Info Pack 1Nalma

Australia-Nepal Dental Outreach Programme, 2014-2015Information PackReleased tothe Registered Volunteers of: Nalma Village Dental Outreach Volunteering “I hear and I forget. I see and I remember. I do and I understand.” Project District Lamjung, Nepal Sunday, 7th December – Saturday, 20th December, 2014Volunteering Students fromAustralia/New Zealand:-Sl No Name Univ 1. Caterina Amato Melb 2. Aditya Athale Melb 3. Kiran Athale Otago 4. Wee Chan Lim Otago 5. Michael Al-Dabbagh Melb 6. Thomas Webb Melb 7. Brandon Krapf Melb 8. Jeffrey Martin Pilot 9. Erica Chong JCU 10. Harmohan Singh JCU … 1www.aroundgoodpeople.com

Namaste and Welcome,Thank you for preferring Around GoodPeople.Around GoodPeople is a people led social enterprise, “I hear and I forget. I see and I remember. I do and I understand.”established to empower the marginalised anddisadvantaged people in the mountainous ruralcommunities of Nepal in self-reliance and simple livingencompassing education, health, economic development,sustainable environment and social justice. We embracethe tenets of the grassroots movement to secure everyindividual a life of dignity and happiness. We have begunour mission in the field of Public Oral Health Care tobegin with. We believe, when all good people cometogether, the world becomes a much better place to livein. Thus, come November 2014, we shall embark upon aseries of two weeks of sharing our skills, time andresources in a unique opportunity to volunteer for a freeDental Outreach in the farming village of Kaski,Syangja, Lamjung, and Parbat , near Pokhara inMid-Western Nepal. We shall be living amidst thesesimple village folks in a basic rudimentary settings,conducting Oral Hygiene Instructions, screening andtreating the local students and villagers in a make shiftclinic at a local school. Many of the villagers will begetting a dental care for the first time in their lives. Theentire two weeks dentistry days would be very busy witha big crowd of keen care seekers.The Australia-Nepal Dental Outreach 2014-15 is ourFlagship project with the first inter university group ofPioneering Australian/New Zealander dental students/oralhygiene arriving in the last week of November, 2014 2www.aroundgoodpeople.com

and subsequent groups following in sequel till the lastgroup of volunteers leaving on the 25th January, 2015.This info pack has been prepared to help you make senseof your informed choice of making it to Nepal finally andfurther to assist you to prepare for your trip and get themost out of your experience in Nepal.The pack is divided into three sections, to help you getstraight to the information you need:o WHAT TO EXPECT - About our DentalOutreach o Local languageo PLANNING AHEAD - Booking flights “I hear and I forget. I see and I remember. I do and I understand.” o Your clinical interests o Travel insurance o Professional indemnity o Health preparations o HIV PEP o Passport & Visa o Weather & climate o Clothing to take o Suggested packing list o Moneyo WHEN YOU ARRIVE - Airport & transfer tothe accommodation o In Kathmandu o In PokharaBenefits of volunteeringTo Nepalese Society• Positive impact on the society and environment• Improved wellbeing of members of the communitywhere the volunteer worksTo the Participant• Improved clinical skills• Improved cultural awareness 3 www.aroundgoodpeople.com

• Increased interpersonal communication skills• Development of strong working and personalrelationships with the volunteer personnel• A personal sense of achievement• Experience of the real (Nepalese) worldWhy go to Nepal for Dental Outreach ? “I hear and I forget. I see and I remember. I do and I understand.”Social determinants of health for the ruralNepalese populationThere is a growing understanding that the socialenvironment has an important contribution to make tooral health. It is accepted that in order to address theissue of prevalence of oral diseases one needs toconsider the broader social, behavioural, andenvironmental context of people’s lives. It is easy toblame the victims for being ignorant and careless abouttheir own oral health however, as health professionals;we must look past the immediate causes of poor oralhealth focusing our attention on reducing the impact ofthe factors which determine how one deals with oralhealth issues.Understanding the barriers to oral health requires afurther comprehension of factors influencing oral health,that are the social determinants which do not act inisolation but rather via complex interactions. Nepal’s poororal health status is shaped by extensive socioeconomicand cultural determinants, such as individual experiencesof poverty, unfavourable living conditions, disease,limited education and low literacy, insecure economicactivities, and insufficient access to health care. Thepriority one places on the significance of oral health maybe reduced due to the influence of these as many poorfamilies attempt to address their more basic and pressingneeds such as safety, shelter, education and food Livingwithin a poverty stricken environment produces 4www.aroundgoodpeople.com

behaviours that may not be conducive to good oral “I hear and I forget. I see and I remember. I do and I understand.”health.To overcome the effect these seemingly insurmountablesocial determinants have upon the oral health of theNepalese population commitment to upstreamapproaches is necessary on behalf of the oral healthprofessionals participating within dental programs acrossthe nation. Adopting this upstream approach willundoubtedly tackle the unmet oral health needs of thecommunities, allowing Nepalese to make healthful,educated choices and practice habits conducive to goodoral health. These critical challenges for Nepal stillremain, however, after a decade of insurgency war andsocio-politico upheavals, some small progress has beenmade in what has been a difficult transition.Oral health needs of rural communitiesDue to insufficient access to affordable oral health careas a consequence of poverty, geographical location andlittle understanding surrounding the need for prophylacticdental care the children living within the rural areas ofthis civil strife wary nation are susceptible to high dentalcaries rates, and obtain very little knowledge surroundingoral health measures. Cultural dietary habits involvinghigh consumption of sugar are affective agents thatcontribute considerably to deteriorating oral health withinthe rural population. Lack of adequate reticulated watersystems resulting in deficiencies in controlled waterfluoridation compounds the oral disease levelsexperienced by these individuals. Poverty affects theability to travel to existing dental services and to pay forappropriate treatment.Recent studies show the dmft (decayed, missing or filledteeth) of 6 year old children in rural Nepal is 11%, with61% of those surveyed reporting never to have brushedtheir teeth. The alarmingly high dmft for the 6 year oldchildren is a result of a range of local, environmental, andsocial determinants causing significant negative impacton their already compromised oral health. 5www.aroundgoodpeople.com

