I recently finished Crime and Punishment by Fyodor Dostoevsky. This book has definetally cemented Dostoevsky as my favorite author of all time. This is probably one of my favorite books along with Notes From Underground. The story of Crime and Punishment was fabulous. The thing I love most are the depth of the characters, my favorite being the protagonist Raskolnikov. He is so very multidimensional, while reading the book I wished to be friends with him. He was so very real. I loved how strange Raskolnikov and loved to read his thoughts. Dostoevsky's characters are endlessly fascinating. Raskolnikov is so logically irrational, or maybe he is so irrationally logical. Is he madly sane or insanely mad? Well, I think a little bit of each one, and that is why he is a wonderful character. I feel as though I could read the book a thousand times and discover new bits about it with each reading. This is what I plan to do. Well, I obviously loved this book and recommend it to everyone. Fantastic!
I also recently finished a book called 1700 about London city life during this time period, by Maureen Waller. For some reason, I felt like reading European history. The book has chapters on all aspects of life from London in 1700, including Death, Disease, Marriage, Childbirth, Prostitution and Vice, Coffeehouses and Taverns, Working, and Crime and Punishment. My favorite sections were probably the ones on Crime and Punishment which go into detail about being sent to the gallows, and Disease which was interesting as many of the diseases from London in 1700 exist here in Kathmandu at the present.
I am currently reading a volume of Roald Dahl's short stories. I think most of us know Dahl for his children's books but his short stories are wonderfully dark and twisted. I find myself continuously laughing at the black humor and satirical stories. They are great! My favorite so far are the stories called "William and Mary" and "Royal Jelly."
Sunday, July 29, 2007
Kuber's House
One of the wonderful things about being here is that everything turns into an adventure. The minute you wake up, the minute you step out of the door, life turns into a fabulous adventure. This phenomenon happened yesterday on our visit to Kuber's house. Well, now I look back on it and think it was a wonderful adventure. At the time, not so much. But as long as you can look back on things, and think they are funny, then it's all good.
So, we planned to visit Kuber's house on Saturday and meet his family. Kuber is our... servant? I hate that word, but I'm not sure when to call him. He cooks our meals, cleans, generally serves everyone. Anyway, we've become great friends with him. He is 17 years old, and a typical pubescent blubbering boy. He is quite amused by us and I think really likes working at the house and getting to hang out with us. Kuber is quite a funny young lad, his English is not so good which sort of adds to how entertaining he is. He just failed his English test, so we are all tutoring him to help him pass his next test. Kuber has a habit of saying "Ok," to everything that he doesn't know what we are talking about. Examples: "Kuber, when is food ready?" "Ok!" or "Kuber, what did you do today?" "Ok!" All of us have become quite good friends with Kuber, he is like our little brother in a sense. So we all decided we must meet Kuber's family. All we really knew about him was that he is from a village and has worked for Anuj for a while. So we woke up early Saturday morning and left to meet Kuber's family. "Kuber, how long to your house?" "30 minute bus ride, 30 minute walk." Ok, that doesn't sound so bad. So we pile on the rickety, creaky, bouncy local bus that seems like it is held together with duct tape and are on our way. An hour later we pile off the bus and set out for Kuber's house. It is pouring down rain at this time and most of us are wearing flip flops, crocs, or other very inappropriate shoes for hiking. And hiking is what it was. Into the corn fields we went, through the rice paddies, up into the hills. It's a bit difficult to describe the "paths" on the way to Kuber's house. The paths are about 6 inches wide, and with the monsoons basically turn into mud rivers. In the first 15 minutes everyone of us (except Kuber) had slipped and fallen in the mud. So, starting to get soggy and covered in bright orange clayish mud we were ready to be at Kuber's house. "Kuber, how much longer?" "Ok!" Hmm.... we continue on. After about 2 hours of mud rivers, rice fields, scramblling and sliding up (and down) trecherous clay hills we were starting to get a bit miffed. We were all covered in head to toe in mud, soaked to the bone, and starting to get rather annoyed that this supposedly "30 minute walk" was actually a 2 hour (so far) trecherous trek through the mud mountains of Nepal. By this time we were deep into the countryside. No houses anywhere, not even any cows. Along the way we had picked up two old Nepali men who were laughing histerically at us. "Nepali road! Nepali road!" Yes, we understood. These were the Nepali "roads" and we were illprepared Americans slipping and sliding through these horrible paths. As we trekked deeper and deeper into the jungle I was not going to be surprised if any R.O.U.S's came out and attacked us. (Rodents Of Unusual Size... anyone seen the Princess Bride?) After 2 and a half hours we were all horribly irritated. I kept reminding myself to not be annoyed, I was trying as hard as I could to not get agitated. Wet, cold, muddy, and hungry. Then to top it all off I took off my shoes to to go get some of the mud out and to my surprise found quite a large colony of leeches had taken refuge between my toes. Wonderful. After leeches attach and start sucking, it's almost impossible to pry them off. So after a long while of attempting to get the little suckers off, finally I succeeded. The little buggers left my feet covered in blood, which just topped it off even more. Almost three hours had gone by. Kuber kept pointing to the nearest house on the hillside that we passed saying it was his house. None of them were. The thing I have learned about many Nepalis is that they will tell you something, even if it is not true, just to make you happy. So Kuber tells us it is a half an hour walk to his house. The problem is that this backfired horribly because we were much more annoyed that he didn't just tell us it was 3 hours into the jungle through mud rivers and leech country in the pouring rain. The thing is Kuber just didn't quite understand this, and it's not his fault. So after a horribly long walk, drenching rains, multitudes of leeches, dozens of falls into the mud, faces covered in scatches by brambles, a couple ant and other unidentified bug bites on our feet, and empty stomaches we arrived at Kuber's house. After this walk I truely understood how difficult it is for rural Nepalis to get anywhere. Going, literally anywhere, would take 3 hours on trecherous paths. It is important to know that Nepal is 90% rural, so this is where most of Nepalis live: in the countryside up incredibly steep hills, with no roads, and usually not even any paths to their homes. Going to the doctor would be a difficult endeavour, so you can image that these rural Nepalis really don't go to the doctor. Too far. (Note: I now understand why at the geriatric clinic we had people who said they have had headaches for 20 years, their knees have been in pain for 10 years, or that they have not been able to hear for 15 years. Too hard to go to the doctor!) Doing something on a whim would be unheard of. Example: Do you feel like going for ice-cream? .... Not if the walk is 3 hours through corn fields and mud hills, and thorn bushes. I think I would be much more content to stay home. I also now appreciate how isolated it is living in these places. Anyway, we finally arrived at Kuber's. I was in a horrible mood because I had just fallen very hard and thought I may have broken my arm. But my temperment changed quickly from the warm welcome from Kuber's family. Pretty much the whole village was at Kuber's house waiting for us. They all stood around and starred at us with smiles on their faces as they watched us drink tea prepared for us by Kuber's mother. Kuber's house is a typical rural house. Mostly made of mud and sticks. It was 2 stories. The bottom story was where the "kitchen" was, actually just a pile of sticks and a fire and some pans. The bottom story was also filled with potates. I have never seen so many potatoes in my life. There were literally thousands. It must be potatoe harvesting season. Well, we were starved and Kuber's mother made us a huge meal. We had dozens of roti (sort of like a Nepali tortilla) which she prepared over the cooking fire, potatoe and pea curry which we ate with the roti, dal, and burned corn which we ate with sugar. The meal was probably the most delicious meal ever. Partly because it really was delicious, partly because we had just had the most horrible walk ever. But we soon forgot our troubles and were having a great time. The whole village piled into the mud hut and had a great time laughing at us. We each got a burned ear of corn cooked in the fire and were eating it how we eat it typically at a BBQ. Straight off the cob. "Monkey system! Monkey system!" they laughed at us. "Monkey system?" "We show you Nepali system." The Nepali system for eating corn was to take all the kernels off the cob and put them on a plate, them sprinkle them with generous amounts of sugar. No more monkey system for us. After the meal we were stuffed. We tested buffalos milk and buffalo fat which was interesting. The buff milk was a bit chunky but very sweet. The buffalo fat looked like bacon grease but tasted like sweet milky butter. We had after meal tea and were all happy. Then we talked with all the villagers and Kuber's family. They all look so much alike, it is scary. After a while with the villagers were were ready to depart. We thanked them all very much and were off to finish the second leg of our journey, which we were not looking forward to. Along the way one of Kuber's village friends invited us to stop by his house and eat "bees honey." So we stopped by another mud hut close by. We all sat on the mud porch next to a few goats. The woman of the house came out and presented each one of us a huge bowl full of honey with a spoon in it! It was a rich orangy brown color. We could see the hives on top of the thatched roof. The honey was so delicious. It had an interesting taste, almost a bit like fermented apples. It had a wonderful grainy texture that melted in your mouth. It was amazing. We sat eating our honey bowls when more villagers came by and huddled in groups starring at us with amazement. I don't know why, I think we looked quite hilarious covered in mud and soaking wet. Anyway, the honey was SO sweet, we couldn't eat it all and felt very bad. But really, all you needed of this honey was one spoonful to be satisfied. Finally we were on our way again. After another 3 hour journey we were back at home. Clean, warm, full, and nestled in our beds. At dinner we sat around the table laughing about our adventure. The whole while during the walk I kept reminding myself "this will be funny in 5 hours, this will be funny in 5 hours." And sure enough, it was. So a simple 30 minute bus, 30 minute walk turned into a 1 hour bus, 3 hour trek both ways. But the rewards outweighed the bads in the end. We had a wonderful time with Kuber's family. They were so kind and generous, and also we had an amazing Nepali meal. I am also happy that I now understand I little more the hardships that come with most rural Nepali's lives. But despite these hardships they are still so happy and appreciative! Rural Nepali life is amazing to say the least. The people of the Nepali hill villages are wonderful and generous and so kind. Another great thing, besides just meeting Kuber's family and his village, was to watch Kuber interact with his mother, father, brother and sister and all his friends. This trip sort of completed a missing piece of Kuber for me. I now understand his life just a little bit more, and appreciate him more as well. From this visit Kuber has become a much more 3 dimensional person. It was so great to see his mother dote on him, his father tease him, his sister hang on his neck, and his older brother joke around with him. Despite the muddy falls, the leeches in my toes, the sprained elbow, and the skinned knees, this day turned into a most awesome adventure. It turned into a wonderful experience that I will never forget. I am very grateful for this opportunity. As long as you can look back, and find your adventures funny, then that means everything is ok.
