Jair and the Team
The 9 hour trek further west to Jair was simply beautiful, wandering past mini hydro mills with old ladies grinding their grains in the dusty dark shelters and, banana and papaya trees scattered in the lush green wheat terraces. Smiling faces, weak sweet Nescafé and peanut cookies comforted our arrival. By this point Kishwor (supervisor and lab technician), who had been accompanying me and helping with translation, had taught me a little more Nepali. Being able to join in on a few of the laughs and understanding the basic medical consult made this a memorable final health-post to visit.
Jair is perched low in the valley by a rushing river thriving with fish, and humans eagre to catch them.. The village bustled with villagers, buffalos, chickens, goats and mice. The three health workers and the agriculture technician live above a stable for a water buffalo family. The huge mother buffalo jaw rhythmically chewing on hay, with eyes closed warming it’s massive head in the sun was nothing but hypnotising.
The team have a small kitchen area with wood fire stove and vent, two bedrooms and a bedroom/store room/second consultation room, and in the hallway is the main consultation area where the examination bench doubles as the desk.
The daily dal bhats were slightly different here. The team liked their meat, and I rarely eat meat. We got delicious fish from the river, and then less appetising dried goat and all the bits of a fresh hen.
The Clinic
The clinic usually sees 40 to 50 patients a day. People can walk 7 hours in the mountains to get there, returning in the dark. The government health posts close to them are often unmanned or without medicines. This clinic is solely run by PHASE. The calmness and respectfulness of the staff here to their local host community was impressive. The staffs skills in treatment and diagnostics improved significantly while I was there, as a result of their determination to learn. We discussed how to rule out serious illness and when suspected how to manage it, which they really knew better than I did as it is a setting they know more about.
Delayed presentations were common, in part due to reliance on traditional treatments first, or distance from health post. Although many patients were advised to go to hospital, money and distance remain a hinderance. Chronic gastritis was rife, and large burn scars from traditional treatments common. Ayurvedic herbs were used for some wounds occasionally to good effect. I have since met many who experienced benefit from Ayurvedic treatments. It strongly emphasises prevention as well as treatment- a holistic approach through changing lifestyle, diet, yoga as well as herbal therapies. Seems great on paper, something i’ll look into more.
Final Note from Nepal
This was my last health post. I had visited five in total, and it got easier and more enjoyable with time. I understood better how and what to teach, also a little more Nepali language plus feeling more in tune with the local culture helped. The Nepali people I met along the way also make it a pleasure to be there, their warm hospitality and kindness glows. The keenness of the healthcare staff is inspirational and rural Nepal is just beautiful. Its no wonder Nepal remains such an attraction for the numerous NGOs present here. If you get a chance and have a couple of weeks spare, I couldn’t recommend this more, even if it does mean a 3 day walk, a plane journey, and 2 buses!
Travelling with General Practice 