LAS VEGAS: Two hundred alumni of the Patiala Medical College from India are gathered here in Nevada for a conference. As an alumnus from Nepal, I am one of the invited speakers at the Monte Carlo Hotel. This is a continuing medical education program for these doctors certified by the University Medical Center of Las Vegas. I spoke to Patiala graduates practicing in the United States about a vulnerable group called VFRs ( Visiting Friends and Relatives). In this case, VFRs are people in the US of Indian origin who visit India and fall sick. Unlike their Western counterparts most VFRs carelessly do not obtain the required vaccines like typhoid or hepatitis A and B when visiting India. In addition, the VFRs are also prone to traveller's diarrhoea as living in the US may have decreased their immunity to common microorganisms in our part of the world.

I also added a bit about about prevention of altitude sickness as many elderly 'Indian Americans' to sacred high altitude pilgrimage sites like Kailash-Manasarovar without awareness about altitude travel and its deadly complications: high altitude pulmonary and cerebral edema which can be lethal.

Most of the doctors gathered here are specialists in many fields (cardiologists, urologists, neurologists, and obesity and pain medicine experts), but they are generally ignorant about travel and altitude medicine.

After the talks in the evening, there is a well- choreographed bhangra dance and plenty of chole bhature and besanke bhurphy. We could be in a party palace in Patiala, and yet just down the escalators from this ballroom is the Monte Carlo casino in full swing with Americans playing blackjack, baccarat, poker, and the slot machines. The contrast is mind-boggling.

The doctors also raise money among themselves to help their alma mater, Government Medical College, Patiala and the adjoining Rajendra Hospital (picture) so that underprivileged and needy students and patients will benefit. Hundreds of young Nepali doctors have recently gone to practice and live in the US, hopefully down the line they too will follow the Patiala example.