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Exchange strengthens hospital links with Nepal

01 May 2018


A health exchange which has seen a nurse from Nepal spend six weeks at the James Paget has created new  links between the Gorleston hospital and a cancer treatment centre in the Himalayan country.

Stoma patients in Nepal are set to benefit from the exchange which has seen nurse Roshani Bajracharya -  who works at Bhaktapur Cancer Hospital, in Bhaktapur, around eight miles from the capital of Nepal, Kathmandu - spend time with her UK counterparts.

 The James Paget already has links with Nepal through Consultant Surgeon and Surgical Tutor Kamal Aryal, who was born in the country.

In 2015 he led a team of doctors from the Paget who went out to assist following the devastating Nepalese earthquake. Subsequently, with support from local community in Great Yarmouth via charity Health Exchange Nepal (HExN) and Nepalese Doctors Association (NDA UK), two school buildings have been built near the epicentre of earthquake. Mr Aryal has also been leading the team of doctors from the Paget going to Nepal each year to provide training in laparoscopic surgery and regional anaesthesia.   

He arranged the exchange in conjunction with Health Exchange Nepal, the charity organisation which brought Roshani to the James Paget to gain an overview of stoma care in the UK. Stomas are surgically created to pass waste material from the body for those with some bowel conditions including colon cancer.

Roshani is a specialist stoma nurse but also looks after patients with different types of cancer – including breast and cervical cancer – and during her visit she also spent time with the breast care team and departments including endoscopy.

She said: “I will be taking lots of useful skills and knowledge back to Nepal.  Things are different here particularly around the resources available to patients. In Nepal patients have to pay for their own stoma bags and this means they are often reused as they simply can’t afford them. I’ve also noticed a difference in the sterile environment - while we wear gowns and gloves, the level of how sterile everything is kept is very different here.

“At the moment we have just one one-hour clinic, so I’m hoping we can expand this as we treat more than 100 patients with stomas.”

While UK patients do not have to pay prescription charges for permanent colostomy equipment, in Nepal individuals have to pay for supplies themselves.   One of the stoma bags can cost 1,200 Nepalese rupees – around £8 – but even for someone on median earnings in the country this equates to a day’s wage. Those on poorer incomes can earn just 100 rupees a day.

Roshani’s visit has inspired the James Paget’s Ostomy Support Group, which is now looking to raise funds to help supply her patients.

While she was at the Paget, Roshani was mentored by Clinical Nurse Specialist Helen Cox, who was recognised earlier this year as one of the top Stoma Care Nurses in the country in the British Journal of Nursing Awards.


Sister Cox, who works closely with the Ostomy Support Group, said the visit was the start of a new chapter in providing support and assistance to Roshani and her colleagues and patients.

“Roshani has been phenomenal  - she’s like a sponge – every day she wants more knowledge. We will be keeping in touch and I hope to go to Nepal next year to see Roshani’s hospital. We want to maintain links and to see what we can do to help by fundraising too.  The support group are looking to raise money to be able to send out supplies of equipment and stoma bags to Bhaktapur Cancer Hospital, so our links will continue.”


Sister Helen Cox, Roshani Bajracharya and Consultant Surgeon Kamal Aryal.