Saturday, June 30, 2007

This blog is plain and white because there's plastic on all the furniture

In my head, and in an eventual reality with a decent connection and more motivation, this site features photos with every substantial post, updated sites, links, and lists, and a bit more quality in terms of ranting. I think that after I'm home from Nepal I'll use the site as a way to manage my thoughts that I forget is visible to a few people, like the moleskine notebook that i leave lying open all the time,but with legible writing.

Earlier in the week I met with the two founder/directors of VSN to discuss my and others' concerns about the health program. I don't feel like rehashing them here for the 4th time. Essentialy the message was that while I realize that the program is only a few months old and has provided healthcare where exactly none previously existed, the level of care could be improved from better-than-nothing to decent with just a few medium term modifications. Rather than resisting what I said, Sej and Sughanda were extremely enthusiastic which was incredibly refreshing after some of the frustrations of trying to change anything anywhere in Nepal.

Long story short, for the remainder of my time here I will be compiling Nepali health statistics, drug trade/generic names with photos, procedure availability and costs andc some other juicy stuff into an orientation manual for all new health volunteers. I will also be visiting a few of the hospitals around Kathmandu and possibly eventually working on fundraising to hire a physician to work for VSN at least part time. Out of steam again, more later

there's no such thing as OSHA in Nepal

I spent Friday standing atop a 1/16th of an inch thick piece of corrugated tin 8 feet off the ground while wildly swinging a pick axe to knock off the roof that was supporting my weight. Extremely cathartic. My pick sent 40 pound brick-missiles soaring into rice paddies, heaps of hay and dung, over bluffs, and into the mud surrounding the clinic. It was glorious, sanctioned destruction.

That night dan and I went back to Thamel for another semi-debaucherous night on the cheap that principly involved gorging ourselves at the one restaurant in Nepal with a wood fired brick pizza oven. I ate a leafy vegetable for the first time in months and it felt like some extremely guilty pleasure. We spent the night in a guest house that cost 1/100th the price of the meal. Most of the night I felt like winged demons were sucking the life out of me. The fist sized holes in the window screen meant that for the entire evening mosquitos were in holding patterns over my head.

this morning we had another amazing continental breakfast, and then did some souvenir/gift shopping at the tourist shops. I'm kind of hoping that I end up in a town with a real winter so that I have an excuse to wear this sherpa gear that I bought today.

Wednesday, June 27, 2007

the tail end of things

under 3 weeks left now

yesterday a monkey hit me after a drunk nepali teenager made kissing noises at it and pointed to me. The monkey (a big fangy male) hopped over a railing and palmed me on the shoulder. So I countered his drunk juju by making the same noise and gesture and pointing at him, which further enraged said fangy male into chasing the little punk down some stairs.

The momo count topped out at 51 when we ran out of dumplings.

The internet is back on at VSN after we replaced a rat-gnawed ethernet cable.

feeling better, back to work.

highs and lows

Today I awoke to a 180 degree panorama of Himalaya that I didn't even know existed in Kathmandu. Apparently everyday, shrouded in the monsoon clouds and smog, the most beautiful view I've ever seen in person or otherwise exists. I had about 30 minutes alone with them as I rode the bus into town for coffee and email. While at the internet cafe I applied for a job as either Paul Farmer or Jim Kim's personal assistant at the harvard medical school. I expect to be rejected shortly but it's something I would lose sleep over if I didn't at least try.

This morning I awoke after sleeping fitfully with a cough, headache, and GI issues. The same lack of cloud cover that made for a stunning mountain view also resulted in a brutal day digging in the sun. We got a lot done but I almost passed out from the heat and my general torpor. Daniel, our friend Christian and I are going back to the monkey temple at sunset since it's his last day here and he hasn't been yet. The internet at VSN is down so I may or may not update again today.

Tuesday, June 26, 2007

one day

6:00am wake up to "greg utnos!"
6:30 chia, peanut butter and banana sandwhich
7:05-8:00 gym
8:30 shower
9:00 daal bhat and omellete
9:30-10:20 emails
10:30-11 walk to construction site
11:00-1:00 play in the dirt
1:30 back to VSN
2:00-2:30 walk to Landless Clinic
2:30-4:00 Clinic
4:30-5:30 coffee in Baneswore
7:00 daal bhat in pepsikola
7:30 a beer at the Hut
8:00 type up what I did today
9:00 sleep

Daniel and I made today our photodocumentary day. I'm uploading the pics to facebook as I type this. In bullet point the day doesn't look like much, but I'm totally depleted at the moment.

