The Word is Out...

After arriving unexpectedly back on the 14th of September (at least to the villagers and clinic staff who were not expecting me - see my first post from Chanaute), word has continued to spread and the clinic has started to get busy. Last week I averaged about 12 patients per day and after starting the week with 13 patients each on Sunday and Monday, we jumped up to 21 yesterday and today we had 24.
Yesterday I also had an interesting case. A gentleman who I would guess was in his 40s or maybe 50s came into the clinic with severe acute leg pain in his right posterior/lateral thigh and calf. I was busy with another patient but my translator asked if acupuncture would help. I suggested we have him drink some water right away in case he was experiencing cramping due to dehydration (he claimed he had experienced cramping before and this was different). After I finished with the patient I was working on, I placed a couple of auricular needles in his ear to try to help calm him down and help with the pain. It seemed to help as he did calm down and no longer appeared to be in quite as severe of pain. The nurse had him lie down and applied a topical muscle analgesic to his calf and wrapped it. I then asked if he was having any low back pain because I thought perhaps he may have some nerve impingement further up stream. He indicated he had a little. I placed needles at L5, S1, S2, (based on the nerve root/dermatomes chart) and UB54, GB30 as well as the bladder xi cleft point of UB63. The gentleman was in so much pain at this point that he was shaking on the bed. The nurse placed a blanket over him. About an hour later I took his needles out and he walked out of the clinic. At that time he did not appear to be in any distress, but I was busy with other patients so I wasn't able to find out exactly how he felt. I'm honestly not sure if it was the fluids we had him drink, the analgesic cream and ace bandage the nurse applied or some of my needles that appeared to help him. Thankfully he seemed to be much better when he left which is what matters most.
After my shift I went for another short hike along a stretch of road I hadn't explored yet heading south east from the village. The view and the sky were amazing. After taking a few pictures like the one below, I happened upon one of the women I'd been treated in the clinic for knee pain.



She doesn't speak much English and so at first I thought she said I should "go home." I thought maybe because it was starting to get dark or something. However, her husband came along and the way he motioned at me made me realize they were actually inviting me into their home. I followed them down the path and sat down in their living room floor on a bamboo mat while my patient (most everyone has long difficult names and I see so many people that I can't remember her name) made me milk tea and I smiled and said namaste to her two little girls who were both adorable and smiling right back at me. There wasn't much talking at first, but then her two older children showed up (a boy aged 9 and girl aged 15 and they both spoke some English so I asked if they wanted to see some pictures I'd taken since I'd been in Nepal and we scrolled through them for the next 15 minutes. After finishing my tea, I thanked them for their hospitality and made my way back to the village.


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Temporary Clinic and Daily Schedule

Back in my first post from Chanaute I included a picture of the temporary clinic which is actually made up of two separate buildings that look like they are joined but the rear structure was built about a year ago and the front building is an older building made of stone and cement (by our standards it could use some serious tuck pointing). The front clinic is where the midwives/nurses administer to the general health needs of the residents of Chanaute including first aid and dispensing western medicines. Behind this clinic room is the newer building that also has a clinic room which is where I'm treating patients each day. See picture below.


On top of these two small structures is a temporary metal shed that is bolted into the stone and cement buildings below and consist of five rooms. The front room serves as a meeting room for the clinic director and is used for everything from town meetings to construction planning as far as I can gather. The next room houses the three guys who perform the heavy construction projects (like building a retaining wall nearby for some new housing that will be built). During the day this room is sometimes used for other purposes like holding a informational meeting for local residents on how to apply for a work Visa abroad. The next room is a kitchen which is where Bina, one of the midwives cooks and where we both eat.


