Nepal Youth Council

by Laura

Recently I was invited to meet the Nepal “Youth Council,” a group of 20-somethings appointed by the U.S. State Department, in collaboration with a youth organization called YUWA.  I wasn’t given very specific instructions about what to discuss with them, so for a while I talked about Eva Nepal’s youth fellowship, Gaky’s Light.  But after I’d been talking for a while, one of the council members – who was nice enough to read the glossy Eva Nepal handout I’d distributed – asked me to describe Handovermatter.

So that’s how my talk on first-generation-literate youth and abroad migration and skills training morphed in to an IMT lesson.  I talked a bit about our project in Nepal last spring and some of the unexpected reasons for pursuing it that have evolved – the themes not just of health care, but teamwork, compassion, and even peace-building.

I was especially excited that one of the participants, Pabitra, a nurse, asked for more information so that she could try out some of our protocols in her hospital.  So I emailed her our community cards, which can be used by anyone from nurses to family members and visitors in any language, with or without literacy skills.  I hope to hear back from Pabitra about what happens when she tries this out in her hospital.

Nepal Youth Council – Talk Turned IMT training

 

 

 

Momo-Chowmein IMT

by Laura

One of my goals for this trip to Kaskikot was to think of ways to help our IMT trainees from last year add some business elements to their IMT work.  So far, I’ve been trying to meet with Govinda at least weekly to treat patients, but the question is, what kind of set up can he put around his skills to make it easier for him to practice regularly, and eventually, to be able to get paid for his work?

Well I for one really have no idea.  But it just so happens that Govinda has set up a new store front in his home in the last few weeks.  We got to talking about what he can do to differentiate his shop from lots of others in Kaskikot, and decided that something the place is really lacking is some good hot snack food.  There are lots of places that sell sugar and crackers, but nothing with a good plate of chowmein or some nice steamed momo.  Plus, Govinda’s house is right at the road, which gets a fair amount of tourist traffic on day-walks.

Obviously, once we (and that mainly means me an Prem) decided that Govinda should make momo and chowmein, it was a short but exciting leap to the innovative concept of this post: Momo-Chowmein IMT!

Last week I stopped in at a new shop in town called the Facebook Cafe.  (There’s another idea – rip off names of anything that’s popular and add it to your product.  Apple IMT?)  I set up an appointment for Govinda and I to come in and learn some cooking.

Which is what we did this morning.  It was a blast!  Our teacher was a 21-year old young man named Ram who is putting himself through college by working in restaurants.  He was the most passionate momo maker I’ve ever met (not that I’ve met that many), describing how he began his journey first by washing dishes and slowly moving in to the cook line, until he came under the tutelage of a momo guru.  We spent a good half hour on the merits of the one-handed dough-roll over the significantly inferior two-handed thug dough roll.

I have no idea what will happen with Govinda’s new shop and his new cooking possibilities.  But we found ourselves incredibly entertaining, learning to fold momos in the name of manual therapy.  But, as I like to say, every great new trend starts with some weirdos.

Joining Hands Therapy starts at Krishna Prasad Hospital

By Laura

This morning the newly formed Joining Hands Therapy group completed the design of their therapist badges and piled in to van to Krishna Prasad Hospital.

Himal and I made sure that the kids took the lead in introducing themselves to their patients and deciding what treatment protocols to use.  Last night we practiced for a couple hours and did some role-playing so they have it down pretty well.

Our first patient, Sajina, was a 20 year old girl who came to the hospital yesterday with typhoid.  She still had a fever and the kids chose exactly the right protocols: Routes of Elimination followed by Detoxification.  They got themselves all set up and I stayed nearby to help them with minor corrections.  Then I prodded our patient to ask questions, like “What the heck are you guys doing?”  “How does this work?”  And the kids did a great job answering her.

At first our Joining Hands Therapists were a little shy, but as the morning went on and they moved on to their second patient, and older lady with COPD and a small baby sharing her bed, they gained confidence and loosened up.  I have really encouraged them to remember that their youthful presence and big smiles will be very healing for people, and not to sweat too much about the therapy, which does its own work.

