Bodnath Stupa and Pasupati Temple

This afternoon Niraj and I went to visit a few more famous temples. This is a picture of the Bodnath Stupa which is very famous. The whole area is owned by Tibetians and many monks live in the area. While I didn't take pictures of them we did walk into some of the rooms where they were meditating. We also saw a "Holy Body" of a famous monk who recently died. His body will be cremated in 10 days but in the meantime there is a display set up with him in it.A doorway in one of the buidlings surrounding the stupa A calendar depicting heaven and hellMe at one of the many buidlings surrounding the stupaNiraj on the phone in the area surrounding Pasupati - a very famous Shiva temple


Me in front of a Shiva statue. Shiva never has a face and is always depicted by a phallic symbol of sorts. I apologize to all of you with better understanding of the religious and cultural aspects. But here is a picture of the statue nonetheless. The main Pasupati Temple. On Shiva Day last week is was absolutely mobbed with people lined up for nearly a mile waiting to get in. It don't know where the fire marshall was during all of this.
A cremation in process. Everyday there are many cremations at this temple.
One of many depictions of Ganesh. He is the son of Shiva and there is an elaborate story about how he came about his unique form. It involves his mother and Shiva becoming angry with him and chopping off his head then having to save him at his mother's request. He used an elephant head and now prayers go through him making him on of the most famous gods. Like I said before, there are over 1,000 Ganesh temples in the Kathmandu Valley.
Milk Baba - this fellow only drink milk for sustanence and meditates alot.

My Danish friend Peter at dinner tonight. We met rather coincidentally on the way to Chitwan last week. He was on a different bus but we happened to stop at the same place for breakfast and chatted a bit. Thought we were at the same hotel but weren't so figured we lost touch. Turns out we were on the same bus back together so we've been hanging out a bit the last few days. He's going to join our trek so now we'll have 4 - Niraj, Peter, myself, and a Sherpa. Tonight I had a rather good filet mignon at a very nice place serving western style food. Tomorrow I'll take it easy and try and get over my illness. Not enough to be crippling but I'll be miserable if I try and trek in my current condition. I'm hoping a few days will fix me.

Back to Kathmandu

It was nice to get away from the city again for a few days. The lodge I stayed at was nice and clean in Chitwan but not too many people to socialize with. I read my book and enjoyed the quite. It was a rather long bus ride and I'm happy to be in one place for a few days but am very much looking forward to getting out in the mountains this week. The trip was rather uneventful although seeing the recently overturned bus at the botton of the canyon 50meters below undermined my faith in the mountain highways a bit. However, it didn't keep me from relaxing on the bus and I don't mind the long rides all that much. It was 6 or so hours to Chitwan and will be a bit further to Pohkara where we'll begin our trek. Pohkara is supposed to be very nice. It's right next to a lake at the base of the mountains. There is a great view of the mountains and their reflection can be seen in the lake.

I got back mid-afternoon yesterday and wandered my way back to Thamel with a few folks I'd met on the trip, Peter from Denmark and Christina from Switzerland. Anyway, we stopped at a rooftop cafe and chatted. I was starting to feel a bit under the weather and I continued to get sick as the evening went on. I stayed in my room most of today and downstairs to the Internet cafe is as far as I've made it. More cold/flu symptoms than your typical traveler's illnesses. I'm just a bit achy with a cold but enough to make me feel lousy. I'm hoping I kick it in the next day or so or I'll have to postpone the trek and shorten it. I'm optimistic though and think I'll be up for at least a little sightseeing tomorrow. Anyway, that's about it. I'm going to go meet Peter at a cafe in a few minutes and hopefully eat something. The Danes have the hook up for education as do most of northern Europe. He's studying the political climate in Nepal for his master's but has really spent the last 3 months hanging out trekking and diving between Nepal and Thailand. He's exhausted his education expenditures but for anyone tuition is paid and you get a stipend to live on. Like my set up but he doesn't have to pay it back. Anyway, nice guy and it's nice to have someone fluent in English to hang out with for a few days.

Royal Chitwan National Park

Me on my elephant safari - you can also see my Swiss friend Christina who is facing the camera behind me. I met her on our canoe ride in the morning and we just happened to be on the same elephant ride as well. She's been traveling for months and months now. Did a tour of Europe then more recently spent 3 months in India but she'll be returning home to find a job this weekend.

Here is one of the bull elephants at the breeding center outside Royal Chitwan National Park. After I arrived on Monday afternoon I went to the visitors center then over here to see some of the elephants and briefly walked through the edge of the jungle before settling by the river that marks the park boundary.

Here is the sunset over the park. The dugout canoes seen in the picture are what we took about 5km down the river the next morning to view the wildlife. Following the canoe ride I got out and had a guide that took me on a jungle walk. We saw lots of crocodiles and many evidences of other animals but didn't actually run into any of them.

A waterlilly of sorts that populate the river and float along in it

One of the 2 types of crocodiles they have. This one resembles and alligator with the longer snout. It eats only fish.

The other crocodile species is "much more aggressive" and will eat just about anything. Seeing at this guy was only 12 or 15 feet long I figured he'd probably start to get full by the time he got to my torso.


After the jungle walk I went by the river where they daily have "elephant bathing" and let the tourist get in the water with them. The elephants play, let people ride them, buck them off into the water, and spray them.