The last two rooms are bedrooms. One for Bina and one for myself.
Last but not least are the bathroom (a small tiled room with a sink and a hose from outside that supplies running water constantly and prevents you from closing the door completely) and a second toilet room that has an Asian style toilet (essentially a porcelain sink like structure that feeds into a hole in the ground that you squat over). I will say there are at least two advantages to this style of toilet. First, if you are not already aware, there are many who believe that it's better for your colon to squat during your bowel movement, so much so that there are devices sold that help you obtain a similar position with a standard toilet, thus creating what some call a squatty potty. Second, for anyone who has used a public toilet and wondered how clean that toilet seat is, with an Asian style toilet your bum never comes in contact with a seat since there is no seat. I actually think we should make all public toilets Asian style everywhere. :-)

My daily schedule so far usually involves waking up between 6:00-6:30, and starting my day by either going for a morning hike or doing some light exercise in my little room. Unfortunately I don't really have a good space to do Tai Chi at the moment.
After my morning exercise I either clean up (i.e. Take a cold bucket shower) or freshen up (comb my hair and put on some new deodorant). From what I can tell, the people of Chanaute don't generally shower every day based on my observations. Twice a week seems to be the high standard. But I'm guessing that many locals shower once a week or as they deem necessary. I actually haven't minded the cold bucket showers so far, but that may change as the weather and the local water source gets colder. After I clean up I meditate for about 20 minutes and then I have tea and breakfast.
At 9:00 am I start seeing patients in the clinic and work until about 11:30 before having lunch. Then it's back to the clinic until 4:00 or 5:00 depending on how busy we are that day.
The remainder of the day is spent doing some reading, listening to an audiobook, writing blog updates or drawing before having dinner and then calling home.




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Greetings from Boudha

Today I've traveled on my off day to Boudha to visit the world heritage site, the Boudha Stupa. I've endured the nearly four hour bus ride of nonstop jolting and jostling (smooth roads, whether paved on unpaved, are nearly non-existent in Nepal) to not only visit this amazing place, but also to pick up some much needed breakfast supplies (more on that in a second) and to figure out the buses, so I can get around without paying a high price for a taxi.

As for breakfast, my first two weeks I've been eating either these processed biscuits (essentially cookies) with tea, or these delicious but very greasy molpas, that are like an unsweetened donut without a hole, essentially fried dough balls.

The first picture below I took this morning. The second picture is what the stupa looked like before the earthquake.

I'm handing over the blog writing to rough guides who can do a much better job of telling you about this amazing place...
The great white stupa at BOUDHA (or BOUDHANATH), about 5km northeast of central Kathmandu, is the swollen sacred heart of a thriving Tibetan Buddhist community. One of the world’s largest stupas – Tibetans call it simply Chorten Chempo, “Great Stupa” – it is also the most important Tibetan Buddhist monument outside Tibet. Since 1959, Boudha has been the focus for Tibetan exiles in Nepal, but it has been a sacred site on the Kathmandu–Tibet trade route for centuries. The 10km corridor from Pashupatinath to Sankhu was known as the auspicious zone of siddhi (supernatural beings), and Boudha was – and still is – its biggest, most auspicious landmark.



Some history

Traditions differ as to the stupa’s origins. A Tibetan text relates how a daughter of Indra stole flowers from heaven and was reassigned to earth as a lowly poultryman’s daughter, yet prospered and decided to use some of her wealth to build a stupa to honour a mythical Buddha of a previous age. She petitioned the king, who cynically granted her only as much land as could be covered by a buffalo hide. Undaunted, the woman cut the hide into thread-thin strips and joined them end to end to enclose a gigantic area.

The Newari legend has a firmer historical grounding, involving a drought that struck Kathmandu during the reign of the early Lichhavi king, Vrisadev. When court astrologers advised that only the sacrifice of a virtuous man would bring rain, Vrisadev commanded his son Mandev to go to the royal well on a moonless night and decapitate the shrouded body he would find there. Mandev obeyed, only to find to his horror that he had sacrificed his own father. When he asked the goddess Bajra Yogini of Sankhu how to expiate his guilt, she let fly a bird and told him to build a stupa at the spot where it landed, which was Boudha.

Whatever its legendary origins, it’s possible that the core of the stupa dates as early as the fifth century AD, and it’s almost certain that it encloses holy relics, perhaps parts of the Buddha’s body (bones, hair, teeth) and objects touched or used by him, along with sacred texts and other ritual objects. The stupa has been sealed for centuries, of course, so no one knows exactly what lies within, but the relics are held responsible for the stupa’s power, and its ability to command veneration.