Well that sure played out today!  When we arrived, Sajina looked about how you’d look if you were laid up with typhoid in a pretty run-down hospital.  She let us work but didn’t say much.  By the time we left, she and all her therapists were laughing and joking.  It was great that she said her fever felt “lighter,” but it was really wonderful that she said, “You guys are really fun.  I like you!!”

I’ll be honest – this isn’t the cheeriest, richest hospital you’ve seen.  By the end, even members of the hospital staff had come by to see what all the fun was and just sat down to hang out.

When we left I gave all the kids hugs and high-fives before I got on the bus back to Kathmandu to catch a flight home to Pokhara.  The deal we’ve set up is that only the working therapists get badges.  It’s up to them to teach the littler kids at the home.  When they feel that the little ones have properly learned how to “do IMT,” they’ll award them badges as well.

The plan is for Joining Hands Therapy to do two hours of community service each Saturday at Krishna Prasad Hospital.  Nice work, guys!

Creating a Kid’s IMT Service Group: Joining Hands Therapy

By Laura

I am back in Panauti at Joining Hands Nepal, following up on the visit we made here last year.  After meeting with Himal when I first arrived in Nepal last month, we decided to shake things up a bit by focusing this year’s workshop on teachers and kids rather than medical personnel.

So yesterday morning some of the kids helped me prep the teaching materials and then we went over to a nearby primary school.  We followed a similar format to last year’s community teaching, but added in some extra activities to help teachers think about how to use simple IMT protocols as a starting point for teaching about other things: anatomy, meditation, teamwork, even art and writing projects based on “the heart” or “my brain.”  It would be pretty fun to come back here next year and see poetry about feet!

I especially liked one of the activities I added in for this workshop: having volunteers come up and stick numbered cut-outs to a drawing of a human body.  Creating a map like this made the concept of process centers concrete and colorful, and it was a simple activity that was interesting for both the kids and teachers.  I would definitely recommend this one, with or without enhancements of all kinds.

Until we have a resource page up, I’m putting the outline I used for this workshop in its own post.  We ended up doing the second half of it back at the children’s home, where it was easier for me to focus on just the kids.  Tomorrow we’re headed to Krishna Prasad Hospital hospital to treat patients, and I found that we needed to have some really focused practical time with our little manual therapists.  It is going to be so much fun to see them in action tomorrow.

My favorite part of the whole day having the kids choose a name for their manual therapy group and create badges to wear to the hospital.  I found laminated pass-holders on neck strings and brought a box of blank notecards for them to draw on.  I loved this activity. It got them working on how they wanted to present themselves and gave them some great critical thinking projects like: What would I want to know if someone wanted to put their hands on me in a hospital?  Which pieces of information about me are most important in this situation (Name = Very important; Roll No. in school = Not so important).

In the end, they worked as a team to develop a layout for their ID badges on a whiteboard, and then got up at 7:30 in the morning and spent over an hour making them.  I had showed them how they could official-ize their badges by drawing a border, and they figured out they could make multi-level borders.  When we finally piled in to the van this morning, they kept double checking to make sure everyone had their ID cards.  It really gave them an identity as specialists and a feeling of importance.

Making therapist ID badges to wear to the hospital

Conveniently, their home name lends itself perfectly to their new community service activity.  Ladies and gentlemen, I am please to introduce you to…

…Joining Hands Therapy!

Multi-Disciplinary Teacher & Children’s Workshop Outline

Multi-disciplinary Teacher & Children 1-day Workshop

For Schoolteachers, Yoga & Movement Instructors, Health Workers & Kids

I. Introduction

• Stand up and have everyone stretch.  Make themselves in to different shapes: a cat, a tire, a notebook, a banana, a house (end with house).

• Even though this was silly, our bodies are houses because we live in them.  If we think of our bodies as the houses we live in, there are lots of ways we can take care of them and keep them strong!

II. House-painting analogy (from community teaching) (5 min)

• A mud house will fall apart if its walls aren’t repainted

• Quick solutions like putting a bucket under the roof don’t solve the core problem

• With our bodies, medicines and surgeries often solve the immediate symptom.  We still have to fix the house!