I think this picture actually happened first. We went and got on the elephant and at the last minute before he stood up this German fellow in quite a nice speedo decided to join me. Unfortunately, he didn't situate himself quite right and mauled me in order to stay on the elephant nearly causing us both to plunge into the water and providing quite the entertainment for the onlookers.
Here is another photo of the elephant safari. This is a different group. Turns out our elephant was giant - they all are but ours towered above the rest by at least a meter or more. It was a fun although bumpy ride. We saw some spotted deer and a wild boar in addition to the rhinos shown below.

Mother and baby rhino

And more pictures with no particular theme in no particular order

Me on the bungy bridge Another posting of the canyon since I managed to distort it below while attempting to enlarge it

On my porch during one of many rainstorms drinking tea, listening to music, and watching the rain Children during morning prayers and exercises
Some kids outside the hospital

Nepali paper drying in a particularly nice piece of farmland Monkeys (seriously, does this really need a label?)

Buff meat for sale - who's hungry? Upendra and Bimala on our walk to the Buddhist temple
Me on a mountain somewhere

Some pictures

A women using her scale at the Saturday market in Khandbari A man and his spices at the market

Upendra and Ganga taking a break during our hike down to Tumlintar to catch my flight to Kathmandu. We ended up catching a taxi for the last 3rd after we had completed the steep part.

Dr. Rajesh and the district hospital's x-ray tech our last day. Dr. Rajesh is looking in on his replacement as he does rounds.

Ok, some minimal success with photos. The first is me at the resort with the prejump jitters. The second one is me standing on the ledge about to plunge to certain death. Then is a shot of where I will meet my gruelling fate. The last picture is the next day after I've survived the jump and am headed to possibly the bigger challenge of returning to Kathmandu on public transportation. See below for the extended version of my weekend excusion.

Adventure

If you want to be really adventurous you should take a local bus through the mountains in Nepal. It's like playing rush and roulette...you never know what you're going to get but it's always exciting. As if hugging the edge of a giant canyon in a bus made in the model T era wasn't enough the passengers add to the fun. Our first but this morning on the "included transportation" which included about a US $5 reimbursement for bus fare was packed. We got on relatively early and snagged the last 2 seats in the very back amidst a pile of boxes that appeared to be full of bottles and a lone child. Within minutes the bus began to fill. Basically, there is only one road and you just kind of wave any bus down wherever you want and they'll stop (not pull over...just stop) and pick you up. Anyway, I soon had people sitting on me as all the standing room was consumed. On our second bus we were greated by an intoxicated gentleman (at 9am) who was telling someone how to catch tigers in Nepali. He pleasantly said goodnight to me as he exited the bus 30 minutes later and 9:30am. Aided by a traffic jam and detour coupled with our needed to stop every 20 minutes or so to put air in one of the tires we managed to spend only 7 hours on buses today. I have an 11 hour reprieve before I load up again tomorrow morning for my safari.

So, onto bungy jumping. Yesterday I awoke around 4:30 and Niraj arrived and we walked to The Last Resort offices where we were to leave at quarter til six. It took awhile to get going and our bus wasn't anything special. There was a large group going representing a half dozen or so nationalities. My entertainment while waiting to leave was the British guys who couldn't remember what hotel they were staying in although they'd just left it minutes before. They got the bungy people to dig out their documents to see if it was listed...it wasn't probably because they didn't know it then either. Don't know if they ever made it back to their hotel last night. Niraj and I were the only ones that decided to stay overnight at the resort. Anyway, we eventually made it to the resort which is in a beautiful location about 12km south of the Tibetian border.

Once there we all walked across the bridge to the resort. There were gasps and much cursing as we walked the suspension walking bridge over the gorge...the one most of us were about to plunge off of. After the weigh in I found out that I was lucky enough to go first as I topped the heavyweight division. I edged out the Icelanders by one kilogram (but I got the Malaysians by a good 15 or 20 an at least 6 inches). Anyway, not only did I find out I'm fat I also had to jump off the bridge first. The "heavy group" marched out onto the bridge. It inclued the 2 medical students from Iceland and the Brits all of whom were pretty pumped and vocal and very very scared. I figured they'd demonstrate or something or at least test the bungy cord that had just been set up with a dead weight or something but no...I was the dead weight to make sure it was safe for everyone else. If it could hold me and not bash my skull against the rocks everyone else was ok. So, like I said 160m or almost 500ft doesn't sound all that high to jump off of but let me tell you it looks pretty far. Anyway, I walked up, got strapped in by my ankles, walked to the edge, waved to the camera and when the bungy instructor (the largest Nepalese man I've seen thus far wearing a jacket with "DIESEL" stenciled on the back) said "1, 2, 3, bungy" I plunged off headfirst. It was rather anticlimactic actually but still a ton of fun. It's the 2nd highest bungy jump in the world. Only one that is 220m in South Africa is higher. I waited at the bottom and the Icelander's made it down. They were pretty pumped and we all shared stories and watched a few more people jump before the hike back up the canyon.

