FRIDAY

 A week anywhere brings heart warming familiarity, and so it is here. We walk to my last clinic past the staring faces - that broadly smile back when you smile at them. The youngest children play happily and carefree in the ‘street’ amongst the dust, ducks and windswept rubbish, with only a rare honking taxi-jeep to displace them. There are no toys, books and bicycles, nor anywhere to buy them. Some children have a home made sticks and ‘wheel’ (old pot or plate) toy. But there is community & a powerful neighbourly ethos. There is the usual group of men talking at the crossroads, whilst I also pass women scrubbing their shiny steel ‘breakfast’ pots and dishes or bent double in the patchwork fields. The warm sunshine reflects brightly on the brisk broad stream that we step stone-to-stone across, and then we briefly climb to the health centre, greeted by a handful of colourfully dressed patients. 

The clinic runs smoothly. The broadly smiling, traditionally dressed, 6yr old girl with three mattress sutures returns for their removal. The sole obese person of the week asks about her arthritic knee pain: she has married into the hills from the plains (Nepalgunj). We finish early for the weekly 3pm ‘phone in’ PHASE meeting for all staff. 

I feel that the staff have learnt a lot from two weeks of teaching by us two GPs. It is an intensive time and can’t be easy being watched. As always with general practice the common things are easy to treat: it is spotting the uncommon diagnoses and the sicker patients that is the greater art. It is not just about learning clinical detail and examination skills: building confidence, boosting morale and learning English are just as valuable. They may not see another GP until the autumn; after the hot summer and the monsoon. Though they do return to ‘base’ in KTM for an annual gathering and the Nepalese New Year celebrations next month. Sadly we will miss it by 3 days (April 13th).