“Education is the most powerful weapon you can use to change the world”
– Nelson Mandela
“What is really needed to make democracy function is not knowledge of facts, but right education”
– Mahatma Gandhi
The WFSA believes wholeheartedly that education and sharing knowledge is vital to our aim of improving anaesthesia care and strengthening global health in order to save lives. However, in our blog series, the WFSA wants to do more than share powerful statements and sentiments alone. We want to put a face to the life and a name to the story.
Whether clinical anaesthesia providers, teachers, patients or communities, the lives that are touched by our programmes have many faces, families, ambitions, opinions - stories.
This week we spoke to Dr Ninadini Shrestha, a young anaesthesiologist from Nepal who was awarded the WFSA Pain Management Fellowship in Kamineni Hospital, Hyderabad, India in July.
Dr Shrestha was interested in Pain Management because of the complexity of the specialty:
“As an anaesthesiologist I had some exposure in acute pain management and regional blocks. However, when you actually sit in an outpatient department and start seeing patients in a pain clinic you suddenly realize that two and two together does not add up to four. Patients’ histories are confusing, examination findings do not match your history or investigations.
“There is no actual disease that can be seen or pointed at, yet, people will continue to suffer. It took me days to understand the pattern of disease we looked at the beginning of the fellowship. I studied books, articles, videos to understand the diversity of patients I was seeing each day.”
Patients are very much the focus of life as an anaesthesia provider. Dr Shrestha, an incredibly friendly and positive person, spends much of her time looking after many different patients, and yet there is one in particular that has stood out so far:
“A 70 year old gentleman, who was brought in by a very smart wife of around same age, was totally incoherent and speaking incomprehensibly. He was a diagnosed with small cell carcinoma in the right lung, multiple secondaries to liver, brain, skin, lymph nodes and bones. He had suffered a fractured to the right humerus, and was in so much of pain he was incoherent and could not even responding to his wife calling him.
“He was given a supraclavicular brachial plexus block with catheterization for continuous plexus anaesthesia. The relief was immediate and he called his wife ‘jaanu’ literal meaning ‘my life’ as soon as he saw her. And she just smiled.
“That was the moment that I became passionate about pain management. That was the moment that taught me that we cannot control or cure disease, but we can decrease the suffering and improve the quality of life by doing pain management.”.
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For Dr Shrestha, the impact of this experience and the lessons learned from the Fellowship as a whole are in the forefront of her mind. It is clear in discussions with Dr Shrestha that she is passionate about helping patients and improving pain management in hospitals in Nepal when she returns.
“There is a tremendous need for me to introduce an organized approach to acute and chronic pain management protocols and assessment tools in our pain management clinic. Designing a database tool that makes our pain cases entry useful for future research and record keeping is my top priority, as it will guide us in our practice.
“I dream of designing a basic pain management workshop with live demonstrations and cadaveric workshops one day. I will strive to bring about public awareness as well as awareness among other medical doctors, nurses and staff members by organising workshops and interactive forums about pain management.”
Of course, education is so important internationally. The WFSA are proud to offer Fellowships like the one Dr Shrestha is currently undertaking in three continents. We hope that all of our fellows are able to learn a great deal during the placement, and share that knowledge with colleagues in their home countries and beyond. Dr Shrestha, agrees with this sentiment, explaining:
“Pain is still such an under-diagnosed disease. The patients we see are just the tip of the iceberg, pain is complex, has numerous origins and is difficult to diagnose. Programmes like the WFSA Fellowship are an ideal way to learn from the experts, and to be very honest there are not many authentic programmes from where we can learn.
“WFSA funded programmes are good quality and also cover our financial requirements, which I believe is a major barrier for people from developing countries like ours to pursue such an opportunity.”
We will be speaking with more former and current fellows, programme heads and some important voices in the world of anaesthesia over the coming months. If you have any questions you would like answered by them, please email with your suggestions.