Comments for Nyaya Health http://blog.nyayahealth.org Working towards Health Equity and Access in Rural Nepal Sun, 08 Jan 2012 17:31:00 +0000 hourly 1 http://wordpress.org/?v=3.3 Comment on Mother’s Love in Achham by Frances Shaffer http://blog.nyayahealth.org/2012/01/07/mothers-love-in-achham/comment-page-1/#comment-670 Frances Shaffer Sun, 08 Jan 2012 17:31:00 +0000 http://blog.nyayahealth.org/?p=4081#comment-670 I think you are right Richa, education is the key. I bet these mothers have known nothing else and if they were properly educated in the beauty of modern medicine then they might have more hope for their children. It sounds like they do not see the beauty of having young children. If the mortality rate is so high there then they might not want to give the child unconditional love due to the high percentage of their child dying. They may not want to get their hopes up that their child might survive. They may not want the disappointment. I am glad you are trying to make a difference but it is going to be hard to change what has been a viewpoint that has been going on for years. It may be beneficial to really focus on the young children. Be safe! I think you are right Richa, education is the key. I bet these mothers have known nothing else and if they were properly educated in the beauty of modern medicine then they might have more hope for their children. It sounds like they do not see the beauty of having young children. If the mortality rate is so high there then they might not want to give the child unconditional love due to the high percentage of their child dying. They may not want to get their hopes up that their child might survive. They may not want the disappointment. I am glad you are trying to make a difference but it is going to be hard to change what has been a viewpoint that has been going on for years. It may be beneficial to really focus on the young children. Be safe!

]]> Comment on Picture of the Week from Bayalpata Hospital by Lynne http://blog.nyayahealth.org/2011/12/28/picofwk32/comment-page-1/#comment-669 Lynne Fri, 06 Jan 2012 14:17:05 +0000 http://blog.nyayahealth.org/?p=3941#comment-669 Your picture combined with the very sad story from Duncan Maru the day before about the Mother who lost her child weighs very heavy on my heart. It points out just how much most of us have come to expect with regard to our health care and how little others in the world look forward to. I can't imagine walking barefoot to get to the delivery room sometimes up to 12 hours, and then to leave with your dead child in a bag to take home. I know as a society we can do better, however, we need to bring these pictures and stories together to bring light to a situation that as a society we can not ignore. Thank you for putting a picture to the stories and making it real for the rest of us. Your picture combined with the very sad story from Duncan Maru the day before about the Mother who lost her child weighs very heavy on my heart. It points out just how much most of us have come to expect with regard to our health care and how little others in the world look forward to. I can’t imagine walking barefoot to get to the delivery room sometimes up to 12 hours, and then to leave with your dead child in a bag to take home. I know as a society we can do better, however, we need to bring these pictures and stories together to bring light to a situation that as a society we can not ignore. Thank you for putting a picture to the stories and making it real for the rest of us.

]]> Comment on Bare and Bloody Feet by Bijay Acharya http://blog.nyayahealth.org/2011/12/27/bare-and-bloody-feet/comment-page-1/#comment-666 Bijay Acharya Wed, 04 Jan 2012 13:06:53 +0000 http://blog.nyayahealth.org/?p=4071#comment-666 Dear Ashma, Thank you for the reply. I was there when we were trying to revive the baby but unfortunately, we couldn't. The family was surprised the baby even survived that long. re- Thank you for your donations. They contributed to this mother getting a safe delivery in spite of the sad events. re- slippers. When we saw that the mother was walking barefoot/bloody back to her home, 12hrs away, we realized that we didn't have a slippers or anything to give her. She would require comfortable shoes that she could use to hike up the long trail back to her home. It is indeed a great idea to give out slippers/warm clothes/food to the mothers but I think we would need to plan and maintain a criteria who gets them. It would be very hard and ethically challenging to do this but we would like to listen to your suggestions. Thank you for your suggestion. Bijay Acharya Nyaya Health Dear Ashma,

Thank you for the reply. I was there when we were trying to revive the baby but unfortunately, we couldn’t. The family was surprised the baby even survived that long.

re- Thank you for your donations. They contributed to this mother getting a safe delivery in spite of the sad events.

re- slippers. When we saw that the mother was walking barefoot/bloody back to her home, 12hrs away, we realized that we didn’t have a slippers or anything to give her. She would require comfortable shoes that she could use to hike up the long trail back to her home. It is indeed a great idea to give out slippers/warm clothes/food to the mothers but I think we would need to plan and maintain a criteria who gets them. It would be very hard and ethically challenging to do this but we would like to listen to your suggestions.

