Leprosy in USA

It's not an overwhelming threat or epidemic in the US. Leprosy is not highly infectious and only about 150 new cases are found annually in the USA - mainly within immigrant populations. But as immigrants move to different areas where the jobs are, leprosy is being seen outside expected port cities. Mostly untrained in the area of leprosy, doctors need to be aware of signs, symptoms and what to do when they see a suspected case. Early detection and treatment can reduce the chances of permanent disability development in patients. Carried by Immigrants, Leprosy in Heartland Surprises Clinicians http://www.medpagetoday.com/InfectiousDisease/PublicHealth/12284 Leprosy Lingers in the U.S. http://www.washingtonpost.com/wp-dyn/content/article/2008/12/12/AR2008121201864.html

Marriage and Child Widows in Nepal

NEPAL: Fighting back against the child widow taboo. RAJBIRAJ, 30 December 2008 (IRIN) - At the age of 11 Purni Shah was forced by her family to marry a 25-year-old man. Four years into the marriage, her husband died leaving her a child widow. Her fate is not uncommon in Nepal, which has one of world’s highest levels of child marriage, according to Nepal’s Demographic Health Survey. Over 63 percent of girls marry before 18, and 7 percent marry before reaching 10, the survey said. But for those who become widows, the stigma can be overwhelming: They are often looked upon with disdain and suspicion, and even blamed for their husband’s death. “It’s a cursed life. There’s too much pain and hardship,” 30-year-old Purni told IRIN in the town of Rajbiraj in Saptari District, 400km southeast of Kathmandu in the Terai region, where child marriage is particularly common. “I don’t want to live like this any more,” she said. Fifteen years after her husband died, people refer to her as `bekalya’ (child widow) and she is denied even the most basic rights. Child widows fare much worse than other widows, often finding themselves marginalised, according to rights activists. In Saptari District alone, there are an estimated 1,000 such women or girls. However, there is little awareness of the issue. Only one NGO - Women For Human Rights-Single Women’s Group (WHR) - is currently working on the problem. The `bekalayas’ suffer terribly in this conservative society which stigmatises them and sets too many rigid rules to control them,” Madhvi Shah, a WHR activist, told IRIN. Banned from wearing new or colourful clothes (white clothes or a sari are socially compulsory for widows), child widows are barred from eating fish or meat, remarrying, and even showing their faces in the early mornings to “prevent bad luck”. They are also forbidden to attend weddings or other social functions, in case they bring bad luck. “We are treated worse than animals,” Shradha Mandal, who married when she was eight and widowed before her 16th birthday, said. To make matters worse, Shradha has no citizenship, making her a virtual refugee in her own country: In male-dominated Nepal, citizenship is acquired only after reaching 18 and on the recommendation of a father, brother or husband. A new law in 2008 allows citizenship recommendations to come from females, but it has not yet been implemented in practice, according to activists. Mandal has no proof of her marriage, and therefore no rights to her husband’s land or property. Instead, she has to survive on food provided by her mother. However, thanks to WHR empowerment training, some `bekalayas’ in Saptari District are starting to speak out and demand a voice. “I have not lost all hope of starting a new life,” 20-year-old Rekha Chaudhary said, explaining that she had started defying the strict Hindu rules in her village, Bisariya. “The first step is to make them more self-confident and aware of their legal and human rights,” said WHR’s Shah, explaining that the training was already having an impact. Kumar Deo, whose husband died when she was only 16, recalled how she started to break the taboo by wearing colourful clothes, put on red bangles and started to walk around freely whenever and wherever she wanted. “In the beginning, I was very scared but as the news about our defiance came out in the local media, that gave me strength,” Deo said with a smile, adding that she was now encouraging others like her to stand up for their rights. Backed by WHR, dozens of widows like Deo are now forming their own self-help groups. “It’s my life and I am not afraid any more,” said 17-year-old child widow Shanti Devi Mandap, married when she was 12 and now looking for a job. http://www.irinnews.org/PrintReport.aspx?ReportId=82135

Nadya gets Nepali Shoes

When Jwala and Dr. Indra visited Baton rouge in September, a friend of mine sent a toy home with them for their kids that made pop noises. The kids loved it and we got to hear it over and over and over...So, now that I have come to visit Baton rouge, I brought a gift in kind. Shoes for their little girl. She loves them and can put them on herself!! :) Don't you want a pair of these shoes for someone you love?

By the way, Nadya's little sister, Arden, was born this morning!!! :) :) :)

Something to look forward to...

Nepal to face major power shortage this winter KATMANDU, Nepal: Nepalese could face as much as 14 hours of daily power cuts this winter because of damage to lines that transmit power imported from India and low water levels in reservoirs that drive hydroelectric plants, an official said Friday. Sher Singh Bhat of the state-run Nepal Electricity Authority said the utility would be forced to increase power blackouts to consumers this winter. Power outages currently stretch to about five hours a day in Nepal. Floods in Nepal's southeast have swept away transmission lines used to import electricity from neighboring India and cannot be repaired by winter, Bhat said. The level of water in reservoirs used to store runoff during the monsoon is much lower than in previous years, which will reduce power from hydroelectric plants. The state-run utility company is producing only about half the necessary electricity to satisfy demand at present. Some electricity is imported from India but not enough to meet the shortage.A decade-long communist insurgency also hampered development work, including the building of new power plants. Although the rebels joined a peace process in 2006 and gave up their armed revolt, political instability has continued.http://www.iht.com/articles/ap/2008/11/14/asia/AS-Nepal-Power-Cuts.php

Update

• Namaste from Anandaban! The cold is here.
• It looks like I may be able to get my laptop back soon. The repairshop in KTM has now said it may/possibly/at the very least take a month "or more" to get in a part at a cost of over 130USD. I found out a TLM rep from the UK is coming this week. He has mercifully agreed to place the tiny part in his luggage. Cost of part: 15USD. The laptop problems began in July. It is now mid-november. The anticipation is almost too much.
• Visitors to Anandaban have been phenomenal. There is a constant influx through the guesthouse next door. This past year has seen: Japanese, Indian, Australian, Sri Lankan, Dutch, Brits, Aussies, New Zealanders, Scots, Irish/Northern Irish, Italian, Canadian, American and then some others with mixed up origins from the multiple countries where they've lived. Some are missionaries/pastors, scientists, clinicians, tons of students, accountants and administrators, counselors, prostheticists, biologists, physios, nurses, surgeons, anthropologists, trekkers and fundraisers. Meals there can be unexpected meetings with people from fields and places you never imagined.
• This is a pic of Anandaban's staff taken in August (with a few extra visitors at the time of course). We have two expat staff right now: me and Elisa the Australian occupational therapist (middle of the back row somehow looking shorter than she actually is). The staff are great coworkers.

