Tuesday, January 31, 2012

"They died because they were in Okhaldhunga"

I stumbled across this blog and was amused reading the first hand account of a doctor, Dr Arbin Joshi, who served in Okhaldhunga. In this post, we were exploring the challenges of inspiring doctor's to go to rural places in Nepal. So reading his words was hearing from the horse's mouth.

He writes about the challenges:
"Slowly and this time more concretely, I got my answer to this million dollar question ‘Why doctors don’t come to place like Okhaldhunga?" People have high expectations of doctors. Not only do they have to provide a high quality of service, but they are also targets of extortionists who see Nepali doctors as elitist parts of the beargoeious. 

 And also ensuing satisfaction of serving in a rural location like Okhaldhunga. What he says about where the focus of healthcare in Nepal should be is quite insightful. The opportunity cost for a doctor to go to a place like Okhaldhunga to practice medicine is huge.
He says that for Nepal it is about providing 'back to the basics' health care for the many Nepalese rather than about providing expensive super-specialized treatment for a few. 

In this post we had explored the challenges that geographic isolation makes in bringing healthcare to places like Mustang and Jumla. Here, Dr Arbin Joshi makes the same point about Okhaldhunga. He says that education and improving access and mobility to Okhaldhunga are the solutions.

What is impressive about Dr Joshis account is the very holistic vision he has for healthcare in Okhaldhunga. He sees the big picture and understands that the health of the individual in Okhaldhunga doesn't happen in isolation. He writes:
"Roads, Education, Health, Communication, Agriculture, Electricity and industries; all should come to the place like Okhaldhunga in a package. If one form comes before another, there will be a chaos."

 He describes both the opportunities and challenges. The blog is well written.

I really appreciated him writing from his authentic voice. He expresses his hurt from the people for whom he was sacrificing, not appreciating what he was doing.
It seems the doctor started the blog to move towards writing a book. It's not clear if he ever got the book out.

It is very satisfying to read about different case studies of the ground realities of someone who has gotten their hands dirty while serving rural Nepalese.

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