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65th BRINOS Ear Camp

BRINOS Ear Care Centre, Nepalgunj, SW Nepal

10th-20th November 2019

Mike Entwistle
Ed Bick
Andy Smith

Sabita Tamang

Medical Student:
Lucy Sayes,

ENT Surgeons:
Angus Waddell, Camp Leader
Neil Weir
Jonathan Blanshard
Imre Gerlinger

The team, led by Angus Waddell gathered in Kathmandu on the 10th November 2019 mostly from the UK but joined for his first visit by Hungarian Professor of Otology, Imre Gerlinger,

There was the usual gathering of supplies in Kathmandu, between changing planes for Nepalgunj.

Finally, Yeti Air safely delivered the team to Nepalgunj, a little late in the day.

Set To Work..

We were met by Puran Tharu, the hospital chief, who gave us a hasty visit to the hospital. That evening, the operating theatre was set up and supplies were unpacked.

This included the essential vials of Lignospan local anaesthetic. Many thanks Septodont UK again.

Professor Imre Gerlinger

The Surgery

The endless stream of patients with ear disease started early.  Patients travel for days to reach the hospital having been screened in the community by the well-established network of Community Ear Assistants - a truly integrated medical service that is now the aspiration of many Western healthcare systems.

We were fortunate in this camp to have Doctors Mike, Ed and Andy as our 'dream' team of three anaesthetists.

This allowed us to perform significantly more mastoid operations for chronic ear disease and cholesteatoma. The latter being a far more invasive and dangerous disease, which in addition to deafness, can cause fatal abscesses in the brain.

The Future

Training is paramount to the future of BRINOS and it was a pleasure to work alongside Doctors Verma and Gayawali, two Nepali Consultants, along with Dr Sagun Shrestha, a lecturer at the local Medical College. The lifelong learning of all, including the visiting team, continues as the legacy of BRINOS.

These “Ear Camps” will continue in March 2020 in the form of Camp 66 as BRINOS continues to integrate into the local medical services.

Drs Sagun Shrestha and

Jonathan Blanshard

The majority of the operations were under local anaesthetic to repair a hole in the ear drum that causes chronic infection and deafness.

The remarkable bravery of Mohammed at the age of 12 years old to tolerate local anaesthesia was truly impressive.

Anaesthetists and Complex Surgery

Patient under general anaesthesia.

 - for surgery on his right ear (picture foreground).

Theatre Nurse in attendance along with the surgeon and anaesthetist (who is partially visible)

On the work-top behind the viewing arm, the smallest box monitors the level of sedation. (on loan by the “good offices” of the anaesthetics team)

Dr's Verma, Gayawali and Shrestha operating assisted by Nepali scrub nurses

Rest Day

A much needed day of rest mid camp took the team to Bardia national park for a picnic and to spot the elusive Bengal tiger to the surprise of everyone.

Jonathan Blanshard

ENT Surgeon

A Lasting Impression

Every day, the striking improvement in the infrastructure in Nepalgunj made the bicycle commute a breeze, although still crazy with the traffic.

And another problem…

Bicycles and wires entangle at the end of
that eventful cycling tour

 Adapted for the Web Site by D. Marsh

Arrival From UK

Brinos - Nepali integration

Note the names in this picture. An example of the BECC being “manned” by all-Nepali medics.

Of course, most of these are long-standing members and/or supporters.

However, this illustrates how the ethos of BRINOS taking on a life of its own.

As one of the founding BRINOS members Dr Gayawali must be very pleased, as was Neil Weir.

Camp 65 Surgical Results

A total of 132 operations were carried out over the 8 days of surgery including 30 under general anaesthesia, the highest number to date in one camp.

Ill fortune and yet Serendipity

On return to Kathmandu the team's work was not quite complete - our guide on a mountain biking trip in Shivapuri National Park fell and sustained a deep cut to his leg. Maybe by good fortune two anaesthetists and two surgeons could administer first aid and escort him to hospital.

The Combined Team

Nepali Team:

The team led by Angus Waddell gathered in Kathmandu on the 10th November 2019 mostly from the UK but joined by a Hungarian Professor, Imre Gerlinger, for his first visit.  

"Professor Imre Gerlinger"

There was the usual handover of some anaesthetic agents from a very helpful anaesthetist in Kathmandu and Yeti Air safely delivered the team to Nepalgunj, a little late in the day.

Dr Gayawali (Consultant Surgeon)
Dr Verma (Consultant Surgeon)
Dr Sagun Shrestha (Lecturer from the local Medical College.)
Theatre Nurses … and the BECC support staff

UK Team members: