4 October, Barcelona. The success stories of Nepalese who have gone abroad often revolve around earnings, struggles and achievements. But what happens in people's minds after leaving the country? What changes in his mental health after reaching a new society? How do you see the effect of living in migration for years?

Nepali doctor and professor has spent a large part of his professional life searching for answers to these questions. Suraj Bahadur Thapa.

Thapa, who settled in Norway and made immigration and mental health a major topic of research, is active in research on the mental health of refugees, displaced persons, people affected by war and trauma, and immigrants starting life in a new country.

He is a professor at the University of Oslo and is in charge of mental health research leadership and is also associated with the Oslo University Hospital.

Treating patients as a doctor, teaching as a professor and working on mental health as a researcher - these three roles have become an integral part of his professional life.

However, his journey to Norway's university and hospital did not begin with position and prestige. It started with a pain experienced by a child who grew up in a normal middle class family in Dhapasi, Kathmandu.

A dream born after the loss of a sister

Thapa remembers the Dhapasi of his childhood as a very different place from the dense slums of today. Farmland, village-like environment and normal family life. Father was in government service. The family was also connected with farming. While growing up in that environment, he experienced an incident in his childhood, which changed the direction of his life.

His two-year-old sister fell ill. At that time, access to health services in and around Dhapasi was not as easy as it is now. The sister died because she could not get the necessary treatment in time. Even after years, that incident remains the same in his memory.

"If she had been treated on time, she kept thinking that her sister could have lived," he recalls, "Then I thought that I should become a doctor."

That desire to become a doctor was born out of a personal pain. However, with time, that desire led his life towards medicine, research and finally understanding human mental health.

From Medicine to the Nordic World

After completing his SLC from Shivpuri Secondary School, Thapa continued his studies with science subject. At that time, there were three possibilities in his mind: studying engineering, going abroad and becoming a doctor. There was also an opportunity to study at the Pulchok campus. However, the desire to become a doctor, which had been in his heart since childhood, overcame other options.

He chose medicine. Thapa, who started medical education around 1990, completed a one-year internship after five and a half years of study. After passing MBBS with gold medal in Internal Medicine from Tribhuvan University, his professional journey as a doctor started.

While working at Narvik Hospital in Kathmandu, along with medical practice, his interest in research also expanded. Prior to this, when he was involved in research on Bhutanese refugees in Nepal, he had the opportunity to closely understand the issues of displacement, torture, trauma and mental health.

The experience connected with the life of a refugee led him to a different question - what happens to a person's mental health after they leave their country and home? With that question, another chapter of research was added to his medical journey.

His first encounter with the Nordic world was not from Norway. He visited Sweden for the first time in 1995 under the student exchange program. After spending about a month in Sweden, he was directly introduced to the Scandinavian society, its health system and the structure of public services. That short stay added a new world to his thinking.

Four years later, in 1999, he went to Norway to study. After completing two years of MPhil, he returned to Nepal in 2001. Spent about a year working in hospitals, non-governmental organizations and international research.

However, political conflicts and instability were increasing in Nepal at that time. He was again looking for a new way for his future studies and work.

At the same time, one of his former professors and mentors suggested him to return to Norway and study. Following the suggestion, he went to Norway again in 2002.

This trip became a turning point in his educational life. The topic he chose for his PhD was 'Migration and Mental Health', that is, immigration and mental health, making the experience of Bhutanese refugees and other immigrants and displaced communities the basis of his research, Thapa began to deeply study the changes in people's mental health along with the change of country.

His journey from a doctor who treats diseases to a doctor who researches the mental state people experience when they change their country, society and life became clear from here.

Dr. For Thapa, migration is not just about getting from one country to another. Before a person goes abroad, the background of his mental state is already prepared.

"Why is a person going abroad, what is his preparation, what is his family and financial situation, what is his expectation also affects his mental health," he says.

Then comes the journey. Someone's journey is easy. Some travel through war, violence, fear, trafficking or unsafe roads. Trauma experienced during travel can have long-term effects on mental health. However, even after reaching a new country safely, not all problems can be solved. Instead, for many, that's where another struggle begins.

"The post-migration factor is very important," says Thapa, "After arriving in a new country, language, work, social relations, family, one's status and the process of assimilation with the new society can have a great impact on mental health."

A person who has built a good social or professional status in Nepal may be forced to do a job completely different from his qualifications and experience when he goes abroad. From the outside, he is earning, sending money to his family, and life seems to be going on. However, inside he may be feeling that he has lost his identity and old social status.

"The status you had in your country can be lost when you come abroad," he says.

The life of Nepalis in Europe is not the same. Some are students, some are workers, some are businessmen, some are doctors, engineers or other professions. Although occupation and income are different, there may be some common reasons that affect mental health - language, distance from family, social isolation, financial pressure, uncertainty of work and not getting opportunities according to one's qualifications.

There is another level of challenge for Nepalis who came abroad with their families. The thinking, language, culture and lifestyle of parents raised in Nepal and children raised in Europe may be different. Parents value one value, the new generation makes their preferences from another social environment.

This can increase the distance and tension within the family. Thapa advises migrant Nepalis to stay connected with their own community, but not to be separated from the society they live in.

"You have to preserve your culture and identity," he says, "but you also have to mix with the society you live in, learn the language, understand the system there and build relationships with the local society."

For them, blending does not mean leaving your roots. It is to move forward while learning the good aspects of the new society while preserving the good aspects of our culture.

