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Just outside the hospital gate are many varieties of houses, restaurants and hotels. Most have been rebuilt and modernized with cement (rather than the traditional mud, brick and tin.) However, there are still a few places that have been put together with whatever could be put up cheaply.
Each morning we walk by a certain house where a widow and her son live. They have been there for over 10 years – even though it is not their land, but is owned by the government. We would call them squatters. When we first came, the husband also lived there, but he became ill and died several years ago.
We came to know that this widow, with whom we often chatted, was actually the second wife of her late husband. His first wife and children lived in a near-by village. This is still more common than we would like in Nepal.
So – after the husband died, the first wife decided to move in next to the second wife, and to build a hut and “squat” there, too!
The second wife has become a believer and we see her coming to church regularly. She is not able to work, and her son has been ill, so the church, and others have been helping her with food. There is no water where they live, so they have to carry it from the local springs and taps. (It is a 5 – 10 minute uphill walk to carry water to their home.)
We know that they don’t have much money, so we were really surprised the other morning as we were climbing the steps beside their homes. Les said – “Look at that! A satellite dish!” Wow. No water. No toilet. But – we have TV! We never cease to be amazed at what people consider to be important, and the choices they make!
This dish is on the first wife’s roof – and we don’t know them really at all, so we don’t want to make assumptions that may not be true. But it just struck us as something we have noticed over the years here in Nepal – the juxtaposition of the old and new.
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Just a few days after our last post in December, we were on our way to the U.S.! We did a 2 week quarantine and got to spend Christmas with our grandchildren. It was wonderful. Then – we got Covid just at New Years time! We are so thankful we had only mild cases, and were able to see family again after another 2 weeks of isolating. It was a strange trip this time, but overall restful and good.
The work permits came through at the end of December for the expats in Tansen. When we returned on Feb 4, we were able to get our first dose of the vaccine! We started back to work on Feb 7 and it hasn’t slowed down since! The numbers of covid patients in Nepal has gone down hugely, and here in Tansen, our isolation ward is now empty, and will once again become the regular Medical Ward. We are thankful for this – the hospital is very full and busy these days… it is virtually impossible to maintain any distancing between people. Most are still wearing masks. Training programs are starting again, as well. Thank you for your prayers for Nepal – and we do pray that there won’t be a second wave! Vaccines are starting to become more available.
Les was finishing up today when he went back to check on a young man (15 or 16 years old) who had come in during the night as he had swallowed pills to try to kill himself. He started to wake up when Les was there and wanted to be allowed to leave so he could go get more pills and try to kill himself again. Unfortunately, our psychiatrist is away for the week, but Les and another pastoral care worker spent a lot of time talking with this young person and praying for him. Les was able to start him on some medication, but he certainly will need prayers. Les is once again back in his element and loving it!
I was happy to see that the 2021 Friends of Tansen magazine had finally arrived. Unfortunately, we are still unable to mail anything internationally, but we do have the digital version! I hope you will enjoy the stories from this past year – a bit different as everything else has been lately.
We love the comments you post – thank you so much for sharing in God’s work in Nepal and for encouraging us along the way. Here is a recent photo from a wedding we attended. Tansen in on the hill behind us.
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I (Les) have not been allowed to work this past week. My work permit and registration at the Nepal Medical Council both expired on Sunday, November 22, and have not been renewed. In fact, the same thing happened to all the foreign missionaries in Tansen. At least for me, as a US citizen, I have a 3 year visa in my passport. Those on our team who are not Americans had to go on a tourist visa to stay in Nepal legally. But none of us are working until we get the work permits. Since we arrived here 30 years ago, this is the first time we have had to stop working. This is the result of several unfortunate things converging at the same time:
1. When the last 5 year agreement was expiring in January, a new agreement still needed to be written, so we were all given 6 month extensions. But the government decided that the UMN hospitals should no longer be managed by a foreign mission, but by a trust set up in Nepal. This is probably the result of increasing nationalism and Hindu lobbyists gaining more influence. This was announced in May, and we were given another 6-month extension to allow time for the legal work of forming the trust. UMN now has the trust established, but there was not enough time for the hospital agreement to be made before time ran out on November 22.
