Changing Lives: Plastic Surgeon at Sankhu

Features Issue 44 Aug, 2010
Text by Dinesh Rai

Could 9,9,1999 mean anything? Number nine is believed to be a  mystical number. But, it’s simply the date of arrival of a certain Dr. Andreas from Germany. He had never been to Asia before, nor had he planned to visit. But fate has its strange ways and it had a hand in bringing this dedicated surgeon to Nepal. “I saw an advert in the papers back home, and I was interested so I applied for it,” says the doctor matter-of-factly. He got the job, and he thought, “ First, let’s go and see!” And so he came and liking what he saw, he did not bother going back. And here he has been ever since; changing the lives of unfortunate/fortunate Nepali people with his surgical skills at the Sushma Koirala Memorial Trust Hospital in Sankhu.

I had heard of the hospital years ago, and the thought of plastic surgery fascinated me, but somehow I never got to visit. Then one day, I made up my mind, determined to find out more about this hospital and the doctors who transform physical appearances with surgery. Since the black topping of the road, Sankhu seems quite close. In fact, it is only 15 Km north east of the capital city, although when the road was just a dirt road, it took an hour by bus. Today, one can make the journey in half an hour by motorcycle.

Walking through the hospital, I soon realized these doctors were doing a great deal more than just changing peoples’ appearances; They were actually transforming lives. Congenital deformities and horrific accident related deformities once corrected, gave these people second lives. After a visit to the hospital, one begins to appreciate the saying, “Seeing is believing.” I left my card and a copy of ECS for Dr. Andreas whom I had never met, and went for a tour of Sankhu.

Three days later, I was back at the hospital, this time with DB, our photographer. Dr. Andreas immediately takes us in to see a patient, a kid with horrible burns that covered almost his entire body. “This is a common case, where the victim of the accident is burnt by a kerosene fire from either a burst kerosene stove or a spill. And the other common factor is their arrival at the hospital many days or even weeks after the incident. This kind of accident is so avoidable, but they don’t know any better,” informs the doctor. He takes photos of the burns with a small digital camera while the nurses inspect the wounds. He then gives instructions as to what procedures should be strictly followed and he emphatically tells the helpers to do away with the dirty cloth covering the patient. We then move to his office where he tells us his story. A lady walks in and he informs us, “This is my wife, Kerstin and she’s a nurse.”

As we sit chatting, we learn that Dr Andreas brought his entire family with him on his very first trip to Nepal. Once he made up his mind to stay, they quickly settled in at the hospital in Sankhu. “The kids grew up in the villages and so speak excellent Nepali and Newari,” says a proud father of two daughters. Jantje, 12 and Nela, 10 are studying at the British School in Sanepa. The hospital then was only a shadow of what it is today. Built years ago as a leprosarium, it consisted of just one building. Over the years, under the guidance of Dr. Andreas as Medical Director, it has grown to many separate buildings that house the operating theatre, post surgical wards, the pathological lab, X-ray room, laundry room, maintenance room and quarters for doctors and nurses with a large dining area. “When they built the leprosarium, they chose a very good location,” says the doctor looking down at the beautiful green valley, covered with rice fields dissected by a small, clean river. Ideally located, pollution free, the hospital’s water source is the nearby wooded hills.

Dr Andreas Settje was born on 10th November 1960 in Hamburg, but the family moved to Oldenberg when he was a child. He grew up in this small neighborhood where he received most of his early education. Graduating with an MBBS from the University of Hannover and Gottingen, Germany in 1988, he then received his PhD from the University of Hannover in 1989 before completing Emergency medicine (Facharzt) from the German Medical Council 1992. He followed this up with a course in surgery and then hand surgery also from the German Medical Council in 1996 and 1997 respectively. It was during his civil service that he worked in an old peoples’ home and realized he wanted to work with people. In 1980, he joined the German Armed Forces and in 1981 completed his civil service. Between the years 1983 and 1988, he worked as Medical Assistant at the Department of Experimental Surgery, Medical School University of Hannover, performing countless microsurgical operations and went on to the District Hospital WST, Department of General and Trauma Surgery where he gained immense knowledge treating in- and outpatients doing emergency and clinical duties and received training in general and trauma (orthopedic) surgery (as Resident Physician between 1988-1991). Then from 1991 to 1999, he worked in the Regional Hospital Ev. OL., Department of Hand, Plastic and Reconstruction Surgery as a consultant in Oldenburg, Germany.

