A dazzling place I never knew. But when I’m way up here, its crystal clear, that now I’m in a whole new world, with you.

Sound familiar? If you are anything like me and love Disney animated movies, Aladdin should be the first thing you think of.  The lyrics match the feelings we all had arriving in Nepal our first night. For all of us, this was the first time to this complex little country. The experience most definitely was dazzling.  And as we circled Mt Everest via Yetti Airlines it was most definitely clear that we were in a whole new world.

Everything about Nepal was new for me. The religions, the smells, the culture, the mountains, the villages, the list could go on. To be quite honest, without sounding incredibly cheesy or predictable, this experience was life changing.  While this song was our group ‘inside joke’ it is also very representative of my overall feelings towards the trip.  Bumpy, dusty, windy roads, long days and short nights, and any other at the time challenging experiences aside, this trip opened up a whole new world to me.  From being in a completely different region of the world I ever thought I’d be, to meeting incredible people and seeing incredible things-both uplifting and depressing-Nepal genuinely is a dazzling place I never knew.

Now that we are back and people ask how the trip went or what we learned.  These are very complex questions I feel. I learned a lot on this trip about myself, what I wanted to continue studying and sorting out through academics, and what I might want to do ‘when I grow up’ (although, lets be honest here, that isn’t 100% sorted out!).  One of the things we all learned in our short trip is that Nepal is a very complex little country with miles to go in its peacebuilding process. We are still debriefing, writing, and analyzing what we’ve learned, observed, and experienced in Nepal.  I am still struggling to sort out exactly what I want to say about Nepal, so the main thing I keep coming back to is the thought: “well I’ll just have to go back.”  It is too complex of a country to speak too soon, judge too soon, or put behind me just yet. Maybe if I put it in writing, on the internet it will happen, but I hope that I can go back to Nepal to continue to learn about its culture, people, troubles, and triumphs.  A country this beautiful and this complex is worth another trip.

I feel very fortunate to have been able to go on this adventure with my colleagues and Dr. Iyer. Thank you so much for the opportunity.  I hope to become much more familiar with this ‘new world’ in my future.

As we walked out of the Kumari’s house (the living godess others have written about) we ran into a little girl who asked Pushpa if she would like her to do henna for her.  This little girl was exactly what I needed to complete my trip.  She was so inquisitive of us, and we were curious about her. It was fun being on the other side of the interview for a few minutes! She wanted to know each of our names. Where were we from? Did Pushpa have any kids? Why were we in Nepal.  But we had even more questions for her. She was quite an articulate little girl.

She lived a bus ride away but comes into the tourist area of Kathmandu we were in to do henna to earn money for her school. Normally her mother does this for a living, but she was sick at the time and so she needed to be the one to come and raise the money.  We were so impressed with her English, which she learns in school.  She said her teachers enforce speaking English in the classroom.  We asked her how many other girls were in her class, by this time in the trip it was a standard question.  She said a few, but more boys.  She wasn’t just book smart though. She was very aware and quite tough. After she finished all our henna’s we each gave her money for her work, but by this point several men had started to move in towards us.  We urged her to put the money in her pocket quickly.  We got quite protective of her, or at least mentally I did.  Pushpa was great about telling the men to leave us be and giver her space.  But even with this show of strength, I was nervous for the girl. The little girl has clearly done this before though. She knew what she had to do. “Don’t worry if one of them tries to take my money I will scream for the police.” She knows how to take care of herself.

My Henna

This memory will stay with me for some time I think.  I am not 100% sure what exactly about it was so impacting.  I fell in love with her a little bit in those few moments. Like she was my own sister. She was intelligent, strong, funny, outgoing, talented (although she did my hand after a few others and I think was getting in a hurry so don’t judge too harshly by this pic! ha)…I can’t help but think this is exactly the type of girl Nepal needs to grow up and lead the country.  She is a great role model for other little girls, not just in Nepal but here too…if girls here could have met her. I hope she stays strong. I hope girls all over the world are able to stay strong, smart, outgoing, and able to lead, against all the trials life, cultures, societies, throw at girls.

