From: Sangita Basnet
Sent: Sunday, March 08, 2009 8:51 PM
To: board
Subject: Update on PICU/NICU at Patan Hospital

Dear ANMF board,

There is rapid progress in the Patan Hospital NICU/PICU project in the past few months, as time for our planned visit to Nepal is quickly approaching. ANMF has been very supportive of our project right from its inception. Posting our grant proposal for equipment on the ANMF website as a fund-raising project gave it a lot of credibility.

The PICU/NICU team is extremely thankful to the ANMF Board members, Mr. Marvin Brustin, Mrs. Allison Brustin, Dr. Libby Wilson and Dr. Janak Koirala, for their generous personal donations.

The following is a brief account of the progress made so far.

Facility

As you know, the Simons Foundation generously donated a large fund for a new maternity building, with space for a 6 bed Pediatric ICU (PICU) and a 6 bed neonatal ICU (NICU), attached to the existing charity hospital, Patan Hospital, in Kathmandu, Nepal.The building is completed and functioning. 

Team and training

A team of volunteers comprising of intensivsits, neonatologists, PICU nurses, NICU nurses, 2 pharmacists and 1 respiratory therapist (RT) is preparing to leave for Nepal to train Nepali healthcare workers, including physicians, nurses and pharmacists, starting June 15th, 2009. We would like to continue it for at least 3 months, on a rotating basis.

Curriculum

There is an extensive nurses curriculum prepared, mainly focussing on the practical aspects of bedside care of the patients, assesments and recognition of clinical signs/symptoms with emphasis on critical conditions. The physicians' training will be done according to modules, e.g respiratory, cardiac,etc. In the morning, an hour's lecture will be given, five days a week. There will be a discussion on case scenarios based on the morning lecture for one hour every afternoon. Once a week we will have case presentations/M&Ms etc., and once a week feedback from the local physicians. Some of the lectures by the RT, pharmacists and nurses will probably be attended by the physicians.

We will be working in the units with the local staff. We will also conduct NRP and PALS.

Equipment

The greatest news  is that the Simons Foundation has generously donated $300,000 for equipment for the units. It is enough to buy brand new essential equipment to jumpstart the project.

Patients
There is approximately 200 admissions a month to the pediatric floor, 4-5 deaths and 4-6 children sent home because the hospital does not have the means to escalate care. The main cause of death is sepsis, congenital heart disease, meningitis, hepatic failure, shock, pneumonia. The main cause of admission is acute respiratory illness, enteric fever, diarrhea/dehydration, malnutrition, etc.

Goals

We hope to establish fully functioning PICU and NICU with trained manpower and basic appropriate equipment. The training will also be attended by representatives from other hospitals. Pediatric residents rotate through Patan Hospital and they will benefit greatly from the critical care exposure. This will most likely produce a ripple effect which will go beyond this one hospital.  We will continue to support the units in the future.
 
Future

We will continue to ask for volunteers who would want to go to Nepal to continue the training even after this project is over. We would like to establish telemedicine in the future, if feasible.

This is our first venture there. We will be learning as we proceed. Although I am confident we will be able to acheive our goal, I know it will get better as we go along.

This is a true collaborative venture with the staff and physicians of Patan Hospital. I have very high regards for them as physicians and human beings.  

Once again, we truly appreciate the support that ANMF has given us to make the establishment of the PICU and NICU in Patan Hospital in Nepal a success. This will definitely contribute to the betterment of health care delivery to the neonates and children of Nepal.

Sincerely,

Sangita Basnet, MD
Assistant Professor of Clinical Pediatrics
Division of Pediatric Critical Care Medicine
Southern Illinois University, School of Medicine
Springfield, IL