Monthly Archives: September 2013

Update: health training

On Tuesday, we had the graduation program for our 9th batch of MLP (Mid Level Practicum) students.  This is a course that takes government health post workers (paramedicals) for 3 months at a time and reviews with them the basic skills of history-taking and physical examination, diagnosing the 20 most common problems seen in health posts, and doing the 10 most common procedures.  There are 6 to 8 participants in each batch, sent by the Ministry of Health.  They are mostly bright, dedicated health workers living in very remote areas and working alone.  Every batch has started out reluctantly, thinking that they already know a lot.  But by the time they graduate, they have learned a lot of things: clinical knowledge they had forgotten since they first went to school as well as an awareness of the need to continue studying during their entire career.   The course includes some time in the classroom, but most of the time is spent in the clinics working together with our own staff, who act as mentors.  We had a final practical test for our participants on Monday.  This kind of training is one of the things I (Les) enjoy most here in Tansen.

Les contemplating....

Training session

These MLP courses were started under the auspices of the Nick Simons Institute (NSI).  Although we had always tried to have training as an important part of our work here in Tansen, it did not really take off until after we became involved with NSI.  The Simons family established NSI in memory of their son Nick, who loved Nepal and was planning to train in medicine and come to Nepal to work until he was tragically killed in a swimming accident.  Directed by our good friend Mark Zimmerman, NSI developed the vision of assisting government hospitals and health posts in Nepal by training staff and building up facilities in remote areas.  Because it has been difficult to get doctors to stay in the villages, NSI has put a lot of focus on training paramedical staff, who tend to stay in their local area.

As one of their partners, we are a training site for MLP.  Other trainings we do in partnership with NSI are the Skilled Birth Attendant (SBA) course for midwives and the Anesthesia Assistant Course (AAC) for anesthetists.  We continue to have resident and intern doctors we train, and we are the site for most of the practical rotations for the nursing students from the Tansen Nursing School.  We have started to work on developing a laboratory technician school that will be based in our hospital, also.

Of course we continue to treat patients who come to us, but through training we can multiply what we do.  Now the effects of what we do go outside the four walls of the hospital, even beyond the boundaries of our district and last longer than the years we ourselves can stay here and work.  Not everyone we train stays in remote Nepal.  In fact, a discouragingly large number of our former residents and interns are now living and working in Western countries!  We can’t be angry with them; it is only natural that bright, promising young Nepali people should try to get a better life for themselves and their families.  But each person who stays in Nepal and serves the people here gives us great encouragement to continue what we do.



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Poor decisions and shattered lives

Some of you will remember the paragraph I wrote in a blog posted June 2 about the “Miss TNS” program I helped to judge at the nursing school right next to the hospital.  The winner of that Miss TNS was a bright, promising young woman who was looking to lead her friends and classmates through their final year of nursing training.  We all had high hopes for her.

Unfortunately, we learned recently that this young woman had been arrested – having been found in a motel room with a married man.  The young man, D, is married to one of the women, B, who works for the missionaries as a house-helper.  D and B have 2 lovely young daughters.  When family and friends tried to ask D why he was interested in this other girl (nursing student), he just said “Everyone is taking a second wife – why shouldn’t I?”.

It is unfortunate that many men in Nepal still take a second “wife” – even though it might not be strictly legal anymore.  We don’t understand – we have known B for many years, and she is a happy, loving person who has always been the kind of person who you would hear before seeing – and what you would hear was her wonderful laugh.  She will now have to contend with a husband who splits his time between her and the girls and his other wife.

Another thing we don’t understand is that the nursing student’s mother actually took her and D down to a Hindu temple and had the marriage ceremony performed.  Why would she support this for her daughter?  And – now the young woman has lost her spot in the nursing school – only months away from graduation.  She will have to start over again in order to learn a skill to find work.

B, with the 2 girls, is living in the same home with her in-laws.  We also heard that the mother in law encouraged her son, D, to take another wife.

So – we see B now – whose bright spirit is somewhat dimmed these days, but who is trying to hold on to her faith in God.  B is a believer, and has been for many years.  What was her poor decision?  To marry a non-believer.  For her husband, D, there doesn’t seem to be a problem with the 2 wives as he is following something in the culture as opposed to trying to live as Jesus would like.

The longer we are here, the more we realize we don’t understand.  This continues to bring us to our knees – and to be even more thankful for those of you who continue to pray for us against the darkness still found in this land.

We also pray for you and for our home country.  It is easy there, as well, to follow the culture instead of the way of our Lord.  Keep the faith!  I was reading in First Corinthians in the Message the other day, and this verse struck me, “Forget about self-confidence; it’s useless. Cultivate God confidence.”  Thanks for taking time to read our thoughts.

B - in a happier moment


B in a happier moment – the house-helpers were gathering for a farewell party and B  won our game, “Pin the tail on the water buffalo”!


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