It is extremely difficult to put into words the last three days. On Friday afternoon we travelled to Sisaghat, a small village around 3 hours drive from Pokhara.

Sisaghat has a population of around 1600 according to one of the locals we met, however it would not surprise me if this figure included neighbouring villages in the area.

We went for our major health camp, to provide medical assistance to these people who are fortunate if they see a doctor once per year. There is a bus that comes through to Katmandu and Pokhara at least a few times per week, however most people have hardly ever left their village. The isolation did not mean these people were insular though and although we were a little bit of a novelty being from Australia, there were lots of questions asked and we were able to see so much.

We were greeted with garlands of marigolds and the traditional Nepalese horn.

For such a small town there was a diverse ethnic mix with a Hindu temple, a mosque and a Christian church. Other houses hung Buddhist prayer flags.

Our guide, a 21yo lad who was studying science in Pokhara but returned home for our visit, proudly showed us his home and we met his mother. They had goats, chooks and buffalo and we were able to watch the Buffalo being milked.

The milk was heated over an outside stove and we were offered it to drink. It had a sweetness that was different to cows milk. We walked down paths and met children and our guide introduced us to his other mother and explained that his father took two wives.

We also saw some of the local crops including the millet which was ground and used for breads and also made into a local spirit which was, er, interesting!

Dinner was back at our host families home and consisted of traditional dal bhat.

The family had killed one of their chickens especially for us.

Sisaghat is in a valley of the Himalayas and in the morning it was cold and a fog had swept in. The temperature was cold enough for us to see our breath as we breathed out, however once the sun came up from behind the mountains it warmed up and we were hot in our shirts.

Our host father cooked chapati for breakfast made from the local millet over the outside stove.

The family kept goats, chickens and pigeons. We heard the goats baa-ing from early morning and eventually they were let out of their pen to graze.

We were here however for the Health Camp.

Doctors from the Fishtail Hospital travelled out to see over 700 people who had travelled from far and wide. Our job was to take the pulse and blood pressure of those who registered and direct them to the doctors. Many people thought we were doctors from Australia and our local guides had to explain that no, we were nursing students and even though we were white skinned, we didn’t know more than the local doctors! Whereas last week a lot of people had blood pressures that were much lower than we see in Australia (90-100/60-70), this week more people seemed to have higher readings. This was just one test and it could easily have been caused by anxiety at visiting a health camp when there is such little medical assistance usually available to them. We took it in turns taking vital signs and at other times sat with doctors.

I first sat with the doctor conducting ultrasounds. The machine looked like it had come straight from the 70s.

I learnt later that the majority of people presenting at the health camp came with complaints of lower back or abdominal pain. This was mainly caused by squatting in the fields all day, or at their stoves, or at their toilets. Ultrasounds showed no major abnormalities on most patients, however I was surprised at the incidence of mild to moderate fatty liver that was found. These were fit, healthy people who eat dal bhat most days, eating very little red meat. I wondered if it had anything to do with alcohol consumption which appeared to be rather high amongst the men especially.

I also spent time with the obstetrician/gynaecologist who again reported women with lower abdominal pain from bending all day. She did tell me that in most villages there are trained locals who can assist with delivering babies, however the infant mortality rate is still quite high. The dentist reported pulling over 30 teeth for the day (I did not stay there long!) and the paediatrician comforted parents and grandparents worried about the runny noses and sore ears of their children.

My most interesting time was with the orthopaedic surgeons however. In Australia, MIML™ and I joke that psychiatry is the basket for all the ‘too hard’ cases in the hospital- if the medics can’t work it out they send it to the surgeons, who send it to psych! At this clinic, the orthopods were the dumping ground for the too hard cases. Yes, I did see men and women in their 50s crippled with arthritis from their hard work, and these consults usually took a couple of minutes with the doctors being very forthright and telling people they need to rest for a week or two and the people saying they couldn’t so the doctors telling them there was little they could do. One consultation took a good deal longer. A local came in and spent the consultation looking at the ground. The doctor spoke with them for several minutes. Afterwards the doctor told me that the patient was concerned that some mornings they wake up and want to sit in a corner and not speak to their family and yet other mornings wake up and want to run up and down the street and they can’t explain their behaviour and they thought something must be wrong. The doctor had listened and even though he told me he thought the patient had a classic case of bipolar disorder, he wanted them sent for a cat scan and for some thyroid tests. Although he was not a psychiatrist he did not mind talking to the patient and offering advice.

Over lunch, doctors talked with each other about what they had seen and bounced ideas off each other. The collegiality was really nice to see.

At the end of the camp we went for a walk around the village. There is a wonderful suspension bridge over the river and we walked across it.

We also came across some locals who had mixed reactions to having their photos taken.

Coming into Winter the harvest is in full swing. Rice was being cut and left to dry on the ground before being piled into stacks.

Corn is also hung around houses ready to be turned into cornmeal.

This morning we said a tearful goodbye to our family and headed back to Pokhara.

The self-sufficiency of the villagers really struck me. They almost live off the grid with electricity connected to the homes in order to run a fridge, a few lights and a small television. Water is not plumbed into the homes. The squat toilet is flushed by pouring water from a bucket down it. People bathe by pouring water over themselves, even in the cooler climate, however there was a fire near the water tanks where the water could be heated. The villagers loved having us there and appreciated the health care, but as one doctor told me the doctors feel like they can’t do a lot for people as they are predominantly healthy. In many ways it seemed an idyllic lifestyle- tending the land and feeding your family, however people grow old very quickly.

~*~*~

I have to include this photo I snapped this evening- I went into a shop to look at scarves and came across this cat who seemed awfully happy with itself!