Saturday, March 24, 2012

Bandipur!

It’s been almost two weeks since clinic finished.  I’ve been in Boudha for most of that time, resting and recovering a bit, hanging out with my beloved  compatriot Seven, to celebrate her birthday and a couple days later to bid her farewell as she travels to Thailand. 
I was unable to kick a cold that started now almost four weeks ago, although diligently wearing my dust mask in the polluted city of Kathmandu, Boudha being sort of a suburb, if you can call it that, where the air is still filled with dust and particulate, along with diesel fumes etc.  So this week I decided to skip town and travel down the highway in the direction of Pokhara, climb the hill by microbus, and land in Bandipur.  What a retreat, and a wonderful way to kick this cold to the curb. 
Main Drag, Bandipur
Bandipur is car-free in it’s center, with slate cobblestone separating the two sides of mom and pop shops, many of which have opened their doors as modest guesthomes running about $5 a night.  Life here seems relatively undisturbed by the recent tourism, at least when you leave town, and the terraced hillsides remain teeming with rotated crops, and families herding goats and cows.  As I walked a trail yesterday a man and his son urged a slow-moving ox along, plowing the field in preparation for the next planting. 

When I arrived the first day I popped into the Old Bandipur Inn desiring a night of luxury.  It was a bit more expensive than I anticipated, the guidebook I am using 3 years old (although the most recent edition, ahem, in need of an update!), but yet with dinner and breakfast included, I decided to be lavish and splurge.  As I went through various emotions of slight guilt, feeling inappropriate, undeserving etc etc I realized:  I couldn’t find a moldy, run-down, podunk motel on the side of I-5 for this price!  (Amazing how relative it all becomes once out of the familiar expensive economic environment of the US) And, this place is absolutely fantastically gorgeous.  After walking down the street a ways, checking out a couple of guesthouses 1/6th the price, or less even (and agreeing to spend two nights at one in the following days, curbing my extravagance...) I found I desired greatly to get back to the Old Inn and sit and relax with tea and my book.  It’s a small haven!  And I am ever-so deserving, I finally allowed myself to accept. 
Nice view!
The following day two new friends arrived in Bandipur, Marie and Dustin, from Pokhara.  We will be trekking together with another couple of friends, Kax and Brian arriving from the states in a few days.  Kax is the mutual friend bringing this whole group together, and it was a fun coincidence that Marie and Dustin were planning to detour up to Bandipur at the very same time I had decided on it, me in need of fresh air and a break from the city, they on their way from Pokhara to Kathmandu.  We shared a lovely dinner over candlelight, where they placed a small American flag on our table (is that so necessary?  I joked, and Marie exclaimed how she wants to fly the flag, reclaiming it from the meanings it has taken on...yes! I agree), and were serenaded by the local musician with his nightly gig, and made to dance by the friendly wait staff.  Magical. 
We hiked to a cave the other day, a good hearty hike sure to build a little stamina for our impending trek in the Langtang range.  It was huge!  And I was happy for the company, having almost made it on my own the day before but knowing I would not have explored it to the extent we did as a group.  We picked up Matthew, a new French friend who had hiked on his own, his girlfriend recuperating from sickness back at their place. 
Tomorrow back  to the valley, where we will meet up with Tsering, our guide for the trek!  It will be a fantastic adventure, no doubt.  Pictures of the grand Himal to be posted upon our return. 


Ok, a preview--Langtang Peak viewed from Nagarkot

 Also, stay tuned for an environmental update, showcasing Beautiful Forest Group, formed in Chapagaon, initiating local clean-up and environmental awareness and education.  Totally inspiring.  Wonderful to witness this happen the final weeks I was in clinic. 

At Kopan Monastery last week




                                                                                                                                          

Monday, March 12, 2012

One final week

Okay!!!!  Out of clinic now, this was the final week's post, then the internet broke...
So here it is.

I am so sorry to not have put anything up for so long!  Things got crammed, then I got sick.  Now on the mend, my energy, thankfully, is up again and ready for one last week of treating patients.  It has been a wonderful ride.

What has it been like?

