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I don’t actually know a lot about the state of health care in Nepal. What I gleaned is that there are too few doctors – for a population of 23 million, there are a tiny 100 medical graduates a year (in comparison, I think Australia churns out more than 1000 doctors annually). I know that in the remote areas, like the Annapurna region we have just trekked through, the nearest doctor is usually at least three days WALK away, and there is no vehicular transport – we have often seen patients being piggy-backed by their family, or carried in a rudimentary stretcher formed by slinging a hammock around two bamboo posts. Up and down the rocky trails these “ambulances” go, walking for days before getting any medical care.

I know that patients have to pay for all consultations, even in hospitals, and for medications. Certain medicines are provided free, but these tend to be inferior choices.

It was difficult to know how much of an impact I made. I think that having seen a doctor gave a lot of people some comfort, and that we relieved symptoms in most of them (and the placebo effect probably had a lot to do with this). I directed a number of people with chronic and complex complaints to hospital outpatients or the nearest “polyclinic”, as they needed ongoing monitoring and care. This is one of the problems about being a volunteer – that it is a temporary post, and little opportunity for followup.

The biggest barrier to good health care in Nepal would have to be lack of education. Ignorance about good hygiene, nutrition and diet, smoking, and the need for regular checkups for chronic conditions impacts on the vast majority. It is perhaps a saving grace that most people work so hard physically that they don’t suffer from diseases of overabundance such as high blood pressure and diabetes.

The one thing I am sure of is that we have a stellar health care system in Australia. It’s accessible to all, it’s of an excellent standard, and it’s free. There are safety nets for those in need. I truly wish that doctors and patients would stop whingeing about the Australian medical system – they should spend a few days in Nepal to find out what life is like on the other side.