III. Telephone analogy (from community teaching) (5 min)

• In order to fix the house, we need many different things.  (Ask what we need).

• Mud, stones, wood, water, all come from different places.  Some people are good builders, some are good carriers, some are good painters.  We need all of them in order to rebuild the house.

• Call audience members: I need water. What’s going on over there? It’s going to rain! Etc. The builder, stone breaker, carpenter and mud-carrier all need to talk to each other.

• Each part of the body specializes in something different.  By placing your hands on two parts of the

body, you create a kind of telephone line.  This helps two different parts talk to each other, so that they can do a better job of healing your body.

IV. Site to ureters card (10 min) – “LAB”

• Look at site to ureters card.  Everybody put one hand on a site of pain and other hand on their ureters.  (Teachers demonstrate on themselves)

• The ureters are pipes that remove urine.  They also help take out swelling and pain from any part of the body.

• Don’t need any pressure or movement.  It’s just a telephone line; communication is enough.  Relax your hands.

• You should keep your hands in place for at least 20 minutes at a time.

• You can also use someone else’s hands.  (Teachers demonstrate – a friend’s hand on ureters).  Everyone try this.

V. Process Centers (10 min) – “LAB”

• What would you call someone who helps build a house? (builder, carpenter, worker)

• The name for a part of the body that helps repaint the house I s a process center.  Just like you can have builders and stone breakers and water carriers – all different kinds of people who build houses – your body has different process centers that have different talents.

• Have a large picture of a body and cut-outs of different process centers:

Heart, Lungs, Liver, Pancreas, Spleen, Ureters, Kidneys (+Adrenals), Feet, Thyroid, Brain (frontal lobe)

-Number the backs of the cut-outs, and matching numbers on the body

• Stick the organs on to the poster of the body by calling up a volunteer to place each one.  For each one, discuss its job.

Heart – Circulation; love à hate

Lungs – Breathing; Feeling alive à Feeling not worth living/grief

Liver – Cleans the blood; Anger à Motivation

Pancreas – Sugar and energy

Spleen – Immunity

Ureters – Pipes for elimination

Kidney (+Adrenals) – Cleans the urine; Fear à Hope

Feet – Foundation of the house; Feeling stuck à Moving forward

Thyroid – Balancing chemicals in the body, the right amounts of things

Brain (Frontal lobe) – Thoughts, intelligence

VI. Solicit Activity Ideas (10 min)

• For teachers: Anatomy lessons, daily focusing or mediation activity, Homeword assignments (such as treating family or doing research on the body), writing or art assignments based on body themes (write about your heart), Team/group work, Peace-making and peace themes

• For yoga teachers: new postures, positional meditation, Interactive poses

• For health workers: giving homework, help from nursing or FCHV staff, involving family members

TEA BREAK

 VII. Specific protocols

• All to all – for everyone! Based on what we just did.  Include problem site.

• Shock – Post surgery

• Elimination & Detox – gastric, all rogi

VIII. Role Play

• Design a few hospital settings for facilitators to act out.

• Provide a chance for the kids to decide on and set up each of the protocols above.

IX. Work Passes

• Have the kids decide on a name for their community service project (Helping Hands, Telephone Touch, etc.)

• Each of the kids gets a business sized notecard to design an ID card that they will use as their hospital pass.  Set some guidelines for this – for example, the name of their organization / title should be clearly visible, along with their names.  You may or may not want to make it a teamwork exercise by having all the kids agree on an identical format.

• Either punch holes in the cards and put neck-strings through them, or ideally, have plastic pass-holders on neck chains to put the cards in.  Have all the kids wear their passes for the last part of the workshop.

X. The big picture

• What are the benefits of doing IMT besides treatment for a specific problem?

-Peace building, teamwork, mixing of ages, castes etc.

-Learning about the body

-Time to look inside / reflect / sit quietly

XI. Discussion about the community

• Open discussion about what to do next, including schools, hospital, community (special 1-day programs or an ongoing effort?), others who could be involved (religious leaders who visit the sick; healers) etc.

