The Hospital at the End of the World

The Hospital at the End of the World

by Joe Niemczura


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There are 2,600 hospitals in Asia, Africa and South America which could be classified as "Mission Hospitals" - far off the beaten path, providing basic medical service to the poorest people of the world. The Hospital at the End of the World tells the story of a nurse from the USA and his first experience as a teaching nurse in Nepal.

Joe Niemczura brings to life the day-to-day realities of life in a rural teaching hospital, literally at the "end of the road." The harsh realities of a lack of modern medical equipment when mixed with the humanness of endurances demonstrates that above all, it is the individual who matters; both patient and caregiver. All else pales in comparison. The strength of this story is in relationships with students, physicians, other nurses, patients, families and most importantly with Nepal itself. There is a sense of community connectedness which the author brings alive as the reader becomes one with the story. The heartbreak and grief of death to the celebrations of life will elicit those same emotions. The thread through it all is the author's own journey as he discovers himself and renews his spirituality. The reader is immediately pulled into the drama and nakedness, and the beauty and mystery of this incredible part of the world.

Ellen L. Bridge, RN, BS, MTS

Public Health Nursing Consultant

Product Details

ISBN-13: 9780911051377
Publisher: Plain View Press
Publication date: 08/16/2013
Pages: 260
Product dimensions: 6.14(w) x 9.21(h) x 0.63(d)

