Women’s empowerment is the best medicine—Dr. Lhamo Sherpa

Happy New Year and welcome to Nepal Now’s first episode of 2022. My name is Marty Logan. Please bear with the nostalgia that accompanies the new year: I still remember when the new millennia was a thing (and we all fretted about the impending cyber doom that would be delivered by the Y2K virus—until 12:01 am on January first 2000, when we sighed with relief after our computers booted up).

Actually, my memories reach much further into the past—but that is for another time. Today we are talking with epidemiologist Dr Lhamo Sherpa. Our chat also delves into the past, as far back as her mother’s childhood in Jiri, Dolakha district, but our focus is current. In particular, we’re discussing what barriers—if any—constrain what a doctor can or should say publicly beyond her specialization. To Dr Sherpa, an avid Twitter user, the lines are clear: see the world through a feminist lens, be compassionate, but bold at the same time.

Embracing that vision doesn’t mean that she has not been intimidated by online trolls in recent times. She singles out the violent reaction against herself and many others who protested authorities’ failed attempts to swiftly and effectively investigate the 2018 rape and murder of 14-year-old Nirmala Pant. They were labelled as foreign agents, fuelled by dollars. (Dr Sherpa doesn’t say this but I know that some women who spoke out on this issue were threatened with brutal sexual assault).

She says that she is more careful now with her online advocacy but the detailed daily posts she uploaded during the recent 16 Days of Activism against Gender-Based Violence demonstrate that she takes her tweeting as seriously as her paid work. Still, more must be done to ensure that women’s rights are tangible, she insists, particularly the right to make decisions about their bodies. Development actors need to revise their approaches, especially to see issues through the eyes of the people they’re meant to  be supporting. Wryly, she notes that both men and women in the villages she works with are very receptive to the message of women’s empowerment—it’s the so-called educated  people in Kathmandu who are slow to accept the need for change.

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Transcript

Marty Logan  0:05  
Happy New Year and welcome to Nepal Now's first episode of 2022 My name is Marty Logan. Please bear with the nostalgia that accompanies the New Year. I still remember when the new millennium was a thing. And we all fretted about the impending cyber doom that would be delivered by the y2k virus until 12 am on January 1 2000—when we side with relief after our computers booted up. Actually, my memories reach much further into the past. But that is for another time.

Marty Logan  0:42  
Today, we are talking with epidemiologist Dr. Lhamo Sherpa. Our chat also delves into the past, as far back as her mother's childhood in Jiri, in Dolakha district, but our focus is current. In particular, we're discussing what barriers if any, constrain what a doctor can or should say publicly, beyond her specialization. To Dr. Sherpa, an avid Twitter user, the lines are clear—see the world through a feminist lens, be compassionate, but bold at the same time.

Marty Logan  1:19  
Embracing that vision doesn't mean that she has not been intimidated by online trolls in recent times. She singles out the violent reaction against herself and many others, who protested authorities' failed attempts to swiftly and effectively investigate the 2018 rape and murder of 14 year old Nirmala Pant. They were labeled as foreign agents fueled by dollars. Dr. Sherpa doesn't say this, but I know that some women who spoke out on this issue were threatened with brutal sexual assault. 

Marty Logan  1:54  
Dr Sherpa says that she is more careful now with her online advocacy. But the detailed daily posts she uploaded during the recent 16 days of action against gender based violence, demonstrate that she takes her tweeting as seriously as her paid work. Still, more must be done to ensure that women's rights are tangible, she insists, particularly the right to make decisions about their bodies. Development actors need to revise their approaches, especially to see issues through the eyes of the people they're meant to be supporting. Dr. Sherpa notes wryly that both men and women in the villages she works with are very receptive to the message of women's empowerment. It's the so called educated people in Kathmandu who are slow to accept the need for change. Please listen now to my chat with Dr. Lhamo Sherpa. 

Marty Logan  2:51  
Lhamo Sherpa, welcome to Nepal Now.

Dr Lhamo Sherpa  2:54  
Thank you, Marty,

Marty Logan  2:55  
It's really good to talk with you today. Just as a bit of background—you have a PhD in epidemiology, which is definitely a skill in demand during a pandemic like the current one. And we're certainly going to talk about your approach to communication and advocacy, which from what I can tell goes far beyond talking about diseases. But first, I'd like you to tell us a little bit about your background—where you grew up, where you studied and worked, that kind of thing.

