Clinic Camp

About 40 Hindi-speaking families from north India live a short walk from our hostel. They came here to find work (apparently, it is all relative) in the form of begging, shoe shine, and cotton mattress stuffing. Five kids from this camp go to Kai and Aaryn’s school. They receive sponsorship for school fees, uniforms and books. They have all lived here for about 5 years. When one of the boys became sick, I was taken to their home and was introduced to the squalor of living in a tent.



With donations from SEDIC—The Sherpa Education Development and Information Center, a 12 women run community organization—one doctor, one nurse, a security guy and myself, went back to the tents for on-site clinic care with two buckets of medicine. Again, as in Thuman village, looking around, it is easy to become cynical and discouraged because what is the point of treating anyone if they have no clean water, and everyone has something to catch. But at least in Thuman, there is that “poor-village life” “celebrated as the natural, happy domain of man (sic) by thinkers from Lao-tzu to Gandhi”—I read it somewhere.

A latrine has been set up at the edge of the tents. Cooking is done in the tent over a kitchen fire. The tents are open to one side and blue plastic tarp and bamboo stakes form the back and side walls. The tents regularly burn down and need to be built again.



In the center of the tent community is a pump for water. Washing dishes and bathing are done here. Every tent contains an extended family, everyone is called auntie, and many husbands are gone. Women and children make up the begging contingent and young boys, the shoe shiners, and the few men, the mattress stuffers.

Eighty people were assessed for upper respiratory tract infection, worms, diarrhea and vomiting. Two women were referred to hospital for more tests. For those with minor complaints, cough syrup and eye drops were handed out to ease the symptoms of cooking over a kitchen fire.



Unfortunately, with these folks, breastfeeding is not a valued form of infant feeding (unlike everywhere else in Nepal, infants are breastfed until they are two years, and solid foods are introduced at 6 months—just like the World Health Organization recommends). There is a product here called Horlicks—it is a malt drink to which you add water. Many people like to feed it to their children and children like it because it has sugar as the first ingredient. Whether or not there is any special nutritional value—when you add dirty water to it—it will make the child sick. At the tents, mothers like to give it to their babies, and after a few days, the mix is finished, the mother’s milk supply has dropped and the baby often won’t go back to breast. So she needs to get more Horlicks—which is of course, expensive—kind of how I perceive the cocaine situation in Manhattan.

Though as discouraging as it could be, there are little treasures of hope. The five kids going to school work hard and do well. I marvel at their clean uniforms that put my own uniform-washing abilities to shame. In the tent we used as a clinic, there was a poster up of the Devanagari script—used for both Hindi and Nepali—just like any attentive parent at home would have. And they are all a very gentle, scrappy bunch who help each other out when one of the tents burn down or when a windfall of Horlicks or rice come their way.

Thuman Village

We went to Thuman Village with a student from the Health Institute who wanted to go back to visit family and do a health assessment project. Pasang is the first and only girl in her village to receive education beyond grade 3. With the help of sponsors, she is completing her Health Assistant Degree next year and will takeover the health post in her village (presently, it is staffed one day a month by a Nepali-only speaker).

In this district, the majority ethnic group is Tamang. They speak TamIang which is similar to Tibetan, with the same script and very different from Nepali. My guide book describes them as relatively recent arrivals to Nepal, probably Tibetan horse traders. They have kept their Buddhist and folk beliefs due to their isolation.



Thuman Village is in the District of Rasuwa, on the border of Tibet, and at the edge of Nepal’s Langtang National Park. From Kathmandu, it is one day by land cruiser and one day walking. There are 60 family homes clutching the side of a small mountain facing Langtang Peaks. Surrounding the village are terraced fields for wheat, millet, barley, rice, potatoes, radishes, and greens. The homes of another 100 families are scattered around the village. They are farmers and weavers, occasionally portering before the tourist industry collapsed due to the civil war. A days trek away, they buy kerosene for lamps, and oil, salt and red chillies for cooking. They trade rice for cloth and animals in Tibet. It is a children’s paradise as there are many baby farm animals, toilet facilities are in the field, you eat by a kitchen fire, you sleep in your clothes, and you never bathe. However, it is a public health nightmare. Everyone has lice, intestinal worms, runny noses and eye infections.

Each home is two stories, the ground level for farm animals, and the second for the family. The ladder up to the second floor leads to a porch, and into a low-doorway which is more like a long window. The other opening is a small window at the front of the house. Both are closed by wooden door that open inwards in case the village is snowed in. The home is one room, with two platform beds, and a mud hearth on a wood floor. There is no chimney and it is only by Pasang’s mother’s deft fire building and maintenance skills that we were not constantly smoked out. Regardless, everyone in the village complains of eye irritation and chronic upper respiratory infections.