So, we planned to visit Kuber's house on Saturday and meet his family. Kuber is our... servant? I hate that word, but I'm not sure when to call him. He cooks our meals, cleans, generally serves everyone. Anyway, we've become great friends with him. He is 17 years old, and a typical pubescent blubbering boy. He is quite amused by us and I think really likes working at the house and getting to hang out with us. Kuber is quite a funny young lad, his English is not so good which sort of adds to how entertaining he is. He just failed his English test, so we are all tutoring him to help him pass his next test. Kuber has a habit of saying "Ok," to everything that he doesn't know what we are talking about. Examples: "Kuber, when is food ready?" "Ok!" or "Kuber, what did you do today?" "Ok!" All of us have become quite good friends with Kuber, he is like our little brother in a sense. So we all decided we must meet Kuber's family. All we really knew about him was that he is from a village and has worked for Anuj for a while. So we woke up early Saturday morning and left to meet Kuber's family. "Kuber, how long to your house?" "30 minute bus ride, 30 minute walk." Ok, that doesn't sound so bad. So we pile on the rickety, creaky, bouncy local bus that seems like it is held together with duct tape and are on our way. An hour later we pile off the bus and set out for Kuber's house. It is pouring down rain at this time and most of us are wearing flip flops, crocs, or other very inappropriate shoes for hiking. And hiking is what it was. Into the corn fields we went, through the rice paddies, up into the hills. It's a bit difficult to describe the "paths" on the way to Kuber's house. The paths are about 6 inches wide, and with the monsoons basically turn into mud rivers. In the first 15 minutes everyone of us (except Kuber) had slipped and fallen in the mud. So, starting to get soggy and covered in bright orange clayish mud we were ready to be at Kuber's house. "Kuber, how much longer?" "Ok!" Hmm.... we continue on. After about 2 hours of mud rivers, rice fields, scramblling and sliding up (and down) trecherous clay hills we were starting to get a bit miffed. We were all covered in head to toe in mud, soaked to the bone, and starting to get rather annoyed that this supposedly "30 minute walk" was actually a 2 hour (so far) trecherous trek through the mud mountains of Nepal. By this time we were deep into the countryside. No houses anywhere, not even any cows. Along the way we had picked up two old Nepali men who were laughing histerically at us. "Nepali road! Nepali road!" Yes, we understood. These were the Nepali "roads" and we were illprepared Americans slipping and sliding through these horrible paths. As we trekked deeper and deeper into the jungle I was not going to be surprised if any R.O.U.S's came out and attacked us. (Rodents Of Unusual Size... anyone seen the Princess Bride?) After 2 and a half hours we were all horribly irritated. I kept reminding myself to not be annoyed, I was trying as hard as I could to not get agitated. Wet, cold, muddy, and hungry. Then to top it all off I took off my shoes to to go get some of the mud out and to my surprise found quite a large colony of leeches had taken refuge between my toes. Wonderful. After leeches attach and start sucking, it's almost impossible to pry them off. So after a long while of attempting to get the little suckers off, finally I succeeded. The little buggers left my feet covered in blood, which just topped it off even more. Almost three hours had gone by. Kuber kept pointing to the nearest house on the hillside that we passed saying it was his house. None of them were. The thing I have learned about many Nepalis is that they will tell you something, even if it is not true, just to make you happy. So Kuber tells us it is a half an hour walk to his house. The problem is that this backfired horribly because we were much more annoyed that he didn't just tell us it was 3 hours into the jungle through mud rivers and leech country in the pouring rain. The thing is Kuber just didn't quite understand this, and it's not his fault. So after a horribly long walk, drenching rains, multitudes of leeches, dozens of falls into the mud, faces covered in scatches by brambles, a couple ant and other unidentified bug bites on our feet, and empty stomaches we arrived at Kuber's house. After this walk I truely understood how difficult it is for rural Nepalis to get anywhere. Going, literally anywhere, would take 3 hours on trecherous paths. It is important to know that Nepal is 90% rural, so this is where most of Nepalis live: in the countryside up incredibly steep hills, with no roads, and usually not even any paths to their homes. Going to the doctor would be a difficult endeavour, so you can image that these rural Nepalis really don't go to the doctor. Too far. (Note: I now understand why at the geriatric clinic we had people who said they have had headaches for 20 years, their knees have been in pain for 10 years, or that they have not been able to hear for 15 years. Too hard to go to the doctor!) Doing something on a whim would be unheard of. Example: Do you feel like going for ice-cream? .... Not if the walk is 3 hours through corn fields and mud hills, and thorn bushes. I think I would be much more content to stay home. I also now appreciate how isolated it is living in these places. Anyway, we finally arrived at Kuber's. I was in a horrible mood because I had just fallen very hard and thought I may have broken my arm. But my temperment changed quickly from the warm welcome from Kuber's family. Pretty much the whole village was at Kuber's house waiting for us. They all stood around and starred at us with smiles on their faces as they watched us drink tea prepared for us by Kuber's mother. Kuber's house is a typical rural house. Mostly made of mud and sticks. It was 2 stories. The bottom story was where the "kitchen" was, actually just a pile of sticks and a fire and some pans. The bottom story was also filled with potates. I have never seen so many potatoes in my life. There were literally thousands. It must be potatoe harvesting season. Well, we were starved and Kuber's mother made us a huge meal. We had dozens of roti (sort of like a Nepali tortilla) which she prepared over the cooking fire, potatoe and pea curry which we ate with the roti, dal, and burned corn which we ate with sugar. The meal was probably the most delicious meal ever. Partly because it really was delicious, partly because we had just had the most horrible walk ever. But we soon forgot our troubles and were having a great time. The whole village piled into the mud hut and had a great time laughing at us. We each got a burned ear of corn cooked in the fire and were eating it how we eat it typically at a BBQ. Straight off the cob. "Monkey system! Monkey system!" they laughed at us. "Monkey system?" "We show you Nepali system." The Nepali system for eating corn was to take all the kernels off the cob and put them on a plate, them sprinkle them with generous amounts of sugar. No more monkey system for us. After the meal we were stuffed. We tested buffalos milk and buffalo fat which was interesting. The buff milk was a bit chunky but very sweet. The buffalo fat looked like bacon grease but tasted like sweet milky butter. We had after meal tea and were all happy. Then we talked with all the villagers and Kuber's family. They all look so much alike, it is scary. After a while with the villagers were were ready to depart. We thanked them all very much and were off to finish the second leg of our journey, which we were not looking forward to. Along the way one of Kuber's village friends invited us to stop by his house and eat "bees honey." So we stopped by another mud hut close by. We all sat on the mud porch next to a few goats. The woman of the house came out and presented each one of us a huge bowl full of honey with a spoon in it! It was a rich orangy brown color. We could see the hives on top of the thatched roof. The honey was so delicious. It had an interesting taste, almost a bit like fermented apples. It had a wonderful grainy texture that melted in your mouth. It was amazing. We sat eating our honey bowls when more villagers came by and huddled in groups starring at us with amazement. I don't know why, I think we looked quite hilarious covered in mud and soaking wet. Anyway, the honey was SO sweet, we couldn't eat it all and felt very bad. But really, all you needed of this honey was one spoonful to be satisfied. Finally we were on our way again. After another 3 hour journey we were back at home. Clean, warm, full, and nestled in our beds. At dinner we sat around the table laughing about our adventure. The whole while during the walk I kept reminding myself "this will be funny in 5 hours, this will be funny in 5 hours." And sure enough, it was. So a simple 30 minute bus, 30 minute walk turned into a 1 hour bus, 3 hour trek both ways. But the rewards outweighed the bads in the end. We had a wonderful time with Kuber's family. They were so kind and generous, and also we had an amazing Nepali meal. I am also happy that I now understand I little more the hardships that come with most rural Nepali's lives. But despite these hardships they are still so happy and appreciative! Rural Nepali life is amazing to say the least. The people of the Nepali hill villages are wonderful and generous and so kind. Another great thing, besides just meeting Kuber's family and his village, was to watch Kuber interact with his mother, father, brother and sister and all his friends. This trip sort of completed a missing piece of Kuber for me. I now understand his life just a little bit more, and appreciate him more as well. From this visit Kuber has become a much more 3 dimensional person. It was so great to see his mother dote on him, his father tease him, his sister hang on his neck, and his older brother joke around with him. Despite the muddy falls, the leeches in my toes, the sprained elbow, and the skinned knees, this day turned into a most awesome adventure. It turned into a wonderful experience that I will never forget. I am very grateful for this opportunity. As long as you can look back, and find your adventures funny, then that means everything is ok.
More Pokhara Stories
Namaste!
Sorry I have not been able to finish up writing about my last Pokhara trip for a while. I've been busy back in the city. So here are some other highlights from Pokhara:
-riding on the roof of the bus (already wrote about it)
-renting motor bikes and cruising the country
-We rented a paddle boat and paddled out as far as we could into Phewa Tal lake. This was actually not that far because there were five of us in the boat.
-On one day we hiked to Devis Falls which is an amazing underground water falls. The water was so incredibly powerful, since it had been raining pretty much constantly for the last month or so. Apparently in the dry season the water subsides to not more than a trickle, but when we went it was raging. It was quite mesmerizing to look at. On this same day we explored the near by Tibetan refugee camp. We were exploring the country side and happened upon a gorgeous raging river. The country people were swimming in it, and the women were doing their washing on the rocks. It was a beautiful milky blue color, like the color of a husky dog's eyes that are stangely blue. We all exchanged looks and knew what we had to do: go swimming in it. So we took of our shoes and went for a dip. It was quite fun. On our walk back into Pokhara the locals I think thought us quite strange, as we all looked like bedragled rats.
-In town there are Tibetan women who peruse the streets with backpacks full of their handicrafts. There are probably the best sales people I have ever met and very persistant. "Looking is free!" We made friends with one woman named Lobsang. She became very fond of us and invited us to her home at one of the nearby Tibetan refugee camps. So, one morning we met her in town and took a taxi about 30 minutes to the refugee camp. She showed us her home which was provided to her by the Nepalese government and is where she has been living since she had to leave Tibet in 1959. It is actually not more than a room, which she shares with another person. It was wonderful though. There were two beds in the room, and one table, and one dresser. The main focal point of the room was a large picture of the Dalai Lama. We sat on the two beds and she made us a most magnificent and delicious breakfast. The breakfast consisted of yak butter tea, milk tea, stacks and stacks of Tibetan bread (sort of like a dense pancake), marmalade for the Tibetan bread, omlets, and bowls of curd (yogurt). Lobsang is such a kind and generous woman and was so eager to tell us about her life and family and about Tibet. After breakfast she had a little "ceremony" for us: she presented each one of us with a milky yellow silk scarf (the kind you may see people present to the Dalai Lama when they meet him) which she placed around our neck and said the Tibetan prayer "om mane pheme houme" (sp?). After the mini-ceremony she took us around the Tibetan refugee camp. It is a wonderfully peaceful place, I suppose this is how Tibet must be, or at least used to be. It is full of little which cottages white-washed, and brightly colored red, yellow, blue, green and white prayer flags strung through out the entire refugee camp. She took us to the monastery which is in the refugee camp. It was closed but she snuck us passed the monks laughing with each other at the gate and took us inside. It was empty but she showed us where all the monks studied and all the amazingly beautiful statues and artwork and icons all about the monastery. At the head of the monastery was a massive golden buddha, next to which was a large framed picture of the Dalai Lama. We each gave a little donation and waited for Lobsang to do a few prostrations infront of the golden Buddha. Then she took us to a juice making factory! Well, it was actually a few rooms dediced to making and bottling juices which they sell in Kathmandu and Pokhara, and I think is a good source of income for the refugees. We met all the workers and watched them slice up pineapples and put labels on the pineapple juice bottles. After we explored the rest of the camp we headed back to Pokhara. All of us and Lobsang squished into a taxi back to town. There was no room so I sat on Lobsang's lap and she had fun stroking my hair and saying the Tibetan prayer. I think she really enjoyed having us to her home, especially since she has no children of her own. "Oh! I will tell everyone I have 3 young miss daughters and 1 young boy son with white skin!" she told us in jest. Going to Lobsang's refugee camp was a most amazing time. She was one of the most radiant, bright and kind people I have ever met despite having had to leave her home many years ago. Soon after she was forced to leave Tibet with her mother, her mother died leaving just Lobsang. Lobsang never married or had any children, but she was so wonderful and didn't let any of the make her sad. She was also so generous to us, although she has so little. Looking around her humble home I thought it is so silly huge mansions in the states and how much space we think we need when some people have so little. She has been living in a home that was provided to her from the government, she did not even want to live there by choice, but she makes the best of it.
