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. 


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.


Every small cluster of houses was visited…


… every house…


…even the most isolated of farms…


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


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


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


At times, they sang as they walked.


They stopped to chat to women along the way.


There were impromptu performances where ever they met with people. 


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


Taking it all in!


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

These songs were for them… to improve maternal health.


Importantly, men also stopped to listen.


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


There were gatherings in small hamlets.


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.


There was intense interest from all ages and genders.


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

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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.


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.


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.


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


The project became ‘owned’ by the community.


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


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

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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.


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.


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.


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.


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.


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.


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


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”.


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.


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


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

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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.

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

More anon

David and Jennie

Video by Binod and the intervention team

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Nepal: Chitre; One of the Song Program Intervention Areas

While David was back in Pokhara, he was able to send through a couple of photos of his visit to the school at Chitre… the children there had taken part in the singing intervention program.

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As you can see from this Google images shot, the terrain between David and Binod’s ‘home base’ at Ranja Deurali (bottom centre) and Chitre (top right) is not an easy walk… and walk it was as there are no roads… unless of course you go right back down to the valley… and that’s a very rough, tortuous road anyway.  To show you the sort of walk, I’ll add one of Binod’s video You Tube links at the end of this post.

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Another closer up Google maps aerial shot shows the area of Chitre. People are scattered throughout the area. Binod took his intervention program to 49 ‘places’ in the area ranging from small settlements of 12 houses to isolated farms. In all he covered 390 homes and the program in Chitre area involved 1,042 people. (In the Ramja Deurali area, which has somewhat larger settlements of up to 25 houses, a total of 1,327 people from 421 houses were involved.) Every house received the visual poster of ways to improve maternal health and pregnancy and everyone had the opportunity to be involved… most were more than happy to do so.

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The above photo from the web looks into the Chitre valley.

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The school was built with the help of volunteers in 2013. Chitre is on one of the newer ‘treks’ in Nepal and has thus had some interest from visitors in the last few years. The school was solidly built and was not damaged in the earthquake. It’s a big asset to the children of the area.


Inside, the school is not quite what we are used to, but they do have a school… and how could you not fall instantly in love with these bright eyed children. There up to 35 children per class.


You may not instantly recognise the man handing out books and pens to some younger children…  It’s David dressed in his bespoke Nepali outfit! In Nepali, the white trousers are called ‘SURWA’, the top is a ‘DAURA’, and the long waist coat is an ‘ASKOT’. And, of course, there’s a hat to add to David’s men’s hat collection that adorns the lounge in our home.

One thing that we  try to do when visiting such countries, is to give books, pens and pencils to little schools like this… but we always buy them in country to add to the local economy.


And here’s David, dressed Nepali style, on the track to Chitre school (blue roof).

An earlier walk that Binod did from Ramja Deurali to Chitre as shown on the following You Tube site recorded a couple of months ago.

More anon

Jennie… David and Binod send their best wishes to all

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Nepal: In Pokhara

David’s time in Pokhara was mostly spent in trying to find a part for the computer. When that failed, he had to order a new computer to come from Kathmandu. In between times he made friends with some locals and had a massage. I’ll add excerpts from his emails and some photos.

” I’ve just arrived back to this view at the Adam Hotel (21.45) after a massage, and dinner at a local bar about a km away.  I had a chicken and mushroom burger with salad and fried potato chips, and an Everest beer… a bit of change from village Nepalese fare! My young waiter, who has been there each of the three times I’ve visited the place, was equally welcoming, and gave me a 10% discount… Perhaps my tips have more than compensated for the discount?!

When I left to walk back it was lightly sprinkling but not enough to bother putting the umbrella up.  There has been plenty of lightning and the occasional roll of thunder.  Perhaps it will develop during the coming hours?  It can do so, but I won’t know anything about it when I crash out for a much needed sleep.

I’m not game to put the kettle on as I may blow/trip the breaker again so I’m content with a ginger nut biscuit, or two, out of a cup which is sitting in a saucerful of water to keep the tiny ants that dart very quickly across the desk, at bay.


The view from my hotel room.


Greeted in the morning on my deck by another hotel guest!


A woman bringing wood across the lake.


A Pokhara fruit market.


Another view of the market.


Peeling a nashi pear with a hand scythe.


Belamcanda chinensis (Leopard flower)

After word that my new computer had arrived, Binod turned up at my hotel on his motor bike… so I can now add the experience of riding on his bike through Pokhara to my adventures.  He was very careful with me on the way to the computer shop. 