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The Hospital At The End Of The World 4.6 out of 5 based on 0 ratings. 15 reviews.
LynneNortonRNMSN More than 1 year ago
I had heard about Joe Niemczura's book The Hospital at the End of the World by reading a review in our Maine nurses publication. The idea of an American nurse travelling to Nepal to help in teaching nursing students intrigued me and I purchased the book. Once I read the first paragraph, I was hooked! What an incredible journey of a skilled, compassionate and spiritual man who embraced the country, its people and the health care system he was thrown into. He patiently trained Nepalese nursing students, (who were pleasantly very well educated and competent in their own right) in new techniques, while teaching them only things experience can teach. He witnessed unfathonable cases of illness and horror in health care never seen in the USA and in many cases was able to overcome what would seem insurmountable odds to help his patients. One example is where he rigged up an old Bear ventilator to support respirations of a young boy who had been bitten by a snake and whose respiratory muscles were temporatily paralyzed...and saw that boy through to full recovery...all the while with the boy's family's vigil sleeping under and around his bed. In reading the book, Joe never lets you lose sight of the thinking, joys and poignance of the experiences from his and other clinicians points of view. It is a wonderful book which I quickly lent to a nursing school student friend who has now passed it along to one of her faculty members suggesting that it should be required reading for all nursing students. Thank you, Joe, for giving us such a inspirational portrayal of the impact one nurse can have. I loved this book. Lynne Norton RN,MSN
Nurse-Willie More than 1 year ago
This book is a big slice of real life in Nepal through the eyes of a registered nurse and nursing instructor. Joe is a skilled story teller who sees life and his clients through a compassionate pair of glasses. He is affected by the people he serves and in this way it is a book about change, culture, and being changed through one's nursing and healthcare work in Nepal. I fully recommend this book.
Meiricea More than 1 year ago
I am not a nurse, but I love both inspirational stories of good will and stories that introduce me to different cultures and people. This book fit the bill admirably. I got to know the unique people and culture of Nepal and witness their courage, humor and patience. I also admired the generosity and skill of the professionals at the teaching hospital, doing an amazing job with few resources. I am giving my copy as a Christmas present because I found it was exactly the right choice to express the Christmas spirit of love and giving as well as hope in the face of the heartbreak that exists in this world.
BGetman More than 1 year ago
Reading The Hospital at the End of the World was like stepping off an airplane into a different, exotic, and at times troubling world. The writers practical and engaging style helped to visualize his experiences, without being overly dramatic. The events spoke for themselves. While I'm not a nurse, the detail the author includes would be interesting to anyone with a background in medicine. Even without that background, I found the humanity of the characters to be striking. A solid read that will hold your attention from start to finish.
LAubert More than 1 year ago
Joe writes, "The Hospital at the End of the Word," with brutal honesty, conviction, and compassion. I admired his willingness and desire to experience and live the culture and traditions of the Nepali people. He wears the traditional Topi to show his respect and even studied the Nepali language prior to his trip. Joe embraced life in Nepal, all of it...the good, the bad, the painful, the joy, and he pushed past his feelings of discomfort and accepted whatever crossed his path. As a fellow RN and person who has traveled to Nepal, I appreciate Joe's insight of Nepal, it's people, it's religion, it's political situation, and it's medical care. His voice comes through as passionate and authentic. He does a wonderful job in describing his experience as a nursing instructor in a third-world country. Additionally, the reader is engaged in Joe's own personal struggles & victories throughout his journey. This real-life story touched my heart, a great read for anyone interested in cultural nursing and/or a spiritual pilgrimage.
dahabdabbler on LibraryThing More than 1 year ago
I won this book from a Goodreads First Reads giveaway.Having lived in a "developing nation" for half of my life, reading Joe Niemczura's account of his trip to Nepal reminded me of many of the initial thoughts I had on my first visit among such poverty. Along with peeks at the culture of Nepal (I would have liked more!) and the ups and downs of working as a nurse in a mission hospital, Joe shares his personal reactions not only to the Nepalese and the working conditions, but also to the international crowd he finds himself working with - which I found entertaining. Despite some of the recounted facts and stories seeming random and disconnected, I found myself still turning the pages to find out what happens - to Joe, his patients, the other staff.
still_linden More than 1 year ago
The Hospital at the End of the World was very interesting. It was poignant and inspiring. I highly recommend it.
MargueriteSu More than 1 year ago
"The Hospital at the end of the World" captures a unique community and presents a glimpse into the world of those living far away from western culture. Niemczura is also able to summarize what most volunteers in remote areas experience. Having worked in rural areas, I can relate to the exciting, frightening, rewarding and lonely emotions that one fluctuates between when traveling and working in a culture so different from ones own. The book is a quick easy read that I would recommend to anyone in the medical field. Additionally, anyone who is interested in anthropology will enjoy this book as it depicts the struggles that many anthropologists face while working in the field.
Anonymous More than 1 year ago
Womankind More than 1 year ago
I just finished Joe Niemczura's book, "The Hospital at the End of the World," and want to recommend it. It is a particularly wonderful read for nurses and nursing students and others in the field of healthcare. If you haven't considered international nursing before, this book will inspire you to consider it! Niemczura's book is the story of transition and of his spiritual and professional journey. I found it to be a heartfelt, honest depiction of what nursing in Nepal -- 'out of the bubble' -- is truly like. Niemczura portrays the medical and nursing staff of the Tansen hospital as compassionate, competent and knowledgeable, however, throughout the book the reader becomes acutely aware of the scarcity of resources available for the medical practice in less developed countries when compared to Western societies. I hope that many nurses and nursing students will pick up a copy and be inspired to go out into the world and practice the art and the science of nursing outside their home countries. Just like for Joe, the life you change WILL be your own! ~ Nancy Leigh Harless, ARNP, Author, Womankind: Connection & Wisdom Around the World, Editor: To the Rescue: Healthcare Workers on the Scenes of Disasters and Caring Beyond Borders: Nurses Stories about Working Abroad.
