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Nepal Newsletter

January 10, 2002
Mark and Deirdre Zimmerman 10 January 2002
United Mission to Nepal
Box 126
Kathmandu, Nepal

"These who look to you to give them their food in due season...
When you open your hand, they are filled with good things."
Psalm 104:27,28

Dear Friends,

It was my fastest trip to Tansen. Having left Kathmandu at 7 that morning, we arrived in this middle-hills town 150 miles to the west by 4 in the afternoon. We had been warned that army and police checkpoints along the main east-west highway would severely disrupt the journey, and that we must break the journey if we had not reached Tansen by dark. In the end, only once did a couple of policemen board the bus and poke half-heartedly at our bags. They did spend longer clambering over the luggage on the roof, and we were watched carefully by their colleagues and a mounted gun from a sandbagged look-out. It seemed that the threat of lengthy body and baggage searches had reduced the traffic greatly, and we had none of the usual delays or accidents that have added up to 6 hours to the journey. We were glad to reach our destination two hours ahead of the voluntary curfew, and we quickly took a taxi-jeep around to the mission hospital, where dinner and a bed at the guesthouse awaited us.

In the week of November 26, the King declared a state of emergency following the sudden withdrawal of the Maoists from peace talks and their breaking of the ceasefire with a particularly bloody series of attacks across the country. Curfews were announced in many towns and cities (but not Kathmandu), several Maoist-related organizations were outlawed, restrictions were placed on group meetings and freedom of speech and, most significantly, the army was called out. Some UMN projects had violent incidents in their vicinity, field work has been severely restricted and all travel has to be approved by senior management. Once again in this year of uncertainty and instability, the country seemed to teeter on the edge of civil war. But once again, we seem to have avoided plunging into chaos as the army clamp-down brought a sense of order, though with a heightened level of security.

It is very difficult to tell what is really going on. Here in Kathmandu we have army foot patrols on the streets and increased police checks on vehicles both day and night, but otherwise life continues as normal. The newspapers assure us each day that the army is making gains each day in the number of Maoists arrested (or killed) and arms recovered, but the current controls on independent journalism make us doubt that we are getting the whole story. There are concerns as to what impact army activities may be having in remote communities known to the Maoist strongholds, and as to how many innocent villagers may be caught between the two sides. Nevertheless, we sense a greater sense of calm and some confidence that finally someone is prepared to "get tough" with the rebels.

Once Tikka, Training Assistant with the Nutrition Programme, and I had arrived at the United Mission Hospital Tansen, the security situation had no effect on our work. Under one of the Nutrition Programme's long-term goals of supporting nutrition work in UMN projects, we were there to review a feeding programme recently started for pediatric patients and to give staff nutrition training and updates. For me, a visit to a hospital project is always rewarding as it gives me a chance to exercise my clinical skills, which are less used in our development work where the focus is of the huge problem of community-level malnutrition. Food rules and restrictions are a strong part of Nepali culture, including the treatment of illness, and the lack of quality dietetic information in medical circles is made up for by a large number of myths and misbeliefs. Diabetics may be allowed to eat wheat and maize, but not the Nepali staple food of rice or potatoes (all nutritionally similar in terms of diabetic control); nutritious yoghurt is not given to people with "cold" illnesses such as chronic lung disease; new mothers must avoid fresh fish lest the bones pass into their breastmilk and harm their child. There is no shortage of educational opportunities under such conditions!

During this visit, I gave a class on diet for high blood pressure to medical assistants working in the outpatient department, and trailled a new patient leaflet on the subject with them. While reviewing feeding on the children's ward, I was able to advise on a special milk for the treatment of life-threatening malnutrition, and teach on the nutritional management of these children. Malnutrition also affects the prognosis and recovery of many of the adult in-patients. Following a lively meeting with doctors it was decided to develop a new nutritional supplement for use throughout the hospital, similar to the special nutrition drinks that are found in Western hospitals. Malnutrition in adult patients was also the topic of classes with nursing staff and a large group of students from the mission's recently opened Tansen Nursing Campus.

Meanwhile, Tikka was busy giving classes in basic hygiene and nutrition to the hospital canteen staff and to local hotel and restaurant owners, on whom many patients and their relatives rely for food and lodging. The hospital team plans to develop community health activities with this group and other townspeople, and certainly they responded with huge enthusiasm and requests for more training in nutrition. So by the end of our 3 day visit we were making plans for a follow-up visit in 2 months time: for myself to assist with the launch of the nutritional supplement in the hospital, and for a small team from our office to provide more training and input for the nutritional component of the community work.

The state of emergency has also affected Christian activities in the country, but not in ways much different from the rest of the population. From rural areas there are reports that mid-week evening meetings for fellowship and Bible study have had to be stopped or moved to afternoons. Christians, as other villagers, have had intrusive searches carried out on their homes and properties. This year one of my favourite parts of a Nepali Christmas was missing as our church cancelled its evenings of caroling around the streets of Patan. Nevertheless, a large crowd gathered as usual on the roof of the church on Christmas Day for the Christmas service and children's programme and the "traditional" church Christmas feast. All was conducted in warm, bright sunshine and "a very good time was had by all!"

As we enter the new year, your prayers are needed more than ever: first that the Maoist issue, and the social problems out of which the movement has flourished, might be dealt with effectively. The peace promised at Christmas does not come without hard work and sacrifice! Please remember the work of UMN: that projects can still function safely and effectively in spite of security tensions. The Nutrition Programme is now looking for a new area for a field project. At Patan Hospital prayer continues to be needed for future development and leadership of the hospital. The new year will also see some minor alterations in our flat as our office/computer room is converted into a nursery! Please pray for Mark and I as we prepare to welcome baby Zimmerman in early May... no doubt a year of many changes ahead of us!

With love,
Deirdre and Mark

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