Happy Diwali at Monkey Temple

"The residents at the hospital said this would be romantic... do you feel romanced?" I asked Kendra, as we gazed out over all of Kathmandu while the sun quietly set over the city; buzzard hawks, floating lazily on thermals, seemed to equally enjoy the solitude of the moment and the comfort of so much empty space.

"No. Not at all," Kendra replied, and I laughed at her rejection, while we both kept gazing contentedly out into the void despite the raucous monkey fights all around us. We were at Swayambunath, the Monkey Temple, and had been loitering since mid-afternoon to watch the sun set over Kathmandu. We were waiting in anticipation of seeing the city alight for the festival of Diwali.

This shop is ready to get the party started 

Diwali is a major Hindu holiday also known as the Festival of Lights. It's celebrated in autumn, and we had the good luck to be here while the celebrations were happening. To quote the ever-eloquent Wikipedia, "The festival spiritually signifies the victory of light over darkness, knowledge over ignorance, good over evil, and hope over despair... On Diwali night, Hindus dress up in new clothes or their best outfit, light up diyas (lamps and candles) inside and outside their home, participate in family puja (prayers) typically to Lakshmi – the goddess of wealth and prosperity" Nepal is the only country to have Hinduism as its official religion (even though I believe India is basically de facto Hindi as well), and Diwali is an official holiday. In the days preceding Diwali night, Crows were first honored as "the messengers of Death" with treats. The next day, Dogs were honored as the guides to the afterlife. All of the stray dogs were dressed in wreaths and even adorned with Hindi red dots on their forehead. The poor condition of the stray dogs had been bothering me unsurprisingly, and seeing the dogs in their at-best lean condition trotting around wearing a wreath was comical if not actually sad. At the very least, they all seemed to be given a biscuit or bowl of rice, so they had a meal for the day. Then the most sacred animal, Cows, were honored, and finally it was time to attract the attention of lakshmi with lights, candles, and decorative sand mandalas. 

Seru, our landlord's dog, looking festive

Selling wreaths and decorative chains of flowers 

To attract the goddess of wealth to your home, you would light up the house with festive lights, adorn candles, and make a sand mandala at your doorstep with a path leading inside (or, for businesses, a very non-subtle path to your cash register). This made for a really wonderful aesthetic a out the city, as virtually every door had a mandala, candles were lit all about, and lights adorned most buildings. Having Wednesday off, the residents had advised me to head up to Swayambunath, a hilltop temple over-looking Kathmandu, to watch sunset fall over the city. It was an excellent suggestion, particularly since this temple is one of the main culture sights of Kathmandu and we were going to have to see it anyway. 

The challenge of getting around Kathmandu is that there was literally no city planning, making for a chaotic maze of streets, and the petrol crisis makes taxis untenable for Kendra and I. Even though the dollar is so strong that a rupees is equivalent to 1 cent, the fuel crisis had taxi prices inflated. Kendra could easily afford this, of course, but she made the unfortunate decision of marrying me and I can essentially afford nothing. In a stroke of luck, however, I was here with Travel Kendra, and Travel Kendra will not be denied a cultural sight. She'd figured out how to take the government bus up north to the commercial district of Thamel (ie the over-touristed 'Chang Mai' of Kathmandu), then we could walk the remainder, about an hour. The green government bus departed just as we arrived at the relatively nondescript bus stop, but another one followed in short order and we had the incredible luck to have tons of space and seats! Unheard of in Nepali public transit. After catching our stop and paying our 15 cent fares, we set about walking west to Swayambunath. Seeing a taxi, though, we asked about the price and learned it was $7. We decided $7 was just about worth it and hopped in, glad to for once be on the giving end of all of the honking that takes place here. The road turned upward and we were glad to have taken the trip. 

We reached a bustling market at the base of a long stairway and hopped out of the taxi. True to form, a large band of +20 monkeys, several with baby monkeys, walked across the road ahead and started fishing around for food in a dump. Kendra then became quite the monkey paparazzi as she took photos among the brightly lit garbage. Now, it's to be said that I love all animals. I joke (it's not really a joke) that I became a human doctor rather than a veterinarian because I had too much sympathy for animals. Sympathy, that is, except for monkeys (specifically Macaques), who are furry fanged hellspawn demons that don't even deserve the garbage they were rooting around in.

 [Explanation:  Kendra and I were on monkey beach in Phi Phi Don, Thailand, and a troop of monkeys took it upon themselves to try to relieve me of my tuna sandwich. The sandwich actually was quite terrible, so the selfish monkeys would've deserved it, but I fought them on principle. The whole affair ended up with me backed up into the surf while several dog-sized macaques bared their 1.5in long fangs at me and made rushes at my feet trying to scare me into giving them my sandwich. Safe in the water from their savage monkey bites, I made them watch me eat my sandwich and took my time slowly chewing big bites. They lost interest when a tourist bus arrived loaded with bread. Meanwhile, in a beautiful demonstration of the different genders' approaches to conflict resolution, Kendra had been sitting peacefully holding her sandwich among monkeys playing at our picnic site and was video taping the whole affair.]

