In over 50 years of working for holistic development, Tearfund and our local partners have seen time and again that tackling poverty requires long-term, sustainable solutions.
Earlier this year, two of Tearfund’s project officers visited longstanding partners International Nepal Fellowship and United Mission to Nepal, who have both been working for some time in a remote, mountainous region of the country. Here, Phil Lindsay reflects on the visit and how the work of our partners is building hope.
Mugu is an area, as bad as anywhere on the planet for survival, where the average life span is 36 years and for every 10 children born, 6½ do not make it to their fifth birthday. Needless to say, whilst the gynaecological camp I was on assisted several individuals, it barely made a hiccup for the overall health of the community there. To this end, INF have recently started an integrated Community Health and Development Programme there which it is hoped will begin to have an impact, although with such work, change comes slowly if it is to be long lasting.
This was how Dr Toni Law, at the time a Tearfund fieldworker in Nepal, reflected on a medical camp she participated in, run by INF in Gamgadhi, Mugu, in October 2002.
At the time, INF was planning a Community Health and Development Program. UMN had been running an education program there for a year or two. Both organisations recognised that Mugu was the most remote area in Nepal and one with the highest levels of need and vulnerability for the people who lived there.
These were my earliest introductions to Mugu: the documents and photos and stories from my wife, Toni, and INF colleagues who either helicoptered in to Gamgadhi on a charter flight, or who walked the five-day trek from the nearest accessible district centre of Jumla (which in itself was only accessible by plane or several days’ walk from the nearest road).
I had tried three times over the past 20 years to get to Mugu, never getting past the airport terminal in Nepalgunj before flights were cancelled due to weather. It seemed unreasonable in March 2023 to expect that our schedule could work: arrive in Nepal late on Sunday night, go to the bustling chaos of the domestic terminal in Kathmandu by 7am on Monday morning, fly to Nepalgunj down near the Indian border, and connect with another flight to arrive in Gamgadhi by 1pm. Flights to Mugu and that part of Nepal are scheduled in a reassuring manner, but can be cancelled at a moment’s notice.
Karnali Region and Mugu District are food deficit areas, requiring additional food to be flown in by the Government … Figures from 1996 gave local production as only providing 25% of required staple foods. An estimated 25% of households (low caste and land-less) in the District grow enough food to survive for 3 months or less, only 14% grow enough food for the whole year.
– INF planning document, 2002
The flight in our twin-propellered plane was spectacular. The airport above Gamgadhi is built on a slope to help with take-off and landing, and rather than walking the two hours to the main bazar as used to be the way, we were able to jump in a jeep for a bumpy 45 minutes on a road that, like most in rural Nepal, is bulldozed into the side of the hills. From the hotel balcony we looked over Gamgadhi that stretched out and down a ridge line above the river below. Snow still sat on the hillsides around.
The condition of the PHC [primary health centre] was appalling, and little improvement seemed to have been made from previous visits. It is unlikely that the PHC will improve in the near future under government supervision. It is therefore recommended that the rehabilitation of the PHC into a functioning health facility be a central part of the health component of IMP. The team who visited felt that although levels of staffing and availability of equipment and medicines were problems, the central problem was a lack of leadership and supervision. Staff were bored (and drunk) and disillusioned.
Below the hotel was a large, recently constructed complex of buildings with an extensive array of solar panels on its roof. “That’s the hospital”, I was told.
The changes in Gamgadhi were remarkable. In a briefing with the UMN staff team we were told that life expectancy is now 56; 20 years in 20 years. It’s clearly still low, but development initiatives, significantly by Tearfund partners UMN and INF, and social changes across Nepal more broadly, have worked together to enable important development progress.
UMN uses a series of progress markers based on wellbeing to assess the context and the impact of its work. These are based on a combination of formal information and community surveys and stories. Scored out of five, they measure wellbeing and security, hope and freedom, environmental sustainability, dignity and respect, and peace and reconciliation. Mugu scored 1.61/5 overall. Despite the positive impact of development, especially in the larger centres, for the people of Mugu and those living in remote communities, life continues to be one of challenge and living on the edge of vulnerability.
The people of Mugu have immediate short-term, as well as longer-term needs… The programme therefore seeks to have both a short-term impact on specific felt-needs at the community and District level, as well as working in the long-term to address chronic on-going problems facing those communities. The programme will focus on working with and improving the health status of local women, …and working with women's groups on health education and other activities they prioritize.
– INF Mugu Program Plan 2002-2003
INF originally planned to work in two villages in the Soru Belt area, one of which, Bhi, we were able to visit with UMN. The day’s walk that it used to take to get there from the nearest market was reduced by a two-hour jeep ride along the side of the mountains and down along the river valley. The “road” ended abruptly, and from there it was a 90 minute walk to the village of Bhi.
Bhi is nestled halfway up a steep hill-side and surrounded by terraced rice fields. At the local schools we heard from the School Management Committees, Parents and Teachers’ Associations, and the Child Clubs about their activities and how they are improving education in the village. I was pleasantly surprised to see a newly painted Birthing Centre at the top of the village, obviously quite recently built and well resourced.
The Disability Network in Bhi is active, includes people of all ages, and has been supported and encouraged by UMN to work on plans to improve the lives of people with disability and break down the barriers to them being involved in society. The group has done training on the rights of people with disability, they’ve started small scale businesses, and all of their members have received their Disability Card that gives them services and benefits from the government. They have been able to use their own resources to build a tap bringing water from further up the hill. Prior to this people had to walk down to the river (steep and slippery) or get water from an open spring. They have plans to submit a proposal to the government to include their work in the budget for the next financial year, and the government is committed to providing them support.
In places such as Mugu progress is not linear, and nor is it equal. We saw homes and previously productive fields destroyed by last October’s landslides. In Bhi, despite the improvements, one of the schools we visited is named after the low caste community in which it is located. That particular school had no running water, there were no toilets in that part of the community, evidenced by the careful picking of your way along the path that was necessary, and people had very different expectations and hopes to others that we met.
I feel so privileged to have been able to visit Mugu and some of the communities there. I was encouraged by the way that lives had changed and people were open in saying how life had got easier and better; people were healthier, and children had hopes of further education.
While Mugu will always be remote and away from the best services and facilities and benefits of development, and due to environmental and geographical challenges an agricultural livelihood will always be challenging, the situation is so obviously different to the one that I first heard about 20 years ago. UMN and INF are committed to being there, faithfully living and working alongside the communities to help them be better able to plan, to respond and to live life to the full in the mountains of Mugu.
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Related projects have received support from the Australian Government through the Australian NGO Cooperation Program (ANCP).
