Between scolding an unruly visitor for not wearing a gown and attending to patients, some so severely burned they can scarcely move, nurses Krishna Sworee Shrestha and Nara Devi Bariya find a few minutes to blow off steam.
Bir Hospital's burn unit is severely understaffed but with caregivers like Krishna and Nara, they do the work of a dozen nurses in other hospitals. The two have just returned from a three-week training stint in Perth and are working with renewed motivation and vigour.
Krishna and Nara's time in Australia was sponsored by AusAid to participate in an intensive training at Royal Perth Hospital. "There are lots," Krishna replies when asked what she found different down under. "In Australia, dressing and basic medicines are free. Here, even poor patients have to pay for everything." For Nara, who's been at Bir for 22 years and is now the sister-in-charge, one big difference stands out: "In Australia, we saw patients with 90 percent burns survive. Here, we can lose patients with 30 percent burns."
Undaunted, Krishna and Nara are trying to improve the survival rate and also make the burns unit a pleasant place for the truly needy. Bir is the only public facility in Nepal dedicated to treating burn victims. The unit was established in 2001 under the former head of burns and plastic surgery, Keshav Das Joshi. "The biggest satisfaction is to see a patient get well and walk out of here. It's what keeps us going," says 33-year-old Krishna.
But both nurses are concerned by an alarming trend of suicide burns in the past few years. Of the eight patients in the ward this week, five are women who attempted suicide. Women make up nearly 80 percent of all suicide burn cases in Nepal and most are between 15 and 30 years old. "It's really an indication of the socio-economic status of Nepali women. The problems pile up, they have no one to talk to, so they douse themselves in kerosene and set themselves on fire. They don't know what burns do, the pain and suffering," says Nara.
Burn treatment is complex, requiring a multidimensional approach as the two saw in Australia. Here, they have to make do with the bare essentials and there is no long-term care and counselling. Still, Krishna and Nara aren't sitting around and complaining. They have started with very basic do-able things like preventing infections, which keep the recovery rate low in Nepal. They take what they have and make the most of it so they can help their patients survive and return to their normal lives.