 

Boston Marathon Shock

by Will

Laura’s earlier post, “Children’s Games: Shock” has an eerie foresight in light of the bombing events in Boston this past week. It seems that Boston, and the US feels the victim of the perpetrator’s “Children’s Games” and certainly the shock has rippled through our culture.

These events have an intimacy that I didn’t experience with 9/11. I live about 8 miles (13 km) from the event and have walked a hundred times by the space where the bombs ignited. I have a client who lives near the marathon’s finish line, another whose jogging found her a ½ mile from the finish line, and still another who lives 4 or 5 blocks from the event. I know of other friends or colleagues who were within hundreds of feet of the explosion. I have a goddaughter who grew up with the younger perpetrator (since 4^th grade) who is processing her disbelief and anger that someone who was “so nice and well liked” could perpetrate something this evil.

When I returned from Nepal last May the first 3 days home I was very sick. I could feel the bacteria and viruses crawling out of me. It was hard to see anything else in the landscape of my experience when dominated by fever, and congestion and my impulse to go to bed at 1 in the afternoon. But just like Laxu’s “dazed” mood my sickness passed and like Laxu, I was latter able to giggle, and tease those around me, a sign of returned health.

I like to think of sickness as an opportunity to slow down. It allows me space to process what I am going through on all levels, physical and emotional. It allows my body to change or even release the physical and emotional discomfort. Several times this past week I have slowed down by doing the very same shock protocol the kids performed on Laxu. At the very least it gives me pause; it allows for a slow moment where my body can decide for itself how to process the shock.

Last week, I found myself lingering over a photo of a police man near the bombing scene. When I slowed down, I noticed my (over) identification with what I saw as the raging Boston police officer was coming more from my own anger. It also led me to cut down my exposure to the media (why would I want to re-injure myself!!?). Another colleague described that when she paused in bed that night, her body shook, releasing tensions leftover from her witnessing the bombing.

So I have attached a copy of the shock protocol we taught in Nepal. Give it a whirl. Might need to do it several times. It can be used for those more ordinary shocks or moods like Laxu was experiencing, or for Boston residents, or for all parties involved in the Afghanistan conflict. It is really meant for everyone.

I realize that some of the basic ideas are not explained but I feel some urgency to get it out to the world. I hope it is simple to understand. I probably need to add a video explanation too. The downloadable PDF below has my email address, so feel free to ask questions.  If you can translate the PDF into another language than English, please email me.

Thanks, Will

Shock Protocol HandOverMatter.Org

Shock Protocol HandOverMatter.Org-Spanish – I have Google translated a Spanish version. It will probably have some strange translations but please email any editing suggestions.

A Leettle Teeny World!

by Laura

So my favorite restaurant in Pokhara is called the Olive Cafe.  It’s practically my second office, I am here working on my laptop whenever I’m in the city.  And last year I took all my friends there a few times (one of these visits led to Lissa’s cheesecake eating experience).

Today one of the cooks at Olive Cafe stopped me and asked if I’d ever been to Panauti. I said yes but couldn’t figure out why this cook looked familiar or how he’d know about me and Panauti – which is 8 hours away near Kathmandu.  I’ve been there only once, during our IMT project with Joining Hands Nepal and Panauti Community Hospital.  I’m headed there again at the beginning of may.

The cook said he was from Panauti and he’d seen my photo there.

“What a second,” I said, “Do you know Himal?”  Himal is the director of Joining Hands Nepal and organized our visit last spring.  I met with him in Kathmandu on my arrival two weeks ago.

Himal at Joining Hands Nepal

The cook grinned and suddenly I knew why he looked familiar.  “Himal is my little brother!” he said.

Now how is THAT for a small world?!?!  Out of all the restaurants in Pokhara’s tourist strip that could be my hangout, or all the children’s homes in Kathmandu that we might have visited during our IMT pilot…

Himal’s big brother, a cook at the Olive Cafe in Pokhara

 

Children’s Games: Shock

by Laura

Today the most amazing thing happened at the children’s home where we did one of our sessions last year.  I’m there a lot because the organization that rusn it, Vision Nepal, is also the implementing partner organizaiton for Eva Nepal’s oral health care program.