Nehringk More than 1 year ago
This book is a thoroughly enjoyable read that impresses by it genuineness. The author is a nurse, not a professional writer; because he is writing about his experiences in adapting his nursing skills to an unusual environment, and adapting himself to a strange environment, the end result is a work of refreshing honesty and engagingly direct appeal. The basic simplicity of Joe Niemczura's prose, and some of the awkwardness you feel in his attempt to give a literary structure to his experiences serve to make this book come alive in its evocation of the sights, smells, tastes, sounds, and overall feel of the time he spent in a hospital "at the end of the world." Adding to the immediacy of the prose are the photos - B&W snapshots - that add to the intensely personal nature of the story being told. The photos remind you that "this really happened" - this is not just a story, it is an account of real people with real ailments being treated by real people with real strengths and weaknesses. From the medical staff to the patients to Joe Niemczura himself, you will find yourself really beginning to get to know these fellow human beings and care about their well-being. In that humble but remarkable way, this book will leave you with a fine gift.
Mainewriter More than 1 year ago
Nursing in Nepal is a cultural world away from the care we often take for granted in western health care facilities. Although it's undoubtedly a beautiful country, Nepal's unforgiving terrain and the high South Asian location are distinct challenges to medical missionaries who seek to care for people living on what some call the roof of the world. "The Hospital at the End of the World" is Joe Niemczura's interesting autobiographical story about teaching nursing in Nepal. It's a thoroughly entertaining and educational documentary including personal photographs and a helpful glossary to assist with Nepalese vocabulary. Niemczura is a brave nurse, and writer who twice made the extraordinary journey to a missionary hospital located off the muddy and beaten Nepalese roads in Tansen, Nepal. He arrived with cartons of his nursing texts during Nepal's rainy season. His purpose was to teach 20th century health care practices to nursing students in Tansen. But, he didn't have the advantages of 20th century medical technology to do it. Instead, he relied on instinct, experience, positive communications and compassion to teach in a hospital where culture, western civilization and medical science can often be at odds. His day to day experiences are cultural short stories. Frequently by his own wits, he quickly learned the customs and habitat of Nepal's pristine land-locked heritage. All the while, he was often teaching out of text books he transported to the hospital from his home base in Hawaii. He writes about the Tansen hospital, "There are no IV pumps; everything is dripped and the drop rate is controlled by a hand roller on the IV line.." Some of us nurses recall how to calculate a drip rate on a hand roller, but those days are ancient history for a modern trained nurse. Every nurse or student of nursing should read this book. For some, it will be a literary experience in cultural immersion. Many nurses, like me, might connect the human stories with the values which drove us to choose nursing over other careers, like computer science or entomology. Niemczura writes about the people who survive and some who, unfortunately, die, in a place where modern medicine is trying to improve outcomes for a litany of endemic diseases. We read about leprosy, hookworm, tuberculosis and venomous snake bites. Modern pharmacology clearly improves the outcomes of these medical conditions in western societies, but they cause widespread morbidity and mortality throughout poverty stricken Nepal. We read how Niemczura teaches the art of healing to eager nursing students who grew up without the benefit of modern medicine at their fingertips. He writes about the compassion shared by the nurses and physicians who arrive at the Missionary Hospital to care for the Nepali. Yet, teaching Tansen nursing students is, more or less, the easier part of Niemczura's story. Learning how to negotiate within the Nepalese culture is as fascinating to read as are the numerous medical situations he describes. Some stories are humorous while others are heart breaking. Niemczura's literary description of trans-cultural health care puts faces on those who depict the biblical proverb "Whatsoever you do to the least of my people, that you do unto me." By his example and experience as a skilled medical professional, Niemczura teaches Nepali nursing students to become experts in providing quality care for their own people.
Joe_Shugrue More than 1 year ago
I was pulled in by every word of "The Hospital at the End of the World." It was excellent, well written, interesting, and full of little personal comments, funny and serious, that made the book. I was impressed that someone who is not a professional writer could express himself so skillfully, especially in conveying his passion for the work of the hospital and his inner ruminations about life, God, and human nature. I admire Joe and his wonderful ability to tell stories. Thanks for writing your book. It gave me some very pleasant hours.
Anonymous More than 1 year ago
JoeNiemczura More than 1 year ago
In the interest of full disclosure: i am the author of this book! I am adding this becasue I just found out it was listed here. There are other, objective reviews on Amazon dot com and also on the book's fan page on facebook ( to find that, enter the title into the Facebook search box). I teach nursing at the University of Hawaii and in 2007 I made my first trip to teach nursing in rural Nepal. I have been a nurse for thritytwo years; I have fifteen years of critical care nursing background; I have been a hospital mid-level manager. While there I keptt extensive notes and a daily journal. The book is intended to serve as a source for any other person who wish to learn about doing a similar thing before they go, but any nurse can enjoy it and a well-educated lay person, I am told, will be able to understand the events. The book is a first-person narrative nonfiction written in the style of a novel. I purposely decided not to write it in a scholarly manner - that would have been too dry and blood less....... Joe Niemczura, RN, MS