Goodbye Kathmandu - Hello Tansen!

Hi from Tansen! I have waited for several months to be able to say that, and now here I finally am. I arrived on May 1, and have been spending the last couple days unpacking, sorting, and working on getting settled into my new house here on the hospital compound. Once I am fully sorted, I will give a blog-tour of the new place and the compound. But I'm not quite there yet.

The drive from Kathmandu to Tansen is about 10 hours long, on a good day. "Good day" means that the roads are in good condition (no potholes from the monsoons), there is no landslide or road traffic accident blocking the road, and no political demonstrations going on to slow things down. Thankfully, the road was in reasonable condition, and there were no obstacles along the way, so we got here in good time. I'm told the roads get really bad in monsoon season, which will start in another month or so. Then we'll see.

Usually hospital staff take the hospital vehicle, known as "the Buck" because it is a cross between a bus and a truck (seating in the front, storage in the back) to and from Tansen. The Buck goes to Kathmandu from Tansen every Wednesday and comes back to Tansen every Thursday. We didn't take the Buck this time, because it was a Tuesday.

There are 3 stages to the drive. The first, which takes about 2 hours, is just getting out of the Kathmandu valley. It's not that the distance is all that great, but there is usually a lot of traffic and it's slow-going. The roads are quite windy at that stage, but because you're going so slowly you don't notice it too much. Once you finally get out of the valley, you suddenly realize you can breathe again (much less smog and pollution), and the road becomes quite flat and straight for the following several hours. This is because you are driving through the Terai, the flat land that is in the south of Nepal (as opposed to the foothills in the middle, and the mountains in the north). After about 6 hours of driving along that road, you pass under the "Welcome to Palpa" arch (Palpa is the district that Tansen is in), and then begins the uphill climb to Tansen.

That climb takes about 2 hours, and it is really the most hair-raising part of the trip, and the time you're most likely to get sick! Though I have to say that going down is worse than going up. The road is narrow and windy, and there really isn't enough room for 2 directions of traffic, but they sure try. There is a steep drop on one side of the road, and no guardrail. Once or twice a month, there is a major road traffic accident with multiple victims that end up needing treatment at the hospital here, and that can be quite a challenge! I will certainly blog about it when that happens. And ongoing prayer for safety would be much appreciated!

Thankfully our drive was uneventful, and we arrived in good time. Almost all my stuff was already here waiting for me in my house when I arrived, as I had sent it on the big hospital vehicle last week. As I said, stay tuned for more details about the place.

The last couple weeks in Kathmandu were good. I spent a final weekend at the Children's Home, where we had a party, complete with chocolate, cream donuts and Coke/Sprite/Fanta, and said our good-byes. I will still see them when I visit Kathmandu, and Paul and I are planning on having a wedding celebration there, Nepali-style, when we come back to Nepal in December. But I will certainly miss the times I had with them there...my big Nepali family!

I also enjoyed a final dinner with my landlady and her family. They have been hosting bideshis for over 25 years, and I enjoyed spending time with them and getting to know them a little bit during my time in Kathmandu. In case you're wondering, the Nepali custom is NOT to smile when having your photo taken. I don't think I plan to adopt that custom as my own!

I now have my wedding dress all designed and ordered, and it is being made for me in Kathmandu. Obviously I won't share any of the details about the dress, but I did think you might be interested in the name of the shop :)

Happy New Year!

Let me be the first (maybe) to welcome you into the Nepali year 2069! They follow a different calendar here, instituted by some king or other way back when. There are still 12 months in the year, but they have different names, and the months start roughly in the middle of our Gregorian calendar months. Most calendars around here have both the Nepali dates and the Gregorian dates on them.

There isn't too much to report at the moment. I have just over 2 weeks left before I move to Tansen. I am cutting back on my language study classes next week to just 2 hours a day, and then won't have any classes that last week, to give me time to shop, pack, and prepare to move to Tansen. Oh, and continue to plan my wedding! I was thinking I should be able to find a dress here, because at Christian weddings more women are starting to wear white western style dresses. But after a lot of asking around, and visiting several places, I have concluded that there are approximately 5 ready-made western-style wedding dresses in all of Kathmandu, and they are all hideous (in my opinion, of course)! Frills and bows EVERYWHERE! I did find a tailor/designer who does a lot of western-style wedding dresses, and she came recommended by a few people, so I'm having the dress made from scratch - woohoo!

