Kathmandu 10/03/2013

On some days our driver goes out of his way because we are going to pick someone up or drop them off.  I don’t think we have gone the same way twice to get to the hospital or back, and each day brings new alleys, neighborhoods, and ever tighter sqeezes between walls, buildings, pedestrians, motorbikes, dogs, trucks – sometimes all at once.  Our driver is amazing and we owe him a lot for the excitement, driving adventures, and private glimpses of Kathmandu back ways and roads.

Today was our last day to lecture to the nurses, and Anne got a beautiful chocolate cake from the hotel.  We had a nice cake party, then lunch, and our final lecture that was about positioning in the OR and turning patients who are asleep.  We finished with a surprise mock code blue and cardiac arrest in the recovery room, so the students had to find the defibrillator, charge it up, and have a plan.  They have been such wonderful and gracious listeners.

Nurses' lounge on the ward.  Hospital still under construction.

This is the girl with the scalp defect who got a flap done, and the girl with the bent leg that is now straight.  They have struck up a friendship; brings tears to my eyes.

This young man is having a complex flap and reconstruction of his lower leg.  Right now he has an external fixator and the base of the same leg is attached to the calf of his good leg.  This flap of skin will be divided Friday and he can begin physical therapy.  He was in a car accident, but does not let it get him down.  There is a stack of chemistry books by his bed, and he continues to work at his studies.

Our little mascot - now his fingers open enough that he can give us not only high 5's, but "Namaste".

Good teaching on the ward, more patients, and more bamboo scaffolding.

Had a few minutes to walk up the street again to the temple, but the incense shop was closed.  Saw a couple of sisters on the road; kind enough to pose and introduce themselves.

Welding with goggles, no gloves, and an audience of unprotected friends.

On the way home we stopped at the Crematorium and viewed the many streets and shops.  Always colorful and full of hungry faces (monkeys included).

Gentle beast.

Loves a chin rub from our deft driver Sujan.

Dinner at the hotel, and early to bed.  Joe Lippi left today for India, and tomorrow we all head for home.

Kathmandu 10/01/2013

OR day, but no cases until late and no Dr. Shankar.  Another wild ride into the hospital, with traffic jams of water buffalo and bananas this morning.

I can't believe the loads we see people hauling like this with their heads and a strap.  One guy was walking down the street carrying a refrigerator in this fashion.  Literally back-breaking work!

One of our favorite little guys was quite a screamer when it came time to leave mom and go to surgery.  But today all is forgiven and he is everyone's perfect child again.

This young man needed work on his hand, and was very quiet but hung around everyone and made us smile.

Everyone is very respectful about taking off their shoes.  It does make me nervous to see people walking about the ward in their bare feet.

Ajeeta, our dear nursing leader, arrives from her motorbike in full regalia.

I worked on sorting machines and equipment to try to see what was needed, finished working on the policies, and made a list of things needed for a crash cart.

A couple more patient photos, and t-shirt...

This was Hien's patient she sat with during surgery.  Her leg was fused in a bent position and she had a release.  She looks happy and well.

Day of surgery.  Our German medical student got to scrub in, and then had a party as today was her last day.

Cute baby.  One shoe off; fascinated with nose.

At lunch with team leader Nancy Chee, and another dedicated Nepali.  The people here are beautiful.

Same baby; different fascination.

Back to the hotel to ready our talks for tomorrow.

Four of the team members stayed at the hotel to either recuperate and /or work on lectures for the rest of the week.  When we all got home, we went out to dinner at the Stupa View; near the Boudha Stupa.  It was our chance to say good bye to Joe and happy birthday to Sandy.  Good vegetarian food and pizza.

Garbage and plastic everywhere.  Effort to get clean containers and bottled water has backfired in that regard.

But non-polluting transporting of items is a help.

The streets are packed.

Bamboo scaffolding; what would OSHA say?

Building efforts with rebar; most of the work is by hand or with simple tools.

Spices.  The smells are wonderful.

The eyes of Buddha.  Clockwise around the Stupa, and everyone walks clockwise around the shops on the street too.

This old man climbed up and was rearranging the marigolds on the wood screen.  No idea what the significance was, but the candles and chanting were mesmerising.