Discrepancies in government policies and on-the-ground realities is common in just about every country in the world.  This is true in Nepal as well; especially when it came to education.  The official government policy on education is ‘education for all’, but this was not what we observed. Despite the government’s stance, education was not being provided to all equally, especially if you were a girl, and a lot of that seemed to be due to inadequate facilities and lack of financial support to schools.

Education, specifically girls’ education, came up in every district we stopped in.  We spoke to girls about their schools as we walked through small villages in the hills around Pokhara, we brought up education programs in most organizations we met dealing with youth issues, but the most vivid experience we had regarding education was visiting a school that educates over 1,000 students a year grades 1-11 in the Bara District. When we arrived at the school, which didn’t look like any school I had seen in my life, just a two story concrete structure with several rooms and an uncovered staircase without railings or barriers on the right side of the building, many men from the neighboring village greeted us.

Men who greeted us at school

Standing in the middle of this crowd with the other students listening to our professor introduce us and the headmaster of the school, it didn’t take me long to notice that we were standing in a sea of men, not a single woman was in sight.  The building was basic.  One classroom for each grade, meaning that some classrooms held hundreds of students, the headmaster told us that half of the schools population were girls.  This became particularly puzzling for me as the classrooms got increasingly smaller as the grades increased, as sign that people were dropping out.

Classroom for 6 graders, One of the biggest rooms holding over 300 students

Much of the research published on girls’ education indicates that girls in many developing countries begin dropping out of school around puberty to take on household duties, because they miss so much school due to their menstrual cycles, or because they have been married. I also noted that I didn’t see a single bathroom, which at the time didn’t strike me because I was aware that defecating out in the open was perfectly acceptable in this culture. Looking back on our trip and at my written observations and photographs of this stop, however, I wonder without restroom facilities how girls manage to take care of their hygienic needs while at school? Is this absence of a major facility within the school why girls cannot continue their education passed puberty?  It is this lack of female friendly facilities, as simple as a restroom, that adds to the mounting structural barrier working against women’s equality.

While the headmaster said half of the students were girls, and the government says education for all, something seems to not match up.  Maybe half of the students are girls in the lower grades, but if the classes are getting smaller, someone is dropping out, and from what we’ve read and observed, I am fairly certain those drop outs are girls.  Education for all is a great stance. It would be even better if the policy was able to be carried out on the ground.

Upon our arrival to Kathmandu from Nepalgunj, Pushpa and I took our colleague to a clinic near our hotel, just to make sure what we found out in Nepalgunj–that she was fine–was an accurate diagnosis.  We didn’t have to drive far to reach the clinic, we were told it was near the British Embassy and was a great clinic.  Walking into the clinic was a dramatically different experience.  We were greeted by two people at a front desk, told to fill out an information sheet and have a seat, that the nurse would be with us soon.  I remember looking at Pushpa at that moment and just smiling.  How different our experience already was.  It was as if we just walked into the US.  I couldn’t help think to myself, ‘what is behind this difference exactly?’.  I got my answer quickly as we turned in the info sheet.  “The cost of your visit today will be 80 US dollars plus any tests or labs you need done, will that be ok?” There it was.  80 US dollars. Our last registration was less than $5! This is a huge factor.  This clinic is tailored to people who can afford paying more for healthcare. This money can be used to recruit great doctors, employ a larger staff, employ a cleaning staff, purchase more equipment, afford a more expensive rent. The list could go on and on.  This was my first observation.

We were called back to a private room to speak with a nurse about what had been going on.  My friend told her of our travels, her symptoms, and what the doctors in Nepalgunj had said.  While she was talking, I was looking around. Noticing the informative posters on the walls, the bucket with a lid clearly marked for biohazards, a box for gloves in the corner, a sink with soap.   All of these things in this small triage room were already things that were non existant in Nepalgunj.  Maybe a room like this existed in that hospital that we didn’t see because we only were in the emergency room? I can’t say, so I won’t rule it out. It was clear that there was a huge disconnect between the level of healthcare was provided to foreigners and what was provided to locals, and I am certain money was the root cause of this.

