About doctors getting “thrashed” in Nepal March 14 2015

There are some “dirty little secrets” of Nepal healthcare – things that everybody knows but which nobody talks about. And my book, The Sacrament of the Goddess, deals with many of them, head-on. That’s why the novel has a cult following among doctors and nurses who have read it in Nepal.

Oh, the descriptions of the novel are a bit vague

“It’s a love story;” or

“It’s about the Civil War in Nepal and the missionaries caught in the middle;” or

“It’s about the way that medical decisions are made in a low income setting.”

Yeah, well, all the above are true, sort of. But the story is also about the way that people in Nepal deal with tragedy during those times when the doctors are unable to save somebody’s life.

“Thrashing” is a euphemism

And that’s where it gets interesting. The newspapers in Kathmandu always seem to publish stories about how this or that group of angry relatives “thrashed” a doctor, beating him (or her) senseless or creating a disturbance. When I first heard the term I thought it was “quaint.” Getting thrashed means that a mob beats you with bamboo sticks. If they are angry enough they can break every bone you have.

It’s not unique to Nepal, it happens a lot in India. On more than one occasion, doctors in Nepal have held a one-day strike to bring attention to the issue.

But there are even more stories that do not make the papers, and every doctor and every nurse is able to share the details of their own encounter with danger.

Young doctors dealing with fear

Young doctors in Nepal are trained at the larger hospitals, but after getting their MBBS degree, many of them spend a year posted in a rural health post, as a partial payment for student loans. If you ask them about this, their near-unanimous feeling is worry about trying to do the best they can, yet getting thrashed by angry family members if things don’t turn out perfectly.

Three actions to take

Every one concerned about this issue can do three things.

First, go to Vajra Books on Jyatha in Thamel, or Tibet Books on Tri Devi Marg, and buy The Sacrament of the Goddess. It’s a highly readable novel that gives a first-hand, truthful picture about hospitals in Nepal. Yes, folks, it’s the book I wrote.

Next, this issue is addressed in the 2- and 3-day courses in cardiac resuscitation taught by CCNEPal. CCNEPal has materials on strategies to minimize the risk of an escalating situation. Those persons who have taken the course can tell you about it. Sign up for a course.

UPDATE May 2nd 2016

If you don’t believe that this is a problem, read this report from Maharashtra State in India.

Finally, in the coming days, I will post a series of blog entries on the CCNEPal blog page, that will educate about strategies to deal with this problem. Click here to get to that blog, and when you do- click on the “subscribe” button. It will be a series you won’t want to miss. You will want to share it with your friends.



meeting the #Nepal fans of the novel, Sacrament of the Goddess March 12th

Meeting the fans of The Sacrament of the Goddess in #Nepal

One of the joys of being an author is to talk with people who have actually read your book, and this has been happening for the past few weeks in #Kathmandu. I teach critical care skills to nurses and doctors, and in some past sessions a few nurses bought the book. I’m told it’s been laying around at one of the bigger hospitals in Kathmandu, and as you might expect, many people share the same copy. ( it would be great if they bought their own, but – this is almost as good!)

Small talk about literature

At some point during a class break, somebody comes to me, grinning, and tells me they’ve read it.

I love this. we talk about their impressions.  Now, I’m biased, but – people have enjoyed the plot, they have found the book to call forth their emotions at certain passages ( which is good, because that was what I was trying to accomplish with my writing) and they ask questions.


Probably the most common question is -” You got it right in terms of depicting Nepali Culture. How could a foreigner know so much about Nepali culture?”

I am flattered by this. Here is my answer. I observe and I ask questions. Also, I studied a lot of books written by anthropologists, and I used some quasi-anthropological techniques to research the book. But most importantly, I was fortunate to have a number of “beta-readers” who were Nepali. These persons were given drafts to read and to comment upon, much like the model of “beta testing” used in the computer software industry. I got their feedback and made changes along the way.

Levels of culture?

On one level, culture is about food, religious ritual, costumes, setting. Those are the easy things to describe. Just like a travel guide.

I wanted to dig deeper.  How does a  particular cultural background influence such things as emotion, family relationships, or even clinical decision-making, in  the case of a doctor? How might this impact life choices made ( or not made!) by a young woman?

So, while the beta readers looked at specific cultural things ( where the brakes on a pedicab are located, for example) it was more important and valuable to me when they gave feedback about the plausibility of certain social situations. When things go bad, how does a particular person pray? (or not pray…) For example, the romance between the two main characters, one American, the other – Nepali. Or, when a mother and a daughter argue with each other. Or when a man talks with a woman co-worker.

Medical scenes

Most if not all of the medical scenes are based on actual events I witnessed or was a participant in during the five trips I took before writing it.

At the time of the 2013 trip, I had what I thought was a finished draft. Then I was on the lookout for ways to make the novel come alive. My Nepali friends were kind enough to allow me one step closer in their lives. For example: the woman named Sushila is a composite of three different women I know, each of whom is devout. I interviewed each one about the family “Puja Room,” and realized that if I described the way this serves as a refuge, it would add a potent dimension and insight for the reader. When I got back to Honolulu I edited and revised, with my new insight.

more on this later.  For now,  a quick reminder that The Sacrament of the Goddess is available at Tibet Books on Tri Devi Marg, or at Vajra Books on Jyatha in Thamel.

Book Review of The Sacrament of the Goddess in Nepali bhasa Jan 19

Note: this book is now available in Vajra Books or Tibet Books in Thamel. click here for the list!