Piles of incense.

Marketing effort, "Dear Human.  Jest feel me ones."  Sounds like a pick-up line gone wrong.

Prayer wheel.  Spin clockwise; the outside has blessings, you say some, and they all float up above to the heavens.

Kathmandu 9/30/2013

Back at our Hotel Tibet, but today is our last day at this hotel.  Trekking season is in full swing, so we are being moved to the original Hotel Tibet International, where we started.  So everyone packed and got ready to have our things relocated, and then to make our way to work.  We have two persons not feeling great who are staying home; the hotel has promised to arrange for their comfortable transfer.

Today is not an operating day, so we did some teaching.  I talked about policies in the OR, and positioning for a spinal.  The nurses talked about more peri-operative care issues.  We did see some of our patients roaming the halls, looking very happy and healthy.

Because we were being moved and a couple of our lecturers were home recuperating, we finished early and made our way home to our new hotel, Tibet International.  Once we got back to the hotel and had some delicious Tibetan and Nepali food, we took a walk to the Boudha Stupa across the street.  It was like a large Buddha Disneyland. 


Someone said the Buddha ashes are here, so it is a very holy site, and a circular structure which must be walked in a clockwise direction.  Across the circular street that surrounds the temple are shops of all varieties.  A bit oxymoronic to indulge in material pleasures next to a monument that honors the ways of the Buddha, but so goes our modern world.

On the way from and to the hotel, we were surrounded by tiny women with their tiny underfed babies, both mom and baby always looking wistful, hollowed, and fatigued.  They didn’t want money, but milk for the babies.  Probably the worst food for a malnourished gut, and often these are a scam – not even a baby belonging to the woman.  It is a very difficult and uncomfortable situation however, and if one gives money or food, the street fills with other takers and one realizes the effort made was so miniscule and brief.

Our burn specialist Len made a walk and had a first hand experience with a woman and her baby.  He visited their “home” and took some photos.  Sobering tale.

Everyone met for dinner, but as we had such a late lunch and I was trying to upload photos and get questions answered for the machine issues, I stayed in my room and tapped on my computer.  Internet did not work well and eventually went out, so I didn’t upload photos.

Kathmandu 09/29/2013 - Pokhara

Leave it to a Resurge team to put in long days all week and then use the weekend to … put in long days!

Today we got up at 4 a.m. to get on the road up the mountain at Sarankot to see first light on the Annapurna range (http://en.wikipedia.org/wiki/Sarankot).  It was interesting to wind up the winding, dark and potholed road and see the locals already up sweeping in front of their stores, walking up the hill to get exercise, and making food for their families.

We finally made it to the pinnacle and as we waited for Nature’s show to begin, the area filled in with more and more tourists.  Then a few buses arrived, and there was this other human show that was interesting too.  Unfortunately the peaceful quiet one would hope could accompany such a scene was not going to happen.  Quite the contrary; loud voices and clicking cameras on tripods dominated the moment.

Finally small rims of pink appeared on the tallest peaks, and then to oohs and ahhs the sun peaked up over the horizon and made a showing.  Then each peak began to brighten up and show its full height and glory.  No clouds to be seen around the mountains, but there were fingers of fog throughout the valley and the foothills.  Very nice display.

I had to be careful taking pictures because occasionally as I was looking through the camera, I would see a flash of color up close.  Enthusiastic neighbors.

Except of course Hien, but we had an arrangment because I can see over her head!

We made our way back down the mountain, had a wonderful breakfast, and everyone made their way back to bed for a nap.

Vickie serenaded with her ukulele.




















Flight back to Kathmandu, relax and shop, a couple of people not feeling great, and we move hotels in the morning back to Hotel Tibet International.  Trekking season, so all hotels are full.

Old-fashioned scale at the airport.

Did some shopping once back in Kathmandu.  Anne needed a pair of speakers to show a teaching video, and the shop owner and her daughter made a beautiful pair themselves.

No lawyers in Kathmandu!  So much construction; some of the store and home fronts have been bulldozed away to widen the streets.  One has to watch closely lest you trip on steps or fall in a hole in the sidewalk!

Thoughtful store owners will remind everyone to take care.