Rupendehi home visits

There were a lot of reasons to be stressed the day before heading out on my the first official home visits for my follow-up project.

I had only found out about visiting patients with Bimala, a community based rehab worker who was going to one of the regions I needed to visit, a week before. At that point, I met her briefly, before she headed out into the countryside for two weeks of visits. I got her phone number, and told her if I could get myself organized in time, I'd call her, and meet up with her along the way. Because of the last minuteness of it all, we had not had a chance to talk about what I needed her to do. In addition to helping me find the patients, I needed someone who would be able actually question the patients, as my Nepali is not up to that yet.

I had managed to get everything more or less organized in the week I had to prepare, although the the questionnaire was only translated the day before heading out. And when I went through a practice round with a patient that afternoon, it was very apparent that I could not be the questioner, there was too much I couldn't say and understand. I had connected with Bimala and arranged that I would meet her in Butwal, a city I had only passed through. So the plan was to take a local bus on my own, to meet a woman I'd only met once in a city I didn't know, and then visit patients and stay in rural homes, and do all of this in Nepali. Despite the good training with not having control of plans living in Nepal for 8 months, this was definitely way outside my comfort zone in terms of facing the unknown and unorganized, and I was really stressed.

When Sandra called me that night and told me she had found out about an INF vehicle going that way the next day, it was such a relief. I felt as if God knew that I was stretched just a bit too far, and gave me some sort of encouragement, living up to his promise that he won't give us more than we can bear. Finding out about the ride changed my perspective, and I felt like maybe I could face this adventure after all.

The next morning started well - I had breakfast at a fancy restaurant with another ex-pat taking the shuttle with me. Then off we went, in the brand new INF camps vehicle. That even had air conditioning! This came in handy when we encountered a landslide blocking the road, and we had to wait for it to be cleared. We were very glad to sit inside the air conditioned car while everyone else sweltered in the sun. And after an hour or so, we were on our way.

I met Bimala in Butwal as planned, though I had to wait a bit. I was a bit concerned I wouldn't recognize her, but since I stick out so much, I wasn't too worried about being found. We jumped onto a small vehicle packed with people, and headed 45 mins outside of town to her friend's house, where we were staying. Her friend was a community rehab worker, who lived there with her teenage son and some other family. The first night, I went to bed early. I was tired from the journey, but also a bit fed up with the TV channel surfing in three languages (English, Nepali and Hindi). The second night there was load shedding, and so no electricity. That night we sat on the roof (cooler than inside), and watched the stars and talked. Mostly I just watched the stars, though every now and again I had to answer questions from the son like 'do they have satellites in Canada too?' when we saw one pass over head. In my opinion, it was a much preferable way to spend the evening!

The terai is beautiful this time of year. Right now its flat fields are green with rice, and it reminded me of the prairies a bit, but with smaller fields and more trees. I was able to visit 3 patients, and my impression was that the terai is a much easier place to live if you're disabled in Nepal. Things are flat, so getting around it easier, and there's space. All of the patients had houses that were large enough for wheelchairs to be used in them, and only minimal changes needed to be done to them to make them accessible. Such a change from challenges presented by tiny houses perched on the sides of hills that I've seen in the countryside so far!

The first day on the field we met with two patients – one at home in a wheelchair, and the other came by a local office. He had quite a low level spinal injury, and was able to walk with a stick and ankle foot orthoses, and came on his bicycle. Both were doing quite well, which was encouraging. The second day, we set off to track down the third patient. We'd managed to speak to someone on the phone the day before who assured us that he lived nearby a certain village, and we set off on the bus. When we arrived, and asked about in the market, we kept being directed to an old man's house – not what we needed, as we knew the patient was in his early twenties. So we went to the community worker's house we had called yesterday. Ah yes, the daughter we had talked to yesterday thought we were asking about the old man with the same first and last name as our patient. But in fact the patient lived a 10 min drive away. The ever obliging Nepalis took Bimala and I on the back of a couple of motorbikes to his house, where we were able to do our interviews. He was much less independent than the others, despite good potential for rehabilitation. His family was really supportive, so he had a good life, and he seemed happy to let them look after him. It was a bit too bad, but perhaps in the future he'll see the need for more independence. We then waited for several hours for the bus to come to take us back. By the end of the day, we'd been going 14 hours, though at least a third of that was spent waiting for buses to come!

Travelling around by local buses is fun, though slow and crowded. Everyone was curious about me, and when they discovered I could speak Nepali, I usually got peppered with questions. After we get through the predictable, where are you from, how long are you here, are you married, and how can I get a visa to Canada questions, most people are satisfied. However, on one of the buses there were a couple of guys who were bored, and spoke some English, and in the two languages I answered their many questions. How expensive is it to live in Canada? How much does a litre of milk cost? (um...help me out here, folks who live in Canada, how much does a litre of milk cost these days?) And, the most unexpected: What's the population density of Canada? Ok, so not totally unexpected, because I like to explain to people that Canada is really big – the second largest country in the world – but with the same population as Nepal. Usually that leads to questions like: Why are there so few people living in Canada? not: What is the population density? But perhaps I should be more prepared...

So I got home four days later, having successfully visited the three patients I set out see, feeling much better about doing home visits in general, and very grateful to Bimala for taking such good care of my on this one. Since then, I've done a couple more visits in Pokhara, but none out in the countryside, as October is holiday month, and much of Nepal shuts down as result. I'll pick up the home visits again at the end of Nov, after trekking with my friends, and going to the INF conference in Kathmandu.