Time to go back to work. I was to spend about a week and a half working with the NRH in Lazimpat Kathmandu.
Learning about malnutrition was not something that was covered in my four years at college so it was an interesting opportunity for me to spend some time developing my professional skills.
Infant mortality in Nepal is one of the highest in the world (64% per 1000 live births). According to a UNICEF report, half of all Nepalese children under the age of five who do survive are malnourished.
The Rehabilitation house is a really great setting. It's a large house with several out buildings, a garden with a children's slide and a kitchen garden for vegetables. There is also a large roof terrace that the carers use for sitting in the sun and doing oil massage with the children. Oil massage is particularly beneficial when the children have some oedema (swelling) related to their malnutrition and exposing their skin to sunlight for a short period helps with the production of vitamin D. It's also a relaxing experience and helps create a parent-child bond the lack of which may have been a contributing factor in the development of malnutrition.
We also had the opportunity to participate in and help fund an outreach clinic to a remote hillside region a few hours away from Kathmandu. The organisation carries out these clinics occasionally (funds permitting) and they are an extremely important part of the work they do. These children have extremely limited access to healthcare and education levels in these remote areas is often low. It also helps develop a picture of malnutrition situation in Nepal as a whole.
We had some training the day before then packed up the bus and headed for Karvre 2.5hrs away. We were to travel along roads you would hesitate to take a 4x4 down but somehow we made it.
When we arrived the need for the outreach work became clear. 328 children, some with older siblings had arrived with their carers to be weighed measured and assessed for their nutritional status.
There was also a hand washing station to show the children how to wash their hands properly and to try and educate people about good hygiene practices, a lack of which leads to diarrhoea, a leading cause of acute malnutrition. There was also a nutrition stand and an ongoing talk about how to prepare, use and combine foods in the most nutritionally beneficial way.
I was very surprised to learn that it is estimated that only about 12% of cases of malnutrition are directly attributed to poverty. The vast majority of cases are due to cultural practice and a lack of education. This is maybe why it is a situation that finally seems to have turned a corner and is atlast considered to be improving. 
Each child that was registered also received a bag of "super flour" which is a blend of toasted pulses and legumes which has a HBV combination of protein and can be quickly and easily reconstituted to make a nutritious porridge.
Thanks to organisations such as NRH carers are being given the education to be able to provide appropriate nutrition for their families and maybe malnutrition will eventually be overcome.
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