It was Great Success!

Here there be mountains! Flight to Lukla.

The trappings of modern society already hang wearily about as this trip has to an abrupt end, though I have no complaints about well designed indoor plumbing or reliable electrical supply. I do appreciate personal transportation much more though.

Please enjoy these last few snapshots of the world we briefly were a part of including a trip to the medical aid post in Pheriche staffed by two British doctors, a paramedic and their knowledgeable Nepali staff.

Despite us both succumbing to the Khumbu Cough by our final days we managed to see a bit of Nepal's beautiful Himalayan scenery, meet many friendly Sherpas and take care of people suffering from varying degrees of AMS with helicopter rescues occurring daily. We were in the presence of a landscape that words and photographs do insult rather than justice and met people not only from Nepal but from around the world who I think would agree.

Overall this trip was part medical mission, part time-travel, part real time National Geographic expose on the trials and tribulations of not only access to and delivery of health care in the third world but also about a nation caught between its traditions and the lure of all the 21st century has to offer.

But to sum it up - any trip where you forget all your debit card pin numbers and most of the password to various important websites and accounts you know you've been doing the right thing.

Waterfall near Phakding.




Kareem, thriller in Himalaya - Tengboche.





Tengboche Monastery

Simple monument to a sherpa who lost his life on Everest. Also our first glimpse of the mountains this day as our initial hike to Namche was beset by thick clouds. All of sudden we looked up and were like - Holy *&# looks at those mountains! !Lhoste face background.

We thought we were high, and then we saw this guy.

Less than 10 minutes after being in Pheriche, we met the doctors, helped a patient to a helicopter and then it flew bit close to 'ole head piece. Just a taste of things to come.

The Gamow bag, being demonstrated by Jenn (L) and Rachel (R) the two HRA docs in Pheriche. Both hail from the UK and were kind enough to let me hang around the aid post and help out (as well as play soccer dice and drink wine!)

The White Yak - best accommodations in Nepal and my home base for a week of Himalayan excursions.

Morning routine at the Fat Yak: small pot milk tea, porridge, look at map and find new place to explore.
Rinse and repeat.

Amadablum - my personal favorite as it's sorta by itslef and is an imposing presence on the landscape, jutting into the sky, a stairway to heaven.

It was just so damn cold at times! This was the major barrier to enjoying the incredible views of the Milky Way and various shooting starts - at night the cold was almost insurmountable for any significant period of time.

Baby Breakfast Yak.

Mt. Sagarmartha - 25% morality rate for those who make the summit. Needless to say, we stopped after some playing in the icefall.

The K-Man, Kalapattar, view looking westish from whence we came. It was a good thing we bought sweet Nepali beanies and knockoff down jackets.

When in Rome.... sharing a cold one at 16,000 feet.

Base camp rock thing. Seemed like a good place to take a picture. Coolest part was knowing that Tibet was just a stones throw away on the other side of the ridge to the left.

Khumbu Ice Fall - complete with crevasses, ancient expedition leftovers and sweet rocks.

Amadablum from Chola Pass.

Kareem succumbed to the Khumbu cough before I did and after he left I saw no danger in wandering the hills and finding offbeat paths to quench my thirst for adventure. At one point the well spoken owner of the White Yak (a mother herself) asked if my mom knew that I was walking around these big mountains all by myself. I said no, and that it was probably best that way. All's well that end well.

Looking down from the entrance to Chola Pass, still very early in a long, long day.

The view I was greated with when I neared my destination the day I crossed Chola Pass from Pheriche to Gokyo. Worst part was I didn't even have enough rupees to reward myself, I settled for 2 boiled eggs and some coconut cookies - short yellow package for those in the know.

Surprise lake near the top of Kong Ma La Pass.

Triumph! Up above the Amadablum Lakes with (L to R) Nupste, Everest and Lhotse in the background.

Airstrip in Lukla. If you take notice (hard in this small photo) the tarmac in the background slopes down and away to the left, with a plane getting ready to take off. This is like being in a roller coaster, you rumble downhill, launch off a cliff then quickly turn to avoid the opposite mountain.

Returning to Kathmandu.

Above all this trip and the acclimatization to the American lifestyle taught me that people everywhere are just the same, and sometimes a smile and some time spent listening can do more for someone than the most expensive medical intervention, whether you speak the same language or not. And you don't have to travel thousands of miles to smile or lend an ear.

We leave you with one of the more enduring moments of the trip:

Everest on fire at sunset.

Oh Snap! Two updates in one day!

So we have failed miserably in our effort to send out some of our photos as post cards due to the many peculiarities involved with foreign travel multiplied by a general complacency Nepal and its pace of life imposes on one's sense of time. As a result, here are a few of the more scenic photos we've thus far withheld.

Lamjung Himal from a distance.

Kareem under a tree napping in the cool hilltop air right after dawn.

This is the view from Lamjung Durbar mid morning on the way back down to work in the hospital. The clouds move in quickly and the mountains were generally only visible in the morning if at all and then best viewed from a hilltop.

Machhapuchhare or Fishtail Mountain as seen on our pre-dawn hike out of Phalebas, Parbat Dist. We had been socked in by rain and clouds all week but finally the peaks peeked through with the rising sun.

Back from the Boonies

Sunrise Himalayas in the distance, from Lamjung Durbar


This update has been the victim of a internet that flows like molasses, power outages that happen only when we find a computer and our own intrinsic dislike of modern electronics when surrounded by the beauty of the natural world. Oh yeah, and sometime we were just plain in the middle of nowhere....but here is the third and most likely last installment as we will be without internet access until we leave.

