Within an hour we were in an area remote enough that we rarely passed other vehicles. When we did meet one head-on, it became a friendly game of chicken to see who would back up to accommodate passing. At times we went no faster than perhaps 10 km/hr. People on foot sometimes passed us!
As proof of the remoteness of our mission: yesterday we noted the shyness of some of our local volunteer interpreters, and asked Bandita (from our host organization, the Nepal Women's Project) about it. She confirmed that in this region of remote farm villages, with no regular bus service and sometimes a few hours' walk to the nearest other village, many people were simply shocked to see a busload of foreign language-speaking visitors, with our matching uniforms, funny instruments and earnest "Namaste"s!
As we climb the mountain passes, earthquake-related destruction is everywhere: piles of rubble, abandoned farm terraces, badly eroded hillsides, random giant boulders, painstakingly restored bridges and roads. Signs marking the good works of UNICEF, the Chinese and Norwegian Red Cross and others abound.
Our clinic day in the village of Kunchuk started with a bang around 10:30 am, mainly with children and older ladies and gentlemen in line. by the hot midday sun, true to our hosts' prediction, dozens of other women began arriving en masse - those who had finished caring for their fields, homes and children then trekked to our clinic site. It pleased us that they had made the trip, as our host group is a women's program in Nepal.
Unlike other projects, where TWECS has had the relative luxury of a fixed clinic location, and often indoors with electricity, in Nepal we are mobile, creating "pop-up" clinics and stroking them at the end of the day. The rough dirt-floored sheds, tents and shacks that host us here are challenging for the ODs, who ideally require a darkened room to accurately complete certain types of testing. Without reliable electricity, many work with battery-powered instruments that can require increased skill to use. Hour after hour the ingenuity (taped-up garbage bags, cardboard, and other light-blocking tricks), patience and professionalism of these doctors is awe-inspiring. Some of them need to be begged to take a lunch break or a drink of water!
|Visual acuity tent|
|Patients wait to enter Triage, Autorefractor and Special Testing Stations|
|Dr. Nixon White performs Retinoscopy|
|David Sakaki performs Autorefractor|
We noticed today that many people were wearing their "Sunday best" in an area that is predominantly Hindu. When one team member inquired why, he was told people dressed up "to see the doctors." So rare are foreign visitors here that the frequent developing-world phenomenon of begging foreigners for money or little gifts is unknown: the villagers expect nothing except the doctors' expertise.
Halfway through our clinic day, a septuagenarian woman was carried in on a stretcher, due to reduced-mobility issues. In Canada she would have a walker or a wheelchair; here she had no options. She was dispensed strong near-vision eyewear that might help her see sewing or other handwork, or perhaps her grandchildren's faces...
|Dr. Rita Messing performs Retinoscopy to determine the prescription|
|Derrick March checks to make sure she has better vision with her new eyeglasses.|
Dr. Blakolmer examined a patient who required -6.00D distance correction in one eye that was clouded with a cataract. Her other eye required a powerful +13.00D distance correction for vision. To benefit the "good" (non-cataract) eye, Dr. Blakolmer recommended +13D glasses. Yet, when fitted with them, the patient was dissatisfied. When Dr. Blakolmer instead tried -6 correction on both eyes, the patient glowed with pleasure. What a serenity-prayer-style reminder that we can only affect the things we have the power to change - like achieving the best patient outcome.
Conscious of limited daylight hours and our long drive back to the hotel, at a certain point we cut off admission form distribution for the day. For the most part people are polite and understanding, but on every project there can be a few unruly individuals who can quickly turn an orderly lineup into an unruly mob. Teenage volunteer Evan literally "holds the line" by himself, turning people away with an understanding smile and firm conviction. His twin sister, 13-year-old Emma, is asked by a Nepalese girl what caste she belongs to, and Emma has to ask an adult volunteer what that means. It's a stark reminder of the extremely privileged lives, freedom and equality we North Americans enjoy.
|Evan holding the line in registration|
|Emma makes new friends|
Our return route was a different, but equally cliff-hanging, 4-hour trip. At one point, some local villagers came to our aid when our heavily laden bus approached an impassible muddy stretch: they laid down planks to help us puddle-jump. At another point, all 18 of us pile out to keep the bus from bottoming out on a deep dip in the road. We arrive at the hotel after a 12-hour day: dusty, tired but satisfied we had helped hundreds.