• This past week, a plastic surgery team composed of a hand specialist, anesthicist and surgical nurse flew in from the UK for a surgical camp at Anandaban. Surgeons from Lalgadh and Biratnagar came to watch and learn. Some patients were prescheduled and another busload arrived Wednesday night (~23 specialty surgeries total). They managed to fit them all in. All but one were leprosy patients. Yesterday, I went to the operation theatre and observed while Dr. Indra and the visiting surgeon performed a tendon transfer on a 14 yr old boy's leprosy-affected hand. It was very, very cool. A tendon in the palm was divided into four and then woven around the bases of other muscles. It will allow him to regain some useful motility in his clawed hand. I have great pics and some video. The boy was awake for most of the surgery (local anesthetic/block). He will need to stay at Anandaban for a couple months to undergo post-surgical physiotherapy and learn how to use his newly "rewired" hand.
• Just to highlight how things go here in Nepal: The surgical team arrived on Sunday with only their carry ons and the clothes they wore. No luggage. No specialty surgical tools. Nearly everyday that meant one of the team had to travel an hour or so to the airport to see if they could recognize their bags in either the morning or afternoon flight from Delhi. Monday: "Sorry, your luggage must have been left in Delhi." Tuesday: "Sorry, your luggage never left London. It is still there." Wednesday: "Sorry, your luggage is now in Phoenix, Arizona, USA." Friday night it arrived at Anandaban after the last surgery was performed. The team left Anandaban Saturday morning. Such is life here. High strung people will not survive.
• In clinic this week, a 12yr old girl came in with leprosy. She came from outside KTM, but we found out that practically all other members of her family have or have had leprosy. She was beautiful and very brave during her slit skin smears. That is a test where a scalpel blade makes a small cut to scrape skin cells from the earlobes, elbow and knee to run a test for leprosy. Kids still get leprosy.
• I attended part of a 3 day national nepal science and technology conference this week. The maoist prime minister and the finance ministeer spoke on different days. There were numerous talks by mostly Nepalese students on their projects ranging from Biotech, Bioinformatics, Korean methods for country development, what diseases are available on products from the local vegetable and dairy markerts to what local drugs are used by Nepalese to treat their sick cows. It was an interesting chance to meet people.
• The lab has been undergoing painting inside and out for the last two weeks. We've also been using the opportunity to try to reorganize and clean out pieces of equipment that are old and irreparable (many things are from the late 70's and 80's and are too outdated for today's science or to get replacement parts). A local group is taking the stuff so that Nepalese biotech engineering students can have a chance to work and learn on medical lab equipment. If they are able to fix some of them, we can have them back for reasonable repair costs.
• 2 Graduate students in our lab at anandaban are finishing up their thesis for graduation from Tribhuvan University. It's alot of work. Imagine correcting multiple drafts of ~300 pages of science writing.
• In December, I will leave on the 4th to go to Delhi for a TLM south asia science meeting and then I will fly to Cebu in the Philippines for an IDEAL meeting (Initiative for Diagnostic and Epidemiological Assays for Leprosy; http://www.turingfoundation.org/lepra_uk.html#ideal). Hopefully, I will also be able to spend some time at the TLM hospital there in Cebu where they also perform leprosy research.
• Elisa has gone trekking outside Pokhara with an Australian "Trek for Treatment" group that arrived last week. Trekking = hiking/camping for days in the mountains. These groups really help to raise funds for TLM sites around the globe that practically minister to those afflicted with leprosy.
• Please pray for us. The season is very busy, but that also means that there are many opportunities.

No more private school, Nepal's Maoist government declares

The former rebels plan to put all children in public schools by 2010, saying it will even the playing field. By Bikash Sangraula Correspondent of The Christian Science Monitor from the November 15, 2008 edition Kathmandu, Nepal - The massive election win last April by Nepal's former rebel Maoists put them in the position to set the government agenda, and bring about drastic changes they promised during their campaign. But their initial proposals on education – to end private investment in schools and distribute academic certificates to Maoist fighters – have left many Nepalese worried. They're concerned that their new government will take the country in too radical a direction that favors its former fighters and Marxist-Leninist-Maoist ideology. "Recent statements by Maoist leaders are indicative of their political immaturity," says Krishna Khanal, a political scientist at Tribhuvan University in Kathmandu. "They have made strange announcements to please their cadres and fighters." The Communist Party of Nepal (Maoist) wields considerable legislative power to advance its policies. The group, which fought a 10-year insurgency from 1996 demanding a new constitution and an end to monarchy, is the largest party in Nepal's 601-member special assembly. With 220 seats, it has twice the representation of the second biggest party, the centrist Nepali Congress. The government also has few moderates who might push back against a radical agenda. The Maoists' biggest alliance partner is the Communist Party of Nepal (Unified Marxist-Leninist), third largest in the assembly, which also has radical roots and a history of armed violence. An 'unequal education system' The controversial announcement came Nov. 6, when Finance Minister Baburam Bhattarai declared the government would end private investment in education by 2010. Private investors, he added, should limit themselves to investing in universities. The Maoists have long opposed private investment in primary and secondary schooling, arguing that it produces an unequal workforce – those coming from private schools have an edge over their peers from public schools, they claim. "We have fought against this unequal education system for years now," said Himal Sharma, general secretary of All Nepal Free Students' Union (Revolutionary), the Maoist party's student's wing. "We are pushing for a declaration next year of free education in public schools till class 8. And a year after that, we want the provision expanded for up to class 12. Ideally, we would want an end to private investment in schools by then," he said. But the announcement has experts worried that the transition will undermine youths' quality of education. According to the Ministry of Education, private schools account for nearly one-third of the country's 41,000 schools. "The plan is extremely ambitious and highly unlikely to succeed," says Mani Wagle, principal and proprietor of Miniland School in Kathmandu that runs classes from nursery to 12. "Two years aren't enough time for the government to provide an alternative arrangement for millions of school-going children and thousands of teachers in private schools." Nepal's government-run schools tend to have poor infrastructure. Newspapers here regularly run stories of government schools in the remote hilly areas where classes are conducted outside due to insufficient number of classrooms. (Earlier this year, many schools went for months without books but yet were still mandated to run.) The passing rate of public school students is poor. According to figures from the Ministry of Education, 82 percent of private school students who take the School Leaving Certificate exam pass the test, compared with 36 percent of public school students. People like Professor Khanal, of the Tribhuvan University, say that privately-run schools have provided the quality education that public schools have not. Suprabhat Bhandari, president of Nepal Guardian's Association, calls the announcement ridiculous. "Is the state intending to produce a mediocre manpower in the name of equality? And how will the state ensure that Nepalese children who do their schooling outside Nepal are not more competent than those who study in the public schools here?" Fighting for a degree Mr. Battarai further announced that the government is working to give academic certificates to Maoist fighters who couldn't attend schools during the war. "Our friends who could not continue their education due to involvement in the armed conflict but have the necessary skills and knowledge should receive due academic recognition," he said. Khanal, calling the idea unacceptable, likened it to the thinking during China's Cultural Revolution, when a degree holder in agricultural science was valued less than a farmer who hadn't received formal education. "These are the same revolutionary leaders who said Nepal's formal education is useless, and asked youths to leave schools and join the war. Why the need for certificates now?" he says

Christians face attacks in India - Violence flares as Hindu militants accuse missionaries of stealing followers

Apparently their election year is having severe repercussions against Christians in India (southern neigbor of Nepal). http://thechronicleherald.ca/Religion/9009157.html There are many articles online. Some of them say that the refugees are being forced out of camps with no where to go. India asked to investigate Hindu massacre of Christians. India's Human Rights Commission has been urged to investigate the wave of violence which killed at least 100 Christians and forced another 100,000 to flee their homes. http://www.telegraph.co.uk/news/worldnews/asia/india/3229253/India-asked-to-investigate-Hindu-massacre-of-Christians.html