Afterwards I hung out with the Icelanders. They're medical students although they're only one semester in and are taking time off. It didn't start so smooth for them and they're aloud to take 2 breaks so they've been traveling. They just spent a month in India and are headed to Bangkok tomorrow. Anyway, nice guys. Iceland sounds pretty good other than the fact it will be one of the first casualties of global warming. Only 300,000 people all employed with basically no poverty they said. I think all of their education is paid for also. After lunch and watching everyone's videos the bus departed taking everyone except for Niraj and I. We stayed the night and had dinner there. The lodge is a beautiful open building with a tin roof and very nicely arranged with lowlying tables on slightly raised portions of the lodge surrounded by pillows for lounging. There is a bar at one end and nice lighting. They played music through the system and I sat in there and read most of the afternoon. We had a rather American dinner of grilled chicken breast, mashed potatoes, mixed vegetables, and cole slaw. We retired early to a nice tent with beds and we stole extra blankets from another vacant tent. I'm glad we stayed up there despite the bus ride today. It was peaceful and comfortable. I wish I had the energy to describe the setting and the resort more adequately but the scenery is stunning and the resort very classy and tasteful. It's the kind of place I'd like to spend an extended amount of time at again or maybe own and run in my 20th imaginary career/retirement plan. Anyway, great trip. Wish I could get the pictures on here for you. I've gotta go grab some dinner and repack for my safari tomorrow. I'm flying solo this time but I think I'll have a tourist bus both ways so I shouldn't get too lost. I got so lost wandering Thamel (and greater Kathmandu) this evening looking for a particular book that I had to take one of the bicycle cabs back to my hotel. I don't think I'll stray too far for dinner.

Shiva Day

Ok, so I'm foolishly attempting to replicate my picture success from Friday morning. However, I also foolishly assumed that the electricity and Internet would concurrently cooperate all day Friday and that failed to be the case. Anyway, after my big picture posting success Friday morning Niraj met me here at the Internet cafe and we went on a temple tour. Kathmandu has approximately a billion temples. For Ganesh alone there are literally 1,000 temples in the Kathmandu Valley. Our main objective was to visit the Monkey Temple which has another more professional sounding name but is thus referred because monkeys line the walkway to it. To reach if from the front you must climb 365 steps up a large hill. From the temple you can see the entire valley. The view is quite spectacular and is only marred by the pollution. It's rumored Kathmandu has the 2nd worst pollution in the world following only Mexico City. What an illustrious claim to fame. Anyway, we also visited a variety of Hindu temples along the way. Friday was a huge holiday here. It was Shiva's birthday so the temples were full of people making offerings and prayers. The streets also had intermittent civilian road blocks where children (and some teenagers - they blocked a main road with a giant bamboo pole) would hold up string across the road to stop vehicles to request money. They use the money collected to have a big party at night. I went to bed early on Friday but definitely heard parties until 4am (I had to get up at 4:30am to leave for the bungy trip). Anyway, the holiday made for some good sightseeing/people watching.

The monkey temple is quite impressive and I'm not brave enough to attempt spelling the real name in print. The steps up to the temple are lined with vendors, statues, and monkeys. One of the more interesting and horrifying things we saw was some of the monkeys carrying something and then taking it up into a tree and dropping it repeatedly. On closer inspection it turned out to be a rather large frog they had found and the repeatedly took it up into a tree and dropped it onto the rocks. After 5 or 6 repetitions that Niraj and I observed they managed to kill it and instantly lost interest. On the way down we fed them some cookies we purchased at the top. The monkeys are shameless and will pluck them right out of your hand with the big ones wrestling food away from the smaller ones if you aren't very deliberate. We also visited the Durbar Square in Kathmandu. The architecture is interesting. Lots of very old temples. Many of which have been converted into businesses. Alright, better move onto the rest of the weekend before it gets too late.

Another Picture Attempt

Ok, I think this may actually work. Here is a picture of Bimala in our "living room" with a chicken. The other picture is Upendra and I attempting to get Makalu in the background. Unfortunately, it is 90% obscurred by the tree. I'm back in Kathmandu now and am heading out in a few minutes to do some sightseeing with Niraj my tourguide/trekking guide. I think it'll be a fun day. We're going to the Monkey Temple which is a famous Buddhist temple. The name comes from the Monkeys that live there and entertain tourists. Then we'll go to Durbar Square in Kathmandu and look at the Malla Architecture. Finally we'll wander around Thamel and do some shopping. I think I'm going to try and get a down jacket. It has persisted to be cold. The day before yesterday they had the first snow in the Kathmandu Valley in 60 years. Yesterday was beautiful and warm but it is cloudy and cold again today. I slept in my sleeping bag and under the covers at the hotel last night as they don't have heat anywhere. However, there is hot water and a bit more variety in food both of which are a welcome change. Ok, going to attempt to publish this with the pictures. If it works I'll give a more thorough update along with more pictures this evening. I also changed the timestamp so that it reflects my time now.

Poverty

Yesterday morning I sat on the front porch with my coffee and watched a man plowing his field just on the other side of the street. Using age old technology of 2 oxen and a rudimentary plow he worked on his small plots of land carved into the side of the hill. The hills are steep and all throughout the country-side tiny plots of farmland have been carved into the side of the mountains creating a stair step sort of pattern. Fields are rarely more than 8 or 10 feet wide (many only 4 or 5) and then there is a drop off before the next plot. The poverty here is striking as I think I've mentioned. However, western culture is sneaking in as the presence of professional wrestling attests. Also, despite being a culture that doesn't know anything about baseball the evil empire (the NY Yankees) has infiltrated and Upendra along with many others has a hat that bears their logo.

