PHASE Nepal

To improve the living standards of people living in remote Himalayan communities, by providing immediate support and empowering them. Through integrated programmes in the areas of health, education and livelihoods, PHASE aims to support the most vulnerable (women, children, low castes, the very poor and people with disabilities) to break the cycle of poverty, by assisting communities and local authorities to lay the groundwork for a self-sufficient future.
Jun 3, 2014

Harmful Traditional Practices in Maila Village

Tooth extraction in Maila sub health post
Tooth extraction in Maila sub health post

Dear friends! This time, we would like to share with you some of the common traditional health beliefs and practices in Maila village.

Chetana Khadka is an18 year old school girl from ward number 9 of Maila village. She is studying in grade 10 in the local government school.

Chetana recalls- “it had been nearly 3 months since I had started being sick. I suffered from headaches, shivering, extreme fatigue when walking, anxiety as well as loss of appetite. At first, I did not do anything about it, thinking that it will be fine but slowly I was getting thin and my face also looked pale. My parents inquired about my wellbeing seeing the change in my appearance. I was afraid and explained about my illness to them.”

In rural Nepal, people often don’t do anything about their symptoms of ill health unless they become totally fatigued and can’t get out of bed. They hope if there is no severe pain then everything will be fine and recover by itself. Chetana also thought her health will recover by itself soon but instead it just got worse.

She explains – “My parents discussed what they should do for my treatment. I had headaches but no other pain except feeling extreme tiredness and losing my appetite. According to my symptoms they tried to decide whether it is better to go to the health post or to call a traditional healer. Finally they decided to call the most popular dhaami (traditional healer) of the village saying that I was suffering from ‘deuta laagne’ (bad spirit). The dhaami saw me and also confirmed that this was the case. So he visited our house every week telling us that it was all because of the ‘bhoot-pret’ (bad/evil spirits) and he could treat it well. He performed ‘jhaar-fuk’ (spiritual chant) for about 3-4 weeks regularly. He burned me with a red hot iron spoon all over my body. I used to feel a little better for some days but again the same symptoms persisted.”

Many traditional healers burn patients with a hot spoon or splash boiled hot water on the body of ill people to make the bad spirit come out from the body. Chetana also got this treatment from the traditional healer. She usually felt better for some days (maybe because of the psychological impact of the traditional healer’s treatment).     

She remembers – “My situation got really worse instead of getting better. My parents asked the dhaami why I wasn’t getting any better, the dhaami said that it could have been the ‘boksi’ (witch) which was affecting me and he could treat that too. He bit me in various parts of my body with his teeth and that was very painful and I had open wounds all over my body. He also bit my thumb on the right hand. But nothing improved. I still wasn’t getting any better.”

By this time Chetana had been ill for two months and wasn’t getting any better.

Chetana emphasizes – “My parents were unhappy with my sufferings. They again asked the ‘dhaami’ about my illness. The ‘dhaami’ then said that he had done everything he could. He suggested I might be suffering from a disease instead of evil spirits and this can only be treated in the hospital. My parents’ face turned pale because of the mistake they had made. We spent a lot of money for the dhaami’s offering and food as well. Now, I also realized it would have been better if I had gone to the health post.”

Chetana and her parents decided to go to health post. They felt quite upset that they had spent so much money and time already.

She says – “My parents and I decided to go to the health post (3 hours walk from my home) the very next day. There were a lot of patients waiting. After a few minutes, a sister called me inside and inquired about my problems. I introduced myself to her. She was a health worker supported by an organization called PHASE Nepal. After a short introduction, I felt quite comfortable with her and began to tell her all my problems. I also told her about the way that dhaami had treated me. She was astonished when she saw the wounds all over my body.”

Although Chetana and her parents had taken a long time to decide to go to the health post, ultimately it was the right decision. As with many patients, Chetana suffered additional pain and distress during the dhaami’s treatment, but she and her parents were merely following tradition.

Chetana recalls – “After listening to all my problems, the PHASE sister was upset that even being an educated girl, instead of making other people aware of these issues, I had possibly put my life in danger by resorting to such traditional practices. I told her that although I was educated, I couldn’t bring any change in people’s beliefs. If we try to change such practices, people will say that they have spent all their life believing in them and they are afraid to make the spirits angry by changing.”

It is not easy to convince the people who believe in traditional practices to change, or to bring change in the community’s social and traditional life. PHASE has organized two sessions of traditional healers’ training in each of its project areas and provided general information for traditional healers so they can refer sick patients to the health post as quickly as possible. They have also trained healers in basic treatment of diarrheal diseases and personal hygiene etc.

