medical trek continued..

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Nov 12th:
We hiked a full morning mid-way up the hill on the south side of the valley on our way to the village of Lapa. As I began reading "The Snow Leopard" by Peter Matthiessen his description of the first days of their trek north of Pokhara fit our walk perfectly (minus the rain, our weather was beautiful). The farmers we walked by were tilling with primitive tools and their buffalo, women were thrashing the millet on straw mats, children were playing and happy, shouting "Namaste!" as we passed. This day I was in the middle of the pack, and able to walk by myself for a long time along the terraces of millet and rice, which was really nice. This was definitely the idyllic scene of farming in the foothills of the Himalayas. Mills to grind their grains were set up in small shacks alongside the streams making their way down the hill to the river below and long granite slabs were the footbridges to cross them. These trails have long been used by porters carrying trading goods from village to village across the country. They put extremely heavy loads on their back, held and balanced by a strap running from their load up and across their foreheads. Its unbelievable the loads these men and women carry as we pass them carrying our light daypacks.
We entered into Lapa village with a welcome by the "Youth club" who again placed garlands of flowers around our necks. As we arrived at the school which was to be our clinic site, Jackie said it perfectly "the martians have landed". While we sat and waited for the rest of the group to come and things to be set up crowds of people sat around the peripherary of the field and stared, watching us. The children were especially curious, crowding around us giggling and laughing, and shooed away by an old man when he determined that they were getting too close. A soccer ball and frisbee appeared and David and Gery had a blast playing with the kids until they got too close to the kitchen and Ram confiscated the toys.
After lunch we had clinic for a half day in the afternoon. Here there was more of a mix of the ethnicities of Gurung and Tamangs (Gurung and Tamang are their last names so we knew which tribe they were from). A quick description of the women of the villages: they all wear traditional dress, beautiful fabrics wrapped around them and large chunky jewelry. All have their noses pierced, some with large gold pieces hanging from the left side, some with septum piercings with long fish-looking charms hanging down, and some with both! All also had large earrings and necklaces as well as bangles on their wrists. The women appeared much younger than their stated age until about age 30, then they started to appear much older than their stated age. Most don't know exactly how old they are, but the toll of the hard way of life definitely starts manifesting itself after age 30 or so. The average life expectancy is around 50 I think, but getting longer.
The biggest "health" difference that I saw between Tipling and Lapa was the incidence of hypertension. There were many more hypertensives (a lot of high diastolics also) in Lapa, and we had a dilemma about what to do with them. The older ones with mild-moderate hypertension we would not treat, but the younger ones who will have preventable long-term consequences we would like to treat. Without knowing that they will be able to have access to, or even take daily medicines, there wasn't much we could do however. Hopefully one day the healthpost will be fully staffed and stocked and long term preventative care can be implemented instead of the "bandaids" we were putting on them.

Nov 13th:
Each morning of the clinics in Tipling and Lapa there was a health talk given to the health workers, volunteers, and anyone in the village who was interested, by one of the physicians. In Tipling George spoke about glaucoma and other opthalmologic problems, and Dawn spoke about gynecoologic issues. In Lapa, Dawn and Bud addressed issues for mothers taking care of their infants. This morning Gery, Jackie an I skipped the talk to hike in the hills above the village. We were escorted by Prem, the schoolteacher, who took us to his sister's house (she and her mother hand-spin yarn and knit items for the SPIRAL foundation to sell), and above to a gompa (buddhist temple). We climbed up and down the terraces taking in the sunshine until it was time for clinic to start. I saw two women with bad cases of what seemed to be rheumatoid arthritis, one younger and one older. Another new complaint was described as what seemed to be tapeworms or hookworms, another common problem here.
This community seemed more vibrant to me than Tipling, the villagers sat around the school in groups, hanging out and laughing and talking together, watching our doings. The children found delight in the smallest things, one group played a tug-of-war game with a towel for a long time, some made a ball out of pieces of string and plastic tied together, and a few boys searched endlessly for the perfect piece of grass to use as whistles. In between patients when I had a minute or two I would stand in the narrow doorway of the tiny dark schoolroom with one window (no glass panes), dirt floor, and a piece of painted plywood as a chalkboard, and look out at the sunny field of people. One old woman stood outside below my room and exclaimed in Nepali that she could actually see me up in the room! She had just received a pair of comical very oversized glasses from George, that she was so proud of. The next day she came back with a long piece of red yarn wrapped around the frames at various points to tie them to her head since they were too big. She strutted around the schoolyard showing them off proudly.
The village again had a cultural show for us around the campfire in the school courtyard. After it was over, everyone scattered, then the party again started up with our staff, volunteers and porters playing the maadel and the girls and boys taking turns singing. They have a handful of folk songs that they all sing, and take turns improvising the verses. We couldn't tell what they were singing about, but every now and again everyone would laugh at what one person sang and the laughter was contagious. After a while I looked around and was surprised to see that the entire courtyard again was full of locals, who wandered back to join the party. We sang and danced until late into the night.

