Some public health students will cite other people’s suffering as the motivation for pursuing their chosen career. A visit to sub-Saharan Africa may have been the tug. Or a stint volunteering at a homeless shelter. Or a heightened awareness of world hunger or disease.
For Tej Mishra, it was eight days of waiting for someone to look in his ear.
Mishra, now a master’s student at the BU School of Public Health, remembers the excruciating pain of an ear infection he suffered at age 11, while living in a refugee camp in Nepal with his family, who had fled their native Bhutan. One day went by — then five, then eight — while he waited to be seen by a medical clinician who tended to the 21,000 refugees huddled in bamboo-and-plastic huts in a Bhutanese camp in the Jhapa region of eastern Nepal.
“I just remember I cried, day and night, from the pain,” Mishra recalled. “I was a kid. There was nothing to do but wait.”
A decade later, when he speaks to fellow students at BUSPH — as he did earlier this year to Monica Onyango’s international health class in “Managing Disasters & Complex Humanitarian Emergencies” — Mishra cites those eight days as the beginning of a narrative of salvation.
“My passion to pursue public health was rooted in that experience,” he explained. “I learned from childhood that public health is the main social issue that needs to be addressed, before anything else can be tackled. There can be no education, no future, without adequate health care.”
Mishra, who is majoring in international health, with an interest in biostatistics and research design, is a study in resilience. At age 5, his family fled Bhutan, a remote and impoverished country in southern Asia, after his father, of Nepalese heritage, was forced out of the country in what Mishra describes as widespread ethnic cleansing.
Mishra would spend the next 18 years in a refugee camp with his parents and siblings before finding his way to a private college in Nepal — and then, in 2010, to the United States.
His memories of the early days in the refugee camp are dark: His brothers and parents holding up the plastic roof in driving rains, infectious diseases spreading from one family to the next, the dead being burned and thrown into the river. Even after U.N. assistance arrived, living conditions were grim, with rationed food and little opportunity for employment or integration into Nepalese society. Mishra was schooled at the camp until high school, when he received aid from a charitable group to attend a private school in Nepal.
“One of the saddest issues of being a refugee is the hatred you face from the local community,” he said. “I was a Nepali, by race, but you are not supposed to go outside and work or make something of yourself, even if you have talent…
“A complete generation of my community has been lost,” he said. “Most of them were not allowed to do anything, for 20 years.”
After high school, Mishra enrolled in Pokhara University in Nepal, working his way through school by tutoring other students and with support from his older brothers. He had known, from an early age, that he wanted to pursue a career in public health, and after the family immigrated to Virginia, he applied to and was accepted into BUSPH.
The boy who wore “a single shirt” through the fourth, fifth and sixth grades now bounds across campus in jeans and sneakers, with a backpack full of experts’ views on international health dilemmas. He does not resent the experiences of his youth — in fact, in some ways, he cherishes them.
“My school days are what I remember the most — sitting on a dusty floor, on a sack I brought from home, listening to teachers from Bhutan who had been schooled in the Indian education system. It’s funny — in some ways, I miss those moments,” he said. “Not the conditions — I would never have had the opportunities to do what I can do here. It’s mainly the human or emotional aspect that I miss.
“There were some aspects of life there that will never be here. It was a community for me, in a way that’s difficult to explain.”
That community continues today in Nepal, where an estimated 60,000 refugees from Bhutan remain in camps, while tens of thousands of others have resettled in the U.S., Australia, Canada and other countries. The Bhutanese refugees first entered Nepal at the end of 1990, where temporary camps were established on the banks on the Mai River. Disease and squalor were rife.
A few years later– within months after Mishra and his family arrived — the United Nations Refugee Agency and the World Food Program began providing assistance to the Bhutanese refugees, including food, water, shelter, health and education.
While violence is minimal within the refugee population, the structural layout of the camps is very dense, with shelters built close together, the UN reports. Frequent fires cause widespread damage, and flooding from rain is common.
Mishra stays in touch with friends at the camps, as well as one of his sisters, who has stayed behind by choice, he said. He has no interest in returning to Bhutan, a country he said is largely misunderstood by the west, in terms of its policies on human rights and social justice. Bhutan’s government forced ethnic Nepalis to leave the country through a variety of tactics, including imprisonment, according to Human Rights Watch and other international watchdog groups. The Bhutanese refugee situation is now one of the most protracted refugee crises in the world.
“Bhutan is not the way the world sees it,” Mishra said. “Not all ethnic groups are allowed to go to school or obtain jobs. Yes, foreigners are warmly welcomed, but they see only the cultural attractions the government wants them to see. And the people in the local villages –they are afraid for their lives to speak the truth against the government.”
He said he is discouraged that so little attention has been paid to the plight of Nepalese refugees:
“There is a chance that the sufferings of my parents will remain as a forgotten history.”
Mishra said he doesn’t broadcast his own history, but he welcomes opportunities to educate others about the refugee experience. In late October, he will be speaking to a class of first-year medical students about refugee life from a public health perspective.
Joe Anzalone, senior manager of the BUSPH Department of International Health, said he’s been impressed by Mishra’s energy and focus.
“Tej is incredibly determined and genuine. Because of his unusual path to BUSPH, I had concerns about his readiness to excel in his coursework. However, I’ve seen the great capacity Tej has for hard work. He has incredible drive and discipline,” Anzalone said.
Rich Feeley, associate chair and professor of international health, said Mishra “spends long hours around the Department. He does very well [academically] for someone who never had the advantages of a U.S. education until he came here. He is clearly a person who takes his public health education seriously.”
While Mishra still has time to decide what to do with the master’s degree he will receive in 2013, he says he would like to find a way to work with the refugees. But he would not be content to help them merely to endure.
“We think in one perspective: that if we provide food and water and basic necessities, that is what people need to survive,” he said. “But if we look deeper, survival is not enough.
“People need opportunities to live healthy, productive lives. I have the opportunity now. I want to use it to help other people.”
Reproduced from sph.bu.edu