Read more: http://www.roughguides.com/destinations/asia/nepal/the-kathmandu-valley/boudha/#ixzz3mqHkvyYl


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Location:Boudha Main Road,,Nepal

Earth shake

On my second or third night in Chanaute I awoke and thought I felt a vibration of some sort. I wondered if this might be a light aftershock but I didn't see anything in my room moving or falling off the ledge where I had a few items so I dismissed it as my imagination. Then last night I again awoke and felt a vibration but this time I was pretty sure it was a very minor aftershock. Again, nothing was rattling off the ledge, so it was definitely minor. Later that day one of the locals asked me if I felt the earthquake last night so I'm sure that there was indeed a minor aftershock last night.
In case any of you are worried about my safety, my room sits above a newly constructed clinic room that was built by an engineer to withstand earthquakes and this part of the structure has withstood the two earthquakes that occurred last spring, so you can rest easy that I'm in a safe place.

Below are a couple of pictures from my hike yesterday morning.



North of Chanaute...



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Where in the world is Dave

Prior to coming to Chanaute I did a few Google searches to try to find out exactly where Chanaute is in relation to Kathmandu. Google maps was not helpful and so I relied on mapcarta.com. Each time I searched it came back that Chanaute was southwest from Kathmandu. On the drive out of Kathmandu I remember thinking that I hope the driver is taking me to the right place because it didn't seem like we were heading in a southwest direction. Once I got here and saw the orientation of the Melamchi river to the sun I realized the we must have traveled north not south from Kathmandu. I finally got the opportunity to try google maps ability to triangulate my location today and sure enough I'm north of Kathmandu (if indeed Google is correct). See the blue dots on the two images posted below.


According to goggle maps, I'm only 19 miles north of Kathmandu, but as I noted on an earlier post it took almost four hours to get here so I'm not sure I trust google on that one. Perhaps it's 19 miles if you could fly here in a straight line.



At any rate, if you were curious as to exactly where I am, hopefully this clears it up.

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Nepal signs new constitution

After going eight years without a constitution, Nepal celebrates the promulgation of the new constitution today with an official ceremony here in Chanaute and throughout the country.

Hasta, the clinic director who is from Chanaute but who has a home and business in Kathmandu, believes the new constitution is a step in the right direction for the diverse country with over 100 languages and hundreds of different ethnic groups and castes. I'm unable to get a read from the majority of villagers on how they view the constitution just yet,
but from what I've read its mostly the smaller minority groups in the South and West that are the most dissatisfied.

Below are two articles regarding the new constitution and what it means for Nepal.

http://thediplomat.com/2015/09/nepals-new-constitution-65-years-in-the-making/

http://www.bbc.com/news/world-asia-34280015

The ceremony today has been going on for a couple of hours and included several speakers. There has been lots of music and dancing also with some well known singers from Kathmandu and the surrounding villages.



Hopefully this is a step toward a better and stronger Nepal. Only time will tell.


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End of First Week

Each day that passes I become a little more acclimated to living in the remote village of Chanaute and I've started to feel more useful. After treating 2 people on Wednesday and 4 people on Thursday, I was also able to treat 10 people yesterday, so it felt really good to get busy and see that word is spreading that acupuncture is available again after 4 months without anyone since the earthquake. While I still feel very much like a stranger in a strange land, I'm starting to get to know the wonderful people here. Yesterday as I was treating one of the villagers a young boy was watching with keen interest. He then noticed the school supplies with pads of paper, pens and colored pencils that I had brought from Kathmandu. He smiled and gestured that he would like to have some. After I gave him some pads and pencils, I soon had a stream of kids coming to the clinic asking if they too could have some school supplies. It was awesome to see their excitement. Many of them stuck around for a while and watched as I treated more patients with acupuncture.




It seems most if not all the children learn English in school and some speak even better than the adults. I suspect this is because it's fresh in their minds while most of the adults lose the skill because they don't have a great deal of people to practice with or reason to keep up the language living in such a remote village. Later I met another 8 year old boy named Saugat who was friends with Bonnie, one of the past volunteers, and he spoke pretty good English as well. He found out later that I was giving out supplies and came by this morning to see if he could get some too! Of course I happily obliged him.
Saturday is my one day off each week. Today I went for a morning walk and I think the villagers are getting use to these strange westerners going for morning walks (the villagers walk all the time for work or to get around that the concept of walking for exercise and enjoyment is foreign to them). I know Bonnie always went for walks, so today when I passed a man he smiled and nodded when I told him I was doing a morning walk.



