Power, politics, and perseverance:

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Power, politics, and perseverance My journey as
a Fulbrighter in Nepal Sean D. Cleary, PhD,
MPH September 28, 2007
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Outline What is Fulbright? My Path to A
Fulbright Nepal History Past/Present
Politics Life in Kathmandu Tribhuvan
University Teaching/Workshops Research Projects
Lessons learned Continued Collaboration
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To promote mutual understanding between the
people of the United States and the people of
other countries of the world.
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Types of Fulbright Awards The Fulbright U.S.
Scholar Program sends approximately 1,100
American scholars and professionals per year to
more than 130 countries, where they lecture
and/or conduct research in a wide variety of
academic and professional fields. In academic
year 2006-2007, these fields included
agriculture, business, journalism, public health
and technology education. The Fulbright Senior
Specialists Program, a short-term complement to
the traditional Fulbright Scholar Program,
awards grants for a period of two-to-six weeks.
The Fulbright U.S. Student Program offers
fellowships for U.S. graduating college seniors,
graduate students, young professionals and
artists to study abroad for one academic year.
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Population (2006 est.) 28,287,147 Capital
Kathmandu, 1,203,100 (2003 est) 2,100,000
(2007est) Languages (92) Nepali 48 (official),
English spoken by many Caste/Ethnic (101)
Brahman 12.7, Chetri 15.8, Newar
5.5 Religions Hindu 81, Buddhist 11, Islam
4 Literacy rate 45 (2003 est.) Economics per
capita 1,500 Unemployment 42
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Africa Antarctica Arctic Asia
Australia/Oceania Caribbean Central America
Europe Islands of the World Middle East
North America South America World Atlas WIN
100 here

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King Gyanendra and Queen Komal
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MAOIST INSURGENCY
A small but growing Maoist guerrilla movement,
seeking to overthrow the constitutional monarchy
and install a Communist government, began
operating in the countryside in 1996. Oct 2002 -
King Gyanendra dismissed the government declared
a state of emergency and ordered army to kill
Maoists Jan 2003 - Maoists signed peace
agreement Aug 2003 - the Maoist rebels withdrew
from peace talks Aug 2004 - the maoists called
a nationwide strike (bandh), blockaded Kathmandu
for a week, cutting off shipments of food and
fuel to the capital
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MODERN HISTORY Feb 2005 King Gyanendra fired
the entire government and assumed direct power.
many politicians were placed under house arrest,
and severe restriction on civil liberties were
instituted April 2005, massive pro-democracy
protests organized by seven opposition parties
and supported by the Maoists took place. King
Gyanendra agreed to reinstate parliament which
moved to diminish the king's powers May 2005,
Parliament voted unanimously to strip the king of
his authority
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Nov 2006, The Maoist rebels and the government
signed a landmark peace agreement, ending the
guerrillas 10-year insurgency that claimed over
20,000 lives Established young communist league
(YCL) March 2007, the Maoists joined the interim
government with the other seven parties November
2007, National elections scheduled
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Daily Challenges -load-shedding (scheduled power
outagesinitially 6 hours a week, rose to a high
of 40 hours a week -no municipal water, purchased
water from trucks, high level of fecal and other
contaminants in water -garbage strike -propane
shortage -fuel shortage -strikes/protests -religio
us holidays and other festivals -pollution -traffi
c -earthquake
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• Epidemiology, Immunology and Biostatistics
•  
• Course Title Epidemiology, Immunology and
  Biostatistics Full Marks 100
• Course No. MB 512 Pass Marks 40
• Nature of Course Theory Year I  
• Objectives
• To give detailed knowledge on epidemiology,
  immunology and statistical aspects of diseases.
• To give practical knowledge on the
  epidemiological and immunological techniques
  which enable
• the students to work in different disciplines of
  science like clinical, public health and
  epidemiological
• fields.
•  
• Course Contents
• Basic concept in the Epidemiology of Infections
  Diseases History definition and Principles (3
  hrs)
• Measuring Health and Diseases Definitions of
  health and disease measure frequency use
• of available information comparing disease
  occurrence, (3 hrs)
• Environmental Factors in Epidemiology Spread of
  infections, outbreak of infections,
• Source of infections and Route of
  transmission, (6 hrs)
• Epidemiological Methods collection of
  observations, Descriptive analysis
  Epidemiological
• survey and analytical studies, Epidemiological
  markers Antigenic composition, phagetyping,

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Training Workshop on Epidemiology
Methods planned and conducted an 8-day, 7
hours/day, (May 31-June 8 there was a bandh on
June 1) training for 25 faculty members of the
Department of Microbiology and invited
guests For many their first exposure to the
field of epidemiology, epidemiology methods,
study design and sample size estimation. Most
participants had an MSc degree, some had a PhD in
related field Also Taught how to use PEPI for
data analysis and sample size calculations
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Training Workshop on Field Epidemiology   Organize
d by Nepal Health Research Council (NHRC),
Ramshah Path, Kathmandu, Nepal Date 7-21 June
2007 (24 Jestha 7 Ashad 2064) At the request
of the medical director of the Nepal Health
Research Council, Dr. Keshab Shrestha, I
conducted a 3-day training, 7 hours/day, (June
12-14 a bandh on June 12) 20 health
professionals from all over Nepal, with MPH, PhD
and MD degrees Since many had some experience
in epidemiology focused on more advanced study
design methods
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• PROPOSED RESEARCH
• Feasibility study of GIS in Nepal
• examine the feasibility of teaching and
  implementing small area analysis
• techniques in Nepal
• 2) examine the geographic distribution of
  diseases in Nepal by mapping
• patterns of morbidity and mortality and
• 3) apply these techniques in collaboration with
  Nepalese colleagues to
• guide health planning.
• a series of maps displaying sociodemographic
  characteristics, morbidity
• and mortality characteristics as well as health
  services availability
• presented the maps during both training sessions
  at TU Department of
• Microbiology and at Nepal Health Research
  Council. Interested in
• continued collaboration and perhaps publication
  of the results.

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OTHER RESEARCH PROJECTS Survey of HIV/AIDS
Knowledge, Attitudes, Behavior Practice In
collaboration with another Fulbrighter, Marsha
Greer (UCSD) surveyed our students Surveyed
both first and second year microbiology students
This is an increasingly important issue in
Nepal as rates are rapidly rising also a
potential occupational hazard for microbiologists
As a result of the analysis of the first year
student surveys, I delivered an HIV/AIDS
presentation as part of an infectious disease
lecture At this time we are planning on
combining the data from all samples and
submitting a manuscript for publication
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Lessons Learned Be prepared - have
contingencies Be flexible Persevere Have
fun!!!