My second trip this year, as a GP volunteer, was to Manbu in the Gorkha area. The journey took two days. A ten hour drive up a very bumpy, mainly off road, track to the road head (made longer by getting stuck in deep mud and having to be towed out by a passing tractor!).
Then the next day a beautiful five hour uphill walk to the village with my two PHASE health care workers, Bharat and Pramila.
There was evidence of damage along the whole journey, in the form of landslides and damaged buildings, as this whole area had been at the epicenter of the earthquake. Blue tin roofs and tarpaulin littered the steeply terraced slopes, but there was also a lot of re-building taking place. The original health post in Manbu had been completely destroyed, but the villagers had generously built the health care workers a new tin house and this was to be my home for the next nine days.
It had the most wonderful views out to Mt Manaslu and Ganesh Himal, which constantly changed throughout the day as the sun passed over the valley. We soon got into the routine of day time clinics and evening tutorials. The nurses managed a wide range of health problems, including: accidents (one child fell out of a tree and badly sprained his ankle), skin problems, chest infections, gastro-enteritis…..much like a day in UK general practice. Pramila showed her expertise in fitting a contraceptive implant in one clinic, and it was obvious the family planning service is much valued at the health post.
On our home visiting day we went to check on a two month old baby that Pramila had delivered at home. The entire family was present, including the grand parents, and I spotted the grandmother shyly press a couple of small fruits into Pramila’s hand in gratitude for the safe delivery of her grandson. After checking the baby, who was clearly thriving, the grand mother handed me a sheaf of hospital notes and pointed to her husband sitting quietly beside her (Bharat translated it for me). He was 76 and had been a Gurkha in the Indian army. Recently however he had developed symptoms of heart failure and been seen at a Cardiology clinic in Kathmandu. There he had undergone investigation including a scan on his heart, which showed a dilated heart and poorly functioning valves. An unexpected teaching opportunity presented itself! He had a very loud systolic murmur which he was happy to share with us whilst we discussed the signs and symptoms of heart failure.
During my time in Manbu I was constantly struck by the resilience of these mountain people and the strength of their community. Already battling to survive in a harsh environment, they have had to re-build their homes since the earthquake, and due to little help from the government, many have chosen just to get on with this themselves. It was a privilege to have spent some time with these people, and encouraging to see how they have accepted the PHASE workers (working there also to help with infrastructure and livelihood projects as well as in health and education) into their community. I hope I can return in the future to see more progress in their lives.