Mohan Bhusal from Nepal

01.12.2012 Memories from Europe
The year 2012 became one of the most memorable years in my life, not only because  I  graduated from  medical school  but also because i  got opportunity to  see the  world outside for the first time. Undoubtedly, I was a travel freak in my country and had been to the remotest places, but  never  before had I had this sort of  international exposure. My Sincere thanks to IPPNW for making everything possible.

My journey this year started with the IPPNW bike tour and the 20th IPPNW  world congress, both held  in Japan. Immediately afterwards, I headed towards Germany under the program “Medical training and social project”, between  IPPNW Germany and PSR Nepal. As I had already seen the Greatest possible technological advancement and sophisticated lifestyle while I was  in Japan, I had not  expected  much from Europe but  I got way more than I had expected, especially from the rich European history and Culture.
Apartment
After a long  transit and tiring flight I landed  at Dusseldorf, the capital of North Rhine Westphalia region. Katharine was awaiting there with   beautiful smile to welcome me. Everything  about my accommodation; a  comfortable and clean room, cozy bed and nice flat mates, was extremely well organized by Katharine and Tatyana. I started noticing the difference, the German way of managing things so precisely. I was   indeed spellbound by their  managerial skills. While residing in the flat with Maria, Lotte and Julia, the issues of cultural shock never came in between us, even though we were not tuned to each other’s culture. I never noticed how fast time flew while we were   busy   sharing our personal details, our hobbies, our experiences, our cuisines  and our culture. Especially it was exciting for them to know about such an unheard yet beautiful country like Nepal and for me about this technocrat society.
Hospital Internship
I was placed as a practical year student at the  General Visceral and pediatric surgery department  of Heinrich-Heine University, Dusseldorf. The morning rounds and the conference were  in German language. My efforts to use every available sense to understand was really tiring.  At times, I felt quite awkward staring for hours ,at  the people making conversation, without  getting even the slightest hint of what they were talking about. That was somewhat depressing. Despite all these, I enjoyed learning at the hospital, especially in that  new setting. I am very much indebted to the resident doctors - Dr. leione, Dr.Ruppe, Dr.kraus  and practical year students; Melanie, Anna muller, Juliana and Marcel, who didn’t leave any stone unturned  in  minimizing  the language barrier.
Academically also it was an enlightening experience for me . I got opportunity to assist in many big operations which I  had never done before in my country. My happiness knew  no bounds when I was even allowed to cut and anastomose the colon using  stapler in a hemicolectomy operation.I had not expected this  even in my wildest dreams. In addition, I saw some world class surgeries like  robotic surgery for donor nephrectomy  being carried out. This was something which I had never seen or heard of  in my country.
If I have to compare the experiences I had while working at my hospital in Nepal with that I gained in  Germany, I would   say, medical science  is perhaps the only field with the least difference between developed and developing nations in terms of  practice. Everything, except the sophisticated instruments and materials used there, were the same. The environment around and within the hospitals in the two countries are contrasting in terms of tranquility. Hospitals in my country are always the crowded  places full of visitors because the patient parties themselves  have to be involved in  bringing medicines and food  and even have to run for  tracing the reports, while each of these things were managed by the nursing staff in Germany. In addition, there are multiple ways for the patients to keep themselves entertained, for instance, with the aid of multimedia attached in every bed, unlike in  the hospitals of my country. I still wonder when the government hospitals in my country will be that peaceful and managed. Besides the infrastructure and the environment, the communication skills of the doctors and medical students in Germany were also quite impressive.
Apart from all these good things, I   had some bad impressions as well. I noticed the sterility while doing dressings was far well   maintained in my hospital back in Nepal. This was contrary to the blind belief that everything about developed countries is always good and perfect.
I also encountered some incidents that were completely strange and terrible for me. Not only the visitors but everyone, from the patients to all those in white coat, were smoking openly within the hospital premises. The scene of Leg amputees in wheel chair  moving outside the hospital with cigar in one hand and intravenous cannula on the other hand was really disturbing. I don’t know if that meant freedom there, but I feel proud in saying that, no one is allowed to smoke within hospital premises back in my country. The so called role models of the society, doctors , were smoking publicly. I still wonder  what kind of influence this has in developed societies like Germany? It took me a while to get used to this.
I also  had a pretty nice relation with the patients during my placement there. Most of the patients were excited to have someone from abroad and tried their level best to minimize the language barrier and even  helped me with some gestures or in whatever ways possible. I could say “Kann ich bitte dein Blut” meaning can I take your blood please, and some greetings to ease the conversation. It would be injustice to complete this essay without acknowledging those lively teachers.
Social Project
Though Germany is a very prosperous country there are still  many problems as everwhere else i.e. the issues of homeless, paperless and the refugees. Working in medinets with those paperless people, not seeking medical advice because of  fear of  revealing their identity, was another novice experience for me. That was the only instance when I realized what deprivation and poverty meant  in a developed country.