Sorry I have not been able to finish up writing about my last Pokhara trip for a while. I've been busy back in the city. So here are some other highlights from Pokhara:
-riding on the roof of the bus (already wrote about it)
-renting motor bikes and cruising the country
-We rented a paddle boat and paddled out as far as we could into Phewa Tal lake. This was actually not that far because there were five of us in the boat.
-On one day we hiked to Devis Falls which is an amazing underground water falls. The water was so incredibly powerful, since it had been raining pretty much constantly for the last month or so. Apparently in the dry season the water subsides to not more than a trickle, but when we went it was raging. It was quite mesmerizing to look at. On this same day we explored the near by Tibetan refugee camp. We were exploring the country side and happened upon a gorgeous raging river. The country people were swimming in it, and the women were doing their washing on the rocks. It was a beautiful milky blue color, like the color of a husky dog's eyes that are stangely blue. We all exchanged looks and knew what we had to do: go swimming in it. So we took of our shoes and went for a dip. It was quite fun. On our walk back into Pokhara the locals I think thought us quite strange, as we all looked like bedragled rats.
-In town there are Tibetan women who peruse the streets with backpacks full of their handicrafts. There are probably the best sales people I have ever met and very persistant. "Looking is free!" We made friends with one woman named Lobsang. She became very fond of us and invited us to her home at one of the nearby Tibetan refugee camps. So, one morning we met her in town and took a taxi about 30 minutes to the refugee camp. She showed us her home which was provided to her by the Nepalese government and is where she has been living since she had to leave Tibet in 1959. It is actually not more than a room, which she shares with another person. It was wonderful though. There were two beds in the room, and one table, and one dresser. The main focal point of the room was a large picture of the Dalai Lama. We sat on the two beds and she made us a most magnificent and delicious breakfast. The breakfast consisted of yak butter tea, milk tea, stacks and stacks of Tibetan bread (sort of like a dense pancake), marmalade for the Tibetan bread, omlets, and bowls of curd (yogurt). Lobsang is such a kind and generous woman and was so eager to tell us about her life and family and about Tibet. After breakfast she had a little "ceremony" for us: she presented each one of us with a milky yellow silk scarf (the kind you may see people present to the Dalai Lama when they meet him) which she placed around our neck and said the Tibetan prayer "om mane pheme houme" (sp?). After the mini-ceremony she took us around the Tibetan refugee camp. It is a wonderfully peaceful place, I suppose this is how Tibet must be, or at least used to be. It is full of little which cottages white-washed, and brightly colored red, yellow, blue, green and white prayer flags strung through out the entire refugee camp. She took us to the monastery which is in the refugee camp. It was closed but she snuck us passed the monks laughing with each other at the gate and took us inside. It was empty but she showed us where all the monks studied and all the amazingly beautiful statues and artwork and icons all about the monastery. At the head of the monastery was a massive golden buddha, next to which was a large framed picture of the Dalai Lama. We each gave a little donation and waited for Lobsang to do a few prostrations infront of the golden Buddha. Then she took us to a juice making factory! Well, it was actually a few rooms dediced to making and bottling juices which they sell in Kathmandu and Pokhara, and I think is a good source of income for the refugees. We met all the workers and watched them slice up pineapples and put labels on the pineapple juice bottles. After we explored the rest of the camp we headed back to Pokhara. All of us and Lobsang squished into a taxi back to town. There was no room so I sat on Lobsang's lap and she had fun stroking my hair and saying the Tibetan prayer. I think she really enjoyed having us to her home, especially since she has no children of her own. "Oh! I will tell everyone I have 3 young miss daughters and 1 young boy son with white skin!" she told us in jest. Going to Lobsang's refugee camp was a most amazing time. She was one of the most radiant, bright and kind people I have ever met despite having had to leave her home many years ago. Soon after she was forced to leave Tibet with her mother, her mother died leaving just Lobsang. Lobsang never married or had any children, but she was so wonderful and didn't let any of the make her sad. She was also so generous to us, although she has so little. Looking around her humble home I thought it is so silly huge mansions in the states and how much space we think we need when some people have so little. She has been living in a home that was provided to her from the government, she did not even want to live there by choice, but she makes the best of it.
Tuesday, July 24, 2007
Pokhara II
Namaste! I have just returned from my second visit to Pokhara which was fantastic! Our journey started out early Thursday morning where we caught a local bus from the bus park. After alot of haggling, we got our bus fare down to 180 rupees. Instead of riding in the bus, we went for the much more fun option of riding on the bus. On top of all the buses in Nepal are shallow metal cage type things to store bags, people, or even a herd of goats. So we climbed up the ladder and situated ourselves for the 7 hour bus ride. I can not emphasize enough how much better it is to ride on the top of the bus. You sort of feel like you are on an amusement park ride though a medieval countryside. The Nepal countryside is probably the most beautifl thing I have ever seen. Everything looks so ancient. I kept expecting a triceratops or a pteradactyl to come out from the hills. Also on the roof you get 360 degree panoramic views of the country which are breathtaking. Especially now, Nepal is incredibly green and lush. It is much more tropical than I had imagined: banana trees, palmish trees, everything blanketed in green. Also riding on the roof, you get the Nepali wind in your hair and face which is one of the best parts. Most of the 7 hour wild ride to Pokhara we shared the roof with an old Nepali vegetable farmer who had enough burlap sacks of potatoes, cabbage, and beans to feed the Nepali army. We whoops and yelled the whole ride while he took naps nestled in his sacks of lettuce. We shared our chocolate with him once he woke up from his nap (how in the world he slept up there I dont know!!). He was very curious about our snacks and cameras and thought we were quite strange I think. Riding on the roof of the bus is like flying sort of. It is like in the omni-max movies how they fly through the grand canyon. You get the best views of villages, the terraced green fields, and the staggeringly large hills. Finally, after 7 hours of riding on the bus we arrived, all thoroughly aired out and covered in dirt. I wiped my face and it was literally covered with grime. Also we all looked like lobsters from sunburn.
The next day we were up for more adventure so we decided to rent motor bikes!! This turned into a huge fiasco. The four of us who were there got motor bikes in the morning and after a 1 minute "lesson" were off! Pokhara is a much better place to learn how to ride a motor bike than in Kathmandu. It is actually much easier than I expected. But, the first disaster struck about 5 minutes into our adventure. Every single one of us ran out of gas. Amie and Christine got split up from me and Matt too. The motor bike rental guy had pointed in the direction of the petrol station, but that did no good. We asked about 20 Nepalis where the gas station was, and we got 20 different answers. We shold have fully realized this before trusted every Nepali we met, but the thing with these people is that they never say "I don't know." So I am pretty sure no one we asked actually knew where the gas station was, they just pointed to where it maybe was. After 3 hours of waiting by the side of the road the motor bike rental guy came and broght us some petrol. We met back up with the other two and were off for the country!! We rode for about an hour on bumpy gravel roads and through the rice fields. Disaster number two: Christine's motor bike ran out of oil. After a very frustrating two hours we finally got Christine another motor bike. And we were ready to cruise so we headed up into the hills! This was so spectaclar! Probably one of the best things I have done. We were winding though monstrous hills, green everywhere, tiny mountain huts, braking for chickens and pigs in the road, stopping to look at fantastic water falls and clear moutain streams. All the while the most fresh mountain air was blowing on our faces. It was motor biking through the hills that I actually got a good scale of how truly rugged and hilly Nepal is. And how small I am compared to these "hills" (which I think are more like mountains). The canyons were so huge, the water falls massive, cliffs jutting high into the sky. After about 8 hours of motor biking we were exhausted! It's surprising how tired you can get from sitting on top of a bus and sitting on a motor bike. Sore too!
The next day we were up for more adventure so we decided to rent motor bikes!! This turned into a huge fiasco. The four of us who were there got motor bikes in the morning and after a 1 minute "lesson" were off! Pokhara is a much better place to learn how to ride a motor bike than in Kathmandu. It is actually much easier than I expected. But, the first disaster struck about 5 minutes into our adventure. Every single one of us ran out of gas. Amie and Christine got split up from me and Matt too. The motor bike rental guy had pointed in the direction of the petrol station, but that did no good. We asked about 20 Nepalis where the gas station was, and we got 20 different answers. We shold have fully realized this before trusted every Nepali we met, but the thing with these people is that they never say "I don't know." So I am pretty sure no one we asked actually knew where the gas station was, they just pointed to where it maybe was. After 3 hours of waiting by the side of the road the motor bike rental guy came and broght us some petrol. We met back up with the other two and were off for the country!! We rode for about an hour on bumpy gravel roads and through the rice fields. Disaster number two: Christine's motor bike ran out of oil. After a very frustrating two hours we finally got Christine another motor bike. And we were ready to cruise so we headed up into the hills! This was so spectaclar! Probably one of the best things I have done. We were winding though monstrous hills, green everywhere, tiny mountain huts, braking for chickens and pigs in the road, stopping to look at fantastic water falls and clear moutain streams. All the while the most fresh mountain air was blowing on our faces. It was motor biking through the hills that I actually got a good scale of how truly rugged and hilly Nepal is. And how small I am compared to these "hills" (which I think are more like mountains). The canyons were so huge, the water falls massive, cliffs jutting high into the sky. After about 8 hours of motor biking we were exhausted! It's surprising how tired you can get from sitting on top of a bus and sitting on a motor bike. Sore too!
