Die letzten Tage in Banjhakateri

Die letzten Tage in Banjakhateri sind angebrochen. Am Dienstag fahren wir nach Pokhara, von wo aus es für uns auf den Annapurna-Trek gehen wird. Unser zweiter und letzter Arbeitsaufenthalt wird dann beendet sein.
Wir haben viele interessante Personen mit unterschiedlichsten Krankheiten gesehen. Zudem haben wir einige sehr nette Dorfbewohner hier kennen lernen dürfen.
Unsere Aussicht aus dem Health Point heraus ist wirklich atemberaubend. Gestern haben wir uns am freien Samstag auf
eine Bank vor den Health Post gesetzt und etwas gelesen. Dabei konnten wir diese Aussicht genießen:

Parkbankblick: unbezahlbar. Übrigens: Im unten rechts angedeuteten Verschlag mit "gelber Markise" sitzt und liegt der älteste Dorfbewohner - schlappe 97 Jahre alt.
Parkbankblick: unbezahlbar.
Übrigens: Im unten rechts angedeuteten Verschlag mit „gelber Markise“ sitzt und liegt der älteste Dorfbewohner – schlappe 97 Jahre alt.

Tagsüber hatten Klaus und Krishna zunächst ein Meeting mit den Englischlehrern. Für die Mitarbeiter gibt es hier Englischlehrer, die jeden Dienstag und Freitag Englischunterricht geben. Dies ist einer der vielen Nebenschauplätze von Brepal hier in diesem Dorf abseits der medizinischen Versorgung. Klaus’ Idee ist es, den Dorfbewohnern beim Besuch im Health Post Sachen zu demonstrieren, z.B. wie eine alternative Bepflanzung der Böden erfolgen kann. Auf diese Weise konnte ein Bauer zuletzt mehr als 300 Euro mehr als üblich erwirtschaften. Noch mal zur Verdeutlichung: Die meisten Arbeitnehmer in Nepal verdienen ungefähr 750 Euro – pro Jahr! Kein schlechtes Zubrot also. Aktuell wird eine Demotoilette aufgebaut. Diese soll den Leuten eine kostengünstige aber doch hygienische Alternative aufzeigen. Wir sehen täglich Frauen mit diversen vaginalen Infektionen, die sicher mit Hygienemängeln zu tun haben.

In den letzten Tagen wurden auch einige Zähne gezogen. Das ist für uns natürlich Neuland gewesen. Amüsierend ist für mich jedes Mal wenn der nächste Nepalese den Zahnarztstuhl besteigt. Dies ist ein typischer Zahnarztstuhl wie wir ihn aus Deutschland kennen. Die Dorfbewohner jedoch sind so einen Stuhl nicht gewohnt und wissen jedes Mal nicht genau wie sie sich auf diesen Stuhl setzen oder gar hinlegen sollen.
Ebenfalls für uns unverständlich ist die Tatsache, dass bisher kein Nepalese, weder in Banepa noch in Banjhakateri beim Mund inspizieren “Ahhh” sagen konnte. Ein Patient hat gar angefangen auf meinem Mundspatel rumzunukeln, weil er nicht wusste, was er damit anfangen soll. Bishnu und ich konnten uns kaum noch halten. Bishnu erklärte uns, dass die Nepalesen nicht wissen, wie sie diese Töne erzeugen sollen…

