Saturday, October 31, 2015

Robbed (of an extra hour of sleep)

Nepal is one of just a few countries that do not observe daylight savings time. Unfortunately for me, that hour of sleep I gave up earlier this year when we sprung forward will forever be lost while all of you back in the states will be enjoying sleeping in tomorrow. Technically, I'll get it back when I fly home, but I'll be so jet lagged that I won't be able to appreciate it.

Speaking of time, Nepal is also one of the few countries that sets its clock in such a way that they are off by 15 or 45 minute increments from the rest of the world as you can see from this screen capture of various cities in different time locations:










From the brief online research that I've done, it appears this was done intentionally to differentiate Nepal as a separate and sovereign nation from its neighbor India.

As of tomorrow I will be 11:45 minutes ahead of Chicago, which means that instead of just feeling like I'm halfway around the world, I really will be halfway around the world at least from a time perspective (okay, technically I'm still 15 minutes shy of being a true half day away).

For those curious, here is the list of countries or territories that have time zones on the half hour or quarter hour from UTC (Coordinated Universal Time).

India: UTC +5:30
Standard time: India Standard Time (IST)
Daylight time: None
Example city: New Delhi

Australian States:
Australia has multiple time zones. Some of them are half-hour and quarter-hour time zones. Not all states and territories use DST.
Northern Territory: UTC +8:45
Standard time: Australian Central Standard Time (ACST)
Daylight time: None
Example city: Darwin
Eucla: UTC +8:45
Standard time: Australian Central Western Standard Time (ACWST)
Daylight time: None
Example city: Eucla
South Australia: UTC +9:30 / +10:30
Standard time: Australian Central Standard Time (ACST)
Daylight time: Australian Central Daylight Time (ACDT)
Example city: Adelaide
Broken Hill: UTC +9:30 / +10:30
Standard time: Australian Central Standard Time (ACST)
Daylight time: Australian Central Daylight Time (ACDT)
Example city: Broken Hill
Lord Howe Island: UTC +10:30 / +11:00
Standard time: Lord Howe Standard Time (LHST)
Daylight time: Lord Howe Daylight Time (LHDT)
Example city: Lord Howe Island

Cocos (Keeling) Islands: UTC +06:30
Standard time: Cocos Islands Time (CCT)
Daylight time: None
Example city: Bantam

New Zealand, Chatham Islands: UTC +12:45 / +13:45
Standard time: Chatham Island Standard Time (CHAST)
Daylight time: Chatham Island Daylight Time (CHADT)
Example: Chatham Islands

Canada, Newfoundland: UTC -3:30 / -2:30
Standard time: Newfoundland Standard Time (NST)
Daylight time: Newfoundland Daylight Time (NDT).
Example: St. John's
NOTE: Only the island of Newfoundland and a few regions of Labrador follow NST/NDT. The rest follow Atlantic Time (AST) and Atlantic Daylight Time (ADT).

Sri Lanka: UTC +5:30
Standard time: India Standard Time (IST)
Daylight time: None
Example city: Colombo

Afghanistan: UTC +4:30
Standard time: Afghanistan Time (AFT)
Daylight time: None
Example city: Kabul

Iran: UTC +3:30 / +4:30
Standard time: Iran Standard Time (IRST)
Daylight time: Iran Daylight Time (IRDT).
Example city: Tehran

North Korea: UTC +8:30
Standard time: North Korea Time
Daylight time: None
Example city: Pyongyang

Myanmar: UTC +6:30
Standard time: Myanmar Time (MMT)
Daylight time: None
Example city: Naypyidaw

Venezuela: UTC -4:30
Standard time: Venezuelan Standard Time (VET)
Daylight time: None
Example city: Caracas

Nepal: UTC +5:45
Standard time: Nepal Time (NPT)
Daylight time: None
Example city: Kathmandu

French Polynesia, Marquesas Islands: UTC -9:30
Standard time: Marquesas Time
Daylight time: None
Example city: Taiohae



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Location:Nepal

Thursday, October 29, 2015

My Halloween Costume (sort of)

I had originally planned to title this post "Darth Vader" although really Hannibal Lecter is probably closer to how I look. That being said, this is not a costume but a means of protecting my lungs from the high level of air pollution while I was in Kathmandu.



I must admit that I felt pretty silly wearing this at first, but I would estimate that approximately 10% of the population in Kathmandu wears some sort of mask to filter out harmful pollutants when they are out and about on the streets. Thus, I gather more attention because of my pale white skin than I do by wearing this mask on the busy streets of Kathmandu. If people knew more about the health risks, the number wearing masks would probably be higher. My guess is that the majority of people wearing these protective masks already have asthma or breathing difficulty that make it necessary to try to protect themselves.

To understand how bad the air quality is, I've posted part of an article below from the Guardian dated March 2014. They had another dire article from April 2015 you can read also if you want to google it.

One topic that is not mentioned in the article and also contributes to the problem is that Nepali's must burn their trash as they do not have trash pickups like we do. Below is a picture of our clinic burning it's trash.



The Guardian Article (excerpt).

Nepal generally evokes images of a pristine mountain nation on top of the world. The thick cloud of pollution that threatens to suffocate Nepal’s largest city, however, provides a stark contrast to this reputation. While there are several environmental crises converging here – severe water shortages, for instance, have become status quo – none is as dire as air quality. In the past 10 years, the number of vehicles on Kathmandu’s streets has risen threefold. The problem has become so acute that many of its 1.74 million residents are left wondering: at what point will their city become unliveable.

Nepal’s air quality ranks 177th out of 178 countries, according to Yale’s 2014 Environmental Performance Index (EPI), better only than Bangladesh. As a physician working in one of Kathmandu’s main teaching hospitals, I see a disproportionate amount of patients with respiratory ailments who are admitted to the wards on a daily basis, the victims of dirty air. Walking to and from work along the crowded, exhaust-choked streets, I sometimes wonder how more people are not sick.

The view from my Kathmandu rooftop certainly seems to bear the EPI findings out. On many days, the relatively close Himalayan mountains are obscured by smog, the brick apartment buildings that form Kathmandu’s skyline shrouded in an oppressive cloud. Those new to Kathmandu frequently complain of sore throats and itchy eyes within a few days of arrival.

“I see rapid changes each time I return,” says Anobha Gurung, a Kathmandu-born doctoral candidate at Yale who is studying the air quality in her home city. “Now it is a common sight to see a gray haze for the valley, especially during the winter months, and city residents venturing out of homes wearing masks.”

Gurung and her colleagues have found that during surges in Kathmandu traffic congestion, the level of small particulate matter can measure over 500 micrograms per cubic metre, or 20 times the World Health Organisation’s safe upper limit. By comparison, the recent smog alarm that led Paris to ban cars peaked at just over a fifth of that level: 110 micrograms per cubic metre.

The sight of Kathmandu residents wearing masks is an increasingly common sight.

Further data is hard to come by. Nepal’s government has several monitoring stations throughout the city, but they have been abandoned for at least six years. Samir KC, a Nepali researcher based in Vienna who has studied pollution and monitoring in Kathmandu, says the monitors were allowed to fall into disrepair. “During our [study], we found that the repair was done and it was up to the government to pay the bill and start the monitoring,” he said. “Nothing happened.”

Most of the research on air quality in Nepal focuses on indoor pollution: cooking fires are ubiquitous in the countryside. In the capital, however, this may be misleading. “Cooking fires are definitely not the cause, as most households use [propane] gas,” says Samir KC. “Suspended particles including dust, exhaust from vehicles and diesel generators are the main culprits.” Of these, it is vehicle congestion that is most strongly correlated to worsening air quality, according to Gurung’s research.