Existing Dental Services “I hear and I forget. I see and I remember. I do and I understand.”Oral health care for the majority of the Nepalese incertain urban pockets is relatively a new phenomenon.However, a large swath of the country still is devoid ofany meaningful oral healthcare. Existing dental serviceswithin Nepal include private and public health carefacilities, foreign and locally trained dentists within non--‐government organizations and charity groups, as well as‘traditional’ dentists. The per capita availability of dentistsin Nepal, to the population is one of the lowest in theworld, signifying a workforce that is inadequately small tocater for its population’s oral health needs. As well as lownumbers of trained personnel, the workplace distributionof dentists leaves the majority of rural areasunderserviced, as most dental providers are situatedwithin urban areas.Currently, the government provides no free public dentalservices. Treatment fees within the public sector aresignificantly less expensive than those within the privatesector however due to the extreme poverty of someindividuals even treatment at this reduced cost remainsimpossible to attain. Traditional dentists are able to offeran alternative to expensive private dental care at low costwithin rural locations of reasonable travelling distance forthe patient. However, they lack formal training in theprofession. Outreach dental service delivery by NGOs isnecessary in many developing nations like Nepal wherean identifiable gap in the provision of services exists andwhere dental services fail to equitably reach allindividuals.About our Dental OutreachOur placements are intended to give capable, confidentstudents opportunities to learn about oral healthcareprovision in unfamiliar environments and cultures throughexposure to the temporary dental clinic in a village highschool near Pokhara. We provide a comprehensivesupport package that is designed to make these 6www.aroundgoodpeople.com

opportunities as accessible as possible - but what you get “I hear and I forget. I see and I remember. I do and I understand.”out of your experience at the Dental Outreach clinic willdepend on what you put in.Be Proactive & Earn TrustJust as with placements you do at home, if you sit on theside-lines and wait to be given something to do you'llprobably wait a very long time. At first, you might lackconfidence being in such a completely new environment,but remember that as a foreigner you are probably asunfamiliar to the dental outreach team members as theyare to you.The dental healthcare professionals you are working withat the outreach clinic are there first and foremost to dotheir regular outreach works, and are certainly notexpected to nanny students. We frequently get told bythe dental supervisors, hygienists and others that thestudents who they feel inclined to give opportunities toare those who actively put themselves forward -volunteering, asking questions and offering help. Thispoint is most important when it comes to getting hands-on experience: Few responsible dental healthcareprofessionals would allow an unqualified student toperform even minor procedures without some evidencethat he or she has the necessary skills and confidence todo them properly; so it is unrealistic to expect hands-onexperience during your first few hours or even initial dayor two in a particular clinical procedure. The best way tomaximize your chance of getting clinical experience is toput yourself forward, ask questions, volunteer answers,get to work early, stay late, work some extra patients andlearn the basics of the local language. Above all, ask forthe opportunities you want - if there is a particular taskyou feel confident in, say so and ask if you can do itunder their supervision. 7www.aroundgoodpeople.com

Common Presenting Oral Conditions in NepalThe oral and dental manifestations of the patients withinthe villages of Nepal have characteristic patterns andpresentations, which differ notably from what iscommonly encountered back, home in Australia. Regularoccurrence of pain and the proportion of childrenpresenting for restorative work compared to preventivetreatment are of significance.Common presenting conditions: “I hear and I forget. I see and I remember. I do and I understand.”• Multiple carious teeth/ rampant caries• Infection due to caries• Retained deciduous roots/ retained root fragment• Resorption of the buccal plate exposing tooth rootsthrough gingival tissue• Pulpal polyps, especially in broken down teethwhere the “shell” remains only.• Early Childhood Caries (ECC)• Extensive interproximal caries on permanent upperanteriorsYour Student MentorPart of the preparation we do for placements is to ensurethat the partner Dental Hospital assign a suitablyqualified Dental Supervisor to act as a Mentor for allparticipating students/volunteers. Your Mentor might bethe practising dentist with our partner hospital with ateaching assignment to other dental public healthstudents, but this isn't always the case.Learn don't judgeWe often find that although students know things will bedifferent in Nepal, many expect the underlying principles 8www.aroundgoodpeople.com

and attitudes of dental healthcare staff to be similar to “I hear and I forget. I see and I remember. I do and I understand.”those at home, which they are often not. Attitudestowards patient care especially, and to issues of privacy,suffering, and even infection control, can be shockingly atodds with the training you have received. For manystudents, these differences are the hardest thing to dealwith - and when faced with practices that would beunacceptable at home it is impossible not to questionthem in your mind. But you should also not forget thatthis diversity in oral healthcare - and attitudes to dentalhealthcare - around the world is a big part of what adental outreach placement is all about. It's important toremember that you're not going to Nepal to changethings, you're going there to learn. You may never fullyunderstand the complex cultural and economic reasonsbehind some of what you see - but if the experience youhave on your placement makes you a better dentalhealthcare professional, it has been worthwhile. 9www.aroundgoodpeople.com