Despite being so far removed here western culture has still managed to rub its affluence in the face of extreme poverty. Cable TV is relatively common and yet neither hot water nor clean water is easily accessible. It seems to be a bit backwards to me. Additionally, there is no means to create more wealth here that I can see. The rural areas are certainly not capable of becoming industrialized anytime soon and the natural resources are already stretched with poor farmland and the people lacking the capital to buy even simple tools that could increase the agricultural productivity. There are some good strides being made by the Britain-Nepal Medical Trust and the Public Health Office. They have community training programs where women are trained in some basic things to teach to others in their community since there is not adequate access to medical care. However, these organizations are wrought with corruption as Dr. Rajesh has been frustrated lately. The Public Health Officer has been trying to get allowances for trips into the district that he didn't really take.

While in Nepal I've slowly been reading through a book I received for Christmas from Michelle who reads entirely too many books. The book is called "Rich Christians in an Age of Hunger" by Ronald J. Sider. This is definitely an appropriate time for me to be reading it as I am surrounded by poverty and have the time to wrap my mind around the concepts. The statistics he refers to are staggering and there are some practical suggestions that can be embraced by all who really want to help stimulate change. Just because it has "Christian" in the title doesn't mean it's not worth reading for the rest of you. His theology is for the most part limited to 2 chapters and I think everyone should read it. I'd be happy to buy it for anyone that will actually read it. Anyway, it is a challenging book to say the least and compliments my experience here well. The gap between rich and poor continues to grow both at home and here.

 

Yesterday afternoon Upendra took me on a walk to a cave. The walk was basically straight down the side of the mountain for an hour to a small waterfall and cave. My knees were killing me on the way down. While my knees felt better on the way back up I thought I was going to die so we'll see how I fair on this trek. However, I've never hiked anything as steep as the walk we took yesterday so I seriously doubt my trek will be quite as intense. It was so steep I slipped a few times even though I had solid footing. Watching children hop around and run down the side of the mountain made me feel pretty bad though. I guess growing up here necessitates agility (maybe there is some natural selection going on). Anyway, we may go back to the cave again today just for the exercise. It's about 1pm on Tuesday afternoon at the moment. I'll be heading back to Kathmandu on Thursday.

Leaving

So yesterday Dr. R told me he will be leaving for Kathmandu today (turns out it will be tomorrow) and a new doctor arrived. Seems like it just happened but it allows Dr. Rajesh to leave Kandbari which I think he is rather happy about. He's been here for almost a year and a half and is the only doctor in the district. The district is pretty big and Khandbari is the "capital" or something. Anyway, it's the biggest town and the district spreads for quite a ways in every direction. People from 16 different regions in the district call him daily to consult on cases. He must round twice a day on the 15 or so patients in the hospital and has an outpatient clinic 6 days a week. Sundays are usually the busiest because Saturday is an off day. We have seen about 60 patients on Sundays. He says the summer is much more busy with around 100 patients a day. This is mostly due to gastroenteritis because the water is not purified and giardia and other bugs are rampant. Also, typhoid fever and malaria are more common in the summer. I'm pretty sure I'll come down the the symptoms of malaria soon as I got a mosquito bite in the middle of the night last night. Figure if it was bad enough to wake me up it probably was a disease ridden mosquito.

A few entertaining things about the hospital. First, it is rather dark and dank (ok, not entertaining more depressing). Only one or two fluorescent lights in each large room that houses 5 beds. I noticed birds flying in and out (more entertaining for me) then a few days later noticed that there is actually a birds nest in a corner of the main corridor. Their are also often dogs wandering in and out. I've gotten used to it but everything here is quite different. There are always dirty children, chickens, dogs, goats, and trash in the streets. One striking difference from other places I've been is that there is barely any begging. When I was in Brazil you couldn't walk 10 ft without someone asking for money. Here I've only seen one beggar. The power continues to be spotty. I am still able to watch professional wrestling and some BBC news so I heard about the shootout in Salt Lake, Anna Nicole Smith's death (definitely world news), and something in Palestine but I haven't really seen enough to get the whole story. Anyway, I think this is a bit random and eclectic as I've been vacillating between writing emails and this. I'll post something more coherent in a minute.

Plans

So, I talked to Niraj my "guide" this afternoon. I had my ticket back to Kathmandu moved up to this Thursday so that I can see some of the sights in the Kathmandu Valley, go bungee jumping at the Boti Kosi gorge, and take an elephant back safari in the Royal Chitwan National Park. Then we'll head up to Pohkra where we'll leave for our trek to Annapurna Base Camp. I think getting out and seeing the sights will be fun. I've enjoyed very much my time in Khandbari and seen great pathology (which I will one day write about for those interested) as well as met great people. However, I figure while I'm in Nepal I ought to see the great Buddhist temples and the other sights. That's my plan for now. I'll go to the Monkey Temple, Bodnath, Bhaktapur, and Patan in the valley with my safari and bungee jumping intermixed.

A Little More Concise...maybe

Ok, Friday I "worked in the clinic" but we only had 3 patients all day. I think I did one ultrasound and listened so some kids heart. That evening I went and rounded with Dr. R then went by Prakash's house. He is the medical assistant at Helping Hands and lives right by the district hospital. Anyway, he's a great guy. 26 years old, married with a 6 year old son and a very pregnant wife. He invested in a pool/snooker table about 6 months ago at the cost of over US $1,000 a staggering sum for someone who only makes 5,000 rupees of about US $75 a month. However, he has it set up downstairs and charges 20 rupees a game and last month he managed to break even. With it he will manage to more than double his income which I think is very impressive. It just shows he's a pretty bright guy. Anyway, I went over and hung out upstairs with him and talked with his little boy. He was doing homework and his writing is very good for his age. Prakash, his wife, and his boy all live in a room that is about 8 x 10ft and their kitchen is a 2 burner stove set up in a tiny hallway leading to their room. Later, he showed me how to play snooker. It's like pool except there are 15 red balls and 6 others. It's points based and you must get in all the red balls in before the other colors will stay. However, if you get a red one you may shoot another one and get the points that ball is worth. It's not too complicated but I think it involves more strategy than pool.