Findings such as these pose a developmental conundrum for governments intent on modernising. It is one thing to stamp out indoor cooking fires as part of the path towards progress. It is quite another, especially in Asian cities that are increasingly oriented around cars, to try to reduce the emissions that come hand-in-hand with industrialisation and urbanisation.

What’s more, modernisation has also fuelled the appetite for electricity, yet infrastructure has not kept pace. Kathmandu endures daily, scheduled “brownouts”. This has had the predictable consequence of driving people to use generators: when the power goes off, their dull roar can be heard throughout the city, pumping yet more toxic fumes into the air.

At present, the Nepali government is either unwilling or unable to make changes. Urban planning of the kind that addresses ecological issues is largely absent. But the situation is not lost on ordinary Nepalis. Daily, newspapers print letters decrying the situation and demanding better from elected officials. Air quality is a frequent topic of conversation here; facemasks are so commonplace, they are now sold in trendy designer styles made of patterned cloth. Other people use scarves to shield their faces.

In the hospital, for the time being Ajay continues to gasp for air. For smokers with COPD, one of the only effective interventions that improves longevity is to quit smoking. But Ajay and those like him have no cigarettes to give up. The air they breathe is making them sick. For them, the question of whether the city will become unliveable is moot. It already is.


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Friday, October 23, 2015

Final 24 Hours in Pokhara

My time has run out quickly here in Pokhara but in the past 24 hours I was able to check out Devi Falls then make my way over to the International Mountain Museum.



The museum has exhibits on how the Himalayas were formed; the different Sherpa tribes and info on their culture; the 14 peaks in the world that are over 8000 meters and who and when were the first ascenders to summit them; as well as the impact of climate change and especially the effects of black carbon on the Himalayas. Before I went to the museum, I read some reviews which were almost all positive, but one person commented that they felt like the admission price was high for what you got. I spent about 2 hours in the museum and the cost was $400 NPR or roughly $4 USD. I'd say it was quite a bargain.



Quick summary on black carbon is that it comes from the burning of any fuel source that does not fully combust, like firewood or diesel fuels. Much of the black smoke you see here in Nepal ultimately settles on the Himalayan snow which causes it to warm faster (black absorbs light, white reflects it), thus causing the snow or glaciers to melt faster.
I also uploaded a couple of short video snippets from the museum showing how India was once it's own separate continent and when it slammed into Eurasia, the Himalayas were formed, which is the youngest mountain range on the planet.

You can cut and paste this link if you wish to check them out. https://www.youtube.com/user/chiguydave1/

This morning I got up early one last time to take a ride up to Sarangkot to see one final sunrise over the Annapurna range as well as a view over Pokhara and Lake Phewa (which you can't see from the Australian camp) before heading to the airport for my flight back to Kathmandu.






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Location:Baidam Rd,,Nepal

Trekking Day 2 (of 2)

After departing the Australian camp, my guide Padam led me on a very scenic hike back down towards the road where I would ultimately catch my ride back to Pokhara. Whereas my first day had been all uphill at an often steep incline, my second day was mostly downhill at a more gentle decline which was nice. It afforded me with plenty of opportunities to view the Himalayan peaks throughout the morning.



In addition to the beautiful hike, I had an opportunity to swing one of the giant bamboo swings that seem to be very popular in Pokhara area as they are all over the place (we probably passed at least 10 during our hike, most of which were being used by the locals of all ages from kids to adults). This was the only one that was vacant when we came across it).



During the hike we passed many terraced farms and at times we passed some local Nepalis, a few of whom were likely on their way to visit family for the Dashain festival as they were dressed up in nice bright colorful clothes.
There was one section of the second day where we did hike upwards (roughly 50 flights) to where the mountain jutted out over the valley where we stopped to eat. Afterward I had the opportunity to receive a blessing with a Tikka placed on my forehead by the mother of the family who ran the restaurant and inn where we had enjoyed lunch. According to tradition, the wearing of Tikka invokes a feeling of sacredness on the wearer and on the people with whom the wearer comes into contact. While some Hindus wear a Tikka on their forehead everyday, everyone receives a much larger and prominent Tikka on the Dashain holiday (they ranged in size with many covering 30-60% of the person's forehead). Mine fortunately was more the normal non-festival size.



After that, it truly was all downhill as we hiked down toward the Seti River (Seti means white as the water comes from the mountain snow melt). My guide had a taxi waiting for me when we got to the end of the trail where we parted ways (he actually lived nearby to the trail end and walked home from there). My second day of hiking covered 9.6 miles and 24,000 steps.



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Thursday, October 22, 2015

Sunrise at Australian Camp

Yesterday afternoon after arriving at the Australian camp (apparently so named because it was the first place where Australians camped in the Annapurna region), it became cloudy and foggy on the mountain side and even rained a little bit. My guide informed me that this was a good sign that we would have a clear view in the morning at sunrise. I decided it was best not to get my hopes up so as not to be disappointed.
When my alarm went off at 5:45 am, about 30 minutes before sunrise, I half glanced out the window and it appeared to be a foggy morning so I hit the snooze on my phone alarm. About 5 minutes later I decided to look out the window again and was pleasantly surprised to see I could clearly see the mountains so I quickly got dressed and ran to the roof and took this picture.



I then went down to a landing and was about to head along a trail to get a good vantage point when it hit me. I was walking in "moderately tall wet grass" and I'd better check and make sure I hadn't picked up any hitchhikers! Sure enough I found a little blood sucking leech clinging to the side of my hiking boot and inching his way as fast as he could toward my ankle. I tried to flick him off a couple of times with my fingernail but he wouldn't let go. So sadly, once again I found a rock nearby on the trail and squashed the slimy little guy.
Bad karma aside, I then went down the trail trying my best to avoid the grass and watched the glorious sunrise while enjoying the views of the huge snowy face of Annapurna South and the sacred peak of Machapuchare (also known as Fish Tail Peak).









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Wednesday, October 21, 2015

Trekking Day 1 (of 2)

Today I trekked from Phedi to a place called the Australian camp. My guide and I started at an altitude of 1100m/3600'and hiked uphill almost the entire time to an altitude of 1880m/6170'. Total hiking time was less than three hours (although we stopped for lunch so the total trip took about 4.5 hours) and involved climbing the equivalent of 226 floors, taking 13,415 steps and walking a little over 5 miles (according to my iPhone).
The first hour was the toughest because it was nonstop stairs (the stairway was made of large rocks). Unfortunately, the clouds hid the Himalayas from view excluding a brief glimpse of some of the peaks on the drive to the trail head (of which you can barely see part of the peaks when we stopped for a quick picture).






The second picture was taken at about the 1/3 mark of my trek this morning. You can roughly see how far I'm already above the river from where we started.





Probably the most interesting thing that happened today was when a group of Trekkers who were going in the opposite direction and had come from the Australian camp reported finding blood sucking leeches clinging to their ankles or in their shoes. Apparently leeches can squeeze their way through the stretchable weave that is common on many running or hiking shoes and also through socks. One woman told me she saw the leech just as it was burrowing into her shoe top. Needless to say she freaked and quickly ripped off her shoe and sock and pulled the little blood sucker off.
Tomorrow we will do a longer trek and hopefully get a better view of the Himalayas (if the weather cooperates) while also doing our best to avoid long wet grass where leeches like to hang out until a juicy meal walks by!