Wednesday, July 18, 2007
Delicious Delights
The food here in Nepal quite delicious! I will admit, it is not the most varied food in the world. Most of the Nepali restaurants all have about the same menus. In Thamel, the touristy area, there is a variety of different sorts of restaurants which are sooooo good! We like to treat ourselves to these every now and then. The flavors are a welcome treat to dal bhat (will describe in a second) everyday. One reason I believe that Nepali food has little variety: I don't think Nepalis have in the past, or even now as much, cared whether they are serving gourmet food. Food is fuel, and that is that. Food is something that you want to eat as much of as you can so that you will have the energy to work all day in the fields planting and picking rice. So gourmet, high quality, top notch dishes are not a priority. That's not to say that the food isn't good, but it's just pretty uniform across the board. Also the food in the restaurants can be a little interesting as well. Sometimes the apppropriate spices seem to be missing, so an Italian pizza may end up tasting more like a Mexican quesadilla. Here is a rundown of the Nepali food:
dal bhatt: this is the national food. Dal is the soupy lentil soup, and bhatt is cooked rice. Nepalis literally eat this at just about every meal. Kuber makes us dal bhatt EVERY day, no joke. You are supposed to pour the dal on to the bhatt and eat it together. Nepalis eat with their hands, and mush the dal and bhatt together and then eat with their hands. They can fit a surprisingly enormous amount of dal bhatt into their stomachs. The dal is a bit bland, but it's good. Dal bhatt usually comes with a bit of curried vegetable and some aachar, a bit or pickled fruit or vegetable.
curd: this is yogurt, a little thinner and less sweet than we are used to. This is one of my favorite things. Sometimes you get it in a bowl, or sometimes in a cup to drink.
milk tea: this is the intensely sweet tea that pretty much flows through the veins of all Nepalis. It is so delicious, although so incredibly rich and sweet that it is hard to drink a lot of it. It's more like a dessert to me.
STREET FOOD:
There seems to be a greater variety of street food. I really like that street food here. It is sold by vendors who may have a tiny stand, stall, or just a little platform they carry around (like peanut sellers at baseball games) with some kind of food on it. Here are the best things I have tried:
A note about street food: It is a bit of a gamble how your stomach will handle this food. Our host dad Anuj tells us "DO NOT EAT THE STREET FOOD!!" But I do anyway becasue I love it. Yes, you may have a bit of a rumbley stomach the next day, but in my opinion it is just as much of a gamble to eat at any of the restaurants. There is no health code, inspectors, or rules regarding cleanliness at all. So you could just as easily get sick out of a nice Thamel restaurant as off a street cart. Especially in a country where washing your hands after going to the bathroom is not observed at all.
Burned corn: I am not sure what the Nepalis call this but I call it burned corn. It is sooo good. It's sold usually by woman crouched on the side of the road next to a small pile of burning coals. Over the coals the roast ears of corn and fan the coals and corn with a bit of card board. The corn is roasted until it has a nice smokey flavor and the kernels get sort of hard. The women hand you an ear of corn in it's husk and maybe will rub some salt on it. It is sooo good. I love this, and it runs about 10 rupees. (15 or so cents.)
Puff balls: I don't know what the Nepali word for these are either. But men sell these on tiny stands dotted all over the road. The are hollow puff balls, then they punch a hole in the puff ball and fill it with a mix of chopped vegetables and puffed rice. Then they dip the whole thing in a small vat of lemmony chili water. It's quite interesting. You eat the stuffed puff balls on tiny tin plates next to their stand, and hand them back when you are done to be reused by the next customer.
Fruit: There are all sorts of fruits you can buy on the side of the road. I generally stay away from the fruit already cut into slices because they aer usually covered with flies, but you can buy chunks of pineapple, coconut, papaya, mango, banana, and apple.
Vegetables: One of the main vegetables sold ready to eat (you can buy any vegetable at the veg markets) are slices of cucumber. The women have a tiny plate with cucumber slices, and when you buy one the slather it with green chili sauce. It is rather interesting with the green chili sauce, but refreshing none the less.
Fried things: Nepalis love fried street food. Along the side of the road are vats of boiling oil in front of food stalls. They fry all sorts of things: samosas, pancake type things, sweet dough, doughnuts filled with cream, and lots of things I have no idea what they are.
Juices: You can get an assortment of juices from carts that men push through the street. The juice of choice for most Nepalis is sugar cane. The men will grind a shoot of sugar cane through their grinder and out comes sugar cane juice! Also from these stands you can get pineapple juice.
Juice bars: These are tiny stalls along the road side. You can get all sorts of fresh juice including apple, banana, carrot, sweet lime, lemon, coconut, papaya, mango, and pomegranate. My favorite to get here is banana lassi. It is a fresh banana ground up in a blender with some curd (yogurt) and a bit of sugar. The banana lassi is equivalent to a banana smoothie. Delicious!!
Chapatis: These are delicious, I had the best ones in Pokhara though. Usually the chapati vendor carts come out later at night. The woman makes a chapati on her tiny stove, which is simlar to a pancake. Then she will put a mixture of vegetables and eggs (scrambled) on the chapati. In pokhara the Chapati was cooked in some butter and the vendor gave me a small plastic bag of a thick chili sauce to dip it in. Yum!!!! YUM!!!
dal bhatt: this is the national food. Dal is the soupy lentil soup, and bhatt is cooked rice. Nepalis literally eat this at just about every meal. Kuber makes us dal bhatt EVERY day, no joke. You are supposed to pour the dal on to the bhatt and eat it together. Nepalis eat with their hands, and mush the dal and bhatt together and then eat with their hands. They can fit a surprisingly enormous amount of dal bhatt into their stomachs. The dal is a bit bland, but it's good. Dal bhatt usually comes with a bit of curried vegetable and some aachar, a bit or pickled fruit or vegetable.
curd: this is yogurt, a little thinner and less sweet than we are used to. This is one of my favorite things. Sometimes you get it in a bowl, or sometimes in a cup to drink.
milk tea: this is the intensely sweet tea that pretty much flows through the veins of all Nepalis. It is so delicious, although so incredibly rich and sweet that it is hard to drink a lot of it. It's more like a dessert to me.
STREET FOOD:
There seems to be a greater variety of street food. I really like that street food here. It is sold by vendors who may have a tiny stand, stall, or just a little platform they carry around (like peanut sellers at baseball games) with some kind of food on it. Here are the best things I have tried:
A note about street food: It is a bit of a gamble how your stomach will handle this food. Our host dad Anuj tells us "DO NOT EAT THE STREET FOOD!!" But I do anyway becasue I love it. Yes, you may have a bit of a rumbley stomach the next day, but in my opinion it is just as much of a gamble to eat at any of the restaurants. There is no health code, inspectors, or rules regarding cleanliness at all. So you could just as easily get sick out of a nice Thamel restaurant as off a street cart. Especially in a country where washing your hands after going to the bathroom is not observed at all.
Burned corn: I am not sure what the Nepalis call this but I call it burned corn. It is sooo good. It's sold usually by woman crouched on the side of the road next to a small pile of burning coals. Over the coals the roast ears of corn and fan the coals and corn with a bit of card board. The corn is roasted until it has a nice smokey flavor and the kernels get sort of hard. The women hand you an ear of corn in it's husk and maybe will rub some salt on it. It is sooo good. I love this, and it runs about 10 rupees. (15 or so cents.)
Puff balls: I don't know what the Nepali word for these are either. But men sell these on tiny stands dotted all over the road. The are hollow puff balls, then they punch a hole in the puff ball and fill it with a mix of chopped vegetables and puffed rice. Then they dip the whole thing in a small vat of lemmony chili water. It's quite interesting. You eat the stuffed puff balls on tiny tin plates next to their stand, and hand them back when you are done to be reused by the next customer.
Fruit: There are all sorts of fruits you can buy on the side of the road. I generally stay away from the fruit already cut into slices because they aer usually covered with flies, but you can buy chunks of pineapple, coconut, papaya, mango, banana, and apple.
Vegetables: One of the main vegetables sold ready to eat (you can buy any vegetable at the veg markets) are slices of cucumber. The women have a tiny plate with cucumber slices, and when you buy one the slather it with green chili sauce. It is rather interesting with the green chili sauce, but refreshing none the less.
Fried things: Nepalis love fried street food. Along the side of the road are vats of boiling oil in front of food stalls. They fry all sorts of things: samosas, pancake type things, sweet dough, doughnuts filled with cream, and lots of things I have no idea what they are.
Juices: You can get an assortment of juices from carts that men push through the street. The juice of choice for most Nepalis is sugar cane. The men will grind a shoot of sugar cane through their grinder and out comes sugar cane juice! Also from these stands you can get pineapple juice.
Juice bars: These are tiny stalls along the road side. You can get all sorts of fresh juice including apple, banana, carrot, sweet lime, lemon, coconut, papaya, mango, and pomegranate. My favorite to get here is banana lassi. It is a fresh banana ground up in a blender with some curd (yogurt) and a bit of sugar. The banana lassi is equivalent to a banana smoothie. Delicious!!
Chapatis: These are delicious, I had the best ones in Pokhara though. Usually the chapati vendor carts come out later at night. The woman makes a chapati on her tiny stove, which is simlar to a pancake. Then she will put a mixture of vegetables and eggs (scrambled) on the chapati. In pokhara the Chapati was cooked in some butter and the vendor gave me a small plastic bag of a thick chili sauce to dip it in. Yum!!!! YUM!!!
Off To Pokhara
Namaste!
Tomorrow morning we are off to Pokhara, me for the second time, everyone else for the first time. I am looking forward to showing my fellow volunteers around and maybe hiking into the hills for a day and having them meet the family that I stayed with. We will leave tomorrow (Thursday) morning and take a bus, which takes about 6 hours give or take. After a few straight weeks in the city we are in need or some cleansing, figuratively and literally. My feet are constantly caked with mud, I swear, no matter how hard I scrub them, especially now that the monsoon rains are coming down more often leading the streets to become rivers or mud. Anyway, we are planning to do some hiking, rent a paddle boat on Phewa lake, rent bikes for a day and bike into the beautiful countryside with a picnic lunch, relax, read, and have fun! We are actually going with quite the entourage: me, Christine, Amie, Matt, Rajendra, Hassia, Apar, BJ, and Ashton. Four of those are our Nepali friends who we invited along. It is always fun to have them come, also they are our shield against rip offs. It should be a nice relaxing weekend, and I will report about the happenings when I am back in Kathmandu on either Sunday or Monday.
Speaking of my fellow volunteers, here is a short rundown on who I have been living with:
Christine: one of my room mates. She is 20 years old, from Chicago and goes to Vasser College in New York. She is studying biology and music and wants to be a surgeon. Her dad owns a homeopathic store, and she has tons of cool homeopathic stuff here.
Amie: my other room mate. She got here about a week or a week and a half ago and is the newest addition to the gang. She is 23 years old, and graduated last year from Oberlin College with a degree in biochemistry. Right now she is about to embark on her second year of Teach For America. This program I had never heard of but sounds like an amazing, frustrating, and incredibly challenging experience. It is a program that employs recent college graduates to teach in inner city schools. So all last year she has been teaching chemistry and earth science at an inner city high school in Chicago. Wow, her stories are amazing. A very noble thing to do, and she seems to have learned a TON. She is originally from Ithaca, New York.