After the monkey dump photo shoot, we turned our attention toward the ~400 stairs leading up to the hilltop monkey temple. Kendra stopped to take a picture of two more picturesquely posed monkeys until I mentioned they were, uh, mating, and laughing in surprise/disgust we kept on walking (if you were traveling with us, you'd frequently observe that I'm quite the buffoon and Kendra is the consummate reserved world traveller, but Kendra's not writing this blog so I can say whatever I want). We had our first experience with someone begging at the base of the stairs, a young woman holding her baby. She was surprisingly persistent, but we've long held to the principle of supporting charities but not giving people money directly (eg in Rochester we give money to the homeless shelter, not the few panhandlers at the roadside, who we've incidentally learned- through Kendra's work at the shelter - make more money per hour than I do). 

Climbing up the steps was a fun chore, and they actually became strikingly steep towards the top. We paid our couple dollar entry fee, which the ticket promised was to put toward maintenance of the site, which is hilarious, and crested the steps to the top. On the drive to the stairs, and then during the climb up, we caught glimpses of Kathmandu well below us, and it was beautiful to see the entire city spread out to the horizon, the omnipresent honking of cars and motorbikes intermittently wafting up from below. Monkeys were practically everywhere, and were I not engaged in a one-sided grudge war of resentment, would be entertaining, while the aforementioned hawks floated all around. We walked around the temple, clockwise to be respectful, and Kendra set about photo documenting all the unique sights, vistas, and textures with her camera. The photos can paint the scene much better than I can describe. 

We ended up spending several hours at the hilltop as we waited for darkness to descend. Slowly but surely the sun fell behind the mountains that frame Kathmandu Valley, and then darkness quickly descended over Kathmandu. The city delivered and made the impression it had promised, with lights popping up all over the city as the light faded. 

Having accomplished our mission, we headed back down the steps. It was fun to hear the monkeys making surprisingly loud and violent calls in the darkness as it gave the staircase a very primitive feel. We caught a taxi at the base (for which Kendra expertly kept the price to $7. "Ten dollars?! No, seven dollars. Yes it is night time but there are many taxis. You don't want $7 price? Fine, we walk to him and offer it" <turns back to walk away> Okay, okay, $7. Thank you very much." So brutal. I love her). 

The taxi through the Thamel area was actually one of the coolest parts of the excursion. We looked out from the cramped cabin into narrow streets and alleyways awash with people, motorbikes, colors, candles, lights, and sand mandalas. 

Reaching Thamel, we set about finding our bus stop. After a circuitous walk and a half hour or so wait, the government bus arrived and we hopped on. They were a bit over-eager in their departure from the bus stop (in fact, I'm not entirely sure they even stopped the micro-bus completely), and Kendra took a spill on-entry bumping her shin. She was a champion though and brushed it off, and we headed back home. 

Or so we thought. This bus turned out to be going in the wrong direction, but a nice man on the bus took it upon himself to be our guide (the Nepali people, basically to a person, are extremely helpful, polite, and self-sacrificing. In fact, Kendra has only once, this entire trip, been "ogled," when someone told her "You are cute." Compared to her experience in India - with throngs of men following her around, many blatantly video taping her with their camera phones - it's quite charming). We hopped off the bus with our new friend and waited at an unmarked bus stop. A micro bus arrived but it was literally overflowing with people and we couldn't make it on. Our Nepali friend was able to ask a taxi for the price, 500 rupees ($5, Kendra had been quoted $20-30 for the same length trip a couple days prior), and I took them up on it ( a bit preemptively, it seems, but it worked out). In exchange for our guides' help, and another guy who I offered a ride to after he confirmed our trip for $5 with the driver, we took off down the road and reached our neighborhood. Then Kendra and I, having not had any water or food for the past 7 hours or so, went to a western style restaurant and had water, banana lassis, a pizza and schwarma in a shameless feast. It was a great day in Kathmandu. 

Social Tours - Cook Like a Local

Sunday morning, I woke up questioning whether or not I had what it would take to get me to my cooking class. At the advice of a good friend who had lived here before me, I signed up online to take a cooking class - to learn to cook like a local - but hadn't realized how far away the class was until the night before. Normally, that's not a problem. You have taxis - a 20 minute drive is nothing! But these aren't typical times. The gas crisis meant that the one-way trip north to Thamel, where the class would take place, would cost $30-40 USD, which is ABSURD, especially in Asia where meals are only about a dollar. I pondered my options. Derek, who was working that day, didn't love the idea of me venturing out on my own with so many obstacles. But, eff those obstacles. I'm going anyway.

So, I wandered down the street in search of the taxi and instead found a gathering of people. I assumed it was some sort of bus stop - there was no sign indicating that it was, but that didn't surprise me. I asked a girl if there was a bus to Thamel. She told me to wait. I saw a taxi pass and contemplated calling him over when a gigantic green bus came around the corner. The girl pointed at it. I assumed I should get on, so I did.

