The world is impacted by COVID-19. From North America to Africa, citizens are reporting the major and minor ways that they’ve seen danger or inconvenience from the global pandemic. People are sharing their stories all over the internet and ways that problems are being solved, but what about areas that already had a lack of access to proper care? What about the people that barely had resources prior and are now seeing a virus thrown into the mix?
“In July 2019, I traveled with Dr. Maryam Farzanegan to Nepal to learn about the health of vulnerable populations, specifically women and children in resource-limited settings,” said Ruby Wry, recipient of the Dhablania and Kim Family Global Medicine Fellowship award. “While there, I witnessed the empowering efforts of caretakers and doctors in a world challenged by poverty, natural disasters, and poor infrastructure.”
“While there, I witnessed the empowering efforts of caretakers and doctors in a world challenged by poverty, natural disasters, and poor infrastructure.”
Ruby Wry is a recent graduate from the University of Southern California with a Masters in Global Medicine. She’s had a passion for providing mental health resources to vulnerable populations since before her trip last year. “My time in Nepal had a profound emotional effect on me and I realized that my initial trip was not my last. Instead, it would be the first step in gaining an understanding of how I could contribute to the betterment of resource-limited settings and marginalized communities - with a particular focus on women. By traveling to Kathmandu, I dug deeper to form an interdisciplinary understanding of why these challenges exist and how they influence the pursuit of health.”
Now, those marginalized communities are being impacted heavily by COVID-19 while retaining the same, limited amount of resources from prior to the pandemic. As of May 20, 2020, Google is reporting that Nepal has 375 cases, 2 deaths, and there are government-issued plans to continue their lockdown until at least June 2nd. While the numbers appear to be low and suppressed, for the time being, it is highly likely that there is a delay in seeing rising numbers from remote areas.
While the entire rural Nepalese population has its own set of issues and limitations that require aid, one group that Wry has a particular interest to work with is the returnee, female migrant workers.
Nepal is one of the main suppliers of labor for countries in Asia, including India, Malaysia, and several countries in the Middle East. When women try to return to Nepal after migrating abroad for employment, some of them find themselves exploited and in slavery. For those that are able to return, they often face victimization during the migrant process. Once back in the country, there is rampant sickness, poverty, sexual assault, and gender-based violence that they have to deal with. On top of this, many women suffer from PTSD & mental health issues caused by their time working abroad. Wry visited women with these stories in her previous observational work.
“One of my most memorable experiences was visiting POURAKHI’s Emergency Shelter,” said Wry. “The small house is a haven for women who had left their homes in Nepal hoping to provide a better life for themselves and their families, only to suffer gender-based violence and abuse in their new migrant countries. It thrilled me to learn about their work. While their programs included various topics to help women reintegrate, little was in place to address the PTSD and abuse these women had faced.”
"The small house is a haven for women who had left their homes in Nepal hoping to provide a better life for themselves and their families, only to suffer gender-based violence and abuse in their new migrant countries."
POURAKHI, established in 2003, is an organization that provides women with a home and resources to rebuild their lives. It is a member-based, human rights defender organization that is run by returnee Nepali women migrants. While their programs include shelter, education, advocacy, and more, the women Wry spoke with shared that they saw a lack of access to mental health care and that they continue to struggle with gender-based violence often.
Inspired by these previous observational visits to the region, and the relationships she built while there, Wry applied for the Dhablania and Kim Family Global Medicine Fellowship. She was granted funding to pursue the study of “Evaluation of Trauma Symptoms, Anxiety, and Depression Experienced by Returnee Nepali Female Migrant Workers.”
“I want to conduct a thorough investigation into the current state of mental health within the Nepali migrant community, focusing on female migrants,” said Wry. “Based on our continued communication, I can strengthen the mental health services offered at POURAKHI by conducting mental health assessments and developing an intervention program that does not require a specialist to administer.”
“I want to conduct a thorough investigation into the current state of mental health within the Nepali migrant community, focusing on female migrants,”
What that program and other aspects of the work looks like now, Wry is mapping out. The pandemic has changed quite a few things about how research can be conducted, who is healthy enough to participate in the research, and even basic subjects like whether Wry and a team can safely travel to and within Nepal.
“This pandemic has shown me that we can approach health care, specifically mental health care, using online resources in a far more creative and diverse way than we have previously,” said Wry. “However, it has also highlighted the fact that low resource areas continue to be at risk despite these emerging technologies and way of life. While I am excited to see how we are adapting, I am forced to think of the women who do not live with the internet or computers. Regardless of how we move forward, our primary objective should always keep in mind health equity as we adapt.”
"While I am excited to see how we are adapting, I am forced to think of the women who do not live with the internet or computers. Regardless of how we move forward, our primary objective should always keep in mind health equity as we adapt.”
On a basic level, she’s currently increasing funding for masks, gloves, hand sanitizer, and any other useful items to combat COVID-19. She plans on donating these to the shelter she’ll be working with. “Right now my primary concern is making sure every person I come into contact with during my research is safe and that there is no exposure, as it is a risk that we will be traveling door to door to obtain data.”
Like others during this time, Wry sees an opportunity to help a vulnerable population that is being disproportionately impacted by COVID-19. You can learn more about her efforts as well as donate directly via her GoFundMe page. She is currently in the process of developing a website to provide further insight on where their donations will be allocated and to include them on the status and progress of the studies she will be conducting. Updates on the status of her website can be found on the GoFundMe page or if you have a time sensitive inquiry, you can contact her at wry@usc.edu.
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