Life is indeed hard for women in Humla. Particularly in the Hindu communities, woman are responsible for much of the hard labour as well as having to raise and support children. Officially banned in law the ancient practice of chaupadi is still widely practiced particularly in the more remote villages. Menstruating women and those in child labour are banned from the home to cowsheds and outhouses because they are considered impure and will bring misfortune such as crop failure, illness and death to the family. It is thought that if they touch men or anything in the house, cook or use public water tanks or wells the community will be punished by the gods.
Slowly these perceptions are changing through education and the Nepal Trust is helping to promote the change through its chain of health clinics and its child education programme. Our Little Doctors programme trains over 60 young students annually in basic health care and young girls now understand that the changes to their bodies is a perfectly natural function that should not be hidden away but helped.
The Trust is also building three Birthing Centres where mothers can give birth in a safe environment. Each centre is linked to an existing Health Clinic so that resources can be used to best effect. The first Centre at Bargaun village is nearing completion and will support a number of surrounding Hindu and Budhhist villages including the largest Hindu village in Humla. The second Centre at Sarkegad is well on the way to completion helped by a Community Assistance Grant. Sarkegad is the economic centre of south Humla and developing rapidly. Our third Centre at Yari will start construction later in the year. Funding is almost in place supported mainly by Rotary International.
Our clinics were very busy during 2013 and over 9000 patients were seen and received treatment. Poor hygiene and dirty water were responsible for a lot of intestinal problems and skin diseases. Smoky homes and damp conditions led to a variety of respitory disorders and conditions like conjunctivitis. Pneumonia and intestinal problems were particularly bad amongst the under 5 year olds and is a major cause of the very high infant mortality rate in this region. Family planning advice and support was given in nearly 4000 cases.
In this report you will see a link to a film on YouTube, 'Journey to the Sky', made by Rotarians from Durango in Colorado. We have said previously that our work is carried out in a very integrated way. We have built many hydro and solar energy schemes over the years to provide clean energy and lighting to homes that previously were lit by polluting oil lamps. This alone has had a beneficial impact on reducing respitory disorders. This film is about a group of Rotarians who travelled to Humla to install solar lamps in a number of homes and villages. They also became involved with one of our Little Doctors courses and saw for themselves how important and valuable this type of health education is.
Thank you for all your support and I hope you can continue to do so or pass on the good news to family and friends.
Our UK chairman, Dr Mike Love, has recently returned from a voluntary three week trip to our project sites in Humla. It was a gruelling trip over high passes and mountain trails to reach some of the villages. He is able to report a satisfactory outcome and genuine progress being made. The new on-site health manager, Ratna Lamichanne, is introducing new methods and training to improve health care delivery. Our cooperation with another Ngo, ISIS, has seen significant improvements at the health clinics in Kermi and Yalbang both in the service delivery and infrastructure. This type of collaboration has positive benefits and avoids duplication and wasted resources in such a remote and difficult area. New staff, particularly female, have been or will be recruited which will give more confidence to female patients who find it difficult to be examined by a man in their very conservative society. A small laboratory is now available in the Yalbang clinic for the analysis of blood and urine samples - another first for the district.
Change is happening rapidly and increasing expectations. Limited roads are beginning to appear from the Tibet side, sometimes hand built by the villagers themselves. Mobile phones can be used over about 75% of the area so contact and keeping in touch is a lot easier. However, for the majority life is how it has been for the last thousand years but with small improvements happening year-on- year.
Our first Birthing centre at Bargaun village is on course for completion in the spring of 2014. This is another district first. Bargaun is working in collaboration with our nearby clinic at Torpa village which will improve efficiency and delivery. About three hours walk down the mountain is the largest, and poorest, Hindu village in Humla, Thehe. We are now in discussion with the village leaders to develop a collaborative health care delivery policy involving Thehe, Torpa and Bargaun. Work has started on a new Birthing Centre in south Humla in the village of Sarkegad attached to our existing clinic. Some initial funds have been secured for this vital project and it is hoped to complete by 2015. The new Birthing Clinic at Yari village in north Humla is at the advanced planning stage and the majority of the funding has already been secured. As always, the community have to contribute up to 10% in kind. This ensures a sense of ownership and future care.
Our three Little Doctor programmes in Simikot, Yalbang and Bargaun have been completed and 66 young students successfully graduated. We urgently need funding for next years programme.
As reported before our other activities are fully integrated with the health programme to help nurture and promote healthier lifestyles. An example of this is our Renewable Energy programme that has developed numerous hydro and solar energy schemes all of which significantly reduce the need for kerosene and wood and leads to a reduction in respitory diseases. Earlier this year eight members of the Rotary Club of Durango Daybreak in Colorado trekked, in horrendous monsoon conditions and under the direction of the Nepal Trust, to deliver and fit 165 solar lamps to homes and small businesses on the Great Himalayan Trail in Humla. These are homes that would otherwise not be connected to another electricity supply and will help them to develop their businesses for trekkers and tourists and improve the local economy. While in Humla they were also able to participate in one of our Little Doctor programmes. They have now produced a fantastic film about their trip http://www.youtube.com/watch?v=4EOTfz-7lBM 'Journey to the Sky'. It is well worth watching to get some idea of the difficulties of working in such a remote area.
If you would like to trek with the Nepal Trust do get in contact. Our Treks 2 Build have been running since 1994 and will provide you with the experience of a lifetime and you will also put something back in to these deprived communities.
Finally, to all our supporters and friends around the world, from everyone at the Nepal Trust, we would like to wish you a very happy Christmas and festive season with your family and friends. We hope that 2014 brings you joy and new hope and that the people of the Hidden Himalayas will continue to see improvements to their hard lives. It is a privilege to work for them when they also share their lives, and what little they have, with us.
