http://blog.nyayahealth.org Working towards Health Equity and Access in Rural Nepal Mon, 06 Feb 2012 04:00:38 +0000 en hourly 1 http://wordpress.org/?v=3.3 http://blog.nyayahealth.org/2012/02/06/follow_up_follow_through/ http://blog.nyayahealth.org/2012/02/06/follow_up_follow_through/#comments Mon, 06 Feb 2012 04:00:38 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4157 http://blog.nyayahealth.org/2012/02/06/follow_up_follow_through/feed/ 0 Posted by Duncan Maru I interact with our patients briefly, in the context of a consultation by one of our clinical team members. For most of the patients with whom I consult, I will never know whether we had the right diagnosis or the right treatment.  Without a clear mechanism for following up with our patients, I [...] http://blog.nyayahealth.org/2012/02/05/cancer_call_for_action/ http://blog.nyayahealth.org/2012/02/05/cancer_call_for_action/#comments Sun, 05 Feb 2012 04:00:40 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4151 http://blog.nyayahealth.org/2012/02/05/cancer_call_for_action/feed/ 0 Posted by Duncan Maru A middle-aged woman presented with abdominal pain, bloating, and vaginal bleeding.  A few years ago, she had had some gynecologic surgery in India where her son was working.  They had no records of the procedure, nor did they know of what precisely the surgery had entailed.  She had suffered no fever or weight loss.  Our [...] http://blog.nyayahealth.org/2012/01/27/theoryofchange/ http://blog.nyayahealth.org/2012/01/27/theoryofchange/#comments Fri, 27 Jan 2012 04:00:28 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3954 http://blog.nyayahealth.org/2012/01/27/theoryofchange/feed/ 0 Posted by Duncan Maru We in the development, global health delivery, and social justice businesses seek to change current conditions that produce poverty, injustice, and ill-health.  On the one hand, our vision is often ambitious and over-sized for our levels of experience both as practitioners and visitors in communities that can remain unfamiliar even after [...] http://blog.nyayahealth.org/2012/01/14/misplaced_fluid_missed_oppor_to_care/ http://blog.nyayahealth.org/2012/01/14/misplaced_fluid_missed_oppor_to_care/#comments Sat, 14 Jan 2012 04:00:19 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4090 http://blog.nyayahealth.org/2012/01/14/misplaced_fluid_missed_oppor_to_care/feed/ 0 Posted by Duncan Maru In Boston, I often see patients bounced around from one hospital or specialist to another.  It is a bit surprising to see this happen here in Achham, where the main challenge is a dearth of clinicians and hospitals, rather than an excess of them.  A sixty year old woman had been [...] http://blog.nyayahealth.org/2011/12/31/psgn/ http://blog.nyayahealth.org/2011/12/31/psgn/#comments Sat, 31 Dec 2011 04:00:32 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3975 http://blog.nyayahealth.org/2011/12/31/psgn/feed/ 0 Posted by Duncan Maru A five-year-old boy presented with five days of dark-colored urine, swelling around his eyelids, and a recent rash over his left lower leg that itself had started over three weeks ago.  He lived relatively closer than many patients, a one and a half hour walk from Bayalpata.  He was brought in [...] http://blog.nyayahealth.org/2011/12/30/chestxrayreading/ http://blog.nyayahealth.org/2011/12/30/chestxrayreading/#comments Fri, 30 Dec 2011 04:00:04 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4001 http://blog.nyayahealth.org/2011/12/30/chestxrayreading/feed/ 0  Posted by Duncan Maru Our patients often walk or are carried several hours to receive care, and in evaluating such patients, our providers often order an x-ray.  Our providers are highly skilled in x-ray diagnosis, but, unlike most doctors in the United States and other resource-rich areas, they do not have the benefit of having [...] http://blog.nyayahealth.org/2011/12/27/bare-and-bloody-feet/ http://blog.nyayahealth.org/2011/12/27/bare-and-bloody-feet/#comments Tue, 27 Dec 2011 04:00:55 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4071 http://blog.nyayahealth.org/2011/12/27/bare-and-bloody-feet/feed/ 2 Posted by Duncan Maru A baby boy died at 36 hours of life.  I had first heard about him back at the staff quarters at around midnight, when a seven month pregnant woman had just given birth in the bathroom.   He was small, 1.5 kg.  His heart rate was very slow, and we started bag-mask [...] http://blog.nyayahealth.org/2011/12/25/diagnosis-moral-paralysis/ http://blog.nyayahealth.org/2011/12/25/diagnosis-moral-paralysis/#comments Sun, 25 Dec 2011 04:00:08 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4097 http://blog.nyayahealth.org/2011/12/25/diagnosis-moral-paralysis/feed/ 0 Posted by Duncan Maru There is a new HIV diagnosis in the outpatient department for a man whose wife is dead, an infant in respiratory distress in the emergency department, an inpatient unit whose patients seem to be bathing in flies.  