I jammed myself into the crowd of people, squeezed into every available crevice the bus had inside to avoid hanging out the door. Buses in front of us had people also packed on the roof. Due to the gas crisis, people are taking public transportation much more frequently than before, and at dangerous levels as was evidenced last week when a bus went off a cliff killing 30 people inside and on the roof. A short girl next to me replied in English when I excused myself for bumping into her (who am I kidding? Everyone is touching everyone else - there's no avoiding it). I asked her if she had any idea how far it was to the area I wanted to go, and she offered to tell the driver to kick me out at the right place. I didn't recognize the area she decided I should get out on - she told me I'd have to walk the rest of the way - but I didn't have a better plan, so I agreed. We chatted about her job until her stop, then I was on my own. At one point, I leaned forward and looked at the driver, who had forgotten about me. He kicked me out right away, probably realizing he should have dropped me off earlier, given the walk I saw I had ahead of me. The ride cost me only 15 cents. Winning!

I found the center, breathless for walking quickly. I expected the class started at 9:30, so when I came in at 9:45 and apologized for being late, they told me I was early and had me wait with milk tea for the others. A gent named Phil from the Lake District in England was there. He had asked to learn how to make Dahl Baaht, and as I didn't have a preference, that was our focus. The lovely chef, Sakuntala, lead us to the market, a small shop where we picked out vegetables. The orange and green lentils are the basis for Dahl, a bean soup that is at the center of Nepali cuisine. Baaht is rice, another staple. We chose to make a cauliflower curry with it. Want to cook with them when you're in Nepal? You can sign up here.

 

We cleaned all of the vegetables with sink water and then with "jar water" as our western stomachs required additional scrubbing with purified water if we wanted to avoid being ill (eh, I think if you're eating regularly in the city, they're likely skipping the jar water wash - just being realistic). For the record, I've not gotten sick yet, and I LOVE street food. If they eat it, I eat it. If there's a line or a crowd, make Anthony Bordain proud and get in line. We followed her instructions and came out with a terrific lunch.

After we ate, they shuttled me to a terrific shop run by Uday called Snow Land. Social Tours refers people to his shop, and he gives them quality products and a fair price. I bought some things there (had to hit the ATM, as no one ever takes a credit card), and when I found a Euro in the pocket of a fleece jacket, they knocked the equivalent off of my final bill. Classy guy :-)

I liked the first class so much, I decided to stay on for the afternoon class to learn how to make Aloo Paratha (aloo are potatos, and paratha is the bread that they're stuffed inside). Phil and I skipped the market visit and let our new additions go on their own - a German and a Canadian who live in Hong Kong. We looked at pictures from Phil's 27 day trek in Bhutan while we waited.

With this class, we got to do our own rolling, prepping the bread skin to be filled, tied, flattened and fried on a tava, a flat pan without sides. Traditionally, this dish came from India and was made in a tandoor (clay oven). Add ghee (clarified butter) and homemade tomato/mint and chili sauces, and we had quite the meal! We even did a few stuffed with sugar - gotta love that they cater to the western palette! It tasted like toffee.

 

Then, I hauled my giant bags from my Snow Land purchases to the bus stop (yes, this does have to do with my mystery plan, which hasn't been revealed yet for a reason - hang in there!), and ran to grab the government bus just leaving. This time, I was precariously hanging near the door, with my bags swinging unprotected. A kind girl who spoke excellent English (she blushed when I told her so) offered to hold my bags up on the dash near the driver so I could get further in. We chatted about her job, America, etc. This time, locating my stop was easier, now that I'm more familiar with my surroundings.

Derek wasn't home when I arrived, so I popped next door to collect a local phone that my neighbors were holding for him. The husband talked at length, telling me about his visits to the states in the 80's to Kentucky and Kansas (so random). He invited Derek and I to his daughter's wedding, starting on the 23rd (they are many days long) in order to introduce us to that important aspect of their culture. I couldn't believe it!

A truly incredible day. What an amazing culture and people with whom to spend our time!

The Golden Temple, Durbar Square, and Dr. Strange

Our Saturday was pretty exciting - we started it by binge watching six episodes of The Blacklist since we finally had internet that was allowing videos through. Around noon, we decided to venture out to see what incredible cultural places were near enough to walk to. We stopped at Samir's noodle shop just a block away and watched little boys breaking pop gun strips with rocks, squealing with delight when they saw the shock on our faces from the loud noises.

Reacting to the boys across the street - they loved my shocked look the most

We headed out looking for Patan's Durbar Square, an amazing cluster of tall temples, some of which were devastated by the earthquake last April. We took a cursory look at our map, and started walking - the geniuses who had used the book before us had ripped out two pages, one containing the local map, so we guessed. We guessed wrong. After walking all the way to the bridge where Patan crosses into Kathmandu proper (2 km, a 20 min walk in the hot sun), we asked a guard if we were close, and he sent us back where we came from. Luckily, we discovered that Google Maps maintains your current location even when you don't have access to wifi, so we used it to work our way back and take the turn we had missed five minutes into the walk.

Of course, we took the back way there, stumbling onto a blockade where we were told that filming was taking place. At least, I hoped it was filming - people kept saying "shooting! shooting!" They meant shooting a film, but combined with blockades and hoards of onlookers, you never know. We turned left, not bothering to try and look through the hoards of people who were trying to catch a glimpse of the film activity, and stumbled quite accidentally on a court yard. There were other westerners there, which we don't see often, so we figured we'd follow a few of them who went through what looked like a house. It wasn't a house at all, but a passageway leading to the Golden Temple.