The weather here has transitioned into much warmer temperatures (mid-to-high 20's), especially during the day. But there have been crazy thunderstorms almost daily for the last 2 weeks. Maybe even daily...I'm not sure. It'll be beautiful and sunny one minute, and the next minute it's pouring rain and there is thunder and lightning. The other night I was awakened at about 2 am by a sound. At first I wasn't sure if it was thunder or really strong wind, because it sounded so strange. In the end I decided it was thunder, but it was the craziest thunder I've ever heard. Not super-loud, but absolutely constant rumbling for about 45 minutes straight, and the lightning was also constantly flashing for that same length of time. I've never seen anything like it! Nobody can quite agree whether this is typical weather for this time of year in Nepal or not. Some say it is, and others aren't so sure. At any rate, I've never experienced so many thunderstorms in such a short time.

I'm getting excited about the move to Tansen, though I will confess that I do feel a bit nervous, as well. It'll be another new place, a new job, and the learning curve will be steep at first. But it is why I've come to Nepal, after all, and I know it will be fine. But I do appreciate prayer for the transition over the next few weeks.

Village Stay

I am now back in Kathmandu, after my 2-week village stay. Village stay is part of the Language and Cultural Orientation Program that I have been doing here in Kathmandu. It's meant to be a language and cultural immersion experience - a chance to see what life is like outside the city. Certainly most of the patients I will be caring for in Tansen will come from more rural settings, rather than a big city, so it is good to get some exposure to a context that is a bit more like theirs.

When I heard about the village stay, I was picturing being out in the middle of nowhere, in little mud huts (or something similar) with no running water or electricity, or even toilets. I was picturing bathing outdoors at a public tap, going with the women in the morning to fetch water from the river, that sort of thing. While that would have made for a good story, I'm quite thankful that it WASN'T like that. The village we (there were 3 of us who went) stayed in was about a 45 minute walk from the outskirts of Pokhara, which is a fairly major tourist city about 6-7 hrs from Kathmandu. It was rural, for sure, but we weren't really roughing it. Homes were cement homes (and even the "traditional Nepali home" that my language teacher pointed out had a "traditional Nepali solar panel" on the top of it!). There was electricity...or at least, as much electricity as there is anywhere in Nepal, where "load-shedding" (i.e. no electricity) happens many hours every day, according to a fixed schedule. The home where I was staying also had running water and an indoor toilet and shower area - woohoo! It was a squat toilet, but that's not too big a deal, at least when you're healthy. Thankfully NONE of us got sick while we were there - big thanks to God for that blessing! That would not have been fun.

The home where I was staying had a family of 6 living there...the mother and father, their 3 children (2 daughters, aged 20 and 18), and a son around age 15. The oldest daughter is married and has a 2-year old daughter, who also lives there. Her husband lives elsewhere in Nepal for work. This is a very common situation in Nepal...husbands and wives living apart and maybe only seeing each other a few times a year - IF that! If they live in other countries (which is also very common) they might only see each other once every few years. I can't imagine!! The family was very welcoming and hospitable. They've had other bideshis stay there in the past, so they were kind of used to some of the differences between Nepali and western culture, which was helpful. We communicated almost exclusively in Nepali, though occasionally the younger daughter spoke English with me. It was really good, at this stage of my language learning, to be forced to communicate in Nepali for an extended period of time...really helped my comfort level and fluency with the language that I do have at this point.

The daily schedule went something like this:

7 am (ish) - someone from the family would bring me a cup of tea and sometimes also some biscuits.

7-9 (ish) - I would get dressed, sometimes shower (okay, not shower, really...the water was WAY too cold to shower - I would run the water just enough to get wet and clean and to wash my hair without getting completely under the running water), sometimes do some laundry by hand, sometimes help make the morning daal bhat, sometimes sit around and read or play my guitar, which I had felt silly bringing, but was so glad I brought.

9 or 9:30ish - Time for morning daal bhat (rice and lentil soup with some kind of side dish of curried vegetables). This is the classic meal for Nepalis, and they eat it twice a day (morning and evening). These are usually the only 2 meals Nepalis eat in a day, and the amount of rice they can consume is astonishing! They are always shocked when bideshis don't even eat half the amount that they eat, and it's a bit of a delicate balance between not eating so much that you feel sick, but also not offending them by not eating enough (or making them worry that you're going hungry). The family sits on the kitchen floor to eat and eats with their hands. I did that the first day, and then I think they noticed I was very fidgety and having a hard time on the floor, and so from then on they had me sit on a little stool and put my plate on a chair to use as a table. And when I burned my fingers from trying to eat with my hands, they graciously gave me a spoon! There would also be buffalo milk (freshly obtained from the buffalo they had, and then boiled prior to serving) that they'd give me, and we'd pour it over the daal bhat.

