Pandemic Fear Grips Nepal's Remote Villages

July 23, 2020 | Pulitzer Center

BY KUNSANG CHODEN


Secluded from Kathmadu, and with no COVID-19 cases, thus far, there is only one health assistant per health post in the event the pandemic strikes the remote village of Nubri. Image by Kunsang Choden. Nepal, 2017.

As Tashi Lama was preparing dinner, a tired-looking man with tan skin and the smell of sweat arrived at her small lodge and asked for a room for the night. "We don't have a room right now," Tashi said, and sent him to another hotel nearby. Later that day, she recorded the visit in her daily COVID-19 journal, which she'd agreed to keep for me. “I am scared of new people,” she wrote, “and don’t want to open my lodge.”

Tashi, 24, works in Nubri, a valley in the Himalayan district of Gorkha, in Nepal. This mountainous, sparsely-settled landscape ranging from 6,900 to 14,500 feet is located a day-long bus ride from Nepal’s capital, Kathmandu, and a five-day walk. The people’s agro-pastoralist lifestyle is grounded in subsistence farming and, more recently, income from the trek-tourism industry. Villagers chant Buddhist mantras and speak in Nubri-ke, a dialect of Tibetan. This population of 2,500 is split across eleven communities. Tashi is originally from Dang, a community of around 50 people that is also the first Nubri village greeting those who arrive from down valley. While the majority of the younger generation Nubribas (people of Nubri) have left their village to either study abroad or to work in the cities, Tashi is one of the few to return to her home village after graduating from high school in Kathmandu. During the summer, she has been working as a seasonal lodge assistant in Samagaun, but because of the pandemic there are no tourists this year. She had little choice but to return to Dang and help her mother work in the fields.

On May 8, 2020, however, Tashi wrote, “I am scared to go back to my village because it is on the main trail, and the village leaders have decided to let mules that carry the food supplies travel between villages during this lockdown. It makes me feel insecure.” In her journal, she highlights how stressed and scared she is because of the pandemic and the lockdown. Mule train drivers have likely encountered many people and could be vectors for spread of the disease.

“I woke up around 7 and did my morning chores,” she wrote on May 10, six weeks after Nepal’s lockdown began. “I didn't check any news about the virus on Routine of Nepal Banda posts on Facebook, as it would disturb me the whole day.” According to Alija Shahi, a health assistant from Community Action Nepal (CAN Nepal) who has been working in Nubri for the past seven years, “Villagers are encouraged not to travel between villages. If someone travels even for short distance or for emergency reasons, they are required to stop at health post between villages and get a full body checkup before they can enter the next village.”

Additionally, she says anyone coming from Kathmandu must quarantine for two weeks in Jagat—two-days walking distance from the nearest village in Nubri. These regulations came into effect on March 28 after the government of Nepal announced lockdown throughout the country. “We received a COVID-19 regulatory message through the ward chairperson for the TsumNubri Rural Municipality, Gorkha," says Amchi Dorjee, a traditional Tibetan doctor from Trok. "After receiving this message, our Gapo, village messenger, delivered the message to each household in Trok.” Before heading back to Dang on May 12, Tashi stopped at the Sama health post to get a medical check-up paper, which she would need to show at the next health posts. Tashi wrote, “I put my mask on as I passed Lho village. I thought the health post staff would see me and come down and check, but they didn't. The health post is well above the trail, and I felt too lazy to go. The Namrung village health post was along the way, so they called me over for a check up.”

Tashi's widowed mother owns a small lodge in Dang. Tashi helps her collect wood and fodder for the cows, and prepares dinner. But now she faces a new dilemma: Nubri’s residents depend on mule trains as a vital supply line for food to compensate for their meager harvests. As concern grows about contacting outsiders, so does concern for high inflation, which has already occurred.

