“Light at the end of a tunnel” – Dr. Ashish K Shrestha

It was that time of the year when nothing was going according to plan. All the plans were canceled and all the dreams shattered. I had to pick myself up and begin from scratch. As I was going through personal turmoil, the world was under the grasp of a very powerful evil. As we were thinking 2021 was going to be so much better than last year, the delta variant of COVID-19 took over the whole show. Due to the high rates of transmission and severity along with our unpreparedness, the country was on a brink of collapse. When the national data increased from 200 daily positive cases to 5000, the hospitals of the entire nation were overwhelmed. It was very chaotic and distressful, hearing the demise of many close relatives and people around the country. No availability of hospital beds, shortage of oxygen supplies, and the rapidly increasing crowd of patients outside the hospitals were the daily broadcasted headlines that aided in adding fuel to the existing wildfire of anxiety. Due to this dreaded situation, I wanted to help the people and the country to fight this war. I was in search of an organization that would provide telemedicine services and address these issues of the entire nation. Finally, Health Foundation Nepal (HFN) came to my rescue. It was such a well-organized and selfless team, working for the benefit of the people. Through this platform, I got the opportunity to contribute my care to patients and in return, could develop my skill as a good physician as well.

​I joined the HFN telehealth team at the end of April after the initiation of nationwide lockdown. I was a part of 20 NMC registered volunteer doctors at first, which later increased to 50. It was like a family where we helped and motivated each other to continue serving the community even in such worrisome situations.  We had about 2 weeks of training as many of us were new to this telemedicine system. I got to learn many things regarding the communication methods with patients, COVID-19 infection, home care, and vaccination from my seniors and mentors. With all the optimism and training, the telemedicine services started on May 8, 2021.

It was the peak moment of the COVID-19 surge, we were receiving 50-100 calls every day. Four doctors were allocated for 4 hours every day from 6 am to 10 pm. One of the patients that I encountered was a 52-year-old male who presented with fever, cough, and shortness of breath. The call was made by his niece who was also a medical personnel. This was a panic call as his oxygen saturation was below 90% and the hospitals were not able to provide him with oxygen. The high demand and scarce availability of oxygen cylinders made it seem quite a challenging task to be of help. Nevertheless, I tried to help her by providing a list of phone numbers who were distributing oxygen cylinders. Luckily, they were provided with one oxygen cylinder. I contacted her an hour later to enquire about her uncle’s condition. Unfortunately, it was not that good. Although on high flow oxygen, he was having difficulty breathing and was desaturating. I advised her to transfer him to the ICU for proper respiratory support. After 2 days, his condition improved; oxygen saturation now being 93-94%. He was showing signs of improvement and the happiness in her voice was palpable.

Thereafter, everything took a U-turn in a matter of days. I called her again after 5 days, and I was stunned to hear that he was on a ventilator in the ICU. He showed signs of multiorgan failure and after all the efforts, we were not able to save him as he died after 2 days due to myocardial infarction. It was a very difficult time and I was heart wrenched. But with all the courage, I called her the next day to console her. Despite struggling with the bereavement, she appreciated what I did and thanked the whole HFN team for such a wonderful job that we were doing. I was so blessed to be showered with such kind words and it was those words of wisdom that motivated me to keep on working for the greater good of the community.

We continued serving our nation. We were able to reach the most underserved regions of the country. During the time of unavailability of transportation and proper hospital services, we were able to provide appropriate treatment and advice to the people to fight this pandemic. By channeling the broadcasting in a positive direction via the commendable efforts of our social media team, we certainly initiated to drizzle over the wildfire of anxiety. This was a very proud moment for me and I feel honored to be a part of this team. Four months back, HFN came as a source of light to a down and dejected person. Four months on, and the very same person became a ray of hope to hundreds of people throughout the country. Through dedication and hard work, there is always light at the end of the tunnel. I would like to thank the whole HFN team and my peers for giving me this opportunity and supporting me throughout this journey. I hope to continue serving my community and country in the same way in the future.

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