8-14 November 2013 #680

A burning desire to help

German plastic surgeon dedicates his life to treatment and training in reconstructive surgery in Nepal
Kunda Dixit

Andreas Settje had a comfortable, well-paying job as a surgeon and a settled family life in Germany when, one day 15 years ago, he saw an ad in the paper from a German charity to help set up a burns hospital in Nepal. It was fated that he should get the job. He sold his house and moved with his wife and two daughters to Nepal in 1999.

He came for two years, but ended up spending nearly nine, helping establish the Sushma Koirala Memorial Burns Hospital in Sankhu and training Nepali doctors and nurses in plastic surgery. There was a conflict going on and they had to treat war wounded from both sides. When the Sankhu Police Station was attacked by the Maoists, the hospital served as an emergency ward for the sudden rush of wounded.

In 2002, a bus travelling on the East-West Highway was firebombed by the Maoists during Tihar 11 years ago this week. Passengers Anju Regmi and her two children were severely burnt and Anju died two agonising weeks later at a hospital in Raxaul. Her husband Bhakta Bahadur, who works as a forest ranger in Patlaiya, was left to take care of the children Rabina and Rabin.

A NEW LIFE: The original story of Rabina and Rabin in Nepali Times of 2 December 2002 and the children after the first of many skin graft operations at the Sushma Koirala Memorial Burns Hospital.


After Nepali Times reporter Naresh Newar wrote about them, there was an outpouring of support for the children. The Bright Horizons boarding school offered scholarships and after he read the story, Settje offered to perform extensive reconstructive surgery on Rabina and Rabin. This week, the sister and brother celebrated Bhai Tika in Patlaiya and it is hard to tell that the two were once so horrifically disfigured. They are doing well in Grades 8 and 9, are self-confident, and are popular with their classmates. The story of the two children was featured in Kesang Tseten’s award-winning film, Frames of War in 2009.

On Tuesday, Rabina and Rabin pose after celebrating Bhai Tika at their home in Patlaiya.

“The kind of personal satisfaction and sense of achievement I have in Nepal is hard to describe in words,” says Settje, now 53, who was on one of his annual trips back to Nepal last month. But more than the individual cases, he is happy to have helped establish a core group of surgeons and nurses trained in plastic surgery who now work in hospitals all over Nepal. While performing surgeries in field hospitals, Settje gets translation help from his two daughters who grew up in Sankhu and speak fluent Nepali, as well as his wife Kerstin, who is a nurse.

One of Settje’s colleagues, Raju Pandey, has set up Nepal Plastic Surgery Aspatal in Harisiddhi and Niranjan Bista has set up his own reconstructive health department for reconstructive surgery at Nepal Medical College in Jorpati after specialised training in Germany. Binod Karn now runs a unit for plastic and burn surgery at the Nepalganj Medical College in Kohalpur. Sundesh Maskey runs a similar department at the Kathmandu Medical College.

Andreas Settje and his team performing reconstructive surgery on an ex-Maoist combatant at a field hospital in Kailali .

“The skills are important, but what is more vital is a commitment to the job of healing,” Settje explains. “It is a thankless job because most patients expect to get back to their former selves and that is impossible when wounds are severe.”

After finishing at Sushma Koirala, Settje has been involved in ManMayaMed, a charity named after one of his first patients who was so badly burnt that her chin was joined to her chest. The group supports training for Nepali doctors and nurses and has set up a self-help Burn Ladies Group in Sankhu where former burn patients take care of others like them who, besides physical injuries, need psycho-social counseling.

Man Maya Bastola after whom Andreas Settje named his charity for burn victims showed dramatic transformation after reconstructive surgery. Man Maya was burnt when she was five and did not get immediate treatment which led to grotesque contractures. Settje performed 15 operations over two years. She is at the Burns Ladies Group in Sankhu preparing for her SLC.

A donor community of 5,000 people in Germany raises money for ManMayaMed’s work in Nepal and Settje returns as often as he can for on-the-job training in latest surgery techniques and field camps in western Nepal where he thinks the need is greatest for burns and accident victims.

Thirty per cent of burns among women in Nepal is from suicide attempts, five per cent are caused by domestic violence, and the rest are accidents. The incidence of acid attacks on women is also on the rise in the Tarai. There are more female burn patients in Nepal and women need more help because many are stigmatised for being disfigured. The most important part of burn care is immediate treatment, which raises the chances of survival and successful surgery.

Settje says his job in Nepal is not finished: “We really need to emphasise fresh burn treatment and to raise the survival rate for those with more than 30 per cent burns.”

Bishnu Lama was severely burnt 12 years ago and now, at age 43, after extensive revision surgery. She is a self-employed mother of two boys.


Read also:

A burning problem

Rabina and Rabin in hospital

See video:

featuring Rabin and Rabina