WHERE there’s one doctor to 150,000 patients, Mike Smith has got his work cut out.

But Mike doesn’t do the counting as patients keep on coming anyway they can to the specialist clinic he helps run in Nepal.

This picture shows Mike with just one of those patients to whom his work makes a difference.

Mike’s due out in Nepal again next month to make that difference all over again, taking two nurses and an anaesthetist from Hereford County Hospital with him.

Mike, an ear, nose and throat specialist with Wye Valley NHS Trust, has dedicated nearly 20 years to providing essential treatment to patients in Nepal with hearing problems including ear infections and deafness.

Many of those patients are children who have never seen a doctor – or any kind of healthcare professional – growing up where health services are some of the least developed in the world.

They come with conditions Mike says would be – and should be – routine back home but made much worse by their living environment.

Mike’s team will usually spend a fortnight in Nepal, around nine days of which are devoted to seeing patients. The rest of the time is taken up by travelling to some of the Himalayan republic’s most isolated regions by the likes of bus, helicopter and pony.

The patients take even tougher routes when they know Mike and his team are on the way.

As lead surgeon, Mike can expect to perform delicate ear surgery on at least 100 of the thousands of patients the team will see.

His wish is to see the work his team does made accessible through some local application. Nepal, he says, is still some way off that, but getting better – slowly.