Gaurab the Bear

Recently, Bethy was in Thailand and discovered that someone there has been making teddy bears with a full set of teeth.

In my life, this is a very interesting and exciting finding.

Bethy decided to order some teddy bears with teeth for health centers in Cambodia that are running an early childhood hood oral health program, and I figured I would bring a teddy bear over to Nepal. It was fairly simple. In brainstorming the idea, we got to thinking about the enormous contribution that Jevaia’s Education Field Officer Gaurab has made in our organization, beginning long before we had a name. Gaurab was our first Clinic Assistant in our first clinic in Kaskikot. He volunteered for years as a teenager in school seminars, teaching kids about about oral health. He became one of our field officers in 2015 and has walked literally countless miles, up and down hills, in the rain, after dark, and in just about every crazy situation possible to promote oral health in schools in Nepal.

We decided our first teddy bear with teeth should obviously be named Gaurab.

When I arrived recently in Cambodia, Gaurab the Bear had completed the first leg of his journey, from Thailand to Cambodia. He came with frens.

We were so excited to meet him!

We hung out in Cambodia for a while, and then Gaurab’s frens said goodbye

And we left for the airport.

We took a tuk tuk.

Gaurab seemed to like the airport

and he really blended in with all the other travelers.

Especially while waiting for his flight.

He settled in, clutching his ticket to Kathmandu

And we enjoyed perusing very expensive jewelry that isn’t really less expensive even though it’s Duty Free, in Kuala Lumpur.

Honestly we were pretty tired by the time we finally arrived in Kathmandu and Gaurab tried to be patient with the visa process but he was ready for a nap.

The next day, refreshed for our flight to Pokhara, we made some NEW Frens in the airport!

You can imagine Gaurab’s anticipation on the flight west…

And finally, upon arrival we were greeted by some real big fans.

Finally, after meeting the rest of the team, Muna and Rajendra,

 

 

 

 

 

 

 

Gaurab was united in the office with Gaurab!

Welcome to Nepal Gaurab!!

Education

Where droplets of water leak through the tin roof
Into the cooking fire
What is an education?
Page after page after page after
She can’t read
Pages.
She can read the weather
She can read the seeds
She can read the incense spiraling up over the roof into the sky to Heaven
I have a book.
I leave it at home and follow her
In my flip flops
Flop after flop after flop after flop down
The stone path to the fields of buried seeds.
We planted the corn
We tilled the corn
The hail is ruining it now
And droplets are leaking through the roof in to the cooking fire
Just one at a time
Plop after plop after plop.
She collects water in tin jugs
For drinking and cooking
From over there, near Bauta dai’s house.
I imagined this place once
When I read about it in a book
My education began when I began
Tearing the pages from the spine
Page after page after page after
LISTEN.
What is this world anyway?
An education.
Pick up your pen again
And again and again and again and again
You must send something
A gift to the future
That somebody can rip in to beautiful pieces
And put in the fire
Where the smoke seeps
Up under a gap in the roof up into the sky up to Heaven
And comes down again
As drop after drop after drop after drop
Of rain.

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Over the Mountain and Up to the Clinic

 

Yesterday morning all 30 of us piled in to a bus to head out to our first day of screening in Puranchaur. I kept being worried that someone on our field staff would bail out, get a flat tire, have a sick buffalo, or need to attend a last-minute puja at an uncle’s house. But everyone made it on to the bus. And it took very little time before bus songs began, complete with Live Traditional Dance By Dental Technician.

Thank goodness I have 12 years of Race to the Rock under my belt. I knew to have a map of our planned camp flow, and I hoped that, as we’d been assured, the needed chairs and tables were already at the Health Post waiting for us. I’d printed out this camp-layout-2high-tech map for everyone in their welcome packets, and I brought an extra copy of the map with me since I knew most people would leave their welcome packets at the hotel, and this series of actions allowed me to answer most questions in either language from any one of 30+ people with: “Ah. Have a look at the map! Oh that’s okay. I put a copy of the map over there. It will answer all your questions.” Tricky, right?