द साक्रामेन्ट अफ गोड्डेस्,,अथवा नेपाली मा भन्नु पर्दा देबी को प्रसाद,,एउटा यस्तो नोवेल जसमा माया,जिबन्,त्याग्,आत्मियता जस्ता आध्यात्मिक कुरहरु को मिठो बयान गरिएको छ, यसका लेखक जो निम्जुरा एउटा अमेरिकि नागरिक र पेसामा उनि नेपाल र अमेरिका दुबैमा राजइस्टर्ड नर्स हुन्,,बिगत ७ बर्ष देखी उनि नेपालमा स्वास्थ्य को क्षेत्रमा उल्लेख्हनिय काम गर्दै आइरहेका छन्,.यो किताब उन्कै मिहिनेत को फल हो,,यसमा नेपालमा दस बर्स सम्म चलेको जनयुद्द को बेलाको.. एउटा अमेरिकन सर्जन र नेपाल को बेनी भन्ने ठाउँमा बस्ने साधाराण नेपाली केटी बिचको प्रेम सम्ब्न्ध को बारेमा बयान गरिएको छ,,,,,, एउटा यस्तो पबित्र प्रेम सम्ब्न्ध जुनसाधारण,,अपरिपक्व,,र सारीरिक तर इन्टेन्स लभ बाट सुरु भएर,,धेरै त्याग र प्रतिक्षा बाट गुजृदै एउटा आत्मिय र परिपक्व्य प्रेम भएर फुल्छ,,यै प्रेम कथा लाई प्रमुख सेरोफेरो बनाएर लेखकले, ,,जिबन का धेरै तिता मिठा सत्य,,जिबन मा गरिने त्याग्,,तपस्या आदी को बारेमा अत्यन्तै सरल तर सत्य,मार्मिक र चित्त बुझ्दो तरिकबाट बयान गरेका छन्,,, नोवेलमा लेखकले नेपाल को गाउँ र शहर दुबै को सुन्दर्ता जती स्वच्छता का साथ बयान गरेका छन्,,,,एउटा बिदेशी नागरिक भएर पनि नेपाल लाई यती नजिक बाट नियालेका छन लेखक ले,,,जती नजिक बाट हामी नेपाली ले पनि नियाल्दैनौ होला माया,,प्रेम्,,,,तपस्या,,त्याग्,, पर्‍खाइ,,धैर्यता,,,, चोखो माया.. जस्तै भगवान प्रती को जस्तै सध्भाव्,,र सङ्सङ्गै मेडिकल ज्ञान ….लेखक का भाबुक्,,पबित्र शब्द बाट सजिएका मार्मिक पल हरु ले धेरै पटक आँखा रसाइदिन्छन एस्तै कुरा हरु को मिश्रड भएको नोवेल हो द साक्रामेन्ट अफ गोड्डेस्,,,, यो किताब को बारेमा थप जानकारिको लागि यसको फेसबुक पेज मा हेर्न सकिन्छ

साथै २४ जनवारी को दिन यस नोबेल को रिलिज हुँदैछ नेपालमा…. ठेगाना:पाटन दरबार स्क्वर समय:दिउसो २ बजे (प्रसिद्ध ब्यान्ड एभरेष्ट ब्यान्ड बाजा का साथ सबै लाई रातो ड्रेस कोड को अनुरोध का साथै नोबेल किन्न इछुक ले नेपाली रुपैया ५०० मा लिन सकिने छ)

Review of my novel The Sacrament of the Goddess by a Nepali RN

The Sacrament of the Goddess is now available on Amazon. You can read the first five chapters on the Kindle site, and decide.

Pre-Publication reviews

In prep for this I sent a number of spiral-bound copies of the draft in pdf to people who might review it. The feedback is beginning to appear.

This book will be of interest to people in Nepal, or who want to learn about the fascinating and wonderful culture of that magical country. Here is a thoughtful review by a friends of mine. Binu is a Nepali citizen and a Registered Nurse in that country.  I would humbly say that she “Gets it”

from  Goodreads

I feel lucky to get pre-publication copy of the book The Sacrament of the Goddess written by Joe Niemczura. I am not fond of reading books but I do read something sometime and if anything interests me I go deep into it. I must say The Sacrament of the Goddess is the book, which created my interest as I start to flip pages of it.

The book is about an American guy Matt who loved a Nepali woman Shushila. He goes to medical school, then comes back to look for his love and volunteers in hospital of Nepal. It is also about a Nepali girl who went through tough time in a relationship. It depicts war between maoist and governmental army of Nepal so clearly.

I am a Nepali reader and I thought in spite of being foreigner, writer knows more about our situation than me. And he presented everything so precisely. When the guy came back to Nepal and volunteer in hospital; episodes of burn victim, emergency cesarean, mushroom poisoning, malaria, and of course, violence against hospital staff are well pictured. It shows Nepali community and cultural aspects also. There are many other characters besides hero and heroine and writer did totally fair with all of them with their roles. Book is about, What happens with hero and heroine and with their love?

I am not finding one right word to say what is the book as a whole, because it’s a love story with tragedy, there is a war and there is a kindness and lots of problems with their solutions. In fact the book is a complete package of entertainment and emotions. And I must mention that it has suspense right up to the last page. As a whole I recommend this book for all those readers who want to read a “GOOD READ”.

I have been tweeting about it, if you are on Twitter, look for @CCNEPal2013