Thank you for your suggestion.
Bijay Acharya
Nyaya Health

]]> Comment on Bare and Bloody Feet by Ashma http://blog.nyayahealth.org/2011/12/27/bare-and-bloody-feet/comment-page-1/#comment-662 Ashma Fri, 30 Dec 2011 00:27:02 +0000 http://blog.nyayahealth.org/?p=4071#comment-662 Dear Writer, I totally understand the feeling and the scenario, i have seen and been there in maternity hospital in thapathali , kathmandu when i was working there as a medical officer for 2 years. I used to be ashamed of myself for being so affluent ,the privileged one. Every month i donate $25 for Nyaya Health, i post donation links of your website in Facebook but no one in my friends list ever "like" and i wonder if they really visit the Nyaya health website,LEAVE ALONE GIVING DONATIONS, and i do not know the reason behind this avoidance....and i am asking donations from people who can contribute atleast $10 per month and not from those that have hard time surviving. I sometimes think that maybe people do not believe that the money really goes to Accham but then i know it does coz u all sound very real and transparent. After reading this blog "Bear and bloody feet" i just want to give you some suggestion which is not great but i feel lets start from the beginning, how about we arrange slippers for mothers like that, a warm clothes and something to eat postpartum. I know being a mother how it feels after all those delivery and i cannot imagine the pain after such a tragedy. Is there any office in KTM, postal address? where i can post some collected slippers and warm clothes and foods- for those brave mothers..... Please reply as i really want to post this blog and also use this blog to collect slippers, warm clothes and some biscuits for those mothers. It may not sound great, but sometimes i feel what can i do at this moment with this blog in my mind and heart...make people aware in a right way,something like donating slippers means a lot to someone who needs it so much..... Dear Writer,

I totally understand the feeling and the scenario, i have seen and been there in maternity hospital in thapathali , kathmandu when i was working there as a medical officer for 2 years. I used to be ashamed of myself for being so affluent ,the privileged one.
Every month i donate $25 for Nyaya Health, i post donation links of your website in Facebook but no one in my friends list ever “like” and i wonder if they really visit the Nyaya health website,LEAVE ALONE GIVING DONATIONS, and i do not know the reason behind this avoidance….and i am asking donations from people who can contribute atleast $10 per month and not from those that have hard time surviving.
I sometimes think that maybe people do not believe that the money really goes to Accham but then i know it does coz u all sound very real and transparent.
After reading this blog “Bear and bloody feet” i just want to give you some suggestion which is not great but i feel lets start from the beginning, how about we arrange slippers for mothers like that, a warm clothes and something to eat postpartum. I know being a mother how it feels after all those delivery and i cannot imagine the pain after such a tragedy.
Is there any office in KTM, postal address? where i can post some collected slippers and warm clothes and foods- for those brave mothers…..
Please reply as i really want to post this blog and also use this blog to collect slippers, warm clothes and some biscuits for those mothers. It may not sound great, but sometimes i feel what can i do at this moment with this blog in my mind and heart…make people aware in a right way,something like donating slippers means a lot to someone who needs it so much…..