10-1 - Nepali lesson - we had 2 teachers come in from Pokhara. I had lessons together with one of the other people who came for the village stay, since we're at a very similar point in our studies. We did the usual Nepali studying (grammar, vocab, etc), and also did some village-related learning. We took a visit to the local health post one day, and to a mushroom farm another day. A couple times he also took us around to people's homes. For each little "field trip" we had to ask questions we'd prepared and talk with the people there about village life, health issues, mushroom farming, whatever the topic happened to be for the day.

1-3 - Sometimes I napped, sometimes hung out with the family. Somewhere in there there was kajaa (snack, which really was lunch for us) - sometimes roti (flat bread), sometimes popcorn, sometimes biscuits, sometimes instant noodles, or other things.

3-7 - The 3 of us would usually go exploring, either on our own, or with some of the kids from the village. One day a couple of the village boys took us to a bat cave...which was kind of fun. Other times we just wandered around and compared notes about how things were going. Usually sometime around 5 we'd go back to our respective homes and I'd usually help with evening chores and daal bhat making.

7 pm - Evening daal bhat time. Same drill as for the morning meal.

Bedtime came early most nights, because there was almost never electricity in the evenings. That was fine with me. I was asleep before 9:00 most night!

It was a good experience, overall. Even though we weren't really roughing it, it was still a cultural and language immersion time, and it was rural. Most people were farmers, and they had crops and animals, and we learned a little bit about rural life in Nepal and what's involved in it all. The highlight for me, I think, was the fact that there was a 2-year-old in the house. She was scared of me at first, but we became good friends, and she was a real cutie. I do have a soft spot for little ones, I must say!

So now I'm back in Kathmandu, and have one more month of language study before I move to Tansen. Moving date is May 1, which is a couple weeks later than originally planned, but I'm glad for one month of "normal" life before I transition, since the last couple months have been a bit crazy.

On another note, Paul and I are doing our best to stay in touch as much as we can. It's a challenge being apart, especially when phone calls are super-expensive and the connection is unreliable. He's just this week gotten internet up and running, and so theoretically we can talk on Skype, but so far it's been quite hit-and-miss, as well. Please keep praying for us in that regard. We'll sure be glad when we're not oceans apart anymore!

Developments...

I just got back from a week-long visit to Tansen for a work orientation. It was great to finally see the place and to meet the people I'll be working with in a couple months. It's a 10-hour bus ride to get there, which is why I haven't visited until now. The hospital has a vehicle, known as the Buck (half bus, half truck) that travels once a week between Kathmandu and Tansen. We took the Buck there and then flew back (the closest airport is about 1 1/2 hours from Tansen along a very windy mountain road that makes you motion sick pretty quickly). After having been there and seen how beautiful it is (SO much nicer than dirty, noisy, smelly Kathmandu!), and spent a bit of time in the hospital, I'm starting to get excited about moving there and starting work. There will definitely be a steep learning curve at the beginning, but that is to be expected. Burns are very common there and all but the most superficial burns usually require some form of surgical intervention. In Canada this is usually done by plastic surgeons, but there is no plastic surgery department at Tansen. What else did I see during my one day of rounds? There was a baby a few days old with spina bifida and an open spinal cord defect (probably not much that can be done for her, but the surgical team is caring for the wound for the time being). There were a few people with TB-related pleural effusions (fluid around the lungs) requiring chest tube drainage. There was a guy with alcoholic cirrhosis (alcohol abuse is a big problem here) with badly infected fluid in his belly...not too much that can be done for him here. There was the usual mix of gallbladders, hernias, appendixes, and other more "typical" general surgery cases.

I was interested to find out that the hospital does have mesh that they can use to repair hernias with. It's expensive so it's used sparingly, but it's good that they have it. That's the gold standard for most hernia repairs in the west, but I wasn't expecting to have that option here. There is a laparoscopic set-up, as well. It's pretty basic, and the picture quality isn't great...but hey, at least they have something. They do try to do their gallbladders laparoscopically if they can, which is great...both for the patients (when it is successful) and for someone like me who wants to keep up her laparoscopic skills if possible. I helped another surgeon with a gallbladder the other day. We started laparoscopically, but it was a pretty inflamed gallbladder, and we were both visiting surgeons and weren't too familiar with the equipment, etc, so we ended up converting to an open procedure, which was the safest thing to do at that point.

Tansen is right in the Himalayan foothills, and the town itself is built into the side of a fairly steep hill. You are almost never walking on level ground. Water supply is a huge problem, and so people walk quite a distance with buckets to get the water they need for daily life. It's less of a problem on the hospital compound, but you still have to use water sparingly.