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Tuesday, October 20, 2015

Holiday Adventure to Pokhara

The clinic is closed for the Dashain Festival so I've taken this opportunity to travel from Chanaute to Kathmandu and then on to Pokhara. After another 4.5 hour adventure on the bus from Chanaute (this one involved stopping in Melamchi on the side of the road for 30 minutes for some unknown reason and then taking a different route on to Kathmandu that literally involved driving up the side of a mountain on a very narrow single lane road that often gives the driver almost no room for error before you would plunge anywhere from 30 to 100+ feet down the side of the mountain).

I then spent the night in Kathmandu and after taking care of some much needed personal care, like getting my hair cut for the first time in 7 weeks (by a barber who scissor cut both top and sides and charged me $150 Napali Rupees or the equivalent of $1.50 U.S. - I tipped him another $350) and then getting a 90 minute massage for $320 NPR / $32 U.S., I was then off to the airport for the 30 minute flight to Pokhara.

During the flight I was able to get my first glimpse of the snow peaked Himalayas, although there were lots of clouds partially obstructing my view as you can see.




After settling into my budget hotel, I was off to check out lake Phewa (see picture at bottom of this post) and the nearby sites (like this giant bamboo swing) and then get some dinner.




Here is some more info on Pokhara from Wikipedia:

Pokhara (Nepali: पोखरा) is the second largest city of Nepal after Kathmandu. It is the headquarters of Kaski District, Gandaki Zone and the Western Development Region. It lies 200 km west of Kathmandu; its altitude varies from 780 m to 1350 m. Three out of the ten highest mountains in the world — Dhaulagiri, Annapurna I and Manaslu — are within a linear distance of 50 km from the city. Due to its proximity to the Annapurna mountain range, the city is also a base for trekkers undertaking the Annapurna Circuit through the ACAP region of the Annapurna ranges in the Himalayas.

Pokhara is home to many Gurkha soldiers. It is the most expensive city in the country, with a Cost of Living Index of 95.




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Sunday, October 18, 2015

Flying Snitch

Harry Potter would be proud. Tonight I was finally able to capture an elusive flying snitch (on camera at least). Actually catching one in your hands would be way too gross! Just in case anyone reading this had never seen any of the Harry Potter movies or read the books, a snitch is a small flying orb that is part of the game of Quidditch. In the movie, Harry must capture the snitch to win the game.

Here in Chanaute, there is a very large bug of some sort that has got to be one of the most uncoordinated bugs on the planet as I swear this bug is constantly bumping into walls and rolling or falling over onto his back and spending the next five minutes trying to roll back over. On the ground he looks like a giant cockroach.

Here is a slow motion video of the bug flying. What do you think? Doesn't he remind you of a snitch?

YouTube Video

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Mountains and Monkeys

Yesterday afternoon I went on my furthest and most strenuous hike since I've been in Nepal (just under four hours). Once again I was led by Karki, my 13 year old guide, who I've come to believe must be part jack rabbit and part mountain goat, the way he nimbly scales the steep and often slippery trail (in a pair of flip flops no less!). I was already breathing hard and we hadn't even gone a quarter mile. Fortunately, we came to a clearing where the local villagers were working in the dried out rice paddies and I pulled out my phone to snap a few pictures and catch my breath (see also the pictures in the Harvest Time post).






From here the trail flattened out for a while and then we came to a road. The road was often very steep, but at least it wasn't slippery and my guide steadied his pace down from jack rabbit to simply mountain goat speed thankfully. As we moved higher into the mountains the view was simply amazing. One thing I noticed was that from this vantage point I could see many more dwellings. From the valley it appeared like there were just a handful of homes along the mountainside, but now I was able to see roughly a hundred or more huts dotting the mountain landscape.






We kept going until we rounded over to the far side of the mountain and came to a small waterfall at which point we had been hiking for almost two hours and we needed to turn back in order to get back before dusk.
While the hardest part about going up the mountain was the ever thinning air, the hardest part about going down the mountain is the pounding your feet and knees take. I definitely understand now why I've been treating so many people with knee pain in the clinic. Even 13 year old Karki's knees started bothering him as we journeyed ever downward.
We reached a point in the road where we were surrounded by woods and I asked Karki if he had ever seen any monkeys in the area (I'd been told by a prior volunteer that the forrest was filled with mean monkeys). Sure enough, not 10 minutes later Karki spotted a monkey in the trees that I would have never seen on my own. Over the next few minutes we spotted several more. Mostly in the trees but one off to the side of the road further up.
Three and a half hours after we started we returned to Chanaute. According to my iPhone, we hiked almost seven miles, climbed the equivalent of 158 flights of stairs (which means we also descended the equivalent of 158 flights on the return) and took 16,000 steps. Not bad for an afternoon hike!


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Saturday, October 17, 2015

Harvest Time

As you can see from the pictures I've posted in today's post, it's harvest time for the thousands of rice paddies. After the paddies have been completely drained and allowed to dry, the plants are cut by hand and set on their side to further dry out. The stalks are then gathered and piled into hut like structures to keep them dry until they can be sent for processing. Every step of the harvesting process is done by humans including the carrying of the plants to the processing location. Click on the link below to see a complete detailed explanation of the rice planting and harvesting process.

















And one more photo taken a bit later to show the stalks being transported.



http://www.nationalgeographic.com/xpeditions/lessons/15/gk2/rhythmriceteacher.pdf


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Thursday, October 15, 2015

Dashain Festival

The Dashain Festival is in full swing here in Nepal. The kids were let out of school starting yesterday and won't return until about the 25th I think. The number of patients in the clinic has dropped from an average of 20+ per day to just 6 yesterday and 12 today. Below is some interesting information on the holiday that I found on visitnepal.com. I'm curious to see what the coming few days bring. This morning I saw a large black water buffalo being led into town. I'm afraid he is likely to be sacrificed for the festival based on what I've read (my understanding is that all the animals sacrificed will be consumed, not simply sacrificed for the festival).

Dashain Festival in Nepal and Information how it is celebrated - VisitNepal.com

Dashain Festivals in Nepal
During the month of Kartik (late September and early October), the Nepalese people indulge in the biggest festival of the year, Dashain. Dashain is the longest and the most auspicious festival in the Nepalese annual calendar, celebrated by Nepalese of all caste and creed throughout the country. The fifteen days of celebration occurs during the bright lunar fortnight ending on the day of the full moon. Through out the kingdom of Nepal the goddess Durga in all her manifestations are worshiped with innumerable pujas, abundant offerings and thousands of animal sacrifices for the ritual holy bathing, thus drenching the goddess for days in blood.

Dashain commemorates a great victory of the gods over the wicked demons. One of the victory stories told is the Ramayan, where the lord Ram after a big struggle slaughtered Ravana, the fiendish king of demons. It is said that lord Ram was successful in the battle only when goddess Durga was evoked. The main celebration glorifies the triumph of good over evil and is symbolized by goddess Durga slaying the terrible demon Mahisasur, who terrorised the earth in the guise of a brutal water buffalo. The first nine days signify the nine days of ferrous battle between goddess Durga and the demon Mahisasur. The tenth day is the day when Mahisasur was slain and the last five days symbolise the celebration of the victory with the blessing of the goddess. Dashain is celebrated with great rejoice, and goddess Durga is worshiped throughout the kingdom as the divine mother goddess.

