Logo
GASTROENTEROLOGY FOUNDATION e.V.
Better medicine for the world's poorest.

Nepal


 


 



National training center for Nepal


The Endoscopy Training Center 'ETC' at Dhulikhel Hospital in Nepal has been on the agenda of the Gastroenterology Foundation e.V. since 2009.


Nepal is one of the poorest countries in the world.In 2016, per capita income was less than USD 2 per day. The earthquake in 2015 also dramatically worsened the situation. More than half of Nepal's 27 million inhabitants live in the foothills of the Himalayas. This destitute population makes up 80 percent of the patients at Dhulikhel Hospital. The hospital is therefore permanently dependent on financial help from outside.


Since its foundation in 1996, incredible things have been achieved at Dhulikhel. This has been possible primarily thanks to the tireless work of the founder, Prof. Ram Shrestha. It is thanks to his charismatic nature and the great commitment of his staff that many small, non-governmental organizations in Europe have donated money to help him achieve his vision: high-quality medicine can also be accessible to the poorest of the poor.


With the help of the Gastroenterology Foundation e.V., the ETC team performed more than 1,300 endoscopic surgical procedures in 2017, the majority of which were life-saving!


Diary

Mai. 2024

In the anniversary year 2024: 15 years (2009-2024) GFNG (Gastro-Foundation Nepal Group) at the 'ETC' Endoscopy Training Centre in Dhulikhel Hospital.

7th spring workshop at Dhos on 5-6 April 2024: Basic knowledge in ultrasound diagnostics and endoscopy.

The special commitment of the endoscopy team, their qualifications and loyalty to the Dhos, coupled with the continuous support from the GFNG, have resulted in the fantastic development of the ETC into the leading reference centre for endoscopy in Nepal. A total of around 500 doctors and nurses have been trained at 17 training courses to date - with the (voluntary) help of colleagues from Germany.

The 7th Spring Basic Course 2024 for US and Endo was again fully booked with 30 participants. Dr Dirk Hagena travelled from Germany to provide organisational and technical support on behalf of the GFNG.

The first day of the course focussed on imparting knowledge and initial experience in abdominal ultrasonography. Lectures provided basic technical knowledge and demonstrated the wide range of diagnostic possibilities in the field of abdominal organs. Between the lectures, the course participants, who had come from all over Nepal, had the opportunity to apply their newly acquired knowledge to patients in groups at several workstations under the guidance of tutors. This learning principle has become a tradition at the ETC in Dhos. The review of the learning success at the end of the long day was very satisfying for all participants.

The topic of the second day of the course was basic knowledge of endoscopy of the upper and lower digestive tract. Here, too, the course began with equipment knowledge and the extremely important hygiene and equipment care in endoscopy. This was followed by lectures on the indications for endoscopy and the various examination techniques, including sedation measures and the most common pathological findings in the stomach and intestines. The theory was followed by 'hands on'. For the majority of course participants, this was their first contact with an endoscope. It was therefore very helpful to gain initial experience on models with the help of the tutors, which was taken up with great enthusiasm by all participants. Live demonstrations of gastroscopies and colonoscopies by experienced examiners and a demonstration of the accessories and instruments commonly used in endoscopy for diagnostic/therapeutic sampling etc. by the ETC endoscopy nurses rounded off the varied event.

At the end, after the certificates of participation had been presented, the obligatory group photo was taken, showing happy faces throughout. Many thanks to Dr Gurung for his masterful workshop management, but also to all participants and the numerous speakers. Most of the radiologists took part in the ultrasound day; the second day belonged to the ETC gastroenterologists and former employees (Dr Bibek) as well as various guest speakers from cooperating clinics in Kathmandu.

We cordially invite you to the next ETC workshop in Dhos, the 11th HoWEU in November 2024.

Dirk Hagena






Mär. 2024

Finally, the large order of important endoscopic accessories has arrived safely at the ETC! We would like to thank the MediGlobe team for their great patience during the ordering process. Furthermore, many thanks to the Namaste Stiftung for their very generous financial support.




Feb. 2024

For the conversion and redesign of the two ERCP rooms in the endoscopy department of the Dhulikhel Hospital (ETC) in Nepal, two X-ray protection walls worth 4000 euros each were needed. Protecting staff from radiation damage is very important, especially given the extremely high number of examinations carried out in this high-volume center.