Monday, June 25, 2007

47 momo and counting

typing in between plates of homemade buff momo. I'm doing this to shatter an obnoxious Canadian's dubious record of 50 vegetable pieces. Today was fantastic. I played in the mud for 2 hours with a broken shovel leveling the soil for the eventual waiting room of the new clinic. Then I visited the Landless clinic which was absolutely amazing. The setting was what I had imagined when I signed up to come here: sewage flowing through the dirt street of a shanty town of tents, lean-to's, and tin buildings. The clinic is in the heart of what is essentialy a refugee camp of internally displaced Nepalis due to causes ranging from floods to droughts and communists. I'm going back tomorrow with Stef, a senior UK med student, and my camera because the existence of the place is hard to believe given that it's 100 yards from the comparatively opulent 4 story homes of pepsikola.

Things I've stepped over today:
dead rat
marijuana plant
used syringe
broken bricks
discarded sari
baby chickens
stray dogs
ducks
a huge pig
flaming garbage
a 4 inch slug

Sunday, June 24, 2007

something tasty with arteries sticking out

Even though today began at 6am, nothing really interesting happened until exactly 2:29 pm. Construction was a total bust. There were 8 Nepali workers, 5 volunteers, and exactly 1 crow bar so I petted goats. It looks like this will be my last week on the construction project as the 2 people staffing the clinic for landless villagers are leaving soon and I think I will be assisting the new UK med students there 6 days a week.

Anyway, at exactly 2:29 it started raining. ra i N I N G... like a switch was thrown, like the monsoon in Forest Gump, it was raining so hard the puddle drops were counter-dousing my knees. Daniel, our host mom Milan, and I were outside waiting for the bus for a trip back to Patan for authentic Newari food, which apparently is the Szechuan cuisine equivalent of Nepal. After a 20 minute Tuk-tuk ride we disembarked at the bottom of a gravel hill at the top of which was a footbridge over the Bagmati river. As we crossed the river, horns began to blow and I saw this procession of people carrying a large tray of vegetables that I assumed were being sacrificed to the river for some reason, maybe to stop the damned rain. So I asked Milan "Tarkari?", Nepali for vegetables, and instead of the usual Nepali head-bobble of assent I was shot the dirtiest look I think I've ever gotten in this country. It was a funeral procession carrying a body to the pyre by the river. It looked like a huge tray of cucumbers to me.

By the time we made it to Durbar square the rain had stopped. Instead of walking into one of the buildings we ducked into an alley so narrow that we all had to back out again to let a newari man with red eyes, dripping tears, and blowing snot-rockets by as he left the restaurant. If you took the American greasy spoon, wiped it on your shirt, then buried it in a dungeon featuring body parts hanging from the ceiling dripping blood on a dirt floor with walls blackend with soot and smoke and probably some more oxidized blood, that would be the restaurant. I don't think it had a name, or a sign, or a door, but the food was delicious and actually a lot less spicy than the weeping man had led me to believe. I ate ommelettes with buff meat and lentil flour, curried chickpeas with green chili and cilantro, potatoes with coconut milk and masala, and then some other buff dish that consisted of globs of gristle studded with blood vessels that tasted great but took about 3 minutes to chew. It looked like those lung tissue samples from cancer patients that little kids are shown in school as anti-smoking motivation. The 2nd best part was the slogan on the bottle of water we were served, "pure as the heart of a small baby." The best best part was that the entire meal for 4 people cost USD $3.

Saturday, June 23, 2007

Long Weekend

6/21
Daniel and I headed back to the construction site without gloves again, which turned out to be a poor decision. We spent the day shoeveling the rest of the dirt into the room to raise the floor and using a metal weight attached to a wooden post to pack the dirt down. The vibrations and splinters knocked my hands entirely out of commision after a few hours. Blister city, so I had to take the next day off looking for work gloves, unsuccessfully.

Several volunteers are leaving in the next week so there was a farewell party at VSN HQ under a tarp over the porch. Everyone was glad to have an excuse not to eat daal bhat, so the party lasted quite a while.

6/22

Although the glove hunt was fruitless, I did manage to make it to the post office to mail some postcards which was interesting because the stamps have this adhesive that only works if the thing is doused in water so I was standing at the counter with a spounge clumsily dabbing my pile of 35 rupee stamps with brown water while trying to attach them before they either dried or dissolved.

After a nap in Pepsicola, Dan and I headed to the local volunteer haunt, The Hut, where the owner was hosting a 'Continental BBQ' for VSN volunteers, which was also popular as yet another opportunity to escape dal bhaat. After eating about 14 pieces of grilled chicken, Dan, 3 of the other volunteers, and I caught a taxi to the tourist district of Thamel which is the only place in kathmandu that doesn't shut down at about 9pm. We ended up staying out late, splitting 2 250 rupee hotel rooms 5 ways, meaning we had clean beds and hot showers for about $1.60, followed by american style omellete, french toast and drip coffee for maybe $3 per person.