We are aiming to have 300 mother/child pairs for Madhurima to screen in the next three days. That is a lot of people to mobilize in a rural area where people are busy cutting firewood during this season, and especially when you consider Puranchaur already has weekly dental services available, plus we’ve done outreach in schools already. We’re hoping that will work to our advantage, and that the teachers assigned in each school to run the brushing programs will bring students and mothers. But it’s also exam time, so we knew things would be slow till mid-morning. Once everything was set up, there was that familiar lull…would anything happen?

…Anything?

Then suddenly we looked out and saw this line of primary school kids in their uniforms winding our way over the hills towards us. If this isn’t the cutest thing you’ve seen related to dental care outreach programs in mountainous regions, you have no heart.

I want to explain how we organized this project using a human-rights design, because it seems obvious, but actually, a lot of these details are rarely prioritized. What we care about with JOHC is the development of dignified, sustainable, high-quality health care for rural Nepali people. It was important to me to set up this collaboration in a way that promoted the development of local services, which meant not only studying interventions or issues in the abstract, or providing a transient benefit to participants in a study, but building the manifest capacity of local providers and institutions.

Fortunately, although JOHC is small it is mighty, because we have those providers and are already working with all the schools, the local government, and the local img_4484Health Post in Puranchaur. The involvement of our team leaders and clinic staff in this project was a great development opportunity for them – and therefore the communities they work in – and as long as consciously nurture it, that benefit occurs regardless of the outcome of the research.

We were also able to set up this collaboration as an opportunity to strengthen and test our community relationships. Our preparation involved a great deal of mobilization, largely done by our team leader in Puranchaur, who is himself a local resident. We’ll still be in Puranchaur when the week is over, so we’re accountable and vulnerable to the way in which the program impacts the community and its power structures. Which is as it should be. In short, the project is about Puranchaur and the other villages where our teams work, not about us, and that’s what I care about.

Of course, we still had our breaths held all morning. We had kids, but would we get mothers? But as the day went on, the pace picked up. Things got so packed in the clinic upstairs, where our technicians were providing their usual treatments plus the new fluoride and silver fluoride treatments, that by the second day, we needed to move to a large training hall. On the second day, as word got out, we got even more people – about 140. Bethy and Keri were able to provide intensive oversight to our technicians as they worked; our team leaders were collaborating with the UCal students to conduct surveys, help with dental exams, and provide the same oral health and brushing instruction they do already in their home villages. On the ride home that evening, our team leader Kasev, who had been conducting interviews with mothers, said that many participants referenced the school brushing programs when talking about their health practices.  It was as awesome a day as we’d have dared to hope for.

Tomorrow we are off to Hansapur, a non-working area where we had to apply our best strategies to get the word out.  It’s a great chance to get some anecdotal evaluation of differences between an area where we work, and one where we haven’t yet.  Let’s hope we get as good a response as we did today!

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Gaky’s Light Family

 

This may come as a surprise…but in addition to our adventures in bamboo shelters, Eva Nepal still has it’s regular programs going. This week our Gaky’s Light Fellows graduated from 12th grade and from their fellowship.

Two years ago, we received 415 applications for the 12 fellowships that we awarded to Nirajan, Anju, Pabitra, Puja, Sandip, Ramesh, Orientation (4)Bhagwan, Krishma, Shristhi, Sabina, Narayan, and Asmita. Each of them has an incredible life story, and within the next few weeks, I hope we will be posting a tumblr that profiles each of them as well as the eighteen GL fellows before them.

The class of 2015 had a special bond, because it was when they arrived that we established the GL community house.  This batch as lived there together and become a true family, and bonded with a handful of wonderful foreign teaching residents who lived with them – Noam and John, Mary, MJ. While most of our past fellows came from Pokhara, this class comes from all over the country. Anju is the first young woman to leave her very conservative community in Janakpur to study higher education in a city sixteen hours away. Nirajan’s home is in remote Dolpa, and he’d been living on his own in Pokhara since he was twelve, performing at the top of his class. Each of our kids’ stories is unique and beautiful. You couldn’t dream them up.

