Fiona and I have been back in Nepal for just over 5 weeks.

After cultural and language revision and update sessions in Kathmandu we moved to Pokhara. In monsoon times (June till beginning of October) it can be hot and very humid, this year is no exception. Our rented first floor flat is simple but adequate, at first we found it difficult as there are long power-cuts every day. We have had a back-up battery system and an extra fan installed. We had no hot water during most of this time, but we now have a gas cylinder on the veranda, with a pipe through the window and a small geyser heater for the bathroom shower. All the taps leak and we are still waiting for the plumber, who is ‘away somewhere’.

We battled with a lot of cockroaches to start with, as the flat has been unoccupied for a long time; we have learnt about several kinds of poison and are trying them all!

We spend 2-3 hours each day in language class. Although we both speak Nepali there is always plenty of room for improvement and while we have the chance we want to take it. We have also needed to buy some furniture as we only had some basics to start with. We had no curtains and our windows open directly up against our neighbours so that has been interesting. We spent time measuring and ordering some yesterday. At first we felt very cut-off without Internet, but once we got phone SIMMs, fought the computers to input ingoing and outgoing mail codes and a bought a dongle package, that has been better. Soon we will get what we hope is a better and faster connecting system.

The ear hospital building is coming on extremely well, although there have been delays, especially due to the earthquakes and also due to some supply problems, it should be complete within the next 2 weeks. There will no doubt be plenty of minor issues to resolve over the following weeks but we do now have a timetable for that. I spent this morning in meetings with the management team and engineers discussing the project and innumerable details. There are still some things outside the actual building contract, such as the solar electric cells and battery backup system and generator to be purchased and fitted.

We had very good news today when the municipality signed off the building completion certificate. There had been a lot of paperwork and some red tape matters that could have held this up considerably.

We are awaiting news of the shipping container of medical equipment that has now been dispatched from the UK. There is also a lot of paperwork being processed for this essential material, without which the hospital could not open effectively. It will come by sea to Calcutta then by land to Nepal, via the border at Birganj. That place is currently obstructed by vehicles delayed by strikes, these are occurring because of dissatisfaction with the new boundaries that the government is trying to set for different regions of the country. There are a lot of political and ethnic issues affecting how these lines are drawn. Nepal seeks to form a new federation of about 6 or 7 regions, which differ considerably from the current 5 regions. We hope very much that the container will reach us within the next two months.

We are working now on many internal issues such as staffing, IT, induction training, furniture and fittings.

The ear hospital and training centre sits on land donated by INF. The new INF ‘clinical cluster manager’ Dhaka Ram Magar has many new ideas about the development of the whole site, including the current Green Pastures leprosy and spinal injuries projects and the associated disability rehabilitation work. The ear work will fall within this. The overall plan is exciting but represents considerable challenges and will take many years to develop. The ideas include a full general hospital with nurse and doctor training. Some of these ideas will directly impact the ear hospital, as we are likely to share some staff and facilities. Central to the plans are income generation and sustainability. These changes represent a considerable departure for INF from its medical work in recent years, which has largely been community based. It is fair to say that the ear hospital has led the way in this development, even though not yet open! The desire for a first rate caring and ethical service that is self-sustaining and seeks to serve the least advantaged, as much as those with the ability to pay, is a single thread through all this.

We have a number of volunteers coming out over the coming months, especially at the time of our official opening in first week of November. At that time we will run an ‘ear camp’ here in Pokhara We are learning to call these events “Ear Outreach Services’, for technical reasons in country. The Swiss donors, SON, who have so wonderfully raised so much for the building itself, will be here. We will inaugurate name plaques and a foundation stone to honour the large and small partners including Ear Aid Nepal. We are committed to supporting the Ear Hospital and Training Centre with contacts, funds and technical expertise.

Thanks so much to all of you who have contributed in so many ways to this work; which we hope will provide a fantastic service for people affected by ear problems here in Nepal.