I expected a unique experience but I could have never prepared for the cultural eye-opener and patient encounters that would forever change my perspectives and life, in general.
As a tired senior resident, I departed Atlanta and caught up on sleep during my 40 hours of travel. Finally, I arrived to Kathmandu, Nepal – a small, impoverished country in South Asia, which is nestled between China and India. I never did receive my luggage so I wore the same clothes for the entire 2 week trip. There were no other options. I quickly understood that I was in no position to complain or dwell on this. There was work to do and these people were in far worse shape than I.
Patients traveled an average of 8 hours to reach the Nepal Orthopedic Hospital so they could be assessed by our team of podiatric surgeons, anesthesiologists, internists, nurses, etc. It was immediately clear that the foot and ankle conditions that affected these people paralleled that of the country’s socioeconomic status.
The children presented with the most complex congenital deformities I had seen. The pediatric clubfoot deformity was primarily managed non-surgically with serial corrective cast manipulations – using the Ponseti Method. Unfortunately, the hospital lacked many “standard” supplies, including plaster and fiberglass cast materials. Our team donated over half a million dollars in donated medical equipment, supplies and service to treat these and future patients.
Lacks in transportation and medical knowledge have also traditionally made it difficult for these patients to receive appropriate care. Most of the 55 surgical reconstructive procedures we performed were for adults with neglected congenital deformities. Surgical management of these complex cases was made more challenging knowing that we did not have our typical intra-operative imaging, instrumentation and surgical fixation. During power outages, there was a dim light emitted from the OR’s window. Nurses shined handheld flashlights onto the surgical field. Our circumstances were very different but we met our surgical goals while teaching the hospital’s staff during surgery and lectures.
When we departed Nepal, we left the patients in the good hands of their doctors who provided us updates and photos via email. The following year I was able to return to Nepal and it was wonderful to examine these same patients for follow-up exams.
I am often asked, “Why did you choose to be a foot doctor?” There are a lot of reasons but it is hard to explain how cool it is to see the outcome of your work when it affects someone’s life. In cultures where deformities influence daily life, jobs, and even caste status, these corrections expand beyond functional and physical improvements and abilities.
During these missions, I have learned so much from this culture and people of so much less. Despite their third world and physical ailments, these people are truly happy and there is so much that we can learn from them.
Dr. Carl Kihm
Dr. Carl Kihm is a podiatric surgeon who works at Village Podiatry offices in Canton and Marietta, Georgia. He earned his doctorate at Temple University and completed his surgical residency at DeKalb Medical Center in Decatur. His training emphasized foot and ankle reconstruction, trauma and elective procedures. He continues to serve the less fortunate in our area and abroad. He is now a co-organizer for the Kathmandu, Nepal mission trips. They work at the Nepal Orthopedic Hospital and the mission is established through a non-profit organization called Healing the Children. Dr. Kihm will be returning for his fourth mission with his team soon March 16-25, 2015.