Chris and Melissa's Adventure

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2009-08-15T21:32:00.000-07:00

Thanks to our readers for following along on our journey. I'll keep this one short. Sydney airport to L.A. Flew all night, watched Star Trek (about time travel) and landed before we took off. Appropriate. L.A. to D.C. Amazing views of the Grand Canyon and (I think) Hoover Dam. Wow. Washington to Rochester. Um, yeah. Few noteworthy anecdotes to relate...it was just a long day. So long for now...

The Beach

2009-08-14T01:37:00.002-07:00

For our last full day in Australia, we decided to take the ferry across Sydney harbor, to the nearby suburb of Manly. Manly is known for it’s spectacular beaches, where surfing enthusiasts hit the waves starting at dawn (even in the winter). Yesterday, there was apparently a baby humpback whale seen splashing in the waves with the swimmers (unfortunately it didn’t make a repeat appearance today while we were there).

The ferry was a pleasant 20 minutes through the harbor, where we got some great views of the bridge and opera house, as well as views of the surrounding neighborhoods on either side of the water, with beautiful houses climbing up the hills. When Chris makes his millions getting a recording deal, I definitely want a house on the water here.

We were entertained on our way there by eavesdropping on more obnoxious Americans, whose conversation went something like this:

(looking at the Sydney skyline, with the Sydney Tower – like Seattle’s Space Needle – a prominent feature, impossible to miss, and written about in nearly every tourist brochure)

American lady #1 – “Look at that big tower thing!”

American lady #2 – “It looks just like a needle or something”

Lady #1 – “It’s so big, what do you think it is?”

Lady #2 – (Asking an Australian sitting next to her) – “What is that big thing there, do you see it?”

Lady #1 – “It’s that big tower thing, with the needle on top, do you see it?”

Lady #2 - (now ignoring the Australian who was starting to tell her about the Sydney Tower) – “Oh, I know, it must be a restaurant, like the one at home that turns around?” (Referring to some kind of revolving restaurant in the US)

Lady #1 – “Except I’m sure this one doesn’t turn around.”

They went on to talk about the incredible “pointy tower thing” for several more minutes, with the whole conversation occurring while they were trying to keep track of several small children that they were holding on those child “leashes”, and offering to give them pretzels if they would please just sit down. It’s very embarrassing being an American in a foreign country sometimes (although amusing to listen to others).

Manly itself, on first appearance, seems similar to many other beach towns we’ve been too – upscale touristy versions of Charleston or Florida or the Outer Banks. We crossed through a central public square, with lots of shops, restaurants, fountains, etc. We came to a beautiful beach – it reminded me of Waikiki, only without the skyscrapers. Manly has multiple coves and beaches, and there are maps detailing many different walks you can take around the water edge.

We started off down one of the many public paths taking us around the coastline to a park in a marine preserve. This particular bay is known for being home to several endangered species, including the woody sea dragon. Next time we’ll have to come in the summer, so we can get in some snorkeling. Even though it’s the middle of the winter here, it was still a sunny beautiful day, and there were a lot of people in the water – all with full wetsuits.

We were going to venture a little further into the “bush” in the nature preserve, but then Chris got “surprised” (I think scared) by a very large spider. It didn’t really come out in the photo, but he assures everyone that it was both big and scary (and I’ll agree to that, although I think pretty much all spiders are scary). Given that we’d both recently read Bill Bryson’s book about Australia, which describes the many poisonous spiders to be found here, we both felt it would be safer to stick to the paths along the coast rather than venture inland.

Our time at the beach made for a quiet and relaxing day – a great way to end what has otherwise been a busy and eventful trip. We’ll head out for one last dinner on the town tonight, then tomorrow we head back to the airport for the last round of planes taking us back to New York.

Tomorrow, we travel through time…

Sports around the World

2009-08-14T01:37:00.001-07:00

When watching TV in Australia, it’s easy to think you’re in the US. But once you get lulled into that universal Americanism of the couch potato, you’re soon to be reminded that you’re in a strange and different place. So OK, you can watch Letterman, the Simpsons, and Oprah. You can watch the world news on the BBC, which is a little weird, but nothing you don’t find on PBS at home. But if you try to watch sports, you’re bound to see something weird.

OK, I know what you’re thinking—Chris is going to blabber more about cricket. Although that’s been a continued source of entertainment on this trip, I’ll let it lie for the time being. In Australia, it’s a given that you’ll see cricket, rugby, soccer, and Australian football (a game one can easily mistake for rugby). I’m also not surprised to see a lot more formula-1 racing—I know it’s much more popular outside of the US. But I’m not talking about those obvious ones. I’m talking about really weird stuff. I’ve seen indoor men’s volleyball. I’ve seen swimming. I’ve seen track and field. Americans don’t even pretend to care about these things on non-Olympic years. But one race I saw takes the cake. I see a pretty scrawny, weird-looking kid racing around a track with a pained expression on his face. I’m thinking, why is he running so awkwardly? The commentators made a remark about how he’s so far ahead he’s walking to the finish line. I’m thinking, is he at the very end of a marathon? Why else would someone run in such a bizarre fashion? Then the camera panned out and I saw the rest of his body. He was powerwalking. Yes, I saw a televised international teenage powerwalking competition.

Mind you, I am not watching the bizarre sports channels on a 1000-channel cable TV. I have about 15 channels in this hotel. This is not ESPN-8, “The Ocho,” or anything. It’s just regular TV.

In Nepal, TV basically shows no sports except for cricket. But I did enjoy reading the sports headlines in the newspaper every day. In the US, outside of the Olympics, usually sports headlines don’t deviate from baseball, football, and basketball. (Though golf is also common.) A hockey headline is a rare sight, and in the right season, you might get the occasional tennis or NASCAR headline. But in Nepal, the non-cricket headlines could be about anything! Formula-1 was in the news since Michael Schumacher is coming out of retirement. (Never heard of him? In the 90s, only a few athletes like Michael Jordan and Tiger Woods made more money.) In Nepal, I also saw headlines about judo, volleyball, cycling, tae-kwon-do, track, and wrestling (not WWE). In an article about a martial arts championship going on in Thailand, the newspaper commented that all the Nepali competitors were out of medal competition except for in a certain class of judo, because only three countries had entered that particular field. I thought that the most ridiculous headline I saw was about badminton—something like “Nepalese Shuttlers Flying High”—until I saw a newspaper headline about competitive rock climbing. You can’t make this stuff up.

On a related note, during our 13-hour layover in the Delhi airport transit room, we sat for several hours next to the Afghani martial arts team returning from that Thailand competition. I didn’t talk to them much, but an annoying hippie girl behind me did. It was interesting listening to their conversations. They were excited to meet an American, and talked mostly about cultural differences, like the fact that they don’t drink alcohol because they’re Muslims, and that it’s very difficult to get good jobs in Afghanistan and in America it’s pretty easy (relatively speaking). They asked her what religion she was and she responded “Child of the Earth.” Ugh. Then they started talking about drugs, and she was amazed they were from Afghanistan and didn’t know what opium was. Great ambassador for America, that one.

Walking in Sydney

2009-08-13T01:24:00.000-07:00

Put on my brown leather shoes and boarded a plane. Touched down in the land of the kangaroos just a little bit south of Brisbane.

Then we went walking in Sydney. We went walking on our feet for like 10 long miles. We went walking in Sydney. And now that’s why Melissa’s full of smiles.

OK, this song is quickly deteriorating into a bad case of rhyme time. And actually, if you’re in Australia, Brisbane doesn’t even rhyme with plane.

It was not a remarkable day, but quite pleasant. Yesterday we were completely exhausted and slept all day. That was because we spent the last two nights in the Delhi airport and in flight, and we didn’t sleep much either night. It was sad to leave Kathmandu, but I was ready to go, and it’s nice to be able to drink tap water again. Australia is just so agreeable!

Our walk took us around a few small inlets of the harbor and through the botanical gardens. I liked that they had a sign that said “Please walk on the grass, smell the roses, and hug the trees.” There’s a fountain there with freshwater eels that sometimes eat small ducks, and despite draining the fountain several times, the eels keep coming back. What an interesting mystery. They think the baby eels wriggle across the lawn from the harbor—weird. We didn’t see the eels, though.

We did see bats. Lots of them! They were hanging from the trees in the gardens, occasionally flying around. They made a lot of noise. I think it’s because they were trying to sleep but it was too bright out.

The walk gave us lots of great views of the opera house as we gradually made our way to its steps. It really is an amazing building—I could just look at it all day. We had lunch on the dock nearby, and a mean seagull eyed our plates the whole time from a nearby umbrella. As soon as Melissa got up, the seagull made its swoop and knocked one of the glasses off onto the cement sidewalk. Stupid bird. We had been warned, though, by the sign that said “Birds will try to take food from your plate.” Australia has great signs of warning. I also bought a kangaroo tie.

Then we went to the harbor bridge and walked across. It was a long, beautiful walk with lots of great views. I was pretty tired, though, and we soon made our way back to the hotel. I estimate we walked 12 miles, but Melissa thinks it was 8. I’m a little too tired right now to be witty in this blog entry.

We’re headed to dinner soon. Last night we had food at a German restaurant, and I ordered weiner schnitzel. I had no idea what it was. Turns out its like a big slab of fried beef, I think. Melissa liked her chicken paprika.

The one complaint about Sydney remains: it’s really expensive. Australian dollars are worth slightly less than American, so I have to remind myself that it’s about 10% less than it seems, but still. Two sandwiches and two drinks for lunch was $35. The hotel charges by the minute (and the megabyte!) for internet usage, we have to pay the hotel extra for a shuttle to the airport, and I still can’t get over that sidewalk cafes charge extra to eat in! Whatever, nobody wants to read this trivial nonsense. I think I should put this blog entry out of its misery. See you in a couple days.

Goodbye, Kathmandu

2009-08-09T20:04:00.000-07:00

Yesterday was a lazy day. We mostly stayed inside and watched movies since it was rainy. And besides, my impatience with tour guides has extended to impatience with salespeople, rickshaw drivers, taxi drivers, restauranteurs, and those teenagers who continually ask if we smoke weed (we turned down 5 in the space of 2 blocks the other day). Yeah, it's time to head somewhere a little less in-your-face than Thamel. So we'll go to Delhi.

In Delhi we plan on a lovely stay in the transit room of the airport. That will be the extent of our accommodations for tonight. Then tomorrow we have a flight to Singapore, and then tomorrow night's accommodations are the lovely seats in coach on the overnight flight to Sydney. Throw in the fact that we have no hot water in our hotel at the moment, and we're looking at the next 2-1/2 days with no shower or bed.

Ah but then we return to serene Sydney, where the air is clear, the water is safe, and everyone says "no worries" instead of "you're welcome." (Well, the water isn't safe if you're swimming, and in fact there's plenty to worry about, what with the sharks and crocodiles and jellyfish.) A three night stay in Sydney will be just enough before I'm ready to get home.

We'd like to return here sometime soon. I'm not too keen on two more weeks in Kathmandu, but a trip to Pokhara and a trek of some kind would be a great experience. Melissa's interested in returning for medical work that involves more than just observation--a career in international health may be in her future. So for now, we're signing off for a couple days as we likely won't have internet until Wednesday.

P.S. Our last activities before leaving for the airport included a shot of the Sabres hats near a buddhist stupa and a typical nepalese marketplace, as requested by Victor.

Rain in Bhaktapur

2009-08-08T06:13:00.000-07:00

Chris has apparently decided he is no longer able to write blog entries without digressing into random personal commentaries, so we'll see if I can do any better.

As he was trying to discuss in his previous entry, today we decided to venture to the nearby town of Bhaktapur. This smaller city is about a 45 minute drive from Kathmandu, through some urban sprawl, with distant views of the hills surrounding Kathmandu valley.

The city itself, as noted previously, is unique in that the city center is a car-free zone, which meant that we got a pleasant break from the incessant honking that usually fills the background of our trips. As with Patan and Kathmandu, Bhaktapur has it's own Durbar Square, where the greatest concentration of significant temples surrounds the palace that was home to the formal royal dynasty (again, with each of the three cities originally having it's own king).

Some of the features which make Bhaktapur's square unique:

Each Durbar square contains one or more museums, usually in part of the former palace. We wrote previously about the excellent museum in Patan, devoted to explaining some of the basics of Hinduism and Buddhism in Nepal. The museum that now occupies part of the "55 Window Palace" in Bhaktapur is devoted to art. We didn't end up having time to explore the museum today, but did note the sculptures in front, which depict two of the more vicious incarnations of Hindu gods, one of which, Bhairab, is shown in the process of disemboweling a demon. Supposedly the demon could not be killed "by man or beast, by day or night, or by any weapon", so Shiva took the form of a sort of man-beast chimera (Bhairab), attacked at dusk, and used it's own claws rather than a weapon, thus saving the kingdom from the evil demon. Public disemboweling - nice. Hindu temples have an interesting way of choosing either the most graphically violent, or graphically erotic scenes to display in public on and around their sites of worship - definitely not PG rated if you take anything more than a cursory glance. With this particularly display, the artistry was apparently considered so fine, that the king had the artist's hands cut off so that he couldn't make a duplicate copy for anyone else. You can see the lovely scene in the picture above (the carving is next to a big stone lion).

In front of the palace is the Golden Gate, which, according to our guide book, is generally considered to be the most important piece of art in the whole valley (although, with so many beautiful and intricate structures, I have no idea how or why they came up with this particular distinction). We were thinking of heading into the courtyard, but it was guarded by several army guys with big automatic weapons - as soon as we brought out the camera they quickly ducked out of view.

We also got to see the tallest temple in all of Nepal, 30 meters in height, with a 5-tiered roof in traditional Newari style. The stairs are guarded on the lowest level by a pair of mythologic wrestlers, who had the strength of 10 men, and above them are two elephants, then two lions, then two griffins, and finally two goddesses. Each set of figures is supposed to have a strength that is 10 times that of the figures directly below them, with the weakest of all, man, being represented by the people in the square. An interesting concept.

The oldest temple in Bhaktapur is dedicated to Vishnu, and surrounded by statues representing his typical symbols, including a disc and conch shell, and his means of transport, the man-bird Garuda. The temple and site have been in use since 1080, according to our guide book. In addition to depicting items that would be associated specifically with Vishnu, there was also a statue of a lingam and yoni (symbolic representations of male and female parts, if you know what I mean), and Chris thought it would be appropriate, given my occupation, to take a picture of them. The yoni always points north, for reasons I have yet to learn.

There are many other incredible structures all around the city center, and by this point, we had gotten a chance to see, at least briefly, most of the primary temples and structures in Bhaktapur's main square. We had a longer walking tour laid out in a tour book, and so decided to stop for a quick lunch before delving into some of these more out of the way places. It turned out to be a good decision, because shortly after entering the restaurant, it started to rain - then to pour. We were able to get a couple great views of the surrounding valley from the rooftop of the cafe just before the weather turned. As we were taking some pictures, we could see the grey haze of rain approaching from over the adjacent mountain-top.

After realizing that the rain wasn't going to stop anytime soon, we decided that a deeper exploration of Bhaktapur's streets just wasn't meant to be on this trip. We booked it back to where our taxi was waiting (he'd agreed to wait two hours for us - we had a little help with our hotel in arranging transport), and, soaked through, were brought back to our hotel.