The Nalma Village Community “I hear and I forget. I see and I remember. I do and I understand.”Introduction:Nalma is blessed with beautiful Mountain View of theAnnapurna and the Lamjung Himalayan peaks,mesmerizing sunset and sunrise. At the altitude of 1500meters above the sea level it is a charming village thatrepresents unimaginable beauty, perfectly and naturallymolded for a lifetime’s experience. This village has emergedas an attractive destination among culture hunting touristsand anthropologists alike to observe and enjoy thetraditional way of life of the martial races of the Gurung andMagar people of the mountain Nepal.Location:AltitudeNalma, a village in Lamjung District is located at an altitudeof 4536 ft. /1383 meters above sea level. Nalma hassubtropical mixed evergreen forest with large number ofAlnus nepalensis locally called (utis), Schima wallichii(Chilaune). The wild animals found here are leopard and thedomestic animals found here are cow, buffalo, chickens,boats, rats and cats. The staple food of this region is Rice,Wheat and Potato. Rice (Dhaan) is typically sown in themonth of June-July and harvested in first week of Novemberwhereas Barley (kodo) is sown in August and harvested inlatter part of November.TemperatureBeing at a high altitude Nalma has cold climate. The winterseason begins from November till the end of January andthe average temperature ranges from 15 to 8 DegreeCelsius. However, the winter nights could be cold andchillier, however it does not snow. 10www.aroundgoodpeople.com

Distance/Time “I hear and I forget. I see and I remember. I do and I understand.”Nalma is at a distance of about 18 km from Besisahar, theDistrict headquarter, which is a mud track requiring 1.5 hourof travel and Besisahar is at a distance of about 142 kmfrom Pokhara making the total 160 km. The total time takenfrom Pokhara to Nalma is 5-6 hours.CommunityThe village is an ethnic Gurung country. They speak theirown dialect which belongs to a Tibeto-burman group. Theyfollow a syncretic form of religion based on TibetanBuddhism. Respect for the memory of the fore-fathers,elderly is pretty high in this community. Women folks have alarger rolein the family and the community than many ofother communities in Nepal. The traditional occupation ofthe people is farming, sheep herding and trans- Himalayantrade. The men are generally involved in Agriculture andanimal herding whereas women are involved in farmingand day to day household works.Belonging to the fabled martial class, the Gurung and theMagar tradition give much importance to military occupationtherefore most of the able bodied young men take it a prideto be employed in The British Army,the Singapore Police, Brunei reserve units and the FrenchForeign Legion. It is considered a great honour if a malemember of the family joins a military service in a foreignland. Chivalry and honour take a special pride in thecommunity. The village folklore is full of stories of braveryand dignity. While serving in the British Army they haveearned more than 6 Victoria Cross awards. Even when theycannot make it to the foreign military service, they want towork abroad. The rate of migration amongst the youth of thevillage is quite high due to foreign employment and militaryoccupation. People of Nalma by natures are lover of fun andare very friendly, socially active and well known for theirtraditional singing and dancing aptitudes !ClinicThe clinic will be operated in the Annapurna secondary 11www.aroundgoodpeople.com

school which will have all the required facilities for the basicclinic operation. The clinic venue is about thirty minutes’uphill walk from the Village Headman’s House (our outreachabove !).Name of the school Number of children “I hear and I forget. I see and I remember. I do and I understand.”Annapurna Secondary 350Laliguras Primary 25Baudha Milan Primary 85Annapurna Boarding 25MahaDev Primary 10Total 495AccommodationThe Village Headman’s House has been offered to us tolodge our visiting volunteers. It is a traditional Gurunghouse, we have tried our best to offer the basic amenities ofa clean and homely accommodation in a traditionalNepalese setting. The entire community was involved inmaking over the property for our purpose including fixing awestern style commode and a hot shower !!PopulationThe population of the community is 2300 (in approx. 658households) which shows a large number of people living inthe village area considering the fact that in mountain Nepalthe human dwellings are sparsely populated. Theneighboring hamlets are Baglung Pani, Purankot andSindure. The local village community ( our local partnercollaborators) has been very generous to invite the patientsfrom these surrounding villages. The culture of sharinganything good is amazing amongst the beautiful peoplehere, despite the fact that the outreach is a one off event,even this rare event is up for apportionment amongstcommunities and hamlets ! 12www.aroundgoodpeople.com

WHAT TO EXPECT ? “I hear and I forget. I see and I remember. I do and I understand.”Local languageNepal is made up of a number of different ethnic groups,originating from various parts of South Asia and eachgroup has its own language and dialect. However, thelingua-franca is predominantly Nepali. It falls undermodern Indian language group. When spoken, it soundsnice and is relatively very easy to pick up. Most of thenative Nepali speakers are soft spoken.No one expects you to become fluent in Nepali, butlearning some clinical phrases and dental terms beforeyou leave home makes a huge difference. It will help youto understand more of what is being said around the DOclinic, and greeting - putting your palms together andsaying 'Namaste' to your supervisor or other localvolunteers in their own language - is likely to impressthem. If you make little effort with the local language,this is likely to have a negative impact on your overallplacement experience, as you may miss out on importantinformation if you are constantly relying on your localcolleague to translate. Being able to converse with localdental healthcare people in Nepali will assist in buildingtrust and the friendship you will develop will mostcertainly compliment your time overseas. There is only alimited number of language software providers availableonline and based on our research, we recommendEurotalk Interactive 'Talk Now Nepali', which is availableon CD rom(http://eurotalk.com/en/store/learn/nepali/talknow/cd).To supplement your language whilst you are out inNepal, we will have a set of Nepalese phrases inRomanised Nepali with simple and basic words andphrases. The dental terms are also indicated tailoredtowards the vising dental students. Everyone involvedfrom the Co-ordinator to the Dental Supervisor and theother local community volunteers will help you, Nepalesepeople are very helpful and easy-going. Some useful 13www.aroundgoodpeople.com

