Kathmandu | June 20, 2022
"See, I am doing a new thing! Now it springs up; do you not perceive it?" - Isaiah 43.19
"Everybody!" I yelled, beginning to lose my in-charge demeanour, "Step back! Everybody, please step back! If you haven't completed your registration form, move out! Only come in the door once you've completed your form". It was the second morning of registration and measurement-taking for the first ever Patan Hospital weight loss competition (for staff and students), and the room was heaving with participants. The crowd inside the nutrition clinic was making it difficult to weigh individuals as they took their turn on the balance scales before sliding behind a curtain to have their waist measured.
The idea for the competition was an attempt to help the many hospital staff who want to lose weight without having to meet each one individually for diet counselling. With just myself, a single Nepali dietitian, and an assistant, we needed to focus on providing services to admitted patients. My plan was to have participants sign up in pairs, so they could have their own 'buddy' for support and encouragement. After toying with the idea for several years, I finally proposed it to hospital administration as we pulled out of the 2 year COVID swirl. Having secured some significant prizes for the 8 month competition (including mountain bikes and sight-seeing flights to Mount Everest), I was anxious about how the competition would be received; those fears were put to rest when returning from lunch on the first day of registration, my young colleague saw the crowd at the clinic door and said "Ma'am, it's like we're opening the doors to a rock concert". By the end of registration, just over 300 staff and students had signed up.
The start of the competition was timed to coincide with Nepali New Year, in mid-April. It was one of many 'new beginnings' which we had been appreciating over several months as COVID rates dropped to negligible levels and life really, truly, finally seemed to be returning to normal. With the arrival of 2022, there was a sudden release of pent-up social activity led primarily by an explosion of delayed weddings. Leading the way at our church were twin brothers Sudeen and Sudeep who had each found the girl of their dreams within the congregation, so there was a wonderful four-fold sense of joy at their joint wedding ceremony in January. We have watched these young men grow from toddlers running around under the watchful gaze of their older brother Subash, to progressing through both school and "Sunday School" (which, like church, happens on Saturdays) and on to opening their own "Twins Mobile [Phone] and Computer Care" business. At church, as well as contributing to the youth group and Sunday school teaching, they have applied their technical skills to running the security, Wi-Fi and sound systems. Their contribution expanded significantly during our prolonged COVID lockdowns when they established and managed the church's many zoom meetings which kept the congregation in close fellowship throughout. All three brothers supported Benjamin with long-distance calls and texts via Messenger during the challenges of his stint at an American boarding school, and so it was a delight to have Sudeen invite Benjamin to be his best man. Benjamin's 6-foot-2 frame with a newly-wed couple (averaging about 5 foot 2 in height) on each side gave a nice symmetry to the wedding photos!
Following the marriage there was a suspicious flurry of feverish illness amongst many in the congregation, including the married couples themselves. Mark, who had preached at the wedding, was perhaps the only person who tested, and he came up positive for his third COVID infection, but all recovered quickly. Across the country Omicron infections in January surged to the highest rates seen since the start of COVID, but there were very few serious cases and within 2 weeks rates dropped dramatically.
The "icing on the [wedding] cake" for the congregation was to come 4 weeks later when the married couples along with several church leaders gathered outside the maternity ward at Patan Hospital. Subash, the twins' watchful older brother and administrator for the church, and his wife Meera (sister to one of the brides) were about to become parents after many years of longing for a child. After a delay of several hours, while the operating theatre became available for the planned cesarean section, the newlyweds were called forward, the grooms to wheel Meera on her stretcher back to the ward, and the brides to take charge of her needs as she recovered from the delivery. Our attention moved from Meera's serene face as Subash came into the waiting area, proudly holding his newborn son with a huge grin spread literally from ear to ear. It is common for Nepali babies to be kept at home for many months, apart from essential health checks and vaccination visits, and they receive their official name at any time from 2 months to 2 years, depending on their ethnic group. Breaking with tradition, Subash and Meera appeared at church just 3 weeks later, to celebrate the day of their 10th wedding anniversary with the dedication and naming of their son Arpan, which means "offering". As our pastor Bekh led prayers of thanksgiving and blessing for them, there were tears of joy in many eyes.
It was around this time that Patan Hospital changed tack and began returning COVID wards to their original specialities. Mark was very pleased to swap his PPE-clad responsibilities for face-to-face interactions with patients and in-person teaching of medical students. In the newly-established Department of Nutrition and Dietetics, we were stretched by rising patient numbers and I wore a track to the offices of senior hospital administrators to plead for more staff. With assurances that recruitment was underway, I took one week's holiday and abandoned Mark and Benjamin to make a quick dash with a Korean friend up to Mardi Himal basecamp at the foot of the Annapurna Himalayas. It was the second week of March and we struggled without appropriate footwear through deep frozen snow near the top of the trek, eventually turning back a couple of hours short of basecamp itself. The views were nevertheless spectacular, and while admiring them it seemed the season suddenly changed; walking back towards the lakeside town of Pokhara the paths were free of all ice and the rhododendron forests showered us with red and pink blossoms.
This year Nepali New Year coincided with the Easter festival, and Christians across the country were delighted not only to enjoy their traditional sunrise services in-person, but also to once again march in public rallies that culminated in large open-air worship celebrations. With the continued increase in the number of churches across the country, Christians in the Kathmandu valley for the first time divided into multiple rallies, one for each of the three districts that make up the urban city area. A month later, in mid- May, local elections were conducted across the country, with the capital city resuming a lockdown-like calm as hundreds of thousands of residents left to cast their votes in their rural birthplaces. With over 5,000 government positions chosen by a voter turnout of 64%, it was the biggest electoral exercise ever conducted in the country and was largely hailed as peaceful and free of controversy.
It was also in May when Patan Hospital administration finally placed an advertisement in local newspapers and told me to prepare for interviews. It was a bright Sunday morning when 11 eager candidates each faced 15 minutes of questions by a panel including the medical director, the head of human resources and me. Although the post was advertised as a basic certificate-level, most came having completed Master's degrees, keen for the opportunity to enter clinical dietetics in a hospital as reputable as Patan. At the end of the morning, as we began to tally up our interview scores, the medical director leaned in to me and said "Good news...I just got a message that we're allowed select two individuals". With clear agreement on who those top two candidates were, he and the HR director jumped up and headed off for lunch, leaving me to tidy up the paperwork and put the files together for the secretary. Sitting alone on a leather couch in the large air-conditioned room, I took a moment to rejoice: the department had just increased to 3 qualified Nepali staff. After 5 years of my consulting at the hospital, we finally had enough dietitians to provide a basic service across all surgical, medical and paediatric wards as well as start running an outpatient clinic.
My summer now promises to be busy establishing department standards and protocols, but not without a break in August when our family will gather in the US. We all look forward to time with Mark's family including his brother, who is undergoing chemotherapy, and his mother who will turn 98. Zachary will join us for a road trip: we will tour potential colleges with Benjamin who needs to plan for the next step after he completes high school in Nepal in 2023. We thank you for your continued support and prayers as we press on into the new things God is springing upon us.
Deirdre and Mark (with Zachary and Benjamin)