Tonight we will hit the town again for dinner - last night we went with a group from the hotel to a place with live music. The cover bands here are actually really good, and this one played a mix of classic rock, Rolling Stones, Hendrix, and also some blues. It was a little too loud for good conversation, but fun to check out the local music scene.

Tomorrow is our last full day in Kathmandu. We've gotten to see quite of bit of the city, and hopefully will get in just a little bit more before we start our two day journey back to Sydney on Monday.

Thoughts about New Jersey and Tour Guides

2009-08-08T05:26:00.000-07:00

Since the weather in Pokhara prevented our excursion to the quaint mountain town, we settled for a half-day trip to Bhaktapur, a nearby city with the standard collection of ancient temples and historical curiosities. Bhaktapur is the third of what were once three kingdoms in the valley (the others being Kathmandu and Patan) and we'd heard that it warrants its own trip.

We left on a beautiful morning, with clear blue skies. The cab ride took us along the Kathmandu-Bhaktapur highway (see previous journal entry), which never really leaves the urban setting, though it connects the two cities. I sort of felt like we were driving through the Nepalese version of New Jersey, a long continuous road of sprawling unattractive development that connects population centers. (My apologies to any friends or in-laws who may happen to be from New Jersey--I know it doesn't entirely conform to my stereotype, but I'm trying to illustrate an impression here.)

Bhaktapur has some things going for it. Notably that no cars are allowed in the main part of town. It makes for a much more pleasant tourist experience, a quieter pedestrian village that feels more authentic than Kathmandu. Still, that didn't prevent the tour guides from accosting us. We had traveled no more than 50 feet from the main gate and we'd already turned down 5 tour guides. It's like they're all trained in the exact same way; every conversation is the same.

Guide: Where are you from?

Chris and Melissa: (silence, reading their guide book)

Guide: Are you from the US?

Chris: Yes, we're from New York.

Guide: Ah, New York! How long are you in Nepal?

Chris: We're here for two weeks. And we're not interested in a tour guide.

Guide: Have you seen much in Nepal? Nepal has much history! It is good to know all about it.

Melissa: We're reading the history in our book. We're not interested in a tour guide.

Guide: The book does not tell you all the history. I tell you everything. I give you good price.

Chris: (walking away) We don't need a tour guide, thank you.

Guide: (walking with us) Not expensive! 1 hour, good price!

Melissa: (walking away) We don't need a tour guide, thank you.

Guide: Very cheap! 10 bucks!

Melissa and Chris: (silence, walking faster)

Guide: I stay here. You change your mind, remember to come back. I'll be here one hour waiting for you!

Such is the standard interaction. But I admit I'm losing my patience. Two weeks of this is enough to try anyone's level of politeness. The conversations have sort of devolved to the following example, which I recall as closely as possible from Bhaktapur today:

Guide: Where are you from?

Chris and Melissa: (silence, reading the guide book)

Guide: Are you from the US?

Chris: We don't want a tour guide.

Guide: I tell you everything!

Chris: We don't want a tour guide. That's it. We don't want one. We're all set. Thank you.

Guide: I give you good price.

Chris: (walking away, waving arm dismissively) No! We don't want a tour guide!

Guide: (spots fresh meat exiting a taxi)

Chris: (to Melissa) Ooh, watch this. Let's see how these poor saps handle this guy.

(from a distance, Chris and Melissa observe the poor saps speaking to the tour guide)

Chris: Uh-oh, first mistake, they stopped walking. Oh, these guys are finished, he's making eye contact. Oh, now he's nodding! Big mistake! Ok, there, he's walking again. Good for him. He's still nodding, though. Ok, I see a dismissive arm wave, he's getting the hang of it.

(By this time, Chris and Melissa have been approached by and dimissed yet another tour guide. Just as the poor saps are ridding themselves of the first, the second tour guide is making his way towards them. Repeat.)

Clearly I have some resentment towards the damn ubiquitous tour guides. But I do feel for them. What a way to earn a living, having to approach strangers and attempt to sell yourself and get turned down hour after hour. I feel bad for having to be rude to them, but their persistence practically requires it! If one is not very very direct with them, it encourages them. I've got to think that educated people with decent English skills can find a more productive way to earn a living.

This originated as an entry about Bhaktapur, and I didn't even get to the bulk of the story. Ah, well. The photo above shows me right upon entering Bhaktapur. See those people in the distance? They're all tour guides. I'll let Melissa write the official entry about Bhaktapur and tell you about our thorough soaking.

Development Money

2009-08-08T04:48:00.000-07:00

So when I think of foreign aid, I have no idea what that actually means. I always envision trucks distributing bags of rice or pallets of water being airdropped from helicopters. Governments give massive amounts of foreign aid to developing countries--where does it go?

I've got a few examples. We did not get to go to Pokhara where there is a museum dedicated to mountaineering that was funded by Germany, if I recall correctly. This makes sense because the Germans, having conquered the Alps during the 1800s, were the most enthusiastic in first attempting to conquer the high Himalayas in the 1900s. That Germany would cherish Himalayan history with a museum is very cool. But we didn't see that one. We did have the opportunity to see a nearby museum about religion, which you may recall from my blog entry "Patan." The museum's pamphlet says that it was made possible by money and work from the Austrian government. Why Austria would put its resources into preserving the culture of Nepal escapes me. Still, I think it's great, because access to education here is limited, and that single museum can provide a brilliant experience for local people that we take for granted with our huge number of museums in America. It's particularly nice that it commemorates and educates about the local heritage, so that local people see value in their own culture and it doesn't get entirely taken over by Nike, Coca-Cola, and Apple. But I digress. The fact that there is no obvious connection between Austria and eastern religions actually makes me happy, because it seems to be that Austria is preserving culture for culture's sake, without any self-interest.

At the same time, I find myself wondering if a museum is really the best use of funds in a country that has great need for basic services. Today we drove to Bhaktapur, a distance of about 20 km, on a road that was in various states of construction. It almost, at times, resembled a normal highway (though with a center line that still is only a suggestion--it makes for some near misses). In one place where it is still entirely dirt there was a large sign that said the Kathmandu-Bhaktapur highway was made possible jointly by the governments of Nepal and Japan. This highway will connect two major population centers along a route of much commerce, so it will benefit the local population a lot. Though it is a shame to see land paved over at the expense of progress, I can only think that if a road connected Kathmandu and the villages suffering from cholera, medical aid might have reached those people soon enough. So yeah, go Japan, funding a much-needed road.

The other government-funded project we're aware of is the maternity hospital that Melissa already talked about. It is funded largely by South Korea. This project contributes directly to a lower infant mortality rate, a lower maternal mortality rate, and generally promotes well-being in a country without good health care. Despite Melissa's descriptions of the facility that make it seem backward to us, it's a heck of a lot better than delivering in a rural village with no health care at all. So yeah, go South Korea.

The absence here of descriptions of US-funded projects is only because we haven't happened to notice any. I have no doubt the US government contributes lots of money to development projects here and elsewhere. Melissa noted, however, that due to the global gag order instituted by President Bush (and Reagan before that) the US government would not fund anything like the maternity hospital because it does counsel about contraception and terminations. (Melissa points out that there are American organizations here that do that kind of work, but they are NGOs that receive no government funding. Obama did rescind the global gag order in his first week of office.)

As I've made note of these development projects, it's led me to think about how international development and economics work on a larger scale. I really don't know a lot about it, and I'd like to read more. It is by no design of my own that the three examples relate to three separate fields: culture, infrastructure, and health care. It seems appropriate that we should distribute aid in such a way, rather than focusing only on delivering food to the hungry, for example. As important as such humanitarian work is, foreign aid would be a never-ending sinkhole if it does not go to establish something permanent. (Which can also, of course, translate into alleviating hunger. I've read about programs designed to educate farmers or genetically engineer higher-yield crops in Africa.) Anyway, I hope that the foreign aid is distributed by people who are both compassionate and intelligent, working within systems that lead to sustainable changes.

(The picture for this entry doesn't really have anything to do with the topic. But it is an example of the odd juxtaposition of a modern building taking shape underneath shaky scaffolding made of bamboo lashed together.)

The Racist Dog and Other Observations

2009-08-07T21:20:00.000-07:00

The Hotel Courtyard has one primary entrance in and out. It goes through, you guessed it, the courtyard. This is the central location where patrons often sit to have a drink and make conversation. The owners hang out there and socialize while conducting the day-to-day business of the hotel. Always present is their little yappy dog, Tibby. I'm not sure what breed of dog Tibby is--it would be sort of like trying to identify the race of Cousin Itt. Underneath the ugly hair and yapping is a pretty friendly dog that will sit in your lap and let you pet him. But Tibby fancies himself the courtyard's guard dog as well and misses no opportunity to defend it from anyone threatening. As the courtyard is the primary entrance in and out for everyone, it has a regular flow of not just patrons, but drivers, porters, deliverymen, cleaning staff, etc., all of whom are native Nepalese. Tibby only barks at them. If I walk in, or an Australian, Brit, Canadian, Greek, German, or Italian, Tibby greets him/her by trotting up and sniffing. If a Nepali or Indian enters, Tibby greets him/her with ferocious barking and occasional nipping at the knees and calves. This racial profiling occurs with remarkable consistency.

It is at times amusing, and at times annoying, to watch Tibby go from placid to vicious with the entrance of a dangerous new visitor. The dog's racism is a joke among everyone here, but it's also pretty curious. The owner explains it like this: Nepalese people don't typically own pets. Dogs fend for themselves, and the notion of a domesticated pet dog is unusual. Consequently, dogs are often subject to abuse by Nepali people. The owner thinks Tibby can somehow sense the different attitude towards dogs. I don't entirely buy this because some of the hotel employees who are around Tibby every day and like him are still subject to the racist treatment. The cook, for example, just smiles while Tibby attacks his heels, and I think he feels affectionate towards the dog despite being victimized by him. Or does the cook just smile because it's the owner's dog, secretly harboring resentment toward the mutt that daily terrorizes his ankles?

On a related note: a westerner might come to Nepal and think that the Nepalese people are pretty homogenous. This is far from the case, which one might expect in a mountainous country with weak central government and poor transportation and communication. Despite its small size, apparently Nepal is quite diverse in its ethnicities and languages. Most people in Kathmandu speak Nepali (and some English) but I understand that the longer treks will take travelers to parts of Nepal where people don't even speak Nepali. The ethnic differences between these peoples would be difficult for westerners to distinguish, but I think that for local people, those differences are quite real. To illustrate, consider the interchange between my hiking companion Bruce and our Nepali guide, Isur:

Isur: I am the only member of my family to come to Kathmandu. I'm from the mountains near Ganesh Himal, so I know the mountains very well.

Bruce: So what, you're like a Sherpa?

Isur: No, Chhetri.

Bruce: Huh?

Isur: Chhetri.

Bruce: So that's not Sherpa?

Isur: No.

Bruce: What's the difference?

Isur: Um...

Chris: They're different ethnic groups, Bruce. I think it would be like assuming Puerto Rican and Cuban are the same because they both speak Spanish.

Isur: Yes, that's right.

Bruce: Ok, cool.

Incidentally, Chhetri and Sherpa don't speak the same language, so it's even a bigger difference than Cuban and Puerto Rican. Still, you get the idea. In an earlier entry I talked about the Newari meal we had, and I commented that I wasn't sure what Newari was. Well the Newari are the ethnic group descended from the medieval people that traditionally inhabited the Kathmandu valley, before the country was unified. "Nepal" is thought to be a poor transliteration of the older word "Newar." Today, "Nepali" refers to any person from Nepal, cutting across ethnic lines, while "Newari" is reserved for those descendants of the medieval Kathmandu valley, and is only the 6th largest ethnic group in the country (thank you, wikipedia).

I'm not attuned enough to the language and culture to detect different attitudes about different ethnic groups here. But in a few conversations with people I've detected condescending attitudes about urban Nepal vs. rural Nepal. One shop owner who sold me a knock-off North Face shirt commented that in the country they're suffering from cholera because they're not educated. He said they don't know better about drinking clean water. I said something like, "Well, aren't they pretty poor? Maybe they just don't have the money to do what they need." And he said, "Yes, they are poor because they aren't educated. In Kathmandu at least we are educated so we know about these things." He continued, showing an awareness of how a westerner (me) might view Kathmandu: "You might look at the streets of Kathmandu, and they are very dirty and dusty, but this is the most modern place in Nepal. We know we need to make our city better, but out in the country they just don't know. This is why there is cholera."

I also purchased the board game that is a traditional Nepalese pastime. Similar to checkers and chess, Tiger-Goat is the official game of Nepal, and we've seen groups of people huddled on street corners to observe an intense game. Shortly after I bought mine, I asked one local person how to play it, and he responded, "I don't know the rules of that game. It's for the peasants and farmers." He was sort of joking, but not really.

Unsuccessful flight, take 2

2009-08-07T03:56:00.000-07:00

Chris and I have been excited, getting ready for a short trip to a nearby city in Nepal to end our time here.

My last day at the hospital was yesterday. Initially the plan was to do an overnight shift with Reena, but, we were both pleasantly surprised to learn (at the last minute), that instead we would be headed back to the same hotel where the week prior we had gone to a conference. Yesterday's session was to discuss the results from a pilot study on initiating a medical termination (aka, taking a pill instead of having surgery) access program across Nepal. Unlike the week prior, where the conference was geared towards Nepalese providers, and thus few of the talks were in English, this workshop was geared towards making new nationwide policies for access, protocols, and monitoring, and in addition to local physicians, there were also members of the World Health Organization, Ipas (a US based organization focusing on international women's health), as well as several other NGOs in attendance. The presentations were all in English, and there were some great small group sessions to listen in on, as these leaders in gynecology tried to establish some ground rules for incorporating a new process into the existing system of care. Plus, I got to meet a few Americans who have dedicated their lives to women's health around the world. Pretty cool.

After Reena and I exchanged contact information and said our goodbyes, I headed back to the hotel. Chris and I hit the town to do the last of our shopping, and got dinner at a great Thai restaurant, accompanied by a Corinne, a British teacher who is staying at our hotel. The plan was for an early AM flight to Pokhara, so we tried (not too successfully...) to get to bed a little early.

This morning, with our bags packed for an overnight stay in Pokhara, we headed to the airport. Pokhara is a smaller city, with a population of around 200,000, that is located about 6 hours away from Kathmandu by bus or car. It is located on the second largest lake in the country, and on a clear day is reputed to have some incredible views of the Annapurna mountain range. Many of the long term guests that we have met have been to Pokhara, and all strongly encouraged us to check out this lovely town. Given that we would have only one, or at best two nights to stay in Pokhara, we decided it would be worth the expense to save time by flying. Also, the roads will occasionally be blocked due to strikes, and, while we've heard that tourist buses are usually allowed to pass with no issues, we still thought the safer route would be to brave Nepal's air transportation system.

As we set off, the weather in Kathmandu was overcast with a light drizzle. We arrived in the airport, and there were crowds of people waiting, many for mountain flights that had been delayed. (Chris and my attempt to see Everest had been on a much clearer morning, and yet the plane had still been forced to turn back because there were too many clouds around the highest peaks). Despite announcements being in loud, static-filled Nepali, we were able to figure out that our own flight was also being delayed by around an hour, but since we'd brought our sudoku book, were able to keep ourselves occupied. Once we boarded, the plane was filled with a mix of tourists from around the world, as well as locals either returning home, or headed to Pokhara for business.