Matt: he lives in the "office" with us, but in his own room. He is going to be a senior at the College of Charleston and studying biology and wants to be a surgeon. He is from South Carolina and is full of southern pride. He is alot of fun, and very funny.
Melissa: she is 23 years old and room mates with Caroline who also lives in the office with us. She went to Grove City College, then got a masters degree at University of Tennessee in public health and epidemiology. She is originally from Colorado. She will be entering medical/PhD school in the fall either in San Diego or Seattle. She has worked alot with Third World medicine, focusing in Central and South America, especially Guatemala. She is very outdoorsy and fun to hang out with.
Caroline: Melissa's room mate. She is 20 years old and half way done with her undergrad at William and Mary in Williamsburg (which I am very jealous of) where she is an English major. She is teaching English here at a elementary school. She is originally from Maryland.
Kuber: (pronounced Ku-bear) he is between the ages of 15 and 18, none of us can figure it out. He is our cook, cleaner, server. I am not really sure what to call it. He lives at the office and has a small fold out bed and sleeps in the kitchen. He was hired by the family from a poor village some where outside of Kathmandu. He is very entertaining, and things we are all very funny. We kid him and pronounce words wrong, like saying Namaste which is pronounced na-ma-stay, we say "naa-mastee!" He teaches us alot of Nepali words, and we help him with his English homework. He just failed his English test, so we are making him study.
Tomorrow morning we are off to Pokhara, me for the second time, everyone else for the first time. I am looking forward to showing my fellow volunteers around and maybe hiking into the hills for a day and having them meet the family that I stayed with. We will leave tomorrow (Thursday) morning and take a bus, which takes about 6 hours give or take. After a few straight weeks in the city we are in need or some cleansing, figuratively and literally. My feet are constantly caked with mud, I swear, no matter how hard I scrub them, especially now that the monsoon rains are coming down more often leading the streets to become rivers or mud. Anyway, we are planning to do some hiking, rent a paddle boat on Phewa lake, rent bikes for a day and bike into the beautiful countryside with a picnic lunch, relax, read, and have fun! We are actually going with quite the entourage: me, Christine, Amie, Matt, Rajendra, Hassia, Apar, BJ, and Ashton. Four of those are our Nepali friends who we invited along. It is always fun to have them come, also they are our shield against rip offs. It should be a nice relaxing weekend, and I will report about the happenings when I am back in Kathmandu on either Sunday or Monday.
Speaking of my fellow volunteers, here is a short rundown on who I have been living with:
Christine: one of my room mates. She is 20 years old, from Chicago and goes to Vasser College in New York. She is studying biology and music and wants to be a surgeon. Her dad owns a homeopathic store, and she has tons of cool homeopathic stuff here.
Amie: my other room mate. She got here about a week or a week and a half ago and is the newest addition to the gang. She is 23 years old, and graduated last year from Oberlin College with a degree in biochemistry. Right now she is about to embark on her second year of Teach For America. This program I had never heard of but sounds like an amazing, frustrating, and incredibly challenging experience. It is a program that employs recent college graduates to teach in inner city schools. So all last year she has been teaching chemistry and earth science at an inner city high school in Chicago. Wow, her stories are amazing. A very noble thing to do, and she seems to have learned a TON. She is originally from Ithaca, New York.
Matt: he lives in the "office" with us, but in his own room. He is going to be a senior at the College of Charleston and studying biology and wants to be a surgeon. He is from South Carolina and is full of southern pride. He is alot of fun, and very funny.
Melissa: she is 23 years old and room mates with Caroline who also lives in the office with us. She went to Grove City College, then got a masters degree at University of Tennessee in public health and epidemiology. She is originally from Colorado. She will be entering medical/PhD school in the fall either in San Diego or Seattle. She has worked alot with Third World medicine, focusing in Central and South America, especially Guatemala. She is very outdoorsy and fun to hang out with.
Caroline: Melissa's room mate. She is 20 years old and half way done with her undergrad at William and Mary in Williamsburg (which I am very jealous of) where she is an English major. She is teaching English here at a elementary school. She is originally from Maryland.
Kuber: (pronounced Ku-bear) he is between the ages of 15 and 18, none of us can figure it out. He is our cook, cleaner, server. I am not really sure what to call it. He lives at the office and has a small fold out bed and sleeps in the kitchen. He was hired by the family from a poor village some where outside of Kathmandu. He is very entertaining, and things we are all very funny. We kid him and pronounce words wrong, like saying Namaste which is pronounced na-ma-stay, we say "naa-mastee!" He teaches us alot of Nepali words, and we help him with his English homework. He just failed his English test, so we are making him study.
Monday, July 16, 2007
Adaptation
Adaptation is an interesting thing. I have been surprised at myself at how fast I have adapted and meshed with this culture and society and life. I remember my first taxi ride into town when I had first arrived from the airport. My jaw literally was dropped the entire ride. I was shocked, amazed, disgusted, ecstatic, and full of wonder. I remember my first walk around the city with a few law students I had met at the airport. It was mesmerizing! Everything completely different. The street vendors, poor children, amputees, open air butcher stalls, vegetable markets lining the streets, goats wandering, cows munching, monks on motor bikes, stupas, cigarettes, holy shrines, trash piles, dead dogs, new born puppies. This seemed a land of endless contradiction. I thought to my self: I will never, ever, ever be able to figure out the streets of Kathmandu. Some are paved, some are not. Some are gravel, some mud. No street signs, and multitudes of dark alley ways. Now though, I can get around anywhere in the city I want to on foot. I know the long scenic routes, the short cuts, all the different possible paths to any destination. I know where to walk if I feel like walking in the shade, or the sun. I know which routes are paved, and which will lead me through an abundance of mud puddles. I know where the worst trash piles are and how to avoid them. I know at exactly which moment to start holding my breath when walking by one of these masses of putrid garbage. I know all the street foods, and which ones will upset your stomach and which ones are ok. I have my favorite vendors of "burned corn," a tiny Nepali lady who squats on the ground and fans cobs or corn for a living (a most delicious treat by the way!!) I know which beggars sit where and for how long. The little blind boy who sings and plays the drum for a few rupees sits on a bridge, the old woman with the kind smile who reaches for a few coins. I know where the man sits with cataracts who shrieks all day. I know where the woman with an amptated leg and the new born baby sits. The hand ful of leprosy survivors and amputees, and polio victims. I know where all of them sit. I know how much things should cost, and if people are trying to take advantage of me. Where all the gangs of street dogs hang out I know and cross the road to avoid rabid ones. How to cross the streets I have learned, to dodge speeding motor bikes, taxis, rickshaws and buses. I've learned the best restaurants, the cheapest, the places with the best milk tea, the best tourist and local restaurants alike. I know how to bargain with a taxi driver for 20 minutes, watch for the massive potholes in the road, tell if a dog is dead or alive, avoid the drug dealers, and when to tell if it is going to rain in 10 minutes or not.
The process of adaptation is very interesting. It amazes me at how normal this environment is to me now. Just 2 months ago it was the most foreign thing I could ever imagine, incomprehendable almost. Now it is normal. I live here and learn how to do all the minute things that take up our everyday life but become a huge obstacle in a foreign land. I am surprised, a bit shocked at how fast assimilating here has been, and also pleased that this place has become so home like. Things that were shocking I now am so used to for example: the rotting trash mountains, the drug addicted street boys, seeing dead animals or even people(!) in the street, or seeing a stray dog chewing on a hand. Things that I was amazing and mystified by are still amazing, but are more normal now. The beautiful dress of the Nepali women, the magnificent mountains, the gorgeous religious ceremonies. The temples and signs of devout religiousness all around me I was at first not used to. But now seeing people doing prostrations on the street is not out of the ordinary. School children, business people, beggars, and families alike all stop and pray quickly and touch their heads in front of the tiny temples sprinkled through the street.
Adaptation is an interesting process, and interesting insight on to the human condition and human tendancy to adapt to surroundings to matter how foreign they may be. I am glad that I have had the chance to observe myself adapting and how I have become a part of this society.
The process of adaptation is very interesting. It amazes me at how normal this environment is to me now. Just 2 months ago it was the most foreign thing I could ever imagine, incomprehendable almost. Now it is normal. I live here and learn how to do all the minute things that take up our everyday life but become a huge obstacle in a foreign land. I am surprised, a bit shocked at how fast assimilating here has been, and also pleased that this place has become so home like. Things that were shocking I now am so used to for example: the rotting trash mountains, the drug addicted street boys, seeing dead animals or even people(!) in the street, or seeing a stray dog chewing on a hand. Things that I was amazing and mystified by are still amazing, but are more normal now. The beautiful dress of the Nepali women, the magnificent mountains, the gorgeous religious ceremonies. The temples and signs of devout religiousness all around me I was at first not used to. But now seeing people doing prostrations on the street is not out of the ordinary. School children, business people, beggars, and families alike all stop and pray quickly and touch their heads in front of the tiny temples sprinkled through the street.
Adaptation is an interesting process, and interesting insight on to the human condition and human tendancy to adapt to surroundings to matter how foreign they may be. I am glad that I have had the chance to observe myself adapting and how I have become a part of this society.
Free Geriatric Clinic
On Saturday a few of the doctors at Manmohan put on a free clinic for the elderly in a little neighborhood about 10 kilometers outside of Kathmandu. Although it was our day off we all decided it would be lots of fun, and the doctors had extended a welcoming invitation for us to come along. So we went to the hospital Saturday and headed out. Almost all of us including the ER docs, internal medicine and family practice doctors, drivers, helpers, and 4 of us volunteers all piled into one of the hospital ambulances. We were like sardines in there but had a great time riding in the ambulance. It turned out there was a strike that day, also I think there was some sort of Maoist protest or something along the way to the clinic. You can always tell because there will be alot of young people waving around the communist flag and sometimes something burning. On Saturday morning most of the route to the clinic was lined with protestors or something. In the middle of the road were tons of burning tires which were a bit of an obstacle but we made it. The clinic was held at an English grade school. A few of the students and parents were there to help out with registration and things of that nature. When we got there we unloaded supplies which included boxes and boxes of medicines. Then we set up shop in an empty room. When we got there, there were already about 100 patients sitting under a tent, listening to someone singing and playing the drum on a stage. They welcomed us an we got started. There were only 3 doctors there, so finally we volunteers could be of service to the doctors instead of just watching, which is what we do at the hospital. Another volunteer named Melissa and I were in charge of taking the blood pressures, taking weights of patients, keeping them in order, and sending them to Dr. Gupta who sat right next to us. Once we started taking BP and weights and writing these down on the charts there was a mad rush!! The patients ranged from around 50 years old to the oldest who was a 104 year old woman!! She was very sweet and appreciative. It was a kick taking all the BP's and weights. Some of the patients were so skinny that it was difficult to take a blood pressure, the lightest woman I think was only 22 kilograms!! Anyway, sometimes the little old Nepalis got a bit pushy and would cut each other in line to see us so we had to settle a few spats between them. It was quite entertaining. It was also quite interesting that I don't think many of these Nepali elders had ever seen a scale or blood pressure cuff before. After we took their blood pressures I would escort them to the small bathroom scale we were provided with to take their weights. A few of the older men tried to sit on it or squat on it like it was a toilet, so I had to demonstrate how to stand on the scale. Also many of the older women stood on the numbers so we couldn't see the weights. Most of the patients began thoroughly describing their ailments to Melissa and I (in Nepali), and didn't understand that we didn't know Nepali. After a whirl wind 3 hours or non stop patients we finally saw the last one. It was quite hectic but so much fun! After our last patient the school children served us milk tea and Fanta. Then a few of the parents had made a massive lunch for us volunteers and the doctors. They gave us pounds and pounds of food. Nepalis I believe have incredibly expandable stomachs because the doctors had finished their plates of dal bhat in about 5 minutes and we still had masses of food on the table. The lunch provided for us included: dal bhat, curried beans, curd (a yogurt drink), mutton stew, and a small plate of curried tomato stuff. We couldn't finish and felt really bad, but we just didn't have room. After lunch we met with the public health minister of Nepal who is a good friend of Dr. Gupta. Then 12 of us piled back into the ambulance to go back to town.