In other (more important) news, as many of you already know, I have recently gotten engaged to be married to a guy named Paul!! No, we didn't meet in Nepal - we've actually been friends for 8 years now, but it's taken this long for the relationship to develop into more. He was just here for a visit (during which we got engaged on a little 18-seater plane, right in front of Mount Everest!), and he was able to come and see Tansen with me, which is great, since he will also be living there after we get married. We also had a chance to spend a weekend at the children's home, where all the kids have already started calling him the Nepali word for "Brother-in-law" (older sister's husband, to be precise). They were all very excited to meet him, and we had a wonderful weekend there. He is off to Africa now for 6 months (sigh) to finish up a building project there. We plan to get married in Canada in October, and then come back to Nepal together as a couple in December. We're very happy (obviously), and everyone - both here in Nepal and back home - has been so great and supportive. People here are excited to have us in Tansen as a couple, and he had a chance to meet some people he may end up working with when he comes back. These next 6 months will be challenging for us, especially since a long-distance relationship between Nepal and Africa isn't the most straight-forward. We're just praying for good phone networks and internet connections so that we can stay in touch as best we can. We did manage to plan the majority of our wedding while we were together, so that was a bonus!

I'm off on Friday to Pokhara (a tourist town about 5-6 hours from here) for a weekend of touristy things with a couple other language students. Then on Monday we head to the village for our 2-week village stay. I don't expect to have internet access there...or showers, for that matter!

Spring is in the Air

Well, I would definitely say that it's getting warmer, and things are much more pleasant around here now that I'm not spending all my energy figuring out how to stay warm. The nights are still cold, but nowhere near as cold as they were. I'm slowly losing layers, and haven't slept with a hot water bottle in over a week now. Yay!

So Spring is in the air, and with that is coming a lot of changes. The people who normally live in the flat I'd been subletting are coming back on Wednesday, and so I've now moved upstairs to a flat that became empty about a month ago. I'm quite happy with the change. It's a smaller flat, but it's got a lot more sunlight that comes into it, so it's much lighter, brighter, and a bit warmer, which for this time of year is a bonus. I'll be living here until the end of April, which is when I'll be moving to Tansen to start work. Though actually I'll be away for a little over 3 weeks in March, so I won't really be living here that long. On March 1 I'm leaving for Tansen to visit the place for a week and get an orientation to the hospital. I'm looking forward to seeing where I'm actually going to be living and working, and to meeting and getting to know some of the people I'll be working with. After the week in Tansen I'll be going to a village somewhere a couple hours outside of Tansen, and will be living in the village for about 2 weeks. That's part of the language and cultural orientation program here. Not sure how primitive it will be, but it will certainly be VERY different from life in the city. I'll be staying in the home of one of the families in the village, and joining in their day-to-day work and life. And I probably won't be speaking much English during that time...so hopefully the Nepali I've learned in the last 3 months will do the trick. I have learned so much, but am aware that I still have a long way to go before I'll be fluent. But that's how it goes. There will be a language teacher coming into the village every day to give us (there will be 3 of us staying in the village, though all with different families) language lessons, so we'll be able to carry on with that to a certain extent.

Speaking of language classes, I only have class on Monday and Tuesday this coming week, and then I'm taking a week off before this 3-week trip. It's worked out nicely - all I have left in the "Basic Language Course" is the review, which we'll do over the next 2 days...and then I can start the "Post-Basic Course" when I get back. Not that I'm anywhere past the "basic" stage, but it's nice to at least have that milestone done.

I mentioned that the people I've been subletting from are coming back to Nepal on Wednesday. I also have some friends arriving on Wednesday for a visit, which is why I'm taking the week off. We plan to spend some time together, and also spend the weekend at the children's home (my connection to the children's home is actually through these friends), which we're looking forward to.

Here is a photo I snuck with my phone camera while walking along the road. I thought these boys were pretty cute!

Of Cultural Blunders and Death Anniversaries

Yesterday when I got home from my language class, my landlady's whole family was in the courtyard area of the house. I said hi to them, and went up to my flat. As I did, I saw that her son had shaved his head. I was curious...had he shaved it because of lice or something? I had no idea.

Then a few minutes later, he knocked on my door. He handed me a plate of food and told me that his family had made this special food for that day and they wanted to give me some. I thanked him, with a big smile on my face. Then he told me that it was his father's 5-year anniversary. So with an even bigger smile on my face, I very enthusiastically said, "That's great!" And thanked him again for the food. It was yummy food - curried veggies and spinach, some kind of legumes with spices and cilantro, roti (flatbread), some kind of deep friend dough thing that I have no idea what it was, and rice pudding (mixed with ghee - which is this really fatty thing - almonds, cashews, and probably coconut milk).