Mental health problems are often not caused by a major incident. Signs of it can also be seen from the changes in people's daily behavior. Lack of interest in things that used to be fun, reluctance to meet friends, frequent seizures, poor sleep, loss of interest in food, weight loss, increased fear and stress, negative thoughts or self-blame - such changes should not be ignored, Thapa suggests.

However, Nepali society is still hesitant about mental health. "The problem of mental health is not a weakness," says Thapa, "it is also a part of health."

His suggestion is simple - if there is a problem, talk about it. With family, friends or someone you trust. If the problem persists for a long time or starts to affect daily life, the help of a specialist should be sought.

Treatment is not the same for everyone. In some cases, counseling and psychiatric treatment may be sufficient, while in some cases, medication may be required. The main thing is not to hide the problem, but to identify it in time.

Physicians, professors and research leaders

While doing his PhD in Norway, Thapa continued his clinical practice along with research. Learn Norwegian. Completed the necessary procedures for medical clearance. Started working in the hospital.

After working in medicine, surgery and geriatric services, his attention turned to psychiatry. He then specialized in psychiatry. Since August 2006, he has been continuously associated with Oslo University Hospital. Since 2016, he has been teaching and researching at the University of Oslo.

Currently, he is a professor and research leader in mental health at the university. He is also involved in research leadership at Oslo University Hospital.

His work is not limited to the treatment of patients. He is also responsible for teaching students, guiding the new generation of researchers, conducting research and leading academic and institutional work related to mental health.

Immigration, refugees, war, displacement, trauma and mental health are the main topics of his research. His name is associated with more than 50 research publications at the international level.

However, beyond these achievements, there is an important aspect of his work - connecting research with people's lives.

After reaching Norway, Thapa not only continued his studies and professional journey, but also continued his relationship with Nepal. The thought that something can be done in the field of mental health in Nepal by staying in Norway led him to cooperation.

"Nepal taught me, brought me up, there was also a pain of not being able to do anything, so I felt that I should do something for Nepal even if I stayed in Norway," says Thapa.

With the same thought, he along with doctors and colleagues from Nepal started collaboration with Tribhuvan University Teaching Hospital, Institute of Medicine and Kanti Hospital related to mental health. Through seminars, conferences and educational programs, the work of exchanging the experiences of doctors, professors, psychologists and students between Nepal and Norway also progressed.

"We held seminars with teaching hospitals, institutes of medicine and the department of psychiatry, later held a big conference and got a grant from Norway," he recalls.

According to Thapa, in 5-6 years of continuous efforts, about 150 students and professors have been exchanged between Nepal and Norway. The work of providing study and research opportunities to Nepalese doctors and psychologists in Norway also progressed.

"We brought MD psychiatrists from Nepal, MPhil psychologists to professors and students to Norway and also took students from Nepal," he says. He says that through this collaboration, 6 psychiatrists and psychologists from Nepal got the opportunity to study in Norway.

Thapa says that they are also involved in developing and revising the curriculum of MD, MPhil and PhD related to mental health in Nepal. He said that cooperation has also been started in the field of child mental health.

"We wrote the curriculum for PhD, revised the curriculum for Master's and MD, and also started cooperation in the field of child mental health in Nepal," he says.

Thapa sees this work that Norway is doing for Nepal rather than a personal achievement, as an effort to strengthen the capacity development and research base in the field of mental health in Nepal.

"Staying in Norway, I have been working on mental health research, capacity development and increasing research in Nepal," he says.

Another connection with the expatriate community

Although he was established in Norway in his professional life, Thapa did not distance himself from the Nepali community. Having worked as the president of the Non-Resident Nepali Association of Norway and a member of the International Coordination Council, he connected with various levels of the Nepali community.

He has also been interested in connecting Nepali doctors and researchers with study and research opportunities and finding possibilities for health and educational cooperation between Nepal and Norway.

Dr. thinks that the knowledge and experience gained abroad should reach Nepal. Thapa says. Another form of the same is the plan to write a book on mental health in Nepali language. What is depression? How does PTSD and trauma affect a person's mind and body? How do you know if you have a mental health problem? When should you seek the help of an expert?

He plans to present such topics based on research but in a language that common Nepalese can understand. He wishes that the expert's knowledge should not be confined within the expert's room.

Looking at Nepal from Norway

Spending more than two decades as a doctor, researcher and professor in Norway, Thapa had the opportunity to understand the health system there closely. For him, who started his professional journey after receiving medical education in Nepal, the Norwegian experience was not only a matter of understanding the health system of another country, but also became a basis for looking at the health sector of his own country from a different angle.

On the question of what Nepal can learn from Norway's health system, his attention goes first to access to health and education.

According to him, health service is not a facility that is determined by people's economic status or social status, but should be established as a basic responsibility of the state.

Along with that, Dr. Thapa talks about treatment methods. He has experience that medical decisions should be based on evidence, patients should be treated according to their needs and the use of unnecessary drugs should be reduced. He considers it important to exercise caution in the use of antibiotics in particular.

For them, the strengthening of the health system is not only the addition of hospitals and equipment, but it is equally important for citizens to get the necessary treatment on time, get the right treatment and have equal access to health services.

The situation in Nepal is different from Norway. Therefore, he does not think that the practice of Norway can be taken down in Nepal. However, he believes that there is room for Nepal to learn from basic aspects such as the responsibility of the state to make health and education accessible to all, equal access to treatment and evidence-based medical practice.

Thapa, who came to Norway as a doctor from Nepal, not only built his professional life there, but also got the opportunity to see two different societies and health systems closely. Therefore, Norway is not only a country for them to live in, but also a vision to see their own country from outside.

Basant Ranabhat is the Europe News Coordinator of Online Khabar.