For the trip, we were a cast of characters-the three of us, Pasang, her mother and aunt, her 4 year old nephew and 9 year old niece, her brother on winter holiday from the monastery in Dharmsala…and one porter for, err, my bag (but in my defence, I brought some equipment, supplies, and gifts). Half way up the mountain, Kai became progressively more whiney, and then on a break at the ridge with a beautiful view, I realized she had a fever, and she had that feel of wet noodles-floppy. This gave me pause as we were far from anywhere (not that I have developed any particular faith in the health care in Kathmandu). Aaryn was in good shape and sprinting ahead, sprinting back to us to tell us about the upcoming view or how steep the ascent was around the next corner. So I decided that-and I hesitate to admit to everyone reading this-we would move ahead, with the help of another porter who appeared from nowhere. For 2 hours, he carried her up the steepest part of the trek while she slept on his back. Along the way, Pasang’s aunt collected a bottle of fresh milk to help her recover. When we arrived at the village, I tucked her into her sleeping bag then sat beside her, watching the family get organized, completely dumbfounded as to how primitive it was. Someone handed me a mug of hot balo, a fermented wheat mash with a kick, and then a plate of cooked greens and chillies with tsampa, a cooked barley polenta-like mound. Pasang’s mother, after this 7 hour vertical trek, went and brought back a huge jug of water from the public tap, and continuously had a pot of salted nak butter tea kept hot by the fire. Aaryn was unphased and gradually moved closer to the fire as the temperature dropped to minus 10 Celsius.



Kai slept through the night, and her fever broke by the morning. She slept through the sight of snow that had fallen and didn’t participate in the snowball fight with the kids wearing only their sweaters-no jackets, no mitts. Pasang’s grandmother arrived with 6 precious eggs to help Kai get better, and a brew of greens from a plant that brings down fevers. She ate some eggs and slept. She awoke that night with gifts of peanuts from Tibet, candies from Kathmandu, and coveted instant Japanese noodles next to her bed.

Aaryn, meanwhile, disappeared into the fields with various relatives to bring back the remnants of an ox for next day’s meal, and herd chicks that had wandered too far from the house.

Our arrival had been announced at the Gompa, the two-room monastery perched dangerously close to edge of nothing. There was an evening of chanting and bell ringing and candle lighting going on. I was introduced and people were told we were there for a needs-assessment health study (I have no idea how that was exactly translated into Tamang by Pasang). They laughed and stretched their arms around-as if to say, “What do you think?”

From interviewing the women, Pasang came up with a list of immediate and long-term plans. As with anywhere you go, medicine was expected to solve the problem and looking at larger issues, such as sanitation and the respiratory ravages of a kitchen fire are not obvious to the community since this is the way it has always been. One guy explained to me that every time he drank balo, he’d throw up-did I have any medicine for him? “Well…” the monk/translator looked at me “…even I could figure that out,” he said.


There is no recognition of a need for maternity care, as it is not considered a ‘sickness event’. Postpartum care, as is the case everywhere in Nepal, is non-existent, yet 60% of women who die of maternity complications do so in the first few days postpartum. Discussing maternity care was embarrassing for them, and the whole birth, as with the Hindus to the south, is one big polluted event, and everyone has to have a good clean-up afterward-though in this village, the woman is not supposed to bathe until 7 days after the birth.

We made plans for a return trip to the village with more useful items. We made the trek down after receiving gifts of rice, corn, potatoes, and walnuts. Pasang’s mother had packed us food for the hike, roasted soy beans and popcorn, and cooked potatoes. We were hesitant to leave, not only because of the bone-crushing, concussion-inducing, vomit-producing land cruiser ride ahead of us, but because these people were so welcoming and kind to us. We look forward to the going back…

Imadol Toilets

Prior to construction, the view from the latrines at High View School.

As the money from my dad’s internet fundraising campaign entitled “Toilets by Monty” or CRAPCAN—as spin off from RAPCAN (Retired Airline Pilots from Air Canada)—arrived quickly, sufficient funds were available to start work. Plans were drawn up by the engineer who designed the Stupa Saangha Hospital.

The construction on the toilets began last Sunday. There will 4 toilets, septic, and taps with water coming out of them. The brick work from the existing latrine was taken down and a new foundation was laid. Bricks in good condition are scraped and stacked for reuse.
The framing for the doors have been put up and the hole for the septic has been dug. Water is pumped in from a well and taps will spurt water for washing—drinking water will still need to be brought from homes—already boiled and filtered.



Everything is done by hand—the taking down, the putting up, the digging and the scraping—and yet moving along at a pace that the Nepali government bureaucracy could learn from (I renewed our visas and with the different departments, and the confusion that Kai’s birthday caused—she’s now 10 and therefore I have to pay but only for the time that she has been 10 which would be a percentage of the time for which I am renewing the visa which would be how much? Who should we ask? We have to wait for the supervisor to come and then the supervisor could ask another supervisor…Ma’am do you want chai?...Once home, I note that each stamp in each of our passports bears a different re-renewal date (?)). Ke garne? What to do? This is the Nepali National slogan, said with a head wobble that means “yes, no, maybe” to indicate that life overwhelms, and it is time to order chai again.