COVID Conversations: Brown Emergency Medicine Fellow in Nepal Fights COVID-19 on Multiple Fronts
PROVIDENCE, RI [Brown University] – Almost as soon as Dr. Ramu Kharel arrived in Nepal on his Brown Global Fellowship to research emergency medicine programs there, he found himself in the midst of a national crisis. A second wave of the COVID-19 pandemic has hit Nepal, causing its already weak healthcare infrastructure to collapse.
“As the international community focused on India, this country of nearly 30 million people was drowning in the pandemic,” Kharel said.
Kharel – who had treated COVID-19 patients as an emergency physician at Miriam Hospital in Providence and is an affiliate member of Brown’s Center for Human Rights and Humanitarian Studies – immediately teamed up with health workers, government officials and NGOs to provide a multitude of creative and effective relief strategies. He has led training sessions for health care providers, advised local leaders on the COVID management protocol, and consulted with health centers on treatment and resource management. Kharel, who just returned to the United States this week (a month later than he originally expected), answered questions about efforts to tackle the pandemic overseas.
Q: What was the state of the COVID-19 situation when you arrived in Nepal on April 1?
In the first 15 days after I arrived, COVID cases started to explode in India, and then soon after, per capita cases in Nepal were even higher than in India. The border between Nepal and India is approximately 1,100 miles long and it is virtually impossible to control all traffic from one country to another. The rate of viral infections in Nepal was as high as 90% in some districts, especially those bordering India. There was a major lack of oxygen supply, testing was inadequate, very few people had received the vaccine, and intensive care beds were filling up quickly.
Q: How did your experience in Rhode Island prepare you to help out in the field in Nepal?
Over the past year, I have spent a lot of time treating COVID-19 patients and working at the Rhode Island Convention Center Field Hospital. Through Brown as well as Project HOPE, the world health and humanitarian organization, I had also participated in trainings with more than 55 countries on the principles of COVID-19 treatment. We had done a three-day training on different concepts. These experiences really put me in a privileged position, when I came here, to help.
Q: As part of a larger Center for Human Rights and Humanitarian Studies / Project Hope projectTo provide COVID-19 training for health workers, you conducted training on clinical management and vaccines for health providers in Nepal. What impact do you think this training will have?
A 4 hour video training course was taken by 300 doctors, nurses, health workers across the country which was the maximum number allowed on my Zoom. The feedback has been tremendous. It is very clear that we do not have enough to equip healthcare workers working on the front lines to fight this pandemic, and one of the gaps is basic clinical management knowledge. Together with my NGO, HAPSA Nepal, we also organized a 2 hour training focused on the staff of the isolation / surge centers. It was also well received. To help this reach more municipalities, we are posting the videos online. When we put the 2 hour training video on YouTube, there were 4,000 views right away. There is a great need in Nepal to train and equip frontline healthcare workers with clinical knowledge about COVID-19.