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These young adults have changed tremendously since they first came together in 2013. At the beginning, basic life skills like arranging a cooking schedule and working out group living issues IMG_7108were new and difficult. Their behavior was segregated heavily by gender. I’ve watched their dress and their mannerisms become urban, confident, progressive. In their weekly Saturday workshops they’ve learned how to use a computer, spell check, do interviews, plan events, speak in front of a group. We’ve taught sections on body language and online image crafting. A number of our fellows have published articles in youth journalism international, including reporting on the morning of the earthquake and on the aftermath shortly thereafter. Last summer, they all did one-month professional internships in sectors ranging from software engineering to child welfare to public health and journalism. Four of them did their internships in Kathmandu.

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But I think the thing that had the most significant and lasting impact was the one where we did the least work: the community house. Each birthday was a whole-house affair. The girls wear each other’s clothes. All of the boys staying in Pokhara are moving in together, except for one who got a job in a nearby youth hostel. The peer community they’ve gained from this transformational two years together is obviously going to be a part of their lives forever.

With this graduating class, we’re bringing Gaky’s Light to an end, IMG_0021at least for now, so that we can focus on dental care, which is our more scalable program. But boy am I going to miss these kids. I am so proud of them. I am going to miss our sleepovers and henna parties. I’m going to miss eating breakfast in Connecticut over chat with them while they eat dinner in Pokhara. At least I know they will be keeping my social media pages full of news (work that online image crafting, kiddoes) and keeping in touch with each other.

GL alumni speaker Kiran Banstola

Their graduation featured lots of speakers: male, female, alumni, parent, me, and our featured speaker, Ramesh Khadka from Right 4 Children, who told his unbelievable life story of growing up on the streets of Kathmandu for ten years and then becoming a very successful social worker with street children.

Instead of going for a day-long celebratory outing like last year, we decided to spend the afternoon at a refugee camp in Pokhara that is housing earthquake victims from the ravaged epicenter in western Gorkha. Our fellows bought and served afternoon snacks.  The Gurung areas of Gorkha have a unique culture, language, and dress. Many of the older people don’t speak Nepali. There were some stunning faces in the crowd. I let the kids and counselors use my camera – I didn’t take all these photos.

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But I did take this one below, one of my all time favs. The woman in the white shirt kept laughing every time I tried to shout 1-2-3 in their Gurung dialect. Watching her through the viewfinder made me start laughing too. That of course made her laugh harder, which made me laugh harder, and soon this entire group of people couldn’t stop laughing. I love this picture.

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And this one…

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Possibility of Tin

 

The first part of the group left for Archalbot on Thursday: Robin and Colin, the French volunteers, and our field officer Dilmaya. I came a day later because I was working on IMG_9463getting our new office set up. Actually I was busy repainting it with the wrong type of paint, so before I left for Archalbot on Friday, I had to call a painter to redo my redo.

On Friday I rode out to Bote Orar, where the road to Archalbot turns off the main highway between Dhumre and Besisahar. When I arrived at about 5pm, the earth bag house already had a one-meter deep rectangular foundation.  Not bad for one day’s work.

As dusk fell, Dilmaya and I accompanied some of the young men to a clearing on the edge of a terraced field for a community meeting. We sat across from the tarp-shelter in the field.

We’d explained the plan to our local organizers, Kripa and his cousin Surya: anyone who builds a shelter gets a tin roof from us; the earth bag house is a sample building style and we can provide materials if anyone else wants to do it; the family in the field will be a sample building project where the community works together build a bamboo house in a day. Kripa and Surya were getting a lot of questions about who would get tin for what, and they wanted to gather their neighbors and discuss this plan in front of us, to protect themselves from future accusations of greed or favoritism.