About 20 minutes after take-off (on what was scheduled to be a 26 minute flight), the pilot announced that weather conditions on the ground were too rough to land, and so he turned the plan around and brought us back to Kathmandu. Chris and I were pretty disappointed that our trip to Pokhara was unsuccessful, but I guess this means we'll just have to return to Nepal one day so we can try again. Fortunately, it seems that the policy here is that if your plane has to turn around and can't make it's destination, you get a full refund.

It was still rainy when we got out of the airport, but we decided to at least hit one tourist site today. We decided to go to the Buddhist stupa at Bodhnath. This is the largest stupa in Nepal, and if not also the largest in the world, is very close to it. It is surrounded by a ring of shops and restaurants, as well as a cluster of Tibetan monasteries. They are pretty incredible structures, with each part representing a different natural element - the base is the earth, the dome is the water, the spire is fire, etc. as well as representing elements of Buddhist symbolism, with the Eyes of the Buddha, etc. The stupa is surrounded by prayer wheels and other smaller temples, and prayer flags (which send their prayers with the wind) are stringed up to the top from around the periphery. The stupas themselves are reputed to contain Buddhist relics, and Bodhnath supposedly contains buried within it a bone from Buddha himself - this plus it's size make it a particularly revered site.

This has otherwise been a pretty lazy afternoon. We got in a nice nap, and the sun has finally come out, so we will likely enjoy a quiet evening around the hotel. Now that we have two more unexpected days in Kathmandu before finally setting out on Monday, we may try to get in another day trip with more sightseeing, but it's also tempting to use this time to kick back and relax - after all, it is summer vacation!

Lots of babies

2009-08-04T21:58:00.000-07:00

Yesterday I spent the majority of the day at the Maternity Hospital here in Kathmandu. As I mentioned in my previous entry, the Maternity Hospital does approximately 19,000 deliveries a year. This has apparently significantly increased in the last year or two, and the number is continuing to grow. After speaking to some of the other medical officers / residents, I learned that women who come to this hospital not only can get their deliveries paid for, but also are eligible for free care for any gynecologic or obstetric issues they may have (for example, a free hysterectomy). Afterwards, in addition to having received this free care (including all meals, which is apparently very unusual for Nepali hospitals), they get 1000 rupees (the equivalent of about 15 dollars US) for transport. Considering that a 30 minute taxi ride usually only comes to about 200 or 300 rupees for gullible overpaying tourists, for locals, this is a pretty good amount of cash. As a result of this government offer, women come to the hospital from all over Nepal for care. The hospital does also have some more private facilities for patients who are able to pay, and most of the outpatient services do have small fees. However, because this is the only area hospital that runs this government sponsored program, they are struggling to keep up with the increasing demand, in terms of space, personnel and other resources. (Interestingly, I was told that only a few months after starting this program, the government is already running low on funding to cover it, therefore much of the money now comes from foreign interest groups, including a large portion from South Korea).

Just try to visualize what hospitals would look like at home if we told people not only would they have no bill, but would be given a stack of cash at the end of the day - as you can imagine, the birth center is quite a site to behold. There are three main areas that comprise the obstetric ward. There is one large room with about 30 beds, for all of the pregnant ladies who first arrive, where they are triaged. If it looks like they might be in active labor, they are sent to another room with about 20 beds, where they sit with a loved one, and wait until they are ready to push. No such thing as an epidural here - there is no pain medication, and in terms of monitoring labor, the typical patient can expect only an occasional auscultation of fetal heart tones with a stethoscope by one of the medical officers rushing through, and periodic checks from the nursing staff. Because of the many patients, all of whom are in active labor and therefore making all kinds of noises, the few nurses are not always able to tell which ones are progressing quickly, and which ones just don't cope as well with contraction pains. Therefore it is not unusual for them to walk past a patient only to notice she is midway through delivering, at which point there is a flurry of activity to try to grab gloves and a clean blanket for the little one that is literally falling onto the bed. This happened twice in the 20 minutes I spent in this part of the unit.

Once a patient is fully dilated (assuming she didn't surprise the staff with a quick delivery), she is whisked down a hallway to another set of three adjoining rooms, each with 3 or 4 beds - there is no privacy here, no curtains or dividers, and so patients are often going through this experience together as a small group, or one who just delivered will look on with sympathy to her still-pushing neighbor. Most of the deliveries are done by a cluster of nurses, who go from patient to patient, taking turns with who does the delivery, who takes and cleans off the baby, and which few stand by to loudly cheer on the patient. There are usually a couple doctors on hand to help with more complicated deliveries, if needed, or to do the occasional uncomplicated one, when things get particularly busy. Following delivery, if the patient does well, she is sent home about 4-5 hours after giving birth. In less than an hour, I saw around 10 deliveries done in this way.

I also had the opportunity to see their crowded antepartum wards, gynecologic wards, and operating theater. (Again, with the ubiquitious communal shoes - if and when I return to Nepal, I'm definitely bringing my own supply of crocs).

Meeting some of the new doctors who work here, I got a little more insight into the medical training process in Nepal. After high school, if a student decides they want to go into medicine, they will go to college to receive a "bachelors of medical science", during which they do all of their pre-med courses as well as the courses that we would consider part of the first two years of medical school, when the bulk of our lectures on anatomy, physiology, microbiology, etc., are given. They then apply for an internship, which seems to be about a year to a year and a half's worth of clinical rotations, similar to our third and fourth year rotations in medical school. After this time, they take exams, similar to our USMLEs. Upon graduation, they can then apply for a position as a medical officer. At this level, they can write prescriptions, do basic procedures, and take care of patients on the wards, sort of like our interns or first year residents. At this point, they have usually not yet chosen an area of medicine to focus on, but can do hospital practice in internal medicine, emergency medicine, pediatrics, obstetrics or surgery, under the general supervision of a specialty trained physician. After a couple years as a medical officer, they then apply for a post-graduate posting, similar to our residency programs, in their field of choice. Ob/gyn is a three year program here, compared to four years in the States.

At the Maternity hospital, the wards and the birth center are covered by a handful of interns and medical officers, with a doctor on call who has completed their ob/gyn post-graduate training. They don't actually have a post-graduate, or residency training, program at this hospital, as it is a government site and not affiliated directly with any university. I think this is a shame, because this would be a gold-mine of opportunities for a young doctor, and hope that at some point in the future they will be able to establish a formal program here.

It is a pretty incredible facility, and despite the staff being overworked and tired, they all had smiles on their faces, and in between catching babies were eager to share their knowledge with this wide-eyed foreigner. After witnessing this incredible group for only a few hours, I feel I can now attest with certainty that any medical provider who spends more than a couple months at this hospital would be more than capable of walking into any delivery situation, and handling it with a calm reserve and great expertise.

So for those who have been putting up with my ramblings about Nepali obstetrics, here are some non-medical observations. Chris may have written previously about the craziness of traffic in Kathmandu. Imagine hundreds of New York City cab drivers, tackling streets that are more maze-like and irregular in their intersections and alleyways, half paved and covered in dust and potholes. Then add to that two or three times as many motorcycles as cars, with all of the vehicles in various states of disrepair. Then imagine that you took away all of the traffic rules - no stop signs or traffic lights, no speed limits, and even the center dividing line is only more of a suggestion, rather than a rule. Add to this hundreds of roving pedestrians and feral dogs, and a handful of cows and goats, all trying to cross the roads at random. This will give you a sense of the insanity of the streets in Kathmandu.

Now, usually, to get a meal, or do a little shopping, we are able to walk, precariously, on the edges of the narrow streets of Thamel, protected by the other throngs of tourists who are also wandering by. To get to the hospitals or more distant sites, however, it is necessary to take a car (or for intermediate distances, you could compromise and take a rickshaw, which we have yet to do, but want to try at least once before we go). So yesterday morning, when I arrived at Kathmandu Medical College and was told that one of the medical officers would be taking me over to the Maternity Hospital, it was my assumption that they meant she would serve as my guide as we took a taxi, to make sure that I didn't get lost. Most taxi drivers speak very little English, so if I need to go to my hotel in Thamel, it is no big deal as they all recognize the names for the popular tourist sites, most of which are within a couple blocks, but to explain how to get to another non-tourist area in the capital is totally beyond our limited communication.

So as you can now imagine, I was pretty nervous when I learned that instead of hailing a cab, we would be taking her Honda motorbike (kind of a cross between a scooter and motorcycle). With my other options pretty limited, I hopped on the back, grabbed on tight, and kept my fingers crossed. After a few initial harrowing minutes, I was actually pleasantly surprised to discover that it was kind of fun to wind our way through the streets, with a cool breeze in our face. There is a sort of unspoken courtesy of the streets, that, while not apparent as a passenger in the back of a taxi, you discover with the more intimate experience of being in the open on a motorcycle. While the Nepalis seem to have no order to their traffic, they do expect all travelers to have a respect for others on the road, and honking here is done as more a sort of warning - a "hey, I'm over here, so be careful not to turn too suddenly" - as opposed to the anger and road rage at home. Nepalis tend to react intensely (and sometimes violently), if any drivers should be irresponsible enough to actually get into an accident, or, god-forbid, hurt someone with careless driving. What I had previously perceived as lucky near-misses seems in fact to have been a graceful style of carefully navigating roads that were never designed for this many vehicles. Not that I am eager to tackle the streets again, nor would I even consider ever actually driving one of those things, but after arriving safe and sound at the hospital, I was glad to have gotten this unique experience, to learn and appreciate a little more about this unusual culture.

On the surface, Kathmandu is seething with activity, crowded, dirty, loud, and generally scary for a Westerner who is unfamiliar with it's ways, but spending more time here, you discover there is a great deal of friendliness, respect and beauty that goes into all of that craziness.

Fair Trade?

2009-08-04T03:49:00.000-07:00

Perhaps you recall a few years ago reading about a massacre of a royal family by a deranged crown prince. Well that was Nepal, and the palace where that took place has since been converted into a museum. I don't know what the museum contains, because it was inexplicably closed today. Well I think it was, but I'm not entirely sure I was at the right entrance. Some guards who didn't speak much English told me that behind the large gate was the museum, but they said "closed"--I think. The guidebook was published before the palace became a museum, so it had no information on it.

A few blocks away was a street that has a lot of fair trade stores, which Melissa and I have been interested in finding, so I set off. (Incidentally, I make no effort not to appear a tourist. I wear my camera around my neck, and carry the guidebook, often reading the map as I walk. I mean, I could hide the camera and guidebook and try to blend in, but who would I be fooling. So I embrace my role as tourist.) I found the fair trade shops and made some purchases (it's a good thing I bought that extra backpack--I'll need it for all the additional stuff we're carting home). I was proud of these purchases, glad to patronize shops that proudly help the local community.

But it's not quite as transparent or simple as that--one of the stores had a cashier who spoke good English and was very talkative. He said that last night he'd watched The Notebook, and really loved it. He summarized the whole plot for me. He said he'd been to the US a couple times for trade conventions, and that made me think he'd be a knowledgeable person to ask about fair trade. I noticed that the stores had almost the same products as all the (not fair trade) street vendors. So I asked him what exactly fair trade means, and whether purchasing from street vendors was good or bad for the local producers. He enthusiastically told me about it, but what he said made me somewhat skeptical of the whole thing. He said any goods purchased anywhere help the population. Nepalis are so in need of jobs and so eager to have people buy their products that revenue from any vendor will go to help those local artisans. The difference is that the prices are controlled in the fair trade stores. A street vendor might mark up a product 100 or 200%, whereas the organization of stores called "fair trade" have fixed prices that can't exceed 30% above cost markup. He said it makes for more fair practice with regard to the consumer. Furthermore, his organizations work hard to market their products abroad and online, so that retailers and wholesalers will be able to sell Nepali-made goods and help the local population. Again, sounds good. But he didn't address in any detail where the products come from. It was this evasiveness on the issue of the products and artisans themselves that makes me skeptical of the whole enterprise. Clearly, so many different stores hawk goods that are so similar, that there must be a limited number of companies supplying all the tourist shops--including the fair trade ones. The cashier said that those producers don't allow their vendors direct access to the artisans. He said the producers provide documentation of the fair practices in production facilities, and vendors must trust that documentation. Further inquiry about where and by whom these goods are produced would be unwelcome.

I think the bottom line is that any work, even if it is backbreaking, repetitive production of tourist items (textiles, artwork, metalwork, jewelry, etc.) is welcome among people who otherwise would have no work. A shop can call itself fair trade, but the degree to which it takes that label seriously seems to vary. For example, one shop had a brochure that described contributions it makes to clinics and community development programs, whereas another had a brochure, but mentioned no such charitable use of its revenue. One might say it's fair trade, thinking that some minimal wage qualifies as "helping the local population" but another might say it's fair trade and genuinely take action to improve quality of life. The industry seems to regulate itself, which makes it difficult to trust. I'm somewhat disappointed that I can't guarantee the revenue from my gift purchases goes to the right places, but I do the best I can, and at least we're not getting ripped off with a 100% markup at the fair trade stores. This would be a topic that could make for really interesting investigative reporting. Perhaps Anderson Cooper or Steve Croft could hire me as a field investigator...

An overdue (and very long) medical update

2009-08-02T05:11:00.001-07:00

Time for another post from Melissa (and again, very timely, considering that Chris' blog from today is just a random smattering of highlights from the Kathmandu Post).

So it's now been a full week that I've been "working" (more like shadowing) at Kathmandu Medical Center, and I've seen quite a bit. Please forgive this very long entry, but it's been an eye-opening experience, and this only just brushes the surface of all I've seen....

After my introductory tour of the hospital, my first full day was pretty much spent chatting with Reena (the one and only ob/gyn resident at the whole hospital), comparing how we do things on opposite sides of the world, and finding that, at least in conversation, most things are quite similar. A laid back day.

The next day, Reena was supposed to be in "OPD", or clinic. This turned out to be quite unlike clinic back at home, where every minute of my time is tightly scheduled, and spent running from patient to patient, apologizing profusely for being late, and then spending even more time trying to catch up on writing notes. Not the case here. Clinic started at 9am. We managed to get there around 10:30, after some delayed rounding and reviewing the few hastily scrawled words that sum up an entire day's worth of medical care. Their clinic is basically a hallway, divided into rooms by curtains strung along every 8-10 feet or so, with each cubicle containing a desk and few chairs, and an examining table with another curtain. So patients who are to be seen in the last cubicle walk through the others where patients are being interviewed and examined, and occasionally pause to listen in as we discussed details that most people would blush to hear (this in an ob/gyn office, after all). No such thing as HIPPA here (the at-times militant set of rules that governs privacy of personal medical information in the US). About an hour into the experience, we were seeing two young women who came in together, one concerned about maybe having an STI, and the other wanting Norplant (which we don't use in the US anymore, so it was pretty cool to see it actually be inserted, rather than just reading about it in the "items of historical interest" section of our textbooks).

At around 1pm, we got a call from Dr. Chanda, who is the doc that is organizing my time here. She asked if we wanted to accompany her to another hospital in the area where she was headed to do a C-section. So just like that, despite a waiting room full of patients, Reena and I were in a cab, headed across town to the private hospital. I learned that this hospital was different because patients were expected to pay "a lot" for the privilege of staying in an open room with only 6 beds or so, as opposed to a free stay at the teaching hospital in a room with 20 beds. Now patients at all of these facilities might get a bill that includes the cost of any procedure that might be performed, or for their bed, particularly at the private hospital, or if they want a bed in a somewhat less crowded room. However, they are expected to purchase and bring with them any disposable supplies and medicines that might be required during their stay - so they routinely show up with a bag that includes a couple pairs of sterile gloves, bandages, antibiotics and pain medications, and any other supplies that in the US, we usually keep in bulk at every nursing station.

