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.