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The Hospital at the End of the World
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
"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
262 pages, Kindle Edition
First published May 15, 2009
5 people are currently reading
344 people want to read
About the author
Joe Niemczura
2 books22 followersThe Sacrament of the Goddess
The premise of TSOTG is simple. I wrote the book I wanted to read.
I am passionate about health care. I get positive reinforcement when the people I care for tell me how I helped them. It is the best possible feeling.
The premise of TSOTG is simple. I wrote the book I wanted to read.
I am passionate about health care. I get positive reinforcement when the people I care for tell me how I helped them. It is the best possible feeling.
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Displaying 1 - 19 of 19 reviews
January 2, 2010
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.
November 3, 2009
Okay so I am the author. Bias exists.
This is narrative nonfiction written in the style of a novel. It is a true story but the names of the major persons have been changed. In summer 2007 I taught nursing at a nursing school run by Christian Missionaries in the foothills of the Himalayas in Nepal.
There is no plot per se, other than a description of the adjustments involved in a new culture and dealing with health care in the Third World.
There is no evil deformed villain.
there no car chase; and nothing gets blown up.
But the setting is describe din intimate detail by a person who knows a lot about hospitals. The target audience is nurses - esp those who have ever harbored any thoughts of serving in a Lesser Developed Country.
This is narrative nonfiction written in the style of a novel. It is a true story but the names of the major persons have been changed. In summer 2007 I taught nursing at a nursing school run by Christian Missionaries in the foothills of the Himalayas in Nepal.
There is no plot per se, other than a description of the adjustments involved in a new culture and dealing with health care in the Third World.
There is no evil deformed villain.
there no car chase; and nothing gets blown up.
But the setting is describe din intimate detail by a person who knows a lot about hospitals. The target audience is nurses - esp those who have ever harbored any thoughts of serving in a Lesser Developed Country.
January 1, 2010
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.
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.
November 5, 2009
I finished this book, which I won through GoodReads, a few days ago and have been contemplating how to write this review. This is a 3-star book written by a 5-star person. You can't help but love Joe Niemczura by the time you finish the book.
This book chronicles the three months Joe spent training nurses in rural Nepal. For me, it was so nostalgic to hear his descriptions of the food, the culture, the dress, the living conditions of rural Nepal. Also, his initial bouts of culture shock upon entering Kathmandu for the first time reminded me of when I first got off the airplane in Nepal. The sights, the sounds, the taxi drivers, the beggars, the poverty, the chaos... it was all so overwhelming. Then, when he returns to Kathmandu three months later, it all seems so very tame and almost luxurious there. I had exactly the same experience.
His experiences at the hospital are well-told, interesting, depressing, and enlightening about just how much we take for granted in the West. For example, we have the luxury to feel and express pain. Not so in such a poverty-stricken area.
All right... the negatives: He only spent 84 days in Nepal. It seemed as though everything that happened to him in that short period, no matter how trivial, ended up in this book. I wish he'd had more material so that he could be more selective in what he included. He also talks a lot about "getting outside the bubble" of his own life, his own culture. I completely get that. I spent years trying to do just that. Eighty-four days, no matter how intense, isn't even enough time to pass through the various stages of simple culture-shock: fear, trepedation, wonder, love, bitterness, scorn, and ultimately accepting a culture for what it is (cultural relativism). The book is one long comparison with life at home (Hawaii); this is inevitable and meaningful but also limiting. He's still trapped inside the bubble of his own culture. I think he ultimately learned more about Celeste than he did about himself. I hope, hope, hope that Joe returns to Nepal (or another area) and stays a longer time. I would love to read his book based on a longer experience.
Technical problems with the book: More than a few annoying typos. They're just so distracting. (I don't believe my copy is an advanced proof. If it were, I wouldn't mention these because it wouldn't be fair.) Shifts in time that could have been handled more skillfully, adding a little tension and foreshadowing to the plot. Redundancy-- because of the time shifts, some stories were partially told all over again, which was just not necessary.
But overall, I very much enjoyed this book and loved Joe. I just wish I knew someone in Hawaii that I could set him up with!
This book chronicles the three months Joe spent training nurses in rural Nepal. For me, it was so nostalgic to hear his descriptions of the food, the culture, the dress, the living conditions of rural Nepal. Also, his initial bouts of culture shock upon entering Kathmandu for the first time reminded me of when I first got off the airplane in Nepal. The sights, the sounds, the taxi drivers, the beggars, the poverty, the chaos... it was all so overwhelming. Then, when he returns to Kathmandu three months later, it all seems so very tame and almost luxurious there. I had exactly the same experience.
His experiences at the hospital are well-told, interesting, depressing, and enlightening about just how much we take for granted in the West. For example, we have the luxury to feel and express pain. Not so in such a poverty-stricken area.