Dr Lhamo Sherpa  3:29  
I was actually born in Kathmandu, and my parents come from the village. It's actually my mother who wanted to become a doctor. And I think she was 10 years old in the early 1960s, when a Swiss doctor, Dr. [F] came to Jiri with his wife and two daughters, and worked for two years in Jiri in Dolakha, and my mother became friends with his younger daughter, who the villagers used to call Kanchi. Her real name is Christine. 

Dr Lhamo Sherpa  4:06  
According to my mother—she passed away 18 years ago but she used to tell me that she used to travel to the villages with Dr. [F]. And because he was helping people in the villages, then she used to help Dr [F] to hold the candle when he performed minor surgeries. He also taught my mother how to do dressing for wounds and what medicines to give for minor ailments. So in that way, I think that made her realize that a village girl can also become a doctor one day. A

Dr Lhamo Sherpa  4:38  
And because my grandparents had 14 children, and she was the eldest one who had to take care of all the siblings, and since she was also a girl child, she was a burden to the family. So she was married off to my father who was not educated never been to school at the age of 15. And my elder brother was born when she was 16, in the village. So I think, all this desire to educate women, a desire to go beyond my epidemiology comes from my mother. She always told me that I have to stand on my own feet, that I should never depend on a husband for money, I should study and earn my own living. And I've been hearing this since I was like eight or nine years old. And perhaps that's the reason I always felt like I have to do something with my life. And that goes beyond, you know, epidemiology or my education sometimes.

Dr Lhamo Sherpa  5:45  
I studied in a Tibetan school, because my father's mother was a Tibetan lady. And I've never seen my grandfather, I don't know how he looks like, but I heard that he was also an artist. And my father was, you know, kind of a nomad who used to herd sheep and goats in the villages. You know, he was an artist, and he always wanted his children to learn about the culture, about our language. So when there was this Tibetan school, called doji school, came up in Bouddha then my brother and I were sent to this Tibetan school. And at school, I was always the topper, because my mother always inspired me or asked me, you know, pushed me to go beyond. So then there was a penpal at school from New Jersey, United States. And she was my age, actually. But she used to support my tuition fees and school dress. And we used to write letters to each other at that time. I think I should still have her photograph somewhere at my father's house. So until high school, she supported me and after school, I wasn't sure what I was going to do, because of my family's economic hardship. But then there were a lot of foreigners coming to Nepal at that time. And once there was a Norwegian lady who was going to Solukhumbhu with her group, and she asked her mother to follow her to Solukhumbu. So when this Norwegian group came back to Kathmandu, they were very happy with my mother's support and help. And they asked what they can do to support the family. And my mother said, educate my children. And yeah, they helped me with my education. I studied medicine in Russia, and the Swiss doctor Dr. [F']s daughter also helped me when I was studying in Russia, because the cost of living in Russia was very expensive. So after completing my study in Russia, I came to Nepal. And then I started working at the hospital for some time. And so that's when I realized that I was seeing a lot of differences, you know, in the way people were being treated, both at the hospital outside the hospital. 

Dr Lhamo Sherpa  8:24  
And so I used to work for a Solukhumbu FM radio program on health, hygiene, maternal health, as well. And I was also working at a community hospital. I used to work voluntarily at the Sherpa service center for the elderly Tibetan and Sherpa people. I was also working at a Tibetan old age home in Bouddha, and that's all voluntary work. So since I was working at a community hospital in Boulder, I used to see all kinds of people—rich, poor, ultra poor, who can speak in Nepali who cannot speak in Nepali, those who can afford medicines who cannot afford medicines. So that made me realize that, you know, this has to do something beyond just providing service through the hospitals. So that's how I went into public health and into epidemiology.

Marty Logan  9:24  
Wow, that's quite a story. You've got on one hand, you know, the Western medicine connection through your mother initially, and then Tibetan culture and the Tibetan family. And then of course, you're going to Russia. That's really quite a combination of things. I don't want to psychoanalyze your mother but do you feel like she felt bitter that she never was able to realize that dream of being a doctor?

Dr Lhamo Sherpa  9:48  
Yes. I always felt that in her, that she was very unhappy that she wasn't able to realize her dream of becoming a doctor. I always felt that during all our conversations,

Dr Lhamo Sherpa  10:05  
rAnd then did you also feel a lot of pressure coming from her probably, like, indirect pressure, for you then to kind of realize her dream. Did you see it that way? 

