Dr. Archana Shrestha Joshi, AMDA Headquarters

From 24 February to 1 March 2019, AMDA Board Member and endoscopy expert Dr. Takushi Sato held an endoscopy workshop at AMDA Damak Hospital in Jhapa, Nepal. The training was attended by the hospital’s endoscopist Dr. Diwash and his aspiring colleagues who are always keen to hone their skills.
Dr. Diwash and Dr. Sato first met when a devastating earthquake hit central Nepal in April 2015. At that time, Dr. Sato was partaking in AMDA’s medical relief activities in Sindhupalchowk as an emergency physician.
In August 2016, Dr. Diwash came to Japan to undergo three-month endoscopy training at Okayama Saiseikai General Hospital. The training program was organized as part of Okayama Prefecture International Contribution Local to Local Technology Transfer Project.
All this while, Dr. Diwash kept in touch with Dr. Sato. In February 2018, Dr. Sato visited Nepal to give technical guidance on an upper gastrointestinal (GI) endoscopy and diagnosis of lesions at AMDA Damak Hospital.

The 2019 workshop marked the second of its kind. Dr. Diwash and other local doctors attended the training with the aim of improving their upper GI endoscopy techniques. Since the previous training in 2018, Dr. Diwash had handled 600 endoscopies in one year. Observing his practical procedures at the workshop, Dr. Sato was impressed by his unwavering attitude towards strengthening his skills and how much achievement he had made during that time.
Prior to Dr. Sato’s visit, Dr. Diwash had informed many patients that his mentor would be coming to Nepal for the workshop. As a result, a total of 73 people (19 to 77 years-old) showed up to receive an endoscopy over the five-day training period.
The comments below are what each of the patients had to say about the examination:
- I had a painful experience with an endoscopy at a different hospital a few years ago, so I was really scared before having it this time. However, it was much less painful than I thought. I actually felt quite relaxed. I would very much like to thank Dr. Sato and Dr. Diwash for this.” (45 year-old female patient)
- I was really afraid when I heard I should put a camera through my mouth to get the endoscopy done. Contrary to what I expected, it wasn’t all that hard which put me at ease. I would like to express my deepest gratitude to Dr. Sato for coming all the way from Japan for all of us. I hope he will come back next year as well.” (19 year-old male patient)
- This was the first time for me to have an endoscopy. It did feel a bit uncomfortable at the beginning, but everything went well after that. I want to thank AMDA Damak Hospital, Dr. Diwash, and Dr. Sato who came from Japan.” (50 year-old female patient)
- My friend once told me that an endoscopy is a very painful procedure. I also had an endoscopy at a hospital in Biratnagar a year ago. At that time, it was so painful that I couldn't stand it. I even had to be restrained by five or six people to undergo the examination. But today, I was glad to be able to receive it comfortably. I’ll definitely recommend others to go to AMDA Damak Hospital if they are considering an endoscopy. I’ve been really grateful to the doctors that performed my examination. I am looking forward to the good medical services the hospital offers.” (45 year-old female patient)
- I had a little discomfort at the beginning of the exam, but it wasn’t painful at all. Thank you all very much. And thank you, Dr. Sato, for coming to our country.” (39 year-old female patient)

After the seminar ended, Dr. Sato said, “The mission to pass on the expertise has significance in a way that it gets cascaded down to the new generations of doctors in a wide spectrum. It is something to be sustained into the future. Nepalese doctors are striving to attain Japan’s medical technology and are trying to become self-reliant, so that they can see more patients by themselves. This made me realize once again the reason why I decided to pursue a medical career in my youth. I strongly feel this kind of effort should be continued in the long run.”

Dr. Nabin, Medical Superintendent at AMDA Damak Hospital, said, “We are very happy with the fact that Dr. Diwash can now handle many patients on his own, thanks to Dr. Sato’s guidance. As you know, there aren’t many doctors who can perform an endoscopy around here. We, at AMDA Damak Hospital, are hoping to ensure an environment that allows us to also conduct colonoscopies and polyp removal by obtaining necessary equipment and resources.”
“In helping us to achieve higher medical standards, I am most grateful to Dr. Sato for taking his time in coming to Nepal amid his busy schedule. Representing our hospital, I want to thank him so much for all the work he has done to support us. His continued guidance would be very much appreciated,” he added.
Also, the doctors who took charge of Dr. Diwash’s three-month training in Japan in 2016 gave comments as below.
“Thanks for letting us know of Dr. Diwash’s recent work in Nepal. Looking back, what we offered him during his training was introductory guidance. However, I am really proud of him, hearing that he has grown to perform an endoscopy on many patients. I fondly remember Dr. Diwash for his warm and gentle character. I wish him all the best.” (Dr. Junji Shiode, President, Okayama Saiseikai General Hospital)
“Considering the short training period, I was a bit worried as to how much our guidance had been of use to him. I was relieved to hear that he is now handling many endoscopies back home. He was a diligent and kind-hearted doctor. I am confident that he is a popular doctor in Nepal by now.” (Dr. Junichirou Nasu, Director of Endoscopy Center, Okayama Saiseikai General Hospital)

From AMDA Damak Hospital to beyond, AMDA will continue to contribute to the advancement of endoscopy in Nepal.