LLOYD: This woman isn’t a doctor – nor is she a nurse. In fact, Tara Kasaju is a primary school dropout. She has no medical qualifications at all. Yet in Nepal, she’s legally allowed to dispense medicines with the approval and blessing of the state.

RAM SHRESTHA: [Nepali Technical Assistance Group] These volunteers have been really, are the frontline workers in Nepal. You know they are our soldiers in the health field, which has really, you know saving thousands of child’s life.

LLOYD: Nepal straddles the mighty Himalayas. It’s a rich landscape of soaring peaks, lush valleys and fertile planes but no matter where they call home, life for most of Nepal’s twenty eight million people, is far from idyllic.

Despite years of foreign aid, one in three Nepalis still lives in abject poverty and until very recently people here were still dying of preventable diseases like diarrhoea and pneumonia in staggering numbers. As you’re about to see, there are vast parts of Nepal that are more reminiscent of third world Africa then they are of Asia.

Nepali’s are among the poorest of the poor. For years the infant mortality rate was one of the world’s worst. Even today, half of those who survive childhood never learn to read and write and most people die before they turn sixty.

Ram Shrestha spent years working in the field of health and nutrition in North America. He came back determined to make a difference.

RAM SHRESTHA: Yeah you know we came you know and then saw that you know, the country was not doing that well about child mortality you know reducing and maternal mortality.

LLOYD: Should Nepal be doing better than it is?

RAM SHRESTHA: I think so. I think so. If you look at the health services and the mortality I think you know, yeah compared to other countries, Nepal is not doing that well.

LLOYD: Health authorities have known for more than twenty years that some diseases could be prevented by increasing the level of vitamin A in the diet. The challenge in such a mountainous country was how to do it, until one man offered a simple idea – let the poor do the job themselves.

You favoured women?

RAM SHRESTHA: Yes.

LLOYD: Why?

RAM SHRESTHA: Because there’s a study that shows that if you really recruit women you know that they will really be able to convince you know, the mothers and you know, understand the problem about the children.

LLOYD: Did people laugh at you when you first came up with the idea?

RAM SHRESTHA: Oh yeah, yeah, they were saying that how could you, you know, how could you use these female who are illiterate you know and not doing much work in the community, could be a leader, you know, on this big mission at reducing child mortality.

LLOYD: Tara Kasaju is one of those females recruited to give vitamin A but that’s not all she dispenses.

TARA KASAJU: Did you take the iron tablet, or not?

YOUNG MOTHER: I haven’t taken it yet.

TARA KASAJU: Why haven’t you? Did you forget to take it after you went to the hospital?

YOUNG MOTHER: Yes, I forgot.

LLOYD: It’s Murthy Jadav’s first baby and Tara isn’t too impressed by how she’s handling the week old boy.

TARA KASAJU: Don’t cover up the baby with the cloth. And don’t make him wear clothes like this that expose his chest. Make cotton vests that cover his neck.

LLOYD: At just forty-five and a grandmother twice over, Tara’s a respected elder in Nepali society but setting young mothers straight doesn’t always make her popular.

TARA KASAJU: Some of the mothers abuse me. Some even come to beat me. You just have to tell them with a calm mind… with a lot of understanding of how things are.

LLOYD: Despite Tara’s health crusade, things are still not good in Ramganj village. Geeta Devi is puzzled by how to stop her son’s diarrhoea.

TARA KASAJU: He’s had it for two days? Why didn’t you come before? You knew I was here.

LLOYD: The kitchen doubles as the clinic with just twelve days of training in basic health and nutrition, Tara’s become the nearest thing to a local GP these villages have ever seen.

TARA KASAJU: Look, dysentery is not a small disease. It spreads. Don’t take it casually. If you take it casually it may prove fatal for your baby.

LLOYD: The treatment, oral rehydration solution, ORS. It’s a combination of salt and sugar mixed in clean water that has saved millions of lives. But here in Nepal, modern health practices compete with the equivalent of voodoo.

TARA KASAJU: Often if a pregnant woman was in pain she would be taken to a witchdoctor. He’d cut a chicken’s throat to ease her pain. Here in this village too, we would do stuff like casting away evil spells. I was involved in that as well.

LLOYD: How much resistance have you had from the witch doctors? You’re kind of taking their job aren’t you?

RAM SHRESTHA: Yeah, yeah in the beginning it was very hard you know but what we did in our training we also involved them so they are also participants of the training. You know the way we have, we have actually encouraged them. We said you know look there are certain things you can do and there are certain things you can’t do right? So, so…

LLOYD: So what sacrifice a goat but give a pill?

RAM SHRESTHA: Exactly.

LLOYD: Nepal has fifteen thousand kilometres of roads, although half are still dirt tracks more fit for horse and cart.

RAM SHRESTHA: The problem is how to get this cheap solution right, like as I said you know the vitamin capsule cost two cents you know? Get this capsule to that person, that’s, that’s the problem.