Cathrin untersucht die Lunge einer Patientin. Ihr Blick ist fachmännisch korrekt angestrengt. Die Patientin übrigens hat es auch sichtlich schwer den Anweisungen:"Tief, durch den offenen Mund ein- und ausatmen" zu folgen. Dies ist hier auch keine Seltenheit in Nepal. Die Menschen atmen insgesamt sehr ruhig, so dass man bei normaler Atmung eigentlich nichts während der Auskultation hören kann.
Cathrin untersucht die Lunge einer Patientin. Ihr Blick ist fachmännisch korrekt angestrengt.
Die Patientin übrigens hat es auch sichtlich schwer den Anweisungen:“Tief, durch den offenen Mund ein- und ausatmen“ zu folgen. Dies ist hier auch keine Seltenheit in Nepal. Die Menschen atmen insgesamt sehr ruhig, so dass man bei normaler Atmung eigentlich nichts während der Auskultation hören kann.
Als wir gestern eine kleine Runde durchs Dorf gelaufen waren und wieder am Health Post ankamen, trafen wir auf Dhanis Tochter. Diese wollte – wie immer – fotografiert werden und verwickelte uns und Klaus im Anschluß in ein kleines Gespräch auf Englisch – sie ist gerade mal Acht Jahre alt. Wichtig war natürlich wie wir heissen, wo wir herkommen und wie unsere Väter heissen. Nachdem Klaus und ich mit Peter und Winfried geantwortet hatten, antwortete sie mit:“Dhani Ram Bhusal Sir“. Echt drollig. Tatsächlich steht auch auf den OPD-Karten der Patienten stehts der Name des Vaters (bei männlichen Patienten) oder der Name des Ehemannes (bei weiblichen). Gelesen habe ich in diesem Zusammenhang auch, dass beim Tode eines Elternteils beim Verbrennungszeremoniell der älteste Sohn den Vater entflammt. Bei der Mutter tut dies der jüngste Sohn (ich dürfte/müsste/sollte/hätte also die Ehre meine Mutter ins Totenreich zu geleiten – bei Cathrins Familie dürfte ihr Bruder als einziger Sohn gar zweifach zündeln ;)). Hat eine Familie keine Söhne, muss ein professioneller – ich nenne ihn mal – männlicher „Anzünder“ dafür eingestellt werden. Emanzipation at its best…

Passt zwar nicht zum Artikel, ist aber eines der süssesten Bilder, die wir hier geschossen haben. Cathrin hat dieses Foto auf ihrem Hike mit den anderen gemacht. Sie sagt das wären Babyschafe. Ich als Tierunkenner glaube, dass es keine Katzen oder Hunde sind und wahrscheinlich auch keine Vögel...
Passt zwar nicht zum Artikel, ist aber eines der süssesten Bilder, die wir hier geschossen haben.
Cathrin hat dieses Foto auf ihrem Hike mit den anderen gemacht. Sie sagt das wären Babyschafe. Ich als Tierunkenner glaube, dass es keine Katzen oder Hunde sind und wahrscheinlich auch keine Vögel…

Noch mehr Bilder für all unsere Bilderfreunde: Meine Aussicht vom "Sofa" aus dem Fenster. Im Vodergrund unser Esstisch mit Krishna und Klaus im Diskurs vertieft. Im Hintergrund meine Schafswollsocken - nicht aus der Wolle der obigen "Schafe".
Noch mehr Bilder für all unsere Bilderfreunde:
Meine Aussicht vom „Sofa“ aus dem Fenster. Im Vodergrund unser Esstisch mit Krishna und Klaus im Diskurs vertieft.
Im Hintergrund meine Schafswollsocken – nicht aus der Wolle der obigen „Schafe“.
Eines Nachts wachte ich auf und sah (im dunkleren) diese Gestalt neben mir liegen. Ich dachte zunächst an eine Mumie. Wie hätte ich das nur Cathrins Eltern erklären können...  Die Auflösung nach meinem Schreck ist aber denkbar einfach und logisch ;) Wir haben einige nächtliche Besucher gehabt, die sich vor allem für Cathrins Gesicht interessierten. Nachdem ich das ganze Zimmer geputzt und den Eingang mit Harz ausgelegt hatte um keine ungebetenen Gäste mehr im Zimmer zu haben, entschied sich Cathrin für die Nummer sicher: Mütze und Halstuch bis zum Anschlag. Eine Burka ist freizügig dagegen... Aber es war mit 30 Grad Celcius auch echt kühl draussen...
Eines Nachts wachte ich auf und sah (im dunkleren) diese Gestalt neben mir liegen. Ich dachte zunächst an eine Mumie. Wie hätte ich das nur Cathrins Eltern erklären können…
Die Auflösung nach meinem Schreck ist aber denkbar einfach und logisch 😉
Wir haben einige nächtliche Besucher gehabt, die sich vor allem für Cathrins Gesicht interessierten. Nachdem ich das ganze Zimmer geputzt und den Eingang mit Harz ausgelegt hatte um keine ungebetenen Gäste mehr im Zimmer zu haben, entschied sich Cathrin für die Nummer sicher: Mütze und Halstuch bis zum Anschlag. Eine Burka ist freizügig dagegen…
Aber es war mit 30 Grad Celcius auch echt kühl draussen…