Dr. Roland Ott had the opportunity to present the Nepal project and the planned purchase to a very interested audience at the Rotary Club Munich-Blutenburg on 26 October 2023 (https://muenchen-blutenburg.rotary.de)

Fortunately, the commission classified us as worthy of support and transferred 4000 euros to the Gastrofoundation account at the end of December.

The second protective wall was financed by the Namaste Foundation (https://www.namaste-stiftung.de).

We would like to thank the Rotary Club and the Namaste Foundation for their generous support. Here are a few more pictures of the ETC team when the new protective walls arrived.


Bild1 en


Bild2 en


Bild3 en


Jan. 2024

Finally, the three protection goggles have arrived at the ETC.? Here you can see Prof. Gurung wearing one of the special glasses.



Jan. 2024

Our member Wolfgang Blank has been active in ultrasound training in Nepal together with his wife for many years.?Read the following article.


Okt. 2023

Report from the 10th HoWEU at Dhulikhel Hospital in Nepal (5.-7.10.2023) From 5 to 7 October, the 10th Workshop for Ultrasound, Endoscopy and Gastroenterology took place at Dhulikhel Hospital (10th HoWEU at the ETC = Endoscopic Training Center). Traditionally, we have been supporting this event for ten years as a Nepal group within the Gastrofoundation.?Rudolf Riepl, Volker Stagge, Michael Guggenberger, Konstanze Tzavella and Roland Ott travelled to Nepal for this workshop – as always at their own expense.?Parallel to the mentioned workshop, the third Workshop of Endoscopy Assistant of Nepal took place. Samira, the head of the endoscopy assistants in the ETC, has successfully founded this professional association of assistants against some resistance in her own country and with the support of our Nepal group and has been president ever since. This was a very important step towards spreading the high standard of training of the endoscopy nurses in the ETC throughout Nepal and raising the level of assistance and hygiene across the board. Our colleague V. Stagge took part in this event as a speaker.

On Thursday, the full-day training for ultrasound began. 33 medical colleagues from all over Nepal participaed. The principles of the technique and the possible pathological findings in the individual organs were demonstrated in lectures by Nepalese doctors and Mr. Riepl, Mr. Stagge, Mr. Guggenberger and Mr. Ott. ?In three sessions, there was the opportunity to perform sonography on patients themselves under supervision. Mr. Riepl had prepared gel models and a meat model on which an olive could be punctured from the outside. As every year, this was a real highlight for the participants.

On Friday, the focus was on endoscopy. At the beginning, accessories, the functionality of the endoscopes and the hygiene of the endoscopes were demonstrated.?In the other two sessions, dilation of stenosis, varicose vein banding, polypectomy and bleeding therapy (clip, injection and beamer) were demonstrated and the participants were offered the opportunity to practice these techniques themselves under supervision. As every year, the enthusiasm and interest in learning the techniques was very high among the participants.?It should also be noted that either plastic models (e.g. polypophant) or pig stomachs, which came as a waste product from the local butcher and were artfully prepared by the sisters for the respective interventions, were used for the exercises.

On the last day, Saturday, 80 listeners from all over Nepal came for the live demonstrations and the subsequent lectures, as well as medical staff from the hospital.?It started with two live endoscopies, with V. Stagge and R. Riepl carrying out the examinations in a team with a Nepalese colleague.?Subsequently, there were eleven presentations from Nepal and five from German colleagues during the day. The selection of topics was always relevant to practice, and the presentation of the Nepalese colleagues was consistently at a very high level.?The following German speakers presented their contributions as a live link via Zoom: Prof. Thomas Rösch (Hamburg, UKE, "Innovation in GI Endscopy") Prof. Roland Schmid (TU Munich, Klinikum r.d. Isar, "Advances in Pancreatic Cancer") PD Dr. Kaspar Trudinger (Gastroenterologist from Switzerland, "Clinical challenges in Colonic Polyps") Prof. H.-D. Allescher President of the Gastrofoundation, Klinikum Garmisch Partenkirchen, "Management of Bile Duct Stones. Timing, selection and technique") The four topics were presented in a highly professional manner. Fortunately, there were no technical problems thanks to electricity protection via an extra solar-powered grid.

