Tuesday, November 8, 2011

8 days in Nepal

Trying to summarize one week in Nepal in one posting is impossible. I have a 7 page journal I am keeping… So here it is my attempt:
Part one: Tucson to Jomsom, Oct 28-Nov 1st. This was a true “journey”: 4 flights to Katmandu, and two more to Jomsom. Steve and I stayed apart for two nights, his luggage and the medical boxes were misplaced. It was really sweet to finally meet in Jomsom on Nov 1st. Jomsom (at 9,000 ft) is where the airport in Mustang valley is and where the main hospital (clinic) was located. The flight from Pokhara to Jomsom was 20 minutes of wonderful views of the valley and the Himalayas and surprisingly smooth.
Part two: Medical mission, Nov 1st to Nov 5th
The team for Mustang had 3 dentists, 3 primary care docs, one OBGYN and several nurses and support staff. We all stayed in Jomsom the first day, even though it started a little chaotic, we managed to see 80 primary care patients of all age, lots of pretty severe high blood pressure and very little resources to care for them. My favorite was the oldest patient I saw this trip, an 85-year-old man who came for a well exam because he had no complaints. We started to get acquainted with Dahl Bat, Steve’s favorite new dish (or not) we had most days for lunch and dinner, the typical Nepali meal of rice and watery dhal made from small beans with some curried veggies and greens. Next day we went by jeep with Siddhartha, the other family doc to Tukuche Village to a health post to care for people from lower Mustang Valley who usually don’t have access to the hospital or any physician. The town was smaller with very little tourism, the health post building was newer but bare of any furniture but soon after we arrived the nurse midwife (an older alcoholic man) brought one exam table and a couple of desks and we were in business. The turnout of patients was amazing; they came from all the adjacent little towns and we managed to see hundreds of them in 2 and half days. Patients of all ages, most of them “untouchables” with access to no health care came with multiple pain complaints, rashes, colds, coughs. The most memorable patient was a 5 year old brought by the mother because she had not learned how to walk, with one look I could determine she had cerebral palsy with spastic paralysis, with no services or special education available for her. Steve was extremely helpful, sitting next to me for hours while seeing patients, he would take the blood pressure, or make dogs out of balloons for the kids and kept a detailed record of all the patients I saw, over 110 in 3.5 days! While in Tukuche we did a couple of short hikes, one to an amazing Buddhist monastery that the community is renovating. The weather was very cold, with no heat in the buildings or hot water. We had 3-4 layers of clothes day and night. The dentists and the other general practitioner came on the 3rd and 4th and we all went back to Jomsom by bus in the evening of the 4th. The bad news was that the weather was bad in Katmandu and Pokhara and there were no flights, the only way to come out of Jomsom if not by plane is by bus, very slowly and bumpy… 180 Km in 13 hours!
Part three: Muktinah, back to Pokhara Nov 5th-Nov 8th
After most of the volunteers went back on the 5th Steve, Bob (one of the nurses) and I stayed behind and went to Muktinah to visit some amazing Hindu and Buddhist monasteries, the trip by jeep was also very memorable: dusty, bumpy and long. The views of Nilgiri and Dhaulagiri were amazing and we walked in spite of the feeling of thin air at 12,000+ ft. On the 6th we woke up to very cloudy skies to the south, which meant no plane, and so we started another unique journey of 13 hours in 3 buses on a narrow dirt road that was very rocky or very muddy at times through a beautiful canyon.
Now it is our second night in Pokhara and we had other challenges, but today the weather cleared, we walked all day in shorts and t-shirts, we’ve had multiple hot showers and were able to eat other things besides Dahl Bat… life has been good to us. Tomorrow we fly to Katmandu for two days and then back home.