The cesarean section at the private hospital was my first experience of the operating room in Nepal. There is a room where you take off your shoes, and put on a generic pair of crocs that are only to be worn in and around the operating theater (crocs that many other feet have worn before you, and which you probably don't want to know when were last cleaned... I still haven't figured out, after a week, why they are so fastidious about changing into these OR shoes when little else about the process seems particularly sterile...). We then changed into scrubs, and move on to the cluster of operating rooms. There is little used here that is disposable. All of the drapes are of a thick cotton material, even most of the sponges are rewashed and reused. Not much gets thrown away at the end of the case except for the gloves, which again, the patient bought and brought with her for use in her surgery. What probably shocked me the most, was that not only are they doing c-sections in sandal-like versions of crocs (visualize the open-toed "shower shoes" of college days), but they actually took off their shoes and operated barefoot in a procedure that at home, we wear knee-high waterproof boots for (c-sections are probably the messiest of all surgeries). While I was somewhat frustrated to be restricted to the sidelines to just observe, I was grateful to not be in the splash zone.

The next day (and after a thorough foot scrubbing after getting back to the hotel), Reena and I were invited to accompany Dr. Chanda to one of the ritzier hotels in Kathmandu for a conference. Dr. Chanda is one of Nepal's leading doctors in reproductive choice, and was one of the first to start performing terminations when it became legal here a little over 5 years ago. This conference was set up so that a group of researchers and public health leaders could present the findings from their just completed study about complication rates associated with surgical first trimester abortions. This is the first study of its kind in Nepal, and the next day there was an article on the front page of the paper about the study, and how well health care providers are doing in terms of making change. Complications associated with abortion care are a major component of maternal mortality in places where women are forced to go to illicit providers, who are usually not trained in medical or surgical care - this is why making and keeping abortion legal, while at the same time expanding knowledge about and access to better contraceptive methods, is so vital, and saves so many lives. The conference was a great opportunity to meet some of the women who have helped to make this huge change in Nepal. I was also pleased to learn that, unlike the situation in the US, where many clinics are surrounded by protesters, and providers are often threatened or worse (like the recent murder of the doc in Kansas), here in Nepal, once the laws were changed, the public, in general, seems to have accepted legalized abortion, and signs for clinics are posted publicly where they can be recognized and therefore the services utilized openly. Pretty progressive (or, more likely, the people are just too focused on bigger issues like getting safe drinking water, stopping the cholera outbreak, etc).

The next day, we were back in the operating rooms at Kathmandu Medical Center for a full day of surgery. While technically the procedures are the same, the differences in the culture of the operating room were pretty profound. Our OR staff runs a pretty tight ship - schedules which are constantly updated, and detailed computerized systems. Patient monitoring with name bands and checks at every corner to be sure we know who is where, and that we are doing the right thing to them. The scrub nurses are like hawks, always keeping an eye on their sterile field, and if you should even approach the margins of that sacred zone, watch out - you will get a stern lecture, and if you should actually violate the sanctity, and (gasp!) contaminate the field, you are in big trouble! Not at all the case here. There is a single unmanned desk, with a pile of roster books which the medical students will periodically write down the name and procedure of whoever they just watched have surgery done. Above this desk are a few printed sheets that list a tentative schedule of the days cases. This schedule is by no means adhered to. We changed the order of every single case (including, for reasons I have yet to comprehend, moving the potentially fatal possible ectopic to the end of the day - fortunately she did not have an ectopic, was possibly not even pregnant, as she just had a small ovarian cyst, and a several day old urine pregnancy test result from an outside clinic). Most of the time, our anesthesiologist and nurses had no idea which case we were doing until we walked the patient into the room, and this was routinely done while the dirty stuff from the last case (I'll spare you details...) was still in the room. And of course the patients were walking in - you guessed it - barefoot. In one of the more shocking moments, while under anesthesia and in stirrups, a patient's foot dropped onto the sterile field not just once, but twice. No one even batted an eye - they just put the patient's leg back into the stirrup, with a single velcro strap, and continued on, using the same instruments from that same table.

Alright, so I'm probably going a little overboard with the shock value here. The doctors here seem very good, and I think they are doing the best they can with the limited resources they have available to them. They are aware of the deficits in sterility, and attempt to make up for them by putting all of their patients on 24 hours of heavy duty antibiotics. Maybe not way I would attempt a solution, but better than nothing. I also had the privilege of watching one of the only two female gynecologists in Nepal who is trained in laparoscopy. Now, coming from an American hospital where we learn from faculty who are national experts in laparoscopic technique, this was far from the mastery of the skill that I've come to expect from my teachers, but still, just the fact that she was one of the first in her country to even attempt to adopt a minimally invasive approach was pretty impressive.

After an eventful week, I had the day off yesterday to spend with Chris (and our new friend Bruce) exploring the temples and museum in Patan, as I'm sure our avid blog-readers are aware.

Today was back to work, with another morning spent in the OR, followed by spending a couple hours this afternoon at one of the Nepal's largest Comprehensive Abortion Care clinics, where I could see all that I'd heard about at the conference in action. Again, the sharp differences in both patient privacy and cleanliness were a bit shocking (although I did get to wear another lovely pair of communal crocs). However, it was great to see that these women at least have a safer option - particularly after my earlier experience in the OR, where I was witness to the result of what a botched procedure looks like when a patient came in after three, that's right three, attempted procedures in a little rural town with no trained medical provider. It was very scary, and she is lucky to have survived.

The rest of my week will hopefully include more obstetric experiences - I still have yet to catch a normal delivery, as well as perhaps a tour of another nearby hospital. Dr. Chanda has offered to take me around the Maternity Hospital. This is a huge facility, run by the government, which only does obstetric and gynecologic care, with a small pediatric wing for the newborns. They do 19,000 deliveries there every year!! Over 50 cesarean sections a day!! I've been told, that spending a few months in this hospital would teach me everything I ever wanted to know and more about the practice of obstetrics and bringing new life into this world. Unfortunately, I'll probably only get a couple hours. But I'm still looking forward to it. Another interesting note about this hospital - apparently the government will pay for a woman to have her delivery here, which is why they get such a huge volume. Every women can have up to two deliveries on the government's dime, although since they don't really keep any formal medical records, that means that any woman who shows up, no matter how many kids she has, will get free care.

Ok, that is more than enough for now (Chris is reading over my shoulder, and telling me this entry is way too long--"enough doctor talk"). Hopefully this hasn't been too boring for all those non-medical folks, if any of you have made it with me to the end.

I'm having an awesome time here, and hopefully will continue to have some great experiences in our last week in Nepal, before we head back to a place where it's safe to use the tap water when we brush our teeth, and where I can wear my own shoes to operate in.

A Boring Blog Entry

2009-08-01T22:22:00.001-07:00

Not much new to report this morning. Highlights from today's Kathmandu Times are as follows:

The garbage strike is over. An agreement has been reached and cleanup has begun (I witnessed some cleanup nearby yesterday). I'm happy for the people of Kathmandu.

Sri Lanka crushed Pakistan in cricket yesterday. I watched some of the match--it was never really close.

And one headline reports that High School Musical star Ashley Tisdale doesn't like to watch scary movies. I'm not sure why anyone would care, especially the Nepalese.

In other news, I've become a huge fan of south asian food. I am not widely familiar with it, but what I know, I like. If I were stranded on a desert island with a chef who only knew how to make one meal for the rest of time, I think I'd be pretty content with chicken tikka masala, mattar paneer, and naan.

The beverage situation is a different matter, though. Bottled water is readily available here, but usually isn't too cold. I like to order the soft drinks because they use the refillable glass bottles, so there's little environmental impact, but the 250ml bottles contain like 3 swallows. That's one part of America's super-sized lifestyle that I won't complain about--when I order a beverage, I like a lot of liquid.

Sorry, not much brilliant cultural commentary today. I'm honing my sudoku skills.

Patan

2009-08-01T05:58:00.000-07:00

Our outing for today (Melissa's day off) was to Patan. Once a separate city, it was one of the three main cities in Kathmandu valley. As the cities grew, they've merged into one giant metropolis, but Patan is still technically distinct. We went there to see the Durbar Square of Patan, where the royal palace housed its king centuries ago, before Nepal was unified. Durbar Square of Patan is known for its remarkable concentration of architecturally significant temples and its royal palace that has been converted into a museum. Bruce joined us for this day trip.

Walking into the square one is immediately impressed by the number of temples, each with remarkably intricate carvings. We read our guide book to learn when each was built and which deity it focuses on. We went inside one temple, dark and damp inside, up to a second floor shrine where people were lighting candles in worship (no photos were allowed here). I was struck by a significant difference between Buddhism/Hinduism and Christianity/Judaism/Islam. In the eastern religions, there are holy shrines and buildings, but nowhere are there rows for gatherings of people to sit and worship together. They have many festivals, but their worship and prayer are not communally based, nor focused on a specific time of the day/week, as best I can tell. This is in contrast to western religions where our holy buildings are primarily built for gathering large groups of people at specific times.

Anyway, some highlights: one temple was draped with what Melissa correctly identified as intestines. We learned from a tour guide that they were water buffalo intestines. You can see them in the photo above. Nice. Also in the photos you see a Hindu ascetic holy man. These people hang around all the major tourist sites, allowing pictures or giving a blessing for a "donation." So we paid him for the picture. Also in the pictures you see me next to one of the mythic snow lion statues. A close relative of mine recently compared me to a dog in my current hairy state--I prefer comparing myself to a snow lion instead. I look positively vicious.

After a bite to eat (which included "chicken lollipops") we went to the museum. Its reputation as one of the best, if not the best, in Nepal is well deserved. It was clean, beautiful, informative, and had a remarkable collection of religious items. Most of the museum was dedicated to explaining the religious iconography of Buddhism and Hinduism. Since we've been here, we've marveled at the structure and age and intricacy of all the monuments, but there are so many and they're all dedicated to such diverse deities that it's quite overwhelming. Hinduism as it exists today is a blending of many ancient religious systems, so the number of deities and the mythologies that surround them are vast. For a westerner (and probably many easterners) it's tough to understand. The museum explained many of the basics, which was great since we knew so little. In one of the pictures above, for example, you see a variety of statues of Hindu deities, and the purpose of this display was to explain the symbolism in the different hand positions. We soon became more familiar with how a given statue or image contains clues to who the deity is and what its intention is. For example, Vishnu often holds a staff that represents wisdom and a shell that represents creation. Another image might look similar, but a close inspection will reveal the deity holding a jug of water, representing health, or a string of jewels, representing prosperity. The other items in the image helps identify as well; each deity has a vehicle, or animal. Ganesh is accompanied by a rat; Vishnu rides a bird; and so forth. I particularly liked learning about the different positions in which Buddha is depicted. A hand extended indicates charity; a hand making an "OK" sign suggests Buddha is teaching; a hand raised represents comfort; a hand touching the ground symbolizes the moment of his enlightenment when he drew upon the power of the Earth. Walking back home, we were able to stop at the roadside shrines and stupas and make more sense of the diverse symbolism. I felt a bit like Robert Langdon. (Melissa says I'm a dork.) One last note on the iconography. It is interesting that on many of the Buddhist and Hindu structures one sees the six-pointed star, an ancient symbol from Hinduism. It is even stranger to see swastikas, an ancient Hindu symbol of balance. And the swastikas aren't just on ancient religious structures. One sees them on buildings conducting business. On the road outside our hotel is a manhole, and the iron cover says something like "swastika sanitation" on it. I imagine the 20th century meaning that this symbol has taken on is pretty far removed from Nepalese religious associations. For a westerner, though, it's pretty strange to see.

A Mini-Trek

2009-07-31T02:02:00.000-07:00

Well I couldn't spend the entire time here in Kathmandu. It's such a beautiful country it would be a shame to spend the whole time in a congested city. However, we've been reluctant to look into hiking because Melissa is working and we don't want to be too out of touch. But today I worked something out that allowed me to see some nature and we were still both comfortable with it.

Certainly I didn't want to go alone, so I asked if one of the other guys here was interested. Bruce, a Canadian literature student and croupier has been here for weeks and not left Kathmandu, and so he was excited to join me. Bruce knows a taxi driver that he trusts (he calls him "my driver") and Pujan, the hotel owner, told us where to go for a good 1/2-day trip nearby and sent someone he knows with us as a guide. So we were off.

If you look at Kathmandu on Google maps, just to the northwest of the city is a large nature preserve called Nagarjun, I think. It was a 20 minute cab ride to get to the entrance of the park, where we paid a small entrance fee. The cab driver waited at the entrance 3 hours for us. The guide led us up a steep hillside, and very soon the sound of honking cars faded, and we were in nature. I had forgotten my bug spray at the hotel. Stupid. It was mosquito country, but our guide used branches to keep the mosquitoes away the old fashioned way of fanning. What bothered me more was the heat. It was very hot and humid.

The hike was rigorous, but not terrible long. It was a well-traveled path, and much of it had steps cut into the dirt of the hillside. Soon it leveled out and we were on a ridge. We followed the ridge for 4km or so, flat in some places and steep in others, until we came to a buddhist shrine at the top of a high hill. I was quite winded the whole time, as was Bruce. Kathmandu is at about 1,300 meters, and we hiked up to 2,200. Much of Colorado is that high, so we were by no means at Himalayan altitudes, but I was winded anyway. Our guide does treks for a living--he said he's been to Everest base camp over 50 times. He was not winded.

Luckily it was a fairly clear day and we were treated to great views of Kathmandu. At the top was small metal tower, and as we climbed it the peak of one of the Himalayas, Langtang, showed itself above the clouds. The clouds quickly hid it again, but we briefly was a 7,000+ meter peak from the ground. From the hill we could see the entire ridge we'd walked up and the entire Kathmandu valley. As planes came in they were below us before they landed (obviously, but it was still cool), and we could see the hill with the monkey temple and the general vicinity of our hotel.

At the top there were a few Buddhists conducting worship. They sat and prayed and chanted, reading from a book that looked just like the one Melissa had bought yesterday! So I now have a vague idea of that item's actual usage.

I've saved the most memorable part of the trip for last: the leeches. When we first got on the path the mosquitoes were bad, but as we climbed, the guide warned us of the leeches. My only experience to this point with leeches was in the lakes at summer camp in the Adirondacks. There the leeches live in the water and look like slugs. These leeches are much more active, living on the ground and sticking their front ends up and moving around. In the photo above, the leech is the thing that looks like a curved stick sitting on the leaf. They were everywhere on the ground, and they stick to the bottoms of shoes then inch their way up to the skin like big inchworms. We had to stop every ten minutes or so to clean them off our shoes. At each stop we'd each have two or three leeches on our shoes, and some made it to our socks and ankles, so at the top of the hill we took off our shoes to really clean them off. Bruce's sock was totally bloody, as a couple leeches had bitten him through his sneakers and socks! It's not painful, though--you don't even know you have a bloodsucker on you if you don't look. When we returned to the hotel I removed a couple more, took a shower, washed, got all cleaned up, and came to the lobby of the hotel to write this blog entry. Halfway through it, I noticed I had blood running down my leg. I asked the receptionist for some paper towels, and when she asked what happened I said "leech" she was rather disgusted. So I bled on the hotel lobby floor a bit, which I felt bad about, but I cleaned it up and I think I'm now leech-free. They're really nothing more than a nuisance--no actual medical danger as far as I know. But we decided they must have an anticoagulant in them because a tiny little dot continues to bleed for some time. I'm fine though, mom--don't worry!

