Public Health Bus to Bangladesh

On a foggy Kathmandu morning on 2 December, a disparate group of Nepalis got into two long-distance buses. There were 70 in all, among them well-known doctors, policy-makers and heads of public health organisations, but more than 40 were straight from the villages, where they worked as village health workers, midwives and non-governmental organisers. They were all headed for Bangladesh, to the People's Health Assembly, which was taking place at a village outside Dhaka 4-8 December..There were a couple of things unconventional about this Nepali delegation. The participants were all going by bus, not a surprising thing to do given the costs involved. But by and large, the participants to South Asian meets and junkets go by air, which always more than doubles the costs of getting participants together. The Nepali organisers hit upon a not entirely novel, but certainly largely untried, idea of going by bus. This meant that the very nature of the group could also better reflect the public health fraternity of Nepal in its diversity..The participants were prepared for a difficult trip that would cover 1400 km, traversing the length of Nepal, cutting through the 'Chicken's Neck' section of India near Siliguri, and heading down through North Bangladesh to Dhaka, across the Jamuna..After a full day of driving through the Nepali hills and Tarai, we reached Nepal's eastern border at Kakarbhitta at 8 in the evening. Starting early the next day, passing through Naxalbari, Siliguri and Jalpaiguri, we arrived at noon in Chyangrabanda on the Indo-Bangla border, guarded on this side by the Border Security Force. The BSF jawans kept us there for hours, asking questions about our mission and destination. It turned out that they had a letter from some government secret service agency alerting them to an ISI agent named 'Yuvaraj' with a forged Nepali passport with us in the bus. They let us through after they were convinced that the one Yuvaraj in our group was who he said he was..By the time, greatly relieved, we entered Burimadi in Bangladesh, it was already 3 pm. It was another 600 km to Dhaka, but the road was wide and well-built, the result we were told of loving care and attention devoted to this region of northern Bangladesh by Hussain Mohammad Ershad when he was ruler. Looking out at the scenery rushing by, one lady passenger remarked how the landscape was exactly like that of the Nepal Tarai. Indeed, that had to be so, as the Nepal Tarai was less than 50 miles away as the crow flies. We were kept entertained, meanwhile, by Bangla friends who plied us with 'khaja', beaten rice and sugar..We had crossed the great bridge over the Jamuna around midnight, and arrived in Dhaka at three in the morning of 4 December, and it was some more time before we made it to the dormitory of Gono University at the village of Savar, outside the capital. There was not much time for sleep before the conference began in the morning..What struck the participants from Nepal most during the conference was the link made clear between economic globalisation and the impact that countries like their's had to face. Also, closer home, they were able to comprehend better the ongoing process of privatisation of health, with the pauperisation of government hospitals and health posts even while nursing homes and private hospitals got established to cater to the upper classes, particularly in Kathmandu..In Dhaka, Nepal's own well-known public health-wallahs were there to speak of Nepal's experience, and against the worldwide trends in public health. These included doctor-activists Mathura Prasad Shrestha, Renu Rajbhandary, Aruna Upreti, and public health worker Sharad Onta. And among the participants was David Werner, whose "Where There is No Doctor" (translated into 86 languages) is known to many a health worker in its Nepali translation. Werner told the Nepali delegation with evident concern, "Your government is showing very little commitment to delivery of quality health care to your people.".What struck the Nepali participants most was the vocal opposition to the World Bank and the International Monetary Fund, to the extent that there was hooting all over the meeting hall when the Bank representative Richard Skolnik took to the floor. Many of the Nepali delegates, of course, did not understand what was being said and had to be constantly updated with translation by their co-participants..As the hall was resounding with opposition to the Bank representative, Nanda Kumari Shrestha was trying to make sense of it all. She is a 65-year-old who has spent decades working as a midwife in Baguwa village, 20 km north of the hill town of Gorkha. "Why is that goray (paleface) not being allowed to speak?" she asked a neighbour. The friend, who did not have much better English, explained what was going on. A light of understanding came to Nanda Kumari's eyes, and she exclaimed, "So he is the guy responsible for making our midwifery kits more expensive!".The effort of busing it to Bangladesh, it seemed, was worth it.