William S. (Bill) Carter, CIH, PhD, an AIHA member since the mid-1980s, is professor emeritus at the University of Findlay in Findlay, Ohio. Carter taught in the university’s environmental, safety and occupational health management program, which he directed for about five years, from 2006 to 2011. The master’s degree program at the University of Findlay attracted many international students, including several individuals from China and South Asia. At the suggestion of one of his Nepali students, Carter began investigating the possibility of teaching at Kathmandu University, where the student had completed his undergraduate degree. Carter applied to teach in Nepal as part of the Fulbright Program and was soon accepted. In 2009, he and his wife traveled to Nepal, where they spent more than six months while he introduced the first course in occupational health in Nepal as part of Kathmandu University’s environmental science and engineering program. Carter is a member of AIHA’s International Affairs Committee and is the association’s ambassador to Nepal. The Synergist: What are some examples of IH-related projects going on in Nepal? While I was teaching at Kathmandu University, I worked with several students who were interested in issues associated with reducing exposure to the smoke from cook stoves, but probably my most satisfying work was with one of the undergraduate students. He and I monitored the metropolitan traffic police in the Kathmandu Valley. Since there is a limited amount of electricity—sometimes as little as eight hours a day—the traffic police have to stand on every corner to direct the traffic of the buses, lorries, and many, many motorcycles on the major roads. We monitored both the dust and the noise and verified that indeed the traffic police were exposed in excess of the ACGIH standard. We also discovered that there was a significant amount of silica in the dust in the valley, and that led us to encourage the people at Kathmandu University to look further in terms of some of the dust monitoring they’d been doing. Meanwhile, the folks at Kathmandu University became interested in doing some additional dust monitoring, particularly in the brick kilns. There are probably about 450 brick kilns in the Kathmandu Valley and maybe as many as 800 or 900 in the country. In the brick kilns, as one can imagine, there is a lot of dust. It is an industry that employs primarily migrant workers, who are workers of the lower caste, called dalit. They are people who come from remote parts of Nepal or India, and in many cases they bring their families. There are certain indications that at least some of the family members, including children, end up doing some of the work. We have some evidence that children as young as 12 are carrying these bricks and are exposed to the dust. It turns out that silica dust and exposure to silica can lead to early-onset tuberculosis, so there’s some causal relationship we’re looking at to see whether we can identify conditions of early exposure. We’re hoping that we can figure out ways to reduce the exposure of children and perhaps all workers in ways that are cost effective and appropriate, both culturally as well as economically. I was just back in Nepal for about a month, giving a couple of lectures at Kathmandu University and collecting and bringing back samples associated with the dust and silica samples that have been collected at the brick kilns. We have an unanticipated but perhaps fortunate comparison: my associates over there, Dr. Sanjay Khanal, and a PhD student, Seshananda Sanjel, had collected samples last year prior to the earthquake, and they have since gone back and sampled at the same kilns that had to be rebuilt after the earthquake. We’re hoping that eventually we’ll get a comparison pre- and post-earthquake. Among other things, the tall chimneys, or battas, were rebuilt differently than before. Now they’re shorter and perhaps a little more squat. It’ll be interesting to see whether there is a difference, particularly in the emissions from the chimneys of the kilns. However, there might also be some indication that when they reconstructed them, they made them more energy efficient. The very preliminary indication is that they may have reduced the amount of fuel the kilns use by as much as 25 percent. That’d be very striking. You know, you’re not able to control all the parameters in every research project you do, but you can take advantage of a change in variables when they happen. TS: ​How is Nepal recovering from last year’s devastating earthquake? BC: There’s no question that they’re still recovering. It turns out that there were about eight areas in the country that were affected. It’s not that many areas, but there was dramatic devastation where they were affected. For instance, we went to an earthquake refugee camp that had been set up by the Portuguese that contained about 30 tents. The men were back in their village, Sindhupalchowk, which is probably 80 kilometers north and east of Kathmandu, trying to rebuild while the wives and mothers stayed at the camp. They were making bags and envelopes out of newspapers, decorating them and selling them as a source of funding. The children were just finishing the school year. My grandson, who went along on this part of the trip, brought toothbrushes and toothpaste to hand out to the young children there. Before we left, we saw the children in front of the water spigot brushing their teeth. That’s an example of an entire village, but some of the areas have been more readily photographed such as Kathmandu itself or Bhaktapur, where there was quite a bit of damage to major temples and historic sites, and literally whole blocks of buildings collapsed. But they’re making progress. There are pictures taken right after the earthquake where it was simply a pile of rubble, and now they’ve cleared the rubble away and you can see the outline of the streets. They are taking every usable brick, strut, and pillar, washing them off, and they’re going to rebuild. They’re not waiting for the government. At this point, the government has only allocated maybe $1,500 per family to rebuild a house, so they’re doing it on their own. The Nepali people know how to pick themselves up and rebuild their lives. They’re hardworking, very intelligent, and very industrious. I am still enthralled with our experience in Nepal.