BMJ GROUP AWARDS


Breaking the silence


Te big winner at this year’s BMJ Group Awards was the Britain Nepal Otology Service or BRINOS. Here ENT surgeon Mr Neil Weir describes how a holiday encounter led to the founding of this innovative charity


the Tribhuvan University Teaching Hospital in Kathmandu. Here I met Rakesh Prasad who, at the time, was the only person in Nepal trained in modern microsurgical ear techniques. He introduced me to his legendary father, Dr LN Prasad, who aſter gaining diplomas in ophthalmology and ENT from the Royal College of Surgeons of England became for a time the only eye and ENT surgeon in Nepal. Dr LN Prasad told me of a disability


A


Mr Neil Weir (right) with Dr Dinesh Mishra


survey which he had directed in 1981 (the Year of the Disabled) and of his surprise that deafness was the single greatest disability in Nepal. He had a vision of bringing ear care to people living outside the reach of the Kathmandu valley but with only his son and no funds for equipment he needed help.


Ear surgery camps I offered to bring a British team of two surgeons, an anaesthetist and two nurses to join with a Nepalese team in order to conduct an outpatient and surgery camp twice a year in the extremes of the country. Tis idea was met with great enthusiasm and aſter setting up a charity and a limited company and raising the funds for sufficient equipment to run two operating tables, the first BRINOS ear surgery camp was held in Pokhara in 1989.


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T the end of a holiday in Nepal in March 1987 I decided to make a visit to a local hospital and was directed to


In subsequent years we have worked


at both the eastern and western ends of Nepal in 50 camps and have examined over 40,000 people and performed over 4,000 major ear operations. Te last 38 camps have been conducted in the southwestern Terai at Nepalgunj, mostly in an old ‘Victorian’ palace which originally had been given by a family to house an eye hospital. Conditions in the hospital are basic. Te


recovery ward is on the first floor adjacent to the theatre but the main ward is temporarily located in a large bicycle shed. Te electricity supply is supported by a generator but there is no running water, instead two large plastic vats are supervised by a waterman. Since 2008 we have found space for a third operating table. Te camps have provided an ongoing surgical training programme for young Nepalese ENT surgeons, nurses, and technicians.


Bottom-up care It was pointed out to us early on in the project that we were treating the end


SUMMONS


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