My new MacBook Air was awaiting pickup and setup which was actually very quick.  A problem arose when I wanted to pay for it by credit card.  We had to go to another shopfront because the repair place didn’t have credit card facilities.  Credit cards are just something that is not common in Nepal yet.  Nepalis still very sensibly save up for their purchases and pay cash for them in full.  Wouldn’t the West be in a much better place if we all did the same?  Living beyond our means, except perhaps for a car and house, causes the whole system angst!

I perhaps caused some of the problem because I didn’t want to exceed my daily limit so asked how much the amount was in AUD.  The daily exchange rate was the next problem to sort.  But, finally, everything worked out for the best, I had a new laptop, the store had my money.

Binod is selling his motor bike so a visit had to be made to that establishment.  This took longer than anticipated (things generally take longer than anticipated here), but with a little patience everything eventually gets done.

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After this it was off to Binod’s uncle’s house as it was yet another festival day.  There are more festivals in Nepal that there are days in a year.  Today’s festival falls on a full moon and is referred to as Janai Purima (Holy Thread Full Moon Festival).  Here, respect is paid to the elders of the house when a cord (made up of six strands) is placed over the left shoulder and under the right arm.  

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Also red and yellow threads are wound around the right wrist.  A tika of red coloured rice is also pressed onto the forehead.  I was not left out of this process as I was considered an honoured guest.  My torso now wears a Holy Thread.  When one of the threads breaks (naturally) the rest can be removed.  My right wrist now has threads from Bhutan, Java and Nepal.  I’m beginning to look like a Christmas tree.

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Food was the next necessity, and very mito (sweet) it was too.  Dal baht with all the usual trimmings of lentil soup, and vegetable tarkari, sweet yoghurt and more than sufficient whisky.  What a delight to meet Binod’s uncle and to be accepted in such esteem.

After all that we still had to travel for around 90 minutes to catch the jeep to go back up the hill to Ramja Deurali.  We were going to be late so Binod phoned ahead and had the jeep wait some 35 minutes past its normal departure time for us to arrive.  Such is the esteem and respect he holds in the area.  I didn’t feel quite so bad after waiting another 30 minutes just a couple of 100 metres from our starting point for some extra passengers.  It took us 2¾ for the ride to Ramja where we arrived at 17.00.  It hadn’t rained for a few days but there are still some tricky places for the jeep to negotiate.  I’ve had three different drivers on the various trips I’ve made but this one is particularly careful of his passengers and vehicle.  It makes the whole ordeal of getting to the village just slightly less of an ordeal! “

Safely back in Ranji, David and Binod send their best wishes to all of our readers

More anon.  Jennie

Al photos in this post are copyright to DY of jtdytravels

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Nepal: A Long Walk to Pokhara

Binod and David’s plan to revisit the villages to collect follow-up data for the maternal health awareness project came to an abrupt end when David’s not so young Apple Air computer finally decided that it didn’t have enough room for all of the video David had taken… and he had run out of external USB capability. An important part of the plan is to have an edited six minute video re the project completed before David leaves Nepal. Now… there’s no shop nearby to pop down to to buy some more external hard drive space. So…

What do you do when you have such an emergency with your computer? Hop in the car and pop down to the local computer store and buy more external hard drive space… or just use another computer that you happen to have in the house. Right?

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That’s the scenerio for most of us… but not quite the case if you are in a remote village in the mountains of Nepal. The nearest town to them is Pokhara… and that journey began with a THREE HOURS WALK from Ranja Deurali to the road head at Dimuwa.  It had been raining and the switch back type mountainous track was muddy and very slippery… and David had to carry not only the computer but also clothes for an over night stay because there was no way they would get back to the village that day. 

(David was able to send some photos of this remote area once he made it to Pokhara… I’ve added his comments.)


David: Nepali doing Harelo Puja (the Land God).  On this day all the planting has been completed so a puja (prayer) is sent to the Gods to appease for any wrongdoing or damage done to the land during the planting season. 


David: Dividing the goat meat up evenly between 10 families who are going to reap the benefits of the 12kg goat that had been slaughtered just minutes before.


David: An interested recipient watching carefully that everything was done correctly.


David: An equally interested recipient.


David:   Lasiandra sp.  I found this flower with accompanying beetle on the path down from our ‘home village’ of Ramja Deurali to Dimuwa.


David: Another little purple flower found growing on the side of the path.

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Finally, Dimuwa and the road head came into sight! (Image from the web)


David: The river near Dimuwa… we crossed this on a long suspension bridge.

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Dimuwa Temple (Image from the web)

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In the village of Dimuwa (Image from the web).

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The next part of the journey took an hour and a half from Dimuwa (near Tilahar) to Pokhara by road.