In preparation for Dashain every home is cleansed and beautifully decorated, painted as an invitation to the mother goddess, so that she may visit and bless the house with good fortune. During this time the reunion of distant and nearby relatives occur in every household. The market is filled with shoppers seeking new clothing, gifts, luxuries and enormous supplies of temple offering for the gods, as well as foodstuffs for the family feasting. Thousands of sheep, goats, ducks, chicken and water buffalo are prepared for the great slaughter. All types of organisations are closed for ten to fifteen days. Labourers are almost impossible to find; from the poor to the rich, all enjoy the festive mood. Anywhere you go the aroma of 'Vijaya Dashami' is found.

The first nine days of Dashain are called Nawa Ratri when tantric rites are conducted. In Nepal the life force is embodied in the divine energy and power of the female, depicted as goddess Durga in her many forms. All goddess who emanated from goddess Durga are known as devis, each with different aspects and powers. In most mother goddess temples the deity is represented simply as a sacred Kalash, carved water jug or multiple handed goddess holding murderous weapons. During these nine days people pay their homage to the goddess. If she is properly worshiped and pleased good fortunes are on the way and if angered through neglect then misfortunes are around the corner. Mother goddess is the source of life and everything.

The first day of Dashain is called Ghatasthapana, which literally means pot establishing. On this day the kalash, (holy water vessel) symbolising goddess Durga often with her image embossed on the side is placed in the prayer room. The kalash is filled with holy water and covered with cowdung on to which seeds are sown. A small rectangular sand block is made and the kalash is put in the centre. The surrounding bed of sand is also seeded with grains. The ghatasthapana ritual is performed at a certain auspicious moment determined by the astrologers. At that particular moment the priest intones a welcome, requesting goddess Durga to bless the vessel with her presence.

The room where the kalash is established is called 'Dashain Ghar'. Generally women are not allowed to enter the room where Dashain puja is being carried out. A priest or a household man worships the kalash everyday once in the morning and then in the evening. The kalash and the sand are sprinkled with holy water everyday and it is shielded from direct sunlight. By the tenth day, the seed will have grown to five or six inches long yellow grass. The sacred yellow grass is called 'Jamara'. It is bestowed by the elders atop the heads of those younger to them during the last five days when tika is put on. The jamara is taken as a token of Goddess Durga as well as the elders blessing.

As days passes by regular rituals are observed till the seventh day. The seventh day is called 'Fulpati'.

In fulpati, the royal kalash filled with holy water, banana stalks, jamara and sugar cane tied with red cloth is carried by Brahmans on a decorated palanquin under a gold tipped and embroidered umbrella. The government officials also join the fulpati parade. With this the Dashain feasting starts.

The eighth day is called the Maha Asthami: The fervour of worship and sacrifice to Durga and Kali increases. On this day many orthodox Hindus will be fasting. Sacrifices are held in almost every house through out the day. The night of the eighth day is called 'Kal Ratri', the dark night. Hundreds of goats, sheep and buffaloes are sacrificed at the mother goddess temples. The sacrifice continues till dawn. While the puja is being carried out great feasts are held in the homes of common people where large amount of meat are consumed.

The ninth day is called Nawami: Temples of mother goddess are filled with people from dawn till dusk. Animals mostly black buffaloes are slaughtered to honour Durga the goddess of victory and might and to seek her blessing. Military bands play war tunes, guns boom and officers with beautifully decorated medals in full uniform stand there. When the function ends the courtyard is filled ankle deep with blood. On this very day the god Vishwa Karma, the God of creativity is also worshiped. All factories, vehicles, any machinery instruments and anything from which we make a living are worshiped. We also give sacrifices to all moving machinery like cars, aeroplanes, trucks etc. to get the blessing from goddess Durga for protection for vehicles and their occupants against accidents during the year. The entire day is colourful.

The tenth day is the Dashami: On this day we take tika and jamara from our elders and receive their blessing. We visit our elders in their home and get tika from them while our younger ones come to our home to receive blessing from us. The importance of Dasain also lies in the fact that on this day family members from far off and distant relatives come for a visit as well as to receive tika from the head of the family. This function continues for four days. After four days of rushing around and meeting your relatives Dashain ends on the full moon day, the fifteenth day. In the last day people stay at home and rest. The full moon day is also called 'Kojagrata' meaning 'who is awake'. The Hindu goddess of wealth Laxmi is worshipped. On this day the goddess Laxmi is given an invitation to visit each and everyone.

After Dashain everyone settles back to normal. After receiving the blessing of goddess Durga, people are ready to work and acquire virtue, power and wealth. Dashain thus is not only the longest festival but also the most anticipated one among all the festivals of Nepal.

~ Article by Avigya Karki




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Wednesday, October 14, 2015

Journey and Blog Goals Midpoint Review

Today marks the end of the first half of my journey to Nepal. So today I thought I'd revisit my goals for this journey and also
my blog.

#1 - To provide the people of Chanaute and the nearby villages who have very limited access to healthcare with an additional affordable healthcare option by offering acupuncture and herbal medicine.
#2 - To help educate the local Nepalis on health risks they face and how to try to avoid them.
#3 - To show the people of Nepal that the world hasn't forgotten them after the devastating earthquake last spring and to restart the line of acupuncture volunteers after a nearly five month break without anyone to provide acupuncture.

I mostly feel that I'm achieving my first goal although I've had to work without a full time translator, which has definitely made this more challenging. The second goal is even more difficult without a strong translator, so I've not been able to make much progress here. On the last goal, I've been able to restart acupuncture treatments here after a 5 month gap, however, there is no word yet on if someone is lined up to take my place after I depart.

As for my blog, in a perfect world I would have set out some goals for this before I started writing it, but instead I've been shooting from the hip and hoping I hit the target (i.e. posting things that are worth reading). So today I finally gave it some thought and here is what I hope you get out of this blog.
#1 - To provide my family and friends a way to follow my journey and know that I am safe, especially in light of of recent events in Nepal last spring.
#2 - To learn about the people, politics, religion, and culture of Nepal and what it's like to live in a rural village in one of the poorest countries in the world.
#3 - To learn a little about Buddhist philosophy and the Hindu religion that the majority of the Nepalis practice.
#4 - To share the beauty of Nepal, both it's geography and it's people.
#5 - To provide everyone who donated to Mindful Medicine Worldwide to help make this trip possible with feedback on how their donations have helped the people of Chanaute and the nearby villages.
#6 - To inspire others to volunteer their time to benefit others in whatever way possible, big or small.
#7 - Where possible, to share information that helps you understand your own body and health a little better.
#8 - To make you laugh or at least bring a smile to your face.

On that note I'll conclude with a couple of pictures of my hiking guides from last Saturday (Karki, age 13 and Suman, age 12). The panoramic picture utilizes a little trick to make the subjects look like they're in two different places at once.












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Monday, October 12, 2015

Intro to Hinduism

In my earlier post I shared my experience at the Kopan Monastery and some of the teachings of the Tibetan Buddhist philosophy. In preparation for next weeks Dashain festival, which is the major Hindu festival celebrated each year in Nepal, I thought I would share a brief description of the Hindu religion in my blog today (since over 80% of Nepalis are Hindu, including the majority in Chanaute). The following was taken from two websites, the Smithsonian Institute and Hinduism Today.

Most Hindus believe in an immense unifying force that governs all existence and cannot be completely known by humanity. Individual gods and goddesses are personifications of this cosmic force. In practice, each Hindu worships those few deities that he or she believes directly influence his or her life. By selecting one or more of these deities to worship, and by conducting the rituals designed to facilitate contact with them, a Hindu devotee is striving to experience his or her unity with that cosmic force.