phrases can be found at the end of this information pack. “I hear and I forget. I see and I remember. I do and I understand.”Just to make things more easier for your workingenvironment, we train and orient the Nepalesemember of the outreach in your native accent andpronunciation ! Our experience tells us, it’s not hardtask!!PLANNING AHEADBooking your flightsPlease remember that you are responsible for bookingyour own flights to Nepal.. However, we can arrange tobook the internal flight from Kathmandu to Pokhara,Since Nov-January months are a high season for theadventure tourists visiting Nepal, flight tickets to andfrom Pokhara are always in short supply. It isrecommended to book the tickets as early as possible toavoid disappointment. We can arrange to get the ticketreservation for you.As soon as you have booked your international flights,and booked the domestic flight through us, please fill inyour arrival details on your bio data sheet which we willsend to you at a later date, so we can make sure one ofour staff is at the airport to meet you on arrival.Arrival airportPlease book your flights to and out of (depending uponyour option to fly back to Kathmandu) we can do this foryou and we will arrange your transfer from the Pokharaairport to the village outreach venue.Pokhara airport is a small regional airport, served mostlyby domestic flights from within Nepal, so you will have toget a connection from your international flight, usuallyfrom Kathmandu. 14www.aroundgoodpeople.com

Dates of travel “I hear and I forget. I see and I remember. I do and I understand.”You can arrive to Nepal either on a day before the startof the programme date, or even before that. We will pickyou up from the Kathmandu airport and thereafter youwill be in our safe hands. Further onward flight toPokhara our ground staff will guide and assist you. (Illustration : we are responsible for your surface travel,air flight is not included), accommodation, food, water,airport transfer from the day you land in Kathmandu. If,you are flying out from Pokhara to Kathmandu on thenext day after the last night of your outreach, we willarrange for your airport transfer.Please note :In the event that you arrive in or leaveKathmandu/Pokhara outside of these days you will beresponsible for the cost of alternative accommodation. Ifyou need, we can provide you with some suggestions foralternative accommodation; just contact us through emailfor details. You could also refer to a guide book or theweb for suggestions.Airline optionsAlthough there are no direct flights between the Australiaand Kathmandu, there are numerous airlines serving theroute with just one change. Several airlines fly fromPerth, Melbourne and Sydney via Hong Kong, Singaporeand Bangkok and offer good value fares, including AirAsia, Dragon Air, Qantas, Thai Airlines, etc. via differentcity hubs. If you do fly via India, you may be required topurchase a transit visa, particularly if you plan to leavethe airport or change terminals. Please contact the HighCommission of India for further information.You will be required to take an internal flight fromKathmandu international airport to Pokhara. The majorityof international travel providers are unable to bookinternal flights within Nepal so you will need to arrangethis leg of your journey independently. As already 15www.aroundgoodpeople.com

discussed, we can also help you do the booking “I hear and I forget. I see and I remember. I do and I understand.”this sector to avoid complications for you.It Is also possible to book your internal flights online withone of the airlines directly, but be aware that the airlineswill require your credit card details and their sites areoften unsecure.Overland optionsIf you are feeling adventurous, it is possible to get toPokhara by bus or hire a land cruiser from Kathmanduwhich is time consuming and uncomfortable but givesyou an opportunity to see a bit of the country. Thisoption is only recommended for experienced travellers,who are happy to spend a night in Kathmandu andorganize onward travel independently.Travel insuranceIt is essential for your own protection overseas, and is arequirement of participating in one of our programmes,that you take out appropriate travel insurance for theduration of your trip. It is particularly important that yourpolicy gives you a high level of medical cover in case youneed treatment overseas or emergency air evacuation.If you have insurance already in place, please check thatit will cover you for the destinations you are going to andthe duration of your trip. Note on cancellation: Goodtravel insurance policies offer cancellation cover, so thatyou can claim back the cost of your trip if you are forcedto cancel for various reasons. This only applies if youhave bought the insurance before you know you have tocancel, so we recommend getting insurance in place assoon as possible and checking the details of thecancellation policy.Professional Indemnity ProtectionIndemnity protection for your particular field ofhealthcare is essential for working in a temporary ruralclinic or a hospital setting. Its main purpose is to providelegal protection and assistance, especially in cases of 16www.aroundgoodpeople.com