Dr Lhamo Sherpa  10:18  
Yes, I saw it that way. But I also understood that whatever she told me came from the experience that she had. And so it was important for me to, you know, do something with my life. So I always had that kind of pressure. Yeah, absolutely.

Marty Logan  10:37  
Okay. Okay. And your father? Was he supportive about this? Or, you know, did he want you to stick more to kind of a traditional Tibetan role?

Dr Lhamo Sherpa  10:48  
No, my father was more like a nomad back then from what he told us, because he's never been to school. So he doesn't know what it is, how it is, like, you know, at school, he has never studied. Even, you know, he can put his signature these days on papers, and that is something that my mother taught him. She went to school until grade five, and that was supported by the Swiss doctor, Dr. [F]. After that, she never went to school, and my father has never been to school. And he said that, when he used to write, you know, like 'A B' on a stone, you know, with a stone near the river, his mother would say  'Don't, you know, study, because this is not for us.' He did not know what it was like. So he always used to, you know, accept whatever my mother used to advise him to do. So he was quite supportive.

Marty Logan  11:47  
And then so you went to to work in these kind of various volunteer roles. And as you said, it opened your eyes to what we now call the socioeconomic drivers of, of health and health care, right, and how people's background and lived experience affects their health status. So when I first came across you, I think it was on Twitter. And you were tweeting about something to do with women's rights and and how women are treated in Nepal. So you're very outspoken on on these issues. Do you ever worry that by being so outspoken, in some people's eyes, that would lower your status as a medical professional?

Dr Lhamo Sherpa  12:37  
Yes, I do understand because earlier, I never, whenever I go to the villages, I don't want to tell them that I am a medical doctor. Initially, I never told them that I'm a medical doctor, or I have a PhD. And they wouldn't even think that I'm a doctor, or I have an education. But what I've realized is that people have some personal issues, for instance, like women's issues, and once I tell them that I'm a medical doctor, they come to me and then they secretly would ask me, you know, 'I'm suffering from this. I have been to a doctor, they're giving me this advice. Can you please tell me?' So now these days when I go to the field, I started to tell them, but I initially I stopped saying that I was a doctor because I wanted to reduce the hierarchy, you know. But then I realized why it was important. 

Dr Lhamo Sherpa  13:36  
But after working at the Stupa Community Hospital, what I realized was that it's not enough only to provide medicines to the poor, because they had difficulty in following some advice that we gave them. For example, there was a Sherpa village woman who came from Solukhumbu. She had a very high blood sugar level. And when I was assessing her diet, she was eating potato pancakes for breakfast, mashed potatoes for lunch, and potato and wheat, noodle soup for dinner. And then there was another childless couple who came for advice. After all the investigations when I told him the price that it would cost for them to have a baby at the in vitro fertilization clinic—at that time, it was available only in OM Hospital, and I'm talking about 2004—the husband said that he can get another wife for 50,000 rupees. So that made me realize and reassess the situation of women in Nepal. So that's why I have been very vocal. And yeah, sometimes it backfires. And it has harmed me in a way like, people think that oh, she's too vocal. She is not fit for this job. But I have to speak. I think somebody has to do that job.

Marty Logan  15:02  
You mentioned that I think sometimes your outspokenness, kind of, I'm not sure if got you in trouble is the right word to use, but maybe created some issues. Can you say anything more about that? Are you talking about officially? Or are you talking about trolls on Twitter? How do you mean that there's been some bad reaction to that?

Dr Lhamo Sherpa  15:24  
No, no, I mean, trolls on Twitter. It's always difficult given that you are a women, you're working in an international organization, and you're working about women's rights, and  people tend to tell you that you are a 'dollar-badi', you know, that kind of connotation is always there. So that's why I'm careful about what I'm saying sometimes. Now, I have become more careful.

Marty Logan  15:58  
Okay. Okay. So a bit less outspoken then before.

Dr Lhamo Sherpa  16:02  
I do speak, quite often, even now, but as you have seen during the Nirmal Panta case, a lot of women were bashed, like, you know, 'These are foreigners' agendas. They are not working actually, for women, you know, they are getting dollars from somewhere,' that kind of, you know, accuse, has always been there.

Marty Logan  16:04  
Right. Okay. And I'm wondering, so you're taking what I would call a feminist approach to your work. And when you go to villages and talk to women, and other people as well, do you change that approach? Or do you think that like, within your work itself, you're also taking a feminist approach? And how do people react?

