My occupational therapy perspective on my Nepal trip


Hi all,

My name is Silvester and I am in the second year of the bachelor’s program in Occupational Therapy at Zuyd University of Applied Sciences. Besides studying, I really enjoy doing things together with friends, like playing sports, taking walks or making music.

In this blog, I will tell you about my experiences in Nepal. I hope you find it entertaining! 🙂

Trip to Nepal

In the summer of 2016, I went with a group of 30 friends to Nepal for 3 weeks, where we volunteered in the village of Thali. These were 3 sweeping weeks full of new impressions and experiences for me. Because I’m from the Netherlands myself, I stepped into a totally different world. In this blog, I would like to tell you something about this fantastic trip from the point of view of an occupational therapist.

The goal of our trip was to build a school in Thali for underprivileged children, most of whom were orphans due to the big earthquake in 2015 (maybe you remember from the news). Many of these orphans were living with their neighbors/family, but not going to school because they were too poor to pay for education. Thus, creating an inequality influencing the occupational performance of Nepali people which also stems from several components.

First of all, culture still plays a big role. This is of course the case for every country, but in the Netherlands, society is fragmented into all kinds of cultures, opinions, and attitudes, so there is no one dominant body of thought. Having one dominant body of thought is, in contrast to the Netherlands, the case in Nepal. For centuries people there have lived according to the ideas of Hinduism. This can be seen everywhere: On the streets, you see images of the various gods, temples are everywhere and you can hear Hindu music coming out of the houses. Yet this creates unequal opportunities in society. There is a hierarchy of castes, which means that people from different castes live alongside each other but not with each other. The richer families go to private schools, while the orphans from the low castes have no access to education. They have to work from an early age to earn money for the household. The richer families also do not feel the need to take care of the less fortunate in their society, as they “deserve it” (as they see it) because they have lived worse in a previous life (karma). Furthermore, behavior that is “different/abnormal” is not allowed and people are disadvantaged as a result. Nepalis with other religions can even be executed in very extreme cases. Thus, culture is a strong component that breeds inequality and limits people from taking part in meaningful occupations.

As a second factor, comes the almost sole source of income: tourism. Therefore, the government continues to invest in this sector as well to maintain and grow revenue. This results in only a small amount of money available for health and quality of life. For example, the government simply cannot finance education for underprivileged children. Healthcare is also not accessible to everyone: only if you have enough money do you have access to healthcare. In addition, there are often long waiting lines, where you can shorten the waiting time with money. In short, the country does not have the resources to take care of its citizens and, therefore seems (unintentionally) vulnerable to corruption. This is therefore the second component that contributes to the inequality in the country, which hinders participation.

There is also limited knowledge about health, which makes the treatment of patients many times less effective than in Europe. In addition, there is little health awareness among the Nepali people, making them unaware of health-related behaviors (such as smoking or ergonomics).

Furthermore, a very practical component is the physical environment. Roads are not asphalted and therefore very restricting regarding accessibility. This is due to the heavy rainfall in the monsoon season. Sometimes the streets are literally flooded! This makes traveling to every other location really difficult thus standing in the way of participation. You must especially think of poor and old people who have mobility problems. It is almost impossible for them to move around.

From an occupational therapy perspective, I found the aforementioned points very important to mention, so that you as a reader can get a good picture of the obstacles in the everyday life of a Nepali. Nevertheless, these points are not decisive for my experiences of the trip. I make a strong distinction between “the system,” which I have just told you about, and “the people,” which I would now like to tell you about.

The people I met were very vital, lively, and positive. They may not have known much about health and inclusion, but they were very active as a community. In the village of Thali where my group was building the school, the people lived very much from a sense of community. The rich young people there were breaking away from the castes and putting their hands up to help build a better future for the orphans from the lower castes. Since the orphans did not speak English, the wealthier and educated youth often translated for us. They were present every day to help build and tell us about their country. If you look at togetherness and commitment, we as “cold” Europeans can learn something from them!

In Nepal, we as a group learned from the people to rely on each other with limited resources when building together as a team. This form of life is totally contrary to our Western individualism. We have realized that you are more resilient in life by working together.

Thus, as volunteers, we have been able to do something for the orphans in Thali and have involved young people from the higher castes in the process. This is totally in line with the vision of an occupational therapist: You make participation possible by making society inclusive and involving people to be resilient together!

In terms of inclusiveness, I think that we are more thoughtful in Europe, but the involvement in Nepali culture is an out-of-this-world experience. I think this should be taken into account more by occupational therapists. Ask yourself the question more often: How can one client be complemented by the other and vice versa? I think that a sense of conformity also gives the confidence to (again) actively participate in society.

In short, my trip to Nepal was very interesting, educational and challenging. I experienced that the system of the country still needs to take a lot in consideration and currently hinders many people in their daily occupations, but that the people themselves are very positive and active in life. It was precisely these people who made me look back on my trip with a positive outlook and with a renewed and humanistic vision!

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