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Mar 9, 2012

Smoke-related Illnesses in Maila

Tobacco smoking is common amongst both men & women
Tobacco smoking is common amongst both men & women

Meet Pulati Chadara. She is a 55 year old mother of five, and she lives in Maila village. This is her story.

‘My husband died 10 years ago. His illness started with a cough that got worse and worse, until he could not walk and could hardly breathe. He used to smoke raw green tobacco leaf in a pipe, and so did I. We didn’t know that this could be bad for you. Our village is so far from anywhere, and there wasn’t even a basic health service here at that time, so, even when my husband was extremely ill we never thought about medication. I just used to take him to the local shaman who would perform sacrifices and rituals. Unfortunately nothing worked and after a prolonged and painful illness he died. It was traumatic for both me and the children.

Since that time I have also developed similar symptoms. It started with a small cough about 7 years ago, but it rapidly worsened and I became more or less confined to my bed. I assumed I would die the same way as my husband, and I was scared. In the meantime however, something had changed in our village. PHASE had started a clinic from the old disused government building, and I had heard that the workers had skills and medicines that treated illnesses that we had previously thought incurable.

So one day I got up from my bed and went to see the healthworkers there. The lady quickly informed me that the name of the disease was ‘chronic bronchitis’ and that there was medicine for this! Not only did she give me the medicine, she also informed me that it was caused through inhaling smoke. This was all the information I needed to kick my tobacco habit! I also try to be more aware of inhaling smoke when I am cooking. It is important for me to know the causes of my illness and what I can do about it.

I take the medicine daily. When I run out I go straight back to the healthpost as the old symptoms return within 3 days if I stop taking it. I can honestly say that PHASE has transformed my life; I can’t tell you how different I feel now. PHASE has in fact transformed our whole community, making treatment available for a whole range of diseases that we previously had either suffered through or died from. And the educational programmes are hugely empowering for illiterate people like us; now we know what we can do ourselves to improve our family’s health.

I would like to extend my heartfelt gratitude to PHASE and all the supporters that make its programmes possible. I can honestly say that you have saved my life. I only wish that it had been possible to save my husband and that he was alive to see this progress. He would have been very proud to see this in our community.’

Pulati and her husband are unfortunately not unique cases. In Maila and the surrounding villages smoke-related illnesses such as asthma and chronic obstructive pulmonary diseases such as bronchitis are extremely common, partly due to high tobacco usage but also because wood fires are used for all cooking and heating. Women especially spend many hours a day, every day, inhaling smoke in the kitchen.

Thankfully, as Putali points out, things are changing in Maila village, and the community is becoming more informed about environmental health hazards such as smoke. They are also are learning to trust in modern medicine and come to the healthpost at the first signs of illness.

We can’t do it without your help.

We have currently raised about a third of what we need to keep this healthpost open for a year.

Please consider making another small donation, or sharing this story with your friends.

On Wednesday 14th March, GlobalGiving will match all donations made by 30%. This means that your money will be worth more for PHASE and the people of Maila. Please keep us in your minds and hearts that day and for the rest of the year and we look forward to sharing more stories of hope and joy in the next few months.

With gratitude,

PHASE Nepal and the people of Maila


Dec 5, 2011

Healthworkers as Dentists in Maila

Dear friends

PHASE Nepal specialises in working in extremely remote areas; places without basic infrastructure and services. When PHASE first started working in Maila in 2008, there hadn’t been a functioning health service there for many years. One of the most common complaints was from people suffering from toothache. Toothache is painful and debilitating and can reduce quality of life considerably, especially when there are no dentists and not even access to painkillers.

The PHASE healthworkers in Maila have a very basic level of medical training, but as the only medical staff in a 60km radius they have to act as doctors, midwives, counsellors, paramedics, educators and even dentists. All PHASE healthworkers take a basic course in dentistry, and PHASE healthposts are equipped with a set of dental equipment. Every month, several patients come to the healthpost in Maila with oral health or dental problems.

Bachu Jaisi was one. He is 24 and unmarried. He was suffering from toothache for 4 days before he decided to make the two-and-a-half hour trek to the healthpost in Maila.

It was really painful,” he remembers. “I couldn’t eat anything at all and my mouth was so swollen I even had problems talking. I made some medicine myself out of local herbs such as titopati and neem, but it didn’t really help. I had heard that the staff in the healthpost had the instruments to pull teeth, and I thought that was what I needed, so I went to see them.

PHASE healthworker Phelu examined Bachu’s mouth and discovered that the problem was not the tooth but a swollen abscess. Instead of losing the tooth, all Bachu needed was a course of antibiotics and some ibroprofen for the swelling and the pain. He was happy to not to have to lose his tooth!

The medicine started to work really quickly. Within a few days I could talk and eat like normal. It was such a relief! I won’t bother trying to make medicine at home anymore now I know that the medicine in the healthpost works so well. Also, the workers there are kind and friendly.”