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With night falling around us, the discussion that unfolded was amazing. It basically boiled down to: “This organization is here to give us tin roofs for completed shelters. How are we going to help each other complete shelters?” They discussed the order of priority in the village – everybody agreed that the tarp family in the field was the top priority – and other matters such as where and how to get enough bamboo. Even the tarp family made their way over to the meeting, but they seemed guarded, unsure whether to believe us and everybody else. It was their neighbors who explained the plan and assured them they needed to start collecting bamboo.

People kept turning to us and saying, “How many houses are you going to build? Tell us and we’ll figure out who should get them.” And Dilmaya and I kept saying, “You tell us how many houses you’re going to build, and we’ll bring one bundle of tin per family. If we have the problem of too many people building, we’ll deal with it later. That’s never happened.”

Dilmaya did a great job of continually redirecting the discussion back to that point, that everything depended on their planning, and we’re there to meet them wherever they can get to. One guy asked if large families would be able to get more than one bundle of tin. We replied that’s not up to us; our allotment is one bundle of tin per family, and people can add more area with re-used tin or natural materials. “On the other hand,” we said, “as a community, if you guys tell us that a certain household really needs more tin than that, we’ll believe you.”  Because nobody’s going to be the jerk who tries to make off with unneeded extra tin under the scrutiny of the entire village.

There are still many of steps between this meeting and a rebuilt bamboo village in time for monsoon. But I’ve been doing community work in rural Nepal for nearly a decade, and this was as good as it gets at this stage. What you hope is that your attention will mobilize existing capacity and snowball in to a collaboration that combines the best of what we have with the best of what local people have. When we can frame our “aid” as an incentive, even though we want to give it away, people start to ask each other, How are we as a community going to capture the possibility of tin?  Our responsibility is to maintain a consistent and intelligent presence, to keep redirecting ownership back to the community, to closely monitor to make sure nobody’s taking advantage, and to live up to our word. We bring in a small quantity of crucial expertise in building, plus the final critical hardware: a new roof.

There’s also the simple value of spending time with people.  When we arrived, the corn field that needed to be cut down to make the earth bag house was still standing, and the family slashed it in half an hour–but IMG_9492they weren’t going to do that until they saw us standing there for real.  Kushal, the twelve year old boy we met during our assessment, called me almost every morning between Monday and Thursday, and he never had anything to say. He just wanted to see if I’d pick up.  Millions of rural poor go unseen by the world unless they are in the midst of a thrilling crisis that offers the chance for airdrops, mass collection of first aid materials, teeth-clenching field medicine, and smoky photos of catastrophe. But the persistent plight of invisibility and systemic disenfranchisement is too complicated and time consuming for most of the world to attend to by looking people in the eye.  It’s not the habit of our global society, of our governments or social organizations, to sit down in a clearing and say, “We’ll stay here and work on this with you. What do you think?”

I understand why large aid agencies can’t work like this. It’s not their job. They have the budget and infrastructure to strategize to best possible average and cast a wide net; their purpose is to get to the highest number of people, not to reduce the amount of waste or increase the amount of human connection. And Nepal needs them.  An organization like ours could never hope to reach any reasonable fraction of those in urgent need using our approach. But I’m reminded how much groups like us matter, even in the face of a gigantic task like building half a million houses in a few weeks. Because the best possible average still leaves out a lot of people, and for each one of those people, their house is 100% of the problem.

This strategy doesn’t always work, and I don’t know how things will turn out in Archalbot, although I admit I have a good feeling about it. But the hardest part is that you have to be willing to walk away if the community can’t carry its weight, and that’s devastating when it happens, because you and your team have put your heart in to it. You sit in the grass with people while they work things out. You tell them you are there for them and that you respect the wisdom they bring to the process as well as the result. When it falls through, it doesn’t just hurt your budget, it hurts your sense of hope and capability. It’s not something you write up in a report and send up the chain to management. You just go home and cry.

But what am I talking about?  Here’s to you, Archalbot.  We’ll stick it out for better or worse.  Show us how it’s done.

