Nepal: The Project’s Future?

The intervention part of the program to create awareness of the need for better health measures to promote better outcomes for pregnant women in isolated and remote villages in Nepal has come to an end. The post intervention data has been collected and it is very pleasing to note that of the 1,656 people who responded to the original data collection, only 50 were not recorded in the post intervention data… they were away from their area at the time. This is an incredible response rate and their responses should give a true indication of the way the program was received by the people. Binod is now back in Newcastle, Australia looking at all his data… and that should be a very interesting read.

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But the other indication of success can be seen on the faces of women visited!

So, it seems, that a very good start has been made in working towards a change in these villages which, over the years, have experienced awful maternal mortality death rates.

But, now that the ‘entertainment’ of the singing and dancing and social interaction of the intense intervention program is over, will the momentum be continued ?

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Binod had prepared for this and, before the end of the program, 1,000 laminated posters were distributed to all of the houses to help the women, and their families,  remember the important steps to follow through the nine months of pregnancy. These are visual in content. They were highly prized and sought after by the families in the villages. Binod has translated them into English for us.

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Months one to four.

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Months five and six

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Month seven.

You may wonder about the comment regarding carrying the woman on a man’s back to get the health post. As there are only tracks, often difficult and slippery, a pregnant woman, especially if not well, would find it difficult to walk down the hills… and up again. You begin to understand the reasons why they often don’t go to the health posts and why more  local health posts are needed.

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Months eight and nine.

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And, if all goes well, a smiling Grandmother with her grandchild.

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And a smiling, healthy mother!

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And a healthy baby.

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So, for the long term hope of better maternal health care, these women need to work together to help each other, and their families; checking the banners that will hang in their houses; reminding each other of the messages in the words of the songs… and, hopefully, the songs will become a part of their village tradition.

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The older women have really embraced these messages, wishing Binod had come earlier when they were of child bearing age… they know only too well the consequences!

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And teachers, mostly men, need to keep reinforcing the messages with their students.

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This intervention is particularly important for the mothers of the future.

These teenage girls are taking intense interest in the messages.

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And so are these young fellows… the fathers of the future.

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Teenagers, like this young man, are the future of these villages.

We hope they remember these health messages and employ them throughout their lives.

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Maybe, by the time these little ones are grown up, the messages of today’s intervention songs will be deeply etched into the culture of their villages and society. Let’s hope so.

And that’s all for our WordPress for the time being. It’s time for us to prepare video presentations to share with others here in Australia and back in Nepal. The goal is to develop this intervention as a model for other isolated communities.

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On behalf of Annie, Roger, Binod and David (photo above), thank you to those who have joined them for the journey to these remote villages in Nepal on their important mission to help abate the maternal mortality rate. If you have enjoyed these armchair travel posts, please pass our site on to others. And for those just joining, there’s plenty to read and enjoy in past posts.

www.dymusings.com

I will add more of David’s Nepal photos to our flickr site as and when I have the time… so pop in there from time to time and enjoy.

More anon when David takes on another travel adventure!

Jennie (on behalf of David and Binod)

                       www.flickr.com/photos/jtdytravels

Binod will be updating his project site from time to time as well:

www.binodbindu.com.np

Our other armchair travel site is

www.jtdytravels.com

Nepal: Taking the Message to the People

From the twenty eight songs that were prepared by the various members of the local communities and schools, six songs were chosen to be performed for everyone. 

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This required hours of walking down and up mountain tracks so that no-one would miss out on the important messages embedded in the songs.

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Every small cluster of houses was visited…

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… every house…

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…even the most isolated of farms…

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… and in every school, across the two intervention districts.

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It was a huge undertaking… all of it on foot… often on slippery tracks.

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The team became something of a ‘wandering minstrel’ show!

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At times, they sang as they walked.

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They stopped to chat to women along the way.

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There were impromptu performances where ever they met with people. 

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Taking a break from working in the fields, these women listen to the messages.

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Taking it all in!

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At another impromptu gathering… the women joined in the dance.

These songs were for them… to improve maternal health.

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Importantly, men also stopped to listen.

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Older ladies wished this intervention had come in their child bearing years.

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There were gatherings in small hamlets.

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There were gatherings in every available gathering space.

This singing and dancing cultural intervention program became ‘owned’ by the community. With such involvement from everyone, it’s possible to expect some really good outcomes for improving maternal health in the area.

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There was intense interest from all ages and genders.

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And there was intense interest, especially, from the young ones. They are the ones who will take such cultural change forward. Hopefully, they will ensure that, in their lifetime, maternal mortality will decrease dramatically and no longer take such a terrible toll on the women and the babies of their remote, rural communities.

More anon

Jennie, David and Binod

More about this project can be found on:

www.binodbindu.com.np

All photographs © copyright DY of jtdytravels

If you are enjoying these posts please pass our site onto others.

www.dymusings.com

more of our travel stories and photos can be found on

www.jtdytravels.com

More of our travel photos are on

www.flickr.com/photos/jtdytravels

Nepal: Messages through Song and Dance

Singing and dancing are common features of everyday life in rural Nepal. The method of intervention for this project was to use that traditional way of passing on the mores of these rural villages. The local people of all ages prepared words about how to improve maternal health outcomes. These songs were to be sung to traditional tunes.

