Delivering medical care in challenging environments can be rewarding – Sandeep Mahat

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Sandeep Mahat joined Medecins Sans Frontieres (MSF) / Doctors Without Borders soon after his medical training. He shares his experiences, from delivering emergency aid after floods in Nepal to providing hospital-care with limited resources in a rural town of India.

My last day at MSF’s Mother and Child Health Centre in Chhattisgarh © Sandeep Mahat/MSF

I first heard about MSF while working as a resident doctor, the last stage of graduate medical training, at a hospital in Nepal’s capital city Kathmandu. At the time, MSF’s medical teams were treating people in the country’s remote mountains, the epicenter of a conflict. This aroused my curiosity and I read more about the medical organisation on the internet.

It fascinated me how MSF treated people in areas where healthcare infrastructure had been destroyed completely by 12 years of conflict in Nepal. In a year’s time, I decided to join its medical staff. I had never imagined the beautiful places I would get to see in my own country while working with MSF, from the high and mighty mountains of Khotang and Kalikot to the plains of Rautahat.

In three years, I worked at three healthcare projects, including emergency care for people uprooted by the Koshi floods in 2009. Despite a challenging environment, it was rewarding that our care was helping save lives. We provided several health services, from obstetric emergencies, pediatric care and malnutrition, to tuberculosis, trauma care and surgery. At MSF, I gained a firm and holistic set of medical skills.

My first assignment overseas with MSF was in the Kupwara valley of Kashmir in India, where we provided primary healthcare as well as counseling to people living amidst a longstanding conflict. From mountainous Kashmir, I traveled to Chhattisgarh, a state in central India, where the temperature was 38 degrees celcius on a hot summer day when I reached.

New skills in new places

On my way to MSF clinic in Kashmir © Sandeep Mahat/MSF

Though I was tired from the long journey, I could not resist visiting my new workplace, MSF’s mother and child healthcare hospital in the town of Bijapur. A 15-bed facility, the hospital’s team helps deliver around 30 babies every month. We also nurse babies born pre-term and/or with neonatal illnesses.

More than 45% of newborns at the hospital weigh less that 2.5kg. Caring for these babies is the biggest challenge in a rural area where we work with limited resources. We are able to nurture some newborns back to health, but it is very disappointing and frustrating for the hospital’s staff to not always be able to save more lives.

Patients from nearby towns also come to the hospital and we see around 100 outpatients every day. MSF’s team treats people for malaria, which is very common in this region, and for tuberculosis as well as its hard-to-treat strain called drug-resistant tuberculosis.

MSF’s teams also take medical care to tribal communities living in the surrounding dense forests, which are the grounds of an ongoing conflict. Each medical team comprises of doctors, nurses, health educators and a lab physician and drug dispenser. These teams carry medical essentials in their backpacks and travel on dusty roads and on foot to reach villages in forests. Every team sets up a day-long medical clinic in a village, where we provide primary healthcare, immunization, antenatal and postnatal care, as well as treatment for malaria, malnutrition, tuberculosis and water-borne diseases.

I worked in Bijapur for nine months but never grew tired of the assignment. The diversity in my work has kept me going. While I supported obstetric emergencies, I was also introduced to treatment for drug-resistant tuberculosis. I have worked in areas with conflict and helped deliver emergency aid during a natural disaster. These experiences have strengthened my medical skills and it is has been very satisfying to help people where healthcare is needed most.





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