The Golden Temple was beautiful - a Buddhist monastery known locally as Hiraṇyavarṇa Mahāvihāra originally built in the 12th Century. The temple is famous for feeding rats, apparently, though we saw none inside, and got its name from the guilded metal plates that cover most of its front (though we came in the back door and didn't see this either). A temple priest offered that I could sit on the steps of the inner Swoyambhu Stupa in the center, the most ancient part of the temple. While sitting on a flat pillow, there is a burning alter in front of me, and just beyond that, the barred entrance to the Shakya Muni Buddha's shrine. A 12 year old boy acts as the main priest for one month before passing the responsibility on to another of his same age and gender.

I asked the priest about an older man nearby with a traditional Nepal hat. I've noticed them throughout the city, only ever worn by elderly Nepali men. He mentioned in broken English that the gentleman was deaf - I could see him signing to another child. I don't think he understood my question.

I did my own research on the hat later - it's called a Dhaka topi (topi = hat, dhaka = material). They are popular with the elderly men here as part of the national dress and have intricate patterns in a light colored weave. Their counterpart, the all-black topi (called a Bhaad-gaaule topi) is also seen. The hats are critical to be worn when in a government office or during festivals where traditional dress is expected. You can get one in the markets for around $1 USD.

 

As we wandered out of the temple through the entrance, we hit a wall of smoke, and were quickly ushered to the left side under a plastic ribbon blocking that street. Once we go our bearings, we realized we had stepped from the temple right onto the set of "Check Mate," the Blockbuster American film that they were shooting there. Ironic, avoiding it earlier only to land right on the edge of the set just before filming. We had no idea. I was much more interested in taking pictures of the extras, set in their specific spot, waiting for their queue. Smoke "machines" created loads of thick smoke, so heavy that you couldn't make out the pale figures in the center one block away. Check Mate? Wasn't that a complete failure of a movie launched earlier this year? Or is it that new one I think Chris Hemsworth was just in a trailer for? Derek and I discussed the marital rules we'd BOTH quickly break, with the permission of the other, should we meet Hemsworth. What if he needs more American extras?! (Kendra and Derek are smart, I assure you, but apparently are more hopeful than logical thinking that more pale people are needed if the company flew its cast and crew to Asia specifically to use locals in the filming). Maybe we should stand here all day just in case, and get lung cancer from the smoke - small price to pay. We contemplated our star lust and how easily it seems to take hold of our attention as we wandered towards Durbar Square.

Finally! Durbar Square. Patan is home to one of three in the Kathmandu Valley, and all are considered UNESCO Heritage sites. We took pictures of the square, climbing up on one of the ruined temple bases (what used to be Hari Shankar - picture below of it before and after the quake) to better see the center. The ruins from the earthquake are piled and stacked around the area - mostly red brick. One of the pillars is missing the icon that used to top it. This place would have been even more amazing before April - damn natural disasters.

Hari Shankar before April 2015 Earthquake

The base of Hari Shankar where we stood to take pictures

Derek wanted to go into the Patan Museum, but the incredible crowds trying to force themselves inside the police-guarded door didn't seem worth the wait, or the possible physical danger of being shoved into a rock. Why is the museum that big of a deal? Later we found out - Benedict Cumberbatch was inside shooting for the movie. The cover-name, "Check Mate," on the staff's badges and vehicles outside of the shooting site was a false front for Dr. Strange, the new Marvel film expected to release in November 2016!

I can't blame the shove-fest, knowing it now, but neither of us realized it at the time. We found out days later from others who had seen the photos leaked on twitter. Both of us agreed, now knowing the actor, that we'd both have thrown ourselves at him, in a very un-cool way, if given the chance. What is WITH that part of us? What about stardom and British accents turns us into drooling stalker types? We're really quite normal. Benedict, if you're reading this and you're still in town, we'd be happy to show you around, learn from your sage acting advise, listen to your voice...all in a very normal way, of course. We're the epitome of normal. Kind of.

Not my picture, tragically. Borrowed it from a luckier gent.

Needless to say, we didn't get to see the museum. It closes for Greatness, apparently. Maybe another day.

We found a few more temples and stupas (Sanskrit word for "heap," associated with Buddhist religious purposes) on our way walking home. We ducked into one courtyard to escape the terrible traffic and smoke and found children playing, women working, and dogs - always dogs. We had one of those moments when you think of what it would look out to zoom out slowly from where you were standing to look at the world, and swing back over to America and zoom in on your empty house and your abandoned responsibilities. It was peaceful. We're glad we're here.

Living in Kathmandu - A Day in the Life

Some of our American friends and family are probably curious what our daily lives look like here. I thought I'd do a quick review of our standard day so you can know how it differs from the one we typically live in Minnesota :-)

Waking up prematurely is something that we have to work against - when the sun begins to rise after 5:30, the city around us starts to wake up - dogs barking, babies crying, pounding, music, etc. If we didn't fall asleep with earplugs in, we get them when this starts to happen. The most common noise we hear is spitting. Spitting is practically a cultural practice here. Perhaps due to the smog, the pollution, the dust, etc, everyone is constantly spitting. And not politely. Projectile spitting is both very loud and comes without warning from men and women. For whatever reason, early in the morning, it is an almost constant noise we hear as we get ready for the day.

