GHAWS' visit to Kushudebu Public Health Mission, Nepal
By Dani Abosh
Year Three UWS Medical Student
To be completely honest, I didn’t know what to expect with my trip to Nepal. I did some research and learnt bits and pieces; about the Himalayas and the terrai (I don’t know if this is a supposed to say ‘terrain’?). However it wasn't till I arrived there, that I learnt about its beauty, nature and people.
For me, Nepal is a country of contrasts and variety. The population itself varies with 80% Hindu, 10% Buddhist, 5% Muslim, 3% Christian and 2% ‘other’, it is interesting to see a society evolve and try to reconcile its conservative past with a different, progressive Nepal of the future. As I turned page after page and scrolled down website after website I learnt about Nepal, the young democratic country with its rich history, religion and culture.
My trip to Nepal was a struggle to reconcile the information I had already learnt, with the reality around me and my own perception of the world.
I also found that it is the small moments that really shape experiences and change perspectives. There were a few moments that struck me deeply and that I will always remember forever. One of these moments was after an impromptu health literacy camp that was held at a nearby (about half a days walk) primary school located on a mountain.
The children were all eager to learn and armed with our health charts and local interpreters, we hiked to the ~2800 m school to teach them about communicable disease, nutrition, hygiene and the environment.
It was only a few days earlier that we had delivered the same talk to a few children in the vicinity of KPHM and it was well received there. The earlier session had also allowed us to identify health issues within the local community that needed to be addressed, especially cultural and social attitudes that inevitably affected health and health delivery. After helping create and deliver the nutrition talk initially, we had realised that cultural perspectives on alcohol consumption were very different here. In fact, routine alcohol consumption during pregnancy and underage drinking was an issue identified by the community as being problematic.
So deeply ingrained were cultural attitudes towards alcohol consumption that the school kids were shocked when we explained that ‘chang’ (a distilled salty alcoholic drink ~70% alcohol) was bad for children and pregnant women to drink. Not only that, but there would be large quantities consumed regularly as part of tradition and to ease pain.
After explaining that pregnant women shouldn’t drink because it ‘hurt the baby’ and that young kids were “still growing and chang stopped them from growing strong and healthy” the local kids began to take notice. After explaining how alcohol affects adolescents, children and babies the kids were little shocked were but continued to be engaged with our presentation that covered healthy eating habits and proper water consumption as well as healthy bones/growing bones care amongst other issues.
It was actually after the presentation, when one of the children were asked what they had learnt, they said they would tell their pregnant mother that it was bad for her and the baby if she drank ‘chang’. This changed my whole perspective on things and I realised that we can all make a difference and our actions can change people’s lives, regardless of how small our actions are.
In this way, the choices we make can have life changing effects on people around us; whether in the hospital or in the community. Whether we are at home or overseas. Whether we are talking to the patient’s themselves or their family members. We can all make a difference.
“Be the change you want to see in the world.”
I remember reading Mahatma Ghandi’s famous quote in a book about Asia and the subcontinent. It was only in Nepal though, amongst the high mountains, deep valleys, tall stuppahs and kind faces in Kushudebu that I understood and that quote completely. Ang and his team at the Kushudebu Public Health Mission helped me learn what really constitutes true healthcare, rural medicine and service to the community. I will never forget those 0540 morning sunrises, greetings of ‘tashi deley’, rocky mountain trails and the wonderful hospitality of the Sherpa people.