Spring 2005 Report

Australians Dr John Barry and his partner Kirsty Robertson ran the post during the April/May trekking season, ably assisted by Chhewang Sherpa. Once again, a room in Namgyal Lodge was used to offer medical assistance to the porters, local people and trekkers who called in for emergency help.

This season the number of trekkers was reduced by approximately 50 %, a sad reflection on the current political turmoil. Despite this the IPPG will continue to develop the project in anticipation of the day when peace and harmony returns to Nepal.

Machermo-building-0605-2Under the supervision of Community Action Nepal (UK), Namgyal Sherpa and the local user group have been very busy organizing the building of the Porter Shelter. This building will provide sleeping and cooking facilities, as well as educational opportunities for porters. Kerosene stoves will be used to reduce the porter’s impact on the surrounding juniper.

The Porter Shelter will also be used to promote interaction between porters and trekkers to improve mutual understanding. Netball competitions, cultural presentations, poetry readings have all been suggested and other good ideas are welcome.

Machermo-building-0605-3The Porter Shelter incorporates doctors’ accommodation and a treatment room. Research, particularly that focussed on porters and local people, but also including trekkers will be encouraged, along with the participation of medical students. In the future we would like to have Nepalese doctors working at the Rescue Post.

The building work will hopefully be completed this 2005 post-monsoon season and we are working on a detailed MOU to define responsibilities and ‘ownership’ of the project.

Machermo-building-0605-1The IPPG is deeply grateful to CAN for funding the huge cost involved in building the Porter Shelter and Rescue Post. IPPG has recently undertaken to repay the cost of the building in order to contribute to CAN’s work in poorer areas of Nepal where the porters come from.

On behalf of the porters of Nepal who work in the trekking industry, I would like to thank all the individuals, organizations and companies who have contributed to the success of the project. Please visit our web site to see who they are (www.ippg.net).

Finally we wish to thank the Kumbila Buffer Zone Committee and the local user group for their encouragement and participation.

Dr Jim Duff

RECOMMENDATIONS

1. A handout informing trekkers about IPPG and related NGOs, porter care, donations (money, clothes, medications) and AMS. Distribute along the trail, at Machermo, Thamel and abroad. (Underway. Jim)

2. Lobbying the National Park Service and government to introduce load weighing at park entry points. (Underway. Jim)

3. Signs need to be set up indicating the presence of the Shelter and Rescue Post. (Chhewang)

4. Inform all guidebook publishers of the Machermo rescue post. (Volunteer needed)

5. The Porter Shelter will be a focus for porter/trekker interaction. (Suggestions)

6. A formal structure of professional development be devised for Chhewang Sherpa and basic training be provided to interested lodge owners. (Dr John Barry)

7. Produce antibiotic guidelines for Nepal/ Khumbu region. (Dr Trish Batchelor)

8. Provision of additional medications for paediatric patients given the influx of local people using the Rescue Post. (Inform new doctors via manual)

Excerpts of the reports from Dr John Barry and Kirsty Robertson (with editor’s comments):

DR JOHN BARRY

CHHEWANG SHERPA

Chhewang was an invaluable help in both the preparation for and in the daily running of the medical post. It is clear that he is well respected amongst the community and his advice is heeded. I noted that in the past Chhewang has been taught to take vitals (blood pressure, temp. heart rate and oxygen saturations) and has knowledge of some drugs (what they are used for and appropriate dosages). I tried to educate Chhewang on a more disease-based system – explaining presenting symptoms, findings on examination, diagnosis and treatment (pharmaceutical and non-pharmaceutical measures). I also taught Chhewang the rudimentaries of chest, ENT and abdominal examination. I have tried to involve Chhewang as much as possible. In general Chhewang elicits the history from patients, sometimes requiring prompting as to the appropriate questions, examines the patient, then comes up with a diagnose and treatment plan which is then discussed. Chhewang is a quick learner but is hampered by inadequate knowledge of anatomy and physiology (we purchased a medical text in Kathmandu for Chhewang, on this topic, written in Nepali). It may be worth considering providing him with some formal education such as the 2-year Medical Assistant course if indeed it is envisaged that Chhewang may run the medical post alone. At the very least it would seem appropriate that an education plan be devised for Chhewang that there is some continuity and structure to the education he receives by the various volunteer doctors. (Our fall back position in the event that we cannot find a doctor to staff the post is that Chhewang will do so alone, ed).