We have a shower without a tub or curtain, so the bathroom is equipped to send water everywhere. You have to make sure the toilet seat is down so you don't completely soak the seat. The water is warm, and is connected to a gas heater, where the gas is turned on and water is pumped through a box where a fire warms the water. This is pretty hard to maintain consistently for the heat - I almost scalded myself even at the lowest setting the first time I ran it - so we generally keep the heater off and make our showers quick, using the reserved warm water in the tank. When we're done, we have a giant squeegee that we use to push all the water in the bathroom towards the corner drain. There is no outlet in the bathroom (due to water going everywhere), so I plug in my hairdryer in the bedroom and use my compact mirror bent against the wall to watch what I'm doing.

We brush our teeth with "jar water" - we keep a bottle of it on the sink. The water here isn't treated to drink, so the entire teeth cleansing process happens with the bottled water. There is liquid soap that is popular in Asia called Dettol - it's strong smelling stuff. We have a "western style" toilet - the kind you can sit down on - but when we are at work, there are eastern style toilets, affectionately known as "squatty potties." It's a hole in the ground with two foot pads on either side. When you're done, you use a spigot and water bucket to wash water down to "flush." If you're lucky, there's toilet paper. If you're not, that same bucket of water is meant for other purposes, too. Bring hand sanitizer :-)

Our laundry is done each Friday by the cleaning person - she washes our towels, sheets and clothes in a bucket that is kept in the bathroom. Powdered cleaning soap sits on the window ledge in there for her to use, and when she's done, she hangs everything out on the clothesline behind the house to dry. Cleaning in a bucket is very common - directions for doing so are right next to the washing machine directions on the back of the soap packet. When I was in India, I did my laundry in the tub, but no tub here, so bucket it is!

For breakfast, as a previous post mentioned, we boil water for oatmeal and mix in some jam to sweeten it, or add bananas. We recently bought yogurt, after we mentally got past the fact that they aren't sealed and the lids are hardly on sometimes. Around this time, we may or may not experience an electricity outtage. If we do, we have eggs on the gas stove instead (the eggs are not refrigerated). We purchased most of our groceries at a little store down the street, but fresh items like bananas have to be purchased from a fruit vendor. Usually they carry the huge load of bananas on their bikes. Derek makes coffee - Nepal just recently figured out how to successfully manufacture its coffee, our landlord told us - in a press.

We wash our dishes by hand and dry them in a plastic basket on the counter.

Derek leaves around 7:30 to walk 20 minutes down the road to the hospital. I leave shortly after him to walk the 40 minutes to the YWAM center. We work until lunch, when each of us takes a short break - Derek goes to the hospital cafeteria, and I go 10 minutes down the road to a little restaurant where they blare music and have newspapers under the glass on the tables that I try to read. They know my order - vegetarian momos, every day. My friend Anne told me to eat as many as I can, and she's never steered me wrong yet! After work, we each walk home. We both leave by 4, so I usually come back to find Derek under the covers in his workout clothes.

It's cold in our place - the windows are anything but sealed (making morning sounds even clearer in the morning), and the bathroom window has to be left open to prevent moisture from forming mold. Our bedroom door doesn't close - for some reason, there is a piece of cardboard jammed in the door, which I found and removed, only to realize just before closing the door that the door handle doesn't work, and if I had closed it, we'd have been locked in our room. We do a lot of our work under our covers or in our coats.

Then, we head to the gym, which we've already described in a previous post. Usually around now, when it gets dark, the city has another power outtage, or it may not. No real consistency these days. On our way back we stop at a local shop for dinner - usually fried rice or noodles or momos. Then, we might stop at an ATM, since we have to pay cash almost everywhere. Some nights we cook, but the food is so inexpensive, and so well made, that it seems a poor waste of our resources to try and do much ourselves. We have had spaghetti twice, when we didn't feel like venturing out again.

When we return, we're followed by the homeless dogs that stay in our area - there are two black and white ones and one blonde one that are sometimes nice, and sometimes not. There is a gate outside of our property that we open with a Cinderella-looking key, and once inside, we pet the resident dog, Seru, who belongs to our neighbor. The neighbor claims Seru is 20 years old....I'm not so sure about that ;-)

Derek gets very tired around 8, but we both try to spend evening time writing or editing pictures or catching up on work we never get done in the states. I try to keep him awake until 10, as he's still struggling to get on a proper schedule. We take out the garbage, which we hang on the gate in a bag for someone to pick up (not sure of the point of this, since most people burn their garbage right in front of their shops, or you'll find huge piles dumped on the sides of the road, also possibly on fire, or not. If the power is still on, we use regular lights, and if not, we use the generator lights, identified by red tape on the switch. Good night!

