At Daybreak in Nepal

Looking north from Amp Pipal.

In the spring of 1988, I went to do voluntary work in Nepal – at that time, the third poorest country in the world outside Africa. I had been there as a medical student in 1976.

The United Mission to Nepal posted me to Amp Pipal in the Gorkha district where they had a hospital in the foothills of the Himalayas. It took four hours to walk up the steep hill to the hospital from the nearest rough road. There was no means of getting to the hospital except on foot – some patients walked for a day or two to come to the clinics. Even the diesel for the electricity generator and the Coca Cola in the little shop had to get there on the backs of the porters who earned about twenty rupees as a daily wage (equivalent to one pound Sterling).

There were four physicians from Europe and Canada working in the hospital – they would be my medical colleagues. Nepali nurses settled patients into the wards and gave them their medication, but it was family members who fed and washed them etc – these carers slept in the ward, on the floor under the patients’ beds.

From a British perspective, the people of Amp Pipal were desperately poor. Their survival each year depended on the success of the rice crop – without a good harvest, there would be hunger. Everyone – men, women, and children – had to play their part in the work on the land.

I had difficult lessons to learn about the impact their challenging life made on them.

One day, parents brought their two-year-old daughter to the hospital. She had been extensively burnt on her hands, arms and torso after falling into the open fire in the middle of the floor of their hut – the fire that was used for both cooking and warmth. When I examined her, it was obvious that she would need dressings on the burns and a series of small operations to prevent contraction of the scarring of her fingers – scarring that would make her hands into stiff claws.

I explained this to her parents. I told them that their daughter would survive and that I wanted to begin the surgical work as soon as possible. A Nepalese nurse was with me as I spoke to the parents so that I could be certain that they understood me.

The next morning, when I went to the ward, I discovered that the family had left the hospital at daybreak.

I asked the nurse what had happened.

‘They have gone,’ she said.

‘But without treatment at the hospital, the little girl will very likely die’, I replied.

‘It’s time now to plant rice,’ she said. ‘If they don’t plant rice, the whole family will die.’

I never saw the little girl again.

Photo: G Cooper. The hospital, Amp Pipal.