David: The view down the valley towards Pokhara… still about 45 minutes drive away.


David: A hairy caterpillar was on the path.  After taking the photo, I lifted it onto a plant at the side of the path… I wouldn’t want somebody slipping on the poor creature!


David: There’s one Roadhouse that Binod can’t pass without stopping for a meal. This is the kitchen. A little different from our kitchens at home!


David: The mortar and pestle that was used in preparing our meal.


David: The meal consisted of boiled rice, a bowl of lentil soup, wok cooked sarg (spinach) and a cucumber stew with spices.  The fresh cucumber refreshed the mouth after the meal.

At least, when they finally got to Pokhara, the internet was a bit better, so David was able to send me the above photos. I’m not sure of the order of the photos but they give us a small glimpse into David’s view of his time in Nepal from behind the lens of his camera.


Another plus in Pokhara for David…there was hot water and a western loo in David’s room at the Adam Hotel… but his computer frustrations were far from over as we will learn from his next email contact.

Jennie (for David and Binod)

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Nepal: Women’s Work! Millet cultivation in rural village

As I write this, David and Binod are still hiking from one village to another to participate in the singing competition to promote awareness for the need for improvement in women’s health in rural villages in Nepal. While they do that, I thought we’d take a look at the daily life of these rural women who are the focus of this program. They work very hard from dawn till well after dark to grow food in their subsistence way of life.

Binod has put a couple of videos on You tube that will help us to take a peep at their daily life. Today we’ll look at Millet cultivation. I’ve taken some photos from the video to help tell the story (video links below).

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Todo millet, or finger millet, is important here as it provides nourishing food to these subsistence farmers. It’s rich in protien, fiber and minerals and vitamins,  a good substitute for, and addition to, rice or wheat.

In a world desperate for good, healthy foods, most people have never heard of Kodo. It’s usually looked upon as a “poor man’s crop” or a “famine food.” In the ‘developed world’, it’s often used only as birdseed! But researchers are finding that it has many benefits for good health; it’s rich in iron, B vitamins and calcium and is naturally gluten-free. It’s a versatile addition to the diet with its mildly corn flavour. It has a light texture when cooked and is relatively quick-cooking because of the small size of the seed.

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The shallow root system of finger millet makes it ideal for intercropping between the corn plants. Here, Binod works alongside the women and gets a feel for the work involved in this backbreaking task that takes hours to complete.

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They take a well earned rest and drink.

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Kodo millet is a member of the paspalum family, Paspalum scrobiculatum. It’s an annual grass that has slender, light green leaves of 20 to 40 centimeters in length.

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When mature, the plant has an inflorescence that produces several racemes.

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The harvested seeds are very small and vary in colour from light brown to a dark grey. This ancient seed, originally hailing from Africa, is a staple in the diets of about a third of the world’s population. The seeds need to be ground into flour to be used in cooking.

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To see the grinding process, Binod heads in the pouring rain to a house in the village.

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Here, the lady uses a traditional hand grinding mill, or janto, to grind seeds into flour.

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Seeds are poured into the centre of the mill a handful at a time. It’s hard work.

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A little one takes a nap on Mum’s lap while she grinds the seeds.

A woman’s work in these rural villages is never done!

Binod’s videos bring this aspect of life for rural Nepalese women into focus for us. I hope that you can get these You Tube links to work for you.

Video links:

Participation in finger millet (Kodo) cultivation with community people – You Tube

Traditional hand mill (flour mill), (Janto) – the rural village women use this technology everyday – You Tube


More of rural Nepalese village life next time.

David (and Jennie)

All photographs and video copyright © Binod Bindu Sharma

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Nepal: Maternal Health Song Contest

David is now moving through several rural villages in Nepal to witness the singing competition program that University of Newcastle health researcher, Binod Sharma, has set up to try to improve community knowledge concerning the key health messages needed to improve maternal mortality in rural Nepal and to try to increase the number of women accessing health care prenatally and at the time of delivery.

Lack of awareness about the importance of antenatal care and skilled delivery is one of the principal causes of maternal death in rural Nepal. The deficiency of health care systems and an unsupportive sociocultural environment combine to create poor outcomes in maternal care for pregnant women in Nepal.

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Singing is a prominent feature of everyday rural life in Nepal. The aim of this program has been to engage each of the communities and especially the school students in developing health messages using traditional songs to transmit knowledge through the community and change attitudes surrounding pregnancy to improve maternal outcomes.

Importantly, this research will develop an awareness program owned by the community. We expect that this program will lead to improved community knowledge concerning the key health messages needed to improve maternal mortality in rural Nepal and increase the number of women accessing health care prenatally and at the time of delivery.