Even more important than the dental treatment provided in the healthpost is the preventative work undertaken by the healthworkers, in the form of oral health education.

So many people in Maila have problems with their teeth and gums,” says healthworker Deepa. “Even when people come to the healthpost for other reasons I try to talk to them about oral health. Lots of people smoke here, that’s one reason, and just a lack of understanding of how to take care of their teeth.

Oral hygiene is a common topic for the regular health education sessions in Maila. The healthworkers say that more and more people are being convinced to brush their teeth at least once a day, although they estimate it is still way below half the population. For those not wanting to use scarce resources on a toothbrush and toothpaste, there are local alternatives that work nearly as well. Many people have started to clean their teeth with twigs from the medicinal neem tree, frayed to make a kind of brush, which works nearly as well

Your donation has been crucially important in keeping this essential health service open. The healthpost treats thousands of patients like Bachu, who would otherwise have not been able get relief or treatment for very simple conditions.

To those of you for whom December is a festive period, please consider sharing some of your goodwill and cheer with the people of Maila. As you have seen, a small donation goes a long way – an average consultation, including staffing and medicine, costs under $3 and frequently saves lives.

This December please consider:

  • Making a small donation for the people of Maila to continue to have a health service over the harsh winter months
  • Buying healthcare for Maila as a gift for friends and family (comes with personalised card)

Standing in solidarity with the people of Maila,

Jiban, Claire and the PHASE Nepal Team


Sep 12, 2011

Maila and the 'Crisis of Malnutrition'

Food Aid by Helicopter-this support has now ceased
Food Aid by Helicopter-this support has now ceased

Dear friends

These last few months, your donation to PHASE Nepal has  provided  essential healthcare services in the remote community of Maila, in north-western Nepal. PHASE healthworkers Deepa, Phelu and Ritu see between 30 and 60 patients a day, most of whom have walked many miles for treatment.

Life in a community as isolated as Maila is never easy, but it unfortunately became much more challenging in June when the World Food Programme withdrew their support of regular food aid that the community has depended on for the last decade. Previously, rice was flown in by helicopter twice a week, but due to funding constraints this support has now ceased.

Donor attention is shifting away from Nepal towards countries where relief and recovery assistance can meet needs that are less chronic in nature.’ (WFP Press release, May 2011). Click here for news reports on this issue.

Malnutrition rates are alarmingly high in Maila, only slightly lower than the Democratic Republic of Congo.– the worst scoring country on the Global Hunger list. Nationally, 41% of children in Nepal are chronically malnourished. In 2008, when PHASE first started working in Maila, this figure stood at a staggering 84%.  Many of the patients seen by our staff have health problems relating to malnutrition – especially children.

Sawni Sunar’s (33), 2 year old daughter was suffering from earache and diarrhoea when she came to Maila Healthpost. Malnourished, the child weighed only 7kg – less than half the recommended weight for her age. Although Sawni had been breastfeeding, she could only do so once or twice a day because she spent most of the day in the field growing food for her family. Ritu and Deepa told Sawni to feed her child 4-5 times a day, and provided information on what foods are particularly nutritious. They also gave her vitamins, iron and folic acid and told Sawni to return again with her daughter in a few weeks.

Nutritional awareness is extremely low in remote Nepal. In 2008 PHASE found that only 5.5% of the population of Maila understood the concept of malnutrition. A major role of the healthworkers has been to raise awareness in the community of child nutrition. One of the ways in which they have been doing that is to run demonstration sessions with mothers groups on how to make ‘Sarbotam Pitho’, or Super-flour, a highly nutritious weaning food.

‘It’s very easy to make, with widely available ingredients,’ explains Ritu BC. ‘You just take 1 cup each of 2 kinds of different grains, 1 cup of soya beans and a cup of another kind of bean, and grind it all together’.

 Two months later, a calmer and happier Sawni returned to the healthpost. She had fed her daughter frequently and had used the super-flour recipe. The child now weighed a much healthier 10kg and was no longer suffering from any health problems.

Providing health services to the people of Maila is an essential task. It will only become more so as food scarcity increases, so PHASE staff are further prioritising nutrition education activities.

The money we have raised so far will keep this healthpost open for the next few months, but we need to continue our fundraising efforts to secure the healthpost for the whole year.


Ways you can help:

-         Buy a gift card for PHASE staff members Claire’s 30th Birthday (13th September) or another loved one

-         Donate  to Global Giving on the 19th October when all donations will be matched by GlobalGiving

-         Continue to help us raise awareness of this important cause


With gratitude and hope


PHASE Nepal and the community of Maila

Teaching mothers to make nutritious
Teaching mothers to make nutritious 'super flour'
A cheeky toddler, Maila
A cheeky toddler, Maila


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