The name Maiti Nepal, an organisation that rescues and rehabillitates women from sex traffiking and abusive homes, have been on my lips since I saw the documentary ‘The Day My God Died’ released in 2003.

Maiti Nepal Documentary
Maiti Nepal Documentary

Maiti Nepal has operated since 1993. The survivors are given free medical care, education services, sheltered housing if required, lifelong support and counselling after their ordeals. Not only do Maiti assist victims of this horrific global trade, but also women and children who have escaped abusive families. They run schools, hospices, houses and education programmes all over Nepal to improve the lives of so many women and children.

Burned into my memory, I must have been around fourteen years old when I first saw the documentary, but it was only when I was flying towards Kathmandu for a months volunteer work in early November that the memory resurfaced that I was about to visit the home of one of the most important charities in the world.

I had sent a brief email asking if it was possible to meet with the charity and discuss their rehabilitation techniques for the trauma survivors, knowing that this group of women are the most likely to develop chronic pain, psychological conditions and nerve pathway disordered symptoms. I was curious to learn how they had been managing such a difficult task, especially considering, as I learn from my time in the hospital, how much of a stigma mental health still has in Nepal.

The very next day I had a reply to my email. Asking if I would like to meet the founder of Maiti Nepal, Anuradha Koirala herself, to discuss the rehabilitation work. Suffice to say I was staggered. Beyond excited that such a busy and important woman had time to talk to me. Ms Koirala has spearheaded the organisation since it’s inception and was awarded the CNN person of the year in 2010.

Maiti Nepal CNN Poster
Maiti Nepal Poster

The Meeting

Through no fault of her own, Ms Koirala was an hour late to our appointment. Late the night before a child, nearby to the main office of Maiti Nepal, was sexually abused by a man. Anuradha had spent all night with no sleep in the hospital with the child arranging free medical care and trying to get her lawyers to expidite the legal care. She explained during our meeting that due to the corruption of the government here, if they didn’t act immediately the man would seek political support and would not be charged for his crimes. Every minute mattered.

Throughout our meeting she had to take many calls to continue this important work, and I didn’t mind a bit. She asked me about my skills and what Maiti currently does to support the woman’s psychological needs at the centre. There was counselling as required, though I later discovered, it was the medical staff’s job to advise when this was required, not the other way around. Currently, there was no physiotherapy support for the women in the shelters and she asked if I wouldn’t mind lending expertise to help them. Slightly daunted by the task, but of course I didn’t mind!

The Challenging Assessment

Less than a minute later we were joined by two of the shelter survivors and I was asked to lend my expertise to why one of the ladies was suffering with back pain. I was asked not to take photos. The slight hitch to a full assessment was that I had to come up with an answer immediately and lady was deaf and mute. Not a challenge at all then.

I ascertained from the friend of this lady that after she was rescued she was retrained into beading and needlework, something she was hugely good at, and that she spent many hours working on the floor doing her crafts. Hunched over crossed legged on the floor, not inherently a bad position, but the same as for any position for the human body, regular changes of position is beneficial. She had full range of movement and minimal to moderate pain in flexion and rotation. Her core stability when tested was poor and she was quick to fatigue with balance. There was, thankfully no neuro symptoms, no red flags and no issues with sleep.

I suggested primarily regular breaks from work, a slightly raised surface, like a solid box or small table for working and to enable variation in positioning. A few basic range of motion exercises for back and some simple core stability exercises to be done a few times a day.

To be honest, the assessment was less than ideal. I would have also very much liked to have found out about the woman’s history, her thoughts on her pain and what she felt was going on. I would have liked to give her some calming strategies and some education on what pain was and what is was not, but alas, considering the vast ocean of communication issues I had to settle with basic advice.

Nevertheless, I was determined that I could offer support for the whole of the Maiti community as and where it was appropriate, with my knowledge on the BPS model and SIRPA training, I already had a few ideas brewing as I was waiting for my taxi, listening to the children singing outside the Maiti School. We finished the meeting off with a decisive, absolutely agreement to tour their local hospice facility in a few weeks time.