Nurse

Margie Barclay is a nurse from Box Hill, Victoria and is presently serving with Médecins Sans Frontières in a newly opened primary health care project at Rukum, in western Nepal. It is the first time Médecins Sans Frontières has worked in the country. She has also served on missions in Tajikistan, Sri Lanka and Sudan. Margie was also born in Nepal.

It’s three weeks today that we arrived and it has gone quite fast. It has been calm here and while the ceasefire [between the government and Maoist rebels] is still in process, it hopefully will stay that way.

Still, it is evident that the area is under control of one side or the other. Each plane that comes and goes is carefully monitored. If you arrive a little bit late for the arrival of the plane (as we did with a young girl we wanted to transfer out with a leg fracture), you just have to wait outside and hope for another plane (which was cancelled in this case).

Rukum is one of the more isolated places in terms of medical access and there are few other medical organisations working there. Being in what has been regarded as the heartland of the Maoist movement, it has certainly been affected by the conflict.

All the same I am surrounded constantly by reminders of why I feel so at home here in Nepal and why it is so special to me: a big chautara and pipal tree down from our hotel, the sound of the roosters in the morning, the small dirt paths, the mother hens and their chicks, the friendly “Namastes” that follow you, the mountains and the valleys and the clouds that hang low in the mornings.

As for the work, there is plenty to do but it is not a process that can be done quickly, and sometimes that has been quite frustrating. There is a chronic lack of staff, and especially those with greater training and expertise – they are glad to have us here.

The doctor and I had the chance to visit a health post about four hours’ walk from here – it was a very long day! We passed through a few villages with fluttering red flags and it was very quiet.

A lot of my time has been trying to sort out the medical stores which were a huge mess, beginning some improvements and training in sterilization, and some midwifery together with the first doctor who is obstetrics-trained. Normally they have maybe one or two deliveries per month but since we came there have been four, all problematic, two with good outcomes and two not so.

There are lots of challenges, but I am glad to be here all the same. This has to go on the plane tomorrow with the doctor who is leaving, so I had better finish for now. Thinking of you all as always.