INMED

INMED Academic
INMED CME

Health Environmental Learning Program

Nepal

Overview

Health Environmental Learning Program (H.E.L.P.) is a community development organization working to empower the poor of the Himalayas of central Asia. Responding to community-initiated requests, H.E.L.P. provides training in literacy, agricultural and animal husbandry, and maternal and child health education. All trainers are Nepali community and church leaders working to meet  both the physical and spiritual needs of the poor.

Those coming for a learning experience at H.E.L.P. will be based at H.E.L.P. headquarters in the city of Dhulikhel. From this location, they will participate in continuing education experiences offered for literacy, agriculture, and health facilitators. Learners will also enjoy opportunities to accompany facilitators in their community activities, with a focus upon the learner’s particular interests.

Location

The H.E.L.P. headquarters is in the municipality of Dhulikhel, population 32,000, located a one-hour drive east of the capital city of Katmandu. Dhulikhel is a developed town with bus stop and a medical school. H.E.L.P. facilitators periodically come to the headquarters for recurrency training. H.E.L.P.’s activities are quite decentralized, with multiple locations primarily in rural communities.

The climate of Nepal varies with location. Northern Nepal is marked by cool summers and severe winters. Southern Nepal summers are very hot and winters are mild to cold. Nepal’s weather is marked five seasons: spring, summer, monsoon, autumn and winter.

Nepal is a developing country. Nationwide literacy rate is about 65 percent, greater among men than women, and boys than girls. Hearteningly, primary school enrollment rate is now about 97 percent. Nepali culture is dominated by cast systems and a vast array of ethnic groups. Median age is very young, about 23 years old. Hindu religion is dominate at 81 percent, with smaller numbers of Buddhist (9 percent) and  Muslims (4 percent).

Per capita income is estimated between $1-3000 per year, and most persons make a living through small agriculture and small business. A CIA report observes, “Nepal is among the poorest and least developed countries in the world,” and “Nepal is heavily dependent on remittances (money sent from abroad), which amount to as much as 22-25 percent of GDP.”

Nepali is the official language. The British post-colonial influence continues to be strong, and some educated people in the larger towns speak English. The H.E.L.P. national director, the international development coordinator (the primary person interacting with INMED volunteers) and some team leaders speak English.

H.E.L.P. leadership is both Nepali and American. Founders and United States directors are Lani and Tim Ackerman. Lani is a Board certified family physician who is a professor currently teaching medical school at Texas Christians University. She has been a family medicine faculty and residency director as well, and taught students and residents for 35 years.  She is also board certified in tropical medicine, geriatrics, and quality improvement and practiced obstetrics, as well, for 20 years. Tim is a community developer, environmentalist, and currently a special education high school teacher. They lived in Bhutan for two years and Nepal for six years, raising their four children there, as well, until returning to the US for the children’s education in 2004.  In addition to regular visits to Nepal, and continual contact with the sister NGO and national team which oversees all HELP activities, the Ackermans are actively engaged in overseeing the HELP work and leading fundraising activities in the US. They most recently have been living and serving in China, but currently are based in College Station, Texas.

Increasing literacy is a major objective of H.E.L.P. Communities make requests for literacy assistance, and each year H.E.L.P. responds with some forty class locations in different areas of Nepal depending upon such requests. H.E.L.P. is also careful to obtain any needed permissions from the government leaders. Literacy facilitators come to Dhulikhel twice yearly for trainings to reinforce their literacy teaching skills. H.E.L.P. works in cooperation with 30-40 literacy teachers, and some 22,000 women have received literacy in the Nepali language through this program.  HELP literacy directors perform field visits of the literacy classes during the year, and also utilize their GR’s, or Group Representatives (extension agents), as well as community and church leaders to follow up on literacy class function and success.

Agriculture training is another objective of H.E.L.P. Similar to literacy, communities make requests for assistance with agriculture and veterinary development.  The agriculture program includes multiple agriculture training programs which are predominately pesticide free, all using sustainable technology.  In addition to about 20 trainings a year in various topics and areas, there are also season-long “farmer field schools” in about 20 communities per year.  Farmer field schools concentrate on the production of particular crops of interest and the utility of farmer cooperatives.

The veterinary department, like literacy and agriculture, are led by HELP trainers and overseen by GR’s. Depending on community needs, approximately 15-20 trainings are held each year in goat raising, poultry farm, water buffalo, and more.

