I still don’t understand the appendix, even though I’ve had the privilege of looking at mine – all pink and red and limp in a glass vial - while recovering from the surgery in a Kathmandu hospital. It seems to me to be like a roulette wheel, or some organ of chance whose function is simply to cause some of us sudden and intense pain in the lower right-hand quadrant of the abdomen, followed closely by a trip to the hospital and hopefully, speedy removal.

I have always told the story of my own appendicitis in Kathmandu and the subsequent navigation of the hospital system there with a mixture of terror and pride - as if I had survived some epic and dangerous journey and emerged nearly unscathed, aside from the beautiful three-inch scar in my belly as proof of my fortitude. I would always embellish the parts about having to bring my own sleeping bag into the hospital, about having my friends go out and buy painkillers from the pharmacy across the street, and how I was too tall to fit on the operating table, thus allowing the careless anesthetist to hit me square in the temple with a heavily-laden stainless steel cart. But I realize I have told this story mostly to Americans, to people like myself who are accustomed to a standard of health care much higher than that experienced by the majority of the world.

I received an email yesterday that changed my perspective.

Padam Kumari Dahal is a very motivated and talented young woman from the extremely remote village of Rakha, where the dZi Foundation has worked for a number of years. Her village is at least a five-day walk from the nearest road, and three days (for a healthy individual) from the nearest field hospital. She was selected by the local organization that we work with as their first employee, and has been working in the community helping motivate community members and oversee projects for the past three months. Just two weeks ago, we sent Padam Kumari and three dZi staff members to the district of Ilam in far Eastern Nepal for a training on cultivation of medicinal and aromatic plants, hoping that this may be a potential means of income generation in Rakha and the surrounding communities. On her way back from Ilam, Padam Kumari stopped in Kathmandu for a few days of work at the dZi offices there. Two nights ago, she woke up with severe stomach pain and rushed to the Teaching Hospital. Yesterday her appendix was successfully removed, and she should be released from the hospital today or tomorrow.

It was just fortunate coincidence that Padam Kumari was in Kathmandu. If she was in her village, chances are she would have first consulted a local faith-healer for help, and only after symptoms worsened significantly after a few days would she have begun the long walk (or submit to being carried) to the Phaplu hospital, which lacks the proper facilities to provide surgery anyhow. Her appendix would have certainly ruptured by the time she reached Kathmandu, with possibly fatal consequences.

It is impossible not to consider the millions of people in Nepal, not to mention worldwide, that don’t have access to such essential care. I am so grateful that Padam Kumari had her appendix removed in Kathmandu and, despite the careless nurses, the far-from-sanitary conditions, the overall chaos and the fear that I experienced for my own appendectomy, I realize now how fortune I am to have had the experience at all.

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