A keystone of reconstructive education
With the aim to establish a new Plastic Surgery and Reconstructive Unit in Bhutan in mind, six trainees were selected to take on the experience and knowledge necessary to make this a reality.
In January, a team of trainees from Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) and Central Regional Referral Hospital (CRRH) Gelephu Hospital in Bhutan arrived in Nepal to complete a month-long residential course at Kirtipur Hospital.
Kirtipur Hospital is a 150 bedded hospital that sits on the outskirts of Kathmandu city. The hospital offers a variety of specialist services; including a renowned burns response unit. This makes the hospital the perfect host to the many visiting medical students, practitioners and organisations from inside and outside of country.
Meet the team
The team from Bhutan represented a diverse clinical background, the kind needed to meet the complex needs of patients with burns. Meet the team:
- Dr. Sangay Wangmo, General Surgeon
- Karma Wangdi, Nurse Anesthetist
- Karma Lodrel, Ward & Dressing Nurse
- Pema Choki, Scrub Nurse
- Tenzin Choden, Scrub Nurse
- Aita Hung Subba, Surgical Nurse
Bhutanese trainees arrive in Nepal and meet senior surgeons of Kirtipur Hospital, Dr. Shankar Rai and Dr. Kiran Nakarmi.
A schedule full of opportunities
Trainees were able to split their time between academic sessions and clinical practice. Kirtipur Hospital conducts robust morning sessions from 8 AM to 9AM, 6 days a week. Attendees come from around the world to learn in these sessions. The team actively participated in discussions around burn care, general plastics and reconstructive cases. Nurses also attended several afternoon classes to focus on their role in treatment for burns.
The Bhutanese trainees also presented sessions on health care in Bhutan; facilitating an exchange of experience and better understanding among all present.
A morning academic session at Kirtipur Hospital.
After these sessions, trainees were able to observe and assist patients in the operating theatre and intensive care unit. General Surgeon, Dr Wangmo, spoke highly of the hands-on experience.
“The majority of the operating cases were burn cases, which involved doing tangential excision and skin grafting in acute burns and release of contractures in post burn contractures. There were excellent opportunities for the team to observe and assist in the management of such cases on daily basis.”
Dr Sangay Wangmo assisting with a procedure in the operating theatre.
All the team members were able practice management of various aspects of burn injuries including pain management, bedside dressings, dressings under anaesthesia, and various surgical procedures in burns. They observed the impact this multidisciplinary approach had on the efficiency of care and overall wellbeing of patients.
A young girl with right hand post-burn syndactyly for release was managed by the Bhutanese team.
But working so closely with patients and their families opened the doors for a challenge that may easily by overlooked. Dr Wangmo told us the team had to learn to navigate emotions “witnessing the impact of burns on the patients and their families” brought on.
Bringing new experience back to Bhutan
Peers at Kirtipur Hospital commended the Bhutanese trainees for their great team dynamics and commitment to ethics. Now equipped with the skills necessary to provide efficient care to those requiring plastic and reconstructive surgery, the team are keen to share their learnings with colleagues back home.
They also look forward to supporting the establishment of the new Plastic Surgery and Reconstructive Unit in JDWNRH, alongside Dr. Sonam Jamstho, who will finish his training in March of this year!
“Overall, the team had a transformative experience significantly improving our skills and knowledge,” Dr Wangmo reflected, “We would like to express our appreciation to Dr Shankar Man Rai, Dr Kiran Nakarmi, doctors, nurses and staffs of Kirtipur Hospital in providing with all valuable learning experiences. Our deepest gratitude and prayers for all the patients who allowed us to learn from them.”
“We would also like to thank the National Medical Services, Royal Government of Bhutan for facilitating our study attachment. Most importantly we would like to express our sincere gratitude to Interplast for providing us with this wonderful learning opportunity and all necessary support.”
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