Category Archives: Health

Westerners bewitched by Nepal’s shamans

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Kirati shaman Parvati Rai coaxing snake spirits out of a young Nepali man who has "lost his soul". AFP PHOTO/Prakash MATHEMA

Covering Nepal for an international news agency takes you into all kinds of weird situations.
I recently took part in a shamanic exorcism in Kathmandu. Here is the account I wrote for AFP.

The shaman’s body begins shaking as she mumbles an ancient mantra to the syncopated beat of a dhyangro drum, coaxing snake spirits from a young Nepali man who has “lost his soul”.
Iron bells hanging around her white shirt ring as she jumps around her patient in a shamanic trance, her head dress of peacock feathers waving wildly as she springs up and flings her arms around him.
In the background, awestruck white Westerners in headbands and beads watch the ancient, animistic ceremony, not in a remote mountain pass or a jungle clearing but in a comfortable, 21st century house in suburban Kathmandu.
“The boy has lost his soul and we are helping him find it,” says Mohan Rai, the 80-year-old founder of the Shamanistic Studies and Research Centre Nepal and a man on a mission to restore what he sees as an dying art in the Himalayan nation.
After decades of modernisation when witch doctors were almost wiped out, “urban shamans” are enjoying a renaissance among Nepal’s metropolitan middle class and Westerners looking to be healed, cleansed or awakened, says Rai.
He has been on the front line of this renaissance since setting up his centre in 1988 to revive a practice he says “has been left behind” by science, technology and the big world religions.
“Shamanism is 75,000 years old. But it is dying out in the villages and I want to keep these traditions alive,” said Rai, who is highly critical of the religions and governments he believes have actively plotted to kill off the practice.
“I have thousands of students a year and, more and more, they are Westerners looking for something else where Western medicine has failed. Many of my students are medical doctors looking to integrate shamanism into their own practices.”
Shamans, known in Nepal as dhami-jhankris, claim to find the lost souls of the sick by travelling between three worlds — lower, middle and upper — connected by an upside down tree called Kalpa Vriksha, the tree of immortality.
They say they commune with the deities and spirits — both benign and malignant — inhabiting each world.
Tobias Weber, 33, a farmer from Germany travelling in Nepal, said he was drawn to shamanism after becoming interested in healing but disillusioned with the limitations of Western medicine.
“Shamanism can complement what doctors and nurses in the West are able to do. Clearly, if you have broken your arm you are probably going to go to a hospital but there is also so much you can get from the spiritual side of healing which people never get to experience.”

Rai with German traveller Tobias Weber. AFP PHOTO/Prakash MATHEMA

Rai, who is in polygamous marriages to two sisters and speaks English, German, Spanish, French, Sherpa, Tibetan and Hindi, has enjoyed a colourful life.
Born into a Bhutanese farming community, he grew up helping his father, “a powerful and well-known shaman” with healing rituals for the sick in his village.
He joined Nepal’s legendary Gurkha brigade aged just 17 and has been a trekking guide in Kathmandu and a mountain rescuer in Alps.
He first came across Nepal’s shamans when he was an assistant to foreign anthropologists trying to locate witch doctors among the country’s indigenous tribes.
He realised that shamanism was of great interest to the developed world and set up his research centre to spread the message, employing shamans from the Tamang, Rai, Sherpa and Gurung Himalayan mountain tribes.
In his centre sits a photograph of a six-year-old German boy Rai claims to have healed after the youngster, riddled with cancer, was given just two years to live.
He also relates the story of a paralysed man he helped to walk within just a few healing sessions.
Australian Laura Martino is taking a course at Rai’s centre and wants to help people in her home town of Melbourne reconnect with their spiritual side.
“I came here with a totally open mind, which I had to because of some of the amazing experiences I’ve had here, like trips to the mountains and sleeping in  graveyards.
“I think the Western world has lost something in its approach to healing and we really need to get in touch again with nature.”
Shamanism has had its critics, however, in a country where ancient superstitions can have a devastating effect.
In February a group of villagers accused a neighbour of witchcraft and burned her alive because their shaman had told them she was a witch.
The crime caused widespread revulsion, with Prime Minister Baburam Bhattarai appealing to Nepalis not to listen to the injunctions of shamans.
“In villages especially, faith healers are from the local community while western medicine practitioners are from cities and towns and are often regarded as outsiders,” said Ravi Shankar, assistant professor at Manipal College of Medical Sciences in Pokhara, Nepal’s second city.
Many academics in the West believe that shamans rely on a powerful “placebo effect” — the tendency of any treatment, even an ineffective one, to show improvements in health simply because the recipient believes it will work.
Even doctors who distrust Nepal’s shamans have in the past relied on their services, training them to use rehydration salts to treat diarrhoea and cotrimoxazole antibiotics in pneumonia cases.
“There is the negative aspect where diseases like epilepsy and mental illness are regarded as entirely due to supernatural causes and modern medical treatment is neglected,” said Shankar.
“But then this was the case in the West also about 150 years ago.”