plausible/alleged negligence. Indemnity protection is notalways required for participation in some of our non-clinical placements. If you are unable to obtain indemnityprotection, The International Helpers (Guernsey) Trustoffers coverage (limit of USD 500,000) with worldwidejurisdiction for healthcare students and professionals. Toobtain their Medical Professional Liability coverage,please select the below link for a quote:http://www.internationalhelpers.co.gg User Name:medmissions; Password: mplYour dentistry interests “I hear and I forget. I see and I remember. I do and I understand.”In order to incorporate your dentistry interests into ouroutreach, we would like to know how do you envision theproposed outreach and what would be your ideal goalsfor the Outreach, we would like to know well in advanceas soon as you confirm your participation at theprogramme. If you could indicate to us our specificinterests and requirements, we can modulate the formand content of the DO module. You can tell us this at anypoint up until 2 weeks before the Dental Outreach, butthe sooner the better as it helps.The basic dentistry related activities at theoutreach would comprise of, the screening andcharting out a Treatment Plan, Oral HygieneInstructions to the villagers and the students,fluoride application, scaling, restoration, andextraction, depending upon the number of DOvolunteering participants, RPD may also beincluded.Health preparationsHIV PEPWhilst the HIV prevalence in Nepal is considered low,there is still risk of exposure to blood borne diseases such 17www.aroundgoodpeople.com

as HIV, and in a healthcare setting this must be taken “I hear and I forget. I see and I remember. I do and I understand.”seriously. There is a limited supply of HIV post-exposureprophylactics (HIV PEP) available to you in the largerhospitals in Nepal. However, as Around GoodPeopledoes not control these stocks we cannot guarantee theiravailability in advance. It is not a mandatory requirementfor you to organise your own stocks of HIV PEP in orderto take part on this programme but you may choose totake a stock with you. Please remember that, althoughour service to you cannot extend to the provision of HIVPEP (it being a prescription medicine), we have staffavailable on the ground 24/7 in the event of anemergency and they would immediately organisetransport to a private hospital / clinic where stocks areavailable. All ground staff are trained and have beenrequired to follow requisite protocol should a situation soarise. Irrespective of whether you take stocks with you ornot we strongly recommend you organise appropriatehealth insurance that will cover you for the cost of HIVPEP for your time in Nepal.Passport & VisaYou must ensure that you have a full passport that isvalid for the duration of your trip and valid until at least6 months after your planned return date. If yourpassport expires less than six months after you are dueto return home we recommend that you apply for a newone before submitting your visa application. Citizens ofmost countries are required to obtain a Tourist Visa inorder to enter Nepal. We advise you to obtain the touristvisa prior to your departure to make your arrival run assmoothly as possible. You can visit the website of theNepalese Embassy in Australia. For obtaining latest andaccurate information about the rules and proceduresabout getting a Nepalese tourist visa. However, you maydecide to go for the ON ARRIVAL tourist visa also as anoption. Nepal does not issue visas specifically forvolunteers. Work permits are often difficult to obtain.Technically, you are not permitted to work on tourist 18www.aroundgoodpeople.com

visas, but because you are not undertaking paid work, it “I hear and I forget. I see and I remember. I do and I understand.”is tolerated. At the time of writing none of our past DOvolunteers, to our knowledge, had encountered anyproblems with immigration authorities at port of entry onthis point.It is the responsibility of the DO volunteers to managetheir own visa.www.necan.gov.npTo obtain a Tourist Visa first download and complete thevisa application form available from the Embassy ofNepal's Australian websitePlease leave those sections that do not apply to youblank. The application form is fairly straightforward butplease enter the information below for the followingquestions:Section Question What to put3 occupation5 Telephone work Student (if studying)12 Leave blank if13 studying16 Address in Banglamukhi Marg, Nepal Maharajgunj 4, Kathmandu, Nepal Purpose of visit Others Type of Visa TouristVisas are valid for a limited time once you are in Nepal soyou need to obtain a visa that will cover the whole timeyou are there. You can choose to purchase a visa that isvalid for either 15, 30 or 90 days and these are pricedaccordingly. It is however possible to extend your visa ifnecessary when you are in Nepal. The prices of the visaare laid out below and are correct at the time of writing.It is wise to double check these prices with the Embassyof Nepal when you apply for your visa. 19 www.aroundgoodpeople.com

It is not possible to obtain a single entry visa. Any visaobtained is therefore a multiple entry visa and allows youto leave and return to Nepal, which is very useful if youplan to do some travelling when you are out there.Please note that a visa is valid for 6 months from thedate of issue. This means you must enter Nepal within 6months following the issue of your visa for it to bevalidated. Consequently, we suggest you apply for yourvisa 6 weeks before you are set to travel.Documents “I hear and I forget. I see and I remember. I do and I understand.”The following documents must be submitted when youapply for your visa:• A passport (valid for at least 6 months after youare expecting to return to Australia)• A completed application form• One official passport photo (with your name on theback)• Visa fee (see below)• A prepaid self-addressed envelope (with recordedmail)Visa FeeTravellers can purchase fifteen-day multiple-entryvisas ($30), one-month multiple-entry visas ($40)(We recommend this visa), or three-month multiple-entry visas ($100) prior to departure from TheNepalese Embassy in Australia or upon arrival atTribhuvan International Airport in KathmanduThe Embassy only accepts the visa fee in either cash, byPostal Order or by Bankers Draft. These must be madepayable to the 'Embassy of Nepal'. Personal cheques andcredit cards are not accepted for visa fees payable to the'Embassy of Nepal'. Personal cheques and credit cards 20www.aroundgoodpeople.com