Saturday we only had 1 patient at clinic. I spent most of the day wandering around the clinic and learned how to play Carem Board which is the national past time. It's a table and is much like pool except it is a chalked surface and flat disks replace the balls. It's fun and I played with a bunch of little boys who were highly entertained by me. After we closed the clinic at 2, Upendra and Bimala took me on a long walk to a Buddhist temple. We also visited another one on the way back. We stoppd and had samosa and curry for a snack. It was a nice afternoon and I really like them. Upendra loves taking pictures so there are many pictures of him that I took and many of myself in various locations. We also went to the market of "Saturday Bazaar" before I rounded with Dr. R that morning. You can basically buy anything there. Upendra went around trying to get the best price on rice and vegetables for our daal bhat. He's been calling himself Dr. daal bhat tarcari (lentils, rice, and cauliflower) since he is the cook. He feeds the 3 of us on 500 rupees a week or less than US $8. Again, my money got lost somewhere in transit but I also see that I could be quite happy living pretty simply. Ok, there is lightening outside and I don't trust the electricity to stay. It was cloudy again today and now is rainy.

Rain on Tin Roofs

Wrote this on Friday but the internet and electricity have not been working simultaneously until now...it's Sunday afternoon.
 
As I was leaving the internet café or "cyber" last night it had begun to rain which midway home turned into a torrential downpour followed by thunder, lightening, and hail. Rain on a tin roof is usually rather nice but hail on 100 tin roofs is quite deafening. I made it home just as the street was turning into a violent muddy river. I probably haven't adequately described where I am and the surroundings. The main street is dirt with rocks of varying sizes. It is rather uneven and in some places crude steps have been formed but for the most part it is quite difficult to even walk on and can be treacherous when wet. It is quite hilly where I am as the village is on a ridge settled amongst the mountains. As far as outsiders, I was the first foreigner to land in Tumlintar since January 6th. They have a book that you must sign if you are a visitor and provide you passport number, etc. During the fall I think they get a few more trekkers passing through as the path to Makalu one of the 8,000 meter peaks begins in Tumlintar and goes through Khandbari along with another week long trek to Makalu base camp. Anyway, I am the only foreigner in the district and it is kind of nice. It's fascinating to see what life in the district is really like and it only sets in after a few days.After getting home and being urged out of my wet clothing by my hosts who take excellent care of me I settled with a cup of tea on my porch to watch the rain. I sat outside for a couple of hours and watched the rain and contemplated life. Time to sit and ponder life is a rare commodity at home and it was nice to be completely relaxed watching the rain listening to some of my favorite music. It made me think of all the things I wished I had more time to do at home (or made the time to do) like play my guitar and cook. Anyway, it turned out to be a lovely evening. Upendra and Bimala went to bed early and I watched the 1st half of "Return of the Jedi" which was on the English Stars movie channel. For some reason the cable was upgraded yesterday and we now also get HBO and BBC News so maybe if the TV has to be on first thing in the morning I can catch up on some news rather than professional wrestling.

This morning the sun finally showed itself and it was a beautiful day. Out the back door we can see Mt. Wana which is a smaller peak but still looks rather impressive. Off the front porch Makalu is obscured by some buildings but some of the snow-covered mountain leading up to it can be seen. I don't know if I've adequately described the clinic yet. It is a 3 story building set on one of the main streets in town. There are porches front and back on all levels. The front opens to the street then beyond the land drops off to some homes and gardens that are below then just beyond is the school run by the same organization as the clinic. It continues to drop off into a valley and then mountains beyond. The back is similar except there is not immediate road. It also drops off into a valley and there are some houses/gardens visible. The valley floor is not visible from either side but mountains are in view from both the front and back. There is a 2 room outhouse off the back of the building and a small shower/wash room. The lower 2 floors of the building house the clinic including receptions area, pharmacy, lab, ultrasound room, x-ray room, GYN room, office, and examination room. On the 3rd floor are our 3 bedrooms, a small common room, and a kitchen. The common room has a bench and a few chairs, a coffee table, and a TV with stand. The kitchen has a sink, a 2 burner stove, and a table. Each room has one bare light bulb. Large open windows are in every room along with a doorway out to the porch. My room has a desk, chair, and a bed. The bed is a wooden frame with a thin (maybe 1 inch) cotton pad on it and a thick blanket. The floors are very uneven and I'm not sure what underlies the ancient linoleum that covers them. The walls are also badly in need of paint but the building serves its purpose. I'm not so convinced the clinic is all that much of a charity organization more of a business. Prices for labs, x-rays, and such are similar or just a bit more than those at the district hospital. They also charged my $250 for my flight from Kathmandu to Tumlintar which can be purchased for $90. If there was an understanding that they were overcharging to raise money or trying to make money this would not bother me but I was told this is how much the flight was. Also, the medical care provided is not free or subsidized for people and I'm not sure who profits by the 'extra' money that I have paid. I also paid an extra US $250 for an "extra month" which will really be only 5 days but I didn't push the issue at the time. Anyway, I let myself be a little annoyed for a few hours but am trying to let it be and not let it bother me. It's just money and I'm very lucky to be here. What bothers me most is the people who need my money the most aren't seeing it.

