Nepal: Earthquake, mental health & society

April 25, 2015 is a date Nepal can never forget. A 7.8 magnitude earthquake struck northwest of the capital of Kathmandu – the worse earthquake in more than 80 years.[1] 17 days later, a second earthquake of 7.3 magnitude struck again.[1] Both earthquakes led to a large death toll of over 9000 people and more than 22,000 injuries.[1,2] Homes and historic buildings were reduced to piles of brick and rubble affecting millions of people. Four years on, Nepal continues to recover and rebuild lives and cities.

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Heritage monuments under reconstruction after the 2015 earthquake. Bhaktapur, Nepal.

I interviewed Oasis Bhaju, a 45 year old resident of Bhaktapur, Nepal. Bhaktapur is a UNESCO World Heritage site and was one of the hardest hit districts.[3] Join our conversation to get a perspective on the earthquake, views on mental health and cultural approaches of treatment, and what we can do to respect Nepali culture when working with their communities.

Can you tell me about your experience with the earthquake.
Firstly, it was very sad because many people died and many people lost their house and family. I lost my house too. I cannot imagine someone who lost their family. I lost my hotel, I lost my family in a way. The family went and never came back to Nepal. I restarted again. It cost a lot of money, energy, but I was not depressed. I wasn’t really shocked. I accepted what happened then I have courage to build again. I knew if I have a good place I can restart again. That was my first motivation. There were always possibilities. If you start living more simple, possibilities are always there. So I was more focused on that. I was totally ready to take whatever happened.

How was the first few days and weeks after the earthquake?
The first few days was… We had a gathering few days later. We made songs about the earthquake and houses and then we were singing for couple of days. We just laughed for a while about what happened.

Tell me more.
If it’s a bad situation it’s always like this. If it happened only to me, it will be a different situation but it happened to many people. There’s also a lot of comparing. You lost what you actually lost but when you see the huge disaster, which is different and not really big for you. We’re living with the community. Let’s gather and take it easy you know. That’s what happened actually.

Awareness about mental health in Nepal grew after the earthquake.[3] What do people in Nepal think about mental health?
In Nepal, people do not understand about mental health. Sick for them is physical pain. Mental things are quite new to Nepal so it’s going to take a long time but it doesn’t mean there are no mental health issues here. There are plenty of mentally sick people here also. I don’t know how to help them because mental sick is referred to a psychiatrist. We need to accept that you have a disease then it’s possible for treatment. If the person is not ready, I don’t think it can really help. The person needs to accept then it’s possible. And people are not ready to accept mental health in Nepal.

Let’s say if someone is experiencing what we call depression or sadness. How would someone express that in Nepal?
I think the first thing is that Nepalese have a lot of time. The lifestyle is not too fast. For every house, if you go outside there’s always community there. You go to teashops and you talk to people and say what happened. They tell you the same thing happened to someone else. You feel included so you express what you have. You are relating to someone else. Instead of you saying that it’s my problem, you openly test the fire. Things have to be expressed. So, once it’s out, there’s less stress and less depression. People also look so happy because this country has celebrations for almost half the year. That makes a lot of happiness too. The grey areas look hidden but it’s always there. People talk more about fun and they easily forget the grey areas because many don’t like talking about deep things.

I love to share whatever problems. I like finding ways to express myself also. I’m not so scared that I have a problem. That’s the reason I felt my mind is quite strong. I always have a good family so we always go in the direction to support each other.

It sounds like in Nepal, community and family are big factors for support.
Yes. I think a lot of family and support is there. That makes a lot of difference because depression is the dark energy that is too powerful. When you’re living alone, the dark energy is a lot more powerful. When you are with many people and extending positive energy, dark energy becomes less. That makes a difference sharing with one another.

How is it like for someone to approach a friend or family to talk about problems?
Firstly, I never really meet people who talk about mental health because I find each and every person has this problem in the world –  different reactions, different stress, some is relationships, some is friendships. All mental problems are there. What I’m trying to say is we take mental health problems and get support by talking to friends and family. You give examples of others and not your problem. It’s like reading a book. You talk about people, about characters, emotional things, money and all kinds of stuff. We talk with friends so when one person is sharing, it connects to other people because humans have the same experience. The deepest feelings like sadness and those emotions because everyone has them. So it’s fixing things by communicating with each other. Giving examples of other people and in this culture, people have similar types of stress.