are not accepted for visa fees. Once the visa is issued, itwill not be amended, revalidated and visa fees will not berefunded.Contact Details “I hear and I forget. I see and I remember. I do and I understand.”Address:Embassy of Nepal22 Kaleelah Vista, O’Malley, CanberraACT2606Tel (02)6162 1554Email [email protected] & climatePokhara is situated at an altitude of around 800 metersand the DO village of Sikles 2000 mtrs and has a pleasantclimate with three seasons - dry, winter and monsoon.The exact timings of these seasons vary from year toyear, but the following is a rough guide of what to expectFrom October through December the weather is dry. Thedays are mild with temperatures ranging between 10°Cto 20 °C. The temperatures dip cooler during the wintermonths from December to March, hovering around 5 °Cto 15 °C. And during the winters, the views of Sikles andthe surrounding is spectacular! It is every photographer’sdelight.Clothing to takeFor workIt is essential that Dental students wear scrubs. Nonclinical volunteer members could also wear the scrubs forprofessional security. Your Nepalese outreach cliniccolleagues would really appreciate a professionalappearance. Please observe hygiene and infection controlstandards by only wearing your scrubs in the clinic, and 21www.aroundgoodpeople.com

not during your journey to or from work. (More “I hear and I forget. I see and I remember. I do and I understand.”information on info pack-2)Footwear for the DO clinic should be lightweight coveredshoes. You can change into your work garb at the clinic,for which a room/spot is assigned. A Change Room isprovided at the clinic venue.Outside workAround town and on public transport etc., ladies shouldagain keep the shoulders covered and wear long skirts(at least knee-length) or trousers. Shorts are fine,provided they come well down the thigh. Not followingthese suggestions may get you some disapproving looksfrom local women and considerable (probablyunwelcome) male attention. For guys, shorts and T-shirtsare fine. Inside the village accommodation house thingsare more relaxed, as the only people who will see you areour staff and other students.Remember it's cold in the evenings and the mornings inthe early winters. You might appreciate a hoodie orfleece jacket in the evenings while your stay at thevillage. It is generally advised to apply a DEET-basedinsect repellent to any skin that is not covered by clothingin the evenings, especially if you are sitting outside.For your safari, bring your shades and hats. Don’t wearyour flip-flops while you are out in the nature walk. If youplan to go trekking around the Annapurna circuit or tothe Everest base camp, you'll also need clothing andequipment for severe mountain conditions including snowand extreme winds. Flip-flops are ideal most of the time(and can be bought cheaply in Nepal), but you might alsowant to take some trekking shoes or light boots fortravelling. 22www.aroundgoodpeople.com

Suggested packing list Documents General  Shorts (We recommend leaving copies  Lightweight trousersof all documents with someone  Swimwear  Lightweight sweater / hoodieat home)  Warm clothes & jacket First Aid kit (between Nov to Feb) Mosquito repellent Lightweight waterproof jacket Passport and/or umbrella Nepal Tourist Visa  Flip-flops / sandals (this is a sticker in your  Covered shoes for workpassport)  Trekking shoes / boots (if you plan on travelling) Travel insurance policy  Wash kit etcdocuments  Torch / flashlight Sleeping bag liner “I hear and I forget. I see and I remember. I do and I understand.” Professional Indemnity policy  (we provide your bedding at thedocuments village house, but this is  useful when travelling - silk Money liners are ideal as (see below)  they pack away incredibly Mosquito net small)  Money belt (for travelling - we provide nets  Padlock for security box in yourat the house) bedroom  Penknfe Sunscreen  Mobile phone & charger (high SPF recommended)  Llocal SIM cards and handsets After sun / moisturizer are fairly cheap in Nepal) Earplugs (so you can get arestful sleep)  Camera & charger  Universal electrical plug adapter Condoms  (mains is 230V, but many Clothing Tampons / sanitary towels sockets are 2-pin type)  MP3 player (some availability in Nepal, but  (mini speakers also handy if younot all types) have them) (Please see previous notes as  Nepal guidebookwell)  Toys (optional - if plan on going Towel to an orphanage Scrubs Jeans, trousers or long skirts forwork Shirts/blouses for work Underwear Socks T-shirts / casual tops 23 www.aroundgoodpeople.com

 and want to make a donation)  Tourniquet Placement-specific items  Alcohol gel (Optional suggestions,  (very useful as limited suppliesdepending on what you think in Nepal) you might find useful for your  Donations for the schools andplacement) village health post clinic Reference books (optional) (clinical dentistry handbookscan be very useful) Stethoscope(You do not have to take donations, however if you do “I hear and I forget. I see and I remember. I do and I understand.”have supplies you can take out then the following areespecially in demand) Sterile gloves (all sizes)  Nebulizers Tooth brush  Nasal prongs and oxygen tubing Fluoride tooth paste  Pen lights Dental Stethoscope Tourniquets  Blood pressure machine with Disposable masks & aprons cuffs - children size Safety glasses (protective  Tape measures eyewear for the clinic)  Small weight scales Alcohol gel & wipes  Hanging watches for Nurses Surgical soap  Small sterilizers Bandages (wool & crepe)  Uniforms (white) Micropore tape  IV cannula with lock and Non adhesive dressings injection port Manual BP monitor Portable pulse oximeters  Digital thermometers Glucometer testing strips  Autoclaving tape  Reference books Catheter  Surgical 'scrubs Ky Jelly  Orthoscope and laryngoscope Bond agent & glass ionomer  Head lamps for surgery/speculum exams cement Goniometer Therabands  Cut gut suture Surgical boots Portable TENS machine  Transcutaneous electrical nerve Cryotherapy gel pack stimulation (TENS)  Basic surgical tools 24 www.aroundgoodpeople.com