Despite feeling somewhat mislead as to the nature of the organization and the related costs the people here are fantastic. They are kind, caring, and happy. The patients are glad I am here although I don't actually contribute much. The guys at the public health office were also grateful that I was here to see the situation in the district. It is much more poor here than in Kathmandu. In Nepal 88% of people live rurally in the hills and 80% make their living by agriculture. 82% of Nepalese people live on less than US $2 a day. The poverty is striking but efforts at improved education and health are in progress. While the Helping Hands clinic and school both appear to be for the most part a business they serve a much needed purpose here. Ok, this seems to have developed into a long rambling so you should be commended if you made it this far. I'll have to see if I can get online and post this. I will have consistent internet access for the next week so feel free to email me at porterjasona@gmail.com as that address is easier for me to check than my other one. Hope everyone is well.

Roxy

So, the sun was just a tease yesterday morning and lasted about 5 minutes leaving us only to be re-engulfed in the cloud. After rounds at the hospital yesterday morning I went back to Helping Hands for the day but there were barely any patients so I mostly just hung out and read. In the afternoon Upendra and I went for a long walk. Afterwards I braved a cold shower and went back to the hospital for rounds. En route I stopped and attempted to upload some pictures at D.N. Shrethsha's (the Chairman for Helping Hands) house/business as it's the best computer I have access to. Unfortunately my attempt was a failure.

I ended up being a few minutes late and missed rounds but Dr. R was sitting outside talking with someone and I suspect he was waiting to see if I'd come by. We went for a walk then back to his house where we had some food and roxy. Still not big on the roxy but I choked down one small glass then declined a refill and opted for water. The stuff is really pretty vile. We also had some spiced buffalo meat with rice noodles, peanuts, and some puffed rice sort of stuff. It was good and a nice gesture. I feel bad for him. He said he didn't used to like the roxy either but now it has become habit. He drinks it every night because of "lonliness." There was another doctor here with him before but he left awhile back. They apparently used to have dinner together every night but now I don't think he has any good friends. He does spend time with the 3 paramedics but I guess it's not enough. Anyway, it made me feel bad that he drinks every day because he feels lonely. Really nice guy and a good doctor. He covers the whole district but more about that later. He also listens to some music in English. His tastes cracked me up. We listened to some Maria Carey and the Eagles. He also likes Christina Aguilara and Brittany Spears.

This afternoon the guys at Helping Hands (Ganga and Upendra) took me to get samosa for our daily small afternoon meal. They call it breakfast but I explained that we call a small meal in the afternoon a snack. Anyway, I had told them that I liked the samosa I had with Dr. R a few days ago so they took me to get it since they can't make it. Last night on the way back from my 2nd roxi experience I also played a game of pool with Parkash (the medical assistant) at his house. He has a table where people play pool and snooker and I think he charges people a little bit. It's a chance for a little entertainment though so I think I'll play over there again. Something to do that doesn't take complicated communication. Some tidbits of good news in the last few days. For one, I found a plug for my iPod charger which I didn't think I'd be able to use while here so now I can listen to as much music as I like. They are all quite fascinated by my iPod and I've been lending it out since I found the plug. Also, the samosa I like and oranges which are excellent here are only 5 rupees a piece or about 7 American cents so I can eat samosa and oranges (more like clementines) whenever I need a change from daal bhat without breaking the bank.

Pictures

Aren't going to happen. I've tried desperately but I think I'll have to do a mass posting of pictures when I get home.

Cloud

So, the first day or two I was here it was cloudy. However, the past 3 or 4 days I think we have actually been in a cloud. Upendra washed some clothes a few days ago and it appears to me that they are probably wetter now than when he pulled them from the water. It's also been cold. I've been sleeping fully clothed including a hat in my sleeping bag. This morning the sun finally popped through after raining all of last night. Now it is warming up a bit and hopefully my clothes will dry so I can change. If it gets really warm I'll brave the cold outdoor shower again. I couldn't muster up the courage yesterday to strip for a cold shower only to dive into my sleeping bag in hopes of avoiding hypothermia.

I apologize if I repeat myself on here. What I've written here, written in my journal, and thought I should write all become a bit blurred. I've decided that a blog is the perfect venue for a narciscist. You can talk and talk without ever listening. It also protects the illusion that what you have to say must be important and that someone actually cares since it is posted on the internet for the world to read. I'm getting pretty good at one-sided conversations anyway since I can communicate but not truly converse with most people here.

Dr. R speaks English fairly well and I think we are becoming friends. He understands a bit better than he expresses. As I may have said before he studied medicine in China for 7 years but is Nepali. Yesterday after clinic he took me to the public health office and introduced me to the Public Health Officer and the staff for The Britian Nepal Medical Trust who also work on improving public health. The people there also speak English fairly well and explained that speaking is harder for them because they don't get any practice. However, all of their studies the written portions are in English but they speak in Nepali so they can read and write quite fluently. Anyway, more about them and their health projects later. They are doing some really excellent things though and having all come from bigger areas and 2 of the 3 being young single guys it's quite a sacrifice to be here in Khandbari without a disco or anything else to do.

