Dispatch, May 2007:

Hi Everyone,  April 20 to 28 we held  workshop/focus groups (each two days duration) in four central locations in Dhading District.  This was the launch of our medical services project in the Maidee area for which MMC provided 'start-up' funds.  The workshops were well attended.  Invitations went out to community leaders, school health teachers, community health workers and representatives of local mother's groups (women's cooperatives).  It was a very intensive 9 days for all the Presenters....one of whom ended up with laryngitis!  It was exciting to see interest and enthusiasm grow as the meetings progressed.  We started out with 7 women and 24 men on Day 1...on the final day at our last stop, there were more than 70 participants with two thirds of the total women.  I have attached a copy of the Agenda for the program (the English version).  Part of the first day's proceedings at each location, we divided the participants into 4 focus groups with the assignment to discuss the programs objectives vs their community's needs to ensure they addressed the priorities as they perceived them.  There was excellent participation from everyone, including the women (which is not always the case in Nepal).  We then had an open discussion with all participants to select priority needs in their area and to identify the issues where they, themselves, had the power and ability to make changes,  In two places, we actually went out together and worked on a problem that could be solved quickly.  At another village, when we visited the local Health Post and found the Dressing/Wound Care area in appalling condition - Health Post staff, at their own volition, organized a workparty to clean it up and proudly showed us the results before we moved on to the next stop.  (There were lots of excuses at first as to why the room was in the condition it was....but later they gave us a personal commitment to take the responsibility to see that it was properly maintained in the future.)  During the workshop discussions we often came back to the focus of "personal" responsibility to keep ourselves healthy and the basic ways that we could do that.

Total expenses to date have been approximately Cdn $ 3213.  This includes transportation, materials, food, Honorariums to local Presentors, accomodation, etc.  I'll give you a detailed list when I get home.  It was necessary to plan the program working with local people to take part in the presentations since very few people in these villages speak any English.  For my part, I worked with a Translator as my Nepali language is inadequate to teach at this level.

The next step has already started.  We have committed to provide some additional training to local Community Health Workers, Teachers and Mother's Groups to equip them to take the "message" to families in their villages.  We are working on the curriculum now that will be an expansionon of the Day 2 Workshop program - plus some basic first aid.  The network of Female Community Health Volunteers - are very committed individuals - but sadly in need of even a basic first aid kit and materials for hygenic/safe delivery of infants (known locally as "Safe Motherhood Kits".  They are already doing some Family Planning Instruction with some illustrated flip charts produced by UNICEF and GTZ (a German INGO).  From available statistics it seems that less than 30% of women in these target villages are literate.....an additional challenge when it comes to developing an effective program. 

Health Posts in this area are few and far between.  One in each Village Development Committee (VDC) area.  Each VDC covers a geographical area of 9 Wards - and many small villages.  The poorest villages, interestingly, are usually at the bottom of deep valleys - near the river.  The Health Post are always in the village designated as the VDC Headquarters....and it is always at the top of what is usually the highest ridge in the area.  This means that women in the 'Dallit" villages - where the most deprived families live and where the birthrate is the highest...often get the least care for their pregnancy and delivery.  It simply becomes impossible for them to get the necessary care at the latest stages of their pregnancy and impossible to have trained help at the time of delivery when complications occur.  (The hillsides in these valleys are extremely steep and the elevation change can be 500m or more to the ridge tops)

There are many opportunities to make a difference in these villages - obviously for some solutions money is needed; however, there are also many things that the people can be taught that will enable them to help themselves.  Would love to have an MMC project team in here!  What could be done, as always, is only limited by resources (human and financial) that are available.

You'll hear more about this later. Sending a few photos in a separate message.  Best Regards to all.  Elsie