Well...what a phenomenal experience (in all senses of the word) it has been to work at the Vajra Varahi Healthcare clinic.  I can't even begin to tell you how much kneepain , back pain, and gastric pain we have all treated.  We have treated stroke sequella and other hemiplegic disorders such as Bell's palsy,  numerous sciatica cases (which can often be lumped in with back pain), shoulder and arm pain, numbness and tingling (in Nepali they will say 'zum zum zum zum' or 'cutta cutta cutta' for various sensations, tingling and aching, respectively) in any part of the body, headaches, and common colds.  There are plenty of complicated cases, difficult at times to suss out, even harder to get straight stories, which obviously makes sussing out all the harder.  I am treating a young patient with cerebral palsy and epilepsy, whose mother's only goal is to help him communicate when he is hungry, and when he needs to go to the bathroom. The only time I have ever needled DU-8 was on him, and I did it without knowing why.  Thankyou, intuition.  (Pardon the shoptalk, non Chinese med readers). 

A patient with whom I have had the deepest connection is a patient with Parkinson's disease.  I so deeply enjoyed working with her, and was terrified of her at the same time.  Treating a virtually untreatable disease is incredibly challenging, especially when the patient you are working with desperately wants to be cured, and seeks numerous avenues to determine if someone can give this 'cure' to her.  I've told a story about part of my experience working with this patient in a blog published on the ARP website.  Please find it here:

http://www.acupuncturereliefproject.org/news-blog

Not too long ago I wrote this in my journal:

I dreamt of my patient this morning.  She was young, agile, interacting with her family with an extreme lightness of character and laughter, jumping even.  I was astounded, waiting for her to come in for treatment.  Then I turned and there again she was, in  her red sari and yellow scarf she wears every day, waiting quietly, still in the body she has come to know only in the past few years.  But she didn't look sad.

If sickness strikes any one of us, or any of our patients, changing reality to a degree unprecedented, and if we can maintain any semblance of a dancing, joyful being inside, if that is what is possible with any form of medicine, then we have succeeded, somehow.



Saturday, February 11, 2012

Blink, another week has passed


Amongst power clicking on and off at strange hours and a work schedule that kicks everyone’s butt, it is certainly hard to get to posting.  Add to it that everyone in the clinic jumps onto the internet when we have electricity and the garbled waves cause it to be as convenient and speedy as snail mail....ok, exaggeration.
But anyway.  Here I am.
And here's the recap....
Monday:
Elissa and I headed to Champi with our interpreters, Prajwal and Mishal.  We heard loudspeaker chanting and music across the valley as we hiked up to the village.  Arriving, we hear that it is a day for puja, this celebration nine days in length.  Our lunch break consisted of hopping over to the tent where we had tikkas placed on our foreheads and were made to dance.  I loved the feeling of being so welcomed.  

Tuesday: 
Normally one practitioner goes by motorbike to Godhavri  but today we were two.  Reason?  To leave early afternoon, meet other team members in Sathobado  and taxi out to Boudha where we would have dinner, crawl into bed at a decent hour and arise the next morning at 5:30 to meet the jeep and taxi who would take us up to the stairway leading to Nagi Gompa, where we would then climb to the monastery and commune in ceremony with the nuns, offer a kata to the Rinpoches, get bonked on the head by what looked like a deck of cards by Chokyi Nyima Rinpoche and brother, receive an “empowerment”, eat Tibetan breakfast, meditate over yak butter candlelight while we are tied in by katas that connect the entire room of two hundred people, descend back to Boudha and find our way back to Chapagaon by evening.  That was a description of....
'stairs' to the gompa

Wednesday:
Thunderstorms break out early morning, which bring a soggy adventure ascending to the Gompa, taxi getting stuck in the mud, which allows a little hiking, yay.  All transpires what was said before, it’s beautiful, comfortable, colourful!  Windy, cloudy, rainy all day, the likes of which is strange at this time of year.  I elect to brave the motorbike back ‘home’ to Chapagaon with Tsering, and am happy to not shop, save for a scarf to replace the one I lost at the Buddhist temple.  I hope a nun is keeping her neck warm by it.
Tsering takes me to his aunt and uncle’s abode in Boudha where we are picking up a bag of Tongpa, fermented millet that is steeped in hot water and refilled, a warm alcoholic specialty that is drunk in the cold months (and perfect for a rainy chilly day).  Tsering cordially declined any being the driver.  His uncle made us Thukpa (noodle soup), the best meal I’ve had yet in Nepal, with buff meat.  We had to wait out the rain, and crossed the city in perfectly dry air, over muddy streets, making it home before the rain began again, soaking the night. 
Felt huge shifts in body and spirit before and while sleeping. 

