Nutrition Outreach in Village of Thakre, Dhading District

Hello readers, this is Bronwen posting on behalf of the NIC nursing students in Nepal, reporting on a nutrition outreach clinic we participated in this last May 14th and 15th. In cooperation with the nutrition rehabilitation home (NRH) in Baluwater, Kathmandu, this two day outreach was organized and executed. Six nursing students, one nursing instructor, two physicians, one dietitian, four nutrition centre coordinators, two Nepali nurses, two cooks, a bus driver, bus driver assistant, and 450 children were in attendance. Children were first registered, then height measurements were taken, followed by weight. Then a calculation was made to determine each child's nutritional status as a standard deviation from the median norm. Children then were seen by a physician, who would advise on health matters and prescribe medicines for any existing ailments. The majority of pharmaceuticals prescribed were brought along with the clinic and provided free of charge and with administrative advice from the Nepali nurses. Parents and children then attended a nutrition education seminar, which is intended to include information that demonstrates how to include complete nutrition with the foods that are available and affordable to villagers. They were then fed a meal and supplied with super flour, a fortified product, one kilogram per participant.
We started with a 2.5 bus ride out to the village, via winding narrow roads over mountainsides, which was breath-taking and exhilarating. When we arrived there were several villagers awaiting our arrival, some had walked great distances up and down mountainsides to attend, carrying children to boot. We took a short time to set up and then began the clinic. It was crowded and hot, and at times there was a significant push on the entry doors from less than patient would-be participants. Nepalis are not much for queuing.
Many of the children were malnourished, ranging from mild to moderate to severe. A significant portion of the children were afflicted with either an acute respiratory infection, acute gastroenteritis, or both together. At times the children were terrified of us, and at others just curious. The villagers provided us with meals and tea, which we were told had never happened for an NRH nutrition outreach before. This is of note as the special service was attributed to the presence of foreigners; us. This leaves an unsettled feeling of enjoying the efforts and intentions of the villagers mixed with discomfort at the thought that they would not otherwise have shown such hospitality. The efforts of the NRH staff are obviously well deserved of the efforts without the foreign presence. Something to think about.
The days were long, and we were exhausted at each end, but incredibly satisfied. Overnight, we drove another hour and a half again over semi treacherous roads to our accommodation, which had been given away to a busload of people who had arrived earlier than we had. Forty minutes later, we had accommodation, yes, but it was less than comfortable. With four to a room, two to a small, rock hard bed, we slept (if you could call it that), to the fine smell of cooking fuel from the kitchen below mixed with smokey incense.
After a 4:30 am wake up, we then half walked, half drove up to a lookout from Daman in the morning, from which the haze blocked us from seeing much at all. Another long day at the clinic, and we headed for home, with eleven children and their caregivers in tow, to attend the rehabilitation home in Kathmandu. Several children and one mother vomited with motion sickness on the twisting, winding bus ride on the way to Kathmandu, attributed to the smell of spilled kerosene and limited bus ride experience. Kudos to Jodi and Marie who sustained vomit soiling and nursed sick children the whole of the bus ride home.
When we arrived at NRH, late in the evening (about 8:30), all the parents and staff came out to greet the new arrivals and assist in unloading the bus. It was such a welcome sight, for us tired travelers, and I am sure, for the parents and children arriving in the dark at the strange new place. I must admit that I was overwhelmed with the smiles and welcome that our greeters provided. As I am placed with NRH for my practicum, I was familiar with them all, and was touched by the joyous atmosphere at our arrival.
I believe I can safely say that we all gained a great deal of knowledge and experience from this clinical experience that will have a profound impact on how we choose to practice as we go forth in our nursing careers.
Namaste, and best wishes, having a fantastic experience, Bronwen.