Feeling good and started work the following morning. Lots of pediatric patients in the morning and then more adults in the afternoon. We had a large group congregated outside and had the police directing crowd control. We then had volunteers directing one patient at a time into our triage booths. I would ask them why they came in, do a focused assessment, and then decide whether they needed to see one of our doctors or whether I was comfortable with dispositioning them myself which we were encouraged to do when appropriate. I would either give them a specific doctors room to see or send them to the dispensary with the escort of one of the volunteers. It was an efficient system and we wound up seeing over 1000 patients by the end of the 4th day. We had several “basket cases” come in which is when patients are literally in woven baskets that their family members carried them in to get to us. Since we lost one day due to the snowstorm, we worked late on the 2nd day. We were all pretty exhausted by the end but felt like we made a difference in the lives here. We sent some people down to Kathmandu for more extensive diagnostics and treatment. We helped train a group of local health workers thus helping in the sustainability of medical care in this region. Another bonfire this evening with drumming and dancing capped off the medical camp.
The following day was our last day of trekking to the desination of a riverside camp with a swimming hole, which everyone was excited about after being in the heat and insect infested villages and dusty trails. It was very refreshing to jump in the cold Himalayan runoff and we had one more big meal under the dining tent. Anil shared some nice final thoughts on the trek and the state of Nepal and the many challenges it faces. There are a lot of problems but also a lot of beauty and he has a sagelike perspective for working for basic human rights for the past 18 years. The next morning was a travel day back to Kathmandu, with a hot, curvy offroading trip in the morning up to the main road and then maneuvered our way back into the congestion of Kathmandu. Last night we had a farewell dinner at Anil and Soni’s house with the whole group and then people slowly started dispersing their own ways. It has been a powerful experience with this group and was sad to see everyone go their own way. Did a little sightseeing in the city today including the famous “monkey temple” where I actually saw a monkey eating a popsicle and another cotton candy. There were many beautiful Buddhist shrines such as the large stupa with the watching eyes. Sarah, Katrina, Ben, and I will be embarking on our next chapter of the trip tomorrow as we set off towards Everest Base Camp. Will try to update from up there if there is access or else when I get back in 2 weeks. Have a 4:30 am wakeup call tomorrow, so better get some sleep.
Woke up with renewed energy and appetite, feeling fine for the next day of trekking which would bring us to our second village of medical camp. Had a brief goodbye ceremony and then started our trek mostly downhill. Crossed a river several times and one of the largest landslides in the country, one that first started sliding about 30 years ago. Was a hot day but we passed the time listening to the iPod, singing songs, and seeing lots of cows, goats, chickens, and various other animals. We are greeted by villagers along the way with friendly “namastes” with hands in prayer position. These villages do not get many foreign visitors. The people are mostly farmers and some do blacksmith work or various other labors. The are weathered, hardworking inviduals and are truly remarkable for sustaining themselves in this harsh alpine climate.
The following day I caught the inevitable stomach bug and energy was pretty weak in the morning. Anil (our great director) suggested I take the day off and since our tents were extremely hot during the day, he arranged for me to sleep at a friends house down the trail. Started up on antibiotics and I slept on a cot on a shaded porch and sipped electrolyte replenished water. The house belonged to an ex-military man of the Indian Army and he could not be more hospitable. I fell right asleep and did not wake until lunch when Anil and Soni came to check on me. Soni asked if the bees on the porch had been bothering me but until that moment I hadn’t noticed the huge swarm about 10 feet from where I had been sleeping. Luckily they never got to me and I awoke in much better health and was able to eat for the rest of the day. Returned to camp with renewed strength after another nap and was able to participate for a short time in the dancing and drumming during the evening which was a favorite of the villagers and volunteers alike.
We started clinic at about 9:30 am. I was assigned to triage which I stayed at throughout the rest of the camp days. We had 3 dentists, 2 adult internists, 2 pediatricians, 1 medical student who starts ER residency this summer, and 4 RN’s (2 ER, 1 ICU, 1 PICU). Got my room ready and only had a few basic supplies, BP cuff, thermometer, etc. Had a big bowl provided of antiseptic solution in water and a towel. Then one translator and one volunteer were assigned per room. They were great but there was definitely a lot lost in translation. We were pretty busy, there were a lot of diseases related to hygiene, such as GI and skin in particular. We saw many respiratory infections and COPD, many due to lack of ventilation in their fire and smoke filled homes. One of the projects HHC is working on is installing efficient clean burning stoves and they have found a very low cost method of providing that and we had a specialist with us to help install. Found it very interesting working with the population and people were generally appreciative of our care.
Woke up and began our trek going mostly downhill until lunch where we reached a river. The heat increased considerably as we descended and it was hot by the time we got to lunch. Apparently the word was out in the villages we passed that the health professionals were in town as we received a heroes welcome! We received multiple flower wreaths and were anointed with red tika dots on our foreheads. The main village we passed and stopped out was Tipling where HHC has done considerable work and has a permanent healthpost. There were also schools they have helped get started and built and various other community projects. We took a tour of the healthpost and got a sense of the services offered year round. We met some dedicated workers there and you could sense the pride of their good work. We continued on to Shertung which was the site of our first medical camp. We were able to take hot showers which were marvelous after several days on the trail. They had set up shower tents and then we received a large metal basin with steaming hot water and a container of cold water to equalize the temperature. We then had pitchers to pour over ourselves. I think everyone felt a lot better after this and we were ready to start work the next morning.