A couple other comments on the above pictures. The pictures of clouds has the peak of Langtang in the middle--it just looks like a cloud. In one photo you can see the ridge we hiked up. There is also a photo of Bruce in his Sabres jersey and me in my Sabres hat. At the games they show people in Sabres garb at locations around the world, so if I don't get a better one, I might label that as Nepal and try to get on the big screen at a Sabres game. I'm a nerd.

Purchases

2009-07-31T01:48:00.000-07:00

Yesterday our goal was to find a cool old map to frame for our wall. We've seen tons of framed pictures in the shops around here, but nowhere have we been able to find a wall map. After a while, we started asking the shop owners, and they wanted to show us road maps. It's a subtle difference to try to convey with a language barrier. One shop had lots of old looking stuff, so we gave it a try. We don't think the man knew what we were asking for, because he led us from room to room showing us random things. He took us deep into his store, unlocking cages of junk to show us things. We kept thinking we might find something good, so we let him continue to show us things, and he led us upstairs to more rooms and upstairs again. On the third floor was apparently where people lived. We were in their kitchen and bedroom and he was trying to sell us things right off of their walls. So although we didn't find a map, Melissa and I just couldn't leave there without buying something from that family. Melissa found a religious "bookcase," which is two carved pieces of wood that contain disconnected pages of handwritten writing about Buddha. It is written in a Tibetan language, and looks quite old, so it might be valuable. It's very tough to tell with these things, but at least it's a more unique item that isn't being sold on every street corner. In the picture above Melissa is laying all the pages out to examine the different pictures of Buddha. I thought I'd buy something for the wall since it doesn't look like I'll find a map, and I got a carved thing to go above a door. It's probably junk, but again, at least it's unique, and we'll always remember that home/store and the old man with cataracts who we bought them from. On a related note, we really need to stop spending money! Everything here is cheap, but when you buy a ton of cheap stuff it eventually adds up...

A Few Random Comments

2009-07-29T21:36:00.001-07:00

1. I always thought cricket was on par with lawn bowling and curling in its popularity. Apparently not. In the world of former British colonies, it's hugely popular--why did America thankfully avoid that? But I've actually been watching and enjoying it. Since the matches are long it's on all the time, and when it's not, they show reruns. Still, I haven't figured out the terminology. Just for kicks, look at the wikipedia article for "cricket terms."

2. Sorry that I lost the comments that people had left for my first few blog entries. We love seeing people comment, so if you are a reader, say hi!

3. In this new blog format, you can click on the pictures to see them in a larger format.

4. No matter how much I try drinking it, I cannot acquire the taste for tea. I keep trying though, since the boiling water makes it safe to drink here. I've gone from actively disliking it to simply not enjoying it. I'm neutral.

5. The music scene here is diverse. Everywhere we walk we hear western music. The soundtrack for this trip has been a combination of Black Eyed Peas, Kings of Leon, and Jack Johnson. But I wonder if that's just to cater to tourists. I've had a few occasions to hear Nepali people hum to themselves and I've been in cars where people had music on, and it's usually traditional in nature. Also, the TV has lots of music channels that are nearly all Indian music videos. However, when the bars around here have Nepali bands that play music, it's a lot of classic rock--you can hear the Beatles and Hendrix echoing from the rooftop cafes at night, sung by Nepalis. Interesting mix.

6. Melissa and I have eaten just about anything put in front of us on this trip to be adventurous, but last night I just couldn't try the wild boar. I'm sure it's not too different from regular pork, but it just looked too gross for me. Melissa went for it, though. Good for her.

Garbage. Wow.

2009-07-29T10:03:00.001-07:00

In my blog, I've commented a few times on the garbage around Kathmandu. I've tried not to dwell on it in the blog. I actually have some real information about it now from today's newspaper. No, piles of garbage in the street is not the normal way of life here. Though I doubt the city would ever qualify as "clean," we do happen to have arrived in the middle of a strike of garbage workers. They are currently on their sixth day of striking, and are negotiating with the government for "more sustainable waste management with a package of development projects." Unfortunately, the paper reports that no headway has been made.

I'm not informed enough about Nepalese politics to comment intelligently, but I'll just say this: if the end result of the strike is an improved waste management system, then it's probably good. Many people here drink bottled water because, as you can imagine, the ground water system is polluted, but there's no system for recycling those millions of plastic bottles, so they're everywhere. It's tragic that in the 21st century people still lack basic sanitation. I don't know the full story, but if the motivation of the garbage workers is truly a better system, then I hope it works out. What I see around here is tragic, but at least it's not permanent.

Here's the flipside of the coin: although the garbage workers may have good motivations and a better system may result, the danger caused by this garbage strike is very real. Nepal is currently experiencing an outbreak of cholera. Yes, the disease where people die of diarrhea. According to today's paper, the outbreak has killed nearly 200 people in the last few weeks. At least this disease is in midwestern Nepal rather than the more populated Kathmandu. If it were to spread here in the midst of the garbage strike, I fear it would be catastrophic. Melissa says that cholera is treatable--simply stay hydrated until the diarrhea has passed. To do that effectively, though, requires clean water.

The paper reports that the government is doing a lot in terms of distributing medicines, setting up health camps, etc. The PM points out that major roadblocks to combatting the disease include geographical hazards, few motorable roads, poor communication networks, undernutrition, and shortage of water, among other things, and these are not problems easily fixed. They are also devoting resources to combatting swine flu (though there have only been 5 swine flu cases in the country, I'm told).

The paper also reports that families that lose someone to cholera are getting monetary relief: 10,000 rupees per family, and 15,000 if the deceased was the family's breadwinner. A goodly sum to them, I hope. It's tough for me to put it in perspective. Melissa and I spent more rupees than that in our first 2 days here.

An Unplanned Walking Tour

2009-07-29T09:52:00.000-07:00

I woke up from my afternoon nap to Melissa telling me we were going to a party of sorts. She had with her Reena, the resident at Kathmandu Medical College that Melissa is shadowing. (Melissa can tell you about Reena and the KMC residency program in a later entry.) Apparently one of the other docs was having a ceremony/party for her 5-month-old daughter, who is at the age where she ceremonially eats her first rice. I thought this would be a cool way to experience some Nepali culture outside of the hospital and typical tourist haunts.

Reena knew where the location of the party was, sort of, but wanted to get a gift for the mother and daughter. She knew of a baby clothing store, sort of, and so we were off to find it before going to the party. We proceeded south from Thamel, and she said it would be a good walk but we were up for it. We traveled crowded streets and narrow alleyways, past more sidewalk shrines and butcher shops. Reena had not been to the neighborhood recently, though, and had to stop to ask for directions. 6 times. So we zigzagged through increasingly unfamiliar streets, late now for the party, searching for a store that Reena wasn’t sure was still there. The walk led us to a sort of outside/inside mall where there were only Nepalese, and I felt like we’d really gotten off the beaten path. No longer were we surrounded by shops hawking miniature Buddhas and hippie outfits, no more stores of pirated DVDs and trekking equipment. This was where real Nepalese people shopped, and there was no traditional Nepali garb. It was all Shakira, Abercrombie, Tupac, American Eagle, etc. No more proud “Made in Nepal" signs—it looked like it all came straight from China, complete with massive amounts of plastic and styrofoam to package it all in.

Reena is Nepalese so obviously she speaks the language and eventually found the store she was looking for. To my surprise, she also ran into people that she knew 3 separate times, in the midst of teeming alleyways in an unfamiliar neighborhood, in a city of 5 million. Weird. After also locating a shop to buy wrapping paper, we were headed to the party. This walking excursion took about an hour, during which time I grew increasingly annoyed at the apparent casualness with which everyone here treats punctuality and organization. But I’ll get over it—it’s just a cultural difference.

The party was located in probably the busiest section of streets we’d seen yet. For the first time, we encountered a 4-lane road. It was packed with minibuses full of people, and crowds of people on the sidewalk waiting to get on more buses. All the streets in Kathmandu have been crowded, but it’s mostly pedestrians, taxis, and motorcycles. This was the first place I’d seen traffic that really looked like a big city. On one side of the street, we were told, was the biggest hospital in Kathmandu, which stretched for blocks. They were in the process of building a new trauma center. The partially constructed building was surrounded by scaffolding made of sticks lashed together. On the left side of the street was our destination—an army base.

From the wrapping paper store Reena said it was a 2 minute walk to the party. 20 minutes later we walked onto the army base. She explained that the doctor’s husband is an army officer, so the party was being held at a recreation club run by the army—so not really a base per se, but it was surrounded with many rows of razor wire and had 5 armed guards at the entrance. So yeah, it’s a base in my opinion. The guards seemed surprised to see Melissa and I walking in.

It was like entering a different world. It was quiet and spacious. We found our way to an outdoor reception area where many people were milling around in nice clothing drinking wine and eating hors d’oeuvres. We met the host and his wife for whom the celebration was happening. We seated ourselves among a number of the other OB docs and had good conversation for a while. Whereas I had expected a traditional Nepali celebration, something different and unique, it actually could have been any reception for any formal event anywhere. It was pleasant but quite ordinary as far as those things go. There was a buffet and some more conversation, and we then got a ride back home. I definitely felt, however, that we were sitting among the most privileged of Nepali people, since right outside that razor wire there were people clearly impoverished, and many others conducting their daily business struggles just to get by—and we were drinking wine among doctors and army officers. Oh, the one difference that distinguished this reception from any I might find at home was the continued presence of those stray dogs. Nobody paid any attention to them. Imagine going to a nice outdoor wedding reception and having random mutts begging at all the tables.

Thamel's Mountaineering History

2009-07-29T09:45:00.000-07:00

After bothering Melissa with my explanations about Whitman, we went to dinner. Our guidebook suggested the Rum Noodle, which I was excited to try because of its connection to mountaineering. It was literally 30 seconds from our hotel in Thamel. This restaurant, which caters to the trekking crowd, is very popular for mountain expeditions because Sir Edmund Hillary ate there (and apparently left his signature on the wall somewhere I think). Consequently, it has become a tradition for mountain expeditions to stop there, and each leaves its mark upon the wall. The marks take the form of giant yeti footprints, which the expeditions draw on or sign to commemorate their trips. The restaurant is big—many rooms—and every surface is covered with giant yeti feet describing the mountain, the date, and the participants. It is quite cool for someone who has read a lot about Everest. I didn’t see any of the famous people’s signatures (I didn’t want to be obnoxious and walk all around where people were eating) but apparently Hillary’s signature is there, along with Reinhold Messner, the first person to climb all the world’s 8,000 meter peaks (I think) and Rob Hall, who’s dramatic death on the south summit of Everest was described in Jon Krakauer’s outstanding book Into Thin Air. In the pictures you can see the giant feet and more of the Buddhist prayer flags that expeditions often use to pay appropriate respect to the sacred nature of the mountains for the Tibetans and Nepalese. Have I mentioned that I want to come back to Nepal during the clear weather season and go on a trek? Yeah. Any takers?

Melissa's Medical Adventure

2009-07-28T05:05:00.000-07:00

So this is my first time writing one of these posts, and it looks like it's about time, if you happen to have read Chris' post from today first - if not, have fun reading it... (it's below this one.)

As you read from earlier posts, yesterday was my first visit to the hospital here. It was fairly brief, mostly just a tour, and completing some paperwork to make my visit official. So today was the first full day at KMC (Kathmandu Medical College). Dr. Chanda has me following one of their "residents", Reena. I learned today that she is actually the only resident in ob/gyn right now. After completing medical school, aspiring doctors first do a general internship year, then do a "post-grad" in whichever specialty they plan to enter. So right now on labor and delivery, there are a few medical officers (their version of third and fourth year medical students), a couple of interns, who are only on rotation for a couple months, and then their one and only post-grad/resident in ob/gyn is Reena. She is on call three times a week, and her post-call days still ends up working, so really she only gets to go home one day a week, maybe one other evening, and just stays at the hospital in her little call room the rest of the time - and this is the same schedule for three whole years! I really love my residency program, let me just say - hearing Reena talk about her work hours gave me a whole new appreciation for the 80 hour work week limit in the US.

Despite her crazy hours, she still has a great attitude, and seemed very happy to have a new "shadow". We started our day with a presentation about cesarean sections - it was pretty basic broad overview, and fortunately given in English. Then on to rounds - their wards are very different from our pods of private or semi-private rooms. There is a big room with 10 beds or so for antenatal patients, another for labor or possible labor patients and one more for postpartum, a room with two beds with stirrups for deliveries or minor procedures, and another room with about 20 beds for gyn/post-op patients. Rounds were very quick, and all in Nepali, so I pretty much had no idea what was going on, other than looking at the patient to figure out if she was still pregnant. Afterward Reena tried to catch me up a little.

Their labor monitoring is very different - every three hours one of the docs goes in to listen to the fetal heartbeat with a stethoscope, compared to home where we essentially monitor all of them electronically continuously. They don't even have a computer on the entire unit. Despite the lack of more intensive monitoring, however, Reena said they have a 40% cesarean section rate, which is even higher than ours at home (which is probably closer to 30%). I guess this disproves Dr. Wood's theory about monitoring leading to increased cesarean section rates...

Anyway, the rest of the day was actually fairly slow - lots of discharges, and then two admissions, which, thanks to the lack of required documentation and paperwork were much faster than any we'd do at home, but no deliveries or surgical cases today.

After tidying things up on the ward, Reena took me out to lunch at one of the local places within walking distance for some daal bhaat - a typical Nepali meal of rice, a sort of lentil soup, and assorted vegetables, washed down with lassi, which sounds kind of yucky - a curd drink, but is actually pretty tasty, kind of like a thin yogurt. I felt very brave, eating at a local restaurant where no one (other than Reena) spoke any English, and I had no idea what we were eating until Reena explained it to me.

The rest of the afternoon was spent mostly in comparing and contrasting how ob/gyn is practiced at home versus in Nepal. Reena and I hung out in her call room, reading through Williams (the obstetrics bible, apparently everywhere in the world), and asking questions about how the other would do things. It was a great chance to get to know her a little better, and also learn more about the many similarities, and few big differences, in how babies are born on opposite sides of the world.

Anyway, enough "doctor talk", as Chris would say. Over the rest of the next two weeks, I'll hopefully get to see some more action, both at KMC, and also Dr. Chanda promises to take me to a few other hospitals in town as well.

It will be a busy but rewarding rotation.

For now, back at the hotel, I'll be catching up with Chris, and I'm sure learning all about Whitman and his Leaves of Grass, and getting some dinner before heading to bed.

More tomorrow, and hopefully soon I'll have some pictures as well.

Gunter's Mental Wanderings about Poetry and Religion

2009-07-28T04:48:00.000-07:00

Today has been an uneventful day for me. As Melissa’s first day at the hospital, I took it easy and stayed at the hotel most of the day. The courtyard is a peaceful place to sit and read, and I didn’t want to go too far without a cell phone.