Doctor Without Borders

I am here in Kathmandu on an elective rotation at Patan Hospital through the Mayo International Health Program. Mayo has a collective trust from which a committee provides scholarships to visit under-served areas internationally and work alongside foreign physicians to experience care in a resource-limited environment and incite interest in future work abroad. I was very fortunate to receive a scholarship to go to Patan, and now we find ourselves here in Kathmandu.

Each day I walk about 15 min down the road to the hospital. Patan is a 450 bed hospital that was originally founded by Christian missionaries, and only recently in about 2008 was it turned over to the Nepali Government. They have a 60-bed pediatric wing, which includes a children’s ward, PICU, and NICU, as well as a two nurseries, an outpatient clinic, a high-risk patient clinic, and a pediatric research unit. The hospital itself offers lab services, blood banking, x-ray, and ultrasound, while CT/MRI can be obtained at another hospital in the city.

After arriving at the hospital, I head over to the library in the pediatric wing for the morning conference. My first day, the conference was a comprehensive audit of the PICU and NICU, where they reviewed patient cases and discussed their management. Multi-drug resistant klebsiella sepsis in newborn infants caused quite a bit of discussion, as klebsiella is a bacteria that can acquire antibiotic resistance fairly rapidly and cause something of an outbreak within a hospital. After conference, we head to the ward to review the patients prior to rounds. I joke that, in being excited about the different patient cases, I sound like a jerk since I’m enthusiastic about, well, sick children, but it’s really quite fascinating. While Nepal hasn’t escaped the omnipresence of bronchiolitis – it’s so common in the US, we call the winter ‘Bronchiolitis Season’ – their most common disease seems to be bacterial pneumonia. It seems the smog in the city, along with the high density of people here, causes a perfect storm of lung infections, and we have several babies on the service right now recovering from pneumonia. One delightfully precocious ~3-year old girl has been in the hospital for several weeks now after a chest tube was needed when her pneumonia turned into a lung abscess.

Beyond the common cases, though, you have the weird/cool cases. There’s a classic phrase in medicine, “when you’re in Texas and you hear hoof beats, think horses not zebras.” It means, basically, that common things are common, so don’t go chasing House-MD style after the strange diagnosis. Well, I specifically flew halfway around the world to see the strange diagnoses, and they’ve been happy to oblige! For example, Diphtheria is the D in the DTaP vaccine that you’ve had and given your children (unless, well, you’re an idiot. Sorry, that’s a little hostile. I mean, unless you’re exercising your parental freedom… to be an idiot). Back in the 1920's, there’d be more than 120,000 cases annually in the US and 10,000 deaths. But after we introduced the diphtheria toxoid vaccine, there’s now about five cases annually. I’ve never seen a case, until now that is. Another disease we rarely see in the States is Epiglottitis, where you have a very serious infection of your upper airway. Even though we rarely see it, everyone learns about it in detail and remembers it because of what can happen if you don’t. In Epiglottitis, children present leaning forward, drooling, and having difficulty breathing while speaking with a muffled ‘hot potato voice.’ If you go to look in the back of their throat with your tongue blade, though, the child may die (the irritation from the tongue blade can cause their airway to lock down). So you don’t mess around with the Epiglottitis, but it’s most commonly caused by a vaccine preventable bacteria, Haemophilus. Well, turns out they get 2-4 cases here a month!

It’s not only vaccine-related diseases, though. A 10 year old boy presented from a rural village with facial swelling and difficulty breathing, as well as a swollen belly. An x-ray showed a pericardial effusion (fluid in the sac around the heart), which began to squeeze his heart and compress it from beating. They had to insert a needle under his rib cage into the space just around his heart to pull the fluid out. He had fluid in his face, his lungs, his heart, his belly… what could’ve caused this? Well, turns out, he comes from the same rural area where children often catch and eat under cooked freshwater crabs, and they get a parasite that causes this massive inflammatory reaction leading to all of the fluid buildup (it’s called Paragonamiasis). Crazy!

I’ve been able to joke around with the interns and medical students here, and we’ve had lunch together in the cafeteria, grabbed milk tea before rounds, and just hung out in the afternoon. Just yesterday they asked me what my thoughts were, about how different our two hospitals are, and I actually had to say my main impression was how similar everything is. It’s really quite striking to be in such a different environment, but rounding with a team where they go to the bedside, have the intern present the patient, then have a teaching session in almost the exact same way we do Stateside. What are we worried about regarding fluid management in the setting of pulmonary disease? SIADH. How many grams per day should an infant gain in the first two months of life? 20 to 30. What’s the differential diagnosis for diffuse swelling? Think liver, kidneys, and the heart… the list goes on. It’s great.

Plus the milk tea is like ten cents. Which is awesome.

                 55 cents total for lunch

At the end of the workday then I walk back home to hang out with The Hotness. We go to our local gym, which I’ll more diplomatically describe as ‘rustic,’ get food for $1 at a local vendor’s shop, and then watch TV shows or wander around. Well, I’ll hang out with The Hotness for now, that is, until her big adventure…

YWAM Kathmandu

Yesterday, after Derek arrived back home, we managed (after some very frustrating pitfalls) to procure a phone and a SIM card so that I can keep in touch with others at the organization I will be working with. They had given me a "map," in pen, to find their office the next day, and I was concerned (for good reason) that going past Derek's hospital for an unknown amount of time or distance, along unmarked roads, to find a red brick building with a black gate, behind a construction building, somewhere on one of four roads...well, you get the picture. When I arrived, the man there said I was very early (they start work at 10 - it was 8:30) and also that I was a magician with orienteering if I actually managed to find the place alone without help the first time. Bonus points for Travel Kendra.