Money “I hear and I forget. I see and I remember. I do and I understand.”Costs & BudgetingOur package includes your accommodation and food at Pokhara and the DO village.It also includes the total cost of the logistics, manpower, materials, medicines,consumables and the consultancy affiliation fees to the partner dentistry school inKathmandu, Nepal. It includes the complete charges of the holiday package thatcomes with the DO sign up. Alcoholic/aerated drinks are not covered.You also need to budget for your spending money to cover things like socializing,optional extra travelling at the end of the DO if you are extending your stay inNepal, buying souvenirs and local travel around Nepal.Nepal is cheap that you can get by on a budget or splash out a little to treat yourselfwithout having to spend a fortune.Local currencyThe currency is the Nepalese Rupee, but it cannot usually be obtained outside thecountry. The exchange rate fluctuates quite considerably, so please check online forthe current rate (e.g. www.fxconverter.com).ATMs, credit & debit cardsNepal remains very much a cash society, and you can only really pay by card inexpensive hotels. There are ATMs in most major towns, including several in Pokhara.The majority of visitors manage to withdraw money without any problems as long asyou phone your bank and let them know the dates you will be in Nepal. Veryoccasionally foreign bank cards do get rejected, although there does not seem to beany clear pattern to what type of card is accepted and what isn't. For credit cards,Visa is generally more widely accepted than Mastercard - but again, this isn't a hardand fast rule. It is not unusual for credit card payment to incur 3 - 5% surcharge soit's better to pay in cash wherever possible.In most major towns, including several in Pokhara. The majority of visitors manageto withdraw money without any problems as long as you phone your bank and letthem know the dates you will be in Nepal. Very occasionally foreign bank cards doget rejected, although there does not seem to be any clear pattern to what type ofcard is accepted and what isn't. For credit cards, Visa is generally more widely 25www.aroundgoodpeople.com

accepted than Mastercard - but again, this isn't a hard and fast rule. It is not “I hear and I forget. I see and I remember. I do and I understand.”unusual for credit card payment to incur 3 - 5% surcharge so it's better to pay incash wherever possible.CashCash is the most useful and flexible way to carry your money as it can be changedwidely throughout Nepal and gets a good exchange rate. A$, Euros and US Dollarsare all equally easy to convert into Nepalese Rupees once you are in Nepal. USDollars are accepted for large payments such as for trekking and safaris (new,higher denomination notes are preferred) so we recommend you take a mixture ofyour own currency and US Dollars. The down side of cash is the security risk ofcarrying it. Our advice is therefore to take as much of your money as you arecomfortable carrying in cash.Traveller's chequesTraveller's cheques are a safe and reliable way to carry money, but its use is gettingless and less by the day. The advantage of these is that they are insured and canusually be replaced quickly if you lose them, but cashing traveller's cheques is muchmore hassle than just going to the ATM and you get less for your money because ofa lower exchange rate compared to cash.American Express or Visa traveller's cheques are universally accepted, butsometimes less known brands such as Thomas Cook are not. You'll get most for yourmoney by taking traveller's cheques in your own currency (some banks suggest it'sbetter to take US Dollars, which is not true in our experience). Depending on whichbank card you have, and how much cash you are happy to carry, taking sometraveller's cheques can be a useful back-up.Telephone bankingWe recommend you utilise Telephone Banking so that you can safely check yourbank balance and perform transactions over the telephone while you are abroad,instead of Internet banking which you can only access using public computers. Callsare often recorded so that identity fraud can be reduced. 26www.aroundgoodpeople.com

WHEN YOU ARRIVE “I hear and I forget. I see and I remember. I do and I understand.”Contact NumbersWe shall be sending you the contact details as soon as your participation isconfirmed. However the following numbers can be used in case of emergency or Ifyou failed to meet our representative at airport or if your flight changed suddenly, orfor any kind of stand-by flight situationNepal +977.9808679825We also recommend that if you are taking your own mobile phone you switch it onas soon as you land.Receiving calls on your home mobile phone while overseas is often very expensive,so we will not normally use this - it's just a useful backup if there is a problem andwe need to contact you urgently.At the airportImmigrationDuring the flight into Kathmandu, you will be given a Nepal Immigration ServiceDisembarkation Form to complete. The form is self-explanatory and should behanded to the Immigration Officer inside the airport, together with your passport.Please tick 'Tourist' as your purpose of visit.After the Immigration counter, proceed on through to the baggage reclaim areaCustomsCollect your bags from the luggage carousel, and walk on through the Customs area.Please remember that the Customs Officers have every right to thoroughly searchyour bags. It's worth noting that the people of Nepal greatly appreciate friendlinessand respect so a smile and polite \"how are you?\" can speed the customs processconsiderably. 27www.aroundgoodpeople.com

WHEN YOU ARRIVE “I hear and I forget. I see and I remember. I do and I understand.”What to do if your bag doesn't arriveOccasionally, bags do go missing at airports. If your bags do not arrive, you shouldgo to the Lost Baggage desk in the baggage reclaim hall and report the loss. You willbe given a reference number and in all but the rarest cases, lost bags do arrive onthe next flight. Our grounds team will assist you should you stand in need of help orassistance in this regard.Hassle at the airportKathmandu airport can be quite bad for arriving passengers being hassled byporters, taxi drivers and agents. This does not present any danger - they are justtrying to get your business - but it can be annoying and intimidating. The best wayto deal with this is to politely but clearly say \"no thank you\" and walk confidently onthrough.You do not need to pay or tip anyone in the airport, whatever they say! Thedomestic terminal is a 5 minute walk from the international arrivals terminal.Kathmandu to Pokhara is a very scenic 25 minutes flight away.Meeting the Around GoodPeople RepresentativeWe always send one of our own staff to meet students at Kathmandu/Pokharaairports. The person meeting you will be wearing a blue Around GoodPeople shirt,carrying a printed sign with the Around GoopPeople logo and will know your fullname. If you are in any way unsure about the person who meets you, feel free toask any questions you like about our programme - if they really work for us theywon't mind!Our representative will be waiting for you immediately outside the main airportterminal doors. It's usually quite busy, but we'll be on the lookout for you - and ifyou wear your Around GoodPeople T-shirt you'll make our job much easier.Transfer from the airportYour transfer from the airport to the Kathmandu hotel accommodation is all paid foras part of our package, and our representative will travel with you. 28www.aroundgoodpeople.com