Bits and pieces

• OK. My laptop is still somewhere in KTM. Anandaban's secretary is probably very tired of me asking about it. The repair shop says they need parts from abroad. Singapore, maybe or maybe not...nobody knows.
• It makes a huge difference when evictions are performed on occupants that you did not know were there. Apparently, I was late for my routine deworming/anti-protozoal. Let's just leave it at that.
• Tihar was an interesting festival. We (Elisa and I) stayed in Bhaktapur with friends for a couple days of it. We'd grown used to the relative quiet seclusion of Anandaban. Sorry, I have. Elisa travels frequently into villages etc to help organize community based rehabilitation groups, so she's slept in many different areas of Nepal. More densely populated village/city life is different from Anandaban.
• On different days of Tihar, people worship the crow, dog, cow, bull and then a day for sisters to worship their brothers. The city shuts down, kind of like Christmas back home. With narrow streets maybe centuries old, there are strings of lights and candles on, around and in front of village homes. The dogs, which are mostly street mongrels (no animal control), are wearing marigold necklaces and have the red tika (dot) painted on their foreheads. Ditto for the cows (which roam free). We saw motorcycle rallies (parades); during which it occurred to me that if I were driving a motorcycle without a helmet, I would not want the guy riding behind me smoking a cigarrette. There is also the wonderful neighborhood vehicle that parks in front of your home at night with large speakers connected to the car battery. This is so the entire neighborhood can simultaneously share in the joys of a bunch of young guys' favorite Hindi tunes. There was one particular song they really liked; but for one or reason or another, the party-mobile moved on around 10pm or so.
• Don't ask me what the dogs did all night. I did get up at first to see. They were acting as if they were on the most important mission in the world - having meetings, conferences and then spreading out over neighborhoods while maitaining communications. It culminated in an early morning (4am) festival in front of where we were staying; which Elisa says finally drew out a neighbor to pitch some rocks at them. People start moving in the streets around 4:30am, ringing the bell at the neighborhood shrine everytime someone completed their morning puja (worship). I recognized some of the dogs the following day when walking the streets. They were sleeping REALLY good. There is also a caroling tradition associated with this holiday, except you're expected to give money to the performers. The second night was much quieter. There were some more carolers that worked the neighborhood; but from the sound of it, the group eventually petered down to one groggy guy. They also had a favorite song (ie, one song).
• We really had a good time and enjoyed the visit. We got to play games with our friend's kids, ate daal bhaat at least twice a day (cooked and seasoned exceptionally well). We walked around and saw places. It was beautiful. We had great company. We did not suffer. :)
• We had another free medical camp last weekend in a nearby village. We had 10 doctors and a couple of volunteer nurses. In roughly 5hrs, 820 people saw a doctor, 500 received medication. Some were referred to surgery. I would love to show you some pics, but you will have to wait with me for my laptop.
• The temps are already dropping. I'm using thermals on some days already.
• Hey, if you read this, drop me a line (or a comment, at least) and let me know how you are doing!

An Indiana paper prints story of recent visitor

• Remember the medical camp this summer with the dentist? Well, it looks like a couple from that crew went home to Indiana and was then interviewed for their local paper.

Trip to Nepal is eye-opener Educators studied schools, hospitals, way people live By Julie Young / Star correspondent Posted: October 30, 2008 It might not be everyone's idea of a dream vacation, but for New Palestine residents Betty and Bill Widbin, traveling to Nepal was an experience they will never forget. "We received a teacher's creativity grant through the Lilly Endowment to go to Nepal for a month. Our son, Kyle, works as a missionary over there, and we wanted him to lead us on a journey though the schools and churches of the region," said Betty Widbin. The Widbins and their daughter, Julie, traveled in June, loaded with care packages for children put together by the students at Belzer and Craig middle schools in Lawrence Township. Betty teaches at Belzer and Bill is athletic director at Craig. Not only did the trip give them a chance to see their son, it also gave them a deeper cultural understanding. "It was a renewal for us," Betty said. "We hadn't seen our son for a year and a half, so we relied on him to get us around, understand the currency and communicate." The Widbins spent their time in Nepal visiting schools, orphanages and a leprosy hospital. Betty said the hospital had a dirt floor and poor conditions, but it didn't stop the spirit of the people. Even the poorest of the poor were willing to open their homes and extend kindness to the strangers in their midst. She said it was a humbling experience to see how much people in the United States take for granted. "Education is the highest priority for parents in that region," Widbin explained. "It really makes you stop and think about what we have here in America." In Nepal, if students do not pass an exam after the 10th grade, they are not allowed to continue their education and are destined to work in the fields. In fact, she said, suicide rates among teens greatly increase when test results are released. Students are taught English, and they loved practicing their second language with the Widbins. "They all looked so dignified in their uniforms that it was easy to forget the poverty they come from," Widbin said. "We also learned that physical education is not taught, but rather students get their exercise walking miles to school each day." In the orphanages, the Widbins distributed the presents they brought from their students, who were given a dollar and challenged to "Pay it Forward." The Nepali children enjoyed the Frisbees, stickers and stuffed animals but also took the time to show the Widbins their games, which they have since brought back to their students. Since returning home, Betty said they have spent hours viewing more than 4,000 photos and eight hours of video footage they shot on their trip. They have shared their experience with family and friends and have even managed to stay in touch with several Nepalis through e-mail. "We will never be the same after this trip," she said. "It definitely had an effect on our roles as teachers and how we see students in America. The feelings of being an American in a Third World country made us realize how blessed we are."

http://www.indystar.com/apps/pbcs.dll/article?AID=/20081030/LOCAL07/810300344/1139/LOCAL07

Hello

• (I still have not figured out how to make paragraphs work in blogger, so just imagine the bullet points as paragraphs, ok?)
• Well, since I last posted, Holly has come and left. It was a tremendous treat to have someone from Baton Rouge in my house here in Nepal. We speak the same language, like food from the same culture and can crack jokes in south Louisiana slang. I cannot show any of the marvelous pics taken during her visit, since my laptop died again the day she left. The laptop is in KTM, but it is the biggest festival time of year and it can be difficult to get things done here in Nepal. Somewhat similar to the Christmas season in the US. Somewhat. Multitudes of turkeys and pigs "discreetly" die in the US during our Christmas season. In Nepal, it seems every family that can afford it sacrifices a goat or a waterbuffalo. I will spare you the details, but the details of the ceremonial dispatch and what to do with the remains are a little more "open" here than where you may live. So, it was my first Dashain festival. There was a definite dent placed in the goat population.
• The hospital closed during the week of Dashain. The day the lab reopened, staff worked feverishly (some literally) all day. So many people had problems. Stomach and fever issues. What happens in a culture where refrigeration is not necessarily common, but festival cooking for large gatherings is made? Some do not eat meat all year except during this holiday. Great aftereffects. It would put me off meat, too. Someday, I may tell you about my experience with beef gel served at a feast we attended...
• In the paper the other day, I saw that 47% of the Nepalese population cannot be accessed by roads. 50% do not have access to a toilet. It is easy to come to Nepal and stay in the tourist places accessible by roads. But those places do not give the whole picture of Nepal.
• Elisa, the Aussie occupational therapist, is the other foreign employee at Anandaban. Her work is very different from mine (lab work in hospital). It is her job to travel out to communities and villages and organize small support groups among those afflicted with the after effects of leprosy or other debilitating handicaps. She helps them learn and maintain self-care so they can potentially limit their disabilites from getting worse. In a culture where most jobs involve alot of physical labor and career changes to suit disability are not a common option, Elisa's work is critical to helping leprosy patients live the rest of their life.
• Anyway, it means that when Elisa travels to the field, she often returns with great stories.
• A few weeks ago she had to go to Chitwan. During the community work, they found a family with six members affected by leprosy. Elisa stayed in the health department's quarters, a several story building. She heard noises at the bedroom door, so she opened it. Three goats came in. They were wandering upstairs in the building.
• A recent foreign visitor in KTM had an earache. Someone offered to take him to a clinic (this is a very loose term here). Whoever the doctor was told the foreigner this advice: "Do not blow your nose or your brains will come out. Take these three medications. "
• By the way, want to trek to Mt. Everest Base Camp? Imagine 21 days without bathing. Water for some washing can be heated in a bucket over burning yak dung chips, if you like.
• How about unwinding bandages from a wounded foot in a clinic and having a frog jump out and scamper across the floor? It happened.
• Anandaban is a haven, a quiet secluded refuge with clear air and beautiful trees. Patients can come here and receive good treatment in a accepting environment. But you do not have to go far off the compound to see the difference.
• Next Saturday, we will be performing a free medical camp in a nearby village. Next month, we will have another one at village more remote. Holly brought donations that are going to help fund this one. We will drive partway and then have to walk the last 3 hours carrying whatever gear we need to treat the people (part of the 47% not accessible by road). Due to the travel time, we will also leave the day before and return the day after the camp. Sleeping bags, etc. I will take pics for you. Hopefully, I will be able to post them by then! As always, your prayers are greatly, greatly appreciated!