6/23
Over the past 2 weeks VSN received a much needed infusion of medical talent. 2 final year UK med students and 2 first year American students are now filling the role of Yet the Dutch G.P., who left last week. On Saturday VSN arranged a 'Health Camp', where a Nepali internist, OBGYN, and Pediatrician saw patients for free at our temporary ward 2 clinic for several hours. The medical students ended up taking over after the doctors left while there were still patents waiting. In all over 120 patients were seen, so the event was extremely successful.

Today
It's back to the c-site with another pair of hands, Pablo a volunteer from the west of Spain. I think we're going to install the new door and maybe knock off a piece of the roof. Just lost interest in typing so I'll leave the rest for later.

Wednesday, June 20, 2007

from Zoo Keeping to Hard Labor

I'm typing this while I wait for the zoo photos to upload to facebook. The trip was fun and suprisingly hassle-free. Sherpherding 39 nepali kids from the OCRC orphanage onto a bus, around the zoo, and feeding them lunch turned out to be far easier than trying to get money out of the atm today. The kids were adorable, so much so that I ended up spending the money I had brought along for a cold beer on a soccer ball for them to play with after lunch, which is exactly why I hate kids. Because i ended up being the lunch porter, carrying a very greasy and pungent cardboard box of about 100 samosas around a zoo-ful of underfed animals, I didn't have any kids to keep up with so I did the only logical thing and got in line to ride the elephant. Very uncomfortable for everyone involved.

Today construction, or rather remodeling, began on the new Ward 2 clinic for landless villagers. Daniel, 6 town guys, and I spent about 4 hours knocking a hole in a brick wall then shoveling dirt (and rocks, and clay, and water buffalo excrement etc.) from a pile beside the building onto the dirt floor of the building to raise it 6 inches or so. Eventually we will rebuild the wall, construct a bamboo enclosure over the new door to make a waiting area, and plant a vegetable garden. The work should take about a month so hopefully there will be some real progress and tangible improvement for us to see before we leave. My hands are covered with blisters from digging, so even if it turns out to not really be helpful at the very least it hurts like something was accomplished.

Monday, June 18, 2007

sherpa work

good news
a new clinic needs a buildin' so Daniel and I are joining the wall-demolishing-bamboo-hut-building-garden-planting team. Should be cathartic. Should be fun. today is the great orphan exodus. will update again tonight. more picks up on face book. http://rutgers.facebook.com/album.php?aid=2177772&l=df6a4&id=8815627

Sunday, June 17, 2007

feelin' fine

in a much better mood now. Tomorrow one of the volunteers is taking an entire orphanage of 40+ kids to the Zoo in Kathmandu in addition to feeding them lunch. Daniel and I will form the photo-expeditionary unit, documenting the event for posterity. Our trip is 2 days shy of being half over. Still a bit burnt out but well fed so it evens out I suppose. looking forward to home and hammocks and harry potter though..

Friday, June 15, 2007

rants from the road

A few random observations of Nepal while riding back to KTM:

Machines here have opposite ratios of intended function to side effect. This bus lookalike device, rather than being intended for locomotion, was designed to convert gasoline into internal vibrations and screeching. The rolling effect is only a consequence of imperfect design and entropy. The same thing happens in motorbikes. Motion is an inevitable inconvenience of the internal combustion mechanism, featuring whatever the exact opposite of a catalytic converter is, the true purpose of which is to transmute Himalayan air into tufts of ash.

Nepal is a world leader on developmental forefront of smoke/smog production technologies, spontaneous combustion products, startling noisemakers, and certainly unpleasant smells of uncertain origin. Its consultants in rickitiness are highly paid and sought the world over to teach seminars on the many uses of tape to make things wobble before collapsing.

Also, on Nepalese roads, the pitch of a vehicle’s horn is inversely proportional to its size. Small 3 wheel tuk tuks have terrifyingly deep blasting ricolla pipes compared to the little-girls- pink-bicycle horn of all trucks and large busses. Mid size buses and oil tankers feature what Daniel has dubbed “the world’s fastest mariachi band” horns. And massive flatbed trucks with irregular loads ranging from 1 dozen water buffalo to other flatbed trucks have horns like keychain kazoos. The only exception are the little-funnel-cake-carts full of anything-but-funnel-cakes. Those lack an engine, instead relying on flintstone style sole power. The horn is usually of the cartoonish squeeze bulb variety taped onto the also taped on umbrella.