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The following photos have been taken from a video so are a little blurred but they will give you the essence of the thirteenth day of the singing intervention, a day enjoyed by David, Roger and Annie and the local people in the villages they visited. Of course, there was much hiking to do between villages, through the lovely but hilly countryside.

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A walk, not for the faint hearted… and where there is down, there is also up!!!!!

Screen Shot 2016-08-10 at 2.48.49 PMThis lady accompanied the visitors all day and danced to some of the songs. Note the young boys taking part in the background by clapping to the music. Hopefully these ‘motherhood’  messages in song will remain with these boys throughout their lives.

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Roger, Annie and Binod happily joined in the spirit of the dances.

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David had his turn, too!

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In another village, young girls danced for the women of the village.

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Annie really enjoyed her turn with the dancing at this village.

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Some of the men got into the spirit of the dance in this village.

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David’s camera was at work for most of the day, but we’ll have to wait for the outcome of that shoot. I’m sure it will be worth the wait!

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And then, of course, at the end of the day, there was that walk back to the ‘home ‘village.

The full video should be able to be viewed if you click on the following link.


I this doesn’t work for you, go to Binod’s website and click on ‘updates’… its the video for Day thirteen.

There will be more anon.

David (and Jennie)

All photographs copyright © Binod Bindu Sharma

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Nepal: #3 Introduction; Maternal Health Awareness Program

After his couple of days in KTM, David flew to Pokhara and then on to the small hill village of Ramja Derail, the red dot on the map, below.

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Pokhara is the second biggest city in Nepal and the village is a further 70 km away.

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This satellite map shows the tortuous road from Pokhara to Ramja Derail.

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Getting there is an adventure in itself!

David is travelling with Roger and Annie Smith from Newcastle… Roger is Binod’s main PhD supervisor.  They are all now safely in the village, but it’s not easy to get photos and information out of there right now. So, I’ll fill in for them today to explain a little more of the reason why David has taken on this adventure. A little background first….David and I are very involved in supporting and mentoring a group of early career medical researchers at Hunter Medical Research Institute and the University of Newcastle in Australia… And one of those researchers is a Nepalese, Binod Sharma.

Binod’s PhD goal is to explore whether tapping into the Napalese village culture of handing on messages through song line, through folk music and dance, can help create community awareness regarding maternal health and well being.  He hopes the outcome will be improved maternity health care and baby welfare in an area where safe pregnancies and good childbirth outcomes have been, to date, very poor. To promote his message, Binod set up an intervention singing and dancing competition.

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To begin with, Binod explained his proposal to the village people. Here he discusses the concept with village health workers.

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He took every opportunity to chat to people as he walked from village to village.

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In the beginning, Binod’s aim was to involve primary age children in preparing lyrics about the importance of motherhood, to traditional music and dance. This young performer is certainly enjoying her moment on ‘the stage’, the bare earth of a village cottage.  She’s cheered on by the village women. (Binod is on the left in the red jacket.)

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But it’s not just the children who are getting involved!

And the banner is bringing home the messages, too.

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Soon, villages were having concerts to show off their songs.

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What has eventuated is a wonderful embracing of the ideals of the competition with people from all parts of these isolated communities, women, men, adolescents and children all engaging in the project… and enjoying the experience.


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It isn’t a walk in the park getting from one village to another. The monsoon has washed out roads and trails and the effort of walking for hours is not for the faint hearted. This is a group of teachers from the high school who have volunteered to go from village to village and perform the best of the 28 competition songs that were produced.

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Binod negotiates a fast flowing stream on his way to one of the villages.

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The teacher’s choir sings their message on the banks of rice paddy. The fact that this choir is made up of male high schoolteachers lead by the school Principal is evidence of the way this intervention is seen as very important by all sections of the community.

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The singers and dancers on this occasion are taking a few minutes off from planting the rice… new plants used as ribbons to wave to the music. Binod gets into the action too.

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Binod takes every chance he can to be as involved as possible with the village people. He was born in this area, so this is the lifestyle of his family and ancestors. Learning to use a plough like this is a real balancing act… and a very muddy one!

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The outcome of the intervention so far has been much better than we could have ever hoped. On this occasion 450 people turned up for a concert of the songs… about 100 were expected. This was the biggest gathering in history for this area. So…an excellent start has been made and it is hoped that this community singing engagement develops into long term benefits for women, babies and maternal health in general. More anon.

Hopefully we’ll get some more input from Binod or David in the next couple of days.

David (and Jennie)

All photographs copyright ©  Binod Sharma

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