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Making Progress

Yesterday I finished inventory of the supplies that were salvaged from the old clinic after the earthquake and finished cleaning the cabinet. I then added the new supplies that I brought with me. Later that afternoon, Hasta, the clinic director arrived and he answered my questions and it sounds like we will able to get up and running this week.
Today was a Hindu holiday called the Festival of Women, where the women dress up and gather to sing and dance. I'm told that they do this to help ensure their husbands live a long life, but you can probably find out more online and check my facts.



Today I also treated my first two patients (Hasta and his mother) and got internet access although the later comes and goes and can be pretty slow.


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First day in Chanaute

I arrived in Chanaute after a long, bumpy, and dusty taxi ride from Kathmandu. The first hour was spent getting through Kathmandu and the outskirts of town and during this time the air was filled with black exhaust spewing from most of the busses and trucks. After that, the ride got a little better as the traffic thinned out and the air cleared up some and we made our way through the smaller towns and into the mountains. The last two hours were along a narrow road that alternated between dry and dusty or wet and muddy. The road ran along the Melamchi river and the view is nice and scenic. However, most of the time we had to follow behind several large dump trucks or busses and waited for those rare opportunities to pass.
When we finally arrived in Chanaute after about four hours, we found our way to the clinic and I met the two midwives working there, Mina and Bina. Neither spoke much English and so I asked about the translator, Bhoudimann and they informed me he will come later. Mina then phoned the clinic director, Hasta, and he informed me that they were not expecting me until the 24th (10 days later). He told me he will be back from Kathmandu tomorrow and so I spent a couple of hours going through the acupuncture and herbal supplies that were salvaged from the old clinic that was destroyed in the earthquake. Bhoudimann arrived three hours later and I gave him the gifts from the previous volunteers, Ari and Bonnie. Bhoudimann then told me he is planning on leaving the country for better work and so I will probably have a new translator.



That night Bina made me a delicious dinner of dal bhat, spicy potatoes and rice. Afterwards it poured down rain and my roof had a few leaks, so I moved the bed and my stuff to the dry sections of the room and placed a pot down to collect the water from the area with the biggest leak. My first day had come to an end.


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Off to Chanaute

This morning I leave for the village of Chanaute. I'm told it will take about 4 hours from Thamel, which is the part of Kathmandu I stayed in last night. I'm not sure when my next post will be but I'll be sure to provide an update as soon as possible.

Below is a picture of Kathmandu valley I took from Kopan.


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Location:Kathmandu,Nepal

Kopan Monastery 10 Day Introduction to Tibetan Buddhism

Post 1 of 2 regarding my time at Kopan.

Earlier today I completed my meditation retreat along with ~40 other students from all around the world. Each day for the first seven days we would awake at 5:45 am, wash up and then gather for morning tea. We would then begin our first hour long meditation (which were actually two 30 min meditations with a short break in between).



After morning meditation we would have breakfast, then have a break, followed by two hours of teachings by our instructor, Ani Karin. There was no talking allowed by the students throughout the morning until after lunch each day (except to ask questions at the end of the lectures).

The afternoon began with group discussions to talk about the morning teachings. After a break we had another 90 minutes of teachings, followed by afternoon tea. The evening began with a 45 minute meditation session, then dinner and then a Q&A session followed by a 15 minute chanting meditation. Then it was lights out until the next morning.


After seven days of following this schedule we then had two full days of silence with seven meditation sessions each day (avg. of 45 mins per session). Before a couple of the sessions we do 15 minutes of walking meditation in the gardens if the weather permits. It was quite surreal to observe a dozen people all walking around very slowly and methodically like they were in a trance. I felt like I was in a dream although it was a bit funny as well. That night we had a light ceremony for our last evening meditation.


The final day we had one last morning meditation followed by our last teaching and then I departed back to Kathmandu after lunch.