Thursday:
Awoke, a new person.  Just like any other day...
Treated 23 patients.  Felt pretty good. 
In the evening had a party for Alison, our team leader, who left us the following day.  Drank Tongpa, my new favourite!  And red wine, which is a great treat in this part of the world for us westerners.  

Friday: 
Treated patients again, all day, said goodbye to Ali at lunch :(, hit a wall in the afternoon, wasn’t sure I could continue for a minute but made it through.  Kept calm through it, good good. 

Saturday (today):
Adventure walk down the road, taking pictures of dwellings and landscapes. Finally encountered the lake we were told to find, where we would also find food (or beer, or tongpa! In my case) at one of the restaurants surrounding.  Followed the nose towards home, through fields of spring onion, wild mustard and the brick yards, getting stares from the locals.  Slightly nervous, hoping to find the right road, but knowing we were headed straight for Chapagoan, companions naming me the human compass once we found our way to a familiar spot.

Sunday (tomorrow):
Treating in Godavri, beginning the week of packed patient schedules.  Wheeeeee! 
Until next time...







Saturday, February 4, 2012

Trash Talk


Feb 4
I wrote a page in my journal during the first week in Chapagaon, concerning my concerns about the trash situation here in Nepal.  From that point, it has been interesting to observe within myself the transitions in emotion and perception surrounding the topic of trash.  From a Western perspective, Nepal is, literally, littered.  There is trash everywhere, the places free from it are mostly the agricultural fields, but even then you may find a stray plastic bag trampled into the worn, narrow path. 
And so.  Here are my feelings from almost a month ago.

Jan 15
Smita (one of the clinic workers) took Seven and I on a walk today, through Chapagaon and its streets, and to a cafe, and then back to the clinic through fields of young fava beans, and flowering wild mustard.  It’s still dusty here in the village, but the diesel fumes are less and so the dust is simply dusty and not sticky-dusty, as it is in the city.
Smita shed some light on what I have termed for myself “the trash situation” as we walked past small ponds, greyish-brown murk with a thin fluorescent green algae bloom towards on end.  She explained that it was not always this way, that when she was a child, twenty years ago, these ponds and canals were clean and clear.  It’s not so hard to imagine how beautiful this place must have been, it’s quite beautiful now.  But the plastic, of every imaginable color, litters every block, every embankment, every edge of beautiful green field, a huge disappointment at the state of the environment here for me, a softie for the earth and easily triggered by lack of care for it. 
I remember the anti-“litterbug” campaign of my own early childhood, and the advent of yellow metal trashcans on every street corner around town.  I remember also, in the sixth grade, our teacher talking about Tenney lagoon and how it used to be a swimspot, the water crystal clear, you could see to the bottom.  Not saturated in a rainbow of plastic trash, like the Vishnumati or the Bagmati Rivers, that run through Kathmandu, but saturated with algae, seaweed and lilypads due to the unregulated Wisconsin farm-water runoff.  The concept of a crystal clear Tenney Park lagoon was about as conceivable as martians joining us for volleyball at the beach.  So my thoughts and questions about my own country, before the yellow trashcan invasion, which provided a constant reminder to us to ‘Keep Clean!’ our city:  did this type of thing ever happen  when every sort of plastic packaging for any sort of good first came on the market?  Was “disposable” considered by the majority of our population as game for simply tossing to the side of the road?  And finally, the fact that we have mechanisms set up to collect, consolidate, and “dispose” of this plastic, among other things (i.e. put them out of site, cover them up etc. etc.) doesn’t make it go away now, does it? 
 
I consider plastic one of the greatest tragedies of the 20th century.  

In any case.  Smita did not allude to either negative nor positive feelings over the matter, but my heart breaks as I think of our globalized economy and witness first-hand what it is doing to the towns and cities of Nepal. 

Their solution?

But it's interesting, the longer I am here, the less I see the trash.  It blends into the landscape.  And I wonder, is it complacency, or coping?  Or is it the sense of Buddhist impermanence?  Although majority Hindu, Buddhism pervades and mingles amongst the Nepali character.  If I am empty, so is the world, and the trash that I see with my mind is only a concept, created by the idea itself.  If I don't see it, is it really there? 



Monday, January 23, 2012

Yes!

Quick news of the day: 

The hot water was fixed (yessssss!!)

And the monkeys were chased off of our roof as the sun went down by a teenage monk from next door, all the other young monks looking on, laughing.  A show ensued on other rooftops as women baring sticks and cups of water sent them away.  I did see the big 'bastard' snatch an apple and eat it casually... 
They scurried quite quickly from the cup of water.  Duly noted.