2. Nepal’s new federal system, written into the constitution that is being implemented now, means that the provinces have more self-governance rather than everything being managed from Kathmandu, the capital. Unfortunately, it is still not clear which powers are being given to the province. It seems that everything now requires approval from both the province and the federal government, doubling the bureaucratic red tape and administrative hurdles. The hospital is getting registered as a new community hospital in the province. But the provincial office staff are learning how to do this themselves, apparently without much guidance on what this process should involve. For example, they requested that the personal information and professional qualifications of all 400 staff be photocopied and submitted. Now that all details have been submitted, they are waiting for a committee with a radiologist, pathologist, physician, and managers to meet so they can review our application. The work in Kathmandu to get our visas cannot go forward until the hospital is registered in the province, and UMN and the government have a working agreement signed.
3. Dashain and Tihar, the 2 main holidays of the Nepali calendar, fell late this year, so most government work was shut down or running with minimum staff from mid-October for a month. And usually when the person with power to authorize something is on holidays, their duty is not delegated to anyone else, but left until that person returns. So right when the crunch was on to figure out an extension or some other deal, nothing was happening until right up to the last few days before time ran out.
4. Lock down and work from home during the Covid-19 pandemic affected all work by both the government office staff as well as the UMN staff working in Kathmandu. Even the hard working ones were struggling to get things done that had been previously managed efficiently.
So while we are forbidden to work, we are taking a break, and have come to Pokhara for 3 days to celebrate my birthday. (We returned safely to Tansen last night) We are also praying about how long we should wait in Nepal for our work permits, before we take a longer break, returning to the USA to see family and friends. On the one hand, we don’t want to leave if God wants us to stay, and if the work permit will be approved soon. But on the other hand, it is even harder to be away from family when our reason for being here, working in the hospital and ministering to patients and visitors, has been taken away for an indeterminate amount of time.
The hospital has been struggling along with only the Nepali national staff working, at least the ones who have not been quarantined for testing positive for Covid-19. Thankfully no staff are critically ill. Hospital work is now running at under 50% of our normal capacity. It is hard to see patients waiting for tickets to be seen, or giving up and going home without care, when we are right here and willing to help. It is also sad to think of the new junior doctors, who still need a lot of supervision and support from the senior doctors, losing half of their mentors. We are certainly thankful that we have at least a few good senior Nepali doctors working hard to keep things running.
So pray, pray, pray! God knows what He is doing, even when we don’t. We are trying hard to see where God is going with all of this, and to join in with Him rather than to fight against Him. Thank you to everyone who supports us in prayer, especially in these coming days.
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Little Khari was just six months old. She lived in a mud/brick house in the village with her older sister, her mom and her grandma. Her father was away in India, trying to earn a cash income to support his family. Until the lockdown (Covid) he was working a good job at a hotel, but that ended in March. He decided to remain in India in hopes of finding some other work, as he knew there was nothing he would be able to do in Nepal. Other than a small senior citizen stipend that the grandmother receives, this family had no money coming in on which to live.
The family did have a little land, and they could grow enough to feed themselves for about 4 months of the year. However – there was only the mom and grandma to work the land and plant the crops. They also had to care for the one oxen they owned.
One day, Mom and grandma had to both be out working in the fields. Khari was left with her older sister – who was just a 2 year old toddler. At some point, Khari rolled into the fire used for cooking and began to scream and cry. Her mother was too far to hear, but a neighbor heard the cries and went to investigate. She pulled Khari out of the fire and took her outside and called the mother.
Khari was still conscious when her mother got to her, but her legs were badly burned. Due to the lockdown, getting any transport was difficult. They managed to get her to a nearby hospital, who referred them to another, bigger hospital in Butwal. That hospital also said they couldn’t help Khari and suggested they go another hour up the hill to the Mission hospital in Tansen.
When they arrived in our Emergency room, the doctors immediately admitted little Khari. She had 12% burns on both legs below the knees, and 2% were deep burns. She received various treatments here – and the mother was provided with a high protein, nutritious diet so that she could breast feed Khari and help her to heal.
This family had to borrow money to get to the hospital – and if it weren’t for the gifts sent by people like you to help give free care for poor patients, little Khari wouldn’t have been able to obtain medical care. Her mother wouldn’t have been able to get good meals in order to gain strength to be able to feed and care for her baby.
Lockdown and Covid have affected us all – but these people who had so little to start with are struggling so much. We are so thankful that – because of you – the hospital can be here….still open and serving the most needy among us.
Khari did fully recover and was able to return to the village with her mom. Thanks for your prayers – and for your support!
After almost 3 days in isolation, the staff who had been in contact with the covid positive patient (5 days previously) were called to the tennis court on the hospital compound to get their swab tests. The process took about 2 hours to get everyone done.
In between each test, the area was disinfected.
