The Gradian team has recently returned from Nepal where the UAM was installed in four new hospitals. Dr. Resham Rana from Bir Hospital, Steve Rudy, and a biomedical engineer and manager from our partner The Nick Simons Institute installed UAMs at AMDA Hospital Damak; Okhaldungha Community Hospital, Model Hospital and Tilganga Institute of Ophthalmology.  The team from Nick Simons Institute have also recently installed a machine for INF, a Nepali NGO that organizes fistula surgery at Mid West Regional Hospital.

AMDA Damak has 75 beds, Okhaldunga has 32, and Model has 125.  Mid West Regional has 300 beds. Tilganga sees 1500 patients in an average day.

We started at AMDA Damak Hospital where the Nick Simons Foundation has built a maternity wing to serve women in this eastern Nepal province. From there we drove nine hours on jeep roads to Okhaldunga, not terribly far from Mt. Everest. Model and Tilganga Hospitals are both in Kathmandu, 14 hours by jeep road from Okhaldunga.  Despite the harsh transport, all four machines were ready to go within 20 minutes of opening the crates.

We had a wide variety of adult cases and a surprising number of pediatric procedures. The UAM is designed to accommodate the Ayre’s T-piece for children under 4 kilograms, and has been used in neonates as small as 1.7 kg. The T piece was used in Tilganga for an eye procedure on a small child.

Dr. Rana conducted most of the training in Nepali. Our sessions include a half-day of classroom instruction and familiarity with the UAM, followed by a day and a half in theatre proctoring the first few cases.  The turnout in these four hospitals was quite large, and fortunately there was sufficient patient volume for all providers to get some hands-on time in theatre with Dr. Rana.

The UAM purchased by INF will be based at Mid West Regional Hospital in Surkhet. While it was acquired to support the fistula programs of INF it will be donated to the hospital for use in any surgical procedure.

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