Another interesting difference was the respect for privacy.  Just to be triaged we were taken to a separate room. Later we would be taken to an exam room where before the doctor begun his exam he checked several times if it was ok we were in the room witnessing the questioning and exam.  Again I looked at Pushpa with wide eyes as if to signal to her “holy cow! This wasn’t asked in Nepalgujn!!”…I think without words she understood my glee.  When my friend needed our EKG we were asked to step outside and wait, which we were perfectly ok with knowing she was in the hands of the woman RN we met earlier.  During this time Pushpa and I got a chance to ask the doctor a few questions about himself, how long he had been in the country (not long) and what kinds of patients he saw.  As we assumed, he saw travelers. Hikers who needed medical care after coming down from the mountains, tourists visiting Kathmandu.  Locals didn’t come here. This was the biggest difference between the two hospitals.  The target audience was one with money, willing and able to pay top dollar for the health services they needed, and staffed by a foreign doctor from the West.  Our nurse was from Nepal and got her RN from a school in Kathmandu.

Healthcare in my opinion is a major challenge for Nepal.  First it was the lack of conversations around health issues in meetings that triggered my realization of health being a major issue.  After our visits to the two hospitals it was the differences between them that made me realize I had to make this my focus.  People so clearly need better healthcare in Nepal, but the challenge of providing that is enormous.  Especially for a country in such transition.  This experience of going through the healthcare system was extremely valuable for me to witness first hand what is happening in health on the ground.  After this experience I am inspired to get to the bottom of this challenge and explore exactly where the disconnect is happening and why people aren’t talking about an issue that affects so many peoples daily existence.

Our story begins in Nepalgunj, located in the southern-mid west region of Nepal, right on the Indian border.  After a long day and our usual nightly debrief session I headed back to my room not knowing that the most primary research I would gather on health was about to happen…you know what they say? Be careful what you wish for.

One of our colleagues was in need of medical attention.  I rushed into the main office to find the hotel owner to find out where exactly we should go to get her proper treatment.  I met Pushpa and the girls back in the bus and relayed what I was told: that there was a good hospital just down the street.  What in the world is going on right now? I thought to myself. Barely hours before I had been asking organizations about what they are doing for people in their community in terms of health services and was coming up with nothing! Now we have to take one of our own to a hospital here? The only saving grace I remembered was what a UN official had told us earlier- that compared with other districts in Nepal, Nepalgunj had a decent grasp on healthcare in terms of number of facilities and their quality.  This calmed me on the bus ride with the others.  Pushpa, myself, our sick friend, and two other girls went to the hospital.  We pulled up to a tall(ish) building blocked off by a large gate.  After the drivers got the attention of the gate keeper and we pulled inside we walked our friend into the ’emergency room’ where I was shocked by what we saw.

In retrospect, I am not sure why I was so stunned to see a dirty room with 6 beds, no curtains. I am surprised I was taken aback by the lack of lab coats and equipment in the room.  We passed a small room where many men were congregated around a few desks, all dressed in normal street clothes and turned the corner into the one room emergency room.  As we laid our friend on the bed I looked down to see an open bucket with bloody syringes just laying inside. By American standards this is NOT ok. As soon as we laid her down I got into defense mode. I was officially out of my comfort zone.  I was focused on observations: what is going on in each corner of the room, what are the doctors saying, who is touching her, how many people are in the room? I realized not only was I feeling quite protective of my colleague who was in pain, I was also needing to research.  For me this was the experience that would define a lot of my research and assumptions about healthcare in Nepal.  I didn’t need to hear about it from others that night…we were living it!

