------,. J R Army Med Corps: first published as 10.1136/jramc-133-02-12 on 1 June 1987. Downloaded from

iN Army Med IMp!. lW!7; 133: 100-102 The BMH Dharan Silver Jubilee Symposium

Lieutenant Colonel G E Ratcliffe, MBMRCPRAMC Senior Medical Officer and Co nsultant Physician BMH Dharan, Nepal

BMII Dharan (Figures 1--4) was built in the lat e 1950's inaccessible parts of the couTltry. The hcalth posts are as all integral part uf Dharan Ca ntonment in Ei1st Nepal, run by health assistants and Brigade of Gurkhas. The • Throat' , kindly donated hy UNICEF in K

replied "Gold", 1979 olle hundred and eleven students have successfull y on October 1, 2021 by comple ted their training. M~di(.'al Organi~ation in N~pa l Dr K R Pandey. the Civi l Surgt:!on fr0111 the Koshi Medit..'al Education in Tribhuwan Uni\'ersit)" Anchal Hospital , Biriltnagar. spoke about His Majesty's Medical School • Departme nt o f Health programme for Nepal. The Or J Diekin~on , Medical Superinte nde nt of Patan country is divided into Zoncs (Anchals) in the main Hospital, Kathlllandu discussed the founding of the centres of which are large Zonal H ospil

• • • • • • • • • •

I BMH Dharan• British Gurkhas Nepal I guest. Protected by copyright. I I I I I Fi~. I. Hospital Sign Fig. 2. BMH J)hanHl - Casualty & Recepliun I I http://militaryhealth.bmj.com/ I I I I

on October 1, 2021 by I

- - - - . ~--... ,...... " .. ------Fig. J. 8:\IH Dharan - TB and I\'linimnl Care Wards Fig. 4. From I. to R Men's Medical Ward . TB W;lrd and Minimal Care Ward "" • J R Army Med Corps: first published as 10.1136/jramc-133-02-12 on 1 June 1987. Downloaded from 102 Th e HMI-I Dlwran Silver Jf/ bilee Symposium • He described the difficulties of trying to produce a It had been huped to compleme nt this talk by asking medical training scheme appropriate to the needs of the Dr Roy We lford , the Medical Directur of Save the country, where unquestionably the main requirements Children Fund (UK) in Dhankuta, to disl:uSS the work at this stage are for community health and primary of SCF in East Nepal. Unfortunately, because of staff health care , with much less emphasis being laid on such prohlems, he was unable to a ttend. things as expensive investigation techniques, renal • dialysis or bone marrow transplantation. Potential Japanese Encephalitis medical students we re chosen from para-medical Since the first great interest in this disease in South workers, laboratory technicians, etc. Following quali­ East Nepal by Major Alan Hendersun in 1982-83, a t-icalion, these doctors are committed to service in research project to quantify various aspects of the district hospitals for four years. Tu emphasise furthe r prohlem has been in progress o rganised hy the Royal • the paramount importance of community health, any Army Medica l Coll ege, the Lundon School of Ilygie ne para-medic who has worked in the remoter areas fo r 3 and Tropical Medicine and the U .S. A rmed Forces years is much more likely to be accepted for medical Medical Research In stitute in Bangkok. training, assuming the necessary educational require­ A slll all epi demi c of the di sease occurred in South ments have been met. East Nepal in 1984 , but in the mo nsoon period of 1985 He also spoke of hi s work setting up the Physiology the bi ggest epidemi c so far of over 300 cases occ urred. • Department of the ~:fedical School. He described the The initial re sults from these cases, attcmpts to isolate value of using everyday mechanical devices to demon­ the virus in fatal cases, the collection of blood samples strate various aspects of physiology; to illustrate this he from sentinal pigs (l:onsidered then to be the amplifying

described a simple water supply from the cop to the host of the virus), and the various entomological aspectsguest. Protected by copyright. hottom of a hill with various intervening taps to control of th e di sease we re di scussed by Dr C Leake. Virologi st • flow as an example of a negative feedhack system. from the London School of Hygiene and Tropical Medicin e, by Mr K Chctwyn , Entomologist fr om the Royal Army Medical College and by Captain D The End of the Road Bell_my. RAMC . Medical Office r tu the project. Mr Frank Guthrie, the Fi eld Director of the British Dr Leake spo ke with great enthusiasm anout the large • Nepal Medical Trust (BNMT) discussed the his tory of numher of pOS iti ve results from CSr- specim ens fro m the Trust .md the work it had done in East Nepal in the suspected cases. 'fhis hopefull y would enable confir­ management of tuberculosis since its in ception in the mati on of Ihe effi ciency of the Biken vaccine against the late 1960s. Hi s talk was illustrated by a videotape, "The di sea~c. With guarded optimism for the future success • End Of The Road", produced by BNMT. whi ch on this suhject. th e symposium dosed aft e r i l very varied described the work of its clinic in Chainpur. a sma ll town and int eresting selectio n of lectures. about fi ve days' wa lk north of Dharan. Within the limita tions imposed by the rugged terrain Acknowledgements of the co untry with it s inhere nt transpo rt difficulties , and T he author would like to express his gratitude to a ll •

its lack of investi gation facilities, rhe T rust has had a speakers, guests and hospit al staff for th eir great effort s http://militaryhealth.bmj.com/ remarkable success in its primary aim , and has also in making this sy mposium so sll l:cessfuL and to Mrs played a huge part in BCG vaccination in East Nepa l. Sant amaya Rili who typed the manuscript. •

• on October 1, 2021 by •

•