A Nepali in Pakistan: On a mission to improve healthcare for underserved communities in South Asia

Although not immediate neighbours in the South Asian region, Nepal and Pakistan face similar social issues and have always helped each other in times of need. And yet there are no direct flights between the two countries.

Abdullah Zahid Jun 08, 2023
Watching Dr Ramu Kharel from behind the scenes in the Geo TV studio as he talks about the Pakistan Life Savers Programme. Photo: Abdullah Zahid / Sapan News

On a usual bustling March morning in Karachi, roads choked with traffic and the air thick with trumpeting horns, the clock is ticking for Dr Ramu Kharel’s morning show appearance on a Pakistan television channel. 

A physician of Nepali origin who teaches emergency medicine at Brown University in the United States, he had also promised to give time to Sapan News Network. That is how I found myself on the short drive from his hotel in central Karachi to Geo News’ studio nearby. 

“Pakistanis have shown us Nepalis so much love, and we feel the same about them,” he says, talking about the hospitality and generosity he received during his trip.

Although not immediate neighbours in the South Asian region, Nepal and Pakistan face similar social issues and have always helped each other in times of need. And yet there are no direct flights between the two countries. It takes barely two and a half hours to fly between Karachi and Kathmandu but Dr Kharel had to travel via Doha, Qatar, enduring a long layover.

Spirit of solidarity

It was an invitation from Dr Junaid Razzak that enabled Dr Kharel’s first trip to a country he had long wanted to visit. Dr Razzak started the Pakistan Life Savers Programme (PLSP) in 2020 at Aga Khan University, ambitiously aiming to educate 10 million lay persons over the next decade on cardiopulmonary resuscitation (CPR) and bleeding control techniques. Cardiac arrests claim up to 47 lives per hour in Pakistan.

“The possibility of resuscitation increases if a person is trained in CPR and choking prevention,” says Dr Kharel, explaining the significance of the initiative. “It typically takes 45 minutes to an hour to wait for an ambulance in Karachi, but if you live in a far-flung area like Thatta, it may take up to four hours.” The brain can suffer irreversible damage within 10 minutes. Hence, bystanders can be the best hope for cardiac arrest victims. 

Dr Kharel hopes to introduce a similar programme in Nepal, training frontline providers in the first round, particularly police officers.

Growing up in western Nepal’s Aanpchour village in the Gulmi district, Dr Kharel experienced the devastating consequences of poor infrastructure firsthand. He not only witnessed young people die from injuries or preventable illnesses because the nearest hospital was a gruelling eight-hour journey away on difficult terrain, but he lost his own mother the same way when he was just eight. The trauma fuelled his determination to improve healthcare access to underserved communities.

Cross-border collaboration

A member of the Southasia Peace Action Network (Sapan) that works for cooperation in the region, particularly in social work and intellectual property, Dr Kharel supports Sapan’s call for soft borders in the region, such as visa-on-arrival. 

“Our mountains unite us and we even look alike,” he says. “Sadly, it’s the petty egos of those in power that keep us divided.”

Research in Pakistan, he says, can unlock valuable insights into Nepal’s healthcare, economic and social challenges. Cross-border collaboration can help address these issues by leveraging insights, even as local expertise is essential in order to implement effective solutions tailored to Nepal’s unique needs and challenges.

For example, traffic crashes claim some half a million lives a year around Southasia. As a member of Sapan’s road-safety sub-committee, Dr Kharel has reviewed the various measures and policies that countries in the region have adopted to address this problem. 

Sapan advocates for a coordinated regional approach to road safety and for a safe, systematic revision of infrastructure designs, as outlined in a letter to the United Nations on 30 June 2022.

Floods and quakes

When cataclysmic floods swept over one-third of Pakistan last year, the government of Nepal promptly donated relief goods, including tons of food, shelter, and medical assistance for the victims. 

Earlier in 2015, when a deadly earthquake killed over 8,500 people and injured over 19,000 in Nepal, Pakistan helped, sending four aircrafts with a 30-bed hospital, special search and rescue teams including Army doctors and food items.

In the aftermath of the disaster, Dr Kharel established a health advancement committee in Nepal in collaboration with local communities to provide more decision-making power over their healthcare system. Working with local administrations, he led a comprehensive overhaul of local healthcare systems, rebuilding them from the ground up. 

On how his experience in Nepal’s 2015 earthquake can help flood victims in Pakistan, Dr Kharel stresses the importance of proactive measures such as building resilience programmes and infrastructure. Such measures should be implemented earlier to effectively address the impact of natural disasters, he notes.

In coming years, Pakistan is likely to face more flooding due to glacier melt and accelerating climate change. “Since local communities will be first to react in an emergency, preparing them for disaster response and developing their healthcare systems is crucial,” he says.

TikTok and Urdu poetry

When he’s not working on ways to improve healthcare, Dr Kharel actively creates content on social media as @namestedoc on Instagram and TikTok. While his target audience is largely Nepali, Dr Kharel has a TikTok following of nearly 100,000 followers, with over 3.8 million ‘likes’ on his videos.

It was during the Covid-19 pandemic in 2020 that he began harnessing social media as a tool for the public good, starting with a TikTok video from Nepal, highlighting the dire situation in the country and appealing for vaccines. Thousands joined, bombarding him with questions about lifestyle tips and public health.

Dr Kharel also loves basketball and Urdu poetry. Guided by his mentor Dr Syed Akbar Hyder, an associate professor of Asian Studies and Islamic Studies at the University of Texas at Austin, he is a fluent Urdu speaker. 

His journey into Urdu started with a couplet by Ghalib shared by Dr Hyder at an introductory class. “We spent the entire class discussing one couplet. I was hooked by the ‘ibham’ (ambiguity), the beauty and the depth of the couplet, and I knew I had to learn this language.”

Under UT Austin’s Hindi-Urdu Flagship programme, he along with six other students lived in India from 2009 - 2010, travelling and immersing themselves in the language and culture. 

Other students in the cohort included Dr Kharel’s close friend Shan Khan from Karachi, now a lawyer in the Washington DC area, who flew back for Dr Kharel’s Pakistan trip. 

An avid gastronome, Dr Kharel loved the diverse food in Karachi. The only thing missing is a Nepali restaurant, he adds laughing.

In India, Kharel interned with an organisation in Lucknow working to raise the standard of living and education for Indian Muslim women. Returning to Austin, he created the Health Awareness Program in South Asia (HAPSA), a nonprofit organisation in Nepal that he still runs. 

He believes that poetry has the power to heal and inspire, and often turns to Urdu verses to make sense of life’s mysteries.

As we head back to his hotel, he is excited to travel that afternoon to the Sufi shrine at Sehwan Sharif in Sindh. His eyes gleam with hope for more collaborations between Nepal and Pakistan.

He quotes one of his favourite poets, Faiz Ahmed Faiz:

"Chale chalo ke woh manzil abhi nahi aaye". Let's keep going, we have yet to reach the destination.

(The author is an aspiring journalist studying mass communication at the University of Karachi. Views are personal. By special arrangement with Sapan News)

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