According to the participants, the workshop with the final congress is unique in Nepal. Only e.g. India offers comparable events in the region.?This encourages us all to continue to actively and unselfishly support this project, which was started many years ago by our members Dirk Hagena, Sepp Philipp and Matthias Breidert. In the run-up to the workshop, Rudolf Riepl visited the hospital in Dolakha and spoke with the director Mr. Tamarkar Dipesh about the need for endoscopic lines. In an operating room there is currently a 160 mm Olympus tower. Endoscope devices are not yet available. The greatest need is to be able to perform gastroscopies in a timely manner. The most common indication would be the detection of gastric malignancies and the clarification of bleeding (esophageal varices). A doctor and an endoscopy nurse are already being trained for gastroscopy at Dhulikhel Hospital. The procurement of a gastroscope is still to be clarified.


Okt. 2023

Dr. Volker Stagge, member of the Nepal Group, talks about his volunteer work in Nepal in this podcast:

https://soundcloud.com/marketing-860487273/inside-ilmtalklinik-vol-3-nepalhilfe



Jun. 2023

Establishment of a professional society for endoscopy assistance in Nepal: Nepalese Endoscopy Technician Society

About 5 years ago, the idea arose to found a separate professional society for endoscopy assistants in Nepal. Here, too, the nurses in endoscopy have a high level of responsibility, special training and a lot of experience in areas that are of considerable importance, such as assistance in difficult therapeutic procedures, for example in ERCP, device reprocessing, sedation, hygiene. There are no national standards in Nepal for the implementation of these tasks or for training. In order to create a supra-regional qualification, to recognise this specialisation as well as to enable further training and networking, a professional society is indispensable. The nurses of the ETC in Dhulikhel, Nepal were willing to go down this path and create an organization for the whole of Nepal. This process, with the fulfilment of all the legal requirements, the motivation of colleagues from other clinics and the creation of the structures, has now led to success after a few years and with the use of a lot of strength and patience. The Nepalese Endoscopy Technician Society was officially recognized in March 2023 and opened at Dhulikhel Hospital during a ceremony and workshop. The president of the society is Samirabhupal Baynju, the senior endoscopy nurse of the gastrointestinal endoscopy department at Dhulikhel Hospital. The German and European groups, DEGEA and ESGENA, have sent greetings and generous offers of support and cooperation for this special step. The Gastroenterology Foundation also continues to support this group generously. For the future, we would like to see more cooperation with German endoscopy assistants under the umbrella of the Gastrofoundation and cordially invite all colleagues to organize themselves here and actively support the progress in Nepal!

 


Mär. 2023

It's time to say a big "thank you"!

At the end of February 2023, the Endoscopic Training Center (ETC) at Dhulikhel Hospital received a new Olympus 190 series endoscopy system with a CV-190 video processor, a CLV-190 xenon light source and a OEV262H - 26" HD monitor from the Gastroenterology Foundation e.V. Munich. To go with this, the ETC also received a GIF-H185 video gastroscope. This means that the Endoscopic Training Center, which is the reference center for interventional endoscopy in Nepal, has an endoscopy system with a better and more lifelike endoscopic image and significantly improved resolution than before. Now the foundation for even better and more efficient diagnostics has been laid. This endoscopy system also paves the way for a step-by-step further modernization of the endoscopes with Olympus 190 series devices. The average age of the endoscopes in use so far is about 17 years. The whole project took almost exactly one year from the decision in February 2022 to its realization. A good 130 days passed just waiting for the import permit from the Nepalese authorities. From the first cost estimate to the arrival of the pictures of the construction of the plant in Dhulikhel, almost 170 emails were exchanged between the parties involved. The costs for the system and the endoscope amounted to approx. 18,500 €. In addition, there are about 850 € for transport and insurance. In total, more than €19,300 was spent. First and foremost, a big thank you goes to our donors and members who made this campaign possible! The purchase of the equipment was only possible thanks to the generous support of Olympus Germany, in particular Dr. Harald Dremel, Mr. Peter Wöhrle and Mr. Peter Müller.?We would like to thank Mrs. Isabella Aigner and Mr. Robert Gassner from the forwarding company Emons Air & Sea GmbH for the transport and the almost infinite patience with us.?Another thank you is for Dr. Claus Kiehling for taking the 185 gastroscope with him to Nepal.

The technicians of Dhulikhel Hospital unpacking the items

Fixing the new monitor

The full new system

Sumitra unpacking the new gastroscope.