Dr Lhamo Sherpa  16:53  
I cannot say about my office in Nepal, but my office headquarter in the US has been very supportive. And they've always said that we have to be bold, we have to be driven. And we have to be compassionate. And we have to look from a feminist lens. And that doesn't mean hating men and boys. Because I know that men and boys and elderly are equally important. But what I'm just saying is that from an equity perspective, women are the ultra poor in Nepal, right? Women are the ones who do not have that kind of power, or never have that kind of privilege, you know, to work on their own body for their own body, they didn't have that kind of support. So that's why we think and I think that women should be empowered to make decisions for herself regarding her, you know, reproductive rights, regarding her future, regarding what she wants to do with her life. So that's the kind of approach that actually I'm taking. Yeah.

Marty Logan  18:00  
And when you go to a village, and you meet women, and you're talking to them about their, their bodies and their health, do they understand that approach? Or do they kind of push back thinking 'You're asking me to do things or talk about things that I shouldn't be doing? Because culturally, that's how they've been raised?

Dr Lhamo Sherpa  18:23  
No, I think it's the opposite. Actually, I'm getting a lot of support, both from men and women in the villages compared to those who are in Kathmandu. So that's very different from what a lot of people would think. People would think that oh, a lot of people are educated in Kathmandu, they would understand the issues better, but no. Because a lot of women in the villages when I tell them, when I give them examples, when I ask them to open up after talking about, you know, women's rights and power, or why we, we should be deciding ourselves our future, then they start to share so many stories. So when I went to the field last time, after talking to women at the ward level, you know, the deputy representative—I was not expecting that—she stood up and said, 'Even I am a victim of gender based violence. So who do I need to reach out to? How can I get support?' So that is the kind of reaction we're getting. 

Dr Lhamo Sherpa  19:30  
So it's completely different from what we assume here from Kathmandu that women might be resisting. No, it's not. I think it's the people in Kathmandu who are actually resisting change. Because we have to look from two perspectives—one is why they are at a disadvantage or why they are marginalized or at the margin, and then the power, how the power is shared between and where the power is concentrated, you know. It's different between different individuals, even within a family, the power and the privilege of, you know, getting to decide whether I want to go abroad or not, whether I want to continue my study or not, it's different between husband and wife, daughter and son, even different within the Sherpa community, even different within the Himalayan community, because it has to do with politics, it has to do with social capital, it has to do with economy. And these are different between different peoples. So unless and until we intersect it at the underlying level, or the cause of why this is happening, we will not be able to understand. So that's why when I reach them at their level and talk with them through their lens, then they understand and they speak out.

Marty Logan  20:55  
Okay, and if I'm not mistaken, you said your mother has passed, but your father is still alive.

Dr Lhamo Sherpa  21:01  
Yeah, my mother passed away 18 years back, and my father is still alive. Yeah.

Marty Logan  21:07  
And do you talk to him about this? Or with any older members of your family? And how do they take these views,

Dr Lhamo Sherpa  21:15  
To be very honest, I've never, you know, talked to my father about women's rights, but he listens to the radio. And he says that, 'Oh, yeah, women should be educated, women should get a job and women should work.' But he doesn't understand the underlying causes. I think he is almost 80 years old now. And his daily ritual is do his yoga, eat his food, paint, and then pray. So that's his daily ritual. So that's very different from what we do in the field work. But I do show him photographs of what we are doing now and then so that he understands, but because he has grown up, you know, in a village, with a single mother, he knows how difficult it is. And he lost his father when he was like 12 years old, and he had to take care of the siblings, and his mother. So he used to have, like I said, sheep and kettles. And he used to trade salt for rice between Tibet and Nepal. And he did not have slippers. He had to, you know, wait for so many opportunities in order to get even a slipper. And so he knows everything. I think.

Marty Logan  22:41  
You know, that's really interesting, because when you're talking about your father, then you see the wide gulf between then as he was living and now, and it seems like, you know, we've gone so far. And even if you look back on development, and kind of the history of development in Nepal—and I've looked a little bit in into healthcare, you know, things like maternal mortality and child mortality—we seem to have progressed so much, you know, in the last four or five decades, but nowadays, it's like, and I think even the figures show this, there's been sort of a plateau in so many of these different, what we call indicators, right, that the progress seems to have leveled off. How do you feel about that? You know, for example, if we're talking about women's empowerment and the development and the rights of women, do you feel like progress is still being made? Or is something got in the way of improvement?