Sunday, January 22, 2012

Boudhiful exhaustion


So it's starting to become real, folks.  We've treated for six days straight, 4 days for me at the home clinic, and 2 days at satellite clinics:  Godavari by motorbike (see previous post) and Champi by foot (pictures to come).  After a full day of treating at the home clinic on Friday, having seen almost 200 cases collectively throughout week, Seven, Alison, Elissa and I hopped onto a micro (a minibus, think vanagon with 3 rows of seats), then a bus, (where we puffed past the beginnings of Friday night life in Kathmandu, running parallel to a wierd-looking tractor for 20 minutes that puffed black smoke into the air), and then a tuk tuk (a 3-wheeled truck) that carried us to Boudha.

Stupa maintenance!  On top of this they keep it sparkling clean.
We spent a day of sight-seeing the next day, circling the stupa that we kept calling a square and then laughing because it really is a circle, and we intermittently shopped and ate.  In the afternoon we went to witness the Puja, regularly done at the Gompas around town on a Saturday, Nepal's holy day and rest day.  We then taxied home, a much simpler and of course more expensive (but really only a Portland bus fare each) way to travel, exhausted but happy with our day. Please see the video below to experience a brief moment of the ride! 
Stupa cleaning
So. I have to say that I would have VERY MUCH looked forward to, at the end of our tourist jaunt out of town and back, a nice warm shower.  Perhaps I've mentioned the water at the clinic was solar-heated, and that if the day was sunny (which is 9 out of 10 times the case), one was gauranteed hot water (even enough to turn on the cold) if one desired. Was.

However.  And this happened Friday, just as we were finishing up our treatment day.... 

I hadn't seen the monkeys for a few days, but here they were all of a sudden, the whole family this time, scrambling down our building, past the treatment room window, running quickly across the alley, and scaling the building across the way.  These monkeys, on the first day of arrival, were introduced to us by our delightful, wickedly smart, and witty clinic director, Nicky (who is British, fyi), as the 'Bastard monkeys'.  Out of curiosity and and a hesitancy to judge, I hadn't quite accepted this title for them, although I knew they stole food and such and really, are slightly nerve-wracking to have around.  A wild animal nimbly climbing up and down our two-tiered roof while eating breakfast, who could easily be carrying rabies is not, well, let's say, calming to the nerves.
So anyhow, a few minutes later, we come to find out that the monkeys have taken off the water pipe on the roof (a normal occurrence) and smashed one of the glass tubes (not a normal occurrence) that holds our precious water, warmed to perfection by the sun, now spreading out over the roof and raining on the ground outside our clinic backdoor.   

Well, even if we knew who to call to have this fixed, it might take ages.  So sponge baths it is.  And that is what I did, out of a bucket of thermos water, still warm, when we returned.  It is amazing what one can adapt to.  Enjoying the ride! (most of the time!)

On a last note, our taxi ride home was delightfully given a soundtrack by the driver, and in the bliss of a good day, and in the exhaustion of all the travels, I attempted a recording of some sights and sounds.  I hope it works! 