morzl
Arzt in Ausbildung zum Internisten. Auf dem Weg nach Nepal.

4 Kommentare

  1. YAKUUR- A pensioner, who came for a verification exercise by the
    Cross River State Government at Yakuur Local Government Area secretariat,
    Yakuur, in the state, collapsed at the venue out of exhaustion , and
    was rushed back home, while several retirees and pensioners alleged ill-treatment by officials.

    They also faulted the method employed by the Verification team from the Auditor General’s office in collaboration with the Pensions
    Board in the local government, saying it was too rigorous for them at their age, especially the ailing ones and accused a cabal of swindling them.

    Some of the pensioners, who spoke to our reporter, pointed out that they have
    not received pensions for a period of three to seven months, alleging that the team skipped payment for
    up to three months.

    One of the retirees noted:“ I am a 76- year- old man and there are so many old people, some are bed-ridden, others on wheel chairs and they have been waiting here for hours, Mr. Journalist, just look around you, the sight is nothing to write home about. They should have distributed the verification forms like they used to before since we still have to go through biometric verification.

    Many dead waiting for pension

    „Many of us have not been paid from January till March, I have
    children but they are not in Cross River State, at least they send me lifeline, but there are
    so many of us who depend solely on this pension for survival.
    Do you know so many have died waiting, while some people
    sit in their offices enjoying this money? The way they are treating us here is
    evidence that they really do not care about us.“ he lamented.

    He added: „I want the governor to take a cursory look at the Pension Board and other related agencies,
    so many of us have died waiting while few persons are enjoying
    our retirement benefits because I do not seem to understand the reason why some
    months are skipped. Do you know that there are some teachers, who have not
    received their money since 2012? We are appealing
    to Prof Ben Ayade to unmask the cabal, we are dying.“

    Another retiree, who also declined having his name in print, said: „They should have
    just distributed forms to us and when we come for the bio-metric verification, they
    can confirm or authenticate our information as filled on the form.
    A man fainted and was taken back home, many
    of us are old, sick and weak, I am almost 80 years and they expect me to stay
    here for hours?

    Sixty-four- year-old Ikpi Bernard Usang, a retired teacher,
    said: „We commend the effort of the government in trying to sanitize the system but the logistics and personnel they have provided cannot efficiently handle this crowd and this will lead to so many of us going to Calabar, which is a three to four hours journey because of bad road. „We appeal that the next time they are coming, they should give us information on the perquisite for the exercise.“

    Too many ghost pensioners- Bassey

    Leader of the verification team, Mr. Alphonsius Bassey, told Niger Delta Voice that they would complete the exercise in two days, as they work until 6.00pm daily, adding: “ They are not orderly, and many of
    them, who came here are not local government retirees.
    We have been making announcements so that those who
    don’t have any business here can leave.

    „The essence of this exercise is to clean the system of ghost retirees, there are many of them who died many years ago, yet their pension is still running, we are trying to be more prudent with funds. This is the reason we are taking all the pain to do a thorough job here, and we have two days for this.“

    Secretary to the Local Government Pensioners in Cross River,
    Peter Ozang, however, disclosed that officials would screen about 5000 retirees and would visit the homes of the incapacitated ones to carry out the exercise.

    A flustered retiree, nevertheless, asked: „How can that be possible, is it not a way of removing those people from the master list and voucher. I can count more than five of my friends who died without getting their benefits for more than eight months.