Friday, July 13, 2007
Books
A few books I have finished lately:
We Were the Mulvaneys by Joyce Carole Oates. This is a wonderful novel about family relationships and dynamics which I recommend to everyone. Very emotionally powerful.
Diary by Chuck Palahniuk. Written in his usual style like all his books. Dark, disturbing, twisted. It was good, although I enjoyed Fight Club and Lullaby much more.
The Lexus and The Olive Tree by Thomas Friedman. This is a good introductory book on globalization. I have become interested on how globalization affects culture. I have been noticing especially how Kathmandu is starting to plug into what Friedman calls the "electronic herd," although I still think Nepal has a LONG way to go. But evidence of globalization around here is everywhere: young Nepalis wearing Avril Lavigne, Britney Spears, and Kurt Cobain t-shirts, American brands plastered everywhere (including in some of the villages I have seen). The beginning of the book focuses on how globalization got started, and alot about the beginning of the internet. An interesting introduction for anyone interested in this new world system. Good, or bad, I am still decided. I think there are good and bad parts though. Traditional culture is going down the drain for American pop culture stuff, but I think globalization also allows a higher standard of living for people who previously did not have this option. A curious thing that I would like to read more about.
I am currently reading a history book about London in 1700. In many ways I feel that London in 1700 parallels life here in Kathmandu. An interesting bit of European history.
We Were the Mulvaneys by Joyce Carole Oates. This is a wonderful novel about family relationships and dynamics which I recommend to everyone. Very emotionally powerful.
Diary by Chuck Palahniuk. Written in his usual style like all his books. Dark, disturbing, twisted. It was good, although I enjoyed Fight Club and Lullaby much more.
The Lexus and The Olive Tree by Thomas Friedman. This is a good introductory book on globalization. I have become interested on how globalization affects culture. I have been noticing especially how Kathmandu is starting to plug into what Friedman calls the "electronic herd," although I still think Nepal has a LONG way to go. But evidence of globalization around here is everywhere: young Nepalis wearing Avril Lavigne, Britney Spears, and Kurt Cobain t-shirts, American brands plastered everywhere (including in some of the villages I have seen). The beginning of the book focuses on how globalization got started, and alot about the beginning of the internet. An interesting introduction for anyone interested in this new world system. Good, or bad, I am still decided. I think there are good and bad parts though. Traditional culture is going down the drain for American pop culture stuff, but I think globalization also allows a higher standard of living for people who previously did not have this option. A curious thing that I would like to read more about.
I am currently reading a history book about London in 1700. In many ways I feel that London in 1700 parallels life here in Kathmandu. An interesting bit of European history.
The Festival and The Jew
Last Sunday I went to my first full fledged Nepali festival! This was great fun, if not a little over whelming as well. The festival was in celebration of the beginning of the monsoon rains, a welcome thing here in Nepal because of the agriculture. Here comes the rice! We have made a Nepali friend named Rajendra who is 19 years old and owns a paper shop in Bhaktapur (a town about 45 minutes from here, and fabulous!) We met Rajendra at our house and Matt, Christine and I headed out to Patan where the festival was to take place. The scene once we got to Patan was madness!! Complete madness and most fabulous!! We started off the festivities going to the "amusement park." We got our amusement from watching everybody else. Hundreds of people were packed in, it was like the Rose Festival x100. We eyed the rides and decided against them as they were a bit rickety. On a few of the rides boys were just hanging off the edges, enjoying a free (and dangerous) ride. After some ice-cream Rajendra suggested we go to the "jew." The "jew"? They have synagouges here? He went to get us tickets for the jew and came back to pass them out. We headed down the street to the jew and I salivated thinking of latkes. Then we saw the sign: "Patan Zoo." Ahhh..... the zoo! We learned that Nepalis call the zoo the jew. I was a bit dissappointed we would not be getting an Manoschevitz wine, but was still very excited for the zoo. Now, I thought the amusement park was chaos. I hadn't seen nothin' yet. The zoo was pandemonium, crazy, maniacal! Insanity! But so great. Since the festival was going on I think every person in Kathmandu decided to go to the zoo that day. We walked along the path where all the zoo animals were. Actually we didn't really walk, but there were so many people that we had no choice but to be moved along by the crowd. The zoo was actually a bit sad. The animals live in tiny cages with nothing much in them. The Nepalis throw every thing they can find in the cages to try to make the animals do something: crackers, cans, rocks, umbrellas. Mostly the animals were hiding in the corners away from the massive crowd. After a while we sad on the side and stopped for a drink. We counted and literally 15 people passed everysecond, so we calculated about 4,000 or more people were in the zoo grounds at that moment. After a while of sitting I suggested that we should hop in the spotted hyeaena cage, and change the sign to "American Monkeys" because we were of much greated interest to everyone than was the hyeana. Next up was the tiger. People pushing to see the tiger was almost a riot. I was surprised no one was trampled underfoot from the tiger riot. We also saw elephants which we got to touch, cheetahs, rhinos, hippos, all sorts of birds, snakes, gazelles, dear, squirells, black bears, and a few other miscellaneous animals. It was quite fun, but I would like to go again when not so busy.
After the jew we went to a restaurant where we got a good view of the festivities. The crowds piled into the streets around this chariot looking thing. The wheels of the wooden chariot were about 15 feet high, and on the chariot was what a guy from Louisiana described as a "Nepali christmas tree." It did look sort of like a massive dead pine tree, decorated with banners, gold ornaments, red sashes, and other things. The "tree" was about 50 feet high. Around 5 o'clock PM was when all the important people started showing up. The police on horse had to keep the crowd back while all sorts of government officials came in their cars. Finally came the prime minister escorted by many army cars. When he got there the band played a while and other festivities took place. Then 3 government officials climbed onto the chariot and held up a black shirt, something ceremonial, I am not sure what it meant. Then the marching band paraded around playing songs. It was a great festival. After it was winding down teenage boys pulled the massive chariot through the streets plowing down everything and anything in it's way including all low power lines. The festival was wonderful!!
After the jew we went to a restaurant where we got a good view of the festivities. The crowds piled into the streets around this chariot looking thing. The wheels of the wooden chariot were about 15 feet high, and on the chariot was what a guy from Louisiana described as a "Nepali christmas tree." It did look sort of like a massive dead pine tree, decorated with banners, gold ornaments, red sashes, and other things. The "tree" was about 50 feet high. Around 5 o'clock PM was when all the important people started showing up. The police on horse had to keep the crowd back while all sorts of government officials came in their cars. Finally came the prime minister escorted by many army cars. When he got there the band played a while and other festivities took place. Then 3 government officials climbed onto the chariot and held up a black shirt, something ceremonial, I am not sure what it meant. Then the marching band paraded around playing songs. It was a great festival. After it was winding down teenage boys pulled the massive chariot through the streets plowing down everything and anything in it's way including all low power lines. The festival was wonderful!!
MMH Updates
Hello everyone!
I'm sorry I have not been updating recently! I have been busy with work at the hospital. The last week has picked in occupancy so we are getting alot of good cases. Here are some recent happenings around MMH:
-A few days ago I watched a bilateral inguenial hernia surgery. This was quite an interesting one. Before the surgery I read up on all types of hernias in the medical encylopedia they keep at the hospital. I was so surprised to learn how kinds there are! The definition in the encyclopedia says that one cause of hernias is lifting heavy objects. There must be a TON of hernias here in Nepal because people carry almost unthinkable amounts of weight on their backs. It is not uncommon to see on the street what I call a "walking sofa" or a "dresser with legs." Men who are about my size carry sofas, chairs, tables, dressers, and all other types of furniture on their back with a rope that wraps around their forehead. Also all the moving of bricks for construction is done by carrying the bricks inside wicker baskets with a rope that goes around the head. I think the Nepalis must be some of the strongest people in the world comparably with their body size. Anyway all the heavy lifting must cause a lot of hernias. So there were two incisions made on this man right above his groin. The first hernia went quickly, and the surgeon reinforced it with some sort of mesh. The second hernia was a bit more difficult and the surgeon was getting quite frustrated. But finally he did it. This was a great one to watch.
-I have been seeing a woman in the ER lately but have not gotten a chance to talk to her. It turns out she is American, from Illinois. She always is bringing in the young street boys who are sick, and I think she pays for their hospital fees. I think this is quite a noble thing to do. The other day she brought a boy in with a horrible fever, and then a few days ago a boy with a foot abscess. She is very nice and says she comes to Nepal a few months out of the year and can't help falling in love with these children (who are incredibly cute!) So I played with these street boys for a bit and found them incredibly happy and resilient. I pushed the one with the foot abscess around on one of the wheel chairs and the rest of his friends who came in (all about age 12) thought it most hilarious. I taught them how to high five too. The thing about these street boys is that although their life is quite unfortunate they are always happy and playing and laughing. (A few exceptions.)
-A man today had cut his finger with glass a month ago and his finger became infected so he covered it with duct tape which killed all the tissue around his finger. This did not look good, and the finger may have to be amputated.
-The following case has been my favorite so far (warning to readers: do not read if prone to queasy stomach!) A woman was in the ER today who has 78 years old. I believe she was from the villages outside of Kathmandu. Her 4th toe on her right foot had become gangrenous and her whole foot was beginning to rot. The 4th toe was blue and purple and was basically rotting off completely. It was dripping brown fluid and leaking blood fromt he healthy parts of her foot. I have never seen gangrene (sp?) before so was quite interested. One of her sons who brought her in let me examine her foot and what popped out during my examination but maggot!! A fly must have laid some eggs on the rotting part of her foot and there were now a small family of maggots rooting around her toes. I told the doctor there were maggots in her foot and they were a bit puzzled. The doc that was on duty had only seen maggots in dead bodies so I think was not sure what to do. But soon after, one of the nurses was bequeathed with the duty to pull out all the maggots with tweezers. I stood by fanning the gangrenous foot to with my notebook to keep the flies from landing on her foot while the nurse pulled out all the maggots. I think we got them all out but there might have been a few more lurking. The whole foot will likely be amputated in the next few days.