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Dental Care Anyway

IMG_4898I’ve been in Pokhara for about five days now. All the usual activities – Saturday workshop with our Gaky’s Light Fellows and Asmita’s 18th birthday party at the community house, where I continued practicing my henna tattooing skills on all the girls…

Last week Kaski Oral Health completed this year’s teacher trainings in each of the three villages that launched over the winter. This is where one teacher from each school, who is called an Oral Health Coordinator, learns to conduct a daily brushing program and also do oral health education throughout the school year. We had to postpone our OHC trainings because the earthquake hit right when they were originally scheduled, and when we did hold them, we had to think about how to keep oral health care relevant in the context that teachers are now facing.

IMG_0525There are approximately 129 damaged homes in our working areas, some of which are unlivable, and just outside of a village where we work in Parbat, a nearby area has experienced even more extensive damage and our dental technician has asked us to help. So we’ve made one trip out there, and we’re considering how to approach another. About 13 schools need some or total rebuilding in our 10 villages. All these realities must be acknowledged as we continue trying to advance the work we’ve been doing in oral healthcare over the last eight years.

One widespread issue is that shelter aid has been largely limited to people whose houses were totally destroyed. For thousands and thousands of people whose homes are standing but too dangerous to live in, significantly less help has been available – by not receiving tent distribution, for example, and that’s where organizations like ours filled in. Going forward, the government is compensating only $250 per damaged house, compared to the $1000 that will go to families whose houses are flattened. Then again, everybody will need to rebuild from scratch, and even a simple village home costs closer to $3000.

All of this is why I want to start pulling back from using our limited relief funds for tents and start focusing on transitional housing that will last people for the length of time needed to rebuild.

On a tangential topic, we’ve outgrown our one-room office, and leased a new space that is currently totally empty, which is both exciting and intimidating. So in between scouring the internet and Facebook for examples of tunnel shelters and super-adobe shelters and shelters that reuse tarps, I am also turning over possible arrangements of the sunny new rooms of our office, which have yet to be set up as our home.

I took a detour from dreams of shelters and offices yesterday to spend the morning with our field officer, Dilmaya, at Deurali Primary School in Kaskikot. This school is just five minutes from my house, and it is where Didi and Bishnu attended grades 1-5. I have known the teachers there for twelve years. For about 4-5 years, Deurali school ran a daily brushing program we’d helped them start, but it eventually petered out. Their Oral Health Coordinator, a really sweet young woman named Chandra, had asked me last winter to help them restart it.

So Dilmaya came up to Kaskikot with her backpack full of brushes and paste, had lunch with me and Aamaa at home, and then we went to Deurali school and sat down with all the teachers in the office. Govinda also joined us – he is one of the founders of KOHCP and was the team leader in Kaskikot for the six years the program ran there.

IMG_0577I was amazed when the headmaster pulled a notebook out of the cabinet. He had kept a log, which started in 2011, of each purchase or donation of brushes and paste, each poetry project or dance performance the school had held to advocate for oral health care. We discussed the school’s plans for future sustainability as our contribution declines next year, a plan we require. The teachers presented each of us with kata scarves, a traditional way to welcome and honor guests.

You all may or may not remember that when we tried to hand-over Kaskikot’s KOHCP programs and clinic in 2012, the project collapsed due to personal interests among government officials (a soap opera that, for better or worse, was covered in a 2013 Washington Post story). So it’s a bitter pill I live with that in order to keep this program growing and developing elsewhere, I had to be willing to watch it fail in my home village. And since then, we have since expanded to 7 clinics in 10 other villages that cover an area of about 50,000 people.

Nevertheless, sitting in this tiny school in my back yard, which has no more than 35 young students, and seeing the enthusiasm and sincerity of the teachers to restart their brushing program, was just awesome. We were all so happy with each other that it was basically one big appreciation fest.

Now that we have field officers, we offered to have Dilmaya come back and run a workshop for the teachers on oral health education, where she can teach the art, math and game activities we do with OHCs now to help them promote oral health care in addition to doing the brushing program.  Their teacher took the new brushes and paste and ran the day’s brushing program.

So that was a nice little pick-me up. Now, back to Pokhara to look at earthbag building.