MCC nurse helps create medical miracles in Nepal

Mennonite Central Committee
Saturday, 8 January 2000

AKRON, Pa. -- The driver swung the wheel to avoid a huge mud hole. For several heart-stopping seconds the four-wheel drive vehicle skittered on the cliff edge, finally halting with one front wheel suspended in mid-air. The valley floor lay hundreds of feet below, but the passengers tried not to think about that as they scrambled to safely. Everyone pushed hard, got the vehicle back onto the dirt track and they continued on their way.

Every year stunning snow-capped mountains and the promise of adventure lure backpacking tourists to Nepal. Mennonite Central Committee (MCC) nurse Ruth McCaslin, based in Pokhra, Nepal, has plenty of breathtaking views and adventures — like this dangerous mountain drive — but that's not her purpose for being there. McCaslin travels with International Nepal Fellowship medical teams to provide surgeries for poor, desperately sick people in remote villages.

About 10 times each year McCaslin helps pack medicines and surgical instruments into four-wheel drive vehicles, along with drums for water and a generator as most mountain villages don't have running water or electricity. After hours of driving, and then walking when the roads become impassable for vehicles, the medical teams arrive to find lines of people already waiting for what might be their chance in a lifetime for an operation. For many villagers, the nearest surgical facility would be an impossible two- to three- week walk away.

Before patients are seen, McCaslin and her co-workers prepare a sterile space. Sometimes villages designate a school or the local clinic, which McCaslin helps spray with formaldehyde, keeping windows and doors closed. She sterilizes instruments in the pressure cooker they have brought and then lays them out on a flat surface, at times a hospital bed or a school desk. The team finds a suitable operating table, often propping it up with firewood to make it a comfortable height for the surgeons. Then from morning to night they operate, usually performing 40 to 80 procedures in five to seven days and seeing 500 to 1,000 patients.

McCaslin has learned to expect the unexpected as word spreads that medical help is available. At the end of one ear surgery camp a woman showed up, her hand black with gangrene, recalls McCaslin. Her family said a week and a half earlier a wall had fallen on the woman's hand. Her bangle bracelet cut through the flesh, down to the bone. Although this medical team consisted of ear specialists, they knew the woman would die if her hand was not amputated. That night they pored over texts, surveyed and rejected their fine ear surgery instruments, and finally located a hacksaw, which they sterilized in the fire. Their ear camp ended with a limb amputation.

Usually doctors and surgeons on the medical teams are from Europe or North America. They give up their vacation time to serve in Nepal for several weeks. Often the doctors can't believe how sick Nepali villagers are "while continuing to walk around and live their lives," remarks McCaslin. Many Nepalis simply have to put up with whatever illnesses they have.

The medical teams try to add a training component for local health workers. Generally providing surgical training is not realistic, so the team focuses instead on preventive health. "We might show how to keep ears clean, what treatments will prevent complications that could require surgery," explains McCaslin.

Although the travel and the medical camps are exhausting, McCaslin is not discouraged. "I feel that I can be part of the solution," she says. "People are so grateful." She cites the example of a 10-year-old deaf boy who received surgery on one ear last January. In November, when McCaslin was helping with another medical camp two difficult travel days away, the boy's parents brought him by. In the intervening 10 months the child had recovered some hearing, had begun to attend school and had learned to read and write.

McCaslin is from Woodrow, Sask., and more recently from Kenora, Ont. She and her husband, Walt McCaslin, are members of Woodrow Gospel Church in Woodrow. Walt is an agriculturist who advises Nepali non-governmental organizations. The couple is currently on home leave in Saskatoon, Sask.

For more information, or to contact Mennonite Central Committee, see their website at: www.mcc.org