Several things struck me that I will write about not only here but in my later papers.  While the cost of getting our friend into the hospital and treated was relatively low by our standards, registration costing around 200 rupees (less than $5 US), we had to buy all the medicines she needed up front.  Obviously this trip to the hospital didn’t dent our wallet much but if you think about it in terms of what an average Nepali makes a month (we heard a good salary was 5,000 rupees a month but many people do not make even close to that) this isn’t as affordable as it looks.  If you are poor and you bring your loved one into the hospital you have to not only pay the registration fee up front, but  you also have to buy all the medicine you need at the time of service, there are no supplies held in the emergency room itself.  So if you don’t have the money up front, you don’t get the medicine you need. There isn’t this concept of get the care now, pay later like there is here in the US. I can only imagine how many people are disenfranchised by this system.  We can also assume the low cost of service is why the hospital’s condition was relatively poor.  They don’t have the money to get more advanced technology, hire someone to clean the floors every hour, get fancy buckets to dispose of the syringes, ect.  There was also very little privacy…wait there was no privacy.  I already mentioned the lack of curtains around beds in the open emergency room, but even just the mannerisms of people were interesting and new to us coming from our American background.  Several people came around us when we walked in, others came and said everything will be ok-it was just very different then the mindset in the States where people’s medical issues are very private.  In the beginning we didn’t even know who exactly our doctor was because of the lack of lab coats identifying who was who.

I journaled that night about just how dirty the hospital was, but seeing as though this was a city and people were saying how good medical institutions were in Nepalgunj, I wondered just how bad other more rural hospitals were.  I remember thinking to myself, this was bad in my perspective but surely it was better than many other hospitals in this country…this upset me.

One aspect of peacebuilding that we observed is visibly absent from our interviews is the aspect of healthcare and health systems.  In a country where various diseases run rampant, there is surprisingly little talk of what is being done for healthcare in Nepal.  I first became interested in health on the second day we were here in Kathmandu while meeting with the organization WOREC (Women’s Rehabilitation Centre). They spoke about their Barefoot Gynecologist Program which consists of women’s clinics established in 7 districts providing women in these communities both health and counseling services.  I didn’t think a whole lot about this aspect while they were speaking, other than I was impressed with the programs they were describing. After several other interviews with organizations you would think would talk about some aspect of health, and didn’t, and several miles driven from city to city, village to village without seeing many hospitals I started to ask myself “what about healthcare?” It wasn’t until half way through our time in Nepal and a few conversations with Dr. Iyer I finally started pressing organizations about health. As the spoke about their programs for women and girls, or their rehabilitation programs for ex-combatants I found that I couldn’t help but say “…and healthcare? Is that an issue for you?” Most people said it wasn’t their priority, or within their mandate, or someone else was taking care of it.  I came to Nepal with the mission to find out about the status of women and how they are being involved in decision making in the post-war society and what their daily lives were like.  I left Nepal with a desire to dig deeper into why healthcare isn’t being addressed and why no one seems to think it is their responsibility to take care of it.  Women are dying every day in Nepal from preventable diseases and complications.

People told us we would leave Nepal with more questions than answers. I assumed that was research rhetoric, something that those who have done research tell us newbies just because. Turns out to be the truth. I am home now with so many more questions than I left with.  It is hard to fight the urge to book another ticket back just to try to get all these leftover questions answered. I know, however, that Nepal is a complex society and I am guessing I could go back 1,000 times and still come home with more questions left unanswered.

What we are hearing over and over again from people on the ground, and the government themselves is that the Nepalese government signs so many UN conventions but are not implementing them fully.  They are writing laws but not telling the public about their new rights.  We are hearing this at all the meetings in all issue areas.  Whether its women, human rights, education or health, there is zero commitment of this transitional government to basic of its people.

Civil society on the other hand is proving for the most part, at least in the Bara district to be very committed to getting people their needs met and communicating their rights to them.  The NGOs we met are working hard to empower women and children in the local communities through awareness, education, and rights programs and campaigns.  Each NGO we met in Bara spoke of its commitment to the government in one form or another but they expressed great difficulty due to the government’s lack of commitment on the ground to its people. NGOs are put in the position to uphold and advocate for the implementation of the UN conventions signed by the government but the government seems to have no interest in this.

