Travellers' tales: spirometry training in Nepal

Abstract

In Nepal there is very little functioning governmental healthcare at the hospital level for a population of around 29 million people. Most hospitals are private initiatives and patients have to pay cash for their treatment. The remote Amppipal Hospital in Gorkha district (fig. 1) is run by a local committee of villagers with the support of non-governmental organisations, like Nepalmed Germany. Nepalmed is a Germany-based group of volunteers from all over the world supporting Nepalese activities in the field of healthcare. The report on the World Spirometry Day 2012 event in the Nepalese capital Kathmandu in the September issue of Breathe [1] inspired me to write about my training sessions in Nepal. In Germany, I worked as a respiratory physician in private practice for 5 years, after a 10-year period spent working in teaching hospitals. In my spare time, I am chairman of Nepalmed and for 4 years have organised medical surveys in Amppipal, Nepal to learn more about the medical needs of the local population. This helps with planning of medication and equipment supplies. It also helps provide specialised physicians to teach the hospital personnel efficient diagnostic and therapeutic procedures. Figure 1 Map of Nepal showing the locations of the hospitals. There has been no dedicated spirometry curriculum in Germany for doctors or nurses. A small group of German respiratory physicians, called The Doctor's Group for Diagnostic Lung Function, has promoted a standardised approach to teaching. This comprised a half-day session in two parts: a lecture on basic principles, followed by practical training using spirometers provided by the respiratory physician as well as the general practitioner's own spirometers. The event ended with case discussions and a written test, which is discussed after completion with all participants. After 1–2 years, an advanced course or a refresher course can be taken. …