Mindful Interventions: Supporting Women and Their Communities Abroad

SN_logoAs a naturopathic medical student preparing to practice in rural Nepal, I’m faced with many interesting tasks. I work with an NGO called Share Nepal, based out of a village in central Nepal called Karmidanda. My time is largely spent on campus at NCNM in Portland, but whenever I can, I slip away to Karmidanda to build on a holistic community development project that will soon be my career.

I will take this opportunity to consider one of the tasks I find to be most difficult and fascinating – applying the principles of holism to international relief work. In this sense, I define “international relief work” as a short term service effort for a community across borders without the intention of sticking around after the work is done. As naturopaths, we are trained to look deeply for root causes of disease and empower patients to heal themselves. To what extent can this be done on a two week service trip? How can we as physicians (and physicians-to-be) make a lasting impact on a distant underserved population?

In Nepal, a convoluted dynamic of wartime recovery, political corruption, and an influx of foreign aid has created a health care delivery system which is largely dependent on “medical camps” that host foreign and domestic philanthropic doctors. The camps typically deliver free health care to populations in great need. Lives are saved, suffering is alleviated, and the local people are truly grateful. So what’s the problem? For some patients, there is no problem because what they needed was a short term intervention to bring them back to health. However, it’s a different story for patients whom suffer from chronic disease or from the effects of poor living conditions. Medical camps can provide symptomatic relief, but once the camp has packed up and moved on, there is no one to follow up with these patients, refill their prescriptions, or address the underlying cause of their symptoms. I think we can do better, as long as we are realistic about the limitations of this sort of work.

The demanding schedule of medical school has forced me to consider the impact of a short term trip, because I’ve not been able to spare more than a few weeks to travel to Nepal in the last several years. In summer 2012, our village hosted three doctors, a nurse, and four medical/nursing students who treated more than 200 patients. While our work was really well received, I found myself back in my Portland home wondering how much of it actually lasted.

This December I’ll travel again to the village with more doctors and medical students. I intend to be more mindful about the impact of our brief intervention. We will be focused on women’s health concerns and will take a more balanced and sustainable approach to providing services. We found last year that women presented to our clinic with quite advanced diseases. That experience has inspired us to better understand the contributing factors to their conditions, emphasize education, and provide treatments that will not necessarily require a refill. We hope that this approach will better serve this distant community in the long term. With these meanderings in mind, our December Women’s Health volunteers have the following goals:

Investigate the root causes of common female diseases

Through round table workshops with local women, the volunteers will create a safe space for open communication about local women’s role in their family, work, and their larger community. A deeper understanding of the Nepali woman will enhance future initiatives and guide medical care.

Provide much needed medical care to local women.

Share Nepal will host the American Naturopathic volunteers, in collaboration with Nepali medical practitioners, for a two day Women’s Health Camp. All local women will be invited for free medical care and well-woman exams.

Educate and empower local women in preventative care for themselves and their families

Naturopaths are trained experts in preventative care. The volunteers will apply this knowledge with cultural sensitivity in a women’s workshop designed from the outcomes of the round table discussions and two day health camp.

The Women In Balance Institute is graciously supporting Share Nepal in their efforts to bring more balance to the lives of Nepali women this December.

By Erin Moore NCNM Naturopathic Medicine Program and director Share Nepal