-A man came in with a snake bite! Well, actually he didn't "come in," he was brought in by his son because he had been comatose ever since he got the bit. A kind of cobra called a karate cobra bit him on the ear. He was about 71 or so. He was unresponsive to anything but was having seizures and coughing up strange things. The day after he came in I was trying to find him but no one seemed to know anything about where he went. Dr. Om thought he had little hope of surviving, so I think maybe they let him go home to "expire."
-A woman was in the other day with epilastic (sp?) anemia. She was covered in bruises. Basically if she even slightly banged something she would have a huge bruise. She had bleeding gums and was constantly tired and always had a head ache. She was only 20 years old and had been having symptoms for 6-7 years. I asked everyone why she didn't come to the hospital for 7 years, but no one really understood what I was saying. I think it was either too far, or she didn't have the money. Anyway, she also had a bleeding disorder. Something like hemophelia, but we learned that with hemophelia woman are carriers but men are the sufferers. So she had some kind of variation of hemophelia.
-The usual cases of TB have come in. One thing I have learned is that tuberculosis is not just a disease of the lungs which I thought before I came here. I have since learned that you can have TB of any organ, the only place you cannot have TB is of the hair and nails apparently. Well a young girl about 18 came in with a distended abdomen. She had ascitis, which is a build up of fluid in the abdomen. She had a TB test which came up positive, and she had abdominal tuberculosis. So in the ER we had to drain her abdomen of this fluid. The doctors missed about 5 times with a enormous needle, but finally the fluid started to flow out. She had to lay on her side while the fluid drained into a water bottle on the floor.
-Tomorrow we are going with the doctors to a free clinic they are putting on for the elderly people about 10 kilometers away from Kathmandu.
-I was walking around the wards and met a man with gout and septic arthritis (i think this is what it is called.) He was an older man but knew English surprisingly well so we chatted for a while. His had was very interesting looking, from the arthritis there were bone build ups coming out all over his hand, and it was all bumpy. Also he had just had his leg amputated above the right knee. He was in high spirits despite just having one of his limbs cut off.
-Dr. Gupta (MMH director) arranged for us volunteers to go meet his cardiologist friend at the Heart Hospital of Nepal. Gupta's driver drove us out to the heart hospital and the doctor gave us a tour. They do anything heart related at the hospital, except they do not do heart transplants. I was very impressed by the hospital, it was incredibly busy and very very modern. Our hospital is very nice too (relative to circumstances) but the heart hospital had some very modern high tech medical stuff. A very impressive place. We toured the pre op and post op areas, the ICU, CCU, rehabilitation center, exam rooms, surgical theaters, and canteen. A great little field trip. In the next week we are also going to get a tour of the teaching hospital.
A few observations about the hospital in general:
-Pretty much every day I sit in Dr. Om's office while he takes patients. I have noticed that going to the doctor is a complete family affair. I don't think I have ever seen one patient who has come in by themselves. The patient usually comes in with 2, 3, 4 or even 5 relatives. They all sit around in the exam room while the patient describes what is ailing them and while the patient is examined. They look quizically at us and are anxious to show the Americans what is wrong with them. Sometimes I wonder what would happen if a patient had something "embarrassing" to discuss with the doctor like an STD, or something else of the sort. I think premarital sex, or anything related to sex in general is taboo to talk about, so I can't imagine this would be easy to talk about with 5 of your relatives standing over your shoulder.
-The patient or the patient's family must buy all supplies to be used for their procedures. By this I mean that when a patient's saline IV runs out, a family member must run over to the pharmacy and buy a new one. The nurses and doctors cannot be bothered by this.
-All the patients are very eager to show us volunteers what is wrong with them. They wave us over and let us examine their rashes, boils, burns, IVs, medicines, amputations, and other problems. They are quite excited of our presence.
-In general, although pretty small (100 beds in total, occupancy usually 50% or less) Manmohan Memorial Hospital is a very nice hospital, modern, with great and well educated doctors. They all very professional and extremely knowledgeable. Most of the doctors did their residency or fellowships in the United States. They are all eager to teach us what they know.
-I was talking to the anesthesiologist during the hernia surgery the other day. He told me to make sure I kept good record of what goes on in the hospital. He said I will never see alot of these cases in America (which is true) and that "human experimentation" more readily goes on here in Nepal. He said life in this area is not valued as much as it is in the west so people will do more brazen things in the name of medicine. I thought this comment was interesting.
I'm sorry I have not been updating recently! I have been busy with work at the hospital. The last week has picked in occupancy so we are getting alot of good cases. Here are some recent happenings around MMH:
-A few days ago I watched a bilateral inguenial hernia surgery. This was quite an interesting one. Before the surgery I read up on all types of hernias in the medical encylopedia they keep at the hospital. I was so surprised to learn how kinds there are! The definition in the encyclopedia says that one cause of hernias is lifting heavy objects. There must be a TON of hernias here in Nepal because people carry almost unthinkable amounts of weight on their backs. It is not uncommon to see on the street what I call a "walking sofa" or a "dresser with legs." Men who are about my size carry sofas, chairs, tables, dressers, and all other types of furniture on their back with a rope that wraps around their forehead. Also all the moving of bricks for construction is done by carrying the bricks inside wicker baskets with a rope that goes around the head. I think the Nepalis must be some of the strongest people in the world comparably with their body size. Anyway all the heavy lifting must cause a lot of hernias. So there were two incisions made on this man right above his groin. The first hernia went quickly, and the surgeon reinforced it with some sort of mesh. The second hernia was a bit more difficult and the surgeon was getting quite frustrated. But finally he did it. This was a great one to watch.
-I have been seeing a woman in the ER lately but have not gotten a chance to talk to her. It turns out she is American, from Illinois. She always is bringing in the young street boys who are sick, and I think she pays for their hospital fees. I think this is quite a noble thing to do. The other day she brought a boy in with a horrible fever, and then a few days ago a boy with a foot abscess. She is very nice and says she comes to Nepal a few months out of the year and can't help falling in love with these children (who are incredibly cute!) So I played with these street boys for a bit and found them incredibly happy and resilient. I pushed the one with the foot abscess around on one of the wheel chairs and the rest of his friends who came in (all about age 12) thought it most hilarious. I taught them how to high five too. The thing about these street boys is that although their life is quite unfortunate they are always happy and playing and laughing. (A few exceptions.)
-A man today had cut his finger with glass a month ago and his finger became infected so he covered it with duct tape which killed all the tissue around his finger. This did not look good, and the finger may have to be amputated.
-The following case has been my favorite so far (warning to readers: do not read if prone to queasy stomach!) A woman was in the ER today who has 78 years old. I believe she was from the villages outside of Kathmandu. Her 4th toe on her right foot had become gangrenous and her whole foot was beginning to rot. The 4th toe was blue and purple and was basically rotting off completely. It was dripping brown fluid and leaking blood fromt he healthy parts of her foot. I have never seen gangrene (sp?) before so was quite interested. One of her sons who brought her in let me examine her foot and what popped out during my examination but maggot!! A fly must have laid some eggs on the rotting part of her foot and there were now a small family of maggots rooting around her toes. I told the doctor there were maggots in her foot and they were a bit puzzled. The doc that was on duty had only seen maggots in dead bodies so I think was not sure what to do. But soon after, one of the nurses was bequeathed with the duty to pull out all the maggots with tweezers. I stood by fanning the gangrenous foot to with my notebook to keep the flies from landing on her foot while the nurse pulled out all the maggots. I think we got them all out but there might have been a few more lurking. The whole foot will likely be amputated in the next few days.
-A man came in with a snake bite! Well, actually he didn't "come in," he was brought in by his son because he had been comatose ever since he got the bit. A kind of cobra called a karate cobra bit him on the ear. He was about 71 or so. He was unresponsive to anything but was having seizures and coughing up strange things. The day after he came in I was trying to find him but no one seemed to know anything about where he went. Dr. Om thought he had little hope of surviving, so I think maybe they let him go home to "expire."
-A woman was in the other day with epilastic (sp?) anemia. She was covered in bruises. Basically if she even slightly banged something she would have a huge bruise. She had bleeding gums and was constantly tired and always had a head ache. She was only 20 years old and had been having symptoms for 6-7 years. I asked everyone why she didn't come to the hospital for 7 years, but no one really understood what I was saying. I think it was either too far, or she didn't have the money. Anyway, she also had a bleeding disorder. Something like hemophelia, but we learned that with hemophelia woman are carriers but men are the sufferers. So she had some kind of variation of hemophelia.
-The usual cases of TB have come in. One thing I have learned is that tuberculosis is not just a disease of the lungs which I thought before I came here. I have since learned that you can have TB of any organ, the only place you cannot have TB is of the hair and nails apparently. Well a young girl about 18 came in with a distended abdomen. She had ascitis, which is a build up of fluid in the abdomen. She had a TB test which came up positive, and she had abdominal tuberculosis. So in the ER we had to drain her abdomen of this fluid. The doctors missed about 5 times with a enormous needle, but finally the fluid started to flow out. She had to lay on her side while the fluid drained into a water bottle on the floor.
-Tomorrow we are going with the doctors to a free clinic they are putting on for the elderly people about 10 kilometers away from Kathmandu.
-I was walking around the wards and met a man with gout and septic arthritis (i think this is what it is called.) He was an older man but knew English surprisingly well so we chatted for a while. His had was very interesting looking, from the arthritis there were bone build ups coming out all over his hand, and it was all bumpy. Also he had just had his leg amputated above the right knee. He was in high spirits despite just having one of his limbs cut off.
-Dr. Gupta (MMH director) arranged for us volunteers to go meet his cardiologist friend at the Heart Hospital of Nepal. Gupta's driver drove us out to the heart hospital and the doctor gave us a tour. They do anything heart related at the hospital, except they do not do heart transplants. I was very impressed by the hospital, it was incredibly busy and very very modern. Our hospital is very nice too (relative to circumstances) but the heart hospital had some very modern high tech medical stuff. A very impressive place. We toured the pre op and post op areas, the ICU, CCU, rehabilitation center, exam rooms, surgical theaters, and canteen. A great little field trip. In the next week we are also going to get a tour of the teaching hospital.
A few observations about the hospital in general:
-Pretty much every day I sit in Dr. Om's office while he takes patients. I have noticed that going to the doctor is a complete family affair. I don't think I have ever seen one patient who has come in by themselves. The patient usually comes in with 2, 3, 4 or even 5 relatives. They all sit around in the exam room while the patient describes what is ailing them and while the patient is examined. They look quizically at us and are anxious to show the Americans what is wrong with them. Sometimes I wonder what would happen if a patient had something "embarrassing" to discuss with the doctor like an STD, or something else of the sort. I think premarital sex, or anything related to sex in general is taboo to talk about, so I can't imagine this would be easy to talk about with 5 of your relatives standing over your shoulder.
