Info for Volunteer Doctors
Brief introduction for volunteer doctors
The rescue post is run by volunteer doctors to serve the acute needs of porters and trekkers during the two trekking seasons. Machermo rescue post started up in the pre-monsoon season of 2003 and since then it has proved its worth by saving numerous lives and helping many porters and trekkers. Volunteers must realise that this job is challenging in that its involves working in a poor country in a remote high altitude wilderness environment. (Note: this is a ‘rescue post’ and should not be referred to as a clinic, health post or hospital). Although there is plenty of contact with other westerners who stay in the lodges in the village communication with ‘home’ is difficult and relies solely on (expensive) satellite phone and letters carried out by trekkers.
The post is open during the trekking seasons: pre-monsoon (March April May) and post-monsoon (late September, October November). In October 2006, after the official opening, we now have a purpose-built rescue post combined with a large porter dormitory/kitchen. These facilities are a little bit spartan but adequate and the food is excellent!
The IPPG pays the expenses for the volunteer doctors once in Nepal. Partners may stay and eat for free at the rescue post but he/she will have to pay for the rest of their expenses. (See financial arrangements below for details).
This is a great opportunity to help stricken porters and trekkers, and to combine this with a rich and varied experience that will enrich your life for years to come. While the Everest region is one of the most spectacular areas on the planet, it is the friendships you will make that are the real and lasting part of the experience.
Please read the reports from previous volunteers, “Machermo reports”
Volunteers must be registered doctors in their own country. GPs (family physicians) and Accident & Emergency docs are the most frequent applicants but we will consider other fields if you have enough altitude/expedition experience. Mountaineering and mountain rescue skills are not required, but walking skills are. Perhaps the most important attributes are patience, emotional stability and, most important of all, a good sense of humour!
We do occasionally accept physicians assistants, paramedics and nurses with wilderness medicine skills to work alongside doctors.
Medical students on elective are encouraged but places are limited, doctors are involved with their education (Med students must realize that they will help with IPPGs research and must get clearance for their own projects before acceptance).
Located in the beautiful Gokyo Valley in the Khumbu (Everest) region of Nepal, Machermo village takes about a week to reach. First you fly by light plane from Kathmandu to Lukla, then walk up to Namche Bazaar. Soon after Namche, the Gokyo trail leaves the main route to Everest base camp and enters Gokyo valley. The post is situated at 4500 meters.
Although not as busy a trekking route as the Everest valley, it is becoming more and more popular, as it is the way to Gokyo-Ri (a fantastic 5400m view point), the Cho-La (a 5500m pass into the Everest valley) and the Renzo-La (a less-used pass leading to Thame).
It can be very cold even in summer and, at times, very hot! Temperatures well below zero are commonplace. It is also windy in the afternoons and snow can start as early as October, and end as late as April. The dining room of the post is well heated (mainly with dried yak dung!), but the bedrooms can be very cold. There is a kerosene heater in the clinic room. Given all this, you must realize the need good warm gear (a suggested list will be sent to you).
Consultations tend to come in two waves, the morning rush hour as people wake up and get ready to leave, and an afternoon session when people start coming down or up. Emergencies may occur at any time and occasionally you may have to visit another lodge or even another village (up to 3 hours walk). You will have to give the daily talks on acclimatization and recognition of altitude illness and show trekkers around the rescue post and porter shelter. There is not a huge workload but it can be intense at times, the pre monsoon season is quieter than the post monsoon.
All volunteers pay their own way to and from Nepal. They will need to spend a minimum of three to four days in Kathmandu to get ready. IPPG will pay an amount per day towards the doctor’s expenses in Kathmandu for a maximum of five days. Food is cheap in Kathmandu, and a budget of about US$20 per day will cover three meals and even a beer at night, though it is possible to do it much cheaper (or more expensively). IPPG will pay a return flight to Lukla (approx 100 US$) and an allowance for basic meals, lodging and porterage on the way up and down from Machermo for the doctors.