Receipt of the Tikka after arriving in Phalebas, Parbat District

After arriving in Besisahar we jumped right in with the daily routine of Lamjung District Community Hospital, morning rounds on all the inpatients at 9, OPD and ED until 3 or 4, then afternoon rounds. There is a staff of 4 doctors, many health assistants and a competent and caring cadre of nurses. It is a joint government/mission supported hospital that serves not only the local community and nearby villages but also serves as a refferal center from the health and sub-health posts scattered throughout the district.

This poor little dude fell and fractured his left radius and both the radius and ulna on the right. No tree climbing for him for ahwile.

Not everyone was sick or dying. This cute little girl loved smiled every time she saw a picture of herself.

We had the oportunity to perform many procedures during our stay. This particular gentleman had a liter or so of pleural fluid removed by us each day for the better part of a week. Also in abundance were abcesses, fractures and lacerations - a result of the hard working lifestyle and difficult access to care in the foothills of the himalayas.

During the Dasain festival (think of Christmas back home) familys get together and celebrate for an entire week. One morning we walked into the hospital to find more than 10 men with bandages on their heads and hands as well as more than a few women. Here Kareem and I repair a laceration to a dude struck with what was effectively a sword. I can still hear the tink tink tink of forceps on skull.

We ate most of our meals at a local family resturant. Our Nepali Thali (set nepal meal) consisted of water, rice, lentil soup, vegetable curry and cucumbers in a spicy tomato sauce. There was sometimes the offer of masu (meat) or doi (yogurt). I generally chose the yogurt while Kareem enjoyed it as well as the mutton and small bits of chicken. Remarkably, a chicken heart I ate here was the best meat I've had the entire trip.

Kareem got sick a couple times - here he is on one of the in between days after we stuffed ourselves with Dal Bhat. We still have not quite become acustomed to the huge midday and late night meals and consumed our fair share of cookies during our adventures. Somehow i've yet toget sick with the exception of a brief cold likely gifted to me by one of the younger visitors to the hospital.

Kareem observing Dasainkickoff festivities in the street belowthe hospital guest house. In the background you can almost make out the hospital. The aftermath was observed in the hospital.



As part of the festiviteis the hospital has a big cookout for all staff before a week of vacation for all but the most essential employees. Here we're cooking more than 12kg of chicken which made for a delicious curry. Unfortunately, despite all the celebrating we partook in, we also had to fend for ourselves for a week as all resturants close and no fresh food is makes it to town during the height of celebration.



Hospital celebration again - making a delcious yogurt, apple bannana drink.




As part of the festival celebration we were invited to a local talent show of sorts where children of all ages danced and sung and received gifts of rupees from approving audience members. It was quite the experience, enhanced all the more by knowing some of those in attendance.

These two little girls on the left were the stars of the show performing again and again to the delight of the crowd.

Several mornings were spent rising before dawn to hike to the top of a nearby hill, site of the Lamjung Durbar, or Palace, formerly the home of a king. It was a great place to catch the sunrise and views of the Annapurna Mountain range including Mt. Machhapuchhre (fish tail), Annapurna II and Lamjung Himal.

Another view, without Kareem and with a small monument.

It was all fun and games until a cockroach ran out onto our desk at the guest house. Check the bottom of the water bottle.

On one of our saturdays off after a failed attempt to summit a nearby mountain due to lack of water, I happened upon some boys headed to swim at a stream near their village.



Needless to say, i attracted a lot of attention. Amazingly, these kids were doing flips and cannonballs into water barely deep enough to swim in. It was probably the most fun I've had on the trip so far, sharing my meagar snacks and receiving simple entertainment in return.

Kareem and Henry, grandson of a nurse at the hostital, here accompanying us on a trip to a nearby health post in Kudhi, near the start of the Annapurna Circuit. He returned to the village of Khasur were we went swimming along with a couple of his friends.

View of the village on the hilltop next to Lamjung durbar, taken on another saturday off when one of the local docs accompanied us to the top.

For our busride from Besisahar to Pokhara (about 3 hours) I jumped at the option to ride on top of the bus. After I dodged the first tree branch I knew I was in for a good time. This guy joined me near the end of our journey and might have been clinically insane. After he smoked some unknown substance he proceeded to ask for his picture to be taken all the while barely maintaining his postition atop the cab.

After leaving Besisahar, we spent a couple days in Pokhara relaxing before heading off to our next placement in Phalebas, Parbat District. Here is Phewa Tal (lake) in less than its usual splendor due to rainy weather that swept through. Aparently you can swim and fish here though we passed on both.

'The clinic in Phalebas was sans doctor during our visit so all the major questions of treatment were directed to the two white dudes. Here Kareem reads an x-ray as it dries outside. We casted several Colles fractures, drained the usual abcess and dressed more interesting wounds. We've come to the conclusion that falling out of a tree in Nepal is akin to "I was just minding my own business when...." in America as a response to how someone became hurt. It seems everyone falls out of trees.

Wanna bet what happened to this kid? Thats right, fell out of a tree. Exploring for foreign bodies... Nepal is unique in that procedures and minor surgery are conducted either in sandals or with no shoes at all.

Our attic lodging at the Helping Hands Community Clinic.

As part of our visit to Phalebas we were asked to do a radio interview about our trip to Nepal as well as various health issues at the local FM radio station - Radio Parbat. Dilip Kumar Gurung who was a health assistant and x-ray technician at the clinic also had his own weekly health radio show and came up with a great list of questions for us.

This is the host family we ate with in Phalebas - Kakka and Kakki (Uncle and Aunt) also known as Krishna Lamsal and his wife Bishnu. They along with their children and the other hospital staff for whom they cooked were incredibly gracious and made sure we wanted for nothing. Their hospitality was truly humbling.