Can you tell me more about giving examples of other people?
People don’t say it’s them having a problem. They say it’s someone else. They give examples exactly like the person who has the problem. When you talk about it, you see other people having similar problems to you. The other person heals at the same time because when you speak, it’s passing on healing. As soon as you feel it, your face goes down and dark because it’s part of dark energy. The person with the same feeling has the same expression on their face. That’s how psychology has been working in Nepal through community. So communities are always important to have. Too much attachment to community can also get you sick. Having the right amount of community is always nice. It’s nice to find a balance.

What are the similar types of problems people face in Nepal?
If people are living together with the family, there are different types of problems because it is not an independent country. We don’t have a system that now you’ve grown up, you get out of my house. This doesn’t exist. It’s not that parents are always taking care of the kids until they are old. After you get married, the woman coming from the other house has to accept the new family, which I can totally understand for a woman, my parents are nothing. My parents can never be like her parents. Once you live together, you must have high respect for parents in law. Many married couples have this problem.

Also, the husband doesn’t want independence because he is not strong enough to take care of himself. If you go out of your parent’s house you have to create your own house which is expensive. The wife can give problems and the husband gets sick from it. And they still have to fix the situation. I saw a lot of married couples have those kinds of problems that I’m well experienced with my parents. I would say a lot of the Newari* community has this problem. Other ethnic groups have problems with splitting property that hasn’t been well divided.

How does Nepal’s cultures and religions influence people?
I think a lot of Nepalese like Hindu and Buddhist countries. I found they have a lot of ways of chanting and praying. So, motivation like going to the temple early morning. Even if you don’t express your pain, you at least express to God. At least you are expressing to the air that makes less stress because they still have faith or belief that God will help.

So it’s using religion and spirituality for hope and support.
Yeah. There’s also cause and effect. Karma cause and effect is very deeply rooted in this culture. It means if you do good, you get good and if you do bad, you get bad. This philosophy is very strong. At least I found this in the Newari community. And of course, time has changed now because influences of money killed those kinds of beliefs. I found money is destroying the beliefs of karma cause and effect. People are more greedy thinking about money. This is growing more and more in Nepal.

And you feel in your experience that society is changing in Nepal?
Yes, because you need quite a lot of money to live now. Nepal is so expensive and I cannot believe how we are surviving and living in Nepal. Everyone is looking at money now. That always loses the karma. They lose their good karma because if you don’t know how to handle money, it can destroy you. Kids need to be taught how to use money, how to earn, how to value, and responsibility.

What do you think about mental health stigma in Nepal?
Honestly, if I see Nepali culture, everyone has those doubts and everyone is going through things. I don’t see many people recognizing their mind except for highly Buddhist and spiritual people like monks or the ones who really practice. There are people who practice but they don’t know the method. They go to the temple without meaning. They are just doing what ancestors are doing. You find all the answers within your mind. I don’t see huge numbers of Nepali people aware of mental health. It’s still there if you are engaged in different activities every day. If you go to the village, they don’t have so much because they need to work physically hard. They have to walk two hours to the shop. This is a type of emptiness practice that is happening. This is what I see more as treatments. It’s not necessarily treatment but there is an unknowing treatment that has been provided.

Tell me more about this unknowing treatment.
Unknowing treatment is for example, a person who has doubts or mental problems. When they go to the town or villages, they walk for five hours. They’re completely in their state of mind like a really empty state of mind where you’re totally connected to the ground. Otherwise it’s very hard to walk everywhere for five or six hours. So during this, the bad energy is sucked out. They don’t know the technique is happening but it’s actually happening because of the place. Nepal is so powerful that everyone can feel it. There’s already a sudden kind of happiness and power inside you that kills all the stress, all the mental problems. That’s what I mean, unknowing treatment.

Do you think Nepalese may benefit in any way knowing more about mental health?
I think mental health is kind of crazy. If you know more, it’s also infinite. It’s digging and digging which is never finished. This is what the West is trying to do but I don’t see their point of total happiness because it doesn’t exist. Once you start digging, it is never finished and then it comes to the point that your mind is too active. And when your mind is too active, your physical things are less active. Then it’s not balanced and then some kind of mental disease is created.

When you’re not in balance?
When you’re not balanced in the body and mind and especially in the heart because the heart knows first then the mind follows.

