Jangsem is an 8 year-old girl from Bridim. She suffers from a complex heart defect, present from birth, and had just months to live. Dr. Sean Keogh and Dr. Christine Bradshaw, two doctors who were invited by Dolma to Nepal in February ’04, examined her and immediately realised that her clinical situation was serious. Following the coordinated efforts of the Dolma Development Fund (DDF) and of Sean and Christine, Jangsem has now undergone heart surgery at Shahid Gangalal National Heart Hospital in Kathmandu. The operation was a success and she is currently recovering.

The DDF will be providing financial and logistical support to Jangsem and her family in the post-operative period. Sean and Christine are now working to establish a new permanent health programme in the region in cooperation with national, regional and local health authorities, and working closely with the Dolma Development Fund.

It was clear from just looking at Jangsem how ill she was. She had a blue pallor and could barely walk a few yards without becoming breathless. But after much care and attention from our visitors, and with the help of a bubble-blowing game, her usual frown broke into a beautiful smile.

Sean is a highly experienced Consultant Emergency Physician specialising in developing world medicine and international disaster relief, having worked in countries and regions as diverse as Montserrat, Iran (Bam), Iraq, North Korea, Southern Africa, South East Asia and Afghanistan. Christine is an experienced Physician and Intensive Care doctor who has also worked extensively abroad in South America and Southern Africa. While travelling at the invitation of Dolma, Sean and Christine didn’t examine only Jangsem, but saw and treated many other local people from Bridim and the surrounding villages. For most, it was the first time they had ever seen a doctor. They were able to treat many ailments from a deep axe wound to a knee that could have left a mountain farmer lame, to serious and infected insect infestation bites. On one of the treks, they saw a lady in Timure (Tibetan: Sedang) who had lost her finger chopping wood 3 weeks earlier. The doctors debrided, cleaned and properly dressed the severely infected wound, and the DDF paid for her transport, care and treatment in Kathmandu. The project that Sean and Christine are now working to establish, with the Nepalese health authorities and with the DDF, will enable specially selected and trained UK doctors to help assist and train local primary health care workers in the area around Bridim. Although there are health centres in the region that are stocked with basic drugs, the problem is that these are seldom open; the clinics are unhygienic and are staffed by poorly trained personnel who desperately want further medical education. There are many reasons why these health centres are not as effective as they might be, including cultural reasons, lack of contemporary medical knowledge, inappropriate use of western medicines and ancient healing beliefs (including Shamanism). The project will focus on creating a system within the region that provides high quality training of local staff in a wide spectrum of topics, ranging from simple basic hygiene practices in the community to advanced treatment of serious wounds. As well as training local staff, the project intends to produce an effective mechanism of referral and transport for patients with serious medical conditions, so that they are treated at the right time in the right place, either locally, in Kathmandu, or in an international centre; the aim is that patients with serious conditions – such as Jangsem – are taken to Kathmandu for proper treatment at an earlier stage of their illness, courtesy of the Dolma Development Fund.