Nov. 14th: We had a morning clinic again and then after lunch packed up our things and left the village. I was sad to leave Lapa, I could have stayed there for a long time. Since its at the end of the valley its protected and is not along a major trade route so it was very pristine culturally. It's easy to romanticize life in the village and not analyze high infant mortality rate and the extremely hard way of life that they have. But with the smiles on their faces and laughter of the children you would never know.

Nov 15th: We continued on our hike "out" today. Along the we again noticed landslides down the valley from the monsoon season. Each spring when the monsoons come the villages wonder whether the land above them will slide down and wipe out sections of houses. It's complete chance. A girl who was orphaned when a landslide killed her family this spring was taken down to Kathmandu by HHC and they will put her through boarding school. They do this often, sponsor orphaned children through school. A handful of them are on the HHC staff or volunteers with us on the trip. We spent the night on the rice terraces just outside a small settlement where we again had a party at the local teahouse that went late into the night. I miss the nights of singing and dancing, this was our last night on the trek.

Nov 16th: After the last morning of trekking, we came to a village where the road comes to. After packing into two landrovers again, we made our way through the valley, again a long, bumpy, and precarious ride. We had several instances of meeting a bus or truck on a very narrow road on the edge of the mountain. One of the vehicles either had to back up to a wider spot or squeeze close together to make it past one another. I preferred being in the vehicle on the "inside" of the road, there was one small incidence of almost plummeting down the mountainside but luckily we made it through. I think there was about 2mm of space between us and the passing bus at one narrow point. Mid-day we stopped in a town to wait for the other vehicle to catch up and I realized my dream or riding on the rooftop of the vehicle for the rest of the beautiful trip up and down the mountains. Gery and I sat up above with some of the luggage and bumped along slowly. The day was gorgeous and the panoramic views were undescribable while the kids and people walking alongside the road waved and smiled at us as we rode by. We finally descended down to Dhadingbesi, a bigger town on a major road, had lunch, then transferred into a larger bus that took us back to Kathmandu. The memories of the villages become more and more precious as we entered the smog, crowds of people and honking vehicles of the city.

Nov 17th: Back in Kathmandu, a small group of us did some more sight-seeing and shopping. Most of the group was slated to leave the next day back to the US. Anil had us all over to his house where we shared photos and had a wonderful dinner. He has a beautiful wife and three great kids. He and his family are really amazing, he has sacrificed so much and put everything he has into HHC. The main thing I took away from this trip is that people like Anil need money. He is serving these communities of Nepal in a smart, practical way, and has a rare comprehensive view of what needs to be done, while working hard on all the small details himself. He can do what needs to be done because he's not an outsider, he's one of the Nepali people he is trying to help so he can actually achieve goals while being respected and helping the people to help themselves. Here's my little plug for HHC, if you want to help a really good, small, grassroots organization, help them. I really believe strongly in Anil and his work. Us being here for a few days was a good morale booster and excitement for the villages but what they really need is education, steady incomes, and sustaining healthcare. He is working on several projects to help make these things happen.

I had such a great time on the trek, saw many amazing vistas, met a lot of really awesome people, and I would highly recommend it to anyone who is interested. I feel very fortunate that I was able to get to know all of the fellow providers from the US, Switzerland and Nepal, and I look forward to keeping in touch with everyone.

END OF MEDICAL TREK!