]]> Comment on Three Hours by Foot, with a Failing Heart by Duncan maru http://blog.nyayahealth.org/2011/12/14/3hrsfootwfailingheart/comment-page-1/#comment-660 Duncan maru Mon, 19 Dec 2011 14:36:05 +0000 http://blog.nyayahealth.org/?p=4058#comment-660 As an update: Agya Poudel (Director of Community Health), Ranju Sharma (Nyaya's founding Director of Community Health), the patient, her mother, and I had a wonderful meeting in Kathmandu at Teaching Hospital with the Cardiothoracic Surgeon Dr. Bhagwan Koraila. He was incredibly gentle and patient with all of us. She received her echocardiogram and EKG, confirming the diagnosis of Rheumatic Heart Disease. I learned quite a bit myself; on his exam, he argued that her diastolic murmur was that of mitral stenosis rather than aortic regurgitation, and the echocardiogram proved him right and my original assessment wrong. Her ejection fraction was mildly reduced at 55%. He said in pediatric cases he prefers to follow them for 6-12 months prior to surgery, especially in a case such as this where anticoagulation (needed to prevent clots from a replacement valve) can be such a challenge. He would like to trial her on digoxin, allow her to grow some, and re-assess the optimal timing. Dr. Koraila will be able to do the surgery for free when the time comes, based on a national policy that he himself had helped to create. In the meantime, we will continue to follow her every three weeks and really establish a rigorous follow-up mechanism. We also are recruiting Dr. Koraila's team to come to the Far West for cardiology screening camps, which I am certain would be of high yield for Bayalpata and our patients. At that time, he can examine his new patient himself in her home district. We talked extensively about the need for better follow-up for patients with chronic diseses in remote rural areas, and how Nyaya aims to help prove that such follow-up can be done effectively. Finally, a note of thanks to Agya's family who has been so gracious in hosting all of us, and to Buddha Air and their Managing Director Mr. Birendra Basnet for partnering with us in transportation. Agya did a beautiful job sitting down and explaining all the findings to her and her mother. In watching Agya do her counseling, I did have a sense that for this one patient, as a team we are advocating and caring for her as a member of our own family. That is a crucial part of our evolution, of developing a hospital and community system that makes a moral commitment to our patients and holds steadfast in that commitment, without letting patients fall through the cracks. As an update: Agya Poudel (Director of Community Health), Ranju Sharma (Nyaya’s founding Director of Community Health), the patient, her mother, and I had a wonderful meeting in Kathmandu at Teaching Hospital with the Cardiothoracic Surgeon Dr. Bhagwan Koraila. He was incredibly gentle and patient with all of us. She received her echocardiogram and EKG, confirming the diagnosis of Rheumatic Heart Disease. I learned quite a bit myself; on his exam, he argued that her diastolic murmur was that of mitral stenosis rather than aortic regurgitation, and the echocardiogram proved him right and my original assessment wrong. Her ejection fraction was mildly reduced at 55%. He said in pediatric cases he prefers to follow them for 6-12 months prior to surgery, especially in a case such as this where anticoagulation (needed to prevent clots from a replacement valve) can be such a challenge. He would like to trial her on digoxin, allow her to grow some, and re-assess the optimal timing. Dr. Koraila will be able to do the surgery for free when the time comes, based on a national policy that he himself had helped to create. In the meantime, we will continue to follow her every three weeks and really establish a rigorous follow-up mechanism. We also are recruiting Dr. Koraila’s team to come to the Far West for cardiology screening camps, which I am certain would be of high yield for Bayalpata and our patients. At that time, he can examine his new patient himself in her home district. We talked extensively about the need for better follow-up for patients with chronic diseses in remote rural areas, and how Nyaya aims to help prove that such follow-up can be done effectively. Finally, a note of thanks to Agya’s family who has been so gracious in hosting all of us, and to Buddha Air and their Managing Director Mr. Birendra Basnet for partnering with us in transportation. Agya did a beautiful job sitting down and explaining all the findings to her and her mother. In watching Agya do her counseling, I did have a sense that for this one patient, as a team we are advocating and caring for her as a member of our own family. That is a crucial part of our evolution, of developing a hospital and community system that makes a moral commitment to our patients and holds steadfast in that commitment, without letting patients fall through the cracks.

]]> Comment on Management at the Margins: the Bayalpata Hospital Staff Crisis by Anil Shrestha http://blog.nyayahealth.org/2011/12/16/mgmtatmargins/comment-page-1/#comment-658 Anil Shrestha Sat, 17 Dec 2011 06:55:27 +0000 http://blog.nyayahealth.org/?p=3901#comment-658 Dear Duncan, I am regular follower of Nyaya Health and I appreciate the service of Nyaya Health for People of Nepal. Its really sad to hear about the issue. Its true, staff grievances are everywhere. I like the way you have presented it in blog and made it transparent to general public. Having gone through your table and blog, couple of things are in my mind with my experience of work. you may agree to disagree. I get sense that your policy will now priorities experienced and senior staff for your work. I can imagine the challenges in Achham. I am also public health graduate and i have been to some remote places as well for work. I am afraid, hiring senior and experienced person at Acchaam at this time may increase your cost of Salaries more which may be constrains for other funding. Also, the work you are doing needs energetic and enthusiastic person and young or mid career professionals would be better choice. I am sorry, if you feel i am being biased for senior workers. They can be hired for advice and guidance always. Another thing is, Is the root cause of this situation is staff being young and lack of experience? These may be linked with culture of the staffs, experience of working or volunteering in other organisations and attitude of learning of those staff or poor communication between level of management. May be it can be worked to recruit young people with good common sense (who know criticize can be done in private) and experience of group dynamics and team management. I wish you all the best for your work. You are setting an example in Nepal Health system. Best wishes, Anil (BPH) Dear Duncan,

