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Local Assets in the Nepal Project

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Let’s move on to another case from Nepal, focusing on children. I conducted a school and community s project in Nepal from 1996 to 2001, working with the Japan International Cooperation Agency and Japan Medical Association. The first phase of the project was to conduct health center based activities, but slowly it was shifted to the second phase, because the area was very rural and out of hundred thousand target population, only five thousand people used the health center. So we started health promotion activities in rural areas.
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In 1996, when I first went to Nepal, about 80% of total population lived in rural areas, and the life expectancy at birth was nearly 60 years old and available infant mortality rate data in those days was 93. It was taken from 1991 survey. Literacy rate was 33%, but in my target area it was only 10%. I mean adult women, their literacy rate was only 10%. Gross National Income per Capita was 210 USD. Many of them are vulnerable population and were suffering from poverty. What to do with this situation? Learning from James Yen, my team and I decided to encourage community participation and we went to the field.
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We expected people could say, “we have done it ourselves” after their active committee participation as shown in this point. Let me read it through. Go to the people, live among them, learn from them, start with what they know, build on what they have, teach by showing, learn by doing, not a showcase but a pattern, not odds and ends, but a system, not relief but release, of the best leaders, when their task is accomplished, the people all remark, “we have done it ourselves.” To reach the community, we used the car, but sometimes we had to repair the road to go further. It’s very rural. We sometimes had to cross the river by using locally made car tire rafts. It’s fun.
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Then in the community, we found assets in children and community people. One of our key health promotion activities was to create a supportive healthy environment. It was to make toilets and drinking water supply to all 84 schools in the target area. When we conducted a survey, only 20% of all the schools had such facilities. So the remaining 80% really needed this healthy environment or else health education may not work. Then we initiated the child to child program to empower children. Then the warming and other health programs were also followed. After empowering these children, this is a picture of community gathering about school toilet construction in a community.
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Many people get together under big tree and we discussed and discussed about what to do. After agreement to construct the toilets, our staff members facilitate the process of community participation to decide their specific roles. Who does what by when? And for each toilet construction at schools, it cost it about $800 USD. Our project supported $400 USD for construction materials and other things to buy. People contributed the remaining $400 as laborers. Half half.

The next example is a case in Nepal, Children, and Women. Dr. Jimba will introduce the background situation and present local photos of this project.

He first shares his experience working with another vulnerable population in Nepal. He also cites the poem “Go to the people” by James Yen. The poem inspired Dr. Jimba’s team to promote community participation in their project. This led to the Supportive Healthy Environment Program and the Child Initiative Program, where the locals were highly involved, contributing greatly to the success of the project. More details of the programs will be discussed in later videos.

The key takeaway of this step is the participation of the target beneficiaries. Empowering them to self-help. This is another characteristic of the assets model. Can you think of how is this important for overcoming diversity and inclusiveness challenges? Why is “self-help” more important than external intervention?

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This content is taken from Taipei Medical University online course
Capacity Building: Core Competencies for Health Promotion
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