Sunset view from a valley hike
As a fourth-year medical student at the Icahn School of Medicine at Mount Sinai, I spent one month in February in Nepal for my clinical elective. This experience was humbling, challenging, and deeply meaningful, undoubtedly shaping my career in medicine.
The Role of Family and Spirituality in Patient Care
I split my time between the pediatric and psychiatry departments at Dhulikhel Hospital, each offering a unique lens into health care delivery in a resource-limited setting. One of the most striking differences I observed, particularly in psychiatry, was the active role of family members in patient care even within the secure psychiatric unit.
Unlike in the United States, family members in Nepal were allowed to remain with patients throughout the entire day. I witnessed firsthand how this level of involvement improved patient outcomes, elevated morale, and deepened the family’s understanding of mental illness. While one might assume this model could compromise safety, staff reported surprisingly few security issues.
Another aspect that stood out to me was the integration of religious and spiritual beliefs into psychiatric treatment. Religion was one of the strongest protective factors for patients experiencing depression, making it imperative for providers to build upon those beliefs to create a safety plan for patients. It was a powerful reminder of the impact of culture on medical treatment and patient-provider trust, a factor often overlooked in medicine in the United States.
The view of Kathmandu from the top of Swayambhunath Temple
Engaging With Nepali Culture
Outside of the hospital, we experienced Nepali culture in countless meaningful ways. Each afternoon, we ate traditional meals like momos, a type of dumpling, and thalis, a variety of dishes served together on a single platter, at small canteens and cafes near the hospital. We visited historic temples and witnessed funeral processions and religious rituals along the Bagmati River. Observing these ceremonies was particularly moving as we were able to see how spirituality, grief, and community are such a visible part of everyday life.
Each evening, we hiked along trails adjacent to small huts, farms, and croplands. This was one of the most peaceful ways to spend the close of the day, among the sounds of the birds, goats, and dogs that would follow us deep into the valley.
The Impact of International Exchange
My time in Nepal was truly inspiring not just within the hospital but also through meeting incredibly caring people and experiencing delicious food and breathtaking nature. It was a privilege to experience both the medical and cultural aspects of the country. I hope to visit again one day as a physician!
Author Salonee Shah, MD, right, shown with Abhi Mogili and Cecilia Katzenstein. They are recent graduates of the Icahn School of Medicine at Mount Sinai. Dr. Shah completed her clinical elective at AMPATH Nepal through funding provided by the Arnhold Institute for Global Health at Mount Sinai. She is a psychiatry resident at Baylor College of Medicine in Houston and plans to pursue a child and adolescent psychiatry fellowship. Her goal is to eventually work with refugee and immigrant families in trauma-focused care.