I am regular follower of Nyaya Health and I appreciate the service of Nyaya Health for People of Nepal.

Its really sad to hear about the issue. Its true, staff grievances are everywhere. I like the way you have presented it in blog and made it transparent to general public. Having gone through your table and blog, couple of things are in my mind with my experience of work.

you may agree to disagree.

I get sense that your policy will now priorities experienced and senior staff for your work. I can imagine the challenges in Achham. I am also public health graduate and i have been to some remote places as well for work. I am afraid, hiring senior and experienced person at Acchaam at this time may increase your cost of Salaries more which may be constrains for other funding.

Also, the work you are doing needs energetic and enthusiastic person and young or mid career professionals would be better choice. I am sorry, if you feel i am being biased for senior workers. They can be hired for advice and guidance always.

Another thing is, Is the root cause of this situation is staff being young and lack of experience? These may be linked with culture of the staffs, experience of working or volunteering in other organisations and attitude of learning of those staff or poor communication between level of management. May be it can be worked to recruit young people with good common sense (who know criticize can be done in private) and experience of group dynamics and team management.

I wish you all the best for your work. You are setting an example in Nepal Health system.

Best wishes,
Anil (BPH)

]]> Comment on Nyaya Health is the 1% by Poojan Shrestha http://blog.nyayahealth.org/2011/12/10/nyayahealth1/comment-page-1/#comment-657 Poojan Shrestha Thu, 15 Dec 2011 17:00:50 +0000 http://blog.nyayahealth.org/?p=4015#comment-657 This is a wonderful news, many many congratulations to the Nyayahealth family. I would like to thank the instigators of this noble project and all the people who have made it a possibility. It is truly inspiring for people who want to make a difference. All of the 133 deserve equal praise for their efforts of making this a reality. I hope this would be taken as an example by all the Nepalese people and understand that working together you can reach heights unimagined, as has Nyayahealth with the Bayalpata Hospital. Congratulations. This is a wonderful news, many many congratulations to the Nyayahealth family. I would like to thank the instigators of this noble project and all the people who have made it a possibility. It is truly inspiring for people who want to make a difference. All of the
133 deserve equal praise for their efforts of making this a reality. I hope this would be taken as an example by all the Nepalese people and understand that working together you can reach heights unimagined, as has Nyayahealth with the Bayalpata Hospital.

Congratulations.

]]> Comment on Picture of the Week from Bayalpata Hospital by Madhuri Mathema http://blog.nyayahealth.org/2011/11/16/picofwk26/comment-page-1/#comment-623 Madhuri Mathema Thu, 17 Nov 2011 19:46:02 +0000 http://blog.nyayahealth.org/?p=3827#comment-623 This is absolutley a beautiful picutre! The baby looks so healthy. It would be nice to have a little story to go with the picture for those who are not familiar with Nepali custom and culture. I think it has some significance from a medical points of view also. This is absolutley a beautiful picutre! The baby looks so healthy.
It would be nice to have a little story to go with the picture for those who are not familiar with Nepali custom and culture. I think it has some significance from a medical points of view also.

]]> Comment on Stubbed Toe by Borgny Ween http://blog.nyayahealth.org/2011/11/13/stubbed-toe/comment-page-1/#comment-618 Borgny Ween Sun, 13 Nov 2011 08:16:35 +0000 http://blog.nyayahealth.org/?p=3788#comment-618 X-rays help, as radiographers also care for the patients. Even a single toe can take a long time. X-rays help, as radiographers also care for the patients. Even a single toe can take a long time.

