With rain jackets, hats, umbrellas and walking sticks, we headed out early that morning for the village of Pandusen. The road was muddy, slippery and crowded. We were going against the "traffic" on the highway as people were bringing their cattle down to the river to graze, children were headed down to Kolti for school and elders were walking to Kolti to attend community and committee meetings.
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| Looking back down the "highway" from Kolti to Pandusen, the fog rises slowly through the valley. |
Once outside the village the highway narrowed to a three-foot wide path. The day was cool, with clearing skies. For the final 45 minutes we could see the village above us in the distance and the distinctly whitewashed CARE office. However, 30 minutes from the village the rain began again.
After we arrived at the CARE sub-office, I spoke with Suja Rai, a CARE community health worker. For the past 22 months, Suja had been the only health worker in the village. Though a government clinic operated nearby, chronic lack of funding and staff, as well as a very large area of villages to cover, meant that the people of Pandusen had had inconsistent access to health services.
One of Suja's tasks had been working with traditional birth attendants (TBAs) and improving the skills of female community health volunteers (FCHVs). TBAs are trained to give pregnant women advice on nutrition and hygiene, education on safe deliveries, as well as to help during delivery. There were now 13 TBAs in Pandusen.
Traditionally during childbirth in Nepal, women are isolated from the household, moving themselves to the cattle shed that is usually the first floor of the house. They are not to be touched, eat separately and, even after the baby is born, stay separated for up to 35 days. If there is a complication, a woman can ask for help but often it is too late.
There are about 100 pregnancies each year in Pandusen. The infant mortality rate is about 50 percent, meaning that in this one small village alone, 50 babies die each year. Since Suja started working, however, she has seen a gradual decrease in the mortality rate thanks largely to efforts by CARE and the Nepalese government. She and Govind recommended that I visit some of the women health workers in the lower caste village. The fog had lifted, so we gathered our umbrellas and headed out.
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| Community health volunteer Bhedi Kadari with her two sons, Lal Bahadur and Raj Kadara. |
Our first stop was at the home of 35-year-old Bhedi Kadari, a mother of three and a community health volunteer for six years. Her two younger children, both boys, 5-year-old Lal Bahadur and 19-month-old Raj Kadara, were sitting with her on the second floor porch. She greeted us warmly.
When Bhedi was a young girl she had been chosen to participate in a CARE education class, but she married and had to leave the class before learning how to read or write. She was proud that she had at least learned to write her name. Her husband, a small shopkeeper, helped her with the writing needed for her FCHV records. Six years ago, CARE had started a sanitation and kitchen gardening training program which she had joined; later she participated in a government training for FCHVs. Since then, she had received other gardening and sanitation training from CARE.
As an FCHV Bhedi had worked with her neighbors to encourage them to grow kitchen gardens of carrots, radishes, and broad leaf mustard. The Kolti farmer's cooperative provided the seeds. She also had organized a neighborhood clean-up campaign, tried to encourage latrine building and started mothers' groups. She pointed over her shoulder at the latrine she had built. She explained that it was very difficult to organize the women because most were illiterate and very poor. They were more consumed by the day-to-day difficulties of clothing and feeding their children.
Nevertheless, Bhedi felt optimistic. She still hoped to attend a literacy class and was very proud that her daughter was in the sixth grade and Lal had started first grade.
When the rain slowed to a drizzle, we started our descent. We made relatively good time and arrived back at Kolti mud-splattered and soaked. There was still some daylight and I was able to get a bucket bath with hot water before dinner. The clouds cleared and we could see stars.
Continue to Day 7