In the Trenches


This summer I’ve been spending a lot of time sitting at a computer, in our lovely bright office, which is definitely a first.  Last summer, for example I was hiking for 10-12 hours a day in the hot sun visiting earthquake-affected homes in Lamjung, and in general, my time in Nepal is spent covering ground, carrying things, and changing elevations.  Well finally, today was a more typical day in the trenches.

We had scheduled our advocacy meeting with the Health Post committee in Bharat Pokhari.  We’re holding these meetings to push for local funding like we did in Sarangkot.

I woke up at home in Kaskikot.  I had to meet Dilmaya at the bus station in Pokhara at 8:30am, and the local bus from Kaski leaves too late and goes too slow to get me there on time, so I’d cleverly arranged a ride with a neighbor in Kaski who drives a taxi.  However, the road between where he lives and our house is totally washed out with the monsoon, so I woke up at 6am – POINTS FOR ME, THAT’S THE MIDDLE OF THE NIGHT IN MY WORLD – and walked 20 minutes to the other side of the muddy section to meet him at 7:05.  Naturally, I discovered at this point that we were still waiting for another passenger, an ill lady slowly making her way to us.  While I got nervous and then annoyed that I’d be late, there wasn’t much to do.  This is why you don’t stay in your village instead of in Pokhara the night before catching an 8:30am bus for an important meeting.

Naturally, we made it to the bus station on time despite all signs to the contrary.  Dilmaya and I took 1.5 hr very, very bumpy ride out to Bharat Pokhari, cutting over some intervening foothills.

After another 20 minute walk up the road to the Health Post, and we had arrived by 10am for a 12:00 meeting.  No sweat – two walks and two vehicles later, all before breakfast.  Aamod came bouncing up the road on his motorbike and, with plenty of time to pass before the meeting, we went in to visit Bharat Pokhari’s weekly clinic.


Bharat Pokhari was handed over just this past spring, which means that its protocols are up to date, subject only to how well they’re being observed.  But funding wise, things are in limbo.  The clinical team has been showing up and working without pay, trusting that between us and their local government, someone is going to come through.  In all transparency, we signed a funding agreement with Bharat Pokhari before we launched the clinic, as we do everywhere.  But seeing these through is challenging in every single place, so realistically, we’re in basically in negotiation with Bharat Pokhari’s leaders about it anyway.

We’ve already met with both the Health Post Chairman, a young and ambitious Public Health graduate, and the Village Chairman, who is older and more traditional; these two hold the main influence, technically speaking, over how funds get budgeted.  We’ve briefed both of them extensively over coffee in Pokhara.  The Health Post Chair was very much down with the idea of piloting a new health service in Nepal’s rural system, and as a public health specialist was easily oriented to the larger vision about what this would mean; but, like many Health Post leaders, he’s an appointed transplant who will be moved to a new location within the year.  By contrast, the Village Chairman is very, very local, with social clout and a more complex set of competing interests.  Any meeting is functionally meaningless without both of them present.

At 12, nobody had arrived yet to meet us.  We used the time to mill about Bharat Pokhari’s Health Post, an impressive, hefty hospital-like building constructed with foreign funds, in which many rooms appear to be empty or minimally used.  At 1, we were still waiting in a spacious meeting room with one very talkative local leader who discussed with us, at length, how difficult it is to get everyone together for a meeting.  We agreed.

Around 1:30, this wonderful looking man came in, and it turns out that in addition to being on the Bharat Pokhari government committee, he is our dental technician’s 86 year old grandfather – a magnificently venerable age for these parts.

IMG_9013 (1)

1:45pm, we were still waiting for the Village Chairman, who, in theory, had called the meeting.  But then he had apparently been summoned urgently to the municipality in Pokhara.