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Nepali Girls Confined by Stigma and Superstition

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Nepal’s Republica newspaper carried a piece in January about a 40-year-old woman called Jhuma Devi Shahi who died while spending the night confined to a shed in the freezing hills of western Nepal.
She had been cast out in the cold by her family because she was menstruating and was considered unclean.
The people of Jhuma’s village believe she was killed by evil spirits and will never be allowed to see proof contradicting their superstition because she was cremated without a postmortem examination.

I investigated this mediaeval practice – known as chhaupadi – on a trip to Jhuma’s district, Achham, in December. Below is the story I wrote for AFP.

UPDATE ON FEBRUARY 5, 2012: The Himalayan Times is reporting today that a 16-year-old girl has died in chhaupadi, again in Achham. She is thought to have suffocated while trying to warm herself by a fire in her shed.

Saraswati Biswokarma, 13, sits in her dark shed, known as a 'chhaupadi goth'. PHOTO: AFP/Prakash MATHEMA

 

 

Saraswati Biswokarma sits in the dark, rearranging the threadbare cotton sheet and straw bed she is forced to sleep on before bringing her knees up to her chest with a shiver.
It is already mid-morning but she has not been allowed out of the airless brick shed where she has spent every night for the past week.
The 13-year-old was effectively banished to the shed — barely big enough to stand or lie down in — where she must experience her first period alone in a traumatic ordeal.
“I’ve been here eight nights so I have one left,” she says with a nervous smile. “It’s not nice here, it’s scary and I felt very alone on the first night. I was so scared.”Saraswati’s isolation is part of a centuries-old Hindu ritual known as chhaupadi that has been blamed for prolonged depression and even deaths in remote, impoverished western Nepal.
Under the practice, women are prohibited from participating in normal family activities during menstruation and after childbirth, and can have no contact with men of the household.
“I’m not allowed to touch any cattle or go inside our house. I have to stay in the shed and when my mother calls I have to wait nearby the house with a plate so she can give me food,” Saraswati says.
She is also barred from consuming dairy products or meat or taking a bath. Even looking in the mirror is frowned upon.
The practice stems from the belief that when women have periods they are impure and will bring bad luck on a whole family if they stay in the house and will contaminate anything they touch.
In 2005, the government, in line with a Supreme Court order, enacted a law abolishing chhaupadi but enforcement has been minimal or non-existent.
Saraswati’s shelter, known as a chhaupadi goth, looks like a miniature cow shed, with a dirt floor and no windows or running water.
In January last year, two women were found dead in chhaupadi goths in the remote district of Achham after temperatures dropped to 30F (-1C). In another case, a 15-year-old died of diarrhoea contracted while sleeping in a shed.
Chandrakala Nepali, 17, is preparing for her fifth night in her goth.
Her parents went to Mumbai to find work two years ago, leaving her and four younger siblings to live with relatives in a house high up in the hills an hour’s walk from Mangalsen, the main town in Achham.
“During the day I’m allowed out but only to work in the jungle, collecting firewood,” she says, sweeping the dark, cold hut, which is barely big enough to lie down in.
“I’m not allowed to walk on the same road as the cattle and I’m not allowed to be with my family for seven days. To eat, I sit outside the house and they bring me food on a plate.
“When I’m alone in the shed I feel scared. There are insects and I’m afraid of snakes coming in.”
Chandrakala says that if she has daughters she would never force chhaupadi on them.
But few women are prepared to challenge the status quo, and many continue the ritual for fear of community disapproval or out of religious belief.
Pashupati Kuwar, 30, lives with her five children in Budhakot, a small hamlet high in the hills.
Her husband is away, working in the Indian city of Pune, while her in-laws died several years ago, but Kuwar still observes chhaupadi.
“I don’t touch any cattle for five days. I sleep on straw. Most of the day I go out but I go back to the shed to sleep,” she said.
Pashupati says she will make her six- and 13-year-old daughters take part in the ritual.
“Some people think it’s wrong but if I didn’t do this my god would be angry.”
Pashupati’s own mother, Kunta Rawal, 45, has turned her back on chhaupadi.
“Before I thought it was important because of what I was told by elders and society but I have been made to realise that it is wrong,” she says.
Nepal’s education ministry is hoping to establish a literacy drive in the region, including health education classes dedicated exclusively to reproductive health and menstrual hygiene.
Thanks to campaigns by humanitarian organisations like UNICEF, the sites of confinement are beginning to improve, with women often allowed in separate rooms in the main house rather than banished outside.
Janaki Bohara, 40, president of the Bahagyaswor Paralegal Committee, a women’s advocacy group supported by UNICEF, says she will refuse to allow her 14-year-old daughter to take part in the ritual.
“If I see families doing this to their daughters I will say to them ‘look at me — I have nothing to do with chhaupadi but nothing has happened to me’. I’m ready to go to villages and fight people about this issue.”