Stepped out of a shop,and suddenly there were 1000's

Fifth convention of NWPP kicks off Himalayan News Service Kathmandu, August 22:A three-day fifth national general convention of Nepal Workers’ and Peasants’ Party (NWPP) kicked off in Kathmandu today.Earlier, NWPP organised a rally in which thousands of people of Bhaktapur participated. After passing through main thoroughfares of the city, the rally converged into a gathering on the premises of National Academy.Inaugurating the national convention, Narayan Man Bijukchhe, president of NWPP, said the nation should be made self-dependent.He said the dependency of Nepal on aid and relief from international communities has to be changed. “We should be capable of providing relief and support victims of natural disasters,” he said.The goal of national development cannot be achieved without advancement in the field of field of science and technology, he said.“Every party is opting for the Ministry of Defence, but none is interested in handling the Ministry of Science and Technology as well as education,” he said, adding, “ The budget for science, technology and education sector has to be increased.”Altogether 200 party members from 35 districts have arrived in Kathmandu to participate in the general convention. The party will have a closed session tomorrow. The election of the executive committee will be held on Sunday. The committee will have a tenure of five years.

The Prime Minister has been chosen

Nepal braces for revolution with ex-warlord as PM 1 day ago KATHMANDU (AFP) — Nepal is set for more major change after the Maoist leader and former warlord Prachanda was declared prime minister promising to deliver a left-wing revolution. The charismatic leader -- whose nom-de-guerre means "the fierce one" -- was overwhelmingly elected as the impoverished country's most powerful man in a vote by lawmakers late Friday. His ascent from rebel to national leader cleared the way for his band of ultra-leftists, who feature on a US terrorist blacklist, to forge ahead with their vow to radically reform the country. Nepal, the world's newest republic, has already undergone momentous change over the past two years, which have seen the Maoists end a decade-long revolt, unpopular king Gyanendra sidelined and then sacked and the 240-year-old monarchy abolished. The Maoists' number-two leader and top ideologue Baburam Bhattarai hailed a "golden dawn" and vowed historic change. "We feel that Nepal has found its hero. For any epoch-changing society, we need a hero," he said of Prachanda, a 53-year-old ex-school teacher. "After Europe's capitalist revolution, Napoleon came along. To institutionalise socialism in Russia, Lenin appeared. "In Nepal, to institutionalise the federal democratic republic after 10 years of People's War and mass popular movement, Prachanda is here. "We have already finished destroying the roots of feudalism in Nepal. Under the leadership of Prachanda , the main agenda of the new administration will be nationalism, republicanism, economic and social transformation," he said. The former rebels were on Saturday locked in negotiations with their allies to form the nation's first post-royal government. "We're in talks with the parties in our alliance and hope to form a government in the next few days," Maoist spokesman Krishna Bahadur Mahara said. Prachanda has come a long way. Until 2003, there was only one photograph of him in public circulation, but as he began work as prime minister, his picture was splashed across the front page of every newspaper Saturday. He was profiled largely sympathetically with writers charting his progress from teacher to revolutionary and finally prime minister. "New Nepal turns left, Prachanda turns PM," the Himalayan Times said in a banner headline. Naya Patrika (New Paper) went with "From the bunker to Baluwatar," referring to the prime minister's official residence. In April, Prachanda steered his party to victory in elections for a new national assembly, set up as part of a peace deal to abolish the monarchy and write a new constitution. But as premier he will face major challenges, including urgently dealing with soaring food and fuel prices that have paralysed an economy struggling to recover from the civil war. There is also the issue of integrating the 20,000-strong rebel army, currently confined to UN-monitored camps, into the national army. "The integration of the People's Liberation Army into the Nepal Army will see lots of arguments and counter-arguments. The way they deal with the army is very crucial," said Amit Dhakal, editor of the Kathmandu Post newspaper. "The Maoists will try to bring in populist and radical economic reforms. But financially they will have lots of constraints." Prachanda, who was inspired by Chinese communist leader Mao Zedong and Peru's Shining Path guerrillas, has also had trouble shaking off his image as a ruthless warlord. Critics say the ultra-leftists have yet to fully abandon violence and that their feared youth wing -- the Young Communist League -- must disband to prove they are committed to peaceful democracy. "He is a communist hardliner, but now he has a responsibility to meet the standards of democratic principles," said top Nepali Congress party official Narhari Achayra. "This is an acid test for him to prove his commitment to democracy."