 

 

 

 


Nov. 2022

The fall workshop at Dhulikhel Hospital took place from November 3-5 and went very well. Wolfgang Scharnke organized and conducted the workshop together with Wolfgang Blank and his wife Ursula on site, supported by lecturing colleagues in Germany. The ultrasound course was attended by 15 people, a good mix of beginners and users. The great interest of the young people in both the lectures and the practical exercises was striking. For the latter, Prof. Gurung had organized male models who willingly allowed themselves to be examined by the course participants. In addition to the models, Wolfgang Blank's gelatine kitchen once again provided the puncture models with a mix of olives, beef and balloons.

On the second day, which was attended by 25 participants, the well-known demonstrations of therapeutic tools in endoscopy took place in the morning.After the ERCP demonstrations, it became practical.The team of nurses shone with their perfect preparation of the two pig stomachs and the models that the Wolfgangs had purchased from Prof. Grund, Tübingen, and donated to the ETC.We were supported on this day by Michael Guggenberger, who came to Dhulikhel from the Scheer Memorial Adventist Hospital in Banepa.

Olympus Singapore contributed to the workshop on the second day and demonstrated the new "1500" series system. Unfortunately, ERBE had to cancel its participation as Ganesh Lim was no longer available due to the relatively short-notice rescheduling of the workshop.
The event was rounded off by the State of the Art Lectures by Matthias Breidert from Zurich and Rudolph Riepl via Zoom.The transmission took place in the Morning Conference room and was technically perfect. In the run-up to the conference, the time until the participants arrived was bridged by Nepalese pictures and music.
The third day took place in the lecture hall. Most of the well-known gastroenterologists from Nepal were present.After the lectures (Endotalk), the 5 posters and the 4 submitted pictures were awarded.
Only the "Rapid fire answers to surgical/interventional endoscopic problems (max. 8 slides, 8 min speech)" was used for presentations, contrary to the intention. The only thing that will help here in future is to rigorously switch off the projector after 8 slides.
Overall, the atmosphere was very good and there was an intensive exchange with the very interested colleagues, also during the breaks.
Not to forget a big thank you from the nurses to the Nepal group of the GF for the congratulations!


Apr. 2022

After a long break due to the pandemic, another face-to-face workshop was held at Dhulikhel Hospital in Nepal on 30.3. and 1.4.22. In addition to the presentations, the participants were given plenty of time to practise the principles described themselves. The Gastrofoundation was represented by Dr. Dirk Hagena, Dr. Wolfgang Blank and Dr. Volker Stagge. The first day was dedicated to ultrasound, and the young doctors were able to practise punctures and drainages on specially made models in addition to basic examinations. The second day focused on endoscopy. After the theoretical part, demo examinations took place and the colleagues were able to carry out simple exercises with the endoscopes themselves using various models. The Nepalese endoscopy nurses had again prepared the individual stations perfectly, including prepared pig stomachs and the models. At the same time, the lecturers from Nepal and Germany were of course always available to answer questions and provide suggestions. Ultimately, this 5th hands-on workshop for beginners was once again a great success, demonstrating the department's function as an endoscopic training center for Nepal.

 


Nov. 2021

Corona has us under control!

That's why we are moving our traditional fall workshop to the virtual space!
On November 18 and 19, the virtual endoscopy workshop will take place in cooperation with Dhulikhel Hospital.

We expect 300 participants.

Today we hosted a test session with speakers and industry supporters.
So good to see everyone! We are looking forward to tomorrow. The exchange is valuable and important.


Sep. 2021

A long-standing member of the Nepal group of the Gastroenterology Foundation and an endoscope repair company have donated two gastroscopes for gastroscopies to the ETC. They are already in use! Thank you very much for this generous donation.


Apr. 2021

After weeks of waiting for clearance from Nepalese customs, our large aid shipment with accessories, repaired endoscopes and protective material has finally arrived at the ETC. We have just received the first photo showing our colleagues unpacking.

A big thank you to all donors!


Apr. 2021

Today, 620,000 CPA masks from Zettl, 50,000 surgical face masks from STRAMA and several boxes of protective material from Straubing Hospital were loaded into two containers and set off on their long journey to Nepal. The loading operation was thankfully carried out by Kühne+Nagel with a team of volunteers.
Many thanks to the donors and to Prof. Weigert and his team for their great coordination!

 



Okt. 2020

After months of waiting, a large delivery has finally reached the ETC in Dhulikhel. Our colleagues were able to unpack three repaired endoscopes, the new X-ray machine for the new ERCP room and coronavirus protective clothing. We would like to take this opportunity to thank all donors, especially the Merck Family Foundation and the Rotary Club Oerlikon.