]]> Comment on Returning Home – The Journey Continues… by Sujata http://blog.nyayahealth.org/2011/10/23/returninghome2/comment-page-1/#comment-613 Sujata Mon, 31 Oct 2011 06:26:30 +0000 http://blog.nyayahealth.org/?p=3576#comment-613 Great job I must say!!!! God bless u all folks Great job I must say!!!! God bless u all folks

]]> Comment on Mortality and Morbidity Conference: Head Trauma by Sujata http://blog.nyayahealth.org/2011/07/08/mmcheadtrauma/comment-page-1/#comment-612 Sujata Mon, 31 Oct 2011 06:16:50 +0000 http://blog.nyayahealth.org/?p=3240#comment-612 I d love to work anyway with nyaya health, m from Nepal currently living in texas I d love to work anyway with nyaya health, m from Nepal currently living in texas

]]> Comment on Picture of the Week from Bayalpata Hospital by Madhuri Mathema http://blog.nyayahealth.org/2011/10/26/picofwk23/comment-page-1/#comment-606 Madhuri Mathema Wed, 26 Oct 2011 15:00:36 +0000 http://blog.nyayahealth.org/?p=3698#comment-606 Jesse: Thanks for this picture and other you have been posting. It would be useful/helpful if you also explain what these people are doing climbing the electric pole and show us the solar panel. Keep up your good work. Jesse:

Thanks for this picture and other you have been posting. It would be useful/helpful if you also explain what these people are doing climbing the electric pole and show us the solar panel.

Keep up your good work.

]]> Comment on A tribute to Nyaya’s Medical Director of Bayalapata Hospital, Bikash Gauchan by Joshan Neupane http://blog.nyayahealth.org/2011/07/10/tributedrbikash/comment-page-1/#comment-604 Joshan Neupane Mon, 24 Oct 2011 15:02:10 +0000 http://blog.nyayahealth.org/?p=3246#comment-604 Great!! All the best Dr. Bikash. Great!! All the best Dr. Bikash.

]]> Comment on Returning Home – The Journey Continues… by Raju Swar http://blog.nyayahealth.org/2011/10/23/returninghome2/comment-page-1/#comment-603 Raju Swar Mon, 24 Oct 2011 05:51:21 +0000 http://blog.nyayahealth.org/?p=3576#comment-603 And despite all those prblems you people face,from the comfort of New York to the pains of Achham........the job you people are doing is awesome!! Hats off to you guys!! And despite all those prblems you people face,from the comfort of New York to the pains of Achham……..the job you people are doing is awesome!! Hats off to you guys!!

]]> Comment on The Road to Healing by Mdhuri Mathema http://blog.nyayahealth.org/2011/10/09/roadtohealing/comment-page-1/#comment-593 Mdhuri Mathema Sun, 09 Oct 2011 17:59:23 +0000 http://blog.nyayahealth.org/?p=3712#comment-593 Dear Gregory: Thank you for sharing the story. I was not disappointed with all the upheavls as I believe that this is how an organization evolves. This is how we learn to deal with all the human components that go on in builidng a strong orgnaization. It could be a test case in teaching how to manage people while running a comlex organization. The hospital in Achham as remote as it could be but it poses the same problems, challenges and issues like in a modrn organization in New York. I wonder whether you being an anthropologist helped to handle the situation in a delicate and more humane way. Congratulations for being patient and looking at such uprising in a positve way. I as a Nepali cannot imagine going to Achham , live there and run a complex instituiton you from America going there risking everything is just commnedable. Wish you luck in your future endeavor for the best of people in Achham. Keep the faith. Dear Gregory:

Thank you for sharing the story. I was not disappointed with all the upheavls as I believe that this is how an organization evolves. This is how we learn to deal with all the human components that go on in builidng a strong orgnaization. It could be a test case in teaching how to manage people while running a comlex organization. The hospital in Achham as remote as it could be but it poses the same problems, challenges and issues like in a modrn organization in New York. I wonder whether you being an anthropologist helped to handle the situation in a delicate and more humane way.

Congratulations for being patient and looking at such uprising in a positve way. I as a Nepali cannot imagine going to Achham , live there and run a complex instituiton you from America going there risking everything is just commnedable. Wish you luck in your future endeavor for the best of people in Achham.

Keep the faith.

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