Since I have no new or interesting pictures or stories about Kathmandu, I’ll talk some about what I read today, which relates well to my journey in the East. I brought along a bunch of books, one of which is Walt Whitman’s Leaves of Grass. I thought poetry would be good for a trip like this because I would likely have lots of short snippets of time to read, which are more suitable for poetry than an absorbing novel. I’ve never been a big fan of Whitman. I pay him some obligatory respect in my 11^th grade class by looking at a few samples, but I rush through to things I find more interesting. He wanted the common worker to read his poetry, so it’s written almost like everyday speech, with no attempt to be pretentious or follow academic contrivances. But that turns me off. I like poetry to be challenging to understand and I like academic contrivances. (I enjoy T.S. Eliot for this reason.) Whitman just seems too, I don’t know, casual and rule-less for my taste, as though he wrote whatever came to his mind and never edited a bit.

But I brought along Leaves of Grass because I know I’ve never given Whitman a fair shot. It’s been on my list to read for a long time, and I’ve avoided it. A while ago I read a book called The American Classics, in which the author argues that there are only five books that warrant that label: The Great Gatsby, Huck Finn, Walden, Moby-Dick, and Leaves of Grass. I knew I had to get through Leaves if I wanted to feel knowledgeable about American lit.

I am going somewhere with this, so bear with me—

Whitman’s poem seems so arbitrary and repetitive, so uneven and long-winded, but it’s actually easy to read, and I found myself enjoying it. I thought it funny that I’d go to Nepal to read something that’s quintessentially American. But as I absorbed line after line of commentary on the beauty of humanity, the oneness of humanity, the joy and depth that can be found in observing humanity, I decided it was particularly appropriate that I’d read it in Nepal. This is a place where I pretty much sit back and watch people, as Whitman probably did on the streets of Brooklyn. I’m observing daily life of tailors, deliverymen, artisans and salespeople, cab drivers and butchers, policemen and beggars. (No garbage men though.) When do I do this at home? Never—I’m too busy watching TV or something. And even when I’m out on the street I don’t think about what I’m seeing because it’s too familiar. (The formalist school of thought in literature says that art succeeds when it de-familiarizes us with our environment—when we notice that a stone is a stone.) Anyway, Whitman struck me as not exclusively American in his observation about the connectedness of society, but as more universal. Perhaps being in Nepal was the best way for me to appreciate what he was trying to get at.

It goes deeper yet. Whitman’s ramblings about the interconnectedness of life include much reflection on death and birth. He meditates in his verse on the timelessness of the universe, the nature of the body, the nature of the spirit. He declares that all people are timeless, that life is the same as death, that each person has god in him/her. And so on. The rationalist in me gets annoyed with all this new-age mumbo jumbo, but that’s to oversimplify Whitman’s reflections. Furthermore, the rationalist look at the universe and the spiritual one are not mutually exclusive: the most devout believer and the most devout non-believer can be equally in awe of the timelessness and grandeur of the cosmos. But I’m getting sidetracked—my point is that Whitman’s philosophy, as he develops it over 100 pages of exclamation points, suddenly struck me as very similar to Eastern philosophy and religion. It sounded like something straight out of a Buddhist or Hindu text. The notion of reincarnation (without using that word itself) was present on every page almost. It was deeply religious in its own way, and completely non-Christian, as far as I could tell, despite mentioning God repeatedly.

So I was once again struck by the appropriateness of my reading Whitman in Nepal. I was almost through with Leaves when I decided to look at that long introduction I’d skipped over. After some explanatory notes about Whitman’s early life and the start of his writing, the critic who wrote the introduction began to explain why he felt Leaves of Grass was a remarkable work of literature. As it turns out, much of that explanation includes a comparison of Whitman to eastern religions! After patting myself on the back for drawing that comparison independently, I read the rest of the introduction.

The critic argues that Whitman had zero knowledge of eastern religions when he wrote it. For that reason it is a brilliant work. It is as though Whitman developed a philosophy very similar to Hinduism and Buddhism completely independently, in the midst of a heavily Christian culture. Part of Leaves of Grass describes a specific moment of revelation that led to the philosophical observations that comprise much of Leaves. Such moments of enlightenment, or ecstasy, are well documented by individuals throughout history. Their true nature (hallucination, hypnosis, divine revelation, etc.) is debatable, but time and again individuals claim such moments and report similar enlightenment following them. Buddha’s is the most famous. (Buddha’s enlightenment under the tree is the central moment of eastern religion, as the Exodus or crucifixion is to western religion.) Anyway, the critic who introduced Leaves argues that Whitman’s text is deeply religious and has more in common with the Baghavad-Gita, the Upanishads (sacred texts of Hinduism) or Arthur Rimbaud’s Illuminations (French poetry) than it has with other American texts. It’s a kind of emotional mind-dump that follows moments of ecstatic vision, and the philosophies that result from those visions are remarkably similar. Again, I’ll point out that Whitman had no knowledge of these texts—they had not even been translated into English when Whitman wrote Leaves. The introduction says that when Thoreau met Whitman after the publishing of Leaves, Thoreau asked Whitman if he knew much Indian philosophy, and Whitman responded, “No, tell me about it.”

Well…if you made it this far with me, I applaud you. I suppose this is what you get when you put a literature and religion nerd in the middle of an ancient religious city and tell him to blog. Well anyway, that’s what I’ve thought about today. I didn’t expect all this gobbledygook to come out in the blog, but I actually kind of like it. Maybe I’ll try to turn it into a publishable essay. I’ll entitle it “Reading Whitman in Nepal.” Wait, no, that sounds like a plagiaristic spinoff of “Reading Lolita in Tehran.” I’ll keep thinking about it.

Melissa Starts Work

2009-07-27T17:50:00.001-07:00

The next day presented new challenges still. Our culture shock has died down as we are becoming acclimated to the environment, but Melissa’s first day at the hospital was sure to be eye-opening. The hotel arranged transportation for her, and I accompanied her the first day to make sure all was well and see the hospital for myself.

The hospital is right near the airport, so the driving route has become familiar now. Geographically it's not far, but with all the traffic and pedestrians in the crowded streets, it takes 30-45 minutes. To make it even tougher, it has started to rain. I suppose that's good news for the millions of Nepalis who want to have a rice crop so they can eat, but it sure makes transportation inconvenient for the tourists! The rain made for fewer people on the street, but not by much. Since there isn't really a sewage system or storm drain system to speak of, it made the roads flooded and messy. Those piles of garbage everywhere are now being washed everywhere, and when we crossed the river, it was clear where that garbage all ends up. Very sad!

The hospital is a building of perhaps 6 stories, and it is roughly U-shaped. The center area on the ground floor is outside, and that serves as the receiving area and waiting area for emergency. This area was full of people, but not any more so than one might see at Strong. We weren't sure if we would see lines of destitute people or what it would be like. Melissa had heard that at some hospitals, pregnant women come from rural areas and camp outside the hospital waiting to deliver. There was nothing like that--it was busy, but not out of the ordinary.

We walked in and just looked around, since Melissa had not been told where to go. We asked a security guard for the obstetrics area, and he pointed us to the stairs. We located the third floor obstetrics ward, which to my surprise looked nearly empty. We were led from one person to another, all looking for the doctor we were to meet. Considering how small the hospital was, she took a long time to locate, but when we found her, we were put at ease. She greeted Melissa warmly and talked about how happy they were to have her. We were led around to meet some of the other faculty members, and then went to the administration offices to do paperwork. Dr. Karki led us the office of the director of the hospital, who sat with us and talked about the differences between how medicine is practiced in Nepal. (All the doctors, by the way, speak excellent English, as they all attained their medical degrees abroad in India, the US, Pakistan, and other places.) The director said that in the US they rely a lot on biochemistry and lab results, whereas in Nepal there are no labs to get results from. Consequently, the practice of medicine is much more clinical in nature, and Melissa will get good experience diagnosing problems with less support from labs.

We were only at the hospital an hour or two. I sat in the reading room and did Sudoku--I stayed because we were in an unfamiliar neighborhood and we do not have cell phones here. Soon enough, Melissa was done, and she starts for real today. Already she learned things she was surprised about. She said that some procedures that are very standard in America are unusual here, and other things she expected not to find are very typical here. For example, their rate of c-sections is as high or higher than at Strong.

I'm sure after she goes to work today and the next few days she'll have plenty of interesting things to report.

After the hospital yesterday we made some purchases at various shops, including a large North Face backpack for camping that I got for only $45. Everything here is very cheap, though it doesn't feel like it because the denomination of currency for most things is in the hundreds and thousands. 1000 rupees is something like $15 bucks. I did find one item I really wanted to purchase but didn't--it was a framed cloth map of India, Nepal, and Tibet, dating back to the colonial era. I thought, "awesome, what a find, I bet this is so cheap!" When I inquired, the man said 200, (like $3), and I was excited, until he said 200,000 that is ($300). Apparently it is a valuable antique. I was surprised to find a valuable antique, since most of the shops here have mass-produced tourist junk. We're trying to keep our purchases interesting, unique, and of high quality.

Tibetan Beer

2009-07-27T17:13:00.000-07:00

After the monkey temple, we ended the journey with a cab ride back to our neighborhood of Thamel, and dinner at the Yak Cafe, a Tibetan joint. The guidebook recommended tongba, a kind of beer. It works like this. They put some hard alcohol into the tube, then fill the tube with millet (this is the first time I’d seen millet, a coarse grain that provides sustenance to much of India). Then they poured hot water into the tube and let it steep like tea. So it’s not really beer, though it has the basic ingredients. More like alcoholic millet tea. Weird, and not particularly tasty. Not as strong as the rice wine from the previous night, though. I suppose if you like it it’s a great bargain, because for about a dollar you get the drink, and you can refill the millet with hot water 3 or 4 times, so it’s actually a lot of beverage. As you can see, Melissa tried it, but she was satisfied with one or two tastes. I drank some more, but supplemented my meal with a Sprite.

The Monkey Temple

2009-07-27T06:24:00.000-07:00

After the mountain flight we decided on our next walking tour. We would go see the Swayambhunath Stupa. The small stupa we saw on our first walking trip is modeled after Swayambhunath. The big one sits on a hill that overlooks much of Kathmandu. (You can barely see it on the hilltop in the photo at the bottom.) Legend says (and archaeologists agree) that the valley was once a lake, and legend says that this hill was an island. So as early as 2000 years ago it was a sacred site, and by the 13th century it had structures of various sorts paying homage to both Hindu deities and Buddha. Now it is almost exclusively a Buddhist location, with statues of Buddha everywhere, of all sizes, ranging from an inch high to the large golden Buddha of 6 meters (about 20 feet) to the giant Buddha eyes that watch the valley from all four sides of the center spire.

Getting to the temple was...interesting. We debated about walking, taking a cab, or taking a rickshaw. We decided to brave it and find our way by foot. Armed with map, guidebook, and compass, we proceeded west from Thamel. Our host had told us it would be about a 15 minute walk. We had to find our way through some crowded streets, hoping we were going in the right direction, but soon enough we were descending toward the river, a distinct landmark, and we could see the hill with the stupa rise on the other side of the river. It was a lot of stairs to climb that hill. The air quality in Kathmandu is very poor--the dust is thick (it has not yet been washed from the air by monsoons), the motorcycles are everywhere, and sanitation is poor. Add to that the fact that Kathmandu is a mile high, and we were definitely winded climbing those stairs.

The coolest part of it all was the monkeys. Though the official name is Swayambhunath, everyone refers to it as the monkey temple because the hill is swarming with wild monkeys. I had a picture of a monkey on yesterday’s blog, but that was just one random monkey. At Swayambhunath they were everywhere! We kept our distance to avoid being bitten (though the danger of that I’m sure was low), and we were entertained by their swinging, jumping, playing, and occasional fighting. They hopped on the Buddha statues and swung playfully from the Buddhist prayer flags that hang from the trees. Melissa particularly liked the mother monkeys that ran around with baby monkeys clinging to their underbellies. Very cute, very human-like, and fun to watch. Monkeys in zoos are fun, but usually pretty subdued. It was just very cool that these were naturally occurring wild monkeys, thriving in this treed hill in the center of an urban mess.

This stupa is one of the main tourist attractions in Kathmandu, if not the main one. It was nice to blend in to a sea of other tourists rather than stick out completely as we do in most streets. But most of the tourists are Indian, it seems, or perhaps Chinese or Tibetan. It was also nice because, though the standard vendors were everywhere, they were not as pushy as most others. It was crowded, but actually rather peaceful. The view of Kathmandu was great, since the hill has a pretty high profile in nearly all directions.

Internet is Fixed

2009-07-27T04:33:00.000-07:00

I have all my old blog posts saved, so I will be able to re-upload them I think, but it will be time-consuming. For new readers, I did have a successful blog going for a few days, and then it inexplicably stopped working, so I've resorted to this clunkier program, but at least it's something.

I'm going to keep this quick: Melissa and I went to a great place yesterday called the monkey temple, where wild monkeys run around in packs around an imposing and ancient Buddhist stupa. Today Melissa found where she'll be working at Kathmandu Medical College, and we've been enjoying shopping around for various things. I ended up purchasing a new backpack for hiking. I've been looking to buy a bigger one so I have the space to pack what I need for trips of several days. The one I bought would cost $150-200 in the US, but I got it on the street here for $45. Anyway, I'm going to work now on recovering my old posts and uploading the photos (that's the slow part...).

Thanks for reading, and I apologize for the technical difficulties!

Internet Frustrations

2009-07-27T04:24:00.000-07:00

This blog is a sad attempt to publish something while here in Nepal. The blog I had going for the first week of our trip has encountered some technical errors and has failed to work at all. So here is something...

The Everest Flight

2009-07-26T06:22:00.000-07:00

Well it was a cool experience but we didn’t see Everest. It was a very cloudy day, and they took us up, and we had some good views, but the clouds were thick and many-layered. We saw some mountains amidst all the clouds, and I thought I saw one that might be Everest, but after a while they turned the plane around and said we couldn’t see Everest so they were going to go land. We never paid anything for the flight, and if we want to go again they will arrange it. Melissa has to work tomorrow, so we’ll figure out what her schedule is like and try to fit it in another day.

We were picked up early and had a quicker ride to the airport, since the streets are mostly empty at 6 a.m. (but not entirely--there were a lot of people up and about already). We went to the smaller domestic terminal, from which flights leave for about 6 other airports in Nepal, and the mountain flight is a daily special.

As we climbed, we got pretty good views of Kathmandu. It is surrounded by green hills higher than anything I’ve climbed, and even those low ones presented some beautiful panoramas, as they were blanketed in layered clouds. It was as though they were floating, hiding in the sky, fading in and out of visibility as we climbed higher. The plane rose in a slow spiral out of the valley, and so we got views of the increasingly rural and mountainous regions. Soon enough, the snow-covered peaks appeared to the north. It was breathtaking. They, too, were blanketed in clouds, so we could never see a continuous mountain from the populated valley all the way to the summit.

Rather, it was like looking at three separate layers of earth--the valley below the plane (then clouds) then the rugged green mountainsides carved by deep gorges and rivers (then clouds) then the jagged snowy tops. At times, the mountains rose above the plane.

We had been given a panorama drawing that illustrated the chain of mountains with labels, but among so many clouds there was no way we could identify what we were seeing. We continued to climb, and I thought, well maybe that was it, and he’s going to do a u-turn. We went higher still, and then more mountaintops popped out of the clouds. Those first ones we’d seen (and I had thought might be Everest) weren’t even among the highest. Crazy.