Tuesday, January 17, 2012

Brick fields and biscuits


Jan 17

Today I hopped on a motorbike with Tsering Sherpa, one of the interpreters at our clinic, and we drove off to Godhavari.  We left the temple grounds at 8:40, the air crisp, the sun just coming over the hills.  The road was bumpy, dirt road most of the way, paved for some it.  As we came around the bend leaving Chapagaon, the landscape opened into green valley to the right of us.  There were a few small smokestacks in the distance--the dark smoke not even close to competing with the misty pink tone of the morning.   We breezed past small houses to the left, women preparing the morning fire, families gathered around their porches, drinking tea, beginning their day.  Goats here, cows down the way, chickens and dogs dotting the scenery.  If it weren’t for the patients scheduled to come to the clinic, I would have insisted on stopping to take photos.   Next time I hope to! At the end of the day. 
Further down the road both sides opened up to terraces of bricks, like a blanket over the rolling hills. Here, Tsering revealed the reason for the smokestacks—this whole area a brick factory.  I have never witnessed industry so beautiful.  Many houses are built with this rich sienna-brown-colored brick, but today’s (this week’s? this month’s?) production was grey.  He explained that they used to make them out of clay, but that recently they have begun making them out of cement.  Color or none, the scene was breathtaking. 
When we arrived at the clinic, our other interpreter for the day, Mishal, had not yet arrived,  so we walked down the road a short way for tea.  As we crossed the small concrete bridge over the tiny brown creek to the patio, three women immediately approached Tsering and began talking to him, concern on their faces.  After a minute or two, he turned to me and said that someone in their family had passed away the day before, and as the custom mandated, they were now supposed to fast all day out of respect for the deceased.  When going for acupuncture, this poses a problem, for anyone who has gone to get a treatment on an empty stomach is a prime candidate for what we call “needle shock”, a phenomenon where one breaks out into a sweat, becomes short of breath, may faint, or sometimes even vomit.  In fact, one of the women now standing there had experienced this very thing the other day.  It made for a great story by the practitioner returning that day, as apparently, in between retching, she had announced to the room “it’s okay, it’s my fault, I didn’t eat today!”  Well, naturally, they were all concerned and were letting us know that they couldn’t make it to clinic.  24 patients had been booked for the day, so we figured that those from surrounding villages who were not associated with the death would still come for treatment. 
So we set up shop, on the third floor patio of a building, out in the sun, overlooking the rest of the village.  This is the Godhavari clinic. The morning was bright, warm (yes!!), and beautiful, and seven patients received needles, some cupping, moxa, and herbs for their complaints.   In the afternoon, the wind picked up, threatening disorganization of our pop-up treatment station, and trying to set sail to our  small paper files.  The ground is covered in dust, and so to avoid dirt and pulverized cement in our eyes, we ventured to the small room adjacent to the rooftop, where we treated another nine patients in a construction-zone, a door lying flat in the middle of the space.    I am learning what relief work is truly like.  It isn’t glamorous.  It’s dirty.   Standards of cleanliness must be shifted, and lots of hand sanitizer gets used.  Alcohol swabs today became some of my best friends (yet still a distant second to the incredible interpreters we work with.  Seriously.  These guys are what really makes this whole operation work).
Slowly, I am learning some key words that help me to directly communicate with my patients.  Duksa, pain.  Is it tender here?  Duksa.  Or, is this okay?  Tiksa tiksa, a patient will say in reply to that question, their heads bobbing from side to side(lateral flexion, no rotation) in an extremely Nepali form of saying, “yes, fine.”   This head shaking had me confused the first day of treatment, as the closest reference I had was the way we might say “yeah, whatever”, or “so,so” but here in Nepal, it has a more affirmative meaning.
Later in the day, in the midst of post-lunch tiredness and restaurant-style rush of patients (in other words, I was slightly overwhelmed) I noticed this beautiful  woman sitting there, waiting for treatment, who I had seen before, but couldn’t quite place where.  A few minutes later, when I could finally sit down for the intake with her, it dawned on me.  She was the woman who had served us tea this morning and who had shown me ultrasounds of all her organs, and doctors notes about sciatic pain for which they were recommending surgery (although no issue was revealed by scans).  She was also one of the ladies who was not going to be eating today, thus having to miss clinic.  “I wasn’t going to come here”, she explained, “but then everyone else was going, and I thought, if everyone else is going, why can’t I?”  Perhaps the custom also allows for sneaking a biscuit so that one can get treated, because this was her strategy! 
As we drove back through the villages, through the small stone-pathed shortcut, through the neighborhoods of people of all ages walking along the side of the road, past children playing ball in a vacant lot, back through the brick fields, up and down through the rolling hills back to the clinic in Chapagaon, I felt enchanted by the scenery, the people, by this life.  We arrived back ‘home’, and rolled up through the iron gates, the young monks playing in the yard, witnessing our return. 
I knew while we rode down the path this morning that this was going to be the day to write about.  Tonight I left our post-dinner chat early, as romantic as it is by candlelight, as it will be lit every night this week.  Our new electricity schedule leaves us with lights and the possibility of connecting over the internet at the most inconvenient of times.  Thankfully it popped on earlier than expected and I didn’t have to wake at midnight to post this, but rather just before 11. And mind you, I am completely aware of this fascination I have with the electricity, or lack thereof...I can't stop talking about it...
I really don’t know how to finish this post!  And there is no time for editing, or picking over it too much.  My hands are cold and I am ready to fall back asleep, provided the dogs outside don’t go berserk as they love to do at intervals throughout the night, and particularly in the morning just before the gongs begin, of course! 
Good night all, Namaste.   Aaah, there go the dogs.