It takes a full day to drive from Kathmandu to the clinic over rough,
four-wheel drive roads for most of the trip. Along the way we stopped
frequently for masala tea, the sweet and spicy tea that is like chai at
Starbucks, without the bucks part. Everywhere we stopped the people were very
friendly and warm.
To get to the clinic you cut through one corner of Langtang National Park
then continue ever up up and up. The peak Langtang is clearly visible the
entire way. The map shows that the "road" continues on past our villages of
Goljung, Gatlang and Chilime, but the map is a little optimistic I think.
There is a crude road of sorts beyond us that goes to the Tibetan border and
there are plans to make it a true port of entry from Tibet to Nepal in the
future, but that will take some time.
The clinic sits atop a hill with a commanding view of the valley below and
its many terraced farm plots. The primary villages we serve are in the valley
just below the clinic, and some additional villages that use our clinic can be
seen across the way, seemingly balanced on the hill side.
The clinic building was donated by the development committees of the three
villages. It is mostly stone, with wood plank floors and a tin roof. On the
first floor is the main outpatient exam room and behind it a room where a
patient could stay the night if needed or where a more private exam can take
place. The supplies sent by EverestNews.com reader Nicole Reilly were
delivered and will be most useful to us. The clinic focuses on basic medical
needs such as antibiotics, first aid, pre-natal counseling and general public
health education. The staff go to the local schools and talk to the students
about healthcare issues such as dental care and reproductive health matters.
We also go each week to help at the government health outposts located in each
village. These are staffed by a local person who received 6 weeks government
training in public health and who attempts, with little support, to inform
villagers of health matters.
They seem to appreciate our assistance a lot. One worker told me that the
supervisor she answers too, and is supposed to be trained and supported by has
not shown up in over six months.
We maintain a small library at the clinic, mostly for children. There are a
couple of small schools in the area but no library or other place to obtain
books. We also have space that can be used to study and has desk, chair and a
real electric light to see by!
There are staff rooms at the clinic as well. The kitchen is on the main
floor. It was added to the building at some point in time and is poorly
constructed and drafty. I felt as if a few of the boards might give way when I
walked on them. The stove is the classic Nepali wood-burner, and is made of
clay with a small firebox and a hole to put the pot on over the firebox.
Nepali stoves do not have any venting, so cooking can become a smoky affair.
Upstairs are two large and one small bedroom with wooden bunks and futon-like
bedding. Tamang are short people, it shows in the size of the bunks! Going to
the villages was a jurassic park type of experience. It seems as if life has
changed little in hundreds of years. The Tamang grow all their own food,
grinding their own flour, weave the cloth for their clothing and gather wood
for cooking fires. Days are labor intensive. Children start very young
in the fields and with the work, around 7 or 8. This accounts for the level of
education obtained by most Tamang, there is just too much work to do to
Our biggest challenge is in public health education, more than in giving
medical treatment per se. Much of what we do treat at the clinic is
preventable with little effort. For instance, we saw many children with cuts
or scrapes that were now infected because they hadn't been kept clean. Some
hot water and a clean cloth were all that was needed in the beginning. Now it
is antibiotics and wound dressings. Likewise, I don't think there is a child
in the village without a runny nose or a cough. There are of course a number
of factors, but too long inside the Smokey kitchens is not helping. Because
respiratory problems are so widespread, serious issues sometimes go too long
before treatment is sought. Recently a 2 year old was brought to the clinic
with severe pneumonia. We wanted the child taken to the Kathmandu hospital,
but the parents would not cooperate. We treated the child with the medicines
on hand and we were rewarded this time, the child lived, but it could have
easily gone the other way. Earlier treatment would have made the situation far
less risky. So, this is a beautiful and beautifully poor country. Our
assistance here makes a crucial difference. Our dollar goes so far here too.
Imagine that this clinic has 2 employees and all the normal overhead costs,
such as electricity, supplies etc and yet we can do all this for around $5000
a year. We hope to increase services and the budget as time goes on, for there
is much more we could do with resources, but wow do we get some bang for the
buck in Nepal. Last year we treated about 1000 people in the clinic, not
including the outreach work in the schools and at the government not-supported
health outpost. Scott