Forum (Spotlight Weekly)

‘Nepal Needs A Continual Process Of Training Medical Professionals’

— ZINA C. MUNOZ

ZINA C. MUNOZ, director of The Renal-Tech Project, which operates the website HYPERLINK "http://www.renal-tech.org" <www.renal-tech.org>, the governing website of the domain, had come to Nepal a week ago to conduct a training course. Munoz spoke to SPOTLIGHT. Excerpts:

What prompted you to support the National Kidney Center?

The desire to unite the global community, to be able to help exchange information, to share ideas and to help one another. Often in the United States, products are thrown away once they are used. A lot of computers were being thrown away in the last nine years. We decided to recondition some of these computers and bring them to Nepal. We decided that Nepal was in need of our assistance and brought computers to Bir Hospital. Nepal was selected for a pilot project in 1998. We delivered computers to the National Kidney
Center, Bir Hospital and Tribhuvan University Teaching Hospital. At all these locations, we set up Internet links and facilitated an e-mail discussion group of professionals, including pathologist, nephroplogists, nurses, and companies representing various groups of people. The group also includes people who are interested in the sector. This has facilitated dialogue among professionals.

What is the mission of the Renal-Tech Project?

The mission of the project is not only to deliver the machines and connect them to the Internet, but also to develop an on-going relationship with the individual. You have so much to teach us as well. It is easy to work in the developed world since everything is in front of you. But it is very hard to work in a country like yours. I have seen the difficulties Nepal faces in caring for patients. The doctors and patients don't have the things they need. We want to step up our support to the National Kidney Center, Teaching Hospital and Bir Hospital. Education of nurses is largely ignored in developing countries. There is no continual process of training to inform them of developments in the medical world. As I myself am a nurse, I may have a certain bias. But nurses are very much ignored in the training process. Nurses are the first people called upon to take care of patients.

Why do nurses need training?

The Teaching Hospital and the Bir Hospital need to tackle the education issue. If a person is trained, he or she can give information to many other people. If something goes wrong, nurses are the first person to know. Therefore, nurses should be properly trained. We are also focusing on nurses' training through, among other things, a web-site of the National Kidney Center to show the world what it is doing.

How do you assess the service at the three centers and how frequently do people visit the web-site?

They do so frequently and Nepalis are participating very actively. The only criticism I would have is that your power supply is not stable and that your communication system needs to be improved. Profit-making organizations are doing quite a good job, but they provide services to a small segment of the population.

How do you look at kidney transplant problems in Nepal?

I have met some patients in Bir Hospital who are looking for kidney transplant, but they are allowed only to have kidney donations from close relatives. It is good that kidney brokers are not allowed here. In other South Asian countries thousands of transplants take place every day among the relatives. In many cases, kidney brokers make arrangements. Interestingly, many wives have donated their kidney to husbands but only one husband has donated his kidney to his wife. I met a woman who was deserted by her family. Nobody showed sympathy for her cause. Such discrimination is disturbing indeed.

What is the scale of the problem in Nepal?

I have seen many people waiting outside hospitals and centers. Many poor people have benefited from these centers.

What benefit does an institution like the National Kidney Center get from this networking?

The center will get immense benefits, including information on nephrology problems andkidney ailments. Hospital staff have received information they previously lacked. Information and ideas on latest developments in kidney treatment have far-reaching value.

How many places is your organization working in?

We are also working in Kosovo, Sudan and other countries.