While scholars, philosophers, and priests debate the finer points of Hindu theology, lay worshipers call upon familiar gods to help with their everyday hopes and problems.

There are three primary Hindu deities:

Shiva
Shiva (the Creator and Destroyer), who destroys the old while creating the new. His consorts include the loving Parvati and the ferocious Durga, who represent the feminine aspects of his complex nature.

Vishnu
Vishnu (the Preserver) and his two most popular incarnations, Krishna and Rama.

Devi/Parvati
Devi (the Protecting Mother), sometimes known simply as the Goddess, who appears in some form in every region of India. She is often identified as the creative energy of the universe, and is considered by her followers the equal of Vishnu and Shiva.


Hinduism was born in India, but it was not founded by one individual. Rather, it is the fusion of many religious beliefs and philosophical schools. Accordingly, Hinduism is said to be a religion of a million and one gods. Its origins are mixed and complex.

Satguru Sivaya Subramuniyaswami, Hinduism Today's founder, assembled these beliefs, a creed shared by most Hindus, to summarize a vast and profound faith. He wrote, "The Hindu is completely filled with his religion all of the time. It is a religion of love. The common bonds uniting all Hindus into a singular spiritual body are the laws of karma and dharma, the belief in reincarnation, all-pervasive Divinity, the ageless traditions and our Gods. Our religion is a religion of closeness, one to another, because of the common bond of loving the same Gods. All Hindu people are of one family, for we cannot separate one God too far from another. Each in His heavenly realm is also of one family, a divine hierarchy which governs and has governed the Hindu religion from time immemorial, and will govern Sanatana Dharma on into the infinite. The enduring sense of an ever-present Truth that is God within man is the essence of the Sanatana Dharma. Such an inherent reality wells up lifetime after lifetime after lifetime, unfolding the innate perfection of the soul as man comes more fully into the awakened state of seeing his total and complete oneness with God."

1 Reverence for Our Revealed Scriptures

Hindus believe in the divinity of the Vedas, the world's most ancient scripture, and venerate the Agamas as equally revealed. These primordial hymns are God's word and the bedrock of Sanatana Dharma, the eternal religion which has neither beginning nor end.

2 All-Pervasive Divinity

Hindus believe in a one, all-pervasive Supreme Being who is both immanent and transcendent, both Creator and Unmanifest Reality.

3 Three Worlds and Cycles of Creation

Hindus believe there are three worlds of existence--physical, astral and causal--and that the universe undergoes endless cycles of creation, preservation and dissolution.

4 The Laws of Karma and Dharma

Hindus believe in karma--the law of cause and effect by which each individual creates his own destiny by his thoughts, words and deeds--and in dharma, righteous living.

5 Reincarnation and Liberation

Hindus believe that the soul reincarnates, evolving through many births until all karmas have been resolved, and moksha--spiritual knowledge and liberation from the cycle of rebirth--is attained. Not a single soul will be eternally deprived of this destiny.

6 Temples and the Inner Worlds

Hindus believe that divine beings exist in unseen worlds and that temple worship, rituals, sacraments as well as personal devotionals create a communion with these devas and Gods.

7 Yoga Guided by a Satguru

Hindus believe that a spiritually awakened master, or satguru, is essential to know the Transcendent Absolute, as are personal discipline, good conduct, purification, pilgrimage, self-inquiry and meditation.

8 Compassion and Noninjury

Hindus believe that all life is sacred, to be loved and revered, and therefore practice ahimsa, "noninjury."

9 Genuine Respect for Other Faiths

Hindus believe that no particular religion teaches the only way to salvation above all others, but that all genuine religious paths are facets of God's Pure Love and Light, deserving tolerance and understanding.

Below is a picture of the Hindu temple that is across the road from the clinic and is the temple for the village here in Chanaute.




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The End of the Story (for this topic, I promise)

If you have been following my blog all along, you've read my comments about adjusting to the Asian style toilet here in Chanaute. Since it's not a topic people generally like to talk about, I had planned to put the topic to rest. However, as fate would have it, I started reading an ebook entitled "GUT: The Inside Story of Our Body’s Most Underrated Organ" by Giulia Enders. I purchased this ebook a ways back, but with school and board exams I'm just now getting into it. In the book, the author gives an insightful explanation of why squatting is beneficial, and for the benefit of all reading this blog, I felt it was my duty as a health care practitioner to give you the end of the story so to speak. Bad pun intended.




Are You Sitting Properly?

It’s a good idea to question your own habits from time to time. Are you really taking the shortest and most interesting route to the bus stop? Or, indeed, are you sitting properly when you go to the toilet? There will not always be a clear, unambiguous answer to every question, but a little experimentation can sometimes open up whole new vistas. That is probably what was going through the mind of Dov Sikirov when the Israeli doctor asked twenty-eight test subjects to do their daily business in three alternative positions: enthroned on a normal toilet; half-sitting, half-squatting on an unusually low toilet; and squatting with no seat beneath them at all. He recorded the time they took in each position and asked the volunteers to assess the degree of straining their bowel movements had required. The results were clear. In a squatting position, the subjects took an average of 50 seconds and reported a feeling of full, satisfactory bowel emptying. The average time when seated was 130 seconds and the resulting feeling was deemed to be not quite so satisfactory. Why the difference? The closure mechanism of our gut is designed in such a way that it cannot open the hatch completely when we are seated. There is a muscle that encircles the gut like a lasso when we are sitting or, indeed, standing, and it pulls the gut in one direction, creating a kink in the tube. This mechanism is a kind of extra insurance policy, in addition to our old friends, the sphincters. Some people will be familiar with this kinky closing mechanism from their garden hose. You ask your sister to check why there’s no water coming out of the hose. When she peers down the end, you quickly unbend the kink, and it’s just a few minutes until your parents ground you for a week. But back to our kinky rectal closure mechanism: it means our feces hit a corner. Just like a car on the highway, turning a corner means our feces have to put on the brakes. So, when we are sitting or standing, our sphincters have to expend much less energy keeping everything in. If the lasso muscle relaxes, the kink straightens, the road ahead is straight, and the feces are free to step on the gas. Squatting has been the natural defecation position for humans since time immemorial. The modern sitting toilet has existed only since indoor sanitation became common in the late eighteenth century. But such “cavemen did it that way” arguments are often met with disdain by the medical profession. Who says that squatting helps the muscle relax better and straightens the feces highway? Japanese researchers fed volunteers luminous substances and X-rayed them while they were doing their business in various positions. They found out two interesting things. First, squatting does indeed lead to a nice, straight intestinal tract, allowing for a direct, easy exit. Second, some people are nice enough to let researchers feed them luminous substances and X-ray them while they have a bowel movement, all in the name of science. Both findings are pretty impressive, I think. Hemorrhoids, digestive diseases like diverticulitis, and even constipation are common only in countries where people generally sit on some kind of chair to pass their stool. This is due not to lack of tissue strength, especially in young people, but to the fact that there is too much pressure on the end of the gut. Some people tend to tense up all their abdominal muscles when they are stressed. Often, they don’t even realize they are doing it. Hemorrhoids prefer to avoid internal pressure like that by dangling loosely out of the anus. Diverticula are small light-bulb-shaped pouches in the bowel wall, resulting from the tissue in the gut bulging outward under pressure. Of course, the way we go to the toilet is not the only cause of hemorrhoids and diverticula; however, it remains a fact that the 1.2 billion people in this world who squat have almost no incidence of diverticulosis and far fewer problems with hemorrhoids. We in the West, on the other hand, squeeze our gut tissue until it comes out of our behinds and we have to have it removed by a doctor. Do we put ourselves through all that just because sitting on a throne is more “civilized” than silly squatting? Doctors believe that straining too much or too often on the toilet can also seriously increase the risk of varicose veins, a stroke, or defecation syncope—fainting on the toilet.
A text message I received from a friend who was on holiday in France read, “The French are crazy! Someone’s stolen the toilets from the last three service stations we stopped at!” I had to laugh, first, because I suspected my friend was actually being serious, and second, because it reminded me of my first experience of French squat toilets. “Why am I being forced to squat here when you could just as easily have put in a proper toilet?” I mournfully complained to myself as I recovered from the shock of the emptiness I saw before me. Throughout much of Asia, Africa, and southern Europe people squat briefly over such toilets in a kind of martial arts or downhill skiing pose to defecate. We, by contrast, take so long, we have to while away the time until we’ve finished our business with reading the paper, carefully prefolding pieces of toilet paper for imminent use, scanning the corners of the bathroom to see if they could do with a clean, or staring patiently at the opposite wall. When I read this chapter out to my family in our living room, I looked up to see disconcerted faces. Are we going to have to descend from our porcelain thrones and squat precariously over a hole to poop? Of course not, hemorrhoids or no hemorrhoids! That said, it might be fun to try climbing up onto the toilet seat to do our business while squatting there. But there’s no need for that, either. It is possible to squat while sitting. It’s a particularly good idea when things don’t come so easily, so to speak. To do it, just incline your upper body forward slightly and put your feet on a low footrest placed in front of the toilet, et voilá!—all the angles are correct, and you can read the paper, prefold your tissue, or stare at the wall with a clear conscience.

