Today was a busy day with multiple bus rides and delicious new (spicy!) food, but more importantly, many inspiring people.
We started off our day with a tour of Dhulikhel Hospital. We were introduced to the hospital itself by Dr. Rajendra Koju, who explained their working mission: since Dhulikhel Hospital is neither a private nor government hospital, their basis is focused on the community in which they serve. Therefore, multiple outreach programs have been developed through Dhulikhel Hospital, where medical professionals travel to those who are not able to access medical care. In addition, the hospital also supports 18 permanent medical outreach centers, public health programs (i.e. the rural child health program, women’s group training, school health programs, family health programs, micro health insurance programs, etc.), and community development programs (i.e. water resource distribution, bridge construction, microfinance, improved cooking stoves, skill development training, etc.).
After having lunch at the hospital, we traveled to Bhaktapur and checked out the the temples and museums in the Bhaktapur Durbar Square area. In Pottery Square, an extension of the Bhaktapur Durbar Square, we enjoyed the beautiful sculptures, wind chimes, and pots made and sold by the local potters. We had a great time perusing through the streets to find kurthis, pashmina scarves, Nepalese flags, Nepalese dhaka topi and other native items that family and friends can look forward to when we return. A valuable skill that we learnt in the shopping trip was to bargain for ourselves in the Nepalese market.
Next, we explored Kathmandu University with the help of our guide, the Dean of KU. As he led us around the university medical campus, he explained that the campus is also comprised of primary through secondary classrooms, so that each student can see their future potential, whether it is becoming a medical professional, engineer, or artist. PhD programs are also offered through collaborations with outside universities. Some of the topics that the PhD candidates currently investigate are – Gender Based Violence, Headache, Hypertension, and Epidemiology of Brain Injury. Our tour guide for the day- Physiotherapist Saurab Sharma is one of the PhD candidates at Kathmandu University and studies pain management.
We then traveled to Raksha Nepal (Protection Nepal), an orphanage established to care for and support sexually exploited girls, women, and their children. When we arrived, we were welcomed by each of the bright-faced children and young girls with a beautiful musical performance, and a ceremony to show their gratitude. We then split into small groups to read with each of the children, play games, and share our native songs (folk tunes like “Resham Firiri” and children’s songs like “If you’re happy and you know it” and each of our national anthems). We were all certainly impressed with the children’s language skills, which speaks to the support and education they each receive at the center. Before departing, we sat down with founder and chairperson to learn about her personal story and the heartbreaking stories of many of the young children and women which Raksha Nepal helps on a daily basis. Each of the children live at the center, go to school, and are provided with the support and love they need to thrive. The love and sense of community felt within the walls of Raksha Nepal was truly tangible.
Finally, we had a delicious Mediterranean dinner at OR2K in Thamel. We sat on pillows on the floor around a candle lit table and enjoyed food, drinks, and wonderful company.—
Sierra and Sonali
We started out the day with a bus ride to Bhaktapur where we got hands on experience with the shopping culture at Durbar Square. Durbar Square is a shopping center, which also contains many things from shopping and restaurants to temples and schools. At first, many of us were hesitant to bargain while shopping, but we ended up enjoying the process. Some of us were better at bargaining than others =) Our families can look forward to many gifts, including shirts, bracelets, scarfs, and other goodies!
After shopping, we went to a national art museum at Durbar Square that originally was a palace for royalty. At first glance, it seemed very small and dark, but we were informed that a large portion of it was damaged during the earthquake last summer. Fortunately, many of the art was saved, but because of the limited space in the current building, only 30% of the original artwork was on display.
Before lunch, we got a tour of Bhaktapur Cancer Hospital. Our tour guide was a surprisingly outspoken orthopedic surgeon. He previously practiced in the United States before returning to Nepal. He was very passionate when explaining the logistics of the hospital and was eager to show us as many parts of the hospital as he could. He emphasized that although we perceive the standards of care (e.g. sanitation, technology, patient privacy, handicap accessibility) at this hospital to be suboptimal compared to the United States, these patients view the care received at the hospital as the optimal choice. He stated that 40% of the care is curative and the other 60% is palliative. He also stated that the hospital does their best to communicate with patients who are deaf or hard of hearing by using a volunteer sign-language interpreter.
Towards the end the day, we made a quick stop at a brick factory. It’s currently not brick making season. This is due to the high humidity and frequent rain (that we all have become acquainted with!), which does not allow the bricks to dry properly, however, we gained useful insight into a profession that many lower income Nepali people are involved in. In season, this factory makes 15,000 bricks a day. They employ 150 workers, and fortunately, this specific factory had no child laborers.
This is our final night in Dhulikhel before we head back to Kathmandu tomorrow!
