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Our clinic in the clouds, Chialsa

Chailsa is a small Tibetan Buddhist Monastery about 280 kilometres east of Kathmandu in the Sulokhumbu. On a clear day, from the top of our hill, you can see Mt Everest, 70 kilometres away to the north.

We travel either by 4-wheel drive on a rough road for 12 plus hours, or 30 minutes by plane! Flying is an option, but very heavily dependent on the weather.

The journey, the remoteness, the beauty, the isolation, the sometimes Wi-Fi, and above all the need for resilience, make volunteering in Chailsa a very special thing, but not for the faint hearted.

We aim to look after the dental health of the young monks from Chailsa and surrounding monasteries.

These are, young men, aged 7-30 years, with wide open smiles, very compliant patients, happy for your care.

In addition, we aim to treat the school children at the Mt Everest Lower Secondary School and its adjacent hostel for “homeless” children. More a boarding school than an orphanage, as children attend from broken homes as well as children from families too far away to commute easily to school.

We first opened the clinic in October 2016, and returned in September 2017. Our aim is to visit once a year from here on.

We leave portable dental equipment, and the usual supplies to enable us to do restorations, scaling and extractions.

The clinic conditions are hard and sometimes trying, but adequate and always a lot of fun.

We sleep in rooms which are warm and comfortable. The separate ablution block is limited, with squat and western toilets, cold showers (sometime solar hot water), and a muddy unlit path during the middle of the night!

We are very well looked after, with three meals a day from the cook. Plenty of rice and pasta, lentils, spicy and curried veggies, soups and flat bread. Chai, tea and instant coffee always available.

The “Abbott” of the monastery is the Geshe . He is backed up by the manager, Khedup, and the Headmaster, Pemba. All gentle, smiling Buddhist monks.

We set up in a couple of class rooms adjacent to the heart of the monastery, the Gompa. One room for surgery and the other for supplies and sterilizing.

We work 8.30 to 5ish doing what we can for those who turn up for 6 or 7 days. We rely on seamless teamwork with everyone doing multiple roles. Sometimes assisting, sometimes operating, sometimes cleaning, sometimes sterilizing, sometimes screening, sometimes restocking, always looking out for others well-being.

We try and have fun with the children, playing cricket, soccer, flying kites, blowing bubbles and encouraging good dietary habits!

But as in most 3rd world countries, sugar is ubiquitous. Here sugar is culturally added to drinks, chai, tea, and coffee. There is, unfortunately, ready enough access to sugary soft drinks and juices and snack bars. So not surprisingly dental caries is universal. We celebrate when we see a mouth with little or no caries! But unfortunately, the norm seems to be rampant caries in the deciduous dentition with “bombed out” D’s and E’s and often carious A’s and B’s. Much of this we leave alone, not wanting to set off potential problems we leave behind.

We try and retain spaces, treat where we can 6’s and 7’s. Sealants are particularly important.

Patients ask for scaling and cleans. We provide both conservative restorations and ART restorations. It’s handy to be adept at exodontia!

Our 5-year goal is to set up a rota of suitable operators and assistants to go once a year to Chailsa to implement a service of ROP, restorative work, scaling and exodontia. We aim, with time, to influence dietary attitudes and understandings of the role, added and embedded, sugar has in causing dental caries.

Chailsa, at 2700 metres above sea level, is well short of the monster mountains surrounding it, but we call it “Our Clinic in the Clouds”.

A wonderful place of peace and isolation.

If you’re up for it, it’s most rewarding.

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