I arrived back in Kathmandu on Wednesday May 21. I felt at ease, nothing like the two or more weeks of culture shock I felt when first arriving back in the US on March 31. Somehow this comfortableness felt uncomfortably strange, but gave me the feeling that I belonged.
I spent my first weekend back in Nepal in Dharan, visiting the B.P. Koirala Institute of Health Sciences meeting with a number of people discussing their new partnership, one which would bring a variety of consultant specialists, e.g. pediatricians, cardiologists, on a once/week basis to PKMM Hospital in Karjanha, Siraha. This type of public-private partnership will improve the range of health services in the Karjanha area.
I’ve witnessed other examples of successful partnerships between communities and the Rotary Club of New Road City-Kathmandu, helping to improve educational facilities in the Patalini Lower Secondary School in Adhimara VDC in Dhading District. I’ve seen how a partnership in developing micro-hydro plants can lead to creating possibilities for an entire village, empowering women, creating educational and livelihood opportunities.
I try to approach development partnerships broadly in using community wide issues as an entrée point to working in an integrated fashion, including a comprehensive range of issues, i.e. health, education, livelihoods, gender, climate change, etc. Jeffrey Sachs Millennium Village Project (MVP) idea of intense interventions makes some sense to me. However, finding complementary partners in the areas mentioned above can be challenging.
How might an inclusive partnership develop/work? Hospitals/health posts, and the areas which they serve, are a perfect entrée point. Health outreach workers might collect baseline data not only on health but also education, livelihood, disability and other issues. One issue that might be found is the continued use by many of in-door wood burning cook stoves, leading to a variety of respiratory problems, but also a need to spend a number of hours each day collecting firewood. This issue could lead to the hospital/health post, collaborating with the VDC, initiating (or using an existing group) women’s groups, beginning discussions on providing alternatives as to how to alleviate respiratory issues and provide more time for employment generating activities. This could lead to using appropriate methods for piping the cook stove smoke out of the house or substituting bio-gas, using rocket stoves and alternative types of (recyclable) fuel, which could also be sold in the marketplace. The private sector, NGOs/INGOs could help to teach people how to make the stoves and develop alternative fuels (livelihood opportunities) and open up markets for these products.
(A great example of a partnership focused on alleviating the cook stove problem is the Biogas Support Program (BSP) started by the Netherlands Development Organisation (SNV) and taken forward by the Alternative Energy Promotion Centre (AEPC). This has enabled hundreds of thousands of rural households to cook more cleanly and lessen household dependence on collecting wood, creating time for developing livelihood opportunities).
Ultimately the women’s groups could be involved in other discussions on issues such as heart disease, diabetes, prolapsed uterus, nutrition, keeping their children in school, how to be further involved in decision making on family issues, livelihoods. The formation of women’s groups could also lead to developing youth, men’s and family groups to open up discussions of importance to each group and creating alternatives on a variety of issues. As per the BSP example Government programs are vital in furthering all of the above.
As an enabling environment is created to help people deal with their needs, more appropriate partners and resources can be brought in to tackle these issues. As one can see from the above examples, partnerships and individual partner resources create chain reactions leading to resolving long standing issues which cannot be overcome by one group taking responsibility for all issues.
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