The reality of life in Nepal is worse than that! The Nepal Trust has established a chain of health clinics following the main trading route through Humla from Tibet and we continue to expand our network. However, it is still a tough walk over steep and rough mountain trails to reach the clinics; sometimes taking two days or more! For outlying and remoter villages it can take longer. Imagine having to carry an elderly relative or young child on your back over steep mountain trails for 8 hours to reach your doctor - it doesn't bear thinking about unless, of course, you live in the Hidden Himalayas. The Trust is working hard to to improve this situation and provide a reliable and efficient health service for all.
In the four months from April to July our clinics treated over 4500 patients. The monsoon season will cause more sickness and we expect patient figures to increase during this period. However, we see a gradual improvement in overall general health as our efforts to reach people and educate the young in particular begins to have an effect. Combined with our other approaches of providing clean renewable energy and income earning jobs we expect to see a gradual year-on improvement.
Our new season Little Doctors health education programme has started and 66 young students have enrolled for this four month course that will raise their awareness of health matters including personal hygiene, family planning, diseases, sanitation, first aid and nutrition. Classes are organised and run through local schools and delivered through trained health workers from the Nepal Trust, local school teachers and local government health workers.
The Nepal Trust works with the government to provide health care according to national legislation. Recently central government has delegated responsibility for health management and delivery to a district committee. The Trust is working very closely with this committee for future direction of our health programme.
Our first Birthing Centre at Bargaun is nearing completion and will open up a whole new opportunity for mothers to give birth under safe conditions for the first time ever. The next two centres at Yari and Sarkegad are well into the planning stage for construction from 2014. There is a small shortfall in funding and we would welcome any additional support and help to close the gap.
The Trust welcomes any feedback, help or advice you can give. Our whole ethos is based on dedicated volunteers who give their time, money and skills to our cause. please contact us if you would like to help in some other way.
Finally, we have attached our latest newsletter that gives a wider picture of our work in this remote and impoverished area. It describes other areas of work designed to give the local people new opportunities and a healthier lifestyle. Ultimately, that is what it is all about!
For such a beautiful, if very remote, part of the world the maternal and child health statistics are appalling in the 'Hidden Himalayas'. Technology is moving fast and computers and mobile phones can be used in Simikot and the small mountain airstrip has a blacktop making take-off and landing a little bit more comfortable. However, 40% of children die before they reach the age of 5 years and 8% of mothers die during labour. Much of this is down to long established beliefs and lack of education. The Nepal Trust is targetting these areas to make a difference. Our Little Doctors programme providing health education is an innovative and rewarding project that is beginning to make a difference. Over 250 young students have completed the 4 month course and have passed on their knowledge to their other family members. A course, for over 20 students, costs £1500 and is delivered through the local education system by health workers and their own teachers. Courses for 2013 are already subscribed and additional funding is required to deliver them. Can you help?
Our first, and the regions first, dedicated Birthing Centre in Bargaun is nearing completion and grant applications have been submitted for the next two centres to be built in Yari and Sarkegad. Mothers will no longer have to go outside or in to the cowshed to give birth. These facilities, staffed by Auxiliary Nurse Midwives (ANM), will provide a clean place with qualified personnel to ensure the birth is as comfortable and safe as possible. Your support for this very important initiative is very much appreciated.
We continue to improve the delivery of our health service and have recently appointed a new Health Manager who will oversee all of our clinics and services. Ratna Lamichhane is fully qualified to supervise and deliver all the work that we do particularly maternal healthcare.
The Nepal Trust has long taken an integrated approach to its overall work in Humla. Our view is that a healthy society is also a prosperous one and, to further this philosophy, we have developed renewable energy projects, cultural and heritage preservation and income generation projects. We are excited to announce a joint collaboration with the Swiss charity Norlha to develop an agricultural project. The project aim is to re-vitalize agriculture development and expand vegetable production and bee-keeping in the Humla area. Today tourism is a viable income source for families along the trek routes, where there is an increasing demand for vegetables and agriculture products. Additionally, since most of West Tibet is semi-desert with low agricultural productivity, the border markets offer trading potential for local farmers. This is just one of many projects designed to improve the livelihood and, therefore, the future health of these remote mountain communities.
Winter in Humla is difficult for everyone. Deep snow restricts movement and the district becomes relatively cut-off for a couple of months. Of course this is normal and the locals are adapted to living in these conditions but in our modern high-tech world planes can't fly and building work has to stop. The good news is that spring has arrived and our new Birthing Centre at Bargaun is nearing completion. Plans are moving speedily ahead for new Birthing Centres at Sarkegad and Yari due to start in 2014. These will provide valuable maternal care in the south, middle and north of the district and will complement our existing chain of health clinics. The Nepal Trust has forged new links with the ISIS Foundation to jointly manage and operate our health clinics in Yalbang and Kermi. This collaboration provides an additional funding stream to upgrade the clinics and improve our services. A new Community Medical Assistant (CMA), Mrs Pratima Lama, has recently been recruited to work at the Kermi clinic to support an increasing workload and to give local women more confidence to seek medical help and support. A recruitment campaign is currently underway to employ a qualified Health Manager to look after the NT/ISIS health programmes throughout the district. Hot springs are a major feature at Kermi and plans are being drawn up to pipe the hot water to the clinic to help improve hygiene procedures. This is an exciting year for the Nepal Trust with new projects approved in agriculture, education and water and sanitation. These will all help to improve personal well-being and the general health of the local populations. Thank you again to all our friends and supporters on GlobalGiving. We hope you can continue to support the people of the 'Hidden Himalayas'; one of the remotest and most deprived areas of the world. It is not easy working there but it is insightful and very rewarding to both beneficiaries and donors alike.
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