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.