India and Nepal
Bet you’ve never had a rat in your computer printer! But that caused the 20-minute delay starting our wrap-up meeting with the administrator at the hospital we’ve been working at, the Spinal Injury Rehabilitation Centre, SIRC. The printer wasn’t working, and, as she started to feed paper thru manually, it started to come thru with blood stains! Removing the printer shell revealed the problem!
So, today was our last day at SIRC, and the rat was truly the only glitch in 2 and a half weeks of hard work and quite a bit of celebration, all related to the elaborate plans to honor the 10th anniversary of the opening of SIRC with a ceremonial ribbon-cutting by Sir Edmund Hillary. SIRC organized and hosted a 3-day conference on the UN Convention on the Rights of Disabled People, a day and a half conference on earthquake preparedness, and a day-long medical clinic open, essentially, to all comers from the district, and we were, to varying degrees, involved in all of these activities. In addition, we’ve been teaching Dr Nabina, a sweet, very young-looking new med school grad from Kathmandu, who has just started working at SIRC, definitely thrown in the deep end of the pool there! Like Dr. Raju, the other doctor we’re helping to train, she has an immense thirst for knowledge, great compassion for the patients (most of whom are indigent, uneducated farmers) and apparent tirelessness! We’ve been teaching her some of the theoretical aspects of the care of people with spinal cord injury (SCI) as well as clinical bedside teaching. Every patient has unique issues to deal with, and one of our messages to her is the need to tailor treatment to the needs of each individual. As you can imagine, aside from the strictly physical problems which result from SCI, issues of psychological, social and economic rehab vary widely, depending on the age, gender, marital status, socioeconomic status, rural v urban living situation etc, so no “one size” of treatment will “fit all”….an important thing to learn….
Every patient we meet reminds us how lucky we are to live in a country like Canada, with good health care. The poor people we’ve met mostly have no money, and there’s no such thing as health insurance, public or private. They have to pay for spinal surgery, including anaesthesia, for every pill or injection they get, for x-rays, CTs and any other medical imaging they may need. Often they don’t actually need surgery (P’s professional opinion), but, convinced to go for it, they arrive at the rehab centre with no money for antibiotics or other essential medications, crutches, wheelchairs, etc, AND deeply in debt to whoever was generous enough to pay for the surgery! Their understanding of what has happened to them is pretty limited, and, often, once the prognosis is communicated to them (which the staff at SIRC is quite reluctant to do), the patient may well be abandoned by family, because a “useless”, non-productive extra mouth to feed will likely tip a family from mere poverty into dire, irreversible destitution…. It’s all very very sad, but if anything can make a difference, it’ll be SIRC. So the work here will be going on for a long time and will involve not just transferring knowledge and skills, the easy part, but also changing people’s attitudes about disability and support SIRC. To get a sense of what life in Nepal can be like for people with a disability, you could view this excellent short film showing how young people cope with disability in Nepal by Development Media Workshop filmmaker Michael Brown: http://vimeo.com/channels/dmw/33790839
To learn more about the the developmemt of SIRC, the work that happens there and to see the events of the tenth anniversary celebration, you can look through the gallery of photos and perhaps follow some of the links at: http://peterandclaire.smugmug.com/Travel/SIRC-April-2012/22267282_2TcSxb
Now, all work and no play makes for a dull life, so do not fear that we haven’t had some fun! After the medical clinic, for example, there was a fantastic party at a house near SIRC, and we were all dancing barefoot in the rain, as colossal lightning bolts illuminated the sky, a considerable amount of beer and Signature scotch was downed and many pounds of barbequed fish and chicken were consumed! Last Thurs was Nepali New Year’s Eve and we and a team of Swiss rehab folks who also came over for the celebration (and also did a lot of clinical work over a 3-week period) were invited to a bash at one on the Kathmandu Rotary Clubs….again, great food, generous drink for those so inclined, good Nepali dance music!
This was Peter’s 3rd and Claire’s 4th trip here, and so it’s difficult to capture/recall our initial impressions of the city. We are still aware of the heart-breaking poverty most people live with, the unbelievable amount of garbage in the streets and rivers, the daily blackouts (called load sharing here) and the consequent irritating, invasive noise of generators, the eye-stinging air pollution, the destroyed streets, roads and sidewalks, the fly-festooned meat in the market….but we no longer find ourselves overwhelmed by it all. And then there are all the wonderful counterpoints to all this: the warmth, friendliness and generosity of the people we meet, the seemingly gentle life of the thousands of small business people, everyone selling something to someone else; vegetables, plumbing, momos (Tibetan equivalent of gyoza), cloth and clothing, furniture, meat, fish, tikas, pop, snacks….And the colour! Saris, kurthas, floral offerings at the thousands of small and large shrines around the city, golden temples, ancient blood-red temples festooned with maroon and gold cloth. The sound of bells stuck by believers as they pass shrines, the tink-tink-tink of metal workers as they fashion Buddhas, jewellery, masks….the work-in-progress in tiny shops all around our “neighborhood”, small boys hawking various wares (also the far more annoying constant roar of motor bikes and cacophony of honking horns, which only seems to communicate “I’m coming”, and/or “get out of my way” as there is no obvious slowing of pace as vehicles close on each other at terminal velocity).
Most motorcycle drivers now wear the ‘mandatory’ helmet, but their fragile 1-3 passengers on the back (and front), often infants, remain vulnerable to the chaos. Similarly, taxi drivers wriggle into the seatbelts when approaching police road checks (well, a small minority do all the time!) The often decrepit taxis do have rear seat belts – but the buckle is nearly always buried in the seat.
Some internet-less days have passed since the preceding paragraphs were written, and we’re now at Tribhuvan Airport, leaving Kathmandu for 3 days in Varanasi (Benares) before moving on to Delhi where we’ll be doing some more teaching as part of the development of an e-learning program being designed to make education about SCI far more accessible to people working in under-resourced countries. After that, we’ll be travelling with C’s friend from New York (who’ll be joining us in Varanasi) down to southern India for 2 weeks of pure vacation. If the gods of cyberspace is good to us, we’ll write again! May you all be well and happy and, ‘til we see you again, think sweet thoughts of our Nepali patients, friends and colleagues!
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