Challenges during fieldwork

​I really enjoy doing these fieldwork trips because it is rewarding to give at least a small amount of help and advice to families whose children have often had little to no therapy so far. Many families are overwhelmed and unsure what their child really needs. At the same time, the work teaches me a lot of patience and flexibility. Assessments often had to be done in whatever place and circumstances were available, and plans changed constantly, sometimes without me realizing until much later.
One of the biggest challenges was the language barrier. Most families either did not speak English or not well enough, so one of our team members had to translate everything. Often I would say something in one minute, and the discussion in Dzongkha would continue for ten. At first I wondered why it took so long, but I realized that the language is less direct and that there are often no precise medical terms, so explanations become much longer. Bhutanese families also tend to explain situations in great detail, sometimes including things that may not seem immediately relevant. I think this is partly because so few people usually take the time to listen to their experiences and challenges.
I also noticed that both the language and the culture work quite differently from what I am used to. Sometimes I would ask a question, receive an answer, and only much later during another discussion an important detail would suddenly come up that, for me, should have been part of the original answer. Often, just when we thought we were finished, very relevant information still emerged. This could be tiring and sometimes made me wonder whether I had really understood the child’s main difficulties or if I had missed something important. Over time, however, I learned to adapt the way I ask questions.
Another difficult aspect of this trip was the weather. It rained almost constantly, so everything was damp and wet most of the time. Normally this period should still be part of the dry season before the monsoon starts at the end of May, which is why we planned the trip then. However, the unusual rain made travelling very difficult. Roads in Bhutan are often already in poor condition, and during rainy periods there are frequent roadblocks caused by rocks and boulders falling from the mountainsides. Many smaller roads are unpaved and become so muddy that driving through them is sometimes impossible.
At one point we tried to visit a child near Lhuentse and had to leave the main road for a muddy track, but halfway there we had to turn around because the vehicle would likely have become stuck, or worse, slid off the road down the mountainside. Because of these conditions, travelling took much longer than expected. Sometimes we had to wait over half an hour for blocked roads to be cleared before continuing.
Road construction added another challenge. In the mountain regions, roads are frequently damaged and often widened from single-track roads into proper two-way roads. During construction, sections are only opened at specific times. If you miss the short opening window, you may have to wait several hours. On the route between Lhuentse, Mongar, and Bumthang there were several of these checkpoints one after another, but frustratingly they all reopened at the same time, making it impossible to pass through all of them in one go. At one checkpoint we had to wait three hours before the road reopened. Since most places only have one access road, there is usually no alternative route.
Accommodation also required flexibility. Especially in Lhuentse there are very few hotels or guesthouses. In one place, the only hotel was fully occupied by construction workers, so we stayed in guest rooms at a local school. Otherwise, we would have had to drive much further each day. In another place, the guesthouse had mouldy walls, a broken shower, and only very basic facilities, although at least we still had warm water. Food options were also extremely limited, with only one nearby restaurant open. Lhuentse itself felt very remote, with only a tiny town centre and very little infrastructure. However, some of the homestays we stayed at during the trip were very welcoming and pleasant.
Overall, I really enjoyed our 17-day eastern fieldwork tour, although by the end I was quite tired and exhausted and happy to return home.