Journalism Team – H4TW
On the morning of April 25th, 2015, a magnitude 7.8 earthquake struck Nepal flattening villages and leaving thousands dead and hundreds of thousands homeless. Dr. Lekhjung Thapa still vividly remembers that day and recounts how lucky he was that his hometown, high in the mountains of Nepal was not devastated. Overtaken by a strong moral obligation, Lekhjung knew he needed to leave his village to help others. Against the advice of his family and community members, Lekhjung and a friend jumped in their car to drive to Kathmandu. He remembers being the only car on the road that day.
Kathmandu, the capital city of Nepal, had taken the brunt of the earthquake; temples that had stood for thousands of years toppled and countless people were left in need of medical attention. Upon arriving at the hospital in Kathmandu Lekhjung helped patients to safety and worked to establish treatment sites in the gardens surrounding the hospital. He remembers that day being very difficult, but knew how fortunate he was to be unharmed and was determined to help other people.
When speaking with Lekhjung it quickly becomes apparent how motivated he is by his work to help other people. His passion was sparked by a personal experience. As vividly as he remembers the morning of the earthquake, Lekhjung remembers a time when he was much younger. He remembers being a boy and rushing his father to a local hospital after he had a stroke. Physicians told Lekhjung and his family that they could offer little help and insisted they bring him to Kathmandu. His father received care but ended up partially paralyzed. Lekhjung was deeply unsettled by what he was told and questioned why resources were so limited. His family quickly became full-time caretakers, and 6 months later his father passed away from a second stroke. The lessons were clear, and Lekhjung’s ambitions to become a neurologist were awakened.
As an established physician, Lekhjung is incredibly driven. On weekdays he oversees the care of 70-80 patients a day in addition to teaching residents. On the weekends he returns to his hometown to assist in local clinics. He was one of the first neurologists to be trained in Kathmandu and presently serves as President of the Nepal Stroke Association and as a commissioner for Nepal for The Lancet: Neurology.
Lekhjung’s unrelenting desires to improve outcome for stroke patients in Nepal is palpable, but he describes the numerous challenges that face stroke patients in Nepal: limited access for rural communities, lack of epidemiological data on stroke, and a dearth of preventative care and education. Lekhjung optimistically confronts these challenges, but notes that they can be overwhelming. When he was contacted by Dr. Rehani and Health4TheWorld, Lekhjung felt a new encouragement.
He describes how the H4TWStroke App, which is downloadable on Android and IOS, helps his patients. The app, which caters to patients who have had a stroke, contains exercises, an effective communication tool, and a wide range of educational information such as signs of stroke, healthy diet tips, and helpful home modifications. The app can also help its users eliminate risk factors for strokes such as high blood pressure and diabetes. Lekhjung says that he “prescribes his patients to use the H4TWStroke App as if it were a medication.” For Lekhjung the app is an important tool providing the necessary reinforcement and repetition that a stroke patient needs. For example, one patient who had right-sided paralysis following a stroke used the app to regain strength and to educate himself and family members on ways to lower his risk for getting a second stroke.
Lekhjung notes that the app’s primary advantage in Nepal is offering the reminders and reinforcements for patients living in rural areas who do not have easy access to a neurologist. For many of his patients, a trip to Kathmandu can mean traveling hundreds of kilometers from mountainous regions. The app provides a greater degree of accessibility to information.
The app also provides secondary benefits to caretakers. Lekhjung notices that children have taken a liking to the app. He encourages patients to bring youngsters, who can in turn help their parents use the app more effectively. Although the benefits of the app are difficult to prove scientifically, he has anecdotal evidence that it works well and finds that the patients who use it routinely greatly benefited from it.
Health4TheWorld has connected Lekhjung to a global community of neurologists and he discusses how lucky he has been to meet and discuss cases with physicians across the globe.
The services that Health4TheWorld has provided physicians are multi-faceted offering improved access to technology and a global network of physicians. Lekhjung recognizes these unique benefits, and contrasts the work of Health4TheWorld with the multitude of nonprofits operating in Nepal. He recalls an incident when an ambulance was donated to a local hospital. Although this ambulance would be extremely effective, the drivers, staff, and infrastructure required did not exist, and the donation could not be utilized. In comparison, he states that Health4TheWorld provides direct support to physicians, and enables them to provide improved care for their patients.
At the end of a long day, after seeing 70-80 patients, and battling the inherent obstacles that come with being a physician in Nepal, Lekhjung notes that collaborating with Health4TheWorld physicians has also given him a strong morale boost. This perhaps is the aspect of Health4TheWorld for which Lekhjung is most grateful.