It wasn't until I had closed the door after offering my hearty congratulations that I realized he was talking about the 5-year anniversary of his father's death. Oops! Maybe I shouldn't have been quite so happy and enthusiastic! Oh well...ke garne! ("What to do?") Such blunders happen when you're living overseas in a different culture. I'm hoping that this family has had enough exposure to bideshis by now that they're not shocked when we do dumb things like that. But I'm not sure! Live and learn...

The "death anniversary" is something that is "celebrated" (not quite the right word) by Hindu families. They come together on the anniversary of the death of a loved one. The sons shave their heads, and they prepare and eat a special meal together. A priest comes and they do "puja" (worship) to the spirit of their deceased loved one, offering up some of the food they have made. They do this partly to ensure that the spirit of the deceased person is taken care of in the "in-between" life (before reincarnation), and also so that the spirit of the deceased relative won't come back and haunt them.

I did ask my language teacher today a bit about the death anniversary, and was reassured to know that although the 1-year death anniversary (and apparently also the 45 day anniversary) is a solemn occasion, after that it is just something that they do...it's neither happy nor sad. So while they certainly weren't celebrating happily, at least I didn't just congratulate people who were in deep mourning. Whew!

February!!

I think it is safe to say that I have survived the worst of my first winter in Nepal. It's still pretty cold at night and in the early mornings, but the days are becoming quite lovely, and inside usually it's actually bearable, though sometimes I still break down with shivers and need to bundle up. But it is DEFINITELY warmer than it was. Woohoo!!

I have also now survived my first nasty GI bug in Nepal. Unfortunately, these sorts of things are inevitable when you live in a place like this. I managed to make it through the first 2 months unscathed, but about a week-and-a-half ago I got hit with a really bad one. It was pretty awful for a few days, and I still am not quite eating normally, but I am MUCH, MUCH better. Antiobiotics were definitely indicated, and fortunately they are very readily available around here, without a prescription. You just go to any pharmacy (of which there are lots) and tell them what you want. And the price is a tiny fraction of what you'd pay back home (like, for a 5-day course of Cipro, it cost me about $2!). Whether there's the same quality control as there is at home is doubtful, but it seemed to do the job.

Mind you, I did learn one lesson: keep a stash of such essential meds at home, so that when you get hit, you actually have them available. Every time I've gone overseas in the past I've brought some with me, but I didn't here, because I know it was so readily available. But I should have gotten some when I first got here - I sure wasn't in a position to leave my apartment, and I live alone. Even my didi (house helper), who usually is twiddling her thumbs needing something to do, wasn't there - she'd taken a leave to go see her mother 18 hours away. Which was just as well - I didn't really want her around when I was so sick. But I could have at least sent her for some drugs. In the end, I phoned a woman who lives close to me, and she picked some up for me and brought it by, which was much appreciated. And I now have a stash that I'm hanging onto here for the next time.

A couple weeks ago I had been struggling with the "post-honeymoon period" phase of cultural adjustment. For any of you who have lived overseas for any length of time, this will be familiar language to you. If you don't know what I'm talking about, cultural adjustment is something that has been well-studied, and you could google it if you're interested. But basically you are initially in a "honeymoon phase," where you're feeling exhilaration about being in the new place, loving it, and even though you are aware of some of the negative aspects of it, you have the emotional energy to just write it off as "different," and not get too worried about it. And then somewhere around now, your reserve of emotional energy, so to speak, is worn down, and the initial elation is gone, and you get a bit of a crash. It's a well-known phenomenon, and although I was hoping I was "above" going through such experiences, well, I'm not! I did have a rough couple weeks there just trying to sort through that.

But somehow surviving my first winter and my first nasty bug made me feel very proud of myself, and suddenly it doesn't seem so bad after all. I'm sure I'll go through more ups and downs, but I'm thankful that for now things are feeling pretty good. I still struggle with people honking loudly in the streets, especially when they're coming up right behind you. I pretty much always want to yell at them, and I do almost always say under my breath, "Is that really necessary?" Or something to that effect. It drives me crazy...and I think there's a definite risk of hearing loss with it all - it's SO loud sometimes!

I am still LOVING the children's home. The kids are so great, and the more time I spend with them, the more I get to know them and they are getting much more comfortable with me. It's pretty sweet! Here's a photo of a couple of the little boys. Noah, the older one, has such a great smile, and is missing all his top front teeth at the moment, which makes him even cuter!