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By Andrew Schlabach

Created: 05 October 2023

Preus reaches down to pick up a piece of candy that he dropped with his left hand. Remarkable. 

I’ve never met Preus (pray-oos) before but I feel like I have. The COVID crisis taught us a lot about working remotely and through the miracle of Zoom, I had consulted with my team in Nepal about this boy many times. Preus, now 9 years old, was brought to our clinic by his mother in late 2020. The story she told us lacked critical details though we were able to deduce that Preus had suffered a brain injury. On further questioning we learned that Preus had been a normal little boy until about age five when he suddenly became ill with a very high fever which lasted several days. This fever could have been caused by COVID but it was more likely to have been caused by Typhoid (which is endemic in Nepal).

This morning Satyamohan (our senior clinician and clinic manager) and I decided to check in on Preus as he had not been back to the clinic for several months despite several calls to his mother asking for a follow-up. I never pass up a chance to visit patients at home if that is an option. It’s only about a 20 minute motorbike ride up the slippery, steep and rocky road just above our clinic but in some ways, it is a world away. Preus’ family are Tamang, a sub ethnic group found in the hill and mountain regions of Nepal. They maintain their own language, customs and rarely marry outside of their ethnic group. We arrive in the small Tamang settlement made up of about a dozen small, mud and stone, houses with corrugated metal roofs. Several children in dirty clothes gape open mouthed at me (a tall, white haired foreigner on a motorbike) bumping up the road to Preus’ house where we were greeted by his mother. She was just returning from the market, walking down the steep hill above their house wearing flip-flops and carrying a recycled 2-liter bottle of a milky liquid. Chaang is a home-made beer made from rice and other grains. A staple food of hill farmers, its low alcohol content keeps it from growing bacteria while being calorie rich to provide energy throughout the day. 

Read more: Like a Miracle

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By Kara Saltz

Created: 29 June 2023

Our patients loved soaking up the rays with treatments on sunny days.

I cannot imagine having started my career as an acupuncturist in any way other than climbing on a plane and venturing to volunteer in Nepal. My time at the Bajrabarahi clinic was full of unexpected friends, learning a lot about myself, and deepening my relationship to my practice. It had been a difficult decision to leave my partner, pets, and friends, to put off my new job for 2 months, to do something so outside of my comfort zone. But I’d been dreaming of this for 4 years, it felt like something I had to experience, to do. I had traveled alone plenty, but never outside of North America. Now I was venturing into a culture so different from my own and practicing a medicine new to me, in a language I didn’t know. It was daunting. The responsibility of being a primary care physician felt heavy. When I left, I was giddy, unsure of myself, and just curious enough to do it anyways.

Arriving in Kathmandu was full of pure joy to explore a new place. I was driven to learn as much Nepali as possible so I could learn more about the people I met along the way! The trip to the clinic was gorgeous and full of anticipation. What was this clinic in rural Nepal going to be like? Was I going to be able to help in a meaningful way? Would I be able to keep up with the clinic flow? The short answer was yes. Everyone at ARP made this whole experience so smooth and comfortable. Sushila, Satya, Sanita, and Bex were so helpful and willing to discuss cases. They taught me a lot along the way, like how to take blood sugar. And they offered advice on things like where to refer out and what options were available for one of our patients who was at risk for DVT (deep vein thrombosis).

Read more: Beautiful Beginnings

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By Andrew Schlabach

Created: 03 January 2023

Our patient sits on a mat that is hand-woven with rice stalks, separating her from the cold stone floor. It’s early and our clinic hasn’t opened yet but this woman’s family called us to come have a look at her. It’s brisk and my fingertips sting and yet the morning sun is doing its best to cut through the frost. The house is made of concrete and clay bricks. It’s unpainted and is adorned with a simple corrugated metal roof. By the looks of it, 8-10 family members live here and they are all gathered around the small outdoor courtyard where the family does its daily chores. A couple of goats, staked in a pen, happily munching on some dried grasses are apparently oblivious to the small crowd of people. Chakkhu Maya Gopali, our patient, appears to be in her seventies. She is barefoot but dressed in a winter-weight kurta made of a bright red, black, and yellow fabric. Around her head and shoulders, she is wrapped in a thick wool shawl. Even before she says “jhumjhum”, meaning tingling, I can see by the way she is sitting that she is having a stroke. I’ve seen this same scene many times.

Read more: The Ripple Becomes a Wave