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Google helps track Nepal typhoid

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“]

Families using a communal water well in Kathmandu. These wells have been identified as a major source of typhoid outbreaks [Image courtesy of Stephen Baker

by Frankie Taggart

This is based on my article for AFP published on October 17. The original can be read here.

Scientists announced this week they had combined cutting-edge gene sequencing technology with Google Earth to accurately map the spread of typhoid in Kathmandu for the first time.

The Nepalese capital was described in a 2008 study as “a typhoid fever capital of the world”, with thousands of cases a year reported, but outbreaks have been hard to chart in a city where streets are rarely given names.

Researchers say they have used GPS signalling and the latest DNA sequencing techniques to plot the course of the disease — and have discovered the source of outbreaks is usually communal water spouts.

“]

Google Earth map of Kathmandu showing locations of the residences of confirmed typhoid infections and the 42 functional water spouts nearby. [Image courtesy of Stephen Baker/Google Earth

The research, published in the journal Open Biology on Sunday, was carried out by scientists at the Vietnam-based Wellcome Trust Major Overseas Programme and the Oxford University Clinical Research units in Kathmandu and Ho Chi Minh City.

You can read it for yourself here.

“Until now, it has been extremely difficult to study how organisms such as the typhoid-causing bacteria evolve and spread at a local level,” said Stephen Baker, a scientist with Oxford University’s Vietnam unit.

“Without this information, our ability to understand the transmission of these diseases has been significantly hampered.

“Now, advances in technology have allowed us for the first time to create accurate geographical and genetic maps of the spread of typhoid and trace it back to its sources.”

Health workers visited typhoid patients’ homes and used GPS technology to capture the exact location, which was then plotted onto Google Earth, which maps the Earth by superimposing images from satellites and aerial photography.

They took blood samples from hospitalised patients to isolate the organism — which mutates as it spreads — and allow analysis of its genetic make-up to identify where the disease had started.

The researchers found that people living near communal water spouts and those living at a lower elevation were at by far the greatest risk of contracting the disease.

“Improvements in infrastructure are fundamental to the control and elimination of typhoid”, said Baker.

Recent advances in DNA sequencing have allowed scientists to accurately track the spread of some diseases by measuring mutations in the pathogen’s DNA when the DNA replicates.