By 2pm we decided to go for tea with anyone who would come with us, and there we finally got in to a vibrant conversation with some of the health post staff, local leaders, and passers-by about the permanence of the dental clinic.  It dawned on me as we talked “informally” over tea that we weren’t even ready for a meeting of 10 or 15 social leaders in Bharat Pokhari, and that in Sarankgot we were lucky with how quickly things got organized.  Here, we’re still lobbying individual people.  It was probably advantageous that we ended up in a public space, chatting in a tea shop with locals sitting around about how the village should be using its public funds.


Bharat Pokhari Health Post

We returned to the towering Health Post with our precarious baby clinic inside.  It sits across from a similarly built community center that the same international agency is building; when I asked for what, I was told, “community things.”  I sighed and, knowing it was a bit too simplistic – but nevertheless, true at this moment – said to Dilmaya, “It’s so easy to build something one time and go, isn’t it?”

By 3:15 we decided we had made the most of our day, and climbed on to bikes to head home: me with Aamod, and Dilmaya with the Health Post Chairman, because, we’re in Nepal.

At 3:30, as we were literally rolling down to the road, the Village Chairman showed up.

We got off the bikes.

All of the positive talk from our earlier coffee with the Village Chairman seemed to have dissipated. Tired, we began again at the beginning, making the same case we’d made just a week ago.  We’re realizing that’s just part of how it works.

Finally, around 4pm, Aamod and I left Bharat Pokhari on his motorbike, which is 9 years old and regularly stalls out.

“Should we take the short road?” he asked.  I know this is a trick question that translates to, “I am planning to take this steeper, bumpier short cut, and I am letting you know that we will not be going the other way, which is only for sissies.”

The bike stalls out.

“Well, why take the long road if there’s a short road?” I oblige. “I don’t really know any of these roads.”  Actually, those things are all true.

The bike starts.  We take the short road.

About ten jostling minutes down the short road, just as we are yelling loudly over the bike about how our day of meeting-hazing in Bharat Pokhari was a necessary step in which we feel we put the time to good use, a bike comes up in the other direction.

“The road is closed below!” says the Guy Going Up the Hill.

“What do you mean ‘closed?'” Aamod asks.

“No road,” the Guy Going Up the Hill explains.

I mentally sigh; now we will have to ride 10 minutes back up the bumpy short road, and then down the long road.  We still have a coffee scheduled at 5:30pm with the Village Chairman from Lwang Ghalel.

“I think we should see it,” Aamod says.  “I mean, how closed can it be? I came up this road this morning.”  I know this is a trick question that means, “I don’t want the road to be closed, so I’m going to ignore the obvious and keep going.”

“Well, if you came up the road this morning, what does ‘no road,’ really mean, anyway?” I oblige.

We pass another bike coming in the opposite direction.

“THERE’S NO ROAD BELOOOOOOOOOOOoooooooooooo…w!” he zooms by.

“Maybe there’s no road,” I suggest traitorously.

“Let’s just see,” Aamod replies.

We pull up to some construction workers – the ones turning around all the bikes.  Presumably the same people responsible for the missing road.

“No road below!” the construction workers inform us.

“None at all?” Aamod asks, because, we should be sure.  “Can a bike cross?”

“Absolutely nothing,” they confirm.  Finally.

“Let’s just have a look,” Aamod says.

“I think it’s going to be closed,” I confess.  “Maybe we should just turn around here, we’re wasting time.”

“How closed can it be?” Aamod asks.

So it takes us about 30 minutes to drop Aamod’s extremely heavy bike down this seven foot trench, maybe cut for concrete piping, roll it across the uneven loose dirt and rocks at the bottom, and get it back up the other side.  I now have a lot of dirt and exhaust up my nose.  But, we have won the road.

“That was definitely faster than going back up to the long road,” Aamod points out as we set off again.  I know this is code for “I never suggested we wouldn’t get drenched in sweat and that rolling this five ton bike out of a ditch wouldn’t be part of the process, and it was still worth it because we have won the road.”  He calculates the amount of time each stage of the going up would have wasted, and, indeed the total is longer than the half hour we have spent in the trench.