LLOYD: We’ve come to see what happens when people in remote areas miss out on vitamin A. Where are we here?

RAM SHRESTHA: This is the house where we have the child with night blind. I think this is the one.

LLOYD: How do you know that there is something wrong with this little girl? Can you show me?

RAM SHRESTHA: Yeah because, because if you look at, the one way is if you look at you know, you see the white space? Here there will be a foamy white patch right? And that’s the you know vitamin A deficiency. Same thing here.

LLOYD: Five-year-old Ruksana Khatun can see as well as anyone during the day but at night it’s a different story. She’s completely blind. It’s a common problem in vitamin deficient children.

How is it that she’s affected but other members of the family and community are not? Why is it one person?

RAM SHRESTHA: Okay there could be many reason, one reason maybe she might have you know prolonged diarrhoea. Diarrhoea for a long time.

LLOYD: Diarrhoea.

RAM SHRESTHA: Yeah. Yeah and also like she might not get you know the vitamin rich foods in her food or she might just be taking bread and onion and salt and nothing else.

LLOYD: Right and untreated what would happen to her?

RAM SHRESTHA: Okay what’ll happen if she will have say that foamy thing there and suppose if she has measles right, she can lose her eyes in forty eight hours.

LLOYD: Permanent blindness.

RAM SHRESTHA: Yeah, yeah and if somebody gets blind with vitamin deficiency you cannot reverse it.

LLOYD: Sunset…… the day is fading and so is Ruksana’s eyesight.

RAM SHRESTHA: Can you see anything?

RUKSANA: No.

RAM SHRESTHA: No she cannot see.

LLOYD: Nothing?

RAM SHRESTHA: Nothing.

LLOYD: Okay.

For such a debilitating condition the cure is just so simple – a few drops of vitamin A.

RAM SHRESTHA: She should you know, see the difference from tomorrow.

LLOYD: Twenty-four hours?

RAM SHRESTHA: Yep, yeah.

LLOYD: Vitamin A night blindness also affects pregnant women. Anita Malaha is trying to make dinner before the light fades.

ANITA MALAHA: Doing anything is difficult now. Before I could do all the work without a problem. Now after dark I can’t cook. I can’t get firewood, or go in and out of the house.

LLOYD: At night the caregiver becomes dependent on the child. It’s not long before we see the evidence of Anita’s predicament.

ANITA MALAHA: I haven’t been able to see at night for one month. I can’t even see with a lantern.

LLOYD: Anita went through night blindness with her other pregnancies. She’d assumed it was just natural until she learnt about Ram Shrestha’s vitamin A campaign.

RAM SHRESTHA: Hello sister, how are things? How is the eye condition?

ANITA MALAHA: I can’t see a thing.

RAM SHRESTHA: You see nothing?

LLOYD: Once again the healing power of a two cent pill is enough to fully restore a person’s eyesight.

Why was this such a problem? What was the missing ingredient in this society?

RAM SHRESTHA: I would say the lack of awareness you know. They, they saw that children are dying but they didn’t know it’s because of simple thing.

LLOYD: It’s not as though Nepal is short on greens that are rich in vitamin A but growing vegetables and eating them are two different things.

How is it that a nation could have a vitamin deficiency with all this fruit and vegetable?

RAM SHRESTHA: Yeah because what happens you know because the people sell all this vegetables which is rich in vitamin A, they sell here and they buy other things.

LLOYD: So rather than eat it they’ll sell it to make money?

RAM SHRESTHA: Exactly. So that’s why the problems of vitamin A is very high you know in the villages here.

LLOYD: Back at Anita Malaha’s, it’s been forty-eight hours since she took the pill.

ANITA MALAHA: That night I couldn’t see anything but today I can see so much better. I can do everything inside and out.

LLOYD: That includes a sure-footed walk to the backyard to pick herbs for dinner. Before the vitamin A campaign, night blindness affected almost one in four Nepalis. The treatment is liberating people whose daily lives are full of enough other hardships.

ANITA MALAHA: I couldn’t go out of the house alone before, but now I can. I can also cook at night now.

LLOYD: Can she see? Can she see me, can she see you?

RUKSANA: Yes.

LLOYD: She can see more than last night?

RAM SHRESTHA: Improving.

LLOYD: It’s only been a day but five year old Ruksana is also getting better. She can see the torch.

So between last night and tonight, what has changed for her?

RAM SHRESTHA: Now that is better, a little better than last night.

LLOYD: You didn’t have to come back did you? I mean you could have pursued an international career couldn’t you?

RAM SHRESTHA: Yeah, yeah. The reason, yeah, the reason, the reason I came back was because I saw a simple way you know you can really make a big change. What you need is very simple technique, easily administered right? And believable and cost effective. That’s what you need.

LLOYD: None of it would have been possible without Nepal’s volunteer mums. Infant mortality has been cut in half. Twenty four thousand child deaths are prevented every year. The grassroots vitamin A campaign is now being copied by other developing nations. In future, those communities may have something good to sing about as well.