P.S. - I believe Bed, Bath and Beyond or possibly some other retailer sells a footrest that is specifically designed to place you into a squat like position and then slide under the toilet when not in use. I'm sure if you google it you can confirm. I'd Google it for you, but as is often the case, my internet is down currently.

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Friday, October 9, 2015

Cat Burglar

Last night we had a break in above our clinic where Bina, the midwife, and I live. I was a little shaken at the time, but fortunately no one was hurt and while the burglar got away I don't think he will try to break in again. My best guess on how the burglar got in was that he climbed the tree outside the clinic and came in through the 3 foot opening between the wall and the roof. From there he managed to perform a high wire walk across the 1/4 inch thick plywood wall between Bina's and my room and then scampered down into our kitchen. I was awoken to see the burglar balanced literally 5 feet directly above my head. His clawed feet precariously gripping the edge of the plywood before he leapt into the kitchen. At this point, Bina had awoken and went into the kitchen (her room opens into the kitchen, mine does not) at which point the cat burglar leapt back up onto the plywood wall above my head before scampering across the wall and then escaped outside. Both times I literally thought that this stray cat was going to jump right onto my head, which given his claws, probably would not have been very pleasant.

To make things a little more interesting, two nights earlier I had spotted what I thought was a small stray cat outside next to the rice paddies about 50 feet from my window. I had my flashlight and at first, all I could see were his emerald green eyes glowing in the dark. I kept my flashlight on the cat as he started to move in my direction alongside a path that leads back behind my room. It was when he got closer that I realized that it was a larger cat or animal of some sort as I could see he was about 2 1/2 feet tall. My best guess was it was like a bobcat or something similar. Unfortunately I had my flashlight on low (I generally always keep it on low to preserve the battery) and didn't think to switch it to high, otherwise I might have been able to better identify what kind of animal it was. Better yet, I wish I'd had time to take a picture of it. Whatever it was, it did not appear afraid of me. One local person I spoke to suspected it was a more likely a fox, but I still think that the head and tail were more cat like in size and shape although it was too dark to tell for certain. The local person also told me that a few years ago a tiger found its way up into this area and ate some farmers livestock.

At any rate, having another cat of some sort dangling over my head in the dark of night two nights later definitely had me alarmed. I was pretty sure at the time that this was not the larger cat I'd seen before but I definitely didn't want this cat on top of me. Fortunately that didn't happen. Below is a picture looking up from my bed. The cat's legs were straddling the two pieces of plywood you see that form the corner of my room.



So if you are sitting at home bored and wanting to add some excitement to your life, feel free to come to Nepal.


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Nepal Fuel Crisis Continues

Ever since Nepal promulgated their new constitution, there has been unrest on the Nepal border with India which has resulted in a national fuel crisis. So far the crisis has not affected me, but that will likely change if it continues for much longer as we could run out of cooking gas at some point and I rely on the public bus to get back to Kathmandu.

Below are the latest articles I've seen from Bloomberg and the BBC:

Growing anger in Nepal’s capital over a crippling fuel shortage is prompting the nation’s leaders to reassess their energy strategy -- and ties with southern neighbor India.
Taxis and buses are lining up for miles at empty petrol stations in Kathmandu, with passengers riding on the roofs of overcrowded buses to get around. Airlines have been forced to reroute flights to ensure they have adequate fuel, throwing Nepal’s tourism-dependent economy into turmoil just months after the country’s worst earthquake in eight decades.
“It really forces us to rethink our economic and strategic policies," Madhukar S.J.B. Rana, a former Nepalese finance minister residing in Kathmandu, said by phone. “We are a landlocked country. This can happen to us anytime."
The crisis began two weeks ago, when Nepal promulgated a new constitution that caused disturbances in the southern plains among groups with close ethnic ties to India that feel under-represented. Nepalese newspapers have accused main trading partner India of conducting an unofficial blockade in response, while India says protesters in Nepal are blocking roads and preventing fuel from reaching the capital.
“If this blockage continues, there’ll be a humanitarian crisis very soon," Finance Minister Ram Sharan Mahat said in a telephone interview on Tuesday. "Gasoline, cooking gas, medical supplies -- there is a shortage of essential goods. You can imagine the turmoil."