Now that everyone was leaving, I had to figure out what exactly to do next, I planned on going to the hospital in Ilam at some point, but wanted to work on my Nepali, and do some additional "fun" traveling in between. Gery, the internist from Boston, was also staying for a while and suggested a mountain biking trip outside of the Kathmandu Valley. Always one for adventure and not willing to admit something may be outside my ability, I said yes, little did I know what I was in for....
We decided to go to Daman, a ride along the Tribhuwan Rajpath, a little used road that the guidebook describes as "gruelling" and a "holy pilgrimage for mountain bikers" taking "between 6 and 9 hours in the saddle, almost all of it climbing" hmmmm..... From Naubise (945 meters), a small town 26km outside Kathmandu it "climbs relentlessly for 30km to Tistung (2030 meters), 7km down to Palung (1745m), then back up 9km to Daman, at an elevation of 2322 meters".
The plan was to rent bikes, take a taxi out of Kathmandu to Naubise, knocking out the first 26km of smog and traffic. Then we would "only" have 46km to ride up to Daman.
The view from Daman however was the goal, and promised to be spectacular. It was described as the quietest and most comprehensive view of the Himalayan viewpoints surrounding Kathmandu, and you can see seven 8,000 meter peaks from there, including Mt. Everest, and several 7,000m peaks.

We rented out bikes and got in our taxi on the morning of the 19th, planning to be out of the city and down to Naubise by late morning and begin our climb. However, as the drive commenced and we kept turning around at various points and trying different roads out of town, our driver explained that there was at strike going on. Two students had been killed by a Maoist organization (the politics here are extremely complex and I'm still trying to get a grasp on them) so university students were striking and had set up roadblocks and fires in the roads. There aren't many main roads out of the city so we couldn't get out. Our driver was persistent though, and after one final attempt at off-roading up to the "Ring Road" which we needed to get on, we hit a huge rut, the car stalled, and something that looked important fell off from under the car into the dirt while oil started spilling everywhere. We had no choice but to bike from here.
We navigated through stalled traffic throughout the city, stopping every once in a while to ask the way to Naubisa. We reached the edge of the city at the top of the valley without getting stopped and started the descent, a long winding road with buses and trucks zooming past down from Kathmandu to Naubise 26km away. It was a bit of a dangerous but very fun descent, and we made it down safely. From here we had a snack and began the ascent to Daman. I can only say that it was indeed a long and gruelling day of climbing in the saddle. We passed several schools and at one point the crowd of children were running alongside me faster than I was pedaling. One little kid I think was actually trying to push me, so sad. I could barely muster a "Namaste" I was so out of breath when passing by people and schoolkids walking along the road. For as difficult as it was though, the views were pretty amazing. As we climbed higher and higher more of the mountains came into view, and the few stops at roadside stands for juiceboxes, water, and biscuits were heavenly. At the end of the 30km we reached Tistung, where we finally got to descend 7km to Palung. The descent was a welcome break, and by the time we got to Palung it was dark. We decided to try to hop on a truck, bus, or taxi the rest of the way up to Daman since my legs were jelly and we were riding by headlamp but after a few tries and no luck, we pushed on ahead. The next 9km going straight up the mountain are kind of a blur. I would focus on the small patch of road in front of me illuminated by my headlamp and sing songs in my head to keep me going. Every once in a while I would look up to see Gery's headlamp ahead, which would disappear around the bend of the switchbacks up ahead. I would hear rustling in the forest next to me, and get a surge of adrenaline pushing me on as I imagined a leopard stalking me....
Every once in a while we would stop alongside the road for a short break and trail mix, switch off our headlamps and see the clear sky and bright stars above us. For as much agony as I was in, I was still able to appreciate where we were in the world and what we were doing.
Somehow, we made it up to Daman around 8:30 that night, after pedaling since noon and at least 3 or so hours in the dark. We found a lodge to stay at, delirious with hunger and fatigue we downed some dinner and headed to bed, with our alarm set to see the sunrise over the promised spectacular mountain views.
We weren't disappointed. We roused ourselved just past 6am and stumbled outside to the terrace to see the sun rise slowly over the vast panoramic range of the Himalayas spread out to the west, north, and east. We could see Daulagiri, the Annapurnas, Himal Chuli, Ganesh Himals, Langtang, and to the east Everest, plus more than I don't know the names of. It was breathtaking and definitely worth the pain of the day before.
We met some Brits at who were also staying there who were flabbergasted when they asked how we got there. They assumed motorbike at first, when we explained that we mountain biked they were pretty speechless. I have to admit it was nice to have the reaction.
We headed back down around noon, and going down I almost couldn't believe that we had ascended what we did. In the light I could see how steep it was, and was glad that I couldn't see it the night before. I think my mind would have won out over matter had I been able to see where we had to go. We sped down the steep switchbacks to Palung, then climbed the 7km up to Tistung. From Tistung we had 30km of complete downhill. This time I raced past the schoolchildren and could shout "Namaste!" with no problem. We descended for a full hour and a half, going fast down the steep road. As we reached Naubise we thought the biking part was over, as we hoisted our bikes and ourselves onto the top of a passing bus going to Kathmandu (we were getting to really like the whole riding on top of the vehicle thing).
But as things seem to go in Nepal, the strike was still going on and the road was still blocked going into Kathmandu. Again we had to get on our bikes and ride through the miles of stalled traffic into the city. It began to get dark as we reached the city proper, and the city was in a blackout so we again had to navigate by headlamp. It was complete darkness by the time we reached the area where the fires were burning in the road and people were milling about in the streets. We switched off our headlamps and took our helmets off to blend in a little bit, not knowing exactly where we were going or what we were headed into. As we penetrated further into the city, shops were closed up early and there was an air of tension around us. We could hear shouting in unison in the distance as we kept going forward. As we came to the top of one small hill and looked down we could see a mob of people dimly illuminated by a couple of car headlights, they were shouting and throwing rocks at the cars in the road while they desperately tried to u-turn and get out of there. There was nowhere to go but forward and as we approached the crowd Gery saw a small side-street that we ducked down. We periodically asked people sitting in the alleys in candlelight how to get to Thamel, the tourist area where we were staying. Riding through the pitchblack night, intermittently illuminated by candlelight, we finally began reaching our destination. There were more lights on and people going about daily business selling their vegetables and wares on the bridges and sides of the roads as we approached Thamel. The tourist village of Thamel was an insulated island amidst the chaos elsewhere in the city. The music blared, people partied, shops were open, and everything was "normal" as finally made it to our guesthouse. We sort of looked at eachother and couldn't quite believe the events of the past two days while we found a place for dinner.