For many of us the day started 5 AM. We were hoping to get a clear view of the mountains before the clouds rolled in. Unfortunately, the clouds beat us to it. A large breakfast was served at 7:30, since we would not be stopping for lunch. At 9 AM we all piled into the bus, ready for a long day of travel. Our luggage was loaded on top. Many of us took car-sickness medicine in anticipation of the windy mountain roads ahead. As a result, we were quite the drowsy bunch.
During a brief rest stop, we were lucky enough to meet a faith healer. He was kind enough to talk to us about his experiences. One story involved his 21 year old son, who had required brain surgery. He stressed the importance of modern medicine in addition to the traditional faith healing practices. He also told a story about a young girl who was blind because The Sky Goddess was angry with her. He was not expecting his practice to work, but ultimately, she was able to see again.
At this same rest stop, we all took turns using the restroom. Bathrooms in this part of the world can be much different than the ones we are used to at home. Instead of a toilet, you will frequently see a simple porcelain-covered hole in the ground with a bucket of water beside it for “flushing.” On this occasion, there were no lights, increasing the difficulty. Dr. Campbell was unfortunate enough to lose her sunglasses to the “squatty potty.”
The rest of the trip was relatively uneventful. We arrived at Dhulikhel Mountain Resort at 3 PM. After a brief snack in the restaurant, some of us took naps while others played cards on the patio. At 7 PM we met for a buffet dinner and then went to bed relatively early.
After our adventurous day yesterday, we were able to get a good night’s sleep and spend a day relaxing at the hotel. Everyone got up when they wanted and made their way to breakfast when they were ready. Santosh surprised us by bringing a henna tattoo artist to the hotel. One-by-one we were able to choose our design. There is currently a month long celebration going on in Nepal where everyone gets Henna, so we were happy to be able to participate! Around the late afternoon, we all decided we were ready to hop back in the jeeps and explore some more! We visited a temple, where we got to see holiday practices taking place. We then walked through the village to see the earthquake damage and the progress on rebuilding their homes. We were able to see where the epicenter of the earthquake hit which was very close to the village that we walked through. It started to rain again so we decided to head back to the hotel and had a relaxing night sitting around a bonfire and enjoying a delicious Swiss dinner. We all retired to our rooms early to prepare for our venture down the mountain tomorrow.
We all trekked through the village district to the public school and met with principal, English teacher, and administration manager. We helped explain what the speech-language pathology profession is and we provided English-Nepalese books that we brought with us from Washington D.C. They let us briefly sit down and interact in a classroom and then we were on our way to a newly established “Deaf and Dumb School”. We were immediately welcomed into two of the classrooms and learned “twinkle twinkle little star” nursery rhyme in Nepalese sign language which was surprisingly similar to American sign language. A few of us received unique sign language names created by the students and the rest of us learned some of their favorite animal signs. Even though they did not have ample resources they presented and gave us a Nepalese calendar and we provided English-Nepalese books to them.
We hopped in four four-wheeler Jeep like cars and drove up the mountain in what felt like an hour of off-roading fun. When we reached the top, we arrived at a small mountain village where Santosh told us that they only shower once every month or two and that when they do, it is the talk of the village. They quickly cooked us up a warm meal of rice, lentil soup, a veggie side, and spicy masala sauce. We carbo loaded for our hike up to 3000 meters to a beautiful temple area. It was worth the sweat to see this peaceful, spiritual area that many Nepalese dream to go to as well. When we all arrived back at the base, we jumped back into our cars ready for our drive back down to the resort. The rain had led to some mudslides on our way down though and our cars got stuck deep in the mud early on the drive. We all got out of the cars and while our guides and drivers pushed each car one by one. We all huddled together under a few umbrellas while heavy rain and strong winds blew against us. All we could do was laugh! Finally, one car got free, and villagers came from the restaurant to provide back up. An hour or two later, a second car got free. We sacrificed the other two cars, and 20 of us packed into the two free cars as it was starting to get dark. We drove half way down the mountain and two other cars came to get us and took us back to the hotel. We took warm showers and ate hot dinners and retired for the evening. It was quite the adventure, and we felt very fortunate for how well the Nepalese took care of us.
Before we left the capital city, we did a little bit of shopping at Big Mart next to our hotel for Nepalese snacks for our trip up into the mountains. We checked out of Hotel Tibet in Kathmandu and boarded our bus for the day. We made lots of stops along the way to break up the long drive. Our first stop was a visit with a former prime minister, Lokendra Bahadur Chand, who served four different terms from 1983 to 2003. He welcomed us into his home with hot tea and a discussion about the country of Nepal and his responsibilities as the prime minister. When asked what sector in Nepal needed the most attention, he said transportation and access to facilities in remote parts of the country. In terms of the lack of reading culture in Nepal, he expressed his disappointment about it, and he thought the curriculum loads students with a lot of homework and course work, which leaves them with less time and interest for reading for fun. It was really interesting how he shed light on the cultural aspect of hospitality in the Nepalese culture. Precisely, when Dr. Campbell asked for water instead of tea, he said, “You do not say no when somebody offers you tea in Nepal even if you are hot.” According to Dr. Campbell, the tea was delicious.