Nepal decided to bar private cars including trucks and construction vehicles from refueling to ensure a steady supply for buses, ambulances and taxis, the Kathmandu Post reported on Wednesday, citing Nepal Oil Corporation spokesman Dipak Baral.
“There is no blockade by India, either official or unofficial,” Indian Ministry of External Affairs spokesman Vikas Swarup said in an e-mail.
The Himalayan nation relies on India for 60 percent of its imports, including almost all of its oil, prompting a discussion in Nepal about how to ensure the country’s energy security. Nepal’s limited road links to China through the Himalayas have been blocked since the earthquake in April, which caused an estimated $10 billion of damage in the $19.6 billion economy.
"Nepal is not just landlocked -- we are virtually India-locked," Mahat said, adding that northern routes will take months to restore and handle only about 10 percent of the country’s freight.
"This crisis has taught us there should be more diversification," he said. "But this takes time. It cannot happen overnight."
Historically, Nepal has had far closer political and economic ties with India than China. Recently China has made inroads, and last year it overtook India as Nepal’s biggest foreign investor with plans to fund a $1.6 billion hydropower project -- one of biggest outside investments ever in the country.
17 Days
"This disruption of fuel supplies has been an additional burden for an economy that has been devastated this year," said Rajiv Biswas, Asia-Pacific chief economist for IHS Inc. "Although Nepal needs to import oil and gas supplies, it has abundant hydropower potential if sufficient investment can be mobilized."
Nepal’s mountain-fed rivers have the capacity to generate more than 80 gigawatts of hydroelectricity -- enough for its own needs as well as for about a third of India.
Right now, though, the country is in a desperate state: Chronic blackouts force businesses and homes to rely on diesel-powered generators for electricity. Nepal has petroleum stocks for about 17 days, compared with 270 days in Israel, 240 days in South Korea and 137 days in the U.S., according to the Kathmandu Post.
"If you had reliable power from the grid, a lot of the diesel fuel consumption used to generate power would be available for transportation," said Thomas Richardson, the International Monetary Fund’s country representative for Nepal and India.
Flights Re-routed
The April temblor had already caused economic growth to slow to 3.4 percent in the fiscal year ended in July, down from 5.5 percent the previous year, the IMF said in a new estimate released last week. It’s still too soon to say if the current disruptions will further affect that outlook, Richardson said.
Dozens of flights to Kathmandu have been affected in recent weeks. Korean Air Lines Co.’s flights from Seoul are stopping in Bangkok to refuel, Malaysia Airlines’ flights from Kuala Lumpur are refueling in Dhaka, Bangladesh, and SilkAir’s flight from Singapore is refueling in Kolkata. China Southern Airlines Co. halted ticketing through Oct. 10 and China Eastern Airlines Corp. is offering free rescheduling or cancellations through Oct. 24, according to a company statement and media reports.
At least 40 people have died in over a month of clashes between protesters and Nepal’s police. India is "deeply concerned" about the violence and has "consistently argued that all sections of Nepal must reach a consensus on the political challenges confronting them," India said in a Sept. 21 statement.
‘Very, Very Angry’
People living in Nepal’s southern plains say the new constitution gives an unfair advantage to those residing in higher elevations. Constituencies in Nepal’s hills and mountains would get 100 seats in the 165-member parliament, with the rest going to the low-lying Terai region that holds the majority of Nepal’s 28 million people, according to the Institute for Defence Studies and Analyses, a New Delhi-based think tank.
Mahat, Nepal’s finance chief, said India hasn’t formally made any demands related to the constitution. But, he added, “they are expecting us to have a dialogue with these dissatisfied groups and to resolve the problem."
“Trade cannot be mixed with an internal political problem," Mahat said, adding that Nepal guaranteed the security of all cargo entering the country.

From the BBC:
Nepal's world-renowned community forests are under threat from a sudden rise in demand for firewood because of a fuel crisis, officials say.
A blockade on the Himalayan nation's border with India has halted imports.
Ethnic communities in the southern plain bordering India are protesting against the new constitution, saying it does not adequately represent them.
At least 40 people have died and hundreds of trucks have been stuck across the border in India.
Nepal is a landlocked country and totally reliant on India for all its fuel, food and medicine imports.
Supplies have been disrupted for over two weeks.
Conservationists say people have been left with no choice but to cut down trees for firewood despite having a tradition of protecting their forests.
"With no cooking gas and kerosene for their kitchens, the demand for firewood has suddenly jumped and our forests are under pressure," said Ganesh Karki, chairman of Federation of Community Forestry Users Nepal, an umbrella organisation of community forests across the country.
"We have received information from our different member community forests that people are now entering forests to collect firewood and in several areas trees have been chopped down."
Nepal has been a global leader in community forestry where local people become custodians of the forests and are supposed to utilise the resource sustainably.
There are more than 15,000 community forests in the country, as well as 20 national parks and protected areas.

Trucks are parked up near the Indian border with Nepal due to the blockade

Illegal logging
And the forestry department has also started making contingency plans if the fuel crisis does not end soon.
"We have assessed our stocks across the country and have found that we can supply firewood to the capital Kathmandu for six weeks," said Department of Forest Director General Resham Dangi.
"We have no choice but to make such a plan because people will need fuel to survive and if the supply chain does not return to normal, the government will have to do what it can."
The government will release stocks of firewood in the first phase but then look at felling trees in a second phase.
Its priority is to supply firewood to the capital Kathmandu which is home to three million residents but has no forests nearby.
Mr. Dangi confirmed that forests in other parts of the country were already coming under pressure in the wake of the fuel crisis.
He said there had been an increase in illegal logging as the authorities are unable to patrol the forest due to the fuel shortage.
"Because we have no mobility, timber smuggling has increased, mainly from the forests of Tarai near the Indian border," he said.

Nepal has abundant water resources which could generate hydroelectricity. However, because of its political instability, not even 1% of its hydropower potential has been tapped, leaving people increasingly dependent on fuel imports from India.

Life in Kathmandu is coming to a standstill due to the petrol shortage.

Nepal Oil Corporation officials say 700 tonnes of cooking gas entered Nepal from India every day before the blockade but this has now collapsed.
"Some 250 of our tankers loaded with cooking gas have been on standby at the Raxaul bordering town of India for 22 days but the Indian authorities are not releasing them," said Mukunda Ghimire, director of Nepal Oil Corporation.
"We used to import 4,500 kilolitres of petroleum products other than cooking gas from India every day and now we are getting not even five percent of that.
"At some border trading posts, the Indian side has even refused to refill our tankers."
Political dispute
India rejects this accusation and says the disrupted supplies are due to unrest on the Nepalese side of the border.
"We had repeatedly cautioned the political leadership of Nepal to take urgent steps to defuse the tension in these regions," its foreign ministry said in a statement.
"This, if done in a timely manner, could have avoided these serious developments."
As the two sides trade charges, conservationists are worried that Nepal's forest resources are becoming a casualty.
"The reputation we earned with years of hard work is at stake because of this crisis," said Mr. Karki of the Federation of Community Forests.
"And so is the future of our forests."


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Thursday, October 8, 2015

View from outside my Window

In earlier postings I've mentioned that I've been drawing some during my off time here in Chanaute. Drawing is something that I have enjoyed as an occasional hobby from time to time in the past, but because of school, I've not done any drawing in several years.
Before departing on this trip, I read a travel blog about how sketching during your travels could be an enjoyable way to document your adventure while forcing you to take more time and really look closely at the finer details of the wonderful place you've traveled to.
Below is a picture I took from just outside my room above the clinic.






And here is my drawing of that view on a sunny day (hence no clouds):





My drawing includes a slightly wider view as well as a few artistic liberties, like adding in the bus that comes by several times a day.
I'm not sure how much more drawing I'll be able to do while I'm here in Nepal as I'm very slow (I wasn't keeping track of how long this drawing took me, but I'm sure it was at least four hours spread over the past three weeks). I'm guessing the person who wrote the travel blog was a much better and faster artist than I am and could churn out a nice sketch in an hour or so.
In the end, I think by far the best part of doing this drawing was the interest of what I was up to followed by the enthusiastic reaction that I got from the local Nepali kids who were curious about what I was drawing. Which brings me to one other point that the travel blogger mentioned in her post. She said that an additional benefit of sketching your adventure is that it forces you to sit in one place for an extended period of time which inevitably draws the interest of those around you. This creates the opportunity to interact with the local people that one would likely never have otherwise. I must say I'm in emphatic agreement with her on this point.

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Location:Nepal

Tuesday, October 6, 2015

(Sort of) Roughing It

For my post today I've compiled a list of the challenges of living in rural Nepal without the many amenities (and/or the consistency of those amenities) that we have grown so accustomed to living with in the U.S. Some may argue that it's hardly "roughing it" if you have a roof over your head, a stove and the Internet. This post is meant to merely compare my current living situation compared to those of you reading this at home. Also, it goes without saying that living away from family and friends is the hardest part.