All right... the negatives: He only spent 84 days in Nepal. It seemed as though everything that happened to him in that short period, no matter how trivial, ended up in this book. I wish he'd had more material so that he could be more selective in what he included. He also talks a lot about "getting outside the bubble" of his own life, his own culture. I completely get that. I spent years trying to do just that. Eighty-four days, no matter how intense, isn't even enough time to pass through the various stages of simple culture-shock: fear, trepedation, wonder, love, bitterness, scorn, and ultimately accepting a culture for what it is (cultural relativism). The book is one long comparison with life at home (Hawaii); this is inevitable and meaningful but also limiting. He's still trapped inside the bubble of his own culture. I think he ultimately learned more about Celeste than he did about himself. I hope, hope, hope that Joe returns to Nepal (or another area) and stays a longer time. I would love to read his book based on a longer experience.
Technical problems with the book: More than a few annoying typos. They're just so distracting. (I don't believe my copy is an advanced proof. If it were, I wouldn't mention these because it wouldn't be fair.) Shifts in time that could have been handled more skillfully, adding a little tension and foreshadowing to the plot. Redundancy-- because of the time shifts, some stories were partially told all over again, which was just not necessary.
But overall, I very much enjoyed this book and loved Joe. I just wish I knew someone in Hawaii that I could set him up with!
May 1, 2016
In a tale that reminds me somewhat of Dieter Lemke's Man No Be God, Niemczura (an American nurse) describes a summer spent volunteering in a hospital in Nepal. The similarities are fairly superficial—while both men worked in developing countries, Lemke spent much of his career in Cameroon as a missionary doctor, while Niemczura's tenure in Nepal was much shorter (and, though the hospital was mission-affiliated, he himself was not a missionary).
It was clearly an overwhelmingly positive and stimulating experience for Niemczura—different challenges than he might face at home in Hawaii, with a lot of culture to learn. It's that interest in culture that satisfied me the most in this book, as Niemczura takes care to describe, in detail, certain aspects of clothing and societal expectation. (I was less interested in his own interpersonal stuff—e.g., with Celeste, his maybe-girlfriend—though I suppose it added a bit of non-medical tension.)
The medical end of things, though, was where I most wanted more. There are some nice little nuggets of things to think about scattered throughout: that burn victims whose burns covered more than 40 percent of their body were sent home to die (pg. 145), because there wouldn't be enough healthy skin to do grafts; that although Niemczura was working in a hospital (one relatively well equipped for the developing world) he still had to look into health insurance 'evacuation' policies (futile, as his area of Nepal wasn't covered, but a reminder of how much and how little a given hospital can do); that the sinks in the guest complex drained into buckets, and the water would later be used to flush the toilet (24); that in Pediatrics they had a policy to take patients to the treatment room, so that the bed would remain a safe space (127). That said, the medical end of things was what reminded me most of Lemke's work: patient after patient, story after story, with not a lot of follow-up. My preference would have been fewer stories told in more detail, allowing me to understand the medical complexities of the situation and the people involved. (Harder to do this when the time period is so brief, of course, but I also would have loved more complete backgrounds on, say, one or two of the trainee nurses.)
At any rate, this made for a nice, quick, end-of-semester read...I have so much appreciation for interlibrary loan!
It was clearly an overwhelmingly positive and stimulating experience for Niemczura—different challenges than he might face at home in Hawaii, with a lot of culture to learn. It's that interest in culture that satisfied me the most in this book, as Niemczura takes care to describe, in detail, certain aspects of clothing and societal expectation. (I was less interested in his own interpersonal stuff—e.g., with Celeste, his maybe-girlfriend—though I suppose it added a bit of non-medical tension.)
The medical end of things, though, was where I most wanted more. There are some nice little nuggets of things to think about scattered throughout: that burn victims whose burns covered more than 40 percent of their body were sent home to die (pg. 145), because there wouldn't be enough healthy skin to do grafts; that although Niemczura was working in a hospital (one relatively well equipped for the developing world) he still had to look into health insurance 'evacuation' policies (futile, as his area of Nepal wasn't covered, but a reminder of how much and how little a given hospital can do); that the sinks in the guest complex drained into buckets, and the water would later be used to flush the toilet (24); that in Pediatrics they had a policy to take patients to the treatment room, so that the bed would remain a safe space (127). That said, the medical end of things was what reminded me most of Lemke's work: patient after patient, story after story, with not a lot of follow-up. My preference would have been fewer stories told in more detail, allowing me to understand the medical complexities of the situation and the people involved. (Harder to do this when the time period is so brief, of course, but I also would have loved more complete backgrounds on, say, one or two of the trainee nurses.)
At any rate, this made for a nice, quick, end-of-semester read...I have so much appreciation for interlibrary loan!
