KELSEYVILLE -- While on a three-week medical mission in Nepal last fall, Dr. Paula Dhanda remembered noticing a woman who hadn't taken any pain medication after undergoing major surgery.
The Kelseyville physician said she asked the nurses if they knew why.
"Well, she's just so grateful that you took care of her. She doesn't want to complain," Dhanda recalled the nurses replying.
For Dhanda, that all but epitomized the character of the women she and her team treated in an underserved area in eastern Nepal.
"The women were very stoic," she said. "They didn't complain about anything. They really had no expectations of anything. They were so grateful to get care."
The international team of medical volunteers arrived in the Asian country Oct. 29.
Dhanda's fundraising foundation, Worldwide Healing Hands, partnered with the nonprofit Himalayan HealthCare on the mission with two goals in mind.
"One purpose is to provide care," Dhanda said. "But I think a bigger purpose is to leave something behind by training the local staff to carry on what we're doing."
It was the fourth medical mission in as many years for Dhanda, the recipient of the 2012 Marla Ruzicka Humanitarian of the Year award at the Stars of Lake County.
The team flew into Nepal's capital city, Kathmandu, and stayed there for two days while getting permission to work in the country.
"We had to be interviewed by the Nepali Medical Council in order to be able to practice there because you cannot just go into Nepal and practice, which I think is a really good thing," Dhanda said.
From there, the group took an hour-long flight and three-hour Jeep ride to Nepal's Ilam district.
There were four doctors, two nurses, one midwife and one student -- Dhanda's 11-year-old daughter, Jasmin Clarke. It was the first time mother and daughter participated in a medical mission together.
"It was amazing to watch how responsible she was," Dhanda said. "She learned a lot, and she's even talking about becoming a doctor."
In another first, a writer and photographer from the National Geographic Assignment Blog followed Dhanda's team. They documented the mission, posted an article online in December and plan to release an electronic book later this month, according to Dhanda.
Team members spent most of their time in the Himalayan HealthCare hospital in Ilam but also traveled to the remote village of Naya Bazar, working out of a makeshift clinic for two days.
Dhanda said they examined 1,483 patients, completed 36 gynecological surgeries and delivered four babies. All of the care was free-of-charge.
That "barely scratches the surface" of the need, she added.
"There were so many women in need and just so much surgery that needed to be done, and we couldn't accommodate all of them," Dhanda said. "The sad part was that some of these women would come in, that had walked three days, and they came in fasting -- they knew they had to be fasting to have surgery -- and we couldn't do them."
To help the medical community address the demand for services, Dhanda's group mentored local doctors, trained nurses, operating-room staff and 10 midwives and left behind essential equipment such as stethoscopes and clean birth kits.
The midwives, some of whom traveled for five days to meet the team, learned to resuscitate infants, suture and recognize normal labor compared to problematic births.
Those lessons were key for the region burdened by a shortage of doctors, according to Dhanda.
"Some of the midwives practice in really remote areas where if there is a problem and they don't know what to do, there is no backup. The women will die," she said. "We can prevent a lot of maternal and infant deaths by training midwives."
In the Ilam district, one in 15 women die in childbirth, Dhanda said.
"That was the focus of this mission: saving mothers. And the reason women die is very preventable," she added.
Dhanda said the primary cause of maternal death is hemorrhage, and most cases can be prevented with medication not readily available in Nepal. The No. 2 reason is infection, which the clean birth kits help address.
Adversity struck the volunteers several days before they left Nepal.
While trekking back from Naya Bazar on a narrow roadway, one of the nurses stepped back trying to get into a vehicle and fell down a seven-foot embankment, fracturing her arm.
When it came time to transport the injured nurse from Ilam to Kathmandu, the team found the road to the airport was blocked because of protests, Dhanda said. Ultimately, a helicopter landed in a cricket field and flew the nurse to the capital city.
Dhanda's medical team also made local history, appearing on the front page of an Ilam newspaper after performing the region's first hysteroscopy.
"That's where we look in the uterus with a camera. It's a procedure that's very common here," she said.
The Karl Storz company contributed the hysteroscopy equipment, serving as just one example of the tens of thousands of dollars worth of tools and money donated for the mission in Nepal -- on top of the medical professionals volunteering their time.
"It's vital to our mission. We cannot function without those kind of donations," Dhanda said.
Dhanda hopes to take another trip to Nepal in May to treat more women and spend time training obstetrician-gynecologist residents.
"We really want to grow this," she said. "There's such a disparity between countries."