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With a goal of just six songs to be prepared by local primary school children, like these, it was exciting to witness whole communities become involved in the preparation of songs, with twenty six songs rather than just six.

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These were prepared by not just the young children, but also by adolescents, teachers, mothers, grandmothers, health workers and small family groups.

Here are some of the words that were prepared and sung:

“Let us ensure four check ups at the health post; First Natal visit in the fourth month, then on sixth, eighth and ninth month.

Let us feed the pregnant woman four times a day to save the lives of both mother and baby. Feed nutritious food at home. Fruits and meat are essential. Take iron tablets.

Care and support should be given by husband and mother-in-law.

Do not keep weight on your feet for a long time. Get rest by laying on the bed.

Do not let pregnant women engage in long and heavy work.

Inform health workers four weeks in advance. Arrange for money (to transport woman).

Let us make sure of a trained delivery.”

These are the translated words of just one of the songs.

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And all ages became involved in the presentation of the songs to their communities.

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The project became ‘owned’ by the community.

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With such involvement from everyone, it’s possible now to expect some really good outcomes for improving maternal health in the area. 

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It’s possible to hope that the current awful morbidity rate will be lowered and that many more mothers and their babies will live to be part of their communities.

Today’s photos were taken from David’s video of the project. We are currently involved in the process of preparing his videos for public presentations… and eventually to be shared with others on You Tube.

More anon

Jennie, David and Binod

www.binodbindu.com.np

If you are enjoying these posts please pass our site onto others.

www.dymusings.com

more of our travel stories and photos can be found on

www.jtdytravels.com

More of our travel photos are on

www.flickr.com/photos/jtdytravels

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Nepal: Why the Need for Better Maternal Health?

Many of you have followed the Nepal series of posts over the last month or so about David’s trip to some isolated rural mountain villages to assist Binod with his project to heighten awareness of the need for better maternal health. Some of you have asked what were the underlying reasons for taking on this project. In this next lot of posts, we’ll explore the answers to that and the outcomes we hope to achieve. I’ll add some of David’s photos from the villages as we go. Today’s photos are of some of the women and their children … some of the ones who are at the heart of this project in the villages.

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A healthy happy Australian mother and baby

In most communities, anywhere, the birth of a baby is held to be a precious event… a new life to be treasured… as it is in my own family (photo above). For those of us in our “developed western societies”, most births can be and are celebrated with anticipation and joy by parents, grandparents, friends and family. For most pregnancies, the new Mum will have had the knowledge and the opportunity to be cared for by professionals, before, during and after birth. Both mother and child have a good chance of going on to lead healthy lives. But this outcome is not the case for many women in the “less developed countries” of the world.

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In general, the health situation for the women of Nepal is poor with maternal mortality being amongst the highest in Asia and one of the worst ten recorded in the world. That’s beginning to be addressed in the large urban areas of Nepal such as Kathmandu but in the rural areas, maternal mortality is at least double the national rate in Nepal… and probably much more. Many maternal and baby deaths occur at home in the village and many of those deaths go unrecorded. The little one above is one of the lucky ones.

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In preparing for this project, Binod noted some of the factors that lead to this poor record of maternal and infant mortality, including; maternal age, birth spacing, malnutrition, poverty, lack of literacy and lack of knowledge about the reasons for problems associated with pregnancy. Health care and information are out of reach of most women in isolated rural areas.

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The aim of the project is to educate the whole community so that far fewer women and babies die in child birth and so that many more women can enjoy healthy children and have good health themselves.

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Most village women have little or no control over their pregnancy outcomes. In rural Nepal, when a woman marries she leaves her family and village to live with her husband and in-laws. And it’s the mothers-in-law who make the decisions about the daughter-in-law’s pregnancy related issues. So part of this project was to educate the older women of the need for better care and ways in which they could better help the younger women. Many of these older women really appreciated this intervention…and just wished it had come when they were younger and of child bearing age themselves. Many sad stories were told.

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Older women are being encouraged to enjoy becoming Grandmothers and to enjoy their grandchildren… and many, like this lady, do just that.

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A quizzical look from this little one… David would have been the first white person he had seen and the camera pointing his way was probably a new experience, too. And no, he hasn’t bumped his head… the red mark is the result of washed off traditional “tika”.

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Part of the intervention program was to encourage men to be more aware of the needs of a pregnant woman… and for fathers and grandfathers to take a pro active role to pay for the help needed by a pregnant woman and to take a role with the children as they grow. For, although the older women can play their part, it is the men who hold the purse strings and make the financial decisions. If a pregnant woman is not working in the fields or grinding flour etc, she’s not adding to the family coffers; going to have pre natal and ante natal care in the towns below costs both time and money; medical intervention costs money. So it’s important for all members of the family to have much greater knowledge and understanding of a pregnant woman’s needs.

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As you can see from this photo, the intervention was well received by all generations.