Another stop that we made was for lunch at Dhulikhel Resort. Most travelers ordered Chicken Sekuwa, a traditional Nepali dish. The dish included chicken roasted in a special pan called “tava” and was served with mushroom rice and veggies. The view from the restaurant was mesmerizing. We look forward to staying there on our way back down to Kathmandu later next week.
The most interesting and unique part of the experience started when we detoured from the Araniko highway, which connects Kathmandu to the northeast part of the country on the Nepal-China border. As we travelled higher up north in the mountains towards our destination, the roads were smaller and more treacherous. The place that we were travelling to was higher up in the mountains, and they had built primitive roads carved out of the hillsides. Additionally, the floods and landslides that have occurred in the last couple of weeks deteriorated the roads further. At one point, our bus was stalled due to trucks ahead of us being stuck in mud. Our host, Santosh, and his friend, Khem, helped in pushing the trucks out of the mud. Even though they were wearing dress clothes, they were successful in helping. Ultimately, the trucks had to be pushed by villagers and a bulldozer. While we were waiting for the road to clear, a jackhammer was chiseling away rock on the mountains to widen the road. While the conditions of the roads that we were taking worried us, we were fascinated by the other beauty we saw along the ride—waterfalls streaming with fresh water and fast moving streams of water. Needless to say, it was an adventurous trip to our final destination for the day, Hotel Panaroma in Charikot in the district of Dolakha.
We arrived to Hotel Panaroma around 9:30pm, and we had to walk about 5 minutes because there was no paved road to the hotel. Hot dinner was waiting for us upon our arrival. We had spaghetti with Bolognese sauce made with buffalo meat. The food was more Western and was different from what we were offered previously in the trip. We speculated the difference in food was because it was a Swiss owned hotel. It was delicious! Overall, we were already getting a taste of the difference between Kathmandu and the mountain villages in terms of food, climate, topography, and living styles. We have a view out of the dining area window of mountains, particularly Mt. Gaurishankar. The hotel is located at a high altitude, and we are always covered by clouds. Our dreams of touching the clouds have been realized!
(The below post is still in progress – but check back later for more pictures!)
Today was quite a busy day filled with lots of learning, fascinating interactions, and of course – tea and cookies. Our first stop was the Nepal Ministry of Health, where we were welcomed and introduced by the staff, then sat for a discussion with a representative.
Our next stop was the Ministry of Education where we learned about access to education for individuals with disabilities, as well as a brief overview of how the public sector of education is organized and run.
Next up was a visit to the United Nations House of Nepal, where we met with a representative from UNAIDS, Mr. del Prado. He gave a very informative presentation on the organization and inner workings of the United Nations, the 2030 Agenda for Sustainable Development, and specific targets for Nepal, including visions and strategies for towards the “Fast Track 2020” Plan to eliminate HIV/AIDS. He offered empowering messages which related closely to our work in healthcare, such as the idea of “community inreach” and that preventative care is typically a thankless job, although it certainly makes a tremendous difference in the world. He also emphasized that one does not “do” prevention, instead that “prevention is an outcome of action”.
Our next to last agenda item was a visit to Habitat for Humanity Nepal, a branch office of HfH Asia Pacific. Here, we met with multiple representatives to learn about how the INGO assists those within the country to ensure that “each person has a decent place to live”. We discussed the general organization and development of programs within HfH, with an emphasis on the emergency response effort organized after the 2015 earthquake here in Nepal. During a Q&A session, we discussed the use of various locally sourced materials in their outreach programs, movements toward permanent housing, sustainable designs (i.e. utilizing solar energy, compressed earth brick in the hill regions, etc.), and the relationship between the government of Nepal and INGO sectors.
Our final activity for the day was a discussion with interns from Youth Asia Nepal. During the discussion, the GW students informed the youth forum about the field of speech-language pathology and answered the youths’ questions about the field. Some of their questions included suggestions for implementing a protocol for nutritional development, educational training in Nepal, and the prognosis of individuals with different speech-language-hearing disabilities. The youth provided information on the prevalence of disabilities within Nepal (General Disabilities: Males= 2.18%, Females=1.71%; Hearing Disabilities: Males= 41,204, Females=38,103). One of the most striking observations during our discussion was the interns’ knowledge and perspective on autism. Although the students had comparatively less knowledge about the disorder and technical terms associated with it, they were familiar with common characteristics associated with it (e.g., repetitive behaviors, poor social skills, etc).
