Alex Howarth – Back in Nepal – 2010

One of the great attractions of Nepal is, for me, the awe-inspiring Himalayas. During my gap year I was able to mix volunteer work in the lowlands with some mountaineering. I enjoyed two trips organised by summit treks ( The first was to Mera peak in the Everest region. Mera is the highest of Nepal’s trekking peaks which means you can achieve significant altitude without huge permit fees. My journey there started with the flight to Lukla, a small mountainside town 2800m above sea level. The short steep runway is daunting because of the perilous drop at the end. We began the climb up to Mera and the way was steep right from the beginning; it takes you through spectacular scenery, with dense rhododendron forests as well as views of some of the world’s greatest mountains. Even while walking amongst the trees we could hear massive cracks and then a sound like thunder as an avalanche powered down the mountain. The trek involved a lot of climbing and was hard going even before we got into snow. We negotiated crevasses and slogged on up to high camp where we had to melt snow for our cooking. The mountains are unbelievably huge and never cease to inspire and wow me but at dawn at high camp before the final assault, the view seemed better than ever even if the air at over 6000m was so thin that it felt like I had to fight to suck in every molecule.

From the mountains, I travelled to the steaming lowlands and Lalgadh leprosy mission hospital. I learned so much in my short stay there. All the staff and patients were very friendly and welcoming. I was given the opportunity to see all the stages of leprosy treatment, from diagnosis and counselling right through to surgery and post operative rehab.

The sense of community was very strong and I felt like I’d entered a giant family. Most of the staff lived in the compound and would often socialise with a game of table tennis, or a volleyball match against local villages. And after a full day assisting in the operating theatre, one of the few places in the hospital to avoid the sweltering heat, it was great to be able to relax with a game of football with the local kids. Playing barefoot on a dusty pitch under the shade of mango trees was something I certainly hadn’t imagined when I booked my flight. There was always plenty going on within the compound. Waking back from lunch one day I encountered a metre-long monitor and I’m not sure who was more startled – it or me; I hadn’t realised lizards could get so big. They were everywhere and I enjoyed watching them.

Christianity was a big part of Lalgadh, although I don’t believe myself it was great to see how faith is such a motivator and how much fun they got out of going to church.

From a medical stand point Nepal has a variety of diseases and conditions that are very rare in the UK, and I was amazed to see how much could be done with minimal resources and technology. The clinical skills of the doctors I worked with were hugely impressive and could teach technology-bound clinicians a lot in diagnostics

One of the most interesting parts of my stay in Lalgadh was observing the surgical and physiotherapy treatments for foot drop. This condition compromises people’s ability to walk; it is also a clear indication of leprosy, and may result in them being ostracized by their community.
Leprosy causes damage to nerves supplying certain muscles, which results in paralysis, particularly to the muscles that raise the foot. Foot drop is most commonly treated with a tendon transfer. The surgeon took a tendon from a healthy muscle and transferred it into one of the affected muscles.
Patients then had a four-week stint of intensive physiotherapy to train the muscle in its new function.
Following surgery patients are able to walk normally which reduces the stigma associated with leprosy and helps people to reintegrate into society and get back to work.

After Lalgadh, I arranged a second trek and this was to the popular and more accessible Langtang region. The 10 hour bus journey was an experience in itself; sitting in the isle next to me was a bemused-looking baby goat. The route up to Langtang and the holy Gosinkund lakes is one taken by pilgrims and passes through vibrant forests and powerful rivers.

I also volunteered in an orthopaedic hospital in Kathmandu, on a separate trip to Nepal when I was 17. This was organized through ‘teaching and projects abroad’ a company that aids people gain experience in the fields of healthcare and teaching all around the world. They organise gap year placements, medical electives and also shorter trips like mine. My two week placement (aimed at 17-19 year olds) allowed me to observe and administer physiotherapy treatment, and to experience healthcare in the developing world. This was just before I started my A levels and gave me lots to write about on my university application.

To fund my travels I worked as a healthcare assistant at my local teaching hospital for the first half of my gap year. This gave me clinical experience as well as material to enhance my UCAS application. It also provided the opportunity to work as much and whenever I wanted.

Nepal offers lots of choices and during a gap year, you can do it all – contribute to something worthwhile, conquer a mountain, try white water rafting, watch wildlife from elephant-back and lots more.


Alex Howarth is a second year physiotherapy student at Brunel University. He lived in Nepal between the ages of three and eight.