November 26, 2009
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.
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.
June 15, 2015
I have to say that I kind of expected this book to be similar to other books written by nurses. Written as though they were charting. But this was quite the contrary which was fantastic. The way the author writes paints a picture for you and gives you the feel of what is going on. He also has pictures taken while he was there. These do not take over the book and are placed so that it complements the writing. The reader does not suddenly see a picture and get distracted. Rather the pictures help to show things that can not be described, which is what pictures in a book should do. I would highly suggest this to my fellow nursing students and other people that are just curious. This is a very nice read and is very informative.
July 2, 2018
Read this book if you want to be grateful for medical care in the US! The author worked in a mission hospital in rural Nepal in 2007.
October 18, 2020
Just Finished: The Hospital at the End of the World by Joe Niemczura
Joe Niemczura is a leader and a teacher, a confidant and a caregiver. But it's his role as a nurse that makes these other functions possible. In this book we see the story of a nurse far away from home, helping to teach nursing students and save lives. But more than that, we see someone struggle and come to terms with what they believe, and why they believe it.
What I really appreciate about Joe's story is he never hides how he feels. His joy at saving lives, his pain at the deaths of patients, his own struggle to believe in God, all of it is laid bare in his novel. Nothing is held back, and all of it serves to make the experience authentic to the reader.
Initially, this is a book about healthcare. But ultimately it's a book about confronting uncertainty with acceptance. Joe is uncertain about the availability of supplies, his relationship with others, his relationship with God, but through it all he accepts that all he can do is his best work to ease others suffering and save lives. It gives me a lot to think about, and I think it's a great read for people of all professions.
Joe Niemczura is a leader and a teacher, a confidant and a caregiver. But it's his role as a nurse that makes these other functions possible. In this book we see the story of a nurse far away from home, helping to teach nursing students and save lives. But more than that, we see someone struggle and come to terms with what they believe, and why they believe it.
What I really appreciate about Joe's story is he never hides how he feels. His joy at saving lives, his pain at the deaths of patients, his own struggle to believe in God, all of it is laid bare in his novel. Nothing is held back, and all of it serves to make the experience authentic to the reader.
Initially, this is a book about healthcare. But ultimately it's a book about confronting uncertainty with acceptance. Joe is uncertain about the availability of supplies, his relationship with others, his relationship with God, but through it all he accepts that all he can do is his best work to ease others suffering and save lives. It gives me a lot to think about, and I think it's a great read for people of all professions.
December 23, 2009
I won this book on Goodreads!
Joe Niemczura, an American nursing instructor, chronicles his time teaching at a remote hospital in Nepal. We follow the author as he leaves everyday comforts in Hawaii to land in desolate Tansen, Nepal. Joe's new home is void of any conveniences let alone modern medical equipment and we see his struggle to care for his patients using third world facilities. As time progresses, it is apparent that Joe is quite fond of the people he meets: the Nepali patients and their families, his nursing students, and the international community including the doctors.
As interesting as the author's journey may be, the writing sometimes interferes with the flow of the story. Transitions between paragraphs are often lacking and leave readers to fill in gaps. The writing style steadily becomes better in later chapters as Joe becomes more confident in his own writing. Overall, the book is a worthy read especially when Joe shares heartbreaking stories of illness and disease.
Joe Niemczura, an American nursing instructor, chronicles his time teaching at a remote hospital in Nepal. We follow the author as he leaves everyday comforts in Hawaii to land in desolate Tansen, Nepal. Joe's new home is void of any conveniences let alone modern medical equipment and we see his struggle to care for his patients using third world facilities. As time progresses, it is apparent that Joe is quite fond of the people he meets: the Nepali patients and their families, his nursing students, and the international community including the doctors.
As interesting as the author's journey may be, the writing sometimes interferes with the flow of the story. Transitions between paragraphs are often lacking and leave readers to fill in gaps. The writing style steadily becomes better in later chapters as Joe becomes more confident in his own writing. Overall, the book is a worthy read especially when Joe shares heartbreaking stories of illness and disease.
April 24, 2011
For a complete review, see my blog (http://lorettajokapinos.blogspot.com/...), but here's an excerpt:
I found The Hospital at the End of The World to be a satisfying read. It was conversational enough for non-medical readers and yet interesting to me as a nurse. The one factor that separates it from other nursing memoirs is Joe's truth in emotion. He shares secrets of coping with the ups and downs, many that I didn't even know I used. He's open, honest and real about the struggles nurses face every day-whether in a third world country or in our homeland.
The structure and writing isn't perfect, but the readability of Joe's voice usurped any of that, at least for me. I tagged many pages that moved me and return to read them when I need to. Overall, I'd give this book 4 out of 5 stars.