PATIENT STATS

SPRING 2005 Porters Locals Trekkers Guide/Sherpa/Other
Total Patients 42 21 10 7
AMS 12 1 5 1
HAPE/HACE 0 1 3 0
Gastritis/ Reflux 10 0 0 0
Viral Illness 17 8 0 1
Chest infection 4 2 1 0
Gastroenteritis 5 3 2 0
Dehydration 10 3 0 0
Khumbu Cough/ Throat 2 1 0 0
Pharyngitis/ Tonsillitis 0 1 0 1
Headache (only) 1 0 0 0
Periodic breathing 0 0 0 0
Other 1 6 4 5

 

KIRSTY ROBERTSON: MACHERMO REFLECTIONS

THE NEW PORTER SHELTER AND RESCUE POST

Building site

Work began on the new building site on April 21st with a 1-hour ceremony by a local lama. During this ceremony he blessed the site and the workers. In Sherpa culture this blessing is very important as without it is believed that bad luck will befall the site. On the previous day workers had arrived and (in snow) built their own accommodation. It is adequate and warm. By the time we had left work was well under way. The weather has been particularly bad and frozen soil in making the work tough and at times slow.

The porter shelter

The porters I spoke with were concerned about the high cost of food up in the Gokyo Valley. I know there are some plans for free cooking facilities perhaps a free meal would also be possible. (We are hoping to provide cooking facilities, buying stoves and kero. This is partly due to concern over juniper destruction and partly concern over porters’ welfare. However I don’t think IPPG should be subsidizing trekking companies and lodges employing porters with food as well as shelter and fuel, ed).

Signs

The new site is isolated and IPPG really needs to work on signage and advertising. Chhewang Sherpa has done a great job with the signs requested. I think more are needed at the entrance to Machermo village and at the lodges in Machermo in particular. It will also be important to get the clinic listed in new editions of guidebooks etc.

TREKKER OBSERVATIONS

The information was obtained by informally interviewing trekkers who were staying at Machermo or passing through.

IPPG-the name

Aside from individuals who already had a past association with IPPG, not a single trekker had heard of IPPG although many were interested to hear about its work. Those who showed further interest became confused about the relationship between Porters Progress, IPPG and HRA. Some trekkers had heard of Porters Progress and they were intrigued that IPPG was not mentioned to them at the same time. I believe it would be useful to draw up an organizational chart (perhaps one already exists) to illustrate these relationships. This would be useful for all who work and volunteer for IPPG and the public in general because fragmentation often looks to the public like disorganization and/or mismanagement. (There are plans afoot for an email conference with all porter-oriented NGOs to promote co-ordination, ed)

Medical donations

Many trekkers showed an interest in donating their left over medical supplies but were reluctant to do so until they had finished their trek. It would be useful to have a medical donation point in Lukla (eg Porters Progress office?) well signposted. It could save IPPG a lot of money and provide people with a connection to the project.

Porter conditions

In general independent trekkers seemed much more aware of and concerned about their porters conditions. Groups of trekkers who had booked their trip abroad with large companies often didn’t even know the name of their porter let alone had they attempted to lift their load or learn more about their life. Most trekkers seemed unaware as to where their porter would sleep. In some cases guides had told them incorrect information e.g. porters don’t get AMS, porters don’t feel the cold as much as we do, etc. About half of independent trekkers had attempted to lift the load of their porters and the majority was embarrassingly surprised at the weight. Only one independent trekker had bargained her porter down to a daily rate that would seem unreasonably low (100 rupees). Although some trekkers would not tell me how much they were paying. (Weighing scales are needed at park entrances as is done on Kilimanjaro. We have been suggesting this but need help to lobby more effectively, ed) .

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