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Time to ban cars from downtown Kathmandu?

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Traffic chokes Kathmandu's central streets. But could we leave the cars at home?

UPDATE ON Saturday, October 22 2011: Since I wrote the post below it appears the real picture is even worse than I had anticipated.
A story in today’s Republica newspaper citing new figures from the Metropolitan Traffic Police says there are now 800,000 vehicles on the Kathmandu Valley’s 1,500km road network. Maths fans: that’s a vehicle every 1.875 metres. Given that the average car is more than twice as long as this we can see the extent of the problem.
The article also tells us the average speed of vehicles at peak times in central Kathmandu is 15-20km per hour (9-12mph). The Kathmandu Valley – a seething metropolis without a single set of traffic lights – has 965 road cops struggling to cope with a workload which would require nearly 1,400 officers.
Ganesh Raj Rai, the embattled chief of the Met Traffic Police, wants the government to build flyovers. This strikes me as an ugly, costly, shortsighted solution. At the current rate of increase in cars, they too would be jammed soon after construction. The only answer is to try to regulate the unsustainable increase in traffic through a congestion charge or an outright ban in the worst areas of gridlock. Some sort of credible long-term mass public transport strategy is also long overdue. Original post below:

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At dawn, before the taxi and minibus drivers start work, before the cacophany of thousands of motorbikes drowns out the courting call of the black eagle, Kathmandu is lovely — one of the loveliest cities in the world.
But by 7:30am it is ugly, its roads gridlocked, its beauty despoiled by the internal combustion engine.
The traffic is the first thing you notice when you arrive in Kathmandu – not the elegant cobbled streets, nor the ornate palaces, not the breathtaking stoupas or even the mountains. Not the mystique and the spirituality of one of the most bewitching and beguiling cities on earth. Just the traffic.
Some 500,000 buses, trucks, cars and other vehicles ply the capital’s congested roads – the equivalent of one carbon-belching motor for every third man, woman and child (compared with the national average of one for every 10).
It’s hard to describe the driving to anyone who has never visited Nepal but ‘chaotic’ certainly does not do justice to the lawless bedlam that characterises Kathmandu’s roads.
Those who have tried to negotiate the capital on a bicycle - as I do, every day – will know what I am talking about. If they lived to tell the tale.
There are a handful of rules and they are seldom followed. ‘It’s my way or the highway,’ would roughly encapsulate the ethos.
No one gives way anywhere, under any circumstance - trucks to cyclists, pedestrians to cars, taxis to motorbikes, anyone to ambulances. You have to assume that if there is a car in your line of sight it is about to pull out in front of you. It doesn’t matter if it is on a side street, an approach to a roundabout, or even unoccupied: within a second or two it will be blocking your path.
I began to get a feel for the vagaries of Nepal’s version of road safety the very first time I took my bike out when I was forced off the road by a minibus with six goats – alive, and standing up – tethered to the roof rack.
Why do I chose to cycle amid all this madness? Because I can get to almost any destination in the capital quicker on a bike than in a car, without really breaking a sweat.
Some people have described this situation as organised chaos – as if there were some byzantine, unspoken code which westerners just don’t get, as if somehow it just works.
But it doesn’t.
The traffic accident statistics in Nepal do not make pretty reading. It doesn’t do to compare numbers of fatalities between cities in Nepal and, say, England as there are too many factors such as vehicle numbers and traffic speed which make the exercise meaningless. You are not comparing like with like.
But here is a horrifying statistic: in a 2003 study of 229 post-mortem examinations at a hospital near the capital, 110 deaths were due to road traffic accidents. If the research is representative – and other studies have yielded similar results – nearly half of all premature deaths in Nepal are due to road accidents.

As an aside, here are some more numbers:

Number of accidents in Kathmandu last year, according to the Metropolitan Traffic Police: 2,765.
Number of deaths: 137
Serious injuries: 720.
Month in which highest number of vehicular accidents occurs: July (see study here)
Most dangerous day: Sunday
Most dangerous time of day: Late afternoon/early evening

And, finally, number of pedestrianised streets in Kathmandu: one.