I’d been in the office all morning talking with our dental program director and was just leaving when I walked past a doorway and saw one of the newest snuggly and bright members, 6 year old Laxu. He was sitting completely still and staring blankly at the floor.  I came in and talked to him quietly but he didn’t respond or move or shift his gaze.  I picked him up and took him to the roof and walked around in the sunshine.  He slumped on me like a doll and didn’t say a thing.

For another few minutes we sat together and he still seemed dazed and afraid and wouldn’t make a sound. I had no idea what to do.  I couldn’t leave him but I also didn’t know how to help.  We only know some of what Laxu’s life was like before he came to the children’s home, but we know it was not good.  He has lost both of his parents and his twin brother is being taken care of elsewhere.  The house mother is a sweet girl in her early twenties but no expert on childhood trauma.

She walked by, and I asked if she’d get a copy of the IMT cards we left here last year.  I put Laxu’s feet on the ground – I wasn’t sure if he would stand up – but he did so I took his hand and put my head in the doorway where the other kids were watching a movie.  I asked for three volunteers and got them immediately.

The kids treated Laxu with the shock template for about 10 or 15 minutes.  They ribbed him a little but mostly just talked to each other and joked around.  The house mother held his head (aside: she told me she regularly goes to sleep with one hand on her belly and the other on her ureters/low back to help manage her stomach problems).  Laxu stayed silent and the other kids sat around him with their hands on him gently.

I suggested that whenever Laxu gets like this – which he does – that they all repeat exactly this activity.  Arjun, the oldest, agreed to be in charge.  With kids, it’s kind of like any other game.

That said they’re kids and I knew I couldn’t keep them there forever, so after 10 minutes or so I asked Laxu if I could take a photo of everyone and then we’d look at it on the camera screen.  I took the photo and started to put my camera away, when all of a sudden, Laxu threw his arms out in the air and burst in to a gigantic smile.  The other kids started to giggle. I snapped a picture and then he leapt up with a blazing look of triumph on his face.  I was astonished.

I’ve made up a special handshake with the kids that has a few moves and ends with a double fist-bump and then holding your arms up to make muscles and show how strong you are.  I put my hands up and Laxu gave me the double high-five, the double fist-bump, and the muscles.  “AAAHHHHH!!!” he gargled and then snuggled for a second. I took him to the other room to watch the film with the other kids and he went right in and sat down.

He completely forgot about looking at his picture on my camera.

A Bumped Up Arm

Today we treated Min Bahadur dai, who got hit in the elbow and has since had a lot of problems with his arm and up in to his shoulder.  He came to our clinic last spring and asked to be “first” on the list of patients this year.  The kids near Govinda’s house are starting to realize this could be a regular gig for them.

 

Kaskikot IMT Clinic 2013, Week 1

by Laura

This week, I met up with Govinda in Kaskikot.  While I’m here this spring, I’m hoping to tool around with ways to help Govinda and maybe others we trained last year establish a format for providing IMT treatment. Surprisingly, the unclear categorization of manual therapy – not traditional local medicine, not traditional western medicine – was probably the biggest challenge our trainees faced when trying for continuity after we left.  So I’m hoping to work with Govinda to try to come up with a delivery system that people will easily be able to fit in to their picture of local health care.  It would be great if our trainees could generate some income in the local economy, too.

Right now, as far as we’ve gotten is deciding that one way or another, we’ll get together every week at Govinda’s house and offer treatment.  He’ll be the leader and I’ll provide support.

This week, our first patient was Aamaa, my host-mother in Kaskikot and now an old-time IMT patient, who spontaneously developed a sore knee last spring and hasn’t properly been able to carry water or do a lot of walking since.

I realize that in this picture it doesn’t look like there’s a knee involved.  I was doing the knee and doubling as the photographer.

Govinda and his kids treating Aamaa

 

 

While we were there, one of the team’s previous patients stopped by: the guy who got a bad back one day while milking his buffalo.  He regaled me with his story – he came to see the new IMT therapists, unable to stand up straight.  After an hour of treatment he walked out standing up.  The team visited him twice more and treated him at home. He never took any other medicine during his recovery. Nice job guys!