Food grown at home is becoming more and more critical to survival. When a neighbor came to buy oil and sugar, for instance, Tashi was nervous about making the sale. "Who knows, with the lockdown situation,” she wrote. “What if the stores in the country are closed for a year, and nothing comes from ‘down’.” [“Down” is the term Himalayan highlanders use when talking about Kathmandu and the lowland valleys.] When her neighbor would not agree to go away bare-handed and was reluctant to ask another neighbor, Tashi had no choice but to take her money and offer her some oil and sugar. Those who run seasonal lodges are normally protected against inflation because they can pass on the additional inflationary burden to the trek-tourists. But when accelerated inflation occurs during a pandemic, they have little source of income and very high expenses. Pema Gyalpo is a health assistant from Trok, a village between Sama and Dang. He highlights similar concerns about the shortage of goods and the desire to hoard supplies. Gyalpo says, "Butter that you could buy for 3,000 Rupees ($30) earlier now costs us 4000 Rupees—and we often aren’t able to find any. Things brought from ‘down’ are all shut off,” he notes. “It's hard.” Except for the few people who own seasonal lodges like the one where Tashi works, the people of Nubri are subsistence farmers—making inflation a major problem.

Nubribas walk four to five days to travel between Nubri and Kathmandu. Advanced health services are out of reach. Image by Kunsang Choden. Nepal, 2017.

Even though Nubri hasn’t recorded any positive coronavirus cases, it's not possible to predict whether Nubri will remain free of COVID-19. “We have PPE for Nubri and Tsum provided by CAN Nepal and Mountain Child,” Alija said. “At our level, we perform basic tests such as vital signs, BP, and fever. So far no cases here.” However, already, there have been some COVID-19 cases down valley from Nubri, and in other Himalayan valleys such as Mustang. Alija said, “The COVID-19 situation in Nepal is rising. This is a very rural area. How will we transport COVID-19 patients? If I myself get sick, how will I be sent to the hospital? Thinking about such situations makes me anxious and scared.” Stressing that local medical facilities are not equipped to deal with an outbreak, Pema adds, “We are four days’ walk from the city. Bringing an ambulance here is not possible, and even to land a helicopter is not an option for us.”

Health infrastructure has always been inadequate in Nepal's highland communities. Pema believes that the national government should take COVID-19 seriously and pay attention to remote areas like Nubri. Each community is equipped with only rudimentary medical supplies, such as pain killers, antibiotics, bandages, and cough syrup. Each of Nubri’s six health posts has only one staff nurse, each serving between 300 to 500 people. “This is not enough,” Pema says. When lockdown and quarantine zones went into effect in Nepal this spring, families and small lodge owners in Nubri were given three bars of soap. “How long will a bar of soap last, especially when it comes to a large family or for the lodge owners?” Pema wonders. Whether the current low level of soap distribution will be continued is also unknown.


Soap distribution to the villagers of Namrung, Nubri, June 2020. Image by Pema Dhundup. Nepal, 2020.

As of July 11, Nepal has seen 16,945 confirmed cases of COVID-19, 3,652 recoveries and 38 deaths, according to Johns Hopkins Coronavirus Resource Center. Nubribas are supportive of stay-at-home orders, despite their drawbacks. Laxmi Lama, the owner of the lodge where Tashi works in Sama, said in an interview on May 6, "It's better not to have tourists for one to two years. If we can't run our hotel, it will be difficult for us, but it is better to have less [income] than die from this disease. I am happy with the lockdown implementation. Before COVID-19, I was busy, without much time to think. Now with COVID-19, we have no guests, less work, and I think a lot.” To cope with the uncertainty that COVID-19 brings, Laxmi spends her time learning classical Tibetan, chanting mantras to remove impediments in life, and inviting Buddhist lamas and monks to perform rituals at her home. She says, “Doing rituals will bring benefit to present and future lives.” Similarly, Tashi wrote in her COVID-19 journal that she watches humorous videos to entertain herself. “Also, I read motivational quotes. It helps me a lot, especially during this pandemic.”

Despite their positive attitudes, Tashi and other residents of Nubri are stuck in a waiting game, not knowing what the future will bring but certain that the local health care system is ill-equipped to deal with an epidemic.


The original article can be found here: Pulitzer Centre


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