Dr Lhamo Sherpa  23:43  
Um, I would say that between then and now, between my father's period, and now, I think there has been a lot of progress, like what you've said, I absolutely agree with that. But in the last, let's say, a decade or so, we have seen both the indicators stagnating at some point, and that has to do a lot with also how we are doing our development work. Are we just copy-pasting the same thing? Or is something happenin g in the world that should be included? For instance, like earlier, we used to think that providing information was important. Right now, these days, a lot of people get a lot of information through Facebook, right? And even through radio messages. So what has to be done differently? What do they really want? The adolescents, the youth, their mindset, it has changed dramatically because they have been exposed to so much information that they are very different from what my mother or my father used to be like. So we have to adjust our programs accordingly. But that's not happening. And that is the problem.

Marty Logan  25:05  
Okay, so we're taking the same a pproaches to a context that has changed immensely in that time.

Dr Lhamo Sherpa  25:12  
Yes, if we are copy-pasting the same kind of proposals, you know, all and all with a little bit of tweak in between, it's not going to help. You know, you have to change, you have to be innovative, you have to go there, you have to talk to people, and you have to talk to people from their level, through their lens and not through our lens. We always have, we already have one set of biases in our mind, and then we go to the field and try to see things from our perspective—that's not helpful. We have to see from their perspective, what do they want, that's more important. If there are people who have no slippers or their slippers are sewn, or if their clothes are torn, their their voices are not represented, because the way they dress up is important for some people. But that's not the point when we're going to the field. And we're saying that we're trying to work with the underprivileged, that's the people that we should be talking to, not the ones who always have some kind of opinions or biases.

Marty Logan  26:16  
Right. Okay. Just a completely different question. If you were talking to a young woman, who was maybe studying medicine, or had just graduated, and was becoming a doctor, and was interested in changing the world, to put it very broadly, what kind of advice would you give her now, given the experiences that you've had and the things that you've gone through? Would you say, 'The path I've walked has been a good one? I've, I've been outspoken on working for women, I'm happy with the work I've done in the way I've gone?' Or would you suggest something different?

Dr Lhamo Sherpa  26:54  
Oh, actually, I'm glad that I have been, I have been given the opportunity by so many people, you know, so many organizations, so many, you know, foreigners, and also people in Nepal who have entrusted me with the work. But going forward, I think we need to do more. Because this is not enough. And one person cannot change everything, we have to work together. And we have to empower I mean, when we say giving power, it doesn't mean holding power, it means giving power to others, so that others will continue the work, dthis work has to continue one way or the other. And somebody has to take the leadership and then pass it on and then pass it on and then pass it on.

Marty Logan  27:41  
Right. Okay. And so people do that when they go to the field in the sense that you'll meet with a particular family or a particular woman, and you'll help them but then, you know, you're dealing obviously with one individual or one only family. Don't you need to somehow look at the system, you know, for lack of a better word, the system and make those changes at a systemic level? Isn't that kind of the only way unless you're going to have another revolution, which has been tried? Isn't that the only way to ensure that power shifts to the people who lack it now?

Dr Lhamo Sherpa  28:21  
Yes, absolutely. There is a systemic approach. And we have to go through that approach. And in order to have that systemic approach, we have to make changes. Initially, we have to start with policies, we have to start with acts. You know, although Nepal has a lot of documents, you know, very good documents, if you go if you look only at the documents, we will think that okay, Nepal is almost like a heaven, but it's not. We have to, first we have to ensure that those are documented, and second, we have to ensure that those are being implemented. And then, you know, we can identify what has worked, what hasn't worked, and then move on from there.

Marty Logan  29:07  
Do you think it's an issue and maybe a problem, that there has been so much support from, let's say, outside Nepal, that sometimes the thinking that's translated into the policies and the directions, it's not indigenous in the sense, you know, in the sense of being from Nepal, it's an outsider perspective. It's an outsider strategy. And we're trying to marry an outsider cultural perspective onto a Nepali culture? I've heard this from other people, right? You may have the best plans and policies in the world, but if they're not actually being applied on the ground, they don't matter. They don't count. And it seems so often that that's the problem. It's the translation from the written word into the action on the ground, and maybe we're not generating enough of the written word in a Nepali way.

Transcribed by https://otter.ai