-Bhairvi and Sierra
Up Close and Personal with Healthcare Research in Nepal
Today I (Bhairvi) had the misfortune of becoming sick, and was unable to participate in most of the day’s activities. However, I had the pleasure of experiencing first hand the Nepal healthcare system. Dr. Campbell accompanied me to the CIWEC 24/7 health clinic (thank you!) where the protocol was similar to a typical doctor’s visit to the US, with a small twist. After a nurse took my case history/vitals, and I was waiting for the doctor, another nurse approached me and asked me if I wanted to participate in a research study. The study was called Epidemiology of Acute Gastrointestinal Illness and Clinical Outcomes in Travelers to Nepal. It was a collaboration with the US Department of Defense and sponsored by the Global Emerging Infectious Disease Surveillance (AFHSC-GEIS). My only role was to simply give them consent to use my information, but I was impressed with how well thought-out and comprehensive the research protocol was. The nurse gave me a research subject information sheet and consent form which provided detailed information on the background, purpose, procedures, benefits, etc of the study. I was also informed that my information would remain confidential and that subject IDs would be used. It was identical to a research protocol in the US and was executed professionally.
We started off the day by touring the Grande International Hospital, which is a private hospital in Nepal. It was an interesting contrast the government hospital we toured yesterday. While this hospital had exceptional facilities and quality healthcare, we learned that a majority of the people of Nepal pay for healthcare services out of pocket, which results in the poorest people being unable to receive this level of care. We also had a fantastic conversation with the audiologist (who also works as the speech language pathologist). He explained there is a lack of resources and education about speech and hearing disorders. This has had an impact on the type of services he provides families, as he explained that a majority of his time is spent on counseling during therapy. The cherry on top of our visit to this hospital was completing a 14 story stair climb to reach the helicopter pad on the roof….such an amazing view!!!
Our next visit was to the Ayurveda Department of Tribhuvan University, which has a hospital and research center devoted to herbal treatments for a variety of illnesses and disorders. The staff was very welcoming and passionate about their work. One of the professors was happy to talk to us about the role that ayuverdic medicine can play in the treatment of speech and language disorders alongside the therapy we provide as clinicians.
After lunch, the group participated in a Q &A with the director of the Central Investigation Bureau. He provided information about crimes involving individuals with speech and/or hearing disabilities, as well as more general information crime in Nepal.
The next leg of the trip was a visit to the Music Center where we were taught a traditional Nepali folk song. The group of us gave a grammy-winning performance to a small audience….the video of which will be destroyed…
Finally, our day concluded with a delicious Nepalese dinner with the Deputy Speaker of the House of Parliament and former Minister of Education. We all enjoyed hearing about her career as an advocate for women and the disenfranchised people of Nepal, and of course, no dinner conversation is complete without a discussion of Donald Trump.
Although still jetlagged, we woke up ready for a busy and exciting day. We started our morning off by visiting the National School of Nepal (Budhanilkantha School). There, we got to listen to several inspiring speakers as they spoke about the importance of education and giving back to their country. We also got a tour of their beautiful school and got a chance to speak with the students about their experience. We were inspired by their passion for education and eagerness to learn about our studies. Their school campus was unlike any other we have ever seen; it was covered with beautiful flowers, a breathtaking view of the mountains (which the students refer to as “hills”), and monkeys roaming around. After the tour we headed to Gate College of Hospitality and Tourism. We made a quick stop on the way to the college at a temple. The people worshipping there were very welcoming and we were all happy that we got the chance to learn about the importance of religion in their lives. When we finally got to Gate College we were greeted warmly by the students there and were taken on the quick tour by the founder of the school. Having only been in Kathmandu for a day, we had only seen glimpses of the city from the bus but at the top of one of the buildings on campus, we got an incredible panoramic view of the city. We also ate a delicious lunch prepared by the students and drank freshly made coffee. Our last stop of the day was not what any of us expected it to be. We got off our calm bus and stepped into the chaotic world of the Tribhuvan Universtiy Teaching Hospital. Right away we were taken to see the emergency room and we were shocked by the condition. There was 4 people assigned to a bed, crowds of people everywhere, and the overall hygiene was very poor. However, we were happy to see that they offered many services and we were especially excited to see that they had a Speech Language Pathology department! We even got the opportunity to sit down and talk with some of the students studying SLP. We found that they were taking many of the same classes that we were but also learned about the struggles that they have. They talked about how the majority of people in their country don’t know about the services they offer and don’t follow up with them. They also were very interested in hearing about our graduate program since a masters degree in SLP is not offered in Nepal and they would have to travel to another country to get this degree. After dozing off at dinner we were all ready for bed but excited for the next 10 days to come!