Chetana continues– “The sister examined me and she also did my blood test. She said that I had a very low amount of blood in my body - probably because of lack of nutritious foods and worms in addition to this - so I was suffering from dizziness, fatigue and other symptoms. She gave with the required medicines and advised me to have plenty of pulses, green leafy vegetables, fish, meat and eggs in my diet.  She told me that it was not because of ‘bhoot-pret’ (evil spirits). She told me to have the medicine for 15 days and to visit her once again after 15 days. Immediately after a week, I started to feel much better! My appetite improved and I felt less dizziness as well. I again went to the health post after two weeks. Sister again tested my blood and said that there has been a lot of improvement. She again gave me medicines for the next 15 days and advised me to come back again.”

Chetana was now well.  Although hers was not a very serious illness, mostly caused by the lack of nutritious foods in this remote and arid region of Nepal, she had suffered a lot of physical and mental distress. 

She further adds – “Even though as someone with an education I should have realised, even I just followed traditional practices. It has been so long in our village that this was the only option people had when they were ill. Now that PHASE is here, we need to start changing our approach to ill health and move away from using dhaami/jhankris as the first line of health care. This may cause some conflict, but I believe that it is the right thing to do. I was certainly helped very much by the PHASE sister, and will use my experience to help others find the right way to treat their health problems in a timely way and to avoid harmful practices.”

Hand washing campaign, Maila village
Hand washing campaign, Maila village

Links:

Mar 13, 2014

Project Update

North Gorkha School Children
North Gorkha School Children

 

The past few months have been busy ones for Nepal Teacher Training Innovations (NTTI). We began working in North Gorkha, one of the most remote and impoverished parts of Nepal where many villages are a three to six days walk from the nearest road and literacy rates for women in some communities are below 2%. So far we have trained 55 teachers and 35 of these teachers have been selected to work as Mentor Teachers who will provide on-going support to the teachers at their schools and serve as role models and sources of inspiration.

Teachers love our trainings!

Munni is a teacher at Shree Chandredaya Lower Secondary School in Manbu, Gorkha district, where she has been teaching for five years. Before participating in NTTI training, Munni says, her confidence was low and she never spoke up or felt able to express her ideas. This changed during the training, however, as NTTI created an environment in which she was encouraged to participate. The opportunity to receive feedback about her teaching from NTTI Master Trainers has helped her to feel less nervous.In fact, Munni's passion and commitment to teaching has resulted in her being selected as a Mentor Teacher. She is proving courageous as well as effective in her ability to provide feedback to her male colleauges, many who come from “higher” castes and have more education and teaching experience than she has.

Munni tell us: “The students say they like our teaching better since we went to NTTI training because we do more work in groups, play more games, and ask them their opinion. Now the children are coming to school more often.” “

Students say our training makes a big difference in what happens in the classroom. Dolma Lama from Nawayug School tells us:

Before there was a lot of cramming for the exam and teachers only taught us from the book. Now they ask us questions to make sure we understand and they ask us what we think.”

To date NTTI has trained 1300 teachers and is having an impact on more than 78,000 students from 11 districts across the country!

Nameste
Nameste
Gorkha student
Gorkha student
Mar 4, 2014

Forced to Early Pregnancy in Maila Village

Clinic health education session in Maila village
Clinic health education session in Maila village

Namaste Friends! Winter has nearly left us; however it is still very, very cold in most of the PHASE field posts around Humla and Gorkha regions. Despite winter, our staff have been working consistently for the last two months in the snowy regions. It is all possible because of your generous support.

Early pregnancy is one of the major causes in maternal deaths in rural areas of Nepal. Social factors such as culture, traditional practice and social status influence early age marriage in much of society, which leads to early marriage and then early pregnancy. To highlight this, let us share a story about teenage/early pregnancy in Maila village. Friends! Meet Rupshila Sarki of Maila village. Rupshila Sarki is a 17 years old girl married to Chandra Bahadur Sarki for the last two years.

Rupshila recalls – “When I was 15, my parents arranged my marriage to a 19 year old boy, Chandra Bahadur Sarki. We lived happily until a year passed but after this time, my in-laws started to look at me strangely. I did not care for a month or two about their weird behaviour but then they started to discuss pregnancy. I came to understand the reason why they looked at me strangely - They wanted me to have a baby soon!”