And you feel that in the West, we focus too much on the mind and that’s why we don’t have enough balance?
Yes, because the whole country has been designed for mind. There are fires in the world because of the mind. The mind is always tricky. The mind is never clean. When energy is always in your mind, you have expectations, plans, and tricks. Mind is mostly like that. How am I going to survive tomorrow? All these things go in our mind. When you have too much in the mind, you get overloaded in the brain. It occupies a lot of space and when you have a lot of space occupied, it hangs. So this hanging is the problem. So once there’s too much in the head, it goes crazy.

With you saying this, do you feel Nepalese society is fine in their practices and don’t need any awareness of mental health?
I think now you cannot deny that part because of the influence of the world into Nepal. It’s already too much mind. One thing is other people, Facebook, or whatever is on the internet. I believe when time is right, it will come. I don’t see so much needs to be changed in Nepal. I think people are quite fine. Something’s needs to be touched on like to let people appreciate what they have. Many people who work outside Nepal return and now they start to appreciate living in Nepal. Having more appreciation for what you have.

How would you say is the mentality and character of the Nepalese society?
Each and every place has different types of people. They have different DNA, different roots, and completely different culture. We have 36** different ethnic groups which is different from the way of food, our marriages, cultures, worship, Gods, everything is different. People who live in the mountains have different things there. If they have a problem with physical health, they have a lot of problem because they are doing the same treatment for the person who has cut the legs. That’s not the right direction. Education is important. People are among their culture. I would say they are quite happy people in general. They know how to live in the moment. If you live in a mountain, you’re always concentrating on breathing. It’s kind of coming in and going. For that reason and also the plants and the energy here. The peacefulness. This is what I’m trying to say, unknowing healing that is happening automatically. The environment heals.

What are some advice or recommendations you can give to people working with  Nepalese?
I think NGO’s are doing many things but a lot of NGO’s actually destroy the culture. They destroy the mentality because Westerners look at things in their way and it doesn’t work in Nepal. They work in their ways in a lot of projects and it’s a failure. They come into Nepal and think how can Nepalese survive 10,000NPR per month. It’s also a business. They destroy what was happy. They are giving more money and started creating greediness. People think the NGO is making my house and they are being lazy and have a begging mentality. I think a lot of NGO’s are founded in Nepal to make the politicians, people, and everyone have a begging mentality instead of an independent mentality by asking for funds. They just need to technically teach us how to use and build. You don’t need fancy toilets in the middle of the jungle. All you need is a big hole. So, they need to teach those techniques rather than providing all these things. Providing makes people beg. This is one of the things I really don’t like.

How can we respect Nepali culture?
If some Buddhist techniques can be used like meditation or just work on feelings like greed and jealousy, the training of mindfulness, and of awareness of meditation. If that can be one of the solutions because we are used to those practices but we are lost in the middle.

So, to use Nepal’s religious and spiritual practices with the people.
Yes. Use what they have. Find them. This is what I was talking about in the beginning. Be happy with what you have. Religions are not necessarily bad but to understand what the science says and to understand what is the philosophy, what is the meaning behind it and to make them clear with what you have. I think that can help a lot. I find Nepalese losing their spirituality. These philosophies come from here and are moving more to the West but we are losing a part of it here too.

Notes:
*Newar is one of the major castes in Nepal. They are the indigenous people of the Kathmandu valley and surrounding areas. Newari culture is rich in history, art, culture and traditions.[4]
** More than 60 ethnic and caste groups exist in Nepal, each having their own traditions and hierarchical ranks.[4]

Thank you to Oasis Bhaju for his time and insights. Oasis is involved in social outreach projects for children with the NGO “Children of the Universe”. The NGO accepts donations and volunteer work to support children through education and rebuilding of homes. Click this link for more information and contact details.

References
[1] Mercy Corps (2018, April 19). Quick facts: What you need to know about the Nepal earthquake. Retrieved from https://www.mercycorps.org/articles/nepal/quick-facts-what-you-need-know-about-nepal-earthquake
[2] Shrestha, M. (2015, May 14). Death toll from this week’s Nepal earthquake rises above 125. CNN. Retrieved from https://edition.cnn.com/2015/05/14/asia/nepal-earthquake/
[3] Shakya, D. R. (2016). The Nepal earthquake: use of a disaster to improve mental health literacy. BJPsych International, 13(1), 8-9.
[4] Shrestha, B. G. (1999). The Newars: The indigenous population of the Kathmandu valley in the modern state of Nepal. Contributions of Nepalese Studies, 26(1), 83-117. 

Photo credit: Image by ii7017 on Pixabay

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