Do you know Travel Kendra? Only a few do. Frankly, she's much more likable and laid back than American Kendra. She has no schedule, no time restrictions, low expectations. She rolls with the punches. Doesn't sound like someone you know? Thankfully, if you know and put up with American Kendra, odds are pretty good that you'd get along well with Travel Kendra.

Also, we got a gym membership and ran on the two working treadmills and lifted weights in a gym that I can only describe as falling short of DAHLC standards (people in Rochester would shutter to find that there is only one tattered yoga mat and NOTHING to wipe the machines down with - a complete shock to us, of course). When we left, I wondered how long it would take for the ring worm to show up. Thankfully, I'm still waiting.

We went to a Japanese restaurant (we were disgusting, but when we tried to ask if we were dressed well enough to dine, they answered us by graciously accepting our patronage and put us in the back of the outdoor garden), had an epic meal of grilled vegetables, and then realized that we were 100 rupees short (the equivalent of a dollar) thanks to their VAT and service charges, so Derek left me while he ran home for the money. I must say for myself, I'm a pretty good ransom assurance.

So today, I made my way through the labyrinth of this city's roads to the YWAM Kathmandu office to start on a project for them. I will be interviewing the leaders of 26 different mission groups to learn more about them, and so that they can have their missions shared to receive prayer and support. Let me tell you about the five I reviewed today:

1. Church Planting Team - Spreads the Good News through discipleship and holistic transformation by building independent, sustainable churches (helps communities with hygiene lessons, Bible distribution, English language assistance, music, sports, etc.)
2. Driving DTS (Brand New) - Still in an ideation phase, this mission caters to drivers, who have a poor reputation in Asia, to minister to them in order to revive their reputations, give them hope, and allow them to share that hope with other drivers and passengers.
3. Jiri Team - A multi-faceted organization that helps through a Children's home, pop up medical clinics (they served 500 people this year in only 2 days), educational scholarships, discipleship training, social work, physical rebuilding efforts, etc.
4. New Life House - For homeless or needy women and their children, this group gives women vocational training (like sewing and basket-making) and sends their children to school during a 5 month training program that helps them get back on their feet and reintegrated with their families.
5. Frontier Missions - Church planting teams that focus on specific people groups in the high Himalayan areas of Nepal.

Want to give to any of these deserving groups? Click here and enter in for the ministry YWAM Kathmandu center, the contact's name is Ishak Tamang (he is the Valley Leader), and indicate which organization you'd like to support in the instructions box. ALL of these groups have incredible projects that need monetary support - they'll use it well.

There's one other thing you should know about Travel Kendra - she has a trigger finger for making crazy, last-minute, life-altering decisions. Today, she was offered an opportunity to work with YWAM in a very unique way - a way that will probably make her mothers in America ill, once again. But, Travel Kendra discussed it with Travel Derek and he's on board! So little time to prepare...

Lalitpur

We are staying in Kathmandu in the Patan district, in the Lalitpur “area” – I think? There are no street signs, or true addresses. The only way to get back to your house once you’ve left is to remember the directions you turn, backwards, and to constantly look behind you to see something that hopefully won’t move before you return to reference. We live by a giant Adidas sign and a tall blue building. Without these two, I’d wind up very lost.

Our neighborhood is nice – there is construction, or at least it sounds like it, on three sides of our building. It begins at 5 am and goes until 9 pm. Earplugs are our new best friends. It’s not really surprising, seeing how we’re visiting an area that has a lot of rebuilding to accomplish after the earthquake they had just 7 months ago. There is a dog that lives on the property, and several that hang outside the gate. One of them rubs his face on your legs, jumping up and down the whole time you walk.

“Loadsharing” (which is a fancy way for saying they’re turning off your power) happens every day, at least twice. That’s when you hold your breath for an hour and a half, hoping it comes back on before your groceries thaw and you risk bacterial infection, or wasting a ton of food. Today, I wanted breakfast (reasonable, yes?), but milk is non-existent or terribly expensive, so we went with instant oatmeal and toast. Nope – couldn’t make toast, or boil water, thanks to the loadsharing, so I sat and waited. Some of you know that I’m hypoglycemic, or at least my body acts like it is, so I have to eat every few hours or I get shaky and a little psychotic. You should have SEEN my face when I heard the refrigerator kick back on…it was like seeing that you had created fire after rubbing sticks together for an hour and a half. Pathetic? Perhaps. But it’s life. And waiting for an hour and a half isn’t that big of a deal if you have granola bars…note to self, find more biscuits (cookies) to keep around for breakfast (there are no granola bars – that’s an invention of Boulder, CO). Cookies for breakfast? Sounds like a win to me!