“Yes, that’s true,” I agree, mildly confused about my final evaluation of having won the road.  “It would have taken way too much time to go back up.”

“You know, the thing is in Bharat Pokhari,” Aamod shouts over the wind, “is that if they just give us a fixed challenge, we can solve it.  But if the challenge keeps changing, it’s gonna be really hard.”

He’s definitely right about that, and we discuss it as we zoom down the short road.  If there’s a real and defined obstacle to overcome to sustain our clinic, we can strategize through it, but if the landscape keeps changing and people aren’t really working with us, we’re pretty much doomed.

“What’s wrong with these people?”

“Yeah,” I shout over the wind.  Politics in Nepal is a whole special level of screwed up, I think.

“They just dig a trench across the road and leave it like that.  They at least need to lay a walkway across before they go.”

“Oh that,” I call out.  “I thought you meant—”

And then my sentence trails off.  The short road presents us with:

Trench Number Two

Trench Number Two

Now we’re between two trenches.

“Well, we have no choice but to cut across this one too,” Aamod states.

“That does seem to be the case,” I agree with happiness and enthusiasm.  It’s either this one, or the first one again.

A bike comes up the road on the other side of the trench and, peering over the opposite side, turns around in dismay. We, however, roll Aamod’s heavy bike in to the trench – for a second time – and lay stones, gun the motor, push the thing from behind, the hot exhaust huffing hot on to our ankles.  I eat a lot more dirt.  I am not very effective at this, so Aamod is doing most of the work, although I get exertion points for lifting a heavy bike at the wrong time and pushing it in the wrong direction, and also for laying stones behind a cloud of exhaust.  And then we are through.

We set off again.

“It’s cause you said that thing about the obstacles,” I offer.

“We should stop for a snack,” Aamod says.

As we finally get near town, we stop for pakora and knockoff Redbull.  We deserve it.  I rinse the dust out of my mouth and wash my arms and shins.  Our 5:30 meeting!  Aamod calls the Lwang Ghalel Chairman.

No answer.

It starts to rain.

We sit for forty five minutes, talking strategy, thinking about new clinic launches, considering how to adjust the initial setup and benchmarks along the way, based on what we’re rapidly learning now.  We still have three other post-handover sites and four mid-term sites to manage.

Aamod calls the Lwang Ghalel Chairman again.  No answer.

More rain.

“Can we call it a day?”

“He’s not coming.”  That was a day all right.

We get back on the bike.  It stalls out.  We restart it.  Aamod drops me off in Pokhara.

Good night.










