Nar Maya Dhakal, 41-year-old exiled Bhutanese from Beldangi-II camp, was suffering from Rheumatic Heart Disease (RHD) since three years. Diagnosed medically as RDH patient, she was having complications with both mitral and aortic valves, requiring replacement. Association of Medical Doctors of Asia- AMDA-Hospital-a local hospital, near refugee camp, looking after health of the exiled folks sponsored by the United Nations High Commissioner for Refugees (UNHCR), denied her referral to a better hospital at the capital for surgery. The frequent requests, often tearful, for the referral rolled down in vein. When he learnt about the referral policy of the sponsoring agency, he had no way out than to raise fund from among the fellow-countrymen, well wishers and relatives outside camp–if any.

The trifling contribution from fellow citizens, who are tightly scheduled with donor's ration, generated at least two-way bus fares and three-day-lodging at a charity house for the couple in Kathmandu. Doctors at Sahid Gangalal Hospital–the county’s biggest heart centre– asked him to collect some two hundred thousand Nepalese rupees for her valvular replacement. 

Devi Charan then booked a pair of bus tickets to Jhapa where his ramshackle hut was waiting to get leakage repaired. He left no stones unturned to raise the fund. He even carried big sacks of pulses and traded in the local markets. He borrowed loan at interest rate much higher than market value and collected some sixty thousand. He even initiated small-scaled business and sold rations donated by UNHCR. Then he had eighty thousand rupees in hand and a hope in mind to get his wife treated.

Helped by the friends and relatives in camps, Charity Trust and the hospital, getting active initiative from the hospital management, Narmaya’s heart surgery was done successfully. She is now happy with her new life and feels relaxed.  

This is not only Nar Maya’s story; it’s the story of an exiled Bhutanese whose heart is successfully treated at in personal initiative. However, all are not equally lucky. Very often they are compelled to hide the disease as they can not afford such expensive treatment and wait for the death. What else could they do?’ Its easy now’, you would say that they are treated for communicable diseases if they choose to be resettled. And, this is what we often hear from doctors and donors at first. 

Resettlement is a complicated and specific program aimed at solving decade long impasse. All with or without such diseases may have to stand-on-line, but none are known to have been yet treated. Hearing the medical check up for all diseases before resettlement, Devi Charan also filled up a form showing his interest for resettlement. He did not dream for heavenly life in the US but to ensure his paradise– his wife would be treated free of cost– is not lost. He waited and followed up the process yet he was not called for interview. Now her damaged valve is replaced and another repaired.  

What would they say if they are offered resettlement now? He has something to say but not denial. 'I owe a lot of money that I have spent on treating my wife’, Devi Charan says adding, 'I will beg them time until I can repay the debt off and would do whatever they say thereafter’ and puts his plan on his head.

Paryankush Pyakurel,24, of the same camp is another lucky refugee whose operation of the heart was successful at his own effort. As Devi Charan did, Dharnidhar Pyakurel, brother of Paryankush, toiled to raise fund for treatment. Helped by the community, relatives, educational institutes and Churches, Pyakurel managed a small fund. 

‘Sahid Gangalal Heart Centre saved my life’, says Pyakurel gratefully. Only after successful operation, UNHCR helped Pyakurel with some money as compensation for bus fare and lodging at the capital.

Some Bhutanese in exile are leant to have returned in dismay from Kathmandu for not being able to produce minimum balance required for the treatment of heart diseases. The hospital has a quota for free valve but only for Nepalese citizen. Still the hospital tries its best not to return any patient visiting with the hope of survival.  

Had there been no humanitarian assistance, initiated at Maidhar camp, number of exiled Bhutanese inviting deaths due to various diseases would be unimaginably high. The donor investments on some of the very sensitive sectors like maternal and child health cares, sanitation and public awareness programs are praiseworthy. However, expensive treatments  are officially denied citing the cases to be terminal. There are over 200 tertiary cases which are denied of further treatments by the UNHCR sponsored AMDA-Hospital. The denial may be justifiable as it has to look after billions of global refugees and internally displaced people. However, countries willing to resettle these folks can not buy time to treat them as they are going to be the residents of the resettling countries, be it on temporary or permanent basis.