead of lying in the same position in the hospital bed all day, can lead to shorter recovery time.
This was not the case at this hospital, so I was determined to present a case study to the doctors in the hospital to persuade them towards my idea. Fortunately, it worked and was able to start physiotherapy rounds in the ICU and General surgery. With more volunteers, it was easy to have some stay in the outpatient department and others to visit the wards. I didn’t expect such a quick result, but there was a dramatic improvement in the state of the patients we treated, they were discharged from hospital a lot earlier and recovered a lot quicker.
I wanted to make sure this would continue when I left so I allowed other physiotherapy student volunteers to shadow me and I taught them the basics to be able to continue once I was gone. The Nepalese physiotherapists were thrilled about this change, and I could not believe I had been a part of this big change in the hospital, I had actually saved lives by implementing this idea, and it was an incredible achievement for me.
Due to my lack of experience in physiotherapy as a newly graduated professional, I was not very confident in my abilities before I came to Nepal. By the end of my 3 months I felt a huge improvement in such a short time, I felt was able to confidently teach others my skills and was happy to be left independently with a patient which is a huge step. The knowledge I gained from other physiotherapists from around the world was unbelievable and it led me to have a wider perspective of physiotherapy. I had more ideas about all the things I could do in physiotherapy and this inspired me to become very ambitious and motivated to come back to London and get started on my journey to becoming the physiotherapist I wanted to be.
Chitwan was a very hot and humid place, and there was a lot of dust, but it is one of the most beautiful places I have ever been. On the way to work, sitting on the rooftop or in the back of a tuk-tuk (a small metal van used as public transport) with the wind in my hair, I was stunned by the snow peaked Himalayas I saw in the sky everyday.
Experiencing the crowds, traffic, pollution and political problems in Nepal actually allowed me to have a broader mind and experience how hard life in Nepal is. It is an unfortunate initial view as you spend your first few days in Nepal, but it is a reality that we must all learn to accept in some way and do whatever we can as volunteers to help.
A day at my placement
A day at my placement included getting up at 6.30am and taking a tuk-tuk to the hospital which took 20 minutes. The tuk-tuks were made to seat about 9 people but they often carry more than this. I get to the hospital and go straight to the physiotherapy ward and treat my first patient. The language barrier was easier for me then my friends because Nepalese is very similar to Hindi, so I was able pick Nepalese up very quickly and use key words to treat my patients and understand them. However, there were times when I just couldn’t understand, but the physiotherapists were always very helpful.
In the afternoon, I would spend time in the ICU and general surgery wards. In the UK the doctors refer the patients to physiotherapy, but here I had to use my initiative to check every patient and decide whether they needed to be treated or not. Initially, I was shocked by the hygiene of the hospital, and the lack of equipment, but I began to realise that this is why I was here and quickly got used to it. I had to improvise when I didn’t have the equipment that I would usually have in the western world, so I would use bed sheets, bottles, anything I could find for exercise equipment, and my hands for everything else.
After my placement
During my time in Nepal I made life long friends from all over the world who I still keep in touch with now and hope to meet up with again one day soon. I also became very close to my host family, especially my host brothers, Shardul and Sagar. I spent 3 months living with them and I always chose to spend my weekends with them rather then travelling around Nepal because I knew I would have to leave soon.
I initially booked to stay for 7 weeks, but I loved it so much I extended to 3 months. I still speak to my host brother’s everyday today, and without them my experience in Nepal would not have been so life changing. They welcomed me into their family as a sister and showed me how tough life was as a Nepali. I began to appreciate the little things in life, such as how easy it is to earn money in London compared to Nepal.
The love their family had for each other was beautiful, and their joyful celebrations of religious festivals left me with a warm feeling in my heart. I did not intend to fall in love with Nepal, but I did and it changed me as a person, I gained a great deal professionally, as well as personally. It really helped me transition from calling myself just a new graduate in physiotherapy to a confident physiotherapist.
I left Nepal with a clear view of where I wanted to be in 10 years, and with new friends and family who love me. Now I am already planning to go back to my second home in Nepal once again!