  2. My Peyronie’s dwelling ›› What’s Peyronie’s Illness?

    ›› Erectile Dysfunction Remedy

    Tlisted here are variety of erectile dysfunction therapies accessible to males with Peyronie’s illness.
    That means they’ve a superb probability of overcoming their erection issues with the correct therapy.

    What is the very best remedy for you relies upon in your
    situation and the underlying purpose in your erectile issues.

    The commonest remedies for erectile dysfunction are:

    Underlying Well being Situations

    Oral Remedy (PDE5 Inhibitors)

    Penis Vacuum Pumps (VED)

    Injection Therapy

    Penis Surgical procedure

    Natural Treatments

    Treating Underlying Well being Circumstances

    Tlisted below are bodily causes behind eighty-ninety% of all Erectile Dysfunction circumstances.
    The very first thing your physician ought to subsequently do
    is to search for any underlying well being downside which may be inflicting your erection issues.

    Treating the underlying well being drawback could also be
    sufficient to resolve the erectile issues. For instance by controlling excessive blood stress
    or optimizing blood glucose ranges in patients with diabetes.

    It is although not all the time so simple as that.
    Treating the underlying well being drawback could require treatment that may interfere along with your erection well being.
    Then some remedy for erectile dysfunction could also be vital.

    Men with Peyronie’s illness (and really all males) ought to examine any medicine they take
    for unwanted effects. If erectile dysfunction is listed as attainable aspect impact, then ask your physician about potential replacements.

    Hormone Therapy to Deal with erectile Dysfunction

    Hormones regulate the features in our physique. Testosterone is a hormone made within the testes.
    Low stage of testosterone can cut back the libido and have
    an effect on the flexibility to develop and maintain an erection. One research confirmed seventy four.Four% of all Peyronie’s patients to have low testosterone stage.

    Dr. Khera believes low testosterone stage may very well be contributing trigger to Peyronie’s illness.
    He recommends his Peyronie’s patients to have their
    testosterone ranges checked earlier than beginning any Peyronie’s
    therapy.

    Low testosterone remedy contains injections each 2 to three weeks, or testosterone patches.
    Males shouldn’t take testosterone with out liaising with their
    physician, as there are some notable potential unwanted side effects.

    Smoking and extreme use of alcohol or medicine could trigger erection issues.
    If any of this is applicable to you, then it’s possible
    you’ll wish to cease smoking / utilizing medication and curtail
    your alcohol consumption so as to enhance your erectile well being.

    Healthy balanced weight-reduction plan and common train can also
    be beneficial for good erectile operate (as total well being).

    Psychological Therapy For Erectile Dysfunction

    Physical causes are believed to be behind eighty-ninety%
    of erectile dysfunction circumstances. That nevertheless leaves sizeable 10-20% with psychological
    causes. Psychological therapy could also be required for these people.

    Actually erectile issues are sometimes the mix of each. What might begin as a
    bodily erection downside (e.g. diabetes) could make males nervous about not getting,
    or be in a position to keep up, an erection… which might make
    it a psychological erectile dysfunction.

    Psychological therapy may also profit males
    with bodily erectile dysfunction. Erectile dysfunction and Peyronie’s illness are
    anxious experiences and may end up in depression and relationship points.

    Psychological therapy also can profit the couples.
    It can assist them to enhance their intimacy and alter to
    the modifications of their intercourse life.

    Pelvic Ground Muscle Workouts

    Various research have proven that pelvic ground workout routines for
    males (also called Kegel workouts) could be efficient for males affected by
    erectile dysfunction.

    „After 6 months, blind evaluation confirmed that forty% of males had regained regular erectile perform, 35.5% improved however 24.5% failed to enhance.

    CONCLUSION: This examine means that pelvic ground workout routines needs to be thought of as a primary-line method for males in search of lengthy-time period decision of their erectile dysfunction“ (BJU Int.
    2005)

    Kegel workouts for males may assist with premature ejaculation, dribbling after urinating and enhance the standard of
    orgasm.