I found The Hospital at the End of The World to be a satisfying read. It was conversational enough for non-medical readers and yet interesting to me as a nurse. The one factor that separates it from other nursing memoirs is Joe's truth in emotion. He shares secrets of coping with the ups and downs, many that I didn't even know I used. He's open, honest and real about the struggles nurses face every day-whether in a third world country or in our homeland.
The structure and writing isn't perfect, but the readability of Joe's voice usurped any of that, at least for me. I tagged many pages that moved me and return to read them when I need to. Overall, I'd give this book 4 out of 5 stars.
July 31, 2010
I did not win this book through the Goodreads giveaway, as many of the other reviewers did. However, it sounded so interesting that I wanted to read it anyway, so I ordered it from Amazon. I have read other books that take place in this part of the world and wanted to "return" there, as I find the people and culture fascinating.
While this wasn't a bad book—I did finish it—I was disappointed. I expected it to be more about the hospital and its patients, and less about the author. I came away from the book feeling that the author was a very competent nurse and a sensitive and self-reflective person. However, the book touched too lightly on the individual patients and medical cases, and I thus felt mislead by the title of the book.
While this wasn't a bad book—I did finish it—I was disappointed. I expected it to be more about the hospital and its patients, and less about the author. I came away from the book feeling that the author was a very competent nurse and a sensitive and self-reflective person. However, the book touched too lightly on the individual patients and medical cases, and I thus felt mislead by the title of the book.
October 28, 2009
This book takes you on a journey into the heart and soul of healing care. Joe Niemczura, RN, MS shares medical stories from the Himalayas. Joe is one of many Christian Missionaries whose care for the body led him to a place where souls meet and spiritual healing comes alive. These stories move your heart into a desire to serve others in need of care.
In these stories, you will find a message regarding how service to others develops one's character and one's soul. The inspirational stories will lead you into a call to action. As you ponder these stories, allow them to create in you a vision to serve the needs of others.
Sam Oliver, author of, The Path into Healing
In these stories, you will find a message regarding how service to others develops one's character and one's soul. The inspirational stories will lead you into a call to action. As you ponder these stories, allow them to create in you a vision to serve the needs of others.
Sam Oliver, author of, The Path into Healing
November 2, 2014
This is a first person account of a three month stint in a mission hospital in a remote part of Nepal. Niemczura very effectively portrays the sights and sounds of a foreign culture and the challenges of medical practice without all the bells and whistles of an American hospital. He takes the reader with him through the joys and sorrows of the experience and conveys a feel for the utter difference of the society in which he worked. At one point, he says that one of his objectives was to get out of the bubble. He succeeds, and also makes us aware of the extent to which we live our lives in that bubble.
July 23, 2016
I really enjoyed contrasting and comparing the health care practices of the mission hospital with my own experiences in the more developed world, particularly his work with the burn patients. The bit with the banana leaves was so interesting!
I admired the author's dedication to writing the truth of his experiences, even if that meant relaying how he got laid on break (get it, Joe) or ruminating on Backstreet Boys songs haha. Maybe I could done without some of it, but overall it gave me a better, and more honest picture of who the author is and his faults, strengths, and motivations.
I admired the author's dedication to writing the truth of his experiences, even if that meant relaying how he got laid on break (get it, Joe) or ruminating on Backstreet Boys songs haha. Maybe I could done without some of it, but overall it gave me a better, and more honest picture of who the author is and his faults, strengths, and motivations.
December 15, 2014
Part travel memoir, part medical memoir, this is the story of Niemczura's stint as a nurse in Nepal. It was interesting to read, and I recommend it to those who enjoy that kind of nonfiction.
I got this for free as part of Goodreads' Firstreads. If I hadn't, I might not have finished it; it didn't compel me the way some memoirs do. However, it is full of Niemczura' thoughtful and positive take on life, and he was a good person to spend some time with.
I got this for free as part of Goodreads' Firstreads. If I hadn't, I might not have finished it; it didn't compel me the way some memoirs do. However, it is full of Niemczura' thoughtful and positive take on life, and he was a good person to spend some time with.
October 28, 2011
I reeaaaallly wanted to like this book more. I think it would have been good to follow maybe as a blog. I think it would be really interesting had I been Joe's close friend to follow his adventure. As a book though, it didn't hold my interest. :o(
July 28, 2012
Major editing issues - spelling, grammar, thought organization. I would have liked more about the people and less about the author's personal life. I wanted to hear more about nursing in a foreign, under privilged land.
This entire review has been hidden because of spoilers.
October 31, 2011
A "4" for content--honest, culturally appreciative account of serving a medical mission in Nepal.
A "2" for typos--needed a better editor.
A "2" for typos--needed a better editor.
Displaying 1 - 19 of 19 reviews