The purpose of the retreat was to learn about Tibetan philosophy and world views as well as to learn or expand one's meditation skills. For me, it was also my final preparation before beginning my volunteer service. It certainly has been a very worthwhile experience. It's impossible to summarize everything we learned during the past week, but I've outlined a few key points:

Buddhism is a philosophy, not a religion. It encourages you to test out the teachings and determine which ones have truth and value in your own life. For example, you may find the teachings on how to treat all living things with loving kindness and compassion resonate with you while not believing in reincarnation.

Buddhism believes that all sentient beings experience suffering. The cause of our suffering is mostly due to internal causes. These causes stem from either our strong attachment or aversion to outside objects (people, places or things. e.g. we get hurt because we like someone and they don't like us back, or we get jealous of someone who has something we can't afford, or we get angry when someone bumps into us or doesn't treat us nicely, etc.).

The primary focus of Buddhist meditation is to develop one's own mind, so they are better able to treat all living things with loving kindness, compassion and wisdom (and ultimately become fully enlightened). For example, rather then becoming angry when someone bumps into us, we understand that the person is hurting in some way and that pain or suffering is the cause for why they were either distracted or intentionally bumped into us. We thus choose to feel compassion rather than anger towards that person. Needless to say, this takes practice!

Most of us have some level of compassion toward others. Small compassion is when we feel compassion toward family or friends. Large compassion is when we expand our compassion toward our community. Great compassion is when we are compassionate toward all living things, including the planet we live on.

I'll end by including some helpful quotes by the 14th Dalai Lama and other great Buddhist teachers:

The True Meaning of Life:
We are visitors on this planet. We are here for 90-100 years at the very most. During that period, we must try to do something good, something useful with our lives. If you contribute to other people's happiness, you will find the true goal, the true meaning of life.

Right from the moment of our birth, we are under the care and kindness of our parents, and then later in our life when we are oppressed by sickness and become old, we are again dependent on the kindness of others. Since at the beginning and ending of our lives we are so dependent on others kindness, how can it be in the middle we neglect kindness toward others.

See a few other quotes in the images below.









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Location:Kathmandu,Nepal

Interesting facts and tidbits from my time at Kopan

Post 2 of 2 on my time at Kopan.

The group of people who came to Kopan traveled from all over the world to learn about Tibetan Buddhism and deepen their meditation skills. There were people from the US, Canada, Australia, Germany, China, India, Ukraine, Sweden, Czech Republic, Brazil, South Africa, Singapore, Hungary, Spain, Ireland, Nepal, and others. The group was about evenly split between men and women. The age range of the participants was from early 20's to around 60, however, the majority of people were in their 20's and 30's.

The weather was much better than I expected at least for the first week. I was expecting hot, humid, rainy weather most days. The first seven days were mostly pleasant, ranging from sunny with a light cool breeze, to a little hazy and humid. On the last three days we finally got a fair amount of rain, ranging from a heavy downpour that lasted a couple of hours to a light mist. We also had some afternoon thunderstorms. The biggest weather challenge during my time was not being able to check the forecast so you just had to guesstimate by looking at the sky each day and adjust accordingly.



The food was delicious and plentiful (self serve, so you can take as much as you want or go back for more). All the meals were vegetarian (Buddhist don't believe in killing any sentient being, which includes animals). I honestly did not miss having meat at all. We will see how I feel about that after nine weeks in Chanaute. Each morning for breakfast we mixed up a bowl with dry cereal grains, nuts, and raisins with a rice and/or oatmeal congee. A congee is a soupy rice or oat dish that has enough moisture to soften up the dry cereal. I always added a big spoonful of peanut butter to mine. One day we also got a hard boiled egg. See picture below of my typical breakfast.


For lunch and dinner we had rice or noodle dishes or stews with lots of in season vegetables. Sometimes there was monos, which are small stuffed pastries. The dishes always had flavorful Indian or Asian spices. Most dishes included flatbread or regular breads (although the one day I took a photo of my lunch we had pizza). Everything was made fresh here at Kopan. The milk and butter came from the cows raised here. It would have been challenging to eat completely gluten free here, so I just tried to minimize how much.



We also had a selection of tea with all meals, including jasmine, black, mint, and a delicious milk tea.