As the time went on, and more were tested, eventually the guys in their hot, plastic PPE had to walk away, and take off their head gear to cool off a bit! Then they suited up again and returned for more tests….
Les was one of the final ones done.
We were so thankful to get the results in 24 hours – and to learn that Les and all the others tested that day were negative! I don’t think an hour passed before Les was dressed and back at work at the hospital. Hmmm – maybe he wasn’t enjoying all that time alone with me?? 🙂
Unfortunately in other testing, it was found that 4 staff had turned positive. They are not sick, but are currently quarantining.
The medical ward was emptied of patients, and has been completely cleaned and disinfected. Tomorrow out patient clinics will resume again. Although – patients never stopped coming – and our maternity ward is filled and overflowing into the surgical area!
Thanks for your continued prayers for the hospital. We are so thankful that in spite of difficulties, the Mission hospital can continue to serve the people of Nepal.
I (Les) saw her on Tuesday morning rounds. She had been admitted on Monday by the surgical doctors with a breast abscess (collection of pus in the breast tissue). But the surgical ward was full of patients, and since the medical ward still had empty beds that day, she was put in the medical ward. She was started on antibiotics, and the pus was drained on Tuesday morning by the surgeons. After she returned from the procedure, the medical ward nurses asked me to write the order for her to be moved to the surgical ward, since there were now empty beds there. But I noticed the surgeon had written that during the procedure her oxygen level had been unexpectedly low, and she was now on oxygen. I went to examine her, to see what was happening.
She was in a regular bed, in a ward with other medical patients. Everyone was wearing masks, which is now our routine, both for staff and patients. She said she had no breathing difficulty or coughing, but I could see she was breathing fast, and her lungs had crepitations, a crackling sound caused by infections such as pneumonia. I added an antibiotic to treat pneumonia, and asked for a chest X ray. I also asked that she be kept on oxygen in the medical ward, rather than moved to the surgical ward. When the X ray came back, she indeed did have signs of an infection in her lungs. By evening she was breathing a little harder, so she was moved to the room for critical patients.
Wednesday morning on rounds she was about the same. When the team discussed the case, we considered the possibility that this could be Covid-19. There were now increased numbers of cases in parts of Nepal, including transmissions within those communities. Although we had not seen many cases yet, we were expecting more to come. We asked for her to be tested for Covid-19, which we are still unable to do on site, but must send the sample to the regional government testing center. While the test result was awaited, it was decided to send her on to the government Covid-19 hospital in Butwal, over an hour away, which was done on Thursday morning.
Her result came back Thursday evening as positive. It was decided that all staff who had contacted her directly would be put in isolation until tested for Covid-19, but all would have to wait until 5 days post exposure. 18 of our doctors, including me, were identified as having had contact with her, as well as quite a few nurses and other staff. On Friday, the remaining doctors mostly spent the day discharging anyone from the hospital who could be, and seeing emergency patients who came.
In my second day of isolation, which feels a bit like solitary confinement, I have had some time to think things over. We are quite a pair here in our house: one of us not allowed to leave the house (me), and the other unable to do so (Debbie), due to her broken leg. We sent Sarda, our household helper, home, so that we wouldn’t be exposing her and putting her whole family at risk. We are also trying to keep safe distancing between the 2 of us, wearing masks even in the house and washing hands a lot. We are trying to stay thankful and to keep trusting God, by doing spiritually uplifting reading and watching some shows (thankful for internet!!), praying, and keeping in touch with family and friends. What is God’s plan for us during this time when we feel like we have absolutely nothing to contribute? I hope to use some of the time to think of our hospital procedures again, to avoid this kind of shut down, and to prepare presentations I need to give in the future. Perhaps we just needed to stop doing our “busy work” and to “be still”. And – I am now the chief carer for Debbie – she says I’m getting good at making chiya and getting her the things she needs!
Debbie is still not able to bear weight on her leg and uses crutches just to get around in the house. Most of the day she has to keep her leg elevated, and she continues to do her physio exercises. In 2 more weeks she will get another x-ray to see how the healing is progressing. Thank you to so many of you who have emailed and been praying for her. And now – thanks for your prayers for us! I should get a swab test done on Monday, and we are praying for negative results.
There are days when I feel as if things will never change… every day is the same, every week, every month. I stopped counting lockdown days at 100… and I have to say how thankful we are that just yesterday restaurants and hotels in our town opened again so we could enjoy a meal “out” – the first in months. We were excited! (We do still wear our masks out in public and in the hospital!)