News snips

• Well, there will be no pics for this update. Here are some news briefs. Unfortunatley, I have not been able to figure out why blooger will not recognize my separate paragraphs. I will try bullets.
• Saraswoti's father passed away suddenly two weeks ago in the hospital. It was unexpected, as he was just checked in and was talking to people. He had a serious infection, but it all happended so quickly. Within minutes, the body was taken. Cremation is normally within the day or so. So, I did not see Saraswoti for two weeks after that, as that is the standard time for funeral traditions.
• Cholera is here. When we go to Patan Hospital, some halls are lined with the extra patients. It's a bad deal.
• The rains are beginning to lessen in frequency. During monsoon, it can take days and days for laundry to dry. I'd never ironed my socks before now.
• Got another leech (thankfully much smaller, and I interrupted his meal this time).
• There was a snake incident at the lab. I have pics but cannot post them...
• My laptop fan died. Therefore, my laptop will not turn on. A computer repair place (rare find) just let us know 2 & 1/2 weeks after inquiries were made that they may be able to fix it. I am to give them my laptop (on which my clutch is pretty tight), they will take a look, see if they can order parts and then see what they can do. Ho long do you think that may take?
• We sent a -80C freezer to a repair shop in March. They just notified us (August) that they cannot fix it. That is a reputable and good repair shop.
• I like my laptop.
• Anyway, the snake (maybe 4ft long; grayish with slight yellow bands; 2" diameter) was hiding in the overhang above the back door of the lab. I was able to watch as two of the guys used sticks to pop it out. Then Ganesh with a stick and Dil Bahadur with a brick rendered it dead within seconds. I was impressed with Dil Bahadur's aim.
• As we are a lab staffed with scientific thinkers, the bulge in the snake's abdomen incited curiosity.
• Yes, we did. Silwar used a scalpel. It was a baby bird (rather large - a bit bigger than a mockingbird).
• This is the season for drying kursani (chili peppers). The people somehow weave the stems to form long bundled chains of peppers that are hung to dry out second and third story windows. Beautiful. But of course, I cannot show the pics to you now.
• You would not believe the size of the slugs here. Think snickers bar.
• Which brings me to language. The other day, someone was talking about eating "slud."
• Wanna guess?
• Salad.
• "Suviets"
• Australian for napkin (serviettes). :)
• However, I'm probably the only one for some distance that uses the word "ya'll".
• Also, this week for journal club, the clinicians had wanted to have a special talk on "flu therapy". Someone else told us that there would also be discussion of "research station". It turned out to be "Fluid therapy and resuscitation".
• I can almost count to forty in Nepali. This is a big deal, since the number system renders practically every number 1-100 a different word. The second digit is actually hinted at by the first word.
• A baby has been born within the last 24hrs to Abidan and Muna, compound staff. Yes, there is a pic. A really nice one also with Jwala - but you cannot see it.
• In the previous post, I asked what you thought Dil Bahadur was doing. He is mowing the lab lawn. I have other pics to show you the small area that he spent the morning mowing in that position. It is not an easy job, and he was not even half way finished. No envy. If any one I knew from home did that, they would not be walking right for days. It was good thing the next day was Sunday and he was off. I've heard a rumor that someone in KTM has a push blade lawnmower (manpowered). I've yet to see a gasoline run lawn mower.
• I heard a story of a previous patient from a nearby village. She was working a threshing/grinding wheel (rotating stone on stone - probably by water buffalo). Her braided hair got caught up in the wheel. She carried her scalp in a plastic bag while she walked hours to the hospital. Dr. Wim Theuvenet, a plastic surgeon, was med superintendent of Anandaban at that time. He was able perform surgery on her.
• Today we had some new patients come to Patan clinic in KTM. Two of them were women. One wept as she did the preliminary tests to confirm her diagnosis. Another young one was 8m pregnant in reaction. Her husband came with her for this visit.
• But it can be very hard. Husbands can cast them out over this diagnosis.
• Please pray for them.
• Dhanyabad (Thanks)

Want to guess what Dil Bahadur is doing?

Some "friends" should not be brought home!

Well, I met my first leech recently.

In Nepali, it's called a jewghaa! Aren't you proud of my vocabulary skills??? They now include a specific "bug", rather that the generic term "keerah". :) Personally, though, I could have done without the introduction to that more specific word.

(Spotted sock courtesy of Mrs. Rita and Mr. Eddie)

In typical blond fashion, I spotted one inching across my bedroom floor and wondered where that thing came from. Blondly, I threw it in the toilet. It promptly crawled out of the water (stupid, they live in water, and their grip resists flushing). Someone told me that one can put salt on them to make them drop off when they are attached. I quickly dumped salt on it. It began to spit up blood and fell back in the water to once again begin its crawl upwards. Where did the blood come from? It must have recently fed!! On what??? It was only then that I decided to pull up the cuff of my jeans to look - and there was the bleeding wound.

Leeches use anesthetic (painkiller) and anticoagulant (bloodthinner). That means you do not feel the bite and then you bleed for hours after. Charming. I had carried it back from a medical camp into the house!! I dumped enough salt on it to flush it and then left more salt in the water in case it tried to crawl back. Uuuugghhhh! My coworkers that have to walk miles to work, arrive in the morning to wash the mud (monsoon) off their shoes and check for the leeches. They say that they are picked up most easily when walking through the grass. As a microbiologist, the breach of my personal skin barrier by a wet slug like creature that could have sucked elsewhere seems particularly invasive and repulsive. By the way, salt/soda/flame makes them regurgitate - so I will not be using that method to dislodge them from my skin!!! They say using a fingernail to break the suction is sufficient. Nasty, bloodsucking, slimy things...

Just so you don't think the week was uneventful...

Doctors call off strike in Nepal Kathmandu (PTI): Nepal Medical Association (NMA) has called off its three-day strike in hospitals across the country, after the government assured them of fulfilling their demands. The doctors across the country went on strike on Wednesday after the relatives of a deceased patient vandalised a private nursing home and threatened to kill the doctor who had treated the patient. Doctors had demanded the government to provide security for health workers and health institutions. The medical body withdrew the strike after the Health Ministry assured them of bringing in the Health Protection Bills and investigate into the incident. "Under the new arrangement the local administration will also provide one security personnel each to doctors as per the threat analysis if the government receives such a request," said Dr Senendra Raj Upreti, chief of Public Health Administration, Monitoring and Evaluation Division at the ministry. The government has also assured the doctors to provide security personnel with communications equipment at all private and government hospitals with more than 50 beds, Dr Upreti said. The government decided to allocate Rs five million immediately for Health Practitioners and Health Security Fund until the new act is enforced. The strike had halted all medical services except emergency at all hospitals across the country for last three days.

Devichaur Med Camp: June 28, 2008

(There are some rather good pics to go in this post, but the monsoon cloud cover is...well, interfering with the upload. So, just check back later and see if there has been sufficient break in the clouds for me to insert them. :) Someone was able to rally up enough cash to do another medical camp last Saturday. So, we loaded up a bus with hospital staff, medicines, equipment and volunteers and headed to Devichaur, a small village just a little further south.

But...let me back up a little to tell the story properly. Friday afternoon at 4pm, when the hospital offices close, I looked out from the lab to see a group of buhdeshies (foreigners) walk by the windows. Apparently some group had come by unexpected again for a tour. It is a very common occurrence. Imagine what would happen in your country if people just walked into the hospital main office and asked for a tour of the hospital?? It happens alot here. Anytime. So, I went out to see who this particular group was. Americans!! One was working as a short term volunteer for a year in KTM, while the others were friends that had come to Nepal for a ~2wk visit (Indiana and Alabama people). The group had met one of our short term volunteers at church. So, late on a Friday afternoon, they show up for a tour to see what happens at a leprosy hospital. I gave them a tour of the lab. They asked what was happening on Saturday, and I told them that alot of us would be going to do a free med camp in a village. They wanted to come. I made a phone call and arrangements for the 7 extra people to go with us. One was nurse and another was an engineer/doctor/dentist. Of course, on vacation, he was without tools. The other 5 were non-med people. By the way...a frozen shipment arrived minutes later for the lab containing some interesting packing materials. I had to find some children!! The kids here, not to mention the adults, had not seen anything like it before. The kids at home will know what this pic means!!! The next morning the hospital staff hurried about to find some dentistry tools and sterilization fluids, just in case there was opportunity for the dentist to do something. If God had sent a dentist, it was probably on purpose. There must be some"one" who needed a dentist that day. Well, within minutes of setting up inside the community school, the dentist had his first patient...and then another, and another... While we saw altogether roughly 310 patients that day, the dentist was the busiest of them all. The other doctors had to wait for him to finish before we could leave!! Another amazing fact was that the people were so happy to have their teeth pulled. And that dentist pulled teeth all day. The lady on the far right was the first. Seth Chandler's flashlight has now been used in two camps. It is a tremondously bright, engineer-approved flashlight that serves doctors and nurses here very well!! I keep it in my backpack. Thanks so much, Seth!!

