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 IMG_2616him 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.

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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.

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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

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!

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New Ideas for IMT Kids in 2013

by Laura
It’s my first morning in Kathmandu and I just had a fantastic meeting with Himal from Joining Hands Nepal, where our team spent two days last spring.  They have used IMT twice this year in the orphanage for acute situations–a fever and a bad case of stomach bug.  Himal reports that this went very well, and he has photos that he’s been meaning to send.  They’ve also used the IMT cards sometimes as the activity for their morning recreation class.
One of our most successful events last year was the full-day training we did at Panauti community hospital.  But since then there’s been a staff turnover, so while most of the administration remains, a lot of the doctors are new.  So the IMT material hasn’t gotten used as much there.
When I met Himal this morning he came with some friends from Panauti. One of them was a school teacher. We started brainstorming about what we could do this year based on what we learned worked last year–and came up with an idea we’re really excited about.
In early May, I’m going to lead a one-day IMT retreat at the children’s home.  In addition to following up with the kids, Himal and his friends will invite some nearby schoolteachers, a local government health post clinician, a rep or two from the hospital, and some yoga teachers.  Without adding any new material or complexity, we’ll use the same basic IMT cards from before, but incorporate them in different settings – P.E. class in school; as part of a yoga practice; at the health post; etc.  We’ll do a lot of role-plays and games.
But here’s the best part!  Pending permission from Panauti Hospital, the 10 kids from the home will go to the hospital the next day, divide in to two groups, and treat patients.  The hope is that this can become their weekly service activity.  I think that having 10 kids from an orphanage using their hands to treating patients at a hospital every saturday is way better than any kind of community training we can do here in a day.  It’s kind of awesome to picture the docs coming in to change IVs and having to navigate around a gaggle of child therapists.  Who knows?

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Has it been a year?!


by Laura

Yep, it has been a year.  And I am headed back to Nepal on March 28, but this time, I will only be in touch with our intrepid 2012 team through email and Skype.

So this was my apartment yesterday as I retrieved our materials and got them ready for another trip overseas.

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Sorting through everything, it’s really fun to revisit some of those earlier versions we went through, and the fond memories of piles of paper associated with them.

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Now then…what will 2013 bring??

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No More Pain Meds for a Handovermatter Alum

by Laura

Recently, our Kaskikot Team Coordinator, Govinda, went to check on one of the most acute patients we treated back in April.

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Mitu didi was one of our first patients on the first day, because she had come to my house in Kaskikot in excruciating pain, asking for medicine. I took this photo and despite the red-carpet smile, you can see how she’s standing.  Lissa treated Mitu-didi for just under two hours; she had what we call a sacral torsion, meaning her sacrum was rotated and tilted in a position that it’s never supposed to be in.  Here is the wonderful update from Govinda, seven months later.

 

Dear Laura Sister,

Today I met Mitu-didi and we talked about the IMT treatment.  Previously, her back pain made it really hard for her to work. Getting up, sitting down, sleeping–everything was difficult.  She had to get a monthly injection and take medication.  

After the IMT treatment, all of it is better.  She doesn’t have to get the injections.  She says, “It’s not hard for me to do labor – I’m working and if I carry an especially heavy load I’m just a bit sore from time to time.”

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See more about Mitu-didi, a patient we followed throughout this blog, before her treatment and on treatment day.

Mitu-didi with me in 2005

Me with Mitu-didi in 2005

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Nepal memories linger on …

by Will

I recently had a trip to Heidelberg Germany. I had a great time performing manual therapy on clients. While there, I shared my Nepal experience with my hosts, Simone and Thomas. Showed them my photos and I encouraged them to consider taking a future IMT trip to Nepal which I assume would be sometime in 2014. Again, I give a lot of thanks to Simone and Thomas. They were great hosts.

I was surprised to find a big reminder of Nepal in Germany, literally a big one. We walked one weekend up in the hills of Heidelberg during the first snow storm of the season. There was about one or two inches of snow (5 cm) as we trudged around an orchid hill surrounded by big green fir trees. I found myself reaching out over an electric fence to pet a cow. The cow turned its head, nudged its nose against my hand and instantly I had a flash back to Nepal. Lu Lu, yes Amma’s water buffalo!

It was an ahh haa moment, I could have had a V8 moment- that’s right – the bovine world speaks with their nose, and this is nose communication. It is a whole new language to me, and why didn’t I realize this about Lu Lu.

Now I have hung out with bovine friends in the past, remember Pink Floyd album covers.

I truly dig their milk too. But there was always some unsatisfied mystery. How can I speak to a ruminating boulder with four legs? Come to think of it perhaps that is how I regarded that unattainable legendary blonde in high school. Either way, don’t get in their way.

My lingering memories of Nepal continued after returning from Germany. I was to give a presentation the morning after I got off the plane from Europe. I arrived at the place only to find out it had been rescheduled to a week later. I was actually relieved and returned home to crash.

I refined my PowerPoint over the next week, and the strength of the Nepal visit lingers with me. It seemed that all my Nepal photos pulled me deeper and deeper back to Nepal. There are the vast vistas and the ever stimulating Kathmandu. I recalled the “little events” of my stay. The ever present purrrr of the motor scouters, there was the quietness of the early morning Kathmandu, there was that bird/animal sounding like a German coo coo clock, there are the bright colors of the Sarees, and there was Amma’s dinner time cries for Laura’s help.

My new Nepalese Facebook friends continue my lingering thoughts of my visit. I now belong to one huge family; having even brothers studying in China of people I met in Nepal Facebooking me. I am impressed with how the people we trained continue to work on people in the Kaskikot area. My mom still asks questions about the Nepal visit, and Laura Spero updates me regularly on her work with Eva Nepal.

A big thanks to the peer group I belong to where I gave the presentation, NEMC. I have posted the PowerPoint on my clinical website although it lacks my excited presentation. I have also updated my photo website.

Don’t worry Lu Lu, as you can see by my persistent memories, I seem to be plotting a return. I’ll see if I can better understand this nose talk, and I hope to better understand Nepalese.

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