Another child in the emergency department fell on her elbow from a few feet [...] http://blog.nyayahealth.org/2011/12/24/fathers_back/ http://blog.nyayahealth.org/2011/12/24/fathers_back/#comments Sat, 24 Dec 2011 04:00:15 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4076 http://blog.nyayahealth.org/2011/12/24/fathers_back/feed/ 0 Posted by Duncan Maru “We’re just going for a walk down the hill.”  As he passed by me, I saw a sense of pride and almost playfulness in the father’s eyes.  He seemed to relish going for a walk with his daughter on a beautiful spring day in Achham.  I had met his daughter, sixteen [...] http://blog.nyayahealth.org/2011/12/23/radiologyrounds/ http://blog.nyayahealth.org/2011/12/23/radiologyrounds/#comments Fri, 23 Dec 2011 04:00:03 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3969 http://blog.nyayahealth.org/2011/12/23/radiologyrounds/feed/ 0  Posted by Duncan Maru We had engaging x-ray rounds today at Bayalpata Hospital.  On rounds the day before, we had been frustrated by the inefficiency and low quality of reading x-rays at the patient’s bedside without a viewbox.  Viewing x-rays at the bedside also did not afford us an opportunity to give meaningful feedback to [...] http://blog.nyayahealth.org/2011/12/20/failinghearts/ http://blog.nyayahealth.org/2011/12/20/failinghearts/#comments Tue, 20 Dec 2011 04:00:50 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3987 http://blog.nyayahealth.org/2011/12/20/failinghearts/feed/ 0 Posted by Duncan Maru This week, a 70-year-old woman with emphysema and heart failure was admitted to Bayalpata Hospital with shortness of breath and limited ability to walk, likely related to heart failure.  She had murmurs indicative of aortic and tricuspid valve insufficiency.  Based on an echocardiogram (ultrasound) performed by our Health Assistant Uday Kshatriya [...] http://blog.nyayahealth.org/2011/12/18/transformationschallenges/ http://blog.nyayahealth.org/2011/12/18/transformationschallenges/#comments Sun, 18 Dec 2011 04:00:43 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3966 http://blog.nyayahealth.org/2011/12/18/transformationschallenges/feed/ 0 Posted by Duncan Maru As I wrote in a recent tumblr post, it was wonderful to walk again through the halls of Bayalpata and to witness its continued transformation into a dignified hospital.  Over the course of ten months since my last trip, nearly every part of the hospital has been better organized and cleaned, [...] http://blog.nyayahealth.org/2011/12/16/mgmtatmargins/ http://blog.nyayahealth.org/2011/12/16/mgmtatmargins/#comments Fri, 16 Dec 2011 04:00:57 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3901 http://blog.nyayahealth.org/2011/12/16/mgmtatmargins/feed/ 1 Posted by Duncan Maru In September of 2011, Bayalpata Hospital in rural Achham, Nepal almost collapsed under the weight of its own staff discontent.  The hospital, a government facility, had been largely abandoned until 2009 when our organization Nyaya Health endeavored to open it in partnership with local and national authorities.   Since then the hospital [...] http://blog.nyayahealth.org/2011/12/14/3hrsfootwfailingheart/ http://blog.nyayahealth.org/2011/12/14/3hrsfootwfailingheart/#comments Wed, 14 Dec 2011 04:00:34 +0000 Nyaya Health http://blog.nyayahealth.org/?p=4058 http://blog.nyayahealth.org/2011/12/14/3hrsfootwfailingheart/feed/ 1 Posted by Duncan Maru She arrived walking, her sandals dusty.  Her small heart, failing her, literally bounding out of her chest, somehow carried her three hours from her village and up the mountain to our small hospital in remote Achham, Nepal.  I first saw her after being called by Chanakya Timilsina, our Health Assistant, who [...] http://blog.nyayahealth.org/2011/12/05/with-gratitude-to-dhulikhel-hospital/ http://blog.nyayahealth.org/2011/12/05/with-gratitude-to-dhulikhel-hospital/#comments Mon, 05 Dec 2011 04:00:39 +0000 Nyaya Health http://blog.nyayahealth.org/?p=3916 http://blog.nyayahealth.org/2011/12/05/with-gratitude-to-dhulikhel-hospital/feed/ 0 Posted by Duncan Maru Our Country Director and I had the honor of visiting Dhulikhel Hospital this week to meet with staff members and Administrative Director, Dr. Rajendra Koju.  Dhulikhel is a not-for-profit, non-governmental hospital that offers affordable prices to its patients and manifests a singular vision of high quality and equitable care in rural Nepal, representing much of [...]