What about the other extra five people that also came at the last minute to help? Do you know that we had a post for each one of them to work? We had not one person too few nor one person too many. We had exactly the right number of people for the camp to run very smoothly. Most did door patrol like me, and we had just the right number to cover every door!! God is good. The malnutrition was not as bad in this community, so most of the little ones had the right color hair. But there were several people identified that needed surgery. It is absolutely amazing to watch patients who have to be in tremedous, unbelievable pain walk distances to come. One woman had fractured her shin bone with a huge visible lump from 15 days ago. She walked there. A 20yr old girl came. she was 9 months pregnant with pre-eclampsia and very high blood pressure. Her husband had left her for another wife or woman. Her inlaws were not really taking care of her - which, in this culture, they are supposed to. In this culture women can't/don't remarry. They typically aren't educated. What prospects would she have for living? How? She was in a pretty bad situation, and only 20. She needed to be admitted to a hospital. Both she and the baby were at risk of dying. We sent her to the city hospital, which could perform a ceasarean if necessary, with a letter to bill us for all of her needs. From the dentist room, I could hear a child screaming and screaming and screaming. Nepalis flocked to stare in the windows. The dentist pulled an infected tooth, and fluids came draining out. Afterwards, a doctor commented that bad infections like that can often turn into meningitis. They said the child could have died without the treatment. This is no lie. The poverty is very bad and people are very uneducated. Therefore, they often do not seek medical care until late. Especially, if it is just a girl... So, today is Wednesday and we went to Patan hospital in Kathmandu to perform the weekly leprosy clinic. We went up to the maternity ward to see the 20yr abandoned girl. We held the so tiny one which was born Sunday. The mother's slightly older brother was there. Someone asked when she would be going home. She could not answer. She will leave the hospital in a few days, but it is a difficult situation. There is so much desparate need here. But in the midst of that, God does very good things. He arranged people to go to her village and put her in a place so she and her baby would not die. The doctor said that we came at just the right time. It had been critical. God did that. He sent a dentist to an area. There were so many there who needed it that day. Now that Dr. Indra, the surgeon, has come to Anandaban - we see many who need surgery in the camps. And he loves to do surgery. :) There is so much that goes on here at Anandaban. These camps only happen once every couple of months when some missionaries scrounge some donations together for us to go. But every day, the people at this hospital treat so many people. I will have to post some pictures and stories from them sometime. It's just that I get to go to the med camps; while on regular work days, I'm back in the lab doing behind the scenes work. :) Those last minute volunteers just showed up. They weren't altogether sure what they would do on Saturday. Maybe go to Nepali church or shopping. Instead God drafted them to the unexpected and employed them. During lunch break at the med camp, I overheard the dentist comment, "This is alot more fun that spending the day shopping..."

Bits and Pieces of Life Here

There have been bandh's (protests, strikes, road closures) for 6 days straight, and then today the road cleared in Kathmandu. People were able to open their businesses and travel about to get what they needed. We were able to get in and out to provide services at the weekly leprosy clinic in a city hospital. Tomorrow, though, it looks like it will be another bandh. Sometimes they are for political reasons. Sometimes they are about fuel. Sometimes both. Sometimes it seems they can be about nearly anything. Someone told me that there are only seven roads leading into the valley. A few strategic roadblocks of flaming tires can paralyze city transport. And, no, the police do not typically stop them. In the city, common people rely on cheap public transport to be able to get to work and get food. Only the very, very, very few have their own car. By the way, I heard that the other day (while I was gone to India) several of the visiting foreigners at Anandaban partook in a jeep ride nepali style : 15 passengers in one jeep designed for 7-9 people. Cars here are not anywhere near as large in size as those in the US. :) They rode for a bit and then three decided they would rather ride on the roof: one nepali and two british guys. The roads here are not quite what you are used to. They are a "bit" rougher. A dutch visitor once commented that europeans sometimes pay money to be therapeutically shaken about like that. :) Anyway, when it began to rain - for it is the monsoon season - the passengers kindly passed up an umbrella through the window to the roof. The veteran roofrider Nepali easily held the umbrella aloft in one hand while the two foreigners clung to the bars with both of their hands for dear life. Luckily, they later on were able to catch a separate vehicle and did not have to do the worst part (around the mountain) of the journey on the roof. It is terrible that no pictures were taken. Such a thing would have needed to be posted here!! :) So, here are a few current headlines to share... Nepal fuel price protesters stone cars Thu Jun 19, 2008 1:41pm IST KATHMANDU (Reuters) - Hundreds of Nepali student activists, demanding a roll back of fuel prices and transport fares, stoned or set fire to several vehicles in the capital Kathmandu on Thursday, police said. State-run Nepal Oil Corporation increased petrol and diesel prices by about 25 percent last week saying the move was needed to cut losses due to a global oil price rise and to meet a domestic fuel shortage. Transport operators also raised fares between 25 and 35 percent for taxis and buses, sparking fresh protests. On Thursday, angry student protesters shouting "withdraw the fuel price hike" marched in the streets of the capital throwing stones on passing vehicles and disrupted rush hour traffic. Protesters threw rocks and destroyed window panes of the car of Nepal's Chief Justice Kedar Prasad Giri, a Reuters photographer on the scene said. Giri was unhurt and escaped with his security guard to a nearby house. "The street has turned into a battlefield with protesters throwing stones at the riot police," said Deepak Rijal, a local journalist at another protest site. A police jeep was also set on fire, Rijal said. Students are demanding a 50 percent discount in transport fares to students, from 33 percent now. Petroleum dealers say fuel was still in short supply despite the rise in prices. Nepal imports about 800,000 tonnes of petroleum products from India annually and owes millions of dollars to the state-run Indian Oil Corporation, the sole supplier of oil. In January, a similar increase in oil prices was rolled back after countrywide protests crippled life for two days. http://in.reuters.com/article/southAsiaNews/idINIndia-34131320080619 But, then I check the US news and see this. I've been here in Nepal for 6 months, away from home for a total of 9 months. Living here changes the perspective of how things look back in the US. Angry Kids Protest Gas Prices After Mom Cancels Cable TV http://www.foxnews.com/story/0,2933,371230,00.html SALT LAKE CITY — Sadie and Pyper Vance have had just about enough of high gas prices. The sisters are still years away from being old enough to drive, but that doesn't mean the $4 per gallon price tag isn't hitting them as hard as anyone else. Cable TV was one of the family's budget-cutting casualties, leaving Sadie, 9, and her 7-year-old sister without their favorite cartoons and shows. "Gas prices are too high," Sadie said. "I just decided to come and protest so they'd go down." The girls marched through downtown Monday chanting and carrying signs made from old campaign signs. "All of my mom's monny goes to the gas tank!" Pyper's sign read. Sadie carried a sign asking drivers to honk to lower gas prices — adding that her mom had to cut "cabel." The girls got some waves and a few thumbs-up to show support. "I think it's great," said Hamid Tayeb, who was walking past on his lunch break. "It's unfortunate that kids are doing it before we do." They lost cable TV? Here a family uses a portable tank of fuel for cooking their food and boiling their drinking water over a gas burner (me, too). Without the fuel, you cannot cook or have safe water to drink. With price hikes, a two week supply for a family of four can now cost nearly half a month's wages. For some, it costs more than a month's wages. Most families are extended - not just four members. They get frustrated. What can they do? The king was just ousted from the palace to be replaced by a government system that has yet to be decided. What can they do? The other day, I commented to one of the compound kids that I had not seen one of the other kids for some weeks. Where was she? They told me that the girl didn't come to play after school anymore. They think she now goes to work after school at the gravel pit with her parents - where most of the labor is by hand with shovels, hammers and baskets to carry. I'm not meaning to play guilt for what we have. I'm just trying to explain what things look like here - when I've been away, outside our culture for months now. It can be difficult to try to deal with or try to reconcile between the two worlds.

