Undoubtedly, the third country resettlement program has added joys to majority of the Bhutanese refugees resettled in various developed countries. As resettled refugees enrich themselves in the country of resettlement, many of their friends and relatives back in camps in Nepal still fear to opt for the resettlement package.
Veteran DK Karki, who demonstrated his political caliber in the early stage of camp settlement in Nepal as an active cadre of the Bhutan People’s Party was never willing to leave camp to settle in western countries.
When most of his contemporary friends involved in the party-politics in exile vanished one after the other grasping such opportunities in various occasions, Karki remained rigid with the opinion that Nepal would be the best place to fight against the Bhutanese suppression.
“I got several opportunities to leave Nepal and get settled in western countries. But, I chose to remain in camps,” Karki says.
But, the year 2009 became worst for him when he was first diagnosed of complications in his liver by the AMDA Hospital that treats refugee patients in UN-monitored camps of Jhapa and Morang of Nepal.
Following a series of treatments at the AMDA Hospital and Life Line Hospital, Karki also spent months in the Indian city of Siliguri fighting against his liver cirrhosis. His friends and relatives financially supported him for his expensive treatment.
When he got discharged, he changed his mind and decided to resettle in America for getting better treatments as AMDA Nepal informed him that his treatment was beyond its criteria considering the cost.
And, accordingly he was processed under an emergency status for resettlement. When his family waited at the International
Organization for Migration( IOM) transit camp in Kathamndu, he was admitted in the Norvic Hospital for weeks.
48-year-old Karki, who waited at Beldangi-I camp for 18 years to return to Bhutan with dignity and honor was eventually resettled in St. Louis of Missouri in July last year.
A private doctor from the IOM escorted Karki from Kathmandu to America. Upon landing in Missouri, he was directly admitted to the Barnes Jewish Hospital.
Last December, a team of doctors at the Barnes Jewish Hospital undertook a liver transplantation surgery that lasted for almost six hours, according to his family.
“Now he is in a stable condition and has already gained weight of 52 pounds (approximately 20kg) ,” mentions one of his family members. According to the Karki family, the hospital has not yet disclosed the details of the person who donated the organ.
Karki, who has been recuperating says he has no proper words to thank the liver donor and the hospital team that have renewed his life.
“I have no words to thank everyone who helped me to come to this stage”, adds Karki with tears in his eyes.
“He is a lucky person to get his liver transplanted within a six months of his entry into the United States,” says Dr Lakshmi Prasad Dhakal, President of the Bhutanese Community in the Netherlands.
He adds, “In the Netherlands, the waiting time for this type of surgery is minimum a year, provided a patient fulfills transplantation requirements. In addition, a patient needs to prove through blood test, an alcohol abstinence of minimum six months”.
According to Dr Dhakal, life long medications to prevent rejection of a transplanted liver is recommended to all patients who undergo such medical conditions, otherwise, the immune system, the defense mechanism of the body recognizes the transplanted liver as “foreign to the body” and tries to expel it.
Most commonly, the technique is orthotopic transplantation, in which a donor liver replaces a native liver.
As of today, Dr Dhakal highlights that liver transplantation is the only option for an end-stage liver disease accompanied by failure of liver functions.
As his resettlement proceeded, Karki kept his hope high that he would be getting better treatments in the United States. However, he never thought that he would one day undergo liver transplantation.
“I never thought that I would live so long. The transplantation was out of my imagination since I knew no patients like me could manage the cost,” he says.
It is not that all end-stage liver patients can manage the operation cost although it varies from countries to countries.
“Surgery in India and Nepal, if a compatible organ donor is found, costs less than 100,000 rupees; in USA only surgical costs would climb around 300,000 dollars and in Europe the cost is nearly two times than that of USA,” says Dr Dhakal.
But, Karki is certainly a select few to get the proper diagnosis and treatment on time. He is also lucky enough to have all of his expenses borne by his Medicaid, the health insurance provided to the refugees by the government. The U.S. government has defined this facility as “a government health program that is available to qualified people for a limited time after their arrival in the U.S.”
“However, bitter part of this procedure is the follow up cost that increases every year,” says Dr Dhakal. As per him, in Nepal this cost would be not less than Rs 15,000 annually.
“Born in Bhutan, spent my youth in Nepal, now I am living with a donated liver in America,” says Karki in the hope to live longer with the transplanted liver.
With inputs from Sanita Guragain, Missouri, USA.