The Kopan grounds include the monastery, a nunnery, a school, bookstore, library, general store, a garden, stupas, gompas, and some cows. One day I walked within 10 feet of a bull eating some grass along the pathway to my room. However, the cows normally are further from the lodges that house the retreat visitors.



The sounds of Kopan: monks chanting, bells ringing, birds singing, crickets chirping, children playing, people working, music playing, people talking, roosters crowing, dogs barking (the last two unfortunately are during the night and early morning). Earplugs are necessary at night.

The cost of Kopan: so how much does a ten day all inclusive retreat cost you ask. If you stay in a private room with private bath, it will set you back about $210 for the entire stay or about $21 per day. If that's too pricey, you can save some if you are willing to take a private room with shared bath, and if you want to commune with others, you can stay for $140 ($14/day) in a dorm room. Yes, that includes all your meals also.

There is one downside to staying in Kopan and Nepal in general. Air quality was not that great at times. Nepali's apparently don't have trash collection so they must burn their trash. This means that one will sometimes smell the not so pleasant or healthy smell of burning plastic and other garbage, which is definitely a concern if anyone has asthma or other breathing issues.

In addition to the 10 day course, Kopan also offers a 7 day intro course that doesn't include the 2 days of silent retreat, and anyone can also come and look into setting up their own private retreat. For more information about Kopan, go to www.kopanmonastery.com



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Location:Jyatha,Kathmandu,Nepal

Greetings from Kopan Monastery

Just a quick post to let everyone know that I have arrived at Kopan and have begun my meditation retreat. In order to maximize my retreat, I've been instructed to remain offline for the next 9 1/2 days until the end of the retreat. I'll post my next update on the 13th.


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Arrived Safely in Kathmandu, Nepal

Just a quick post to let everyone know that I have arrived safely in Kathmandu tonight. The flight was on time and uneventful, just as I like them. I was able to quickly secure my visa for 90 days, claim my baggage and connect with my arranged ride to the Hotel Osho Home.



The only minor exception to this smooth travel day was when a local guy on a motorcycle hit a bump in the road and slide his bike down and across the pavement just as he was trying to pass us. Fortunately he got right up and after a short stop to make sure he was alright we continued on our way.

Tomorrow I start my meditation retreat so I don't know if I will have the opportunity to post any updates during the next ten days but will provide an update once I am able.



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Location:Jyatha,Kathmandu,Nepal

Stopover in Doha, Qatar

Today I arrived safely in Doha, Qatar via Qatar Airlines on a direct flight from Chicago. The flight was just over 13 hours long. I was very fortunate in that the flight was not completely full so I was able to have the center row of three seats all to myself. This helped me get more rest than I would've otherwise as unfortunately I cannot sleep sitting up. This still presented challenges for my 6' 1" frame as the armrest did not fully retract upwards on the Boeing 777 and the bucket seats created an uneven sleeping surface that pressed into my rib cage and my hip. But I'm still very grateful for the extra space all the same. Upon deplaning I got the opportunity to feel the oppressive Qatar heat. The temperature was 103°F today as we exited onto the tarmac to board the shuttle bus. The low will be 91 tonight.

Brief observations from the Hamad international airport: The airport is almost brand-new as it was just completed in 2014. The center of the airport is like a mall. There are lots of shops, restaurants, a food court, hotel and spa, as well as play areas for children. For some reason at the duty-free shop it seems like they have more than enough staff to help the customers, so much so that many of the staff are gathered in small groups of 2 to 4 employees and are standing around chatting like they were just hanging out as opposed to at work.




One other thing that I observed at the duty-free shop is that all the cigarette cartons have bold blunt messages that take up half of the carton and warn customers of the hazards of smoking (see some of the attached pictures for example). I wish all countries would require similar messages on their cigarette cartons.









Fast facts about Doha; first established in 1825, the population currently is about 900,000. Doha means "the big tree" and it is located on the Persian golf. It's Qatar's fastest growing city and had been the capital since 1971.

Fast facts about Qatar: richest country in the world per capita. Has the third largest natural gas and oil reserves. Area comprises just under 5000 square miles and sits between Saudi Arabia and the Persian Gulf. Total population is about 2.2 million currently.





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Location:Doha,Qatar