After I chatted with the guys at the public health office for awhile I found Dr. R again and he had me stick around until evening rounds. We went to his house and had some tea. Then we had samosa an Indian dish that is some sort of friend breading around potatoes and vegetables and served with a curry. It was very good and nice of him to have me over and try something not daal bhat as I think he knows the same thing for every meal is a change for me. Well, hopefully the mildly improved weather will continue and it will warm up a bit here. I'm off to clinic at Helping Hands. I'm alternating days between the Helping Hands clinic and the District Hospital Clinic. I've seen lots of great pathology which I'm sure I'll write about later as well.

Food and Beverage

So, the Nepali staple is daal bhat which literally means lentils and rice. They have it at least twice a day around 10 or 11am then again around 7pm. Some sort of cooked vegetables are also served with it. The rice is on one plate and the daal and vegetables are in separate bowls on another plate. All are mixed together and eaten with the right hand. As I think I said before I can't master eating wet rice with my non-dominant hand so I've stuck with a spoon. Sometimes I also have a fried egg with the daal bhat. For breakfast and a late afternoon snack I've been having noodle soup which is basically ramen noodles in an extra salty broth.

Nepali tea is the staple beverage. It is basically what we call Chai tea latte. They have it first thing in the morning but I brought my French press and a couple of pounds of Starbucks which is the best idea I've had in years. The coffee with some sugar and powdered milk is an excellent way to wake up on the porch overlooking the mountains. Anyway, we also have tea either before or after rounds at the hospital. I like the tea at the hospital as it's a bit spicier. The other night Upendra and Ganga also had me try the local alcoholic drink roxy at Ganga's house. It was pretty vile really but when they asked me how it was I could only say it was ok not terrible and forced myself to drink the glass. I couldn't get the idea that the stuff my cause me to go blind out of my head as I drank it. However, they all appear to see fine so I think I'm in the clear. While I've never had moonshine I think that's basically what roxy is, a homebrew of sorts. I also had the Everest beer when I was in Kathmandu with dinner the other night. It was pretty good just your generic beer like budweiser or something. Anyway, I'd better run and had my morning daal bhat before returning to the hospital for Dr. R's (I cannot say and have no idea how to spell his name) outpatient clinic.

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Trapped

I felt a bit locked in yesterday. The electricity was not working and it has been very cloudy since I've been here which means no flights have been leaving from Tumlingar. So, in essence I am trapped here until the weather gets better. Additionally, it has been rather cold with all the cloud cover. While the temperature probably has not dropped below 40 degrees without any heat it is a bit uncomfortable in the mornings and evenings. I've been sleeping fully clothed in my sleeping bag. During the day it is not bad although the people here have been complaining about the cold.

I also felt a bit lonely yesterday morning but soon got over it. Knowing the Super Bowl was going on while I was having my coffee alone on the porch but having no way to check the score was a bit disconcerting. It's the small things I guess. However, when the power is working the TV in the house which has cable does get ESPN in English. Unfortunately, it appears to be a 24hr Cricket network. The TV also gets professional wrestling at about any hour of the day also in English (America's influence on the 3rd world) so I can watch WWE over my coffee while I listen to the village wake up. I've done some reading and played some more chess with Upendra to fill the time. It's good to have some down time after a crazy couple of months so I think I'll continue to adjust until I run out of books which won't be too long.

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District Hospital

Just for reference - if my blog appears invisible under a visible heading it is because I forgot to change the color from black so you must highlight it in order to read it. I fogot as you can see below in my rafting blog. Anyway...

 

The first night in Khandbari Umpendra took me to the district hospital and I met the doctor there. There is no doctor in the Helping Hands Clinic right now just an assistant. The doctor at the district hospital has been there 14 months and works for the government. However, he will not be staying much longer. There is little incentive as there is no one to learn from and the pay is not good. Additionally, he is not from here and has no family so he would like to continue his training elsewhere. He told me to come back the next day at 9am for rounds so I did.

 

The hospital is 15 beds in 3 rooms plus an OB room. The patients have many lung diseases and there were a number of babies with gastroenteritis. They are able to provide basic treatment much like we do back home. Metronidazole and IV fluids for gastroenteritis, antibiotics for pneumonia, O2 and steriods for COPD, and DOTS for TB. There are 5 beds in each room filled with pts with the above stated diseases. Also, pts with bad but closed fractures were there. Today (now, Sunday), we reduced 2 bad breaks in children. One, a supracondalar fx in a little girl definately would have been surgical management in the states but they cannot do open surgery here so we gave her ketamine and reduced it. There is a guy that is very good with orthopedics and her reduced and casted her and another boy with a Colles fx. Anyway, rounds are quick and there weren't any new patients yesterday or today. Before or after we have some tea and the doctor talks a bit with his staff and does brief notes. I just drink the tea and respond if he addresses me as Nepali is basically impossible for me. I can say Namaste which means both hello and goodbye - you place your hands like you're praying and bow your head when you say it.

 

Saturday is the big market day and on the way to the hospital I walked through there with Umpendra. After rounds I returned to the Helping Hands Clinic and met the assistant. I have no idea how to spell his name...something that starts with a "P". Anyway, I saw some patients with him before returning the the hospital for evening rounds. We saw a variety of complaints. They have an ultrasound machine so we used that and did abdominal scans on some folks. One little boy compaining of abd pain had gallstones that were clearly visible so we refered him for surgery. Unfortunately, that means going to Kathmandu involving the trip I spoke of before. By the way....by my own very scientific method I decided a pressurized cabin does not exist. My water bottle on the way up lost all of it's creases which I expected to happen a bit. However, after taking a drink at elevation the bottle imploded in my hand thus confirming my suspicion. I'm sure the boy would survive the trip as I did but cost is the real issue. After clinic I returned for brief evening rounds. There was also a trauma pt who had hit himself in the head quite forcefully with a machete. He was hacking branches and managed to hit himself in the back of the head hard enough to slice to the bone and fracture his skull. We talked a bit about the management of trauma and today saw the x-rays of his skull.