Our first two days in Nepal have been filled with informative meetings with organizations, chaotic drives through town, and great opportunities to sit with amazing people and listen to their diverse stories.  Our first stop this morning was to the Women’s Rehabilitation Center (WOREC) which for me was an incredible experience.  The issues women face here are of great importance to me, and the focus of my research.  Yet trying to decipher what exactly the biggest challenge they face in today’s post-war society is a great challenge for me.  While I am sure there are many women in Nepal who feel their lives are great and they are very happy with their status and livelihood, there are many many obstacles standing in the way of women’s equality and empowerment overall. While I have read about much of what we heard today at WOREC prior to my arrival, listening to the women (and man) talk about the challenges facing women gave us all an even deeper understanding of just how little social status women have in the country. Health and reproductive issues, discrimination, rape and other violent acts toward women, inability to own and sell land, are just some major categories of challenges faced daily by women here.  One category that I hadn’t put a ton of thought into in my pre departure research, but really affected me today was caste.

We met with the National Dalit Commission today, a government mandated commission with very few teeth whose objective is to stand up for, and advance the rights of the Dalit community. I was really struck by the struggles faced by people due to the caste system, and the particular challenge added to the women.  For those of you who don’t know the Dalit caste is the lower ‘untouchable’ Caste.  I won’t go into much discussion about this issue just yet in this forum because I am really no expert on the subject. But what I want to leave you with tonight is the story of what happened when we left the Dalit Commission.

As we left we all stopped and took photos of the scene around us, and before we knew it many kids from the area were surrounding us taking our pictures and waving. As I got in the van I noticed my friends/colleagues Alex and Marina talking to a big group of kids. I got in our van not thinking much about it but after a few minutes decided maybe I’ll go see what they are doing and take a photo of the interaction. Marina, who is wonderful with kids, was practicing her Nepalese with the children. One very bright little girl who was born in the US but lives here was confirming whether or not Marina was correct in her word choice and pronunciation.  As I walked up to them Marina was introducing herself and where she was from.  This little girl confirmed that yes indeed Marina had introduced herself properly and said where she was from and followed up with the question in English to Marina “and what is your caste?”…..This question, right outside the Dalit Commission where we had an hour long meeting about caste discrimination was eye opening. The girl was no more than 12 and was blown away when Marina set off to explain she had no caste, that in America we are born equal…

For those of us who know little about Nepal, typically, Mount Everest is what first comes to mind when thinking of the small country.  Before I began really researching Nepal the only reference point I had of the country was the Everest. Now, as I learn more about Nepal and it its history, including its brutal 10 year conflict, I find myself eager to uncover what really lies beneath the snow capped Himalayas.

Maybe it is idealistic of me to say and think, but I do believe that in every country there is beauty around each corner, even during the most brutal of conflicts and worst of poverty.  The funny thing to me about beauty, however, is its ability to mask, or allow us to gloss over, what is really taking place in an area.  While I love to always seek out the beauty of every situation, person, or country, it is important for us to uncover the reality of where we are as well.  I know when we finally get to Nepal the beauty of the country will overwhelm me with, especially as someone who loves mountains as I do, but I wonder what not so beautiful sights lie ahead?

As I read various articles and watch powerful documentaries that begin to prepare me for what I will see and experience in the field, I can’t help but wonder if what I will feel in Nepal will be similar to the feeling of the end of winter, before spring fully blooms.  Anyone who has lived in an area where snow falls probably understands what I am talking about.  When the snow begins to melt and the beauty and mystique of winter begins to wither away exposing again the dirt, muddy pavement, and dead trees that slept covered up all winter under the snow.  It is an interesting time of year, a transition period for seasons; rather like Nepal’s current political state.  It is almost as if with the rise of conflict in the late 1990s into the 2000s the ‘snow’ melted away to reveal a darker, dreary, dirtier side of the country.  A side where human rights violations were being committed, poverty was being worsened from conflict, people were being killed around the country, and where a kingdom seemingly loved by its people usurped too much power for its own good.

I wonder though, is spring coming for Nepal? Yes, the conflict has been over for 5 or so years now, technically, but has life gotten better for its people? According to many readings I’ve done and documentaries I’ve seen there is still much work to do in rebuilding and restrengthening this country.  There are many roadblocks ahead for little Nepal.  In this period of preparation and anticipation for our trip, there is this burning curiosity rising within me to know what really lies beneath the snow  and what Nepal’s spring will look like…when it comes.