Memories of my mother in a Crusader camp sketch wearing yellow oilskins and with an eye stuck to her forehead was as much as Kathmandu meant to me before arriving in Nepal.
While contemplating my elective I had decided to use it as an opportunity to learn more about working in mission overseas. Following time spent abroad in the past I had developed an interest in working in the developing world in the longer term, but knew I had a fairly romantic view so I applied to Interserve's On-Track programme, seeking reality. They sent me to Nepal.
Kathmandu
Reality greeted me in Kathmandu, I was travelling with Sarah, my flatmate who was spending her elective in a different hospital. We were met by someone from the United Mission to Nepal (UMN) and taken to the guest house. This was my base for the next seven weeks, while I worked at Patan Hospital.
The guest house proved a good place to start my mission to understand mission! It was the first port of call for anybody connected with UMN who arrived in Nepal. Some people who had come to work long-term were starting their five month language and orientation programme, The pain of leaving family and the stresses of starting still seemed to be fresh in everyone's minds.
They were faced with rice and daal on a daily basis, the seemingly insurmountable barriers of language and culture, the relentless pollution of Kathmandu streets and the discomfort of always being different to everyone else. All this without the luxury of knowing they would be leaving in a few weeks. I was challenged by their joy and enthusiasm and their unwillingness to complain. Even those who had to care for their children faced each day with a firm and constant trust in the Lord. They had come to offer their service and they were cheerful givers.
Patan Hospital
So what were the reasons for such people leaving the luxuries of the West for this very different place? Patan Hospital is jointly run by UMN and the Nepal government. There are a number of Christians from overseas working there as doctors, pharmacists, dentists and in hospital management. I spent three weeks shadowing doctors in different specialties and saw the remarkable as well as the usual. The 'remarkable' included tiny premature babies sharing a fullsize bed with their mothers - in England, I'd only seen them nursed in high-tech incubators. The usual included big outpatient clinics, overworked staff, and constant pressure on resources.
I was most challenged in all this that the work of these 'missionaries' was hardly different from my own life as a Christian in England. The romantic mission field of Nepal was the same as my mission field in the East End of London. They too shared the desire to witness to the gospel with colleagues and patients, and the continuing battles with fear, lack of boldness and the demands of a busy job.
Nepal is a Hindu kingdom. To change one's religion is a punishable offence. I found it difficult to know how I could communicate my faith with others without it being inappropriate and without putting others in the Nepali church at risk.
I began to realise however that there was more involved in the work here as Christians. I began to see the suffering and hardship with which the people of Nepal had to live. Initially the great differences in their culture blinded me to their poverty. Daily I saw people arrive at the hospital having walked or been carried for many days. I saw people leave the hospital inadequately treated because they could not afford to pay. I saw malnutrition of children and the debility of patients with untreated TB and leprosy.
All this reminded me that the Lord commanded us to love our neighbour as ourselves. To enjoy the luxuries of the West while so many others suffered so greatly didn't seem to me to be particularly loving. I was shocked and ashamed that it had taken me so long to become aware of such suffering. I learnt how hardened my heart had become by my wealth and the opportunities given to me in life. I began to see that coming to work in a less developed country might be one way in which I could love these neighbours, and use the gifts given to me for the sake of others.
Community Development and Health
Having spent three weeks in hospital medicine, I moved on to the Community Development and Health Programme (CDHP). This programme was working in the more rural areas surrounding Kathmandu trying to improve people's standard of living. This involved improving sanitation, providing a safe water supply, improving agricultural methods and basic health, and increasing adult literacy.
I stayed for nine days at a health post which was a six hour walk from the road. My strongest memory of that walk was my struggle to keep up with the porter. Even though he was walking in flip-flops and carrying a 40 kilogram load on his back, he still marched at a greater pace than I could manage. Work at the post involved running a general clinic and specialist clinics such as antenatal care, mother and child health, and family planning. As it was isolated I had to learn very quickly how to express my basic needs in Nepali, how to eat rice with my hands and how to survive on two meals a day.
While there began to think about the contribution an expatriate doctor could make in such a country. The initial groundwork in CDHP was found to be more effective if it was done by Nepalis who could engage with the local people and encourage community initiative without fostering dependence. CDH interests me greatly but I left with more ideas about what I could not do rather than what I could do.
A remote hospital
I went up to see Sarah at her hospital. This meant a six hour bus journey and a four hour walk. It seemed incomprehensible that a fully established hospital could be so far from the road. There were a number of doctors from overseas doing an amazing job. Nepal does train its own doctors but very few are willing to work in such remote areas. Here, Christians have been able to provide basic health care. I found out more about the practicalities of living; for example, how to educate one's children, how to establish genuine friendships with local people, and how to be involved with the local church.
I set out to learn the realities of life on a different mission field from my own. I learnt much from living amongst the Nepali people as well as from meeting Christians from overseas. My willingness to work somewhere like Nepal has by no means diminished even though I have seen the less romantic side of the work.
Rebecca Underwood was a final year medical student at Bart's/The Royal London when she did her elective in Nepal in January and February 1998