Day 2 found us in camp due to the snowstorm. It was actually quite sunny when we woke up but the large snowstorm would prevent us from crossing the ridgeline without help from our porter team. We took a short hike in the morning which turned into having a giant snowball fight and a lot of laughs. Took it easy the rest of the day, trying to stay warm by the fires, played some more games, read, and ate. There was a river going through the village and it is an area where they extract zinc and other metals. After lunch the weather began to turn again and everyone was nervous we would be stuck there indefinitely. In the high mountains, any small clouds on the horizon starting the day can be an ominous sign. However, the following day we awoke to perfectly clear skies and the trek was back on. This day was stunning with gorgeous views, steep climbs, and more variations of weather. After a morning climb, we hit the “ledge” which is an narrow ridgeline with steep dropoffs. The porters had broken trail and following their footsteps was not technically challenging as long as you kept your focus. We were on this section for about 2 hours and got great views of a couple high peaks such as Langtang. We saw four yaks at our lunch stop who were resting quietly until our group approached and then they got spooked. After lunch, we continued to the pass which was at approximately 14,000 feet and then we descended considerably to camp at 10,500. Felt good with the altitude as long as we kept slow and steady. Didn’t wind up taking any Diamox and happy not to as people reported some strange side effects especially extremity numbness and tingling. We read a book of Nepali folk stories around the campfire as well as Twister. I also played my ukulele which our group has gotten pretty good singing with.
Just got back from the medical trek. It was a great experience and am loving my time in Nepal. The trek was definitely off the beaten path and we did not see any other foreigners during the 2 weeks on the trail. It started with a 10 hour trip, leaving the dusty and crowded big city, weaved up and out into the foothills of the Himalayas over 10 hours. Got to know my group members well during the trip and we played various games along the way to pass the time. We made it to our camp at 9000 feet and were welcomed into the village by the Tibetan Buddhist community living there who proceded to perform traditional dancing and singing. Tents and a food tent were already set up when we arrived and we ate a big meal which became an everyday three times a day occurrence. It was great sleeping outside in the clean air after a week in hot dusty cities. We were up at 6 am to begin the first day of trekking. Temperatures were warm quick and continued that way until 11 am when we stopped for lunch. Dark clouds began rolling in and shortly after beginning again, a large hailstorm brought pelting snowballs. We continued on but stopped for cover when thunder and lightning was upon us. After that passed we continued on through a mix of snow and rain and climbed several thousand feet before descending towards camp. We were welcomed by fireplaces and hot tea and slowly began to warm up. We had been told probably not to expect snow but it continued to snow through the night forcing us to stay put the following day. Porters went up to clear the next days mountain pass aka “the ledge”. Felt alright with the altitude and waited for some clearer weather to see the mighty mountains around us.
The group is all here and we are quite a diverse bunch. We have people from all over the states (including a fellow Portlandite), a Canadian, 2 Aussies, and have a number of ethnicities represented as well. The final count is roughly 6 MD’s, 4 RN’s, 3 dentists, the local staff which will be approximately 15-20, and 72 porters. We had a fabulous evening last night. We were picked up in a van and brought to the Himalayan Healthcare (HHC) office for a welcome reception. The director Anil gave a moving speech about the vision of the NGO and answered our questions about the trek. I think a number of us were ready to get right to the trek but we have to wait until tomorrow. We were then off to a local restaurant where we sat on cushions by candlelight and were entertained by traditional village dancers followed by a gigantic feast.
Taking it easy today and preparing for whats to come in the next couple of weeks. We have heard different things about the weather, I think basically we need to prepare for everything, although it probably won’t be terribly cold. We are only responsible for carrying a daypack and will put everything else in a duffel bag which the porters will carry and we can get to at night. We each have a tent and sleeping mat for the evenings. We will primarily be in 2 villages but will stop over in a third. The villagers will take care of their morning duties each day and then see us if needed. Anil said there is a potential to save perhaps 10-15 lives and educate hundreds more. There is some possibility and likelihood that some patients will be needed to transfer to Kathmandu for further care as we will be without sophisticated diagnostic testing capabilities.
The temperatures in the city have remained high as well as the air pollution levels. Our hotel luckily is out of the main city and we have some fresh air to breathe. 4 of us have met with our guide for the Everest Base Camp trek which we plan to do after the medical trek. The trekking guides are very nice people and have a lot of experience. They assured us that everything is taken care of and should run smoothly. Looking forward to hitting the trail! Next post around April 9 or 10 when we have returned from the medical trek.
Day 2 in Kathmandu, starting to get my directional instincts of getting around. Sarah is here now, nice to have a traveling companion of an old friend. Going to hit up the shopping district today and get some last minute trekking items and finalize the Everest Base Camp trek. Hopefully will find a decent new backpack as mine is hanging together with pieces of duck tape. Went back to the temple square yesterday in the late afternoon/early evening and caught the end of the festival that I had seen earlier. The smells and sights are truly exotic here, it is truly a fascinating place. Still on the hazy side in the city but have seen the silhouettes of some big mountains right from our hotel balcony. Will be nice to get out of the heat and start hiking.
Made it to Kathmandu and am the first of the volunteers to arrive at the hotel. Got in late last night and thus didn’t have a view of the mountains coming in, I think they should ban night flights over the Himalayas! Have had a bit of a walk around this morning. I was immediately struck with the narrow, winding streets and the traffic zooming by with frequent and loud honks of their horns. I think this will be something I’ll get used to but it was a bit daunting at first. Also there is a serious lack of street signs, but managed with my trusty Lonely Planet map. In a short period, I saw a myriad of temples, stupas (with the famous watching eyes), and even a festival which featured ornately dressed women who were praying and celebrating the health of their husbands. Stopped for a fresh juice from a shop where the man manual cranked an antiquated juicer that produced a fresh refreshing pineapple juice. Then had lunch at a restaurant where the staff were all hearing and/or speech impaired. It was in the LP book and the food was delicious, fresh steamed momas (vegetable dumplings). Looking forward to more sightseeing, for now heading to the airport to pick up Sarah.
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