IPPG will not cover calls home, alcohol, food/drinks exceeding three meals/day at the rescue post. Partners (but not friends) may stay at the rescue post for free and be fed there.
Charges to patients
This facility is the only one available for acute care in the Gokyo valley and it is vital that you collect the charges
set out, as the money you raise goes to run the post next season. To neglect this aspect of the operation can result in a disaster the following season. The money raised from westerners also subsidises the cost of treating porters and other Nepalese. While it is hard for some doctors raised in a free medicine society to get into the stride of charging, it is essential. Most trekkers are insured and you will have to give them a medical report and a receipt so they can claim their expenses. We also sell T shirts, patches, simple medications and first aid books when available.
How much time do I need to commit?
There are usually two doctors (or a doc and a paramedic) at the post at any one time. We sometimes have a change of doctors mid season as we realize many of us find it difficult to be away for such a long time.
As a minimum, the volunteer doc needs to spend five to six weeks actually at the post. Ideally it would be best to spend 8 to 10 weeks at Machermo to cover the whole season. Add two weeks as a minimum to the time at the post
to allow for walking in/out, flying to and from Nepal and time in Kathmandu. A total of seven to eight weeks minimum ex home.
Chhewang Sherpa rescue post manager, and Maila chef
Chhewang Sherpa is the porter shelter/rescue post ‘rescue worker and manager’. His job description is rich and varied and you must accept that his wisdom is worth listening to, even in the clinical area! You should be prepared to help him as much as possible especially with his medical education, as he may need to run the rescue post if a doctor fails to turn up! He is a great companion and acts as your assistant, translator, sirdar, accountant and travel agent. He and Kancha run the porter shelter. He is very much part of the enjoyment of your journey. Obviously he will go up with the first doctor and come down with the last one. Chhewang was the headmaster at Gunza school before joining IPPG. He is a valued part of the team with an overall responsibility for keeping the project running.
The rescue post
This is basic, no fancy equipment, no expensive gear. A solar electric system runs a small oxygen generator. There are a couple of oxygen bottles (to be used sparingly). A hyperbaric bag (PAC) is useful for backup, call outs and when walking patients down. There is a pulse-oximeter, basic surgical instruments for simple suturing (no surgery is undertaken) and a supply of appropriate drugs (including penthrox inhalation for acute pain). There are a few textbooks. There is a heater in the kitchen and clinic room. There are four beds in two bedrooms. There is an indoor urinal and two outdoor composting toilets.
Try beating the porters at volleyball!!
The porter shelter
Porters use the shelter attached to the rescue post, and cook on kerosene and stoves we provide. This is a highly regarded facility and we hope you get to have some contact with the porters who use the facility. We have a TV and DVD for educational use for the porters (but keep an eye on the batteries!!)
Even though we now have a dedicated building, we still need to be aware of the cultural dos and don’ts of Nepal and
the Sherpas. For instance, men and especially women need to dress conservatively. Humour and courtesy are appreciated. Remember you are a guest in their country, land and village and to leave a good impression for the next doctors to benefit from. Make an effort to go round all the lodges regularly to meet the owners.
Nepal is in the grip of an internal political upheaval, as a result of the change from a feudal monarchy to a democratic system in recent years. This civil war does not impact on foreigners and the Everest National Park in particular is free from conflict. Both sides of the conflict have taken care not to injure or involve foreigners. A ceasefire has been declared in 2006 and peace has resumed.
Kathmandu needs personal safety awareness around traffic, huge unlit potholes, theft and dark alleys at night (be home by 9pm, always carry a torch).
Become part of the IPPG “family”
IPPG is organized entirely by volunteers. There is no membership as such and by volunteering you become part of the IPPG ‘family’. Please have a look at the website and read the doctors reports on each season and past IPPG newsletters to get a feel for how IPPG works.
If you would like further information, please contact firstname.lastname@example.org.
Or download the application form: IPPG Application form for volunteers 2015_16 final