And if you’ve ever wondered where all the unsold t-shirts from forgotten metal concert tours go to die, look no further than the Himalayan hills where the village elderly are as likely to be sporting a slipknot shirt as a newari hat.

end rant

Daniel and i are back in Pepsicola and tired.
The monsoon is coming and I'm starting to feel a bit burnt out before even having done anything here.

Tuesday, June 12, 2007

I'll trade you your address for a postcard from Nepal...

post it here as a comment and Daniel and I will drop off a card headed your way in the next 7-1012 business days (Nepali postal system is "unreliable").

We are alive, sunburnt but well , and returning to Kathmandu (inside the bus this time) in 2 or 3 days.

Saturday, June 9, 2007

bus to Pokhara

Daniel and I just completed a 12 hour journey from kathmandu to the laketown of pokhara , 4 hours of the trip on the roof of a bus careening through the himalayan foothills at 50+mph. it was absolutely the most exhilirating experience yet. hairpin turns on two wheel s over rivers and waterfalls fed from the runoff of the 8000m peak snow melt. we passed at least 3 overturned trucks without even slowing down. the last hour we spent crammed into the bus becaus eonce we hit the plains the monsson rains started up again. we're staying in a private stone cottage on lake phewa tal, almost IN lake phewa tal, for 30 usd per night becaus all the other tourists fled with the rain and heat. the trip was so worth it. i'm absolutely exhausted but so so glad to be here.

Wednesday, June 6, 2007

Eating Lychee on the Roof

That's what I'll remember doing today. I will forget going to Baneswore to do my AMCAS on a 56k equivalent connection. I will forget that 8 year olds are much better than I am at Criquet. I will try to forget seeing an abcess lanced with a bare scalpel blade of questionable sterility, without an antiseptic, analgesia provided by expired lidocaine. But I will remember sunsetish lychees on the roof. I hope.

Sunday, June 3, 2007

Me vs. emaciation, Monkey Temple, 1st Clinic Day

So the Nepali diet is not exactly conducive to the maintenance of mass of any kind let alone muscle. 7am tea, 10am rice, thin lentil soup, potatoes 7pm rice, soup, potatoes... delicious, and served in gut busting portions but recently i find myself salivating, unthinkingly staring at cows and fingering the swiss army knife in my pocket. So for the past week I've been on an increasingly desperate search for a reliable non-nasty protein source and a place to exercise. My stop gaps have been pull ups on the crossbeam of the soccer goals and a steady stream of almonds. Solutions: Buffalo meat momos (Tibetan dumplings, 10 for 1 dollar), and the Fitness Gym Club. The absolute total quantity of weight in the gym is MAYBE 300 pounds if some of the nepali kids stand on the bars, but it stopped the cravings.

Saturday is the one day-off in Nepal so some of the other volunteers and I went to the aptly named Monkey Temple for a few hours. http://rutgers.facebook.com/album.php?aid=2172010&l=6e7e7&id=8815627

http://en.wikipedia.org/wiki/Swayambhunath

It was absolutely amazing; Overlooking all of Kathmandu from one of the Himalayan "foothills." (Greg:What's the name of this mountain?, guide: we don't have names for hills.) At sunset the wind was circulating around the base of the hills creating updrafts where as many as 11 hawks would glide in place for 10 minutes without a single wing flap. Also we had the opportunity to observe monkeys in their environment of choice: garbage. They were drinking out of juice boxes, unwrapping leftovers in newspaper, and slurping chowmein with an appropriately inhuman dexterity. Observing animals in their natural habitat is the only way to truly experience nature.

Today I made it out to the Godjihaara (butchered the spelling) clinic with the only doctor at VSN, Yet from Holland. The clinic is one of several that VSN assists and is comprised of 3 rooms: a pharmacy, and exam room, and a TB isolation exam room. The first thing I saw when I walked into the clinic was a cardboard box full nearly to the brim with USED, uncapped needles. Yet nearly had a stroke trying to explain the absolute gross negligence of the situation. (she said something along the lnes of, "you'd be chased off the continent of Europe if you did something like that within a 1000 meters of a hospital in Holland." After that situation was "handled" (I'm buying a sharps bucket tomorrow), we started cleaning and organizing the chaotic shelves of the exam room. In the process we found some badly needed thermometers, bp cuffs, stethescopes, sutures, bandages completely hidden underneath the randomly strewn papers of the post staff. Tomorrow the other shelves are getting the same treatment, so it will be a long but hopefully productive day.

I'm starting to get into a groove here and am really enjoying the country in general and the people in particular. I Miss everyone who's reading this (probably).