No one knows what the future holds – but we are hopeful that things will continue to open here to make people’s lives easier. We are thankful that bus service within our district has opened so that more patients can make it to the hospital. So many were waiting until too late to come or arriving much sicker than normal. The maternal-mortality rate had skyrocketed due to the lockdown. Now our outpatient clinics are almost at capacity again, and the wards continue to be full. The doctors and staff are working hard!
As for covid patients – we have had very few. For awhile, there were dozens of positive cases housed in isolation areas near us. Virtually all were young men who had been working overseas or in India and had tested positive upon returning to Nepal. They were housed and fed – and entertained themselves by singing and dancing. All have now been sent home to their villages after their 2 weeks of isolation.
The schools remain closed in Nepal. On our hospital compound, there is the small “tutorial group” which has been the school for missionary kids for many years. In March, there were only 2 students in the school – a brother and sister from Korea whose dad is a surgeon here. Also living on the compound were 4 other young school aged children who were home with nothing to do (their school was closed). We decided to make a change and to invite those children to join the school for several hours 4 days a week. We got a couple of volunteers (including myself) and the school has been very lively these past weeks. We are thankful we can help these children to have a bit of “normality” during these strange days. I tutor the oldest Korean boy 3 days a week in English – he is doing great! We just finished reading “The Magician’s Nephew” which brought back so many memories of me reading to my own children here during our homeschooling days. I also have been doing music once a week again – now that there are enough children to make it more fun!
Flights into Nepal are scheduled to start again on Aug 17. We wait to see what will happen. We continue to pray for Nepal, for the U.S., and for the world – for an end to the virus, and for an end to the hatred and division which seems to loom so large in these times. Let us love each other as best we can! And take time to sing and dance a little – it can brighten your day.
Many years ago (30 now!) when we first came to Nepal, we were told by the Methodist church (our sending agency) that they would pay for certain appliances and necessary items for our home in Tansen. This list included things like beds, table and chairs, gas cooker/oven, and refrigerator. However – one item was not included – a washing machine. At that time, I will admit that no one had a washing machine in Tansen. That is one of the reasons we had a house helper – to wash all our laundry by hand. I remember getting blisters on my hands from wringing out diapers during the occasional absence of our house helper, so when my parents came to visit us soon after Hannah’s birth, they brought a “mangle” purchased at an Amish store! (For those too young to know what this is: https://en.wikipedia.org/wiki/Mangle_(machine) That was amazingly helpful for our remaining 10 years in Nepal with kids.
During our almost 10 years in the U.S., I once again enjoyed a washer – but I still clung to the habit of hanging our laundry out on lines to dry as much as possible.
In 2012, we returned to Tansen and found that our househelper (same one as before) had aged right along with us, and doing our laundry by hand was harder for her!
So, when a family left Tansen soon after our arrival, we purchased their machine – a simple twin tub washer which you filled with water, washed, moved the clothes to the other tub which was a spinner, then refilled the other side with water to rinse, and then another spin. It was a good system, but still could use quite a bit of water – even though we drained it into buckets and used it on the garden. It was also a bit time consuming.
This machine was kindly paid for by good friend of ours in the U.S. Because, our sending church still did not consider a washing machine as a necessary piece of equipment. Now – I do want to say that Global Ministries and the United Methodist Church are a great supporting agency. They pay us a salary, give us insurance and support us in many other ways. We are so thankful for them and for many people who support us! I just find this particular rule a hard one to understand sometimes.
We used to think that washing machines used more water than by hand – but that isn’t always the case. People here run water from the tap the whole time they are washing – filling bucket after bucket of water. Frustrating in a place where water can run short.
We moved to another house 4 ½ years ago, and got to use the machine left here – a front loader which was amazing! It used so little water and was very efficient. But – it was old, and leaked, and then – right after the lockdown started here – it quit. So – we had no househelper (due to the lockdown), no washing machine, and no shop open in order to purchase a new one! I “borrowed” other people’s machines who lived near us to get through this time. No – I didn’t go back to doing our laundry in buckets. (Even though we were remembering that way back when I used to wash our laundry by hand even on family vacations in Nepal! I was younger then…)
So – imagine my delight this past week when shops opened up, and I found just the type of frontloading washing machine that I wanted! We got our old machine taken out of our house (and had to remove the bathroom door in order to get it out!) and I scrubbed the long-neglected floor under that old machine to prepare to get our new one! The next day, a “bokne manche” (a person who makes a living carrying things on their backs) was dispatched from the store in the bazaar to bring our machine to our house. (That walk takes us about 30 minutes only carrying ourselves!)