-The patient or the patient's family must buy all supplies to be used for their procedures. By this I mean that when a patient's saline IV runs out, a family member must run over to the pharmacy and buy a new one. The nurses and doctors cannot be bothered by this.
-All the patients are very eager to show us volunteers what is wrong with them. They wave us over and let us examine their rashes, boils, burns, IVs, medicines, amputations, and other problems. They are quite excited of our presence.
-In general, although pretty small (100 beds in total, occupancy usually 50% or less) Manmohan Memorial Hospital is a very nice hospital, modern, with great and well educated doctors. They all very professional and extremely knowledgeable. Most of the doctors did their residency or fellowships in the United States. They are all eager to teach us what they know.
-I was talking to the anesthesiologist during the hernia surgery the other day. He told me to make sure I kept good record of what goes on in the hospital. He said I will never see alot of these cases in America (which is true) and that "human experimentation" more readily goes on here in Nepal. He said life in this area is not valued as much as it is in the west so people will do more brazen things in the name of medicine. I thought this comment was interesting.
Wednesday, July 4, 2007
Cases
Here are some recent interesting cases at the hospital:
-I scrubbed in on a very interesting surgery on a young girl's wrist. She I think had carpel tunnel and some other nerve problems in her wrist. It was very interesting to watch this surgery and see all the tiny nerves and delicate bones of the wrist. Amazing!
-Watched one of the ER docs remove and infected toe nail of a young guy. I have a pretty solid stomach usually, but this made my stomach churn a bit I will admit. He had an infected big toe from an ingrown toenail. It was sliced off with a tiny scalpel head.
-I got to feel a breast cancer, which I have never felt or even seen before. It was actually closer to being in the woman's armpit. She is havin chemotherpy treatment every monday. It was huge and very very hard. It seemed to be about the size of a golf ball.
-Today a young boy aged 7 was rushed in after being hit by a motorbike. I am surprised we don't see more traffic accidents coming in judging by the way people drive around here. Anyway, he was mostly bleeding from his face and head, but once cleaned up wasn't so bad. We were awaiting x-rays when I left to see if he had any fractures or broken bones. There were quite a few police hanging around the ER after the boy was brought in.
-Watched a minor surgery to remove a boil from an older woman's abdomen. It was right next to her belly button, and the surgeon said was from a staff infection. He first just sliced it open to drain the puss then cut off alof of the surrounding infected skin. The woman was awake and moaning during the whole surgery which surprised me. Another thing that surprised me: after the surgery she had a gaping hole in her lower abdomen where the boil had been removed but she was not sutured up! The surgeon said they were leaving it open because it was an infection and needed to be cleaned for a week. We asked if she would be hospitalized for the week and he said no. She would be going home, but coming to the hospital everyday for new dressings. I was a bit surprised that they would be leaving a huge hole which exposed organs and innards and she would be going home with that hole. She was too poor to affored hospitaliztion for the week, which probably would have amounted to $10 USD or less.
-Watched surgeons biopsy a man's penis. He was very old and had some sort of penis cancer. He also had a massive testicular tumor. Lets just say I felt very sorry for this man, and it looked VERY painful. After the biopsy he will be having a genital "amputation" as the surgeon put it. Mostly everything will be removed and his urethra will be rerouted and the doctor said he will then have to "pee like a woman."
-There have been the usual cases coming in of tuberculosis. I have been reading up on TB lately because it is very common here. We usually see a few TB patients daily. I was surprised to learn that it takes 6-8 (or sometimes more) months to treat!!
-A few street kids have come in with fevers and headache and "throat pain." The only way they ever come to the hospital is if an adult brings them in. And the two times a street kid has been brought in it has been by an American, looking like a tourist. I am not sure if they see these kids and take pity on them so bring them to the hospital and pay their registration fee. The sick boys are always accompanied by a gang of about 5 other street boys, all are very dirty and never have shoes and are incredibly fascinted by the ER equipment. A few times they have got into fighting matches with one another. The "throat pain" I believe is caused by glue huffing.
-A fistula surgery and a gall bladder surgery two days ago.
-The "burn man" (the one who spilled a pot of boiling dal on himself) has come in every day since his initial accident for clean dressings.
-Quite a few cases of typhoid. The hospital director has taught me a good method for diagnosing typhoid.
-An oral ulcer. I got to look at this one with Dr. Gupta (the hosptial director). I diagnosed it as some sort of herpes of the mouth. It looked like a massive canker sore inside the gums of a teen boy. Dr. Gupta said it was an ulcer and would be treated with a topical anesthetic.
-I learned to take blood pressure. I was very excited about this one, although it is very simple, I had not learned how to take BP until a few days ago!!
-I scrubbed in on a very interesting surgery on a young girl's wrist. She I think had carpel tunnel and some other nerve problems in her wrist. It was very interesting to watch this surgery and see all the tiny nerves and delicate bones of the wrist. Amazing!
-Watched one of the ER docs remove and infected toe nail of a young guy. I have a pretty solid stomach usually, but this made my stomach churn a bit I will admit. He had an infected big toe from an ingrown toenail. It was sliced off with a tiny scalpel head.
-I got to feel a breast cancer, which I have never felt or even seen before. It was actually closer to being in the woman's armpit. She is havin chemotherpy treatment every monday. It was huge and very very hard. It seemed to be about the size of a golf ball.
-Today a young boy aged 7 was rushed in after being hit by a motorbike. I am surprised we don't see more traffic accidents coming in judging by the way people drive around here. Anyway, he was mostly bleeding from his face and head, but once cleaned up wasn't so bad. We were awaiting x-rays when I left to see if he had any fractures or broken bones. There were quite a few police hanging around the ER after the boy was brought in.
-Watched a minor surgery to remove a boil from an older woman's abdomen. It was right next to her belly button, and the surgeon said was from a staff infection. He first just sliced it open to drain the puss then cut off alof of the surrounding infected skin. The woman was awake and moaning during the whole surgery which surprised me. Another thing that surprised me: after the surgery she had a gaping hole in her lower abdomen where the boil had been removed but she was not sutured up! The surgeon said they were leaving it open because it was an infection and needed to be cleaned for a week. We asked if she would be hospitalized for the week and he said no. She would be going home, but coming to the hospital everyday for new dressings. I was a bit surprised that they would be leaving a huge hole which exposed organs and innards and she would be going home with that hole. She was too poor to affored hospitaliztion for the week, which probably would have amounted to $10 USD or less.
-Watched surgeons biopsy a man's penis. He was very old and had some sort of penis cancer. He also had a massive testicular tumor. Lets just say I felt very sorry for this man, and it looked VERY painful. After the biopsy he will be having a genital "amputation" as the surgeon put it. Mostly everything will be removed and his urethra will be rerouted and the doctor said he will then have to "pee like a woman."
-There have been the usual cases coming in of tuberculosis. I have been reading up on TB lately because it is very common here. We usually see a few TB patients daily. I was surprised to learn that it takes 6-8 (or sometimes more) months to treat!!
-A few street kids have come in with fevers and headache and "throat pain." The only way they ever come to the hospital is if an adult brings them in. And the two times a street kid has been brought in it has been by an American, looking like a tourist. I am not sure if they see these kids and take pity on them so bring them to the hospital and pay their registration fee. The sick boys are always accompanied by a gang of about 5 other street boys, all are very dirty and never have shoes and are incredibly fascinted by the ER equipment. A few times they have got into fighting matches with one another. The "throat pain" I believe is caused by glue huffing.
-A fistula surgery and a gall bladder surgery two days ago.
-The "burn man" (the one who spilled a pot of boiling dal on himself) has come in every day since his initial accident for clean dressings.
-Quite a few cases of typhoid. The hospital director has taught me a good method for diagnosing typhoid.
-An oral ulcer. I got to look at this one with Dr. Gupta (the hosptial director). I diagnosed it as some sort of herpes of the mouth. It looked like a massive canker sore inside the gums of a teen boy. Dr. Gupta said it was an ulcer and would be treated with a topical anesthetic.
-I learned to take blood pressure. I was very excited about this one, although it is very simple, I had not learned how to take BP until a few days ago!!
The End of Poverty
I finished a book called The End of Poverty by Jeffrey Sachs about a week ago, and am still deciding my opinions on the book. Well, I was moved, motivated, and inspired by the book, thats for sure. Sachs lays out a clear and conscise economic plan to eliminate extreme poverty completely by the year 2025, in our lifetime. I was shocked and dismayed to learn how little the US is contributing in foreign aid compared to the amount of money the US has available for expenditure. The US has time and time again promised to give 0.7% of GNP to foreign aid, but is right now contributing about 0.15%. Sachs lays out exactly how and where the money should be spent and in which countries. I am keeping the book rather than selling it back because there are many sections I am going to read over again. Some parts were had for me to fully understand because the book, although clear and readable, is full of economic and political jargon that I am not familar with. I am still not decided what I think though. In the next week or so I will post a more thorough review and my opinions in greater detail. Right now: I think it is absolutely possible to attain the goals in Mr Sach's book, the question is are the rich countries and super-rich people (especially the top 400 richest people in the US) willing to do it? As of now, it seems the answer is no. But, I am not sure how much longer we can allow 10,000 people in Africa to die every day of preventable and treatable illness.... When I post my full review I will also post my opinions of how the Millenium Development Goals in The End of Poverty relate to Nepal, and how Nepal might fit into this plan to end extreme poverty in our life time.
More to come....
More to come....
Hospital Updates
It has been rather slow at the hospital since the beginning of the week, but has started to pick up again. The lag in patients was a from the "incident" as we call it at Manmohan. I reported about this about a week ago: when the young woman died from complications of an ovarian cyst surgery. The day after the surgery I showed up at the hospital to find it teeming with riot police. I was confused about this but found out later that the family of the girl was enraged (of course) and said that her death was the fault of the attending surgeons. So, they threatened to burn down the hospital, throw rocks at it, and kill the doctors involved in the case. This was the reason for the police presence. The family also threatened to get various violent gangs involved, including the YCL. Thank goodness, the YCL never showed up to the hospital. The family also demanded a HUGE sum of money, I cannot report the exact amount but it's in the many hundreds of thousands of rupees. The hospital bargained this sum down a little, but not much and paid the family. The doctor I work with frequently said he thought this was a major mistake of the hospital and that they should not have paid the family any money.
Because of all this, which a bit of was leaked to the press, the flow of patients has been down quite a bit. When sitting with Dr. Om to take patients we normally would have 15 to 20 in a few hours. Recently it has been more like 3. But, I'm glad to say that I think the "incident" has blown over as the patients are coming for treatment more than they were at the beginning of the week.
Because of all this, which a bit of was leaked to the press, the flow of patients has been down quite a bit. When sitting with Dr. Om to take patients we normally would have 15 to 20 in a few hours. Recently it has been more like 3. But, I'm glad to say that I think the "incident" has blown over as the patients are coming for treatment more than they were at the beginning of the week.
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