Our Future After the Earthquake

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Dear friends and family,
First, thank you with all my heart for the flood of emails, texts, calls, posts, and chats that have blown up my phone and computer in the last 72 hours.  It’s true that the darkest moments show us the brightest things – the world has never felt smaller to me than it did this weekend, chatting with people I love in Nepal with one hand while answering emails about them with the other.  Everybody is okay, and I was/am in Connecticut for six weeks.  Everybody’s been sleeping outdoors for fear of aftershocks, one of our students lost his house, and there is some damage in our working areas–but we were mostly spared because the earthquake moved east.  Had it moved west, Pokhara and Kaskikot would be rubble, as we were just 50 miles from the epicenter.
Tons of people have asked how they can help.  After days of looking into this, it’s clear there are a million conflicting answers amid widespread caution; disasters of this nature cause huge sums of money to be suddenly poured in to a poor country with corrupt public systems and an overzealous, wealthy international aid machine. Terrible precedents in Haiti and other places, strong opinions that the punditry is already debating on the news….
We have to start someplace, so here’s the advice I’ve settled on.  There are two types of donating: a large relief agency, and something more closely related to your area of interest or personal connection to a place or organization. These roughly correlate to massive crisis relief vs. community recovery, as well.
1. MASSIVE AID: If you are most comfortable giving to a large, well-recognized agency, there are recommendations in the links below. The up side is these organizations play an essential role in crisis relief, and their financial pluses and minuses are known.  The down side is that they get saturated with more donations than they can spend on the specific crisis in question, and these agencies are not good mechanisms for long-term recovery.  That said, Nepal couldn’t possibly deal with the immediate disaster on its hands without their involvement, and the same will be true of the next disaster, if that’s where your dollar technically lands.  I’d also suggest the Nepal Red Cross Society as these funds will at least stay in Nepal ( – this link doesn’t work in Safari, that’s Nepal for you), or Doctors Without Borders ( in the hope they’ll be quicker to get out to neglected rural areas.
Top recommended by PRI:
2. COMMUNITY-BASED RECOVERY: It is going to take many years to rebuild, and smaller, local organizations with experience in grassroots organizing and sustainable community work will play an essential role because of their nuanced knowledge, experience, and granular infrastructure. The challenge here – and I will be the bad guy who says this now – is that nobody knows exactly what will be required of them yet. I’ve been in contact with many of my friends who have long standing connections and expertise in Nepal, and we’re all grappling with the same problem, trying to figure out where we can best apply our efforts.  But the truth is that everything is unknown.  It has only been three days and people are currently sleeping in the rain with dwindling food supplies.
Here is a short, poignant article that talks about how hard-to-reach areas have already been widely neglected by both aid and the media – because, well, they are harder to reach – but how badly they will be needed to avoid another Haiti fiasco. I wish this could be on the cover of every major newspaper.
Therefore after much deliberation, I’ve decided the best thing I can do is create a relief fund that will be used intelligently as things clarify. I will be arriving in Nepal in 2 weeks, and working with others to find something unreachable by “big aid” that needs doing and figure out who is the best person or agency to do it. I may donate this whole fund to a nimble community organization or individual doing critical work, or we may set up something ourselves. There may be a water source that needs repairing for a whole village, or a single family or child whose life has been forever altered where we can intervene with a surgery or other aid – I just don’t know yet.  But Pokhara is fifty miles from Gorkha, which looks like this:
Courtesy of the New York Times

Courtesy of the New York Times

As my friend Prashant said, “Laura, I can’t see with my fingers or eat with my knees.  We each have to do the thing we’re suited for.”  So in that vein, please don’t take this as pressure to contribute to Eva Nepal’s recovery fund specifically – the point is to choose something and pitch in.  Since I find myself among a tiny minority of Americans with a long-standing personal connection to this country and its people, that’s what I’m going to start with.  I simply know my area and its ecosystem better than I know other things about this colossal situation.
Here is the link. Please write RELIEF in the indicated space:, I would be extremely grateful if you would share this with people asking you where to donate.
If something else calls you, go for it.  The only real DONT’s are:
  • send stuff (google “send money not stuff”)
  • go running to Nepal (unless you have an expertise to offer – but I don’t think most of you were considering it?)
  • do nothing. The scale of devastation in Nepal is staggering. When I think about being in New Orleans eight months after Hurricane Katrina and the inside-out buildings that were still piled up on the streets, I can’t even fathom how Nepal with its underlying poverty and challenging terrain is going to rebuild without a lot of help.  Please pick something and pitch in.
I will leave you with a thought from the article I linked above, that helped me put the storm of the last few days in to perspective as they relate to me, one person with a tiny mud and stone home in Nepal that I love dearly.
Far away from Mt. Everest’s glamorous peak…villagers are reeling from injuries, death and the destruction of already precarious livelihoods on a massive scale. One villager told us that although his family and many others were unharmed, his home of mud and stone, like the entire village, was a pile of rubble. For many of the rural poor, a two-story home is a most prized asset. While their plight may not make the international headlines, rural Nepalis across the country will need long-term support to rebuild their lives. 
With much love and gratitude for all of your inquiries and prayers,
Laura and all of us.

Base Camp