Europe and the European culture
Besides  the hospital chores, I enjoyed  time there   hanging around the Rhine, Altstad and Konigsalle in Dussledorf.;  Alexanderplaz, East side gallery and Friedrichstraße in Berlin. I consider myself way too lucky to come across some extraordinary Nepali people like Bijaya Pokahrel and his  German wife Juliana; Saroj Chudal and his wife Sabina and some amazing young people like Pratik and Ritesh  who helped me  during every thick and thin.
I was impressed by the freedom and youth friendly environment of Germany. People working hard throughout the week, partying  and getting wild during weekends, the night life  there were something worth remembering and cherishing for me. I had  never  had experienced such night life back in my country with such a strong sense of security and openness. Poor me and  youths like me in Nepal, where, even drinking before thirty is considered a taboo.
I saw places like Amsterdam where prostitution is legalized and marijuana is free yet there are minimal traces of antisocial activities resulting from this. Only then could I realize to what extent freedom can be. I was impressed by the Dutch government for regulating things so nicely. I saw couples locking lips at public places like train, parks and streets .This was considered love by the flexible and broad minded society of  Europe but my  rigid society calls it vulgar.
Transparency in the government offices including the chancellor office and the Parliament  is another  that  fascinates people like me  coming from a  country where bribery and corruption are at their peaks. The political scenario ( politics of ethics and honesty)  of Germany is  also really  inspiring .  One of the major political party in Germany comes from environmental background named Green party. Back in my country we have around  thirty parties but none of them has environmental issues as their agenda.
The clean green environment and the freshness there stills makes me envious of. Poor me, I come from one of the most polluted cities of the world where I come home everyday buried in dust.
Twenty four hour public transport was another thing worth applauding.  The punctuality of the public transport and the speed they possess still enthrall me.  The megastructures  like four to five storeyed Hauptbanhof (central train station),skyrocketing towers, eye straining criss cross roads, skyscrapers, tall bridges and the railway trams are the technological masterpieces I saw in Europe. Hats off to those  Engineers and their master minds. Equal share goes to the Automechanics, by dint of their hard work and perseverance, German economy is the strongest  in the European Union. Recalling these memories, I am taken back to my country where I walked for five to six days to reach some places, which are in fact a distance of few hours in a fast train in Europe. Seeing this, I wonder if my country will ever experience such a boost in technology and infrastructure.
Within  Europe I travelled many other  places like Paris, Rome and Poland. I also sensed the intra European cultural variation while I was in those places. The most fascinating  things for me in Europe  were  the museums and the cathedrals. The museums of Sachsenhausen  in Berlin and the  Louvre in Paris  had  unimaginable collection of  historical and artistic things. I was simply awestruck by the grandiosity of those collections. The extraordinary art of Basilica in Vatican  and other cathedrals in Rome made me speechless. I salute to those designers.
Moreover, there was lot to learn from the punctual, workaholic and  straight forward Europeans. The scenario of people  rushing in streets, in trains, with bread and coffee  in their hand made me realize  how important time and work was for them. 
I was impressed by the life style of even the average Germans. I am jealous of the way they are spending life in such sophistication. Everything is mechanical or automatic there making life the easiest we can ever imagine. Immediately I am taken back to my country where majority of the people are below the poverty line and do not  have access to electricity,road and safe  drinking water. How can I expect them to have a better quality of life. With the existing political instability hovering around, I doubt   if an average Nepali  will have access to those things even in the  next decade, let alone sophisticated life.
But then, I don’t want to undermine the spiritual happiness and cultural richness possessed by the  Nepalese. What inspires me is that most people are still satisfied  and happy  despite being poor, deprived and  ignorant while individuals of  the western societies, despite enjoying luxurious life, are not happy due to rush in life, loneliness, unstable relationships and the  growing competitiveness they are facing .This is reflected in the form of  growing depression and suicidal rate in  those nations. One has to be a Nepali to know what family life means and how good it feels to be living together in a family until late, especially during times of  thick and thin.
These were few of the  impressions I  had from the ocean of  many. Still there were hell lot of things I experienced during my stay which is impossible to express in this small piece of writing but they remained indelible in my memories and heart. I consider myself fortunate to have had the chance to experience a completely  different world.  I developed a totally new perception about the world and people in there after returning from my Europe trip and I am happy that  this  even started reflecting in my actions. I hope the things I learnt there will  widen my horizon, broaden  my  mind and help  me think in wider perspective.
Once again my humble gratitude to IPPPNW Germany and to all those who directly or  indirectly aided in making my stay a very memorable one. Finally, as chrismas is also approaching very near, my warmest wishes for the upcoming chrismas. 
MERRY CHRISTMAS. Keep yourself warm with the glue wine.



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