First Treatment Day

by Laura

Our IMT Clinic space in Kaskikot


The first ever Eva Nepal IMT Clinic has had its first treatment day in Kaskikot!  Our clinic space was donated by a hotel high on a hill just behind Aamaa’s house where I stay.  We stare out over Kaskikot and across to the Annapurna mountains.


Patient attendance has been one of my main concerns because nobody knows what manual therapy is, and I’m worried about timing too–we’re counting on patients to show up for a time slot in an environment where nothing happens on a clock-oriented schedule.  Many of our patients probably can’t read a clock.  Last night, Govinda and I made visits to today’s patients to confirm their participation.  We stopped in to see Mitu-didi around 8pm and she said she’d be at our treatment area at 9:30am sharp.

This morning, Mitu-didi came over at 8am to tell me she had to go work in the fields today and wouldn’t be able to come after all.  Her back pain is so severe she can barely stand without a cloth band around her waist. But every day when the sun comes up there is one thing after another to be planted, pounded, cut or carried, cooked, moved, built, taken down.  Today was no different, and many people in Kaski live with their pain the way Mitu-didi does.

Mitu-didi and me in 2005

I’ve known Mitu-didi for years and I told her that she could have given up her place yesterday, but now it was too late to find a replacement; this morning at 10am, we were counting on her.  I said she was now stuck spending two and a half hours letting herself get treatment today and that her fields would surely still be there at 11:30am.  I can’t say she looked pleased with me and I didn’t think she’d show up.


I went up to our treatment area a bit early to set up our tables.  I saw the rental company had delivered five tables yesterday.  One is great.  One has a gigantic hole in the middle.  Two have insanely unstable legs.  One has completely unstable legs.  So, we have one usable table and four unusable tables.  After some debate, we decided that with a piece of foam over it, the table with the gigantic hole would do all right.  Then we took one of the outside dining tables from the hotel, which is made from two huge slabs of rock (very stylish, not to mention comfortable) and it took four of us to haul that over to our treatment area.

All we need is tables and patients here, people.  Come on.  It’s going to happen.

We told all our patients to arrive 45 minutes earlier than their treatment time.  This is because everyone arrives at least 45 minutes late for everything in Nepal.  But at 9:15am, we had three patients ready and waiting–including Mitu-didi.

I set to training our volunteers on our patient intake.  This required me trying to translate things like “Do you have a medical diagnosis?” for Nepali volunteers, who then had to ask Mitu-didi and the other patients, and then translate the answer back, and then write it in English on the patient form.  I don’t know words like “diagnosis” in Nepali.  Our volunteers didn’t speak good english.  After a chaotic 20 minutes, we gave up on most of the patient intake.

Welcome to the first day of a brand new rural health program.

At last, we cut to the chase: therapy!  Our three patients began their treatment.  All of a sudden quiet descended; I put on some music.  I circulated and alternated between translating for our therapists, taking pictures, helping trainees, and joining in with the other therapists to treat their patients.  We are seeing six patients per day for two and a half hours each.  I have never seen Mitu-didi stay still for two and a half minutes, much less two and a half hours.

Kaskikot IMT Clinic

In the evening, Mitu-didi came over to the house gain to see us.  Looking at Lissa, her therapist, she said cautiously, “It seems…a little better?”  Then she looked at Aamaa.  “Is it because I didn’t do much work today? Let’s see about tomorrow.”


Mitu-didi at the water tap, a few days after treatment

The next afternoon, we passed Mitu-didi at the same tap where I caught her grimacing last week and followed her home to give her advil.  We saw here there again and again over the next few days.  Each time I’d say, “Didi, how is your back?” and she’d look back and forth between Lissa and me and answer: “What the heck? It…it’s better….”



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