    It subsequently appears apparent that every one males ought to discover
    ways to carry out Pelvic Ground Muscle Workouts.

    They’re free, straightforward to do, don’t have any identified unwanted side effects, have numerous penile well being
    advantages and might simply be mixed with most different erectile dysfunction remedies.

    Oral Erectile Dysfunction Therapies

    In latest years, oral medicine has turn out to be fashionable remedy for erectile dysfunction. Who has
    not heard about Viagra?

    Viagra solely grew to become accessible in 1998 however it’s one among three PDE5 inhibitors which can be
    at the moment authorized as erectile dysfunction remedy:

    PDE5 inhibitors (phosphodiesterase-5) work by blocking the PDE-5 enzyme and
    assist the graceful muscles of the penis to chill out and improve
    the blood move to the penis when males develop into sexually aroused.
    PDE5 inhibitors solely work when males are sexually aroused, i.e.
    they don’t assist with low libido.

    It is vital to remember that PDE5 inhibitors don’t cure erectile dysfunction. The erection issues nonetheless exists, it’s a must to take a dose each time you wish to have sexual intercourse.

    PDE5 inhibitors will not be appropriate for everybody.
    Sure medical situation and treatment can stop males from taking them so all the time verify along with your physician if
    interested by oral erectile dysfunction therapy. Additionally, be sure to solely purchase them from a good provider.

    PDE5 inhibitors might be handy selection for males in good well being
    that should not have circumstances that stop them taking them.
    Numerous research have proven them to work for
    70-eighty% of males with erectile dysfunction (Pfizer). Males that don’t reply
    to PDE5 inhibitors could have low testosterone.

    However, for people who don’t love taking medicine on extended foundation, then penis vacuum pump could also be one thing for them.

    Penis Vacuum Pump (VED)

    Vacuum erection machine (VED) or erectile dysfunction pumps
    are one other standard remedy for erectile dysfunction. Vacuum pumps are simple to make use of, they’re value efficient (one-off funding) and they’ve been proven to be very efficient to assist males to attain agency erection (in eighty-ninety% of circumstances).

    Tlisted below are a number of varieties of penis
    vacuum pumps accessible however all work on the identical precept.

    The erectile dysfunction pump is positioned over the
    penis to create blood circulate. The pump sucks out the air from the container to create a vacuum, inflicting the blood to be drawn into particular tissues
    of the penis, which causes erection to happen.

    Rubber band is then positioned at the bottom
    of the erected penis to take care of the erection and permit sexual intercourse to happen (the rubber
    band should be eliminated inside half-hour).

    Various clinical research have proven vacuum erection units to be very efficient as
    erectile dysfunction therapy.

    „clinical success fee is roughly ninety%… A lately reported survey of 5,847 vacuum customers confirmed that 83.5% of patients proceed to make use of the gadget for intercourse as desired“ (World J Urol.
    1997)

    „Quite a lot of stories have cited satisfaction charges above eighty%. This therapy has been proven to end in particular enchancment in erection hardness, enhance in frequency of intercourse and enhance in total sexual satisfaction. Elevated satisfaction for the companion has additionally been demonstrated“ (Cornell Urology)

    Penile pumps are typically thought-about protected gadget however sadly they aren’t appropriate for each Peyronie’s affected person.

    Vacuum therapy just isn’t advisable for males with extreme penis curvature because the straight tube might exert a lot stress on the
    curved penis, leading to trauma to the already bent penis shaft.

    So be sure you learn my article about utilizing Penis Vacuum Pump To Deal with Peyronie’s Illness earlier than choosing erectile dysfunction pump.

    For those who qualify for any such erectile
    dysfunction remedy, I like to recommend the Androvacuum penis pump.

    Androvacuum is manufactured as a medical system.
    It has restricted and managed quantity of stress inside
    the advisable restrict, however the stress shouldn’t exceed
    200-250 mmHg. Androvacuum has been proven to be very efficient for treating erectile dysfunction / enhancing erectile well being.