Shortly thereafter the flight attendant said we were turning around. The whole flight was maybe 30 minutes. I don’t actually know how close we came to Everest, but it couldn’t have been far. I think it was probably in front of the plane. When they said there were too many clouds, I don’t know if that meant it was entirely invisible or if they could see it but just not well. If we go again, we’ll find out. So our whole excursion was technically a failure, but by any other measure it was an awesome experience.

A Newari Dinner

2009-07-25T06:19:00.000-07:00

Last night’s dinner was great. The hotel owner’s uncle is opening a bar addition to his restaurant a few blocks away, and so to celebrate, many of the hotel’s guests were invited for a traditional Newari meal. Newari is a cultural group within Nepal--I don’t know what makes it distinct, but we frequently see signs that say “Nepali and Newari food,” so it is different. The meal was quite good, though I have no idea what I ate. It consisted of many courses, each only a few bites. For starters there were fried soybeans, a fried piece of hard-boiled egg, and some crunchy flakes that we think were a kind of flat, uncooked rice. Then came some meat (lamb?) and various breads, then some french fry looking potatoes, some dumplings that were stuffed with chicken, and some other items and couldn’t identify. It was all mildly spicy and tasty. It ended with a dessert which tasted like a sweet yogurt.

Right before the meal, our host had everyone join him in a toast - little shallow bowls were put in front of everyone and filled to the brim with a clear liquor - the server then dipped his fingers into a last bowl and then set the liquor on his fingertips on fire to demonstrate the “purity” (which also told us whatever this stuff was has a pretty high proof...). Everyone then toasted and drank it down like a shot. The drinks kept coming after that, although we both declined any more of the “rice wine.” During dinner we were treated to several choreographed traditional dances, with four men and four women, and a silent comedy routine that involved a giant peacock outfit.

We also enjoyed the company. There were about 15 people or so, and Michelle and Pujan (our hosts and hotel owners) asked us to sit next to people that we weren’t traveling with to improve the conversation. I talked a lot to the Canadians, who were students studying law and literature. Across from me was an Australian who grew up in the outback and had come to Nepal with her three siblings. They are going whitewater rafting tomorrow. We also talked at length with a couple who just moved to Nepal to explore job opportunities in the region. The husband is Australian and the wife is from Indiana. They just came from China where they lived for six months, studying Chinese. They are in the process to adopt an Ethiopian child. Quite an interesting couple. On my right was a couple from Miami who had just arrived in Nepal today, tourists like us. The wife works for the World Health Organization, and her area of focus is women’s health, so she and Melissa had a lot to talk about. Potentially a good contact for Melissa in the future. Melissa was sitting in a group that included a Canadian medical student, a college student from South Africa, Michelle (our hostess), and an ex-pat social worker living in Germany who travels the world helping to arrange adoptions for other ex-pat Americans.

I expected to find other foreigners in Nepal, but I hadn’t expected to so smoothly fall into such an interesting combination of expatriates. I’m sure it will continue to enrich our experience abroad, as people who come to Nepal are by nature adventurous and cool people (if I do say so myself).

It is 5:30 in the morning. We are leaving right now for the Everest flight. They do it early in the morning when it’s most clear, and they guarantee everyone a good view of the mountains or they’ll take us again another day. Everyone gets a window seat. So I hope it’s all it’s cracked up to be. It’s pricey ($157 each), but as one of the other guests said, it’s not like 20 years from now I’d say, boy, I’m really glad I saved that $157. Carpe Diem.

Culture Shock

2009-07-24T06:16:00.000-07:00

When we arrived in Nepal yesterday the airport went quite smoothly. I almost became complacent, thinking that I would very soon be at ease. Oh no. Our driver sped through streets inundated with people and motorcycles. I’m sure anyone else who’s been to a major city in a truly impoverished country knows what it looks like. For me, though, no amount of reading or pictures quite prepared me for the realities of the third world. And I’ve only been here 24 hours, just scratched the surface. As he maneuvered through streets that had no lanes or rules, dodging around the pedestrians, our driver pointed out a few of the temples and other places we might visit. I was more interested in just observing the city life of Kathmandu. It was complete sensory overload for me.

I’m sure Melissa was also thinking “Oh my, what have we gotten ourselves into here?” We would occasionally look at each other in the midst of the chaos with expressions of speechlessness. I have no pictures that quite convey the real nature of the city as we saw it on that first car ride.

After 20 minutes or so we were at the hotel. It is a gated hotel in the midst of the most touristy area of Kathmandu, and highly rated on tripadvisor.com. Walking in the main door, the owner immediately greeted us, bounding down the stairs and calling us by name. Born in Nepal, the owner lived most of his life in a British boarding school in India and then the United States. After years in Seattle and marrying an American, he returned to Nepal to operate this hotel. His smile and Americanism immediately made us feel at ease.

The hotel is popular with Americans, Brits, Canadians, and Australians. Those nationalities comprise almost all his business. He and his wife are on a first name basis with all their clients, hanging out with them in the courtyard and cooking meals for them. They make their hotel a small community of foreigners who come for long stays and often come back from year to year. It is an oasis, insulated from the bustle of street vendors, bicycles, rickshaw drivers, and stray dogs right outside the door.

Melissa and I did not venture far that first day. After checking into our room we walked around the block. Despite being the touristy area of Nepal, there are remarkably few tourists (it’s the rainy season, after all, but we’ve had no rain, so we’re lucky). It seems that regular life proceeds for most of the locals without paying too much attention the small number of westerners. Those who earn their living from the tourists, though, are plenty. We could not stop to read our map without a rickshaw driver asking to take us somewhere or a teenager trying to sell us jewelry. We politely declined, and all but a few of the vendors left us alone. The persistent ones would walk with us a block or so and then go on their way. Despite being persistent, everyone here is kind and respectful of the tourists, and despite being overwhelmed, we have not felt unsafe.

In the evening we had dinner at the hotel. The owner cooked tenderloins on a grill he’d imported from Tennessee. We chatted with the other travelers. We were invited to dinner tonight by a family who travels abroad a great deal doing social work with adoption agencies. That family was making arrangements to take a plane flight around Mt. Everest tomorrow morning, and we will be able to join them for that trip too--we hope to have great pictures on Sunday’s blog. I also was surprised that someone in Nepal recognized my Sabres hat. Being from Alberta, Canada, one of the other guests started talking hockey with me, and it was a strange combination of setting and conversation. Still suffering jet lag, we turned in early.

Without being too condescending or sensationalistic, I should mention that outside our courtyard, the poverty is evident. People warned me that that fact is what I would find most shocking. Melissa and I awoke early this morning, and by about 7 am were walking around the streets again, politely ignoring the groups of children sleeping in the street. There are also piles of garbage in the middle of the street, and I haven’t yet figured out if that’s the normal method of waste movement or if it’s an unusual amount of garbage due to periodic strikes in garbage collection. It was easy to see how the packs of dogs eat, but I was pained when I saw children picking through the garbage. Readers can understand our reluctance to take pictures of these aspects of Nepal that will be most permanent in our own minds.

The poverty is just life here, and it seems most people do what they can to make a living. Commercialism is booming, at least in this part of town. Like any major city, each vendor hawks his wares to the passers-by, and Melissa and I spent much of the day politely declining. There are stores lining the streets selling food, handmade carvings, clothing of all sorts, musical instruments, tours, backpacking equipment, etc. Wall-sized framed photographs of mountains that would be $50 or more in the US sell for like 10 bucks. But how are you gonna get it home?

We decided to be brave and follow a walking route recommended by our extremely useful Lonely Planet guide book. This path took us south from the Thamel area of Kathmandu to Durbar Square, a site of many ancient shrines. This walk was dotted along the way with minor shrines and temples, and it was remarkable how ancient holy artifacts that would be treasures in a western museum were around every corner. Most are in use today, meaning that everyday Nepalis stop to make offerings and pray as they go about their daily routine. That does not mean, though, that they are well-preserved or in any way separate from actual life. Steps of holy shrines had people sleeping on them or selling fruit, some were surrounded by garbage, some were falling apart.

The first main one we saw was Kathesimbhu Stupa, a holy place for Tibetan Buddhists. This beautiful structure in a courtyard was surrounded by many smaller shrines to various deities, and people were lighting candles and offering prayers at many of them. Here you can see the Buddhist prayer flags that make it quite picturesque. Some people climbed onto the stupa to walk around its main section, but Melissa and I admired from a distance, feeling too ignorant of religious custom. We’ve read a lot about Nepal and its religious heritage, but there are so many shrines and so many deities, and actually being here is intimidating. It reminds me of a place like Paris, where there’s a beautiful medieval church around every corner, only here, I am so unfamiliar with culture and history that it’s even more difficult to appreciate them. So we mostly just observe, looking at the architecture, the symbols, the images of deities, and the people at each one conducting their worship, sales, or begging.

Other notable religious things we found on our trip include a statue of Buddha dating to the fifth century. That is astounding to me. On Antiques Road Show it would be the most valuable thing ever, probably worth millions, and here, it was ignored on the street, stuck inconspicuously into the stairs underneath an eye clinic. Unbelievable. Another notable religious relic was the ancient shrine to the deity of toothaches. People hammer coins into it to prevent pain. Here you can see it over Melissa’s shoulder. It was on a street with many dentists.

The last stop was at the bookstore. Having read in Lonely Planet that Thamel had a Barnes and Noble, we were somewhat annoyed that American culture permeates even the most remote places, but also relieved, considering it indicative that we would be safe and welcome. We found the Barnes and Noble bookstore, we think, but it seems to have been sold to Waldenbooks instead. We perused the mostly English selections (which included a heavy dose of books about Everest), bought some postcards and a Nepali flag, and were on our way.

It is midafternoon. We have returned to the hotel, having ordered both breakfast and lunch from small Nepali street establishments. Tonight we eat dinner with the other Americans, and tomorrow morning is the Everest flight. I can't control the placement of pictures on this site, but up at the top you see the 5th century Buddha, the stupa with prayer flags, and a hindu temple where cows, apparently unattended, are just wandering around among the pigeons.

Welcome to Nepal

2009-07-24T06:08:00.001-07:00

We’ve been in Nepal for about 3 hours now. But allow me to pick up where I left off--on the plane.

It was a half full flight. Mostly Nepalese, though a few westerners and Indians. We sat next to a Nepali man who worked for the UN and journeyed back and forth to India regularly. Again we didn’t have a window seat, but I didn’t think there was much to see in Delhi as we took off. It was hazy and cloudy.

The flight was short--an hour and a half or so. I saw some of India way below me. As I watched the physical map on the flight tracker and we neared Nepal I began to look for mountains but saw nothing but flat ground. We were at 30,000 feet, about the height of Everest. I imagined mountains this high up. Impossible. I felt like we were so much higher than any land could possibly be. Then I looked across the aisle, out the far window, to the left (north) side of the plane. There the Himalayas rose like a wall out of the clouds. In the distance were mountains that were at eye level. I could never have imagined anything like it. On my right, flat plains miles below me. On my left, a massive wall of blue and white, snowy peaks rising from a bed of clouds as if in a painting. I snapped only a couple photos before we descended into the clouds. Since it’s rainy season, those may be the best views of the mountains we get the whole time we’re here.

One of the people nearby saw me gawking (as many people on the plane were) and asked if it was our first time in Nepal. Like it wasn’t obvious. We got in a conversation with him as we watched the mountains, and it turns out he’s a Nepali who has climbed Everest twice. He looked like a kid! Maybe 25 years old at most, and scrawnier than me! He had lots to say about it. I asked if we could see Everest from the plane. He said sometimes, if the angle is correct, but not today. Everest would have been at about our 11:00, but from the plane’s tiny windows one can only see from about 8:00 to 10:00. We thought it was pretty remarkable that we were sitting next to someone who’d climbed it. Though one might think most Nepalis would have, the odds are actually quite slim when you realize that only a few thousand people have climbed Everest ever and Nepal has 20 million people.

From above, the city was a sprawling urban mess. I was glad to see it surrounded by high hills, but they were all shrouded in clouds as they likely will be for the next two months. The airport was a bit scary for us, being so out of our element, but it went off pretty smoothly. A single large room for health check, money changing, and immigration. That took about an hour. Our bag was waiting at the baggage claim, and customs inspection consisted of a guy looking at us and waving us through. We exited into a crowd of porters, drivers, and family members crowding around the exit of the airport, and Melissa and I must have looked completely at a loss. How does one handle this kind of situation, where you have no idea what anyone’s saying to you and you think anyone might try to take advantage of you? How do you call a taxi? How do you find where to go? The first guy that spoke to us said “Where are you going?” and my instinct was to ignore him as I had been told to do. But being at a loss as I was, I figured, why not, maybe he can help. I said “Hotel Courtyard” and he said “oh yes, follow me.” Melissa and I looked at each other and shrugged our shoulders. He led us through the crowd and said “they have a car waiting for you.” Someone popped out of the crowd with a sign that said “Melissha Gunter” and we suddenly felt very relieved. For as scary as it was, it was remarkably easy and we had no troubles at all! “Trust the system” I say, even if there seems to be none at all.

Our ride to the hotel was unlike anything we’d experienced before. But we’ll save those thoughts for the next entry. (I have no more photos to add yet.) At the moment, all is well and we are thrilled to be here. This will be the experience of a lifetime.

Serene Sydney, Speedy Singapore, Dicey Delhi

2009-07-23T06:06:00.001-07:00

Our final morning in Sydney had to be short because of a midday flight. We decided to just walk downtown and see what we could find. We began with breakfast at a sidewalk cafe. Feeling familiar now with the local cuisine, we ordered the usual: Bacon and Egg with Tomato Sauce (Ham and Egg with Ketchup). It was a normal eating experience, with one exception: we noted that a menu item for breakfast was two eggs with baked beans. I don’t even know what to say about that.

A short walk brought us to Observatory Park, which we decided to check out. It was small, empty, and awesome. It is a gentle hill with an observatory on top, with park benches that overlook the old part of the city near the harbor. A beautiful 180 degree waterfront view, including the remarkable bridge, was ours to enjoy alone in the crisp Sydney morning. To conclude our visit to the Southern Hemisphere, we had a vegemite sandwich and I hummed Men at Work’s “Down Under” until Melissa was annoyed, and then I just hummed it in my head. We enjoyed the sandwich while watching the conclusion of the same cricket game that started the day we arrived in Australia. What a weird sport. They take breaks for tea and lunch in the middle of the game.

Shortly thereafter, we were off to the airport for the second half of our journey to Nepal.

At the airport we were initially worried because, although we’d gotten visas for Nepal, we didn’t think we needed ones for India to change planes. The agent was worried, but as it turns out, they just put you in a holding room between planes, and no visa is required. Deportation averted. Whew!

Sydney to Singapore took us across the entire continent of Australia. We had no good views from the plane because we were, once again, in the center section of the plane. All was not lost, however, because Quantas airways is amazing. They had vast TV selections and they fed us all we could eat, including alcohol free of charge. Melissa and I went easy on the alcohol because although free drinks are nice in theory, who wants to be going to an airplane restroom every five minutes? Still, I appreciated the hospitality.