Gery's friend Anju was slated to arrive in a couple of days and I decided to join them for another short trekking trip in the Annapurna Conservation Area, north of Pokhara. I took a bus over to Pokhara, and they joined me the next morning. We hiked for five days, from Naya Pul, up to Tikhedunga, then up to Ghorepani. From Ghorepani we got up at 4:45 to hike for an hour up to Poon Hill, one of the best views of the Annapurna's , Machhapuchhre, and Dhaulagiri. It was a freezing cold morning, and the clouds began to move in and obscure the stars as we hiked up, but luckily they broke again as the sun came up and we were able to appreciate the sunrise over the mountains again, this time more spectacularly close-up than Daman. Afterward we descended to Ghorepani again, then hiked over to Ghandruk. From here we went to Dhampus, then ended the next day back to Pokhara again. We did a standard "teahouse trek" where instead of camping we stayed in small guesthouses along the way. This was trek was easier now that I'd had a full two weeks of hiking and two days of mountain biking up at altitude. We had a great guide and porter, Dorgee and Lama, who were very good and entertaining, and had an awesome time in Annapurna. It's the most hiked area in Nepal so we met many other trekkers along the way, many doing the whole Annapurna circuit and up to base camp (ABC). Gery and Anju had to leave so time was limited but I now have visions of doing the two week circuit in the spring when the rhododendrons are in bloom.

That catches up to now, whew! This has been a blogging marathon. Right now I'm in Pokhara, Gery and Anju have left and I'm now beginning the next segment of the journey, the traveling on my own! I have decided to go up to Sarangkot nearby for a yoga/meditation retreat before heading over to Ilam to stay at the hospital.

Thanks for reading, will write again soon!

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Comments

[Christina]

WOW
I just had the most wonderful time reading your amazing tales, and you still have months to go! I am thinking of you often and pray for your continued safety and happiness. Thanks so much for these detailed accounts of your travels. I'm on the edge of my seat for more. LOVE YOU!

[Tom]

Your work and travels are inspiring. Enjoying the read!