So, tomorrow I fly to Delhi for a meeting...

Jackals, lizards, raptors delay flights in India Jun 17, 3:14 PM (ET) NEW DELHI (AP) - Jackals, monitor lizards and raptors descended on a runway at New Delhi's main airport after heavy rains Monday, delaying flights, an airport official said. The animals were looking to dry off and warm up after the first monsoon rains hit India's capital, and their appearance on the runway forced authorities to stop planes from taking off and landing for about an hour, Indira Gandhi International Airport spokesman Arun Arora said in a statement. Animal welfare authorities cleared the runway of wildlife, including monitor lizards that measured as long as 2-3 feet, Arora said. Arora didn't say how many flights were delayed. The Hindustan Times newspaper said about 100 flights were affected. In the monsoon season, which runs from June to September, heavy rains routinely delay flights all over India. http://apnews.myway.com/article/20080617/D91C0RL03.html

So, the warmer weather has come. The snows in the Himalayas melt. Rain develops and the rivers fill. The water creates hydroelectric power and we have fewer power outtages. Nice, but the cloud cover is not so great for satellite internet! Ah, well, we can't have everything...

080531 Med Camp

Anandaban treats those afflicted by leprosy every day. It is an enormous task, as some need to stay a long time due to complications or needing surgery and physiotherapy to help reconstruct their ability to live outside. This can take months and sometimes recurring visits for years. Yet Anandaban also has the privelege of reaching out to the communities nearby that are in need of help. It will never be an understatement in Nepal: Life here is very different. While the US may be called the land of opportunity, people living in these conditions can live for generations with very limited options. That can be very difficult to understand, when we have become so used to always being able to "do something" about most problems we have. It is beautiful, but the foundational logistics of clean water, adequate power supply and food are issues here. This past Saturday, we were able to do another med camp in a village about 45 minutes further away from KTM (Kathmandu). It is really a unique opportunity. Someone donated funds. We take the funds, fill a the hospital bus with staff from the hospital, boxes of medicines and some local missionary type volunteers. We then travel to a site for a day to provide free medical checks. This weekend, we rode only 45 minutes further out into the hills. Someone had built a few buildings there as a school. We set up in several rooms there: a mens room, women, and pharmacy with med records holding a registration table outside. This trip, we had 8 doctors that traveled with us: 4 volunteer Nepali doctors, 2 Nepali doctors from Anandaban, an Irish doctor that previously worked at Anandaban who was back to visit (and could speak excellent Nepali) and a swiss volunteer (she had a translator beside her). That was the most doctor volunteers I had seen us to have, but we needed it! In less than 5 hours, they saw and treated roughly 435 people. Several cases were identified that needed surgery: several hernias, two with broken bones (1 from a month ago), and another who had had a perianal abcess for a month was carried in on a stretcher. We are so glad to have Dr. Indra, the new surgeon. These people are now scheduled to have surgery back at Anandaban this week. Because I'm lab personel, I can't really help the doctors much here! So, I help with crowd control. :) This helps to keep things orderly so they can properly work with each patient. I stood at the door of the room where women were seen by the doctors. I know how to smile and say "please come in", "please sit down", "please wait" and "another person please come". I can also take pics to help communicate with people back home. Sometimes, many of the people come with colds, stomach parasites/problems, aches and pains. Sometimes it is things more serious (like the surgery cases). At another camp, there was a young girl who had been unable to walk for months; but she had just been left in the house. We transported her to a hospital that day. And then there are the little ones. Nepalis usually have beautiful tar black hair, but some of the little ones in the villages don't. It's because of malnutrition. Sometimes, they are not usually responsive like normal, healthy babies either. They sometimes just stare or cry. When it looks like highlights, it can show seasonal changes in diet. Sometimes there is good food, sometimes not. Also, some of the girls marry very young (12-15 yrs, sometimes into homes of multiple wives), have many children and the cycles that occur for generations just keep going. How old do you think this girl is? And the child in front of her with severe malnutrition? (I do not think it was hers) Some of the volunteers also collected clothes and shoes in KTM to distribute. Here are some of the shoes that were donated to give to the kids in the village. These are the communities we are posted to work and live amongst.

Some of these things, it just hurts to see them. And it should.

Historic Vote Ends Nepal's Monarchy

Published Date: 29 May 2008 By Russell Jackson NEPAL's political leaders last night voted to abolish the monarchy and declare a republic, ending 239 years of royal rule. Once the resolution is passed, King Gyanendra will have 15 days to leave his pink 1970s-era concrete palace in central Kathmandu.The Maoists, who emerged as the largest party in elections held last month, had led calls to oust the king and create a republic. The former communist rebels signed a peace agreement in 2006 that ended a decade-long insurgency. The proposal, which was opposed by only four members of the 601-seat assembly, states Nepal is "an independent, indivisible, sovereign, secular and inclusive democratic republic nation". Royal privileges "will automatically come to an end", the declaration adds. Last night there was no immediate response from the palace on the vote. Across Kathmandu, young men marched with red flags as Nepalis young and old celebrated.Near the convention centre where the Constituent Assembly was meeting, thousands chanted, "Long live the republic!" . Although the celebrations were largely peaceful, police at one point used tear gas to disperse a crowd that gathered too close to the building."This is the people's victory," former Maoist rebel Kamal Dahal, 22, said. "With today's declaration of a republic, we have achieved what we fought for."The government of the new Nepalese republic is expected to be led by the Maoists.The assembly has two years to come up with permanent arrangements for a new constitution.

Jolien's pics

The internet seems to be working rather well this evening!! So, while I go to someone's house for a meeting, I'll leave it to load up photos!!

A Dutch scientist, named Jolien (pronounced Yo-leen), has come for a month to perform a short study. Over the past few weeks, she has taken some very good pictures. Here are a few. This is the hospital bus returning from a day at clinic. I'm looking out of the window!

Rebekah (center) and her younger sister Elisa came to my house to finish Rebekah's cake for her 13th birthday. She had broken her arm the day before I came back from my trip.

Here are some of the people working in the lab, plus a couple of visitors who wanted training in PCR (the two guys on the far left and the far right). The two girls in the back are graduate students (Prativa and Binita) doing their masters project in the lab. The girl in front (Saraswoti - not the same one who works in my home) is a research assistant in the lab and the man with the mustache is Kapil, who has worked at the hospital since 1979 and with every head of the research lab (est. 1983) that has ever been at Anandaban.

Silwar works in the clinical lab. Here, Silwar is performing some standard tests on patient samples. Although primarily a leprosy hospital, Anandaban also provides general hospital services to the surrounding area.

Kapil collecting patient samples in the hospital. (They are laughing!)

Sometimes, we also have to go to other clinics, like this TB clinic, in order to collect patient samples.

Here, Kapil is freezing patient cell samples in liquid nitrogen so that we can run tests on them later as a group.

Here are Aychut and Dhurba performing a mouse footpad harvest in the clinical lab. This test allows us to check if a patient has a drug resistant form of leprosy; however, it takes 6m-1yr to properly complete. Research has identified a faster method, but it is currently far too expensive and technical to practically use in the field. So, we have to use mice...

Here are four of the men who also work in the lab or take care of the mice. They do an excellent job.