Momos are literally the greatest thing on earth – I was told by a friend to stuff down as many as I could get my hands on, and true to my word, I’ve had them once a day since arriving. They are little dumplings stuffed with meat and veggies that you dip in a spicy tomato sauce. My culturally-deprived Rochester stomach is literally hoarding them. Restaurants have very limited menus because of the Petrol Crisis, but fortunately for me, momos seem to be too great a staple for them to have dropped off the available list…at least for now.

When we first arrived, our driver pointed out the MILES of cars parked in line for gas (petrol). The lines were so long that I didn’t see a gas station almost the entire drive that they were aiming to get to. It takes 3-4 days to get gas. A new friend of mine at YWAM Kathmandu said his brilliant wife filled their car’s gas tank before the crisis hit its critical point, and the family is siphoning gas from its tank to fuel their motorcycles, which can go much further than cars on the available gas. Trade has stalled – India is Nepal’s main goods supplier, and they’re not helping anything. The next concern is clean water’s availability – India supplies that too. This place seriously needs a break – pray for the whole nation. Pray for their political groups and government, that they’ll take this seriously and act swiftly.

Yesterday, I met with representatives from YWAM Kathmandu. This Christian organization is one that I’ve worked with in many cities all over the world, and I’m excited to lend my business and operational acumen to a new project to document the 26 ministries that they support. My new friends Nar, Dilli and Ishak will work with me this month to meet with leaders of all 26 NGOs to record their missions. Want to donate, or pray for them? Do! You can find them via Google, as you can with many things J That is, unless your internet is spotty, or non-existent, like mine is. Typing this up in my kitchen in a word doc until the power comes back on and maybe I can get online. Want a break from constant connection? This is your place!

And Derek? Well, he’s working at Patan Hospital – they call him Dr. Derek. I don’t know exactly what he does there all day…I guess I’ll let him do the next entry so you can learn about his adventures. Meanwhile, I’m off to schedule cooking classes to figure out how to make my own momos back home, and maybe land myself some time at the Yoga “school” down the road. Also, I paint, did you know that? I almost forgot myself…it’s been at least 4 year since I picked up a brush, so I’m committing to get back to that while I’m here. Hold me to it! 

Shanghaied to Kathmandu

Tips for traveling to Nepal:

1) If you have a deep desire to spend 3 hours in Shanghai’s immigration “box,” by all means save money and get tickets through China Eastern airlines. Our outgoing flight was canceled the month before, we weren’t notified, so we were placed in time out and monitored by police until they rescheduled us. Yes, the thought of going to jail in China was, to Kendra, a very real fear, but while she was crying about it, Derek fell asleep and was so pale that the officers were looking at him like he might have Asian Bird Flu (yes, they were checking forehead temps of people passing by). Three of our four flights through them were rescheduled.

2) If, after the box incident, you spend another 3 hours trying to figure out where your bags went, how to get a shuttle and a hotel, then that wait is appropriate. No one telling you what is happening? Being straight ignored when asking about anything? Totally normal. Stupid Americans, wanting to know where in China they’re being shuttled to…why can’t they just follow simple point and grunt directions? We were loaded onto an incredibly packed van (yes, that’s how I know I’m in Asia if I’m ever not sure: Is someone on my lap? Yes. Is it a baby that I took willingly? No = In Asia) and sent to a free hotel and handed a baggie of very “unique” looking foods (including Chinese Ramen, which we called our Victory Ramen, and committed to eating it only if we made it out of China). The free breakfast was nice, but having China Eastern eff up once again and this time cancel the flight they JUST re-booked 8 hours before to put us on an earlier flight kind of ruined the digestive process. Bonus – they sent an airline rep to rush us through immigration (no box!) and security, only to find it was delayed (their own airline, and they didn’t know about the delay = professionals).

3) If you have to be stuck in one international airport for five hours, the Hong Kong airport is the place to get stuck.

4) Sit next to an elderly Nepali woman and try to interpret her stories while being repeatedly touched. Give her your number when she asks for it because it’s not like your phone will work for the next month anyway. Watch a dozen B-rated movies that you’d never waste your time on if you weren’t stuck in a seat for the 40^th hour in a row with an inch and a half of wiggle room (*cough - Hot Pursuit and San Andreas).

5) Finally make it out in the Kathmandu airport and go through the metal detector which sounds off constantly without anyone being stopped (the point?). Wait an hour and wonder whether China Eastern actually put your bags on the right flight. Try to change cash at a window marked “Cash Window” and get laughed at because, clearly, they don’t change cash. Finally change cash, ask for a receipt, get told no, point to the plaque above his head that says you have a right to a receipt, still have him say no. Give up.

6) Order a cab ahead of time – avoiding the headache that is caused by those offering taxis when you arrive is worth the premium. Who wants to think about fair taxi prices after you’ve traveled for three days?! Two days? I’m not sure – we skipped a day somewhere.

7) Crash in your bed and wake up four hours later to cat fights, dog barking, spitting, radios, and construction. Ok, so Nepal wakes up with the sun at 5, does it? Makes sense, given the power outages, that maybe alarms aren't reliable. Great. Derek, is your complete lack of sleep going to affect your ability to doctor people in 3 hours? Par for the course – this is actually more sleep than he got in the states!