They brought the machine to the house, and our workshop guys helped us install it. (They also rehung the door!) Now – I am so happy to be able to put the laundry in our new machine, and not have to run up and down the hill to where I had been using another machine (which was one of the twin tub types so it meant multiple trips per load). Sometimes I go and watch our new washer work – just for entertainment! (Les has threatened to put a bow and ribbon on the machine and say that it is my anniversary/birthday present. Actually – I am okay with that!) 😊
Life in Tansen goes on – and we are thankful for small mercies, like washing machines! If you have the time, watch the “magic washing machine” TED talk. I found it quite fascinating! https://www.youtube.com/watch?v=6sqnptxlCcw
Thanks for your prayers. Thanks for reading this more light-hearted look at our life. During these days of so many difficulties, we hope it brings a smile to your face. We think of you and pray for you. Stay well!
I have written this blog post at least 3 times – and it just hasn’t been right. I find it very difficult to put my thoughts into words. Please accept my rather rambling jottings as I try to share.
This is day 72 of our lockdown in Nepal. For many, many days, the numbers of patients in the country stayed very low. Then, a couple of weeks ago, the numbers started rising quickly, and now the positive count is over 2000, with 8 deaths. On top of that, we actually got our first positive cases here in Palpa on Sunday evening. Right now, we have 5 positive (but not sick) men in isolation in a small building just outside the hospital. Our staff is helping keep an eye on things there. In our isolation room at the hospital, we had one man die yesterday (but his test results haven’t come back yet) and another man waiting also for test results.
The government decided to once again extend the lockdown until June 14, and the airport is closed until June 30.
When the first news came through here about the terrible death of George Floyd, we also learned of 2 young dalit (untouchable caste) men who were killed in a nearby district. One of these young men had fallen in love with a high caste woman, and he and his friends were on their way (according to Nepali custom) to meet her at her home and then they were going to get married. The hopeful groom and one of his friends’ bodies were found later by the side of a river. The other friends had run for their lives. These young men had apparently been beaten to death by high caste villagers who were against an inter-caste marriage.
My heart breaks for those who have no voice. The poor, the oppressed, the children. I pray for God’s mercy on us all and long for the time when we can care for and love each other better.
I know that many of you are also praying for this world. I am thankful to so many of you who have loved and supported us and the people of Nepal for so many years.
I am attaching a link to a short video recently put together by our surgical team here. Thank you, in the midst of all the chaos and need, for taking time to read my words, and to listen to this video. #stillinmission
It was 8 years ago today that we returned to Nepal to serve again at the United Mission Hospital, Tansen. When we were applying to come again, we had to put down how many years we were willing to be here. Les said, “10 years?” I was quite emphatic in my response, “No way!” And here we are – 8 years gone by already! I am reminded again that it is good (for me) that God doesn’t tell me in advance His plans!
Last month I was privileged to visit the New Life Psychiatric Rehab Center for a Prayer service for the new building. It wasn’t quite finished, but people were visiting and it seemed a good chance to gather and thank God for the work done, and pray for the future needs.
The building looks great – it will be wonderful to be able to house more people who are in need of care – those with mental illness or other problems who have no family to care for them, and no other place to get help. Currently there are 9 clients in the facility, but this will more than double the amount who can stay there.
It was encouraging to see the animals being cared for, and fields and crops being raised and used to help create some financial support for the clients and staff. It isn’t much, so there is still a big need for gifts from outside to fund the running of the NLPRC, but it was good to see the residents themselves able to do their part.
I met a man there named Karka. He had been kept chained up by his family, and was brought into the hospital with deep wounds on his wrists from being kept in bonds. The bones were visible, and there was so much infection that one of the orthopedic doctors was sure that the hands would need to be amputated.
Pun Narayan, who is the force behind this center, and also the head of the Pastoral Care/social services department at the hospital, didn’t want to see this amputation happen. He prayed – and he believed that God could do anything – including the full healing of Karka.
And it happened! Yes, he has some scars to remind him of what he went through – but he has full use of his hands and is able to remember that God was the one who healed him.
I am sure I do not have the faith of Pun Narayan. I continue to be humbled by our Nepali Christian colleagues. Even though they always ask us to speak at gatherings, lead bible studies, or teach them, I am constantly thinking that it should be the other way around. I have so much to learn from them.
Please do continue to pray for the NLPRC – that the new building would be completed soon, and that the staff would remain strong and faithful in their service. And pray for us to be humble servants willing to be used as God asks.