In addition, there is a large microfinance emphasis with farmer groups, teaching both group formation, business, and more. Over 5,000 known businesses have been started over the last 20 years via the literacy, agriculture, or animal husbandry departments, often in conjunction with the training held.

H.E.L.P. also offers education to improve maternal & child health, primarily through nutrition and women’s health education, first aid, construction and use of smokeless stoves (built with local materials). Smokeless stove programs have had a huge impact to decrease COPD and childhood burns, and are taught in concert with literacy, ag, and animal husbandry programs, as well as health. Clean water and sanitation – including promotion of toilets and pit latrines as well as water projects are part of health training.   All health education is undertaken at the request of particular communities.

All of H.E.L.P.’s programs rely on the use of group representatives (GR’s). These men and women are leaders within their community and churches who intentionally model Christ’s ministry to meet both the physical and spiritual needs of the poor. H.E.L.P. assist in community needs assessment, follow up, impact and results after trainings, and more. Such representatives also ensure that government and community leaders are involved and aware of H.E.L.P. trainings, and supervise the many national volunteers.

Finally, H.E.L.P. hosts a child sponsorship program for  over 200 children a year. These kids live in the home of a relative, with H.E.L.P. overseeing provision of uniforms, shoes, health screenings, and payment of school fees in concert with a community church leader or GR.  In addition, HELP has an orphanage in Dhulikel, which has 70 graduates and 20 children currently residing.  Food for the orphanage is provided through the HELP agriculture land and products, and plots are sometimes used for agriculture training, as well.

Wi-fi is available in the H.E.L.P. office but not in the sleep room or most of Nepal outside of the capital. Users pay by the gigabit. Most people in Nepal communicate via WhatsApp or Facetime. Visitors should check with their cellular providers about whether or not service is available in Nepal.

INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED personnel to become involved in this important aspect of international healthcare.

Travel and Logistics

Learners will fly into the capital city of Katmandu. H.E.L.P. can send a driver and vehicle to pick-up visitors and transport them to Dhulikhel. Local transport by local bus or taxi is also available. Visitors should exchange money at airport and purchase groceries while in transit to Dhulikhel.

For current information please visit the Nepalese embassy website appropriate for one’s home nationality. United States citizens can obtain current visa information from the website of the Embassy of Nepal in Washington, DC.

Generally speaking, United States citizens can receive a visa upon arrival that is valid for up to 60 days. A “tourist” visa is the appropriate type of visa to request.

One should consult with their personal physician before traveling. All routine vaccinations must be up to date. Typhoid, either oral or injectable, is recommended. Rabies vaccine and Japanese encephalitis vaccine are generally not recommended. Refer to the CDC travel website for the most up-to-date health information.

Travelers are advised to refer to the United States State Department website for the most up-to-date general travel information, and to regularly view current travel advisories.

Those coming for a learning experience at H.E.L.P. will be based at H.E.L.P. headquarters in Dhulikhel. From this location, they will participate in continuing education experiences offered for literacy, agriculture, and health facilitators. Learners will also enjoy opportunities to accompany facilitators in their community activities, with a focus upon the learner’s particular interests.  Learners should contact HELP as soon as possible to make sure activities are ongoing at the time of year they would like to come, and that there is appropriate staff support.  HELP charges fees for covering costs of transportation, food, and lodging which is all given to the sister NGO for both their costs and to support the projects.

Learners are offered housing in a room at the H.E.L.P. headquarters. It features bunkbeds and a shared bathroom. Mosquito net and bedding are provided. The facility has running water, and electricity most of the time. Laundry is available.

A cook is available to prepare meals, which most often consist of rice and lentils and flat bread. Outside dining is also available, and appropriate food safety precautions should be observed.

Nepal is a very conservative society. Learners should not smoke, drink alcohol, or be alone with someone of the opposite sex. Dress must be modest. Pants are permissible for women, but no tank tops. Men do not usually wear short pants, except in very hot weather.

Tourism thrives in Nepal, which boasts beautiful mountain hikes, historic old Kathmandu, Mount Everest Base Camp, the Golden Gate in Baktapur, and the Royal Thai Buddhist Monastery. For destination inspiration, visit Lonely Planet.

Learners should bring copies of all healthcare profession licenses, diplomas, or certifications. A carry-on bag should be packed that contains essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather and be prepared to dress in layers.

Ear plug are useful because of barking dogs at all hours. Good walking shoes are essential. Insect repellent is recommended.

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