    See my Androvacuum Evaluate for extra info.

    Erectile Dysfunction Injections

    Tlisted here are variety of medicine that can be utilized to realize
    erection, e.g. Papaverine Hydrochloride, Prostaglandin E1 (Alprostadil) and Phentolamine.
    Mixture of medicine is generally used for optimum efficacy
    and minimal complications.

    If occupied with this selection then you should see a physician and he will educate
    you find out how to inject the medication appropriately into the penis.

    The injected drug will increase the blood circulate
    and causes erection, normally inside quarter-hour.
    An erection will happen whether or not you might be sexually aroused or not (in contrast to
    when taking oral remedy like Viagra). Because of this medical doctors use this after they want their affected person to have an erection for bodily examination functions.

    Possible aspect impact of erectile dysfunction injections is priapism, a
    persistent and sometimes painful erection that may final for a number of hours.
    The injections may also be painful and trigger scarring of the penis.

    Erectile dysfunction injections have good success price (round eighty%) however PDE5 inhibitors at the moment
    are way more in style choice. Oral treatment will
    not be solely extra handy. It additionally has much less potential negative effects.

    Penis Surgical procedure To Deal with Erectile Dysfunction

    Penis surgical procedure as erectile dysfunction remedy is about reconstructing the arteries so as to extend the blood move to the penis or to dam veins that drain blood from the penis.

    Penis Implant Surgical procedure nonetheless contains implanting gadget
    that allows the penis to turn into erect.
    The implant is an inflatable gadget (prostheses)
    that enables you to regulate when and for a way lengthy you’ve an erection, i.e.
    offers males agency erection on demand.

    It is essential to remember that penis implant surgical procedure is a non-reversible operation. You will be unable
    to attain pure erection after having penis implant surgical procedure.

    Penis implant surgical procedure needs to be
    thought of because the final choices, i.e.
    solely used if different erectile dysfunction therapies haven’t labored.
    That is due to the excessive threat concerned with any penis surgical procedure and the everlasting nature of this surgical process.

    Potential negative effects embrace infection, implant malfunction, gadget migration, system erosion, and auto inflation. Penis prosthesis may injury the penis tissues and lower the sensation within the penis, i.e.
    trigger penis numbness.

    Natural Cures As Remedy for Erectile Dysfunction

    Some males want to make use of pure treatments for erectile dysfunction. There may be little or no scientific proof that pure treatments for erectile dysfunction work.

    It doesn’t robotically imply they do not work, it simply means there may be little proof for his or her
    efficacy and security (or not).

    Natural treatments for erectile dysfunction embody:

    Bear in thoughts that some pure substances might interfere with different medications.

    So at all times liaise along with your physician earlier than utilizing any pure
    treatments for erectile dysfunction (particularly you probably have any chronic well being issues).

    Complementary Therapies

    Some males desire so referred to as complementary
    / unconventional / various therapies. Others like to make use of them together with extra
    standard therapies, whereas others consider all of them as whole waste of money and time.

    Examples of complementary erectile dysfunction therapy embrace heat therapy, acupuncture, reiki, aromatherapy, reflexology, spiritual healing, chiropractic, naturopathy,
    relaxation methods and so forth.

    The backside line is that there’s little or no or no proof that complementary therapies works (or not).
    In some circumstances, they’ll embrace components that might work together with different medications and trigger critical
    negative effects so all the time test together with your physician previous to including complementary
    therapies to your erectile dysfunction remedy plan.

  3. Hey,

    Independence Day Sales – Get up to N2000 Off for the following:

    Makeup, Skincare, Hair, Bath & Body, Personal Care, Healthy Living, Gifts, Books, Magazines, DVDs & more.

    Find out more here>> https://girlyessentials.com.ng/

    call us on: 08179224062 to Order

    Do Have a Nice Day!

Schreib einen Kommentar

Deine E-Mail-Adresse wird nicht veröffentlicht.