At first, Rupshila did not overly worry about her in-laws’ demand, thinking that every in-laws wants and deserves grandchildren. Chandra also did not listen to his parents. But Rupshila became stressed when she went to her parental home.

She says – “When I went to my parental home, both of my parents insisted that if I did not become pregnant within a month or two they will not allow me to visit my parental home again. They kept reminding me of the importance of having a baby. They also reminded if I do not become pregnant soon then society will cast doubt upon me; including my relatives.”

In this area, it is believed that if a married couple do not have baby within a year or two then it is because they did something wrong in a previous life. On the other hand, having a baby is seen as a symbol of prestige and status. Rupshila’s parents and in-laws did not want their family status to suffer.

Rupshila continues – “I was not able to think clearly. I did not want to become pregnant that soon. I used to sit in the community health education sessions run by PHASE staff in the village and came to know that early pregnancy is harmful to both me and the baby. But on the other hand, I could not bear the force from both my parents and my in-laws. I talked with my husband and decided go to the health post for counselling the very next day. I went to health post and met two PHASE sisters in the post. They took me inside the separate room when my turn came. I told them everything about my family problems.”

Rupshila had chosen the right place to go at the right time! PHASE staff gave her some advice about the risks and realities of early pregnancy and asked her to come again as soon as possible with her husband. When she was on the way to home she met some village women carrying fodder from the jungle. They asked her whereabouts and she explained, giving them the details. Rupshila found out from talking to her friends that there was also a rumour in the village that Chandra – Rupshila’s husband- has a problem with his reproductive system, which was preventing Rupshila from becoming pregnant.  

Rupshila struggled to say – “When I heard about my husband’s problem from friends I felt like I was buried down in the earth; however after a while I also felt quite comfortable because there is no problem with me, it is all because of my husband. I planned to tell the facts to all my parents and in-laws and they will start to blame on my husband instead of me. I reached home and told my husband that PHASE sisters want to meet both of us together at the health post. I did not mention the rumours about his problem. The very next day, we went together to the health post. PHASE sisters took us inside the separate room and asked us about our education, family background and marriage date etc. They started to advise us about the risks of early pregnancy. They said best time to become pregnant is between 20 to 35 years of age. Whilst we are still young, the reproductive organs in our body are still developing, so it may cause vaginal bleeding and abdominal cramps which lead to miscarriage, placental abruption and placenta previa, premature birth and ectopic pregnancy as well. They also informed us that early pregnancy may lead to swelling and pregnancy induced hypertension. I felt scared and worried after hearing all their advice, and promised not to become pregnant before 20 years of age; my husband was also committed to do so. After a long counselling session, PHASE sisters advised us to bring our parents if they continued to insist on my becoming pregnant. I was happy but nervous on other hand. My parents and in-laws never stop insisting about us having a baby.”

Rupshila was happy but nervous. She was scared about the reaction from her parents and in-laws. On the way to home, she discussed with her husband and decided to take both their parents to the health post to clarify the reasons why she does not want to have a baby sooner.

“At first, my parents did not agree to come to the health post since they live in 4 hours walk away. Also, they were upset with us because of taking advice from health staff. They were upset and said that we ruined their social status by going to health post to stop pregnancy. They also said- they were only 19 when they had their first baby, and have had 6 children without any problem. They also said this is a natural gift; we have to accept it as soon as possible without delay.” Rupshila further adds – “I ignored their reproach and said calmly that PHASE sisters are good and they will give us the way to become pregnant in healthier way as soon as possible. After refusing for a while, they agreed to go the health post thinking that they will become grandparents soon. We six including parents and in-laws went to the health post after a week. PHASE sisters were in their usual duty. After half an hour, they called us inside. We all entered into the separate room. PHASE sisters greeted all of us and started the conversation from wellbeing and usual daily lifestyles. After a while they repeated the same counselling again with my parents and in-laws. They queried that if anything happens to me who will be responsible? If I am not in perfect health then how can I give birth to a healthy baby? They incorporated several examples of risk and dangers in early pregnancy and convinced our parents that it would be safer to have a baby after three years. After the counselling both parents were happy and promised not to force me until three years. We thanked sisters for their help and support. We returned happily to our home.”

PHASE staff organizes community health education session, door-to-door home visits, clinic health education session and school health education session every three days in a week. Rupshila attended the events and kept in mind that early pregnancy is dangerous. This helped her to avoid the possibility of early pregnancy. 

Thank you very much for your generous support!!!

Please help us continue our work in Maila so that women and children can get the health service they need. 

Mothers group after child health training
Mothers group after child health training

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