Jolien took this picture while looking into the bus before we went to Kathmandu to perform a clinic. The pile is medical records and supplies needed to serve the patients. That's me sitting next to the pile!

During clinic, two new graduate students from a local university came to discuss possible projects for next year.

WARNING: somewhat graphic wound photo is next! Don't worry, I will probably never post the really bad ones.

Leprosy patients can lose the ability to feel in affected areas, often the hands and feet. It is common for patients to come in with wounds from rats that come during the night. Sometimes these patients live alone. The patient does not feel it and is unaware until they notice the wound afterwards. This man's toes and heel had been knawed on by a rat(s). Dr. Paul Brand used to recommend giving these patients a kitten. What is sad, is that this patient may have been cured years ago; however, the nerve damage from the disease can cause permanent or ongoing problems.

During clinic, patients come from all over Nepal. This man was particularly hard of hearing but our dr's tried to find some way to communicate. He just smiled and said he still could not hear them!

During a national holiday (everyone was off from work), Jolien also visited a leprosy colony on the other side of the valley. I have not been there yet. Here are a couple of the people who live there. Saraswoti and Jolien (who took all of these pics). Jolien will leave next Thursday to return to Holland.

What is Beautiful?

Every heard the saying "beauty is in the eye if the beholder". It's true. In the US, certain colors are fashionable. Certain jewelry. Certain mannerisms. Put them together and there is the cultural ideal of what is beautiful and what is not. In Nepal, a nose stud is beautiful. Most women and girls have them along with multiple ear piercings. Earrings are more common amongst men and boys. Showing the midrif for women wearing a sari is entirely acceptable. Cleavage is not. Dots strategically placed have great meaning. A child placed yellow petals on my head and said it was beautiful. Marigold petals are used in worship by the hindus. You will see men walking about with a single petal at the top of their head or tucked behind their ear. Garlands of flowers mean great honor. In my culture, soft colors can be beautiful. Here, when I bought sheets or towels of gentler hues...the people here did not think them so beautiful. They looked old. Bright, blaring colors in a land of hand laundry appropriately indicates new "beautiful" purchases. So, I'm learning what is beautiful here. Sometimes what I wear and do would be "beautiful" in my country, but not here. I have to learn. As Christians, we live in the world, but not of it. We are born into a different culture while remaining in this one. God's definition of what is beautiful is different. We have to learn to suit Him even if that is different from what we've known. There are things a Christian is to clothe himself in, that the natives will not find attractive or "beautiful". God's bride, the church, is being clothed to suite Him; but when He was here in the flesh, those very attributes led Him to be despised and rejected by the culture of this world. What does God find beautiful? Which cultures acceptance do you have? Which one will you seek? When you see Him face to face, will you suite Him? Will you be like Him? Charm is deceitful and beauty is passing, But a woman who fear the Lord, she shall be praised. Provers 31:30 P.S. What would you say if I came back with a nose stud? :)

Why we are not going to Patan Clinic today

Occasionally, there are strikes and protests called bandhs (nepali for closing). All roads are shut down by protestors. Today Kathmandu is shut down for another one. So, today we cannot travel into town for the weekly leprosy clinic there nor will most of the patients needing it be able to access public transport to get there. This is why this time: http://afp.google.com/article/ALeqM5ghSAZ8I4zwrYZtU1xDZcGn4jgAdA

Anandaban 50th Anniversary Celebration

For the 50th celebration, some of the kids dressed in traditional clothes and performed a dance. This is Rebekah, Samen and Mumtah.

These are some pics also taken at the celebration.

Dr. Rachel and Elisa dressed for the occasion.

Rachel, Murdo and their kids James and Esther in front of the main hospital building.

Murdo and James.

Some of the kids dressed in traditional clothes to form the welcoming party for the honored guests and officials. (Left to Right: Samen, Alisa, ?, ?, Rebekah, Mumtah, Esther and Ankit)

I could never get the two of htem to look at me simultaneously!!

Caroling in the wards

Video left over from Christmas caroling in the hospital wards. This one is one of my favorite songs. Many of the songs are nepalized versions of foreign songs, but this one is an original Nepali one.

Hills, Mountains and Villages

There is no way to do justice in photographs to the Himalayas. Anandaban is in the foothills. On clear days, the Himalayas miles away become visible from Kathmandu. These videos are taken on the ride from Anandaban to the Kathmandu city, which is in the valley usually about an hour's drive away (16km). The road is "rough", but I promise you I am trying to hold the camera as still as possible. Even though, we could see the himalayas on these days, you cannot see much but maybe a seemingly insignificant white line of stuff in the photos. Because there are only a few places on the drive through which glimpses are good through the trees, some videos may have duplicate locations on different days. One has the gravel pit where women and men work from dawn to dusk. All those big trucks on the road are carrying rocks to gravel pits to be crushed. The actual crusher is a machine, but everything else is manual labor.

These next videos are clips from riding through some of the, I think 7, contiguous villages we go through before entering Kathmandu proper. Life is a little different.

Video's of Anandaban Hospital Grounds

A panorama in front of the main hospital building (there are more wards behind it).

From the front of the main hospital to the lab.

Internet in Rio allows for video posting!

On a Saturday, Saraswoti invited me to go with her and some other women on a "walk" to see some monkeys. We walked for about an hour and half, seemingly mostly up hill, before we reached the destination. It did yield some nice pic opportunities. This video is taken about halfway to the moneky place. The last mountain seen, covered in pine, is the one Anandaban is on - where I live. So this is part of the valley my workplace overlooks...every day. Beautiful.

Dr. Rachel, Ishwor and Sarag Thapa

Checking patients from Western Nepal.

Nepali homes

These are pictures of some typical nepali homes in the valley below Anandaban. The animals are generally kept in the first floor (I think).

Med Camp at a Brick Factory

This Dr. Sushma treating some people living at a brick kiln. She is one of the doctors that works here at Anandaban.

Saraswoti and James MacDonald

James is the son of Murdo and Rachel MacDonald. They've now left for Scotland...and there are now no infants on the compound. Hopefully not for long, though...surely. I am spoiled to having access within my community to the entire spectrum of age groups: infant to retirees! Such vacancies, especially in the infant range, cannot be tolerated long! :)

Anandaban (the main hospital building)

Ok, It takes quite awhile to load up pics, but here is one.... :)

Besides seeing a working elephant intermingled with traffic today...

Nepal Students Burn Tires to Protest Fuel Hike http://in.reuters.com/article/businessNews/idINIndia-31524820080122 KATHMANDU (Reuters) - Hundreds of students burned tyres and brought traffic to a halt on the roads of Nepal's capital on Tuesday in protest against a steep hike in the price of cooking gas and diesel. The Nepal Oil Corporation, the state-owned monopoly, raised prices of diesel, kerosene and cooking gas on Monday by up to 20 percent to cut losses. It was the second rise in three months. Protesting students said poor people would suffer because of the hike. Black smoke from burning tyres filled the sky of the hill-ringed city, home to 1.5 million people. Activists threatened to stone vehicles of drivers ignoring their call to stay off the roads. They threw stones at riot police who tried to stop them from starting fires. Several people were injured in the clashes, police said. Landlocked and impoverished Nepal imports about 800,000 tonnes of oil from India annually, but in recent months has faced an acute shortage after India's state-owned Indian Oil Corporation (IOC) reduced supplies. It said Nepal had not paid its bills. IOC is the sole supplier of oil to Nepal, which has no wells of its own. Petroleum products account for about a tenth of Nepal's energy needs, most of which is met by fuelwood.