 

After rounds I returned home and played chess with Umpendra. Apparently in Nepal you get to take 2 moves to start. They call all the pieces by animal names for the most part but still refer to Castling. Anyway, it was nice to play a game and of course I like to win. I hope we can find some other games or activities that allow me to spend time with him and Bimala without too much verbal communication. Alright, lets see if I can change the color on this one the first time.

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Khandbari

Friday morning I woke up early and arranged my belongings because I could only take a portion of them to Khandbari. Then I got breakfast and waited in the hotel lobby to be picked up to go to the airport. After a few phone calls I was eventually picked up at 10:15 for my 11:20 flight. I made it to the airport and without too much trouble got my bag checked, paid the airport tax, and made my way to the departure area. Unfortunately, the screens announcing departures were not working properly and I had no idea which of the 2 gates or when I would be departing for my flight. Apparently the "help desk" does not exist but an overhead voice announced in what appeared to be English that my flight was delayed until 14:00 or so I thought. I was sitting only somewhat anxiously chatting with a Tibetian monk and writing in my journal around 12:45 when I by chance heard someone at one of the gates yelling "Tumlingar" which is where I was headed so purely by luck I made it to my flight.

 

My anxiety was peaked when I boarded the bus to take me to the plane. The bus didn't look like it should run and sounded like it might no run for much longer. The flight was rather uneventful. The plane seated about 20 people and had great views of the mountains despite it being a bit overcast. We landed at the Tumlingar airport which is a grass strip on a plateu with the Arun river on one side and the mountain on the other. I was met by Umpendra who I initially thought was just a boy sent to pick me up but it turns out he is my cook and 22 year old. He and his wife Bimala are staying with me above the clinic.

 

The journey from Tumlingar to Khandbari was interesting. I had initially planned on hiking but since it has been dry the road is "good" and passable by 4wd vehicles.Our vehicle was a large jeep. It started off with 15 of us inside and one person on the roof with the luggage. Later, after one of many times the vehicle stalled Umpendra got traded out for a stereo that the couple sitting across from me was transporting. After multiple stalls that resulting in having to push the jeep backwards down the mountain in order to restart and one tire change we made it up to Khandbari. The people in the jeep were nice. A very pleasant couple and their stereo sat across from me. A tiny woman sitting to my right kept dozing off clutching her backpack in front of her and leaning on my shoulder. Near Khandbari we picked up an old man who I suspect was intoxicated. He provided entertainment for everyone as he crouched between the stereo and the dozing woman and attempted to communicate with me. All in all it was a successful trip and I'm glad I didn't have to hoof it. The people are very pleasant with good faces and a mix of modern and traditional attire.

 

Khandbari is on a ridge of the mountains and is a fairly large village. It is the capital for the region. There is a 15 bed district hospital where there is a docto whom I am going to work with a bit. He agreed to teach me in exchange for sharing what I know. In fact I must leave soon for evening rounds with him. We already saw all the patients this morning. I am staying in the upstairs of the clinic. There is no doctor but the assistant has been working there for 6 years and seems to be very good. Umpendra, his wife Bimala, and Ganga the clincs accountant all sleep on the same floor as I do. The views from both the front and back of our level are stunning. I enjoyed coffee on the back porch this morning with Ganga as the sun was rising. It was a bit overcast but still nice to be outside listening to the town awake looking at the misted mountains. Ok, back to the hospital now.

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Rafting

Wednesday night I returned to the hotel as it was getting dark. I braved the streets by myself and was trying to make it home before it got too dark since Niraj said after the electricity is turned off it can be dangerous. Yes, much of the electricity in the city was turned off at 6 although it seems like it was on later on Thursday night. Anyway, I completely walked past my hotel and had a moment of panic where I felt quite lost and vulnerable. However, after asking directions I managed to get back to my hotel and proceeded to almost fall asleep while waiting for my very delicious dinner in the hotel restaurant. I went to bed at 8 but woke up at 5 which is a trend I've continued while here.

 

Ok, onto rafting. Niraj met me at 6am and we went and picked up Jo at her hotel. He then dropped us off at a bus that was to take us to the rafting spot. The route involved the main highway in Nepal that runs the whole way to India. The Prithiv Hwy is a narrow winding 2 lane road that joins the Trisuli river outside of Kathmandu and follows it west to India. After about 3 hours we arrived and were met by our rafting guide and his two helpers (they just helped us to paddle since there were no other clients). Since it is the dry season the rapids weren't as good as they are during the monsoon season but there were still some fun ones maybe one or two class IV rapids and at least a handful of class III. It was nice to be outside on the river and we passed many small villages and people working/playing/bathing along it. The main industry is that of making sand and gravel. Young men with pick axes were breaking up large rocks in the river bed. On the side of the road you could see small children and elderly people with hammers smashing smaller stones into sand. Many walking bridges also spanned the river and led to good people watching. Anyway, it was a lot of fun. Back in Kathmandu we got massages and had dinner at the Kathmandu Guest House's restaurant. I then returned home and was back in bed just after 8 although once again I missed my hotel in the crowded streets. This time however they had closed up the front so it was completely indistinguishable from all the other closed store fronts.

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