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So it is for women of child bearing age, like this one, that the project was begun… and it will continue by being a model of working with and for rural communities to provide much needed knowledge, to work towards changing unsupportive cultural practices and, in the long run, to provide better professional maternal care for women. That’s the dream!!!!!

More anon

David, Binod and Jennie

All photographs copyright © DY  of  jtdytravels

the project site is

www.binodbindu.com.np

If you enjoy these armchair travels, please pass our site onto others

www.dymusings.com

more of our travel stories and photos can be found on

www.jtdytravels.com

More of our travel photos are on

www.flickr.com/photos/jtdytravels

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Nepal: More Video of Village Life

Today let’s share another couple of Binod’s videos of village life in the remote rural region of the Ramja Deurali area of Nepal.

The first one shows Binod working with the men and trying his hand at ploughing with the buffaloes to prepare the rice paddies for the planting.

https://www.youtube.com/watch?v=cyoQaLfZ-DU

The second one is of the women milling the rice grains it in the traditional way.

https://www.youtube.com/watch?v=sdPEH1GYARk

More anon

David and Jennie

Video by Binod and the intervention team

www.binodbindu.com.np

Some of David’s Nepal photos and more of our travel photos are on

www.flickr.com/photos/jtdytravels

If you enjoy these armchair travels, please pass our site onto others

www.dymusings.com

more of our travel stories and photos can be found on

  www.jtdytravels.com

Nepal: Video of Day Eight of the Intervention Program

David is safely back in Australia from Nepal… tired but very happy that he was part of such an important program to raise awareness of the need for better maternal health in rural villages. We have just begun to sort his photos and video clips … as well as moving and preparing our old house for the spring sale market! So, because time for writing is a little short at the moment, we thought we’d add a video taken of the intervention group visiting isolated villages and farms to present their important messages in song and dance… even in the pouring rain!

More anon David and Jennie

Video by Binod and the intervention team

www.binodbindu.com.np

Some of David’s Nepal photos and more of our travel photos are on

www.flickr.com/photos/jtdytravels

If you enjoy these armchair travels, please pass our site onto others

www.dymusings.com

more of our travel stories and photos can be found on

  www.jtdytravels.com

 

Nepal: More photos from the Villages

As I prepare this post this morning, David is winging his way back home from his month helping his Nepalese friend (and PhD scholar at the University of Newcastle), Binod, with an awareness intervention program to improve maternal health in rural mountain villages in the area of Ramja Deurali and Chitre, north west of Pokhara in Nepal.

I know that David has fallen in love with Nepal and the Nepalese all over again… he worked in Nepal 37 years ago on a tree planting project. He’s sent some more photos of the people and the scenery that he will miss when he gets home to a very different scene in modern day Australia.

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Scenery on the walk to Chitre. David was particularly pleased to see the number of community planted trees. These assist with soil erosion around the terraced rice paddies as well providing a sustainable source of firewood as cooking is done on small wood burning stoves. (See video link at the end of this post)

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A smiling Hari on the stoney track on the way to Chitre School. Great gum boots!

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At the end of the intervention program, items bought for use in the program were handed on to local schools for their use. Here David hands over the printer to the Principal of Chitre School.

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Dandapani, who’s been part of the program, poses with David at a shawl embroiderers stall. I know that David will miss all of the team… they have all played such an important part in making the project such a success..
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And speaking of the team, here’s a happy snap of them “all tikad up”… David’s description! Front row, Binod and David with Roger (Binod’s UoN supervisor) and his wife Annie.

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A path can suddenly become steep, often slippery, steps in this part of the world.

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Walking these steep paths is part of everyday life for the locals. here a couple of young men carry ‘dokos’ full of cut herbage for tethered animals at home.

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Most of all, I think David will miss the interaction with these hard working women who were so very appreciative of the intervention program. Here, a group sits in their corn field watching an impromptu concert of songs and dances about the importance of their health.
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Older women like these commented often that they just wished that a program such as this had happened in their younger days. Too may women and their babies have died from lack of knowledge and assistance. But now they will help the young women of today… mother’s-in-law caring for daughters-in-law.

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And of course, he’ll miss the children like these… a serious sister, a smiling brother.

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And just as David will miss the people he lived with for a month, I’m sure those like his little shadow, Gani babu, will miss their experiences with a foreigner from Australia. I have a feeling that one day David will return to see how they are all getting on in life.

As David wings his way towards Australia, I’m sure he’s looking forward in many ways to being at home. And being one who loves to cook, he may well appreciate even more his modern cooking facilities. Let’s finish today with a video of Binod cooking his meal in the village in the traditional way on a small wood fired ‘stove’.

More anon   Jennie (for David)

All photographs copyright © DY  of  jtdytravels

The project site is

www.binodbindu.com.np

If you enjoy these armchair travels, please pass our site onto others

www.dymusings.com

More of David’s Nepal adventure photos are being added to our travel flickr site:

www.flickr.com/photos/jtdytravels

The project site will be updated by Binod

http://www.binodbindu.com

More of our travel stories and photos can be found on

www.jtdytravels.com