In 1999, Dr Andreas took up his post as Medical Director at the SKMT Hospital at Sankhu, and on our visit recently, he took the trouble to give us a tour of the premises. He has a keen personal interest in everything including the many water tanks that are so essential for a constant supply of clean water. Lifting the lid of the massive 100,000 liter tank he showed us the huge volume of water accumulated underneath our feet. The tank itself is cleverly hidden under grass and flowers. What looks like a lovely garden conceals thousands of liters of water underneath it. There are many such tanks around the compound. Self-sufficiency is the ultimate goal of the hospital and Dr. Andreas is making sure that it is so in every sense of the word. There are two generators for power supply, a filtering unit for the water supply and an incinerator under construction. With typical German efficiency, the good doctor had an experimental incinerator built behind the buildings. Garnering the knowledge, a second, proper and more powerful incinerator is coming up. Toxic hospital waste will be the least of the neighbors’ worries.

Our next stop was the wards where patients were in various states of recuperation. We observed two nurses helping a patient with physiotherapy in the upstairs room. The foreigner was a volunteer. “It’s 50% surgery and 50% physiotherapy,” informed Dr. Andreas. We discovered that most patients take a long time to recover since their limbs are stiffened as a result of the severe burns (contractures). We were then shown the dentist’s clinic. Dentists arrive from Germany to teach local doctors.  The hospital aims to give all medical facilities to the local residents of Sankhu besides the surgeries.  There is even a classroom where the recovering children attend classes and learn to read and write.

For  the  first  few  years,      Dr. Andreas found himself working most of the time, there being no one to assist him. Then he began training doctors, so today he can afford to take time off. He has trekked to Langtang and the Annapurna regions. He went to Gokyo on his own. Today he finds more time to observe local festivals, which are so much a part of the valley life. Recently, the Settje family has moved to Sanepa. “Because my daughters go to school in Sanepa and all their friends live around Kathmandu. Sankhu is too far for them to be with friends,” says the doctor. He has been cycling all the way to the hospital in Sankhu. “After I quit smoking two years ago, I gained a lot of weight, so I started biking to work and in the process have lost 15 kg. in one month,” he explains. There’s a tip for all overweight people.

Talking to Dr. Andreas, his enthusiasm for the hospital’s future rubs off on you and you cannot help admire his total commitment. Asked why we do not hear much about the hospital, he says, “We have to be prepared for the services we promise, no? So I am training Nepali doctors to meet our needs.” His campaign to promote the hospital is about to kick off. He has had t-shirts and brochures made recently. Quite often, Dr. Andreas goes to Germany to raise funds while his family visits home every two years. He explains, “For every patient that cannot pay his fees, we have to find a sponsor. We take photos and make a detailed report and send them to Germany. The support system then helps find financial support. Some programs on German television have been of great help to give us publicity and to help us find sponsors,” says an enthusiastic Dr. Andreas, “And most of the people who come here are poor.” The future plan is to gradually do more cosmetic surgery, which the rich can afford. With the money thus raised, it is hoped the hospital will be self-sustaining, which is as mentioned before, the ultimate goal. The poor however will continue to get free services. For the moment the focus is totally on the poor, as the donors need to be convinced that the money they send is not being spent on cosmetic surgery. 75 percent of the hospital’s expenses are still being funded by INTERPLAST.

It was a day without surgery for the Medical Director, which gave us the opportunity to talk and get to know him. In his friendly manner, Dr. Andreas explained in detail the workings and goals of the hospital. It has come a long way from its humble beginnings and is making immense contributions to the welfare of needy Nepali people.

By the time the clock struck three and it was time to say goodbye, we were highly impressed by the efficiency of its operation and the great progress made by the hospital. Obviously, it owes a great deal to the sincerity and dedication of this surgeon from Oldenburg. We rode out of the hospital grounds convinced, “They’ve found the right man.”