'The clinics in Humla face unique challenges even by Nepali standards. The district is incredibly isolated, with no road access from lowland Nepal, and some of the Nepal Trust sites lie a week’s hike from the district headquarters and sole airstrip at Simikot. The physical landscape limits supplies and the local population carves its livelihood out of back-breaking farm labor on steeply terraced hillsides and the portering of goods over high mountain passes. The clinics, in turn, must diagnose and treat the numerous ailments incurred from food insecurity, environmental exposure, sanitation and physical strain, all without the benefit of imaging or laboratory testing, and with limited access to medications and higher levels of care. It’s a real challenge to tell a 60-year old man with congestive heart failure and a bout of chest pain that he needs to hike 10 hours across a 900m pass to get an ECG or a chest X-ray. Then again, he probably wouldn’t need a stress test.
Cultural differences provide their own challenges. Gynaecologic complaints were commonplace, yet physical exams by male practitioners, local and foreign alike, are simply not done. A patient with a cough might be unwilling to expose his back for auscultation out of embarrassment for poor hygiene; a large laceration would forego irrigation and suturing due to reluctance to remove a poultice of herbs “blessed” by a local monk; knee pain treated with ritual burns to the skin ends up with secondary infection; is the patient’s chronic productive cough from TB or simply the result of residing in a smoke-filled room with neither windows nor chimney? Each patient presented a unique diagnostic and therapeutic dilemma.'
Our health education programme for children - Little Doctors - is successfully challenging these social and cultural issues and a new generation is moving forward to a healthier future. Three new LD programmes have been planned for this summer in the villages of Simikot, Yalbang and Torpa/Bargaun.
Plans for the new Birthing Centre in Bargaun village (linked to Torpa) are well advanced and the community have commenced collecting stone and timber. A 'Trek to Build Health' is going to Bargaun in September 2012 to help with construction works. Our T2B started in 1994 and are one the earliest forms of eco-tourism and a very unique way of putting something back. If you are interested in participating go to our website www.nepaltrust .org for more information.
Finally a new batch of medicines is about to be distributed to all clinics. This will be in collaboration with our partner organisation the ISIS Foundation.