Top Challenges
▫️Sealed housing - I have a gap of anywhere from 4 inches to about 3 feet between to top of my walls and the overhang of the roof. I also have a gap around the edge of the floor of about an inch, although it's close to 3 inches in one spot. The overhang is enough to keep the rain out, save for some leaks, but does not keep out the bugs, spiders, and other critters, especially my friends, the mosquitoes. While 90% of the time the bugs don't bother me, it's the other 10% where they either sap some of my blood or simply flock to my phone because it's a bright screen in a dark room. In addition to the bugs, I also feel the full effects of the weather, whether it be the super high humidity of the monsoon that just came to an end (I hope) or the chilly night air that causes condensation to form on the corrugated steel roof that then drips down in my room. Most tents are more sealed than my steel box of a room.
▫️Unpredictability of the power and the internet - fortunately my job treating patients does not require a power source other than batteries and most of my food is cooked on a gas stove, so I can live without power for most of the day or night. I only need power for about an hour or two per day to keep my phone charged (which I do use frequently to reference material when treating patients) and so far that has never been a problem. The main problem with the power outages which often last most of the day is that when there is no power, there is no internet service either. And to make matters worse, sometimes we have power, but I'll still have no internet service. Again, I don't need the power or this service to do my job and I could go most days without. However, since it's cheaper to call home via Skype, I prefer to have the service at least once a day during the small windows I have to call home at a decent hour.



The following are more annoyances, as opposed to challenges.
▫️Slow Internet - this comes close to being in the top challenges. The service is fine to check email and update my blog (as long as I don't post more than two pictures). I try not to spend too much time on the internet while I'm here, but it's still a useful resource to share information with the locals, like where Chicago is or what the cityscape looks like or to help explain a challenging topic.
▫️Internet only works outside - perhaps because I live in a metal box, but I can't access the Internet without being outside, so all my calls home and any other information I need has to wait until I can go outside. At night, this can be especially annoying with the bugs who want to flock to my phones bright screen.
▫️Cold showers - the first ten days I was here, the weather was nice and warm and the local water source wasn't that cold, but each day the temperature drops a little lower at night (currently it's been about 59 degrees when I wake up) and the local water gets a little colder. So far this hasn't been that bad, but by late October and early November it's going to be quite the wake up call.
Below is the room where I take my showers. The hose brings in clean water that is collected somewhere from up the mountainside.


Other inconveniences:
▫️Doing laundry by hand and hanging to dry - the worst is when it rains later in the day and clothes get wet again. Fortunately this has only happened once so far.
▫️Sleeping on a four inch thick mattress that has almost no give - although I'll admit it is a slight improvement to the two inch mattress I started with that was squashed down to about 1/2 inch after three weeks. Maybe if I was 27 instead of 47 this wouldn't bother me as much.

List of things that I don't really miss much:
▫️T.V. - I admit if there was one around with American programs available it would be hard not to tune in, but I don't really miss having it.
▫️My computer - I'm not saying I could go without one given all the things I use it for at home, but I definitely don't miss sitting in front of it.
▫️Eating meat - I've actually been served chicken meat about once a week since I've been in Chanaute, but here in Nepal you have to assume there is going to be some small bone or cartilage in each bite, so you have to tread carefully. Aside from that inconvenience, I simply don't miss it. Of course, longer term, you need to be well educated to eat a strictly vegetarian diet to ensure you are getting all the complete proteins your body needs, but I would like to try to eat less meat when I return home.
▫️A toilet seat - once you get the hang of the Asian style toilet, squatting to potty really isn't that bad.

So that's my list. What would you find the most challenging if you were here?

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Saturday, October 3, 2015

Drawing and Games

Today I was outside on my off day working on a drawing when 9 year old Saugat came by (I mentioned him briefly in a previous post and that his English is pretty good). He was curious about what I was up to and I showed him my drawing and asked him if he wanted to join me and draw something himself. He smiled and nodded yes, so I handed him some paper and offered him his choice of colored pencils. Below is Saugat and his masterpiece. In the lower corner it says Art by Saugat.





Saugat then ran off only to show up again later with a hula hoop of sorts (essentially a piece of plastic tubing with a piece of wood wedged to hold the two ends together in a ring). He then demonstrated his excellent Hula skills. Afterwards we played tic tac toe, Rock Paper Scissors and a couple of other games (three other kids had joined in or were watching at this point).
Eventually the kids wore me out and I told them to run along and maybe we can play again next Saturday.


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Clinic Update

This week gave me a sense of what clinic will be like during the remainder of my time here in Chanaute. Over the past four days I've performed almost 100 treatments. The majority of complaints are normally pain related with the top three being back, knee and shoulder pain. Surprisingly I've not seen more neck pain because the Nepalis almost always use an strap that wraps up and over the forehead to help them carry heavy loads on their backs (although I have seen neck pain complaints, just not as frequently as the other three noted). It's easy to see why when you see how physically demanding the work is around here. Between the farmers working in the fields, to the villagers who are tearing down and rebuilding by hand their homes and shops damaged during the past earthquakes. I purposely have not taken a lot of photos of people working because I would rather have their permission, but I've attached a couple of examples. The first is of a gentleman carrying a couple of backpacks and a large rolled up piece of corrugated steel up the hillside.


In this next picture you have to look very carefully and see if you can spot the woman carrying a giant bundle of feed she has cut and collected for her livestock.



She is very well camouflaged as she walks down the road away from me, but if you look closely at the right side of the road you can just make out where her feet are on the right edge of the road.
Back to the clinic, I also treat a lot of gastritis and headaches. Other issues include high blood pressure, breathing issues, and dermatitis or other skin issues. Besides working extremely hard, many of the local Nepalis eat diets high in salt, sugar and cooking oil. And many of them cook over open fires inside their home that are often not well ventilated.
All of this creates a high demand in the clinic. On my busiest days I have seen 24 patients so far and I expect that number will grow to around 30 on some days before I depart.


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Friday, October 2, 2015

Close Encounters

Needless to say, living in a rural village in Nepal you come into much greater contact with bugs, spiders and animals than you do living in Chicago. So far all of my animal encounters have been friendly or at least benign. Many of the farmers have goats, chickens, and cows, including this stubborn bull.


In addition to the farm animals there are lots of dogs, plenty of different types of birds, at least one stray cat and a rat that I've seen twice now. The first time he ran up the steps and under the door into our kitchen. Fortunately all the food is kept in a metal trunk, so I think he must have scampered on out at some point since I haven't seen him in the kitchen since.
There are lots of colorful butterflies, dragonflies and grasshoppers, like this guy.



Most of my encounters with the bugs have been with the mosquitoes, to whom I make small daily blood donations.
Then there was this spider that I found in my room and was able to relocate to just outside my room (I'm hoping he nabs a few of those Mosquitos!)



And last but not least, the other morning there was my really close encounter with this other larger (and wickedly fast) spider about the size of my palm who I first came across one evening on some shelves in the hallway between our two treatment rooms. On my second encounter she happened into the bathroom as I was about to take a shower. Worse yet, she had me cornered. I tried to use the water hose to spray here out of the bathroom but the door was already closed and she was so fast that she was racing up the inside of the door, then darting across the tiled wall. I could barely keep the water directing her away from me and I was freaking out that she was going to crawl up my leg if I didn't do something to get her out the bathroom fast. After having no luck washing her underneath the door (she was too big to fit under the 3/4 inch opening), I finally decided I had to take drastic action and so I grabbed a rock that was on the window ledge, and well, let's just say I earned some negative karma that morning.

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