If you're hungry, tired or even want to explore the city at this stage, please do sayso - we're here to help.WHEN YOU ARRIVE “I hear and I forget. I see and I remember. I do and I understand.”In PokharaMobile phonesYou can buy a local mobile phone SIM card in Nepal for about A$2Calling and textinghome is generally much cheaper from a Nepalese SIM than using the roamingservice of your home network provider. Please note that some networks block theirhandsets to prevent the use of other SIM cards. You can buy a basic mobile handsetin Nepal for around A$30-35.InternetInternet access is widely available in Nepal. Like everywhere else, mobile on theinternet is very popular, mobile data card rates are very reasonably priced by boththe 2 carriers in Nepal. One can also access the internet either inKathmandu/Pokhara by visiting one of the many internet cafes, the best of which arevery reliable and fast enough to make checking emails a fairly quick job. For workingon job applications or assignments, the lakeside in Pokhara and Thamel inKathmandu has lovely cafes including Wi-Fi networks if you have your own laptop.ElectricityMains electricity is 230V, but wall sockets are a mixture of the European two-pintype and three-pin ones. We therefore recommend taking a universal travel plugadapter if you want to use appliances from home. Nepal's supply of electricity islower than its rapidly increasing demand, and the infrastructure is somewhat shaky.There is regular load-shedding (scheduled power cuts to spread usage) andunplanned power cuts are frequent and unpredictable. Fluctuations in the supply candamage sensitive equipment, especially laptops, when they are plugged in.LaundryMost Nepalese still wash clothes by hand, and we have areas where you can do thisat the village house. If you prefer to have your laundry done for you, the lady whowe contract to wash bedding etc. at the village accommodation is normally happy toprovide the service for a small fee. Please bear in mind that the washing methods 29www.aroundgoodpeople.com

used can be very hard on clothes, so we strongly recommend you wash anythingdelicate or of value yourself.Useful Nepali phrasesAs well as standard greetings and responses, it will be useful to practice a fewphrases and terms that are specific to your placement. Below is a quick introductionto the language, but you may want to build on this. There is usually a good phrasesection in the regular guide books-for example the lonely planet guide is veryhelpful. If you really want to get to know the language you can buy phrase books atlarger bookshops and online.Hello, Greetings Namaste / Namaskar “I hear and I forget. I see and I remember. I do and I understand.”How are you ? Sanchai hunu hunchha?Goodbye Raamro sanga jaanusBye Ta taSee you Feri bhetaulaGood RaamroYes Hajur, hoNo Hoina, chhainaPlease Kripaya (very formal)OK Hunchha, husBad NaraamroMy name isWhat is your name? Tapai ko naam k ho ?Thank you DhanyabaadThank you ( very much ) Dherai dherai dhanyabaIt’s ok, that’s alright kehi chhaina Thikai chhaI ‘m sorry Malai Maaf garnus 30 www.aroundgoodpeople.com

Idon’t understand Maile bujhina “I hear and I forget. I see and I remember. I do and I understand.”How much is it ? Yo kati ho?I don’t have money Paisa chhainaPlacement related Aaram garnusRelax Lhaamo saas phernusTake a deep breath BasnusSit down Kasto hunu hunchha?How are you feeling ? Dukhchha?Do you feel pain Dukhyo?/dukhyoPain JaroFever Sancho chhainaSick BimariSick JiuBody ToukoHead ChhaatiChest PetStomach Haath Khutta HaddiHand Legs bone Baaya/debre Daaya/daineyLeft right ShrimaanMister Mahila (ma-hee-la)Woman KetiGirl Budi (also means wife)Old woman 31 www.aroundgoodpeople.com

Child (female) Naani/Baabu “I hear and I forget. I see and I remember. I do and I understand.”Child (male) Bachha/PurushBaby, man, boy KetaOld manTooth Budo / buda( also means husband)Gum DaantBlood GeejaTooth decay RagatSwelling Daant keera-lay khanuTreatment SunninuExtraction UpacharDisease FalneInfected RogPlaque SankramitCavity Daanta leuDental Root ChidraRetained root Daant ko jaraPyorrhoea Tukro jaraSpit Danta harsaDirty ThukMedicine FohorHot AushadiCold TaatoHot/cold sensation Chiso Daant siringa hunu 32 www.aroundgoodpeople.com

Bite Toknu/aathnuNumbers 6 Chha1 Ek 7 Saat2 Dui 8 Aath3 Teen 9 Nau4 Chaar !0. Dus5 PaanchOther “I hear and I forget. I see and I remember. I do and I understand.”Today Aaja Afternoon DiusoYesterday Hijo Evening BelukaTomorrow Bholi Night RaatiMorning Bihana…………………………………………………………………………………………………………………… 33 www.aroundgoodpeople.com