By Dr. Ken Zafren, MD, FAAEM, FACEP, FAWM – Associate Medical Director
Overview: the Himalayan Rescue Association was founded in the early 1970s and operates an office in Kathmandu as well as two aid posts in the mountains of Nepal. There is posts use volunteer physicians to serve the medical needs of trekkers and local people. They operate during the two trekking “seasons:” spring or pre-monsoon and fall or post-monsoon. Living conditions at both posts are primitive, food is basic and there is little communication with “home”. There are two volunteer physicians at each post each season. Volunteers should be willing to put up with the inevitable hassles of living and working in a third-world country as well as with prolonged living under conditions which at home would be associated with wilderness travel.
Qualification: Volunteers must be physicians, usually from the primary care specialties. Emergency physicians and family practitioners are the norm, but others may be considered if they have enough experience beyond their own fields. Mountaineering and mountain rescue skills are not required. Camping skills and sense of humor are essential.
Pheriche Aid Post: Located in the Khumbu (Everest) region of Nepal, the post usually takes two weeks for volunteers to reach, most of which is spent walking in. The post is located at 14,000 feet and serves the large number of trekkers going to Kala Patter, the most popular spot for close-up views of Mt. Everest. It is could most of the year, often windy, and the building can only occasionally be heated using scarce firewood.
Manang Aid Post: Located at 11,500 feet on the Annapurna circuit, the most popular trek in Nepal, the aid post sees more local people than Pheriche. Manang is warmer than Pheriche and takes only about a week to reach, of which all but the first day is spend walking.
General Information for volunteers: Volunteers pay their own way to and from Nepal. The aid posts operate from March to end of may (pre-monsoon) and early October to early December (post-monsoon). Volunteers arrive in Kathmandu by 1st March or 10 September for these seasons and should expect to stay in Nepal for at least 3 months. Prior to leaving for the posts, volunteers help with organizing supplies for the coming season. The Kathmandu office will help with arrangements. Volunteers are fully supported financially only after leaving Kathmandu: however Kathmandu is not very expensive place. The first few days are devoted to orientation, but medical and a general introduction to working at the posts, as well as sightseeing in Kathmandu, Each volunteer may bring a spouse or significant other who will also be supported. There are no provisions for children at higher post getting along with other volunteers and the Nepali staff (in Kathmandu and the posts) is very important. Volunteers should not encourage medical students or other health professionals to come along and help them during their tour of duty (let the office handle this). Research and teaching take a back seat to patient care. Please do not volunteer if research of teaching wilderness medicine to a medical student or resident is your main goal.
The Work: Volunteers are the only source of medical care in each area. In addition to clinic hours (easy to set, but hard to enforce) and emergencies (anytime, just as at home), volunteers give daily lectures emphasizing prevention, recognition and treatment of altitude illness and other medical problems of trekking. The posts support themselves on fees charged for medical services and supplies, donations and the sale of HRA logo items (patches and t-shirts). Medical skills are often less important qualifications then the ability to function in stressful situations and a talent for diplomacy. At each post, local people serve as medical assistants and translators and do most of the cooking and general maintenance.
The rewards: Spending a season at one of the posts is an unparalleled opportunity to practice wilderness medicine and to meet people from different cultures, both those of Nepal and of many other countries. Although the scenery is spectacular, it is the local people, especially your assistant living with you at the posts that make the experience one you will always remember.
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