It’s not that people are averse to walking — according to the Clean Air Network Nepal 18 per cent of daily trips are made entirely on foot, and of the 56.5 percent of commuters who use public transport, a large percentage walk part of their daily commute. And not just to the nearest bus stop.
But the city was not designed as a place for people and vehicles to share. There are almost no pavements in the narrow streets of downtown Kathmandu. Elsewhere pedestrian crossings are ignored.
Crossing the road is redolent of the 1980s video game Frogger (play it here - not now, after you’ve finished reading this): you step out in front of one line of traffic and hope you don’t get squashed, only to have to repeat the Sisyphian task endless times before getting to the other side and encountering the next road.
Researchers from the Asian Development Bank walked 48 Kathmandu streets and interviewed hundreds of members of the public for a recent study on the pedestrian-friendliness of Asian cities.
Kathmandu got a “walkability” score of 559, compared with dirty, overcrowded, polluted Bangkok’s 121. A lower score is better.
I won’t dwell on the environmental effects of all this traffic except to say that Kathmandu’s jams are not made up of green-conscious Toyota Priuses or fuel-efficient Smart cars. If you don’t wear a face mask and wrap-around shades when you are cycling you arrive at your destination with Marlboro lungs and eyes that feel like hot pickled onions.
The valley is especially vulnerable to air pollution due to rapid and haphazard urbanisation and its bowl-like topography which restricts wind movement and traps in the fumes. In winter you get a heat inversion, a kind of mini-greenhouse effect caused by cold air from the Himalayas getting trapped under a layer of warmer air which acts as a lid, sealing in the pollutants.
A government white paper on pollution in the capital points out that particulate matter in the air is thought to have increased by 82 per cent over the last 15 years.
During general strikes – known as banda days - Kathmandu returns to the pleasant city  it must have been before Henry Ford invented the assembly line. The hues are vital, the parks are verdant and the air is crisp, at least, if not exactly fragrant.
The dust, smoke and noise has become so unbearable many people now look forward to these strikes – a blight on the lives of ordinary people in every other way.
“It was only during banda days that I felt somehow able to breathe well. It was also fantastic to see so many children playing outside,” says Anil Bhattarai in an op-ed for the Kathmandu Post.
So why not at least pedestrianise Thamel, the city’s central tourist district? It has been tried before but the naysayers have always won the day. You will have heard the arguments against – access for deliveries, disability access, the taxi trade – ad nauseum.
But these problems are just dealt with in other cities like Cophenhagen, where pedestrianisation has worked. They are not insurmountable.
It is odd that no major political force in Nepal has ever made day-to-day walkability, breathability, liveability, a focus of the agenda when the poor air quality and noise pollution that chokes the life out of Kathmandu is the capital’s biggest daily challenge.

 

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Unpaid AIDS charity workers turn to prostitution

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Pic by Wen-Yan King from India/USA (Every 6 seconds, someone contracts HIV.) [CC-BY-2.0 (www.creativecommons.org/licenses/by/2.0)

I was told today that charity workers in the HIV/Aids sector who haven’t been paid for months are offering themselves for sex – often unprotected – because they cannot afford to eat or pay their rent.
This is a grim irony which makes for good copy but is not a story one relishes having to tell. See the article I wrote here.
The chronic poverty in the sector is not down to a lack of cash. According to the World Policy Institute think-tank, $10 million in international donations for Aids charities has been lying idle as people die without proper treatment.
The problem is bureaucracy.
As with so much else in Nepalese public life, the process of getting the money where it is needed is being hopelessly delayed, hamstrung by a mountain of red tape, trifling legal issues and egregious procrastination which looks positively venal given the urgent need of the country’s 700,000 HIV/Aids patients.
This worrying development emerges as Nepal’s parliament nears yet another deadline to agree a constitution to take the country forward and complete a peace process which has been dragging on since the end of the civil war in 2006.
In a country which has seen so much suffering in recent years, a stifling inertia brought about by a lack of will to exact change may well be Nepal’s biggest tragedy.

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