We got nervous again in Singapore because we had a very short layover. Like, we ran through the airport. The first sign we passed said “boarding,” the next we passed said “last call” and the third we passed said “gate closing.” This was in a span of about 1 minute, while running through the terminal. It was like something out of a movie. Luckily we made it, having spent less than ten minutes in the Singapore airport.

Allow me to interrupt myself here for a random observation. On the flight to and from Singapore, and in the Singapore airport, we saw almost nobody who looked Asian. Everyone was white! Not only that, all the signs were in English. Ok, that’s not a surprise, but what did surprise me was that they were only in English. I feel bad for any native Singaporeans who wish to speak their own language in their own country’s airport. Talk about English taking over the world...speaking of which, this reminds me of a song you might like. Download Richard Julian’s song “Syndicated.” It says what I’m trying to say.

Our journey to Delhi was on Jet Airways. I have mixed feelings. The flight was great, the service was great, the food was great. They served us food on real dishes with real utensils, and it was quite tasty. The Jet Airways experience went downhill once we were on the ground. It was 2 am Delhi time. We’d been up for about 20 hours. The representative wrote down our names and took us to the transit area, a holding room where there were a handful of sleepy people. One other person was with us for the Kathmandu transfer, a Nepali--the first one we met. His name was Chris. (Well, actually Krish, short for Krishna, but it sounded like Chris.) His English was poor but he helped us read our Nepali language phrase book, and seemed to enjoy that we were trying. As our flight time neared, nobody told us what to do. Occasionally another rep would walk past, ask us what flight we were waiting for, and then tell us to wait longer. Finally the guy came and asked for Kathmandu people. He had a list of names, but we were not on it. He told us to wait and then disappeared. He came back a few minutes later, still had not found our names, and told us to wait, and then disappeared. He did say our bag might be in a holding warehouse if it even made it to Delhi. At this point, you can imagine Melissa tapping her foot and verbally going through all the worst case scenarios while Chris simply nods and says, “have faith in the system. I trust the system.” Sure enough, I was vindicated and the man showed up a few minutes later with boarding passes and said that he knew where our luggage was. Thus we left the purgatory of the Delhi airport transit room. (By the way, that was the closest we got to a night’s sleep Thursday night.)

On to security. I’ve never seen more security screeners standing around doing nothing. There was a line of like 6 people, and 15 security screeners, and nobody even looked at us or told us what to do. When I finally did go through the metal detector, the guard took my Nepali language phrase book from my pocket and started thumbing through it, stopping occasionally to read intently. He was completely disinterested in hurrying us to the flight we were late for. When we made it to the gate, we quickly boarded the plane by walking on the tarmac. It was a hot and hazy day in Delhi. Then we got off the plane. They made the entire plane deboard and enter a bus which sat on the tarmac for a half hour. They told us nothing about why. When we got back on the plane, they said it was so that they could “spray” the plane for swine flu. Awesome.

Needless to say, we were glad to be in the air. I have few pictures from this journey since my camera was packed in my carryon and I was reluctant to snap photos in strange places where men with guns were telling us to go to holding rooms already. I thought I’d just leave the tourism for more picturesque locales. Read on to our next entry for the first impressions of Nepal.

Wildlife, Cliffs, Water

2009-07-22T06:03:00.000-07:00

Today we took a coach on a tour of, well, a lot. It started with a stop at the wildlife park. I was skeptical, but it ended up being pretty awesome. We walked in and the first part was a wallaby petting zoo. I didn’t know what a wallaby was, but they’re like mini-kangaroos. They let us pet them and they sometimes hopped around. There were kangaroos for petting in the next pen, and we watched them hop around too. I didn’t realize there are more kangaroos in Australia than people--apparently they thrive, though cars and encroaching civilization have strained their habitats. This park was interesting because many of the animals were able to walk around with each other. Hanging out with the kangaroos were emus and egrets and all sorts of other exotic animals I’d heard of but could never identify. An emu is a giant bird. Those things didn’t do much, but they were fascinating just because they are so big. When we would approach one it would sort of growl or burp and grudgingly allow us to stand near it. It looked mad, though, so I didn’t try to pet the emu. We did pet the koalas, which were extremely cute but rather inactive. We saw wombats, kookaburras, penguins, bats, cassowaries (also giant birds), crocodiles, quokkas (like hedgehogs), dingoes (dogs), echidnas (like porcupines), and a host of spiders, snakes, lizards, and songbirds. The only Australian animal we didn’t see was the tasmanian devil, which is nocturnal and shy.

Then we went to the Blue Mountains, which are in Australia’s great dividing range, the only mountains on the continent, rising as high as 7,000 feet (though we were only at about 3,300). We had clear and pleasant weather the whole time. The town of Katoomba is a high-class, quaint mountain town and popular attraction due to the beautiful cliffs and the rock formations known as the three sisters. We stopped at a number of lookouts to get lots of great views of “Australia’s Grand Canyon.” It was not much compared to the actual Grand Canyon, but it was nothing to sneeze at. Great sandstone cliffs that had once been under the ocean have been weathered to quite a breathtaking panorama. There was a tourist area known as “Scenic World” which we thought was a cheesy name but otherwise very nice. It had two cablecars, one of which we took across a deep chasm. Then we took the steepest railroad in the world, which dropped us at a scary 53 degrees 450 feet down. Our tour guide commented that one tourist asked him if that 53 degrees was celsius or fahrenheit. He said, “Guess which country he was from...hint, it wasn’t Canada.” After the train, a walk through the temperate rain forest and another cablecar ride up, we were on our way.

We stopped at a cute candy store, another lookout for tea, the olympic park, and then we had a riverboat ride back to downtown Sydney. We briefly saw the Opera House from the water at nighttime. It was raining a bit, but still an amazing sight. Then we walked back to the hotel, got rained on a bit, ate some dinner and came back to the hotel. Tired!

Lastly, I’ll comment on some quirky culinary observations. Ketchup is indeed called tomato sauce. Bacon apparently means ham. Our restaurant last night served us but required us to order at the bar. Our restaurant tonight took our order but required us to go to the kitchen to pick up our food. I haven’t quite gotten Australia’s restaurant system figured out yet, and consequently, I have no idea what to tip for these partial serving experiences. And finally, we ate kangaroo stir fry for lunch. As our tour guide so aptly put it, we got to pet skippy in the morning and eat him in the afternoon. A weird experience, but I must admit skippy was tasty.

Sydney - A Day at Darling Harbor

2009-07-21T05:58:00.000-07:00

Our hotel is conveniently located about a block from the waterfront of Darling Harbor, a tiny piece of the larger Sydney Harbor. It’s a pretty touristy area, but picturesque, not too crowded, and full of interesting things. We meandered along the boardwalk, through gardens, by fountains, and eventually decided to check out some of the museums that surround Darling Harbor.

The first we went into was the powerhouse museum, which is dedicated to the history of technological innovations. It’s focused on the 1800s, so much of it involves steam engines. It’s kid-focused, with lots of hand-on exhibits, but not nearly as interesting as other science museums I’ve been to. It had an odd mix of “technology” exhibits, including ones about furniture, pottery, mail-order shopping in colonial Australia, and fashion. Pretty eclectic.

From there we moved to the National Maritime Museum. The main exhibit in the entrance of Australia’s national museum was about the maritime culture of the United States. Apparently this exhibit was a gift from the US to commemorate Australia’s bicentennial. We must have thought the Aussies didn’t know much about that strange foreign country, the US. There was also an interesting exhibit about the travels of Darwin. I didn’t realize his travels on the Beagle took him to Australia. Other highlights of the maritime museum included a beer can boat (apparently there’s a regular competition in Australia for designing and sailing boats made entirely of beer cans) and a gallery devoted to the history of women’s swimsuits. The section about topless swimsuits had the boys in the museum quite rowdy.

Lunch was odd. We ate at a food court in a mall. Since there are no quintessentially Australian dishes we had to try, we had calzones. The server asked us what kind of sauce we’d like: sweet chile, bbq, or tomato. Interesting question. Tomato, of course. She handed us two cups of ketchup. Now several things could be going on here. Maybe she mistook the ketchup for tomato sauce. Or maybe ketchup is called tomato sauce in Australia and she thought we were nuts for asking for it with our calzones. Or maybe ketchup is called tomato sauce and the Australians are nuts for eating calzones with ketchup. I’m really not sure.

Feeling jetlagged, we returned to the hotel for a brief midafternoon nap and then hit the aquarium. The best part was the sharks of course, though we also liked the crocodiles, seahorses, stone fish, and eels. They had several large tanks with tunnels that ran through and underneath, so the views were really cool. The aquarium was a bit pricey, but a cool experience.

Our evening concluded with a nice dinner at a dockside restaurant. The waiter pronounced filet like “fill it,” but otherwise it was a nice meal. We’re going to sleep early because we have a long day tomorrow with our tour of the mountains and the harbor.

Morning in Sydney

2009-07-21T05:56:00.000-07:00

In Bryson’s book he comments on the efficiency and ease of the Sydney airport, so I made note of a few checkpoints myself. 6:35 am, plane touches down. 6:40 am, walking through the gate. 6:47 am, through customs. 7:04 am, baggage collected, in the lobby. 7:08 am, money changed, in the taxi queue. Pretty quick, I’d say.

The morning was chillier than expected: 9 degrees Celsius, but since I have no idea what that means, I estimate it in the low 50s. It is winter, after all. But the sky is clear and beautiful, and the temperature is expected to rise to 19 or 20, which, again, is no help. I’ll take a jacket to be safe.

The taxi driver drove on the left, and despite being in the biggest city, downtown, at rush hour, on a weekday, there was only light traffic. Our initial impression of the city is that it is clean and pretty but somewhat unremarkable. I could have been in Ottawa. The most striking features of the Sydney skyline are the opera house and the harbor bridge, which we haven’t seen yet (though our hotel is quite near both). I will say that despite Sydney’s pleasant unremarkableness, Melissa did have one of the happiest grins on her face I’ve ever seen. It feels damn good to be here. It’s Melissa’s first time outside North America, and we have a feeling Australia will be a great start to her intercontinental escapades.

The hotel allowed us to check in early, so we’re relaxing and showering before setting out to see what we can find. Our hotel room is not overly-large, but comfortable and chic. We initially were perplexed that the lights didn’t work, and then we figured out the card slot which enables the lights and saves electricity when we leave the room: a reminder of how Americans are somewhat less cognizant of wastefulness than Europeans and their southern hemisphere brethren.

Right before we left for the day we checked out some Australian television. I was pleased that the first two channels were rugby and cricket. Australia lived up to expectations. The next two channels, however, were The Simpsons and Family Guy. Australians must have a great impression of American families.

Off we go...

Where did the time go?

2009-07-20T05:55:00.000-07:00

Monday did not exist for us. We lost it somewhere over the Pacific when we crossed the international date line.

The Flight

2009-07-19T05:45:00.000-07:00

Well, we departed from Rochester on Sunday for the long trip to Australia. It all started in the lovely Rochester airport. We arrived quite early. Early enough, in fact, to sample some of the local cuisine. We enjoyed a chicken sub from Subway, and I have to say the Rochester airport had perhaps the two nicest Subway employees I’ve encountered. The young man who made our sub asked where we were traveling, and when we said Australia, he commented that we should look at the stars. He’d seen on the Discovery Channel that it’s one of the best places on Earth to stargaze. (Though probably not in Sydney, where we will be. I suspect that tip is valid in the other 99% of the country which is nearly empty. Nonetheless, I appreciated his advice.) After we munched on our sub, I broke a shoelace--not an auspicious beginning for a trip on which we plan to walk everywhere.

After a flight to and brief stay in a Dulles airport that lived up to its name, we were off to San Francisco. Melissa watched Monsters vs. Aliens and I read most of Bill Bryson’s In a Sunburned Country, about his wanderings in Australia. Good book. We were in the middle section of the plane, so I didn’t get any good views, but I heard some people speaking German, so that was exciting. (Yes, if that’s all it takes to excite me, I’m pretty easily excited, and our international travels might just be complete sensory overload.)

At the San Francisco airport we had little time, but I purchased replacement shoelaces. Crisis averted. We then followed the signs to the international terminal. I felt like we were walking to some back corner of the airport, and at any time we might stumble into an alleyway. The hallway was deserted. But then we rounded a corner and I felt like a VIP. We were in the Cadillac of terminals. Ritzy shops, pristine clean floors, beautiful artwork and gentle fountains guided us to a comfortably large and quiet gate. I imagine this is what airports are like in Scandinavia. Again, I’m easily impressed. We also had nice views of a sunset over the mountains by San Francisco, but my camera was packed up so I missed it.

The experience at the San Francisco airport quickly deteriorated. As the gate filled up, I realized we were on a flight with more children than I would think belong in Australia. There was at least one infant or toddler screaming for an hour straight, and sometimes many at once in some interesting harmonies. Melissa said it’s because they’re tired. I thought if I were tired I’d go to sleep rather than scream my head off. Then I realized maybe they were screaming because their parents insisted on continually jostling them up and down. Admittedly, though, I have a lot to learn. I’m sure everyone at the gate was predicting a miserable 14-hour flight to Sydney.

Actually, it wasn’t too bad. Nearly everyone fell asleep immediately, and with a few brief exceptions, there were no children screaming for the duration of the flight. I did have trouble sleeping, even though it was very late by Rochester standards. I’m trying to avoid the tempting cliches about sardines--suffice to say it was cramped for 14 hours. Also, we were two rows behind the TV screen, which was nice when we wanted to watch TV, but trying to sleep sitting up while ten feet from a giant flickering screen is not easy.

The screen did allow for occasional updates on our position, and I made some notes for any friends who might be aviation enthusiasts. From San Francisco to Sydney we traveled over 7,000 miles at an average speed of 500 mph. Our elevation ranged from 33,000 ft. to 35,000, about a mile higher than Mt. Everest. Up there, the ambient temperature hovered around -45 and we encountered winds typically between 30 and 50 mph. We passed very close to Hawaii and New Caledonia, and were within a stone’s throw of Fiji. We entered Sydney at sunrise, and though we were in the center of the plane again, we could glimpse some spectacular red colors in the sky as we touched down. The only other moment of note was when the captain spoke to the plane as we were descending. He gave us several warnings about moderate turbulence to come. Shortly thereafter, he said, “In the event of an emergency landing, leave all your carry-on luggage behind.” That was an odd and poorly timed comment from the captain. It was followed by probably the smoothest descent and touchdown we’ve ever experienced.

Preparations

2009-07-17T05:33:00.000-07:00

The preparation has been pretty easy so far. We’ve made plane reservations, gotten travel visas, made hotel reservations, and so forth. Now we’re leaving in a few days, and we’re dealing with details like clothing, prescriptions, books for the journey, purchasing a new camera, arranging for cat-sitting, and planning the sights we want to see. Many of the arrangements involve sitting at the computer, to look at websites.

We’re looking forward to our second day in Sydney, when we’ll take a touristy trip that will go to the Blue Mountains, some small Australian towns, Australia’s “grand canyon,” the steepest railroad in the world, a wildlife preserve, and a boat ride on Sydney Harbor...all in one day!

When in Kathmandu, Melissa will be working with a doctor for two weeks, during which time I’ll probably hang around Kathmandu, checking out the sights and writing this blog. We’ll have a couple days after Melissa’s done working during which we might be able to take a trip out to the countryside for a day or two to do some hiking. For the trip, Melissa got a new haircut, and Chris got a new camera.