Dhulikhel – The last Week

This week beganwith Christmas Eve and I spent the morning at work helping Sumana, Krishna and Pushpangali to prepare for the first Pulmonary Rehab session at the hospital.  Sumana announced it in Morning Conference and received many questions from Dr Ram who is the senior doctor at the hospital and new Vice-chair of Kathmandu University which is a prime-minister appointed post and extremely prestigious.  The news was taken very positively which was excellent.

Lunch was Dal Bhaat as normal and then I headed back to the Guesthouse to start getting ready for Christmas.  The plan was to have a European Christmas dinner and to invite all the people who were special to us in Dhulikhel, 28 people in all.  Lisa Charlotte and I packed up the Christmas decorations and the tree at the guest house and headed over to Dhulikhel Lodge Resort which is the only hotel in Dhulikhel, and the one we had persuaded to cook our dinner for us.

 

In DLR kitchen

Lisa and Gill

We were having dinner in the downstairs cosy café as this was a private dining room with a lovely open fire.  We arranged the room and put up all the decoration we had bought.  The hotel staff were extremely accommodating and interested in what we were up to there was a small audience the whole time!  Lisa and I went into the hotel kitchen and prepared mulled wine, bread sauce and stuffing balls (Paxo all the way from England!).  The chefs in the kitchen thought this was highly entertaining, but they enjoyed the tasting, particularly of the mulled wine!

Isabel and her friend

Geyatri

Gill and Charlotte continued to decorate the room and Gill and Michel had bought masala boxes for everyone as a stocking.  These are small boxes with sweets, fruit and nuts that are given here at festival times.  Charlotte had also made biscuits in the shape of everyone’s initials that we were going to use as place settings.  The Christmas music was attached to the speakers, the lights and fire were lit and we were ready to go.

Alon

Me and Sumana

Apple pie and bright yellow custard

Our guests were the physio department, some of the nurses, min and his brother, and friends we have met during our stay.  We had purposely mixed everyone up with the seating and everyone settled and got talking.  The dinner came minus the stuffing balls as the chefs didn’t realise it was to be served with the meat! Eventually everything was present and we tucked in.  it was SO good to have roast chicken and roast potatoes with all the trimmings.  Pudding was apple pie with the most luminous yellow custard I have ever seen, but it was all delicious.

Krishna, Vijay (the DJ) and me

The atmosphere was festive and everyone got into the spirit.  For some it was their first ever Christmas celebration and it was great to have our new friends there.

Nishchal, Lisa and Sophie

Charlotte and Pushpangali

After most people had headed home the foreigners, min and Sam sat around the fire for a last drink and it was the end to a perfect evening.  We packed up the decorations and headed back to the guest house where we put the decorations back up before heading to bed.

Vijay, Min and Sam

Christmas day Lisa, Charlotte, Alon and I were invited to Vijay (the DJ)’s church in Bhaktapur for their Christmas day service.  Lisa and Charlotte took the bus and I went on the back of Alon’s bike which was great fun apart from the small near miss altercation with a bus!  We met Vijay and headed to the church which was a building on 2 floors in its own gate enclosure.  We met Bimala, Vijay’s sister and their family and friends.  They were so welcoming and really took great care of us.  WE arrived at about 10am and the service started soon after.

In the church everyone sat on the floor as we expected.  The programme was made up of singing, dancing both spontaneous and dancing demonstrations, plays and dramas, games, gift giving, prayers and very short sermons.  It was all in Nepali and we didn’t understand the majority but with Alon’s translation and with the atmosphere we certainly got the themes of the day and the atmosphere was special.  The service finished at 5pm and even though we had been there for 6 hours we had thoroughly enjoyed the whole day and it had not felt too long at all.

After the programme we had delicious food prepared by the church caterers, and The king of Curds, “Bhaktapur curd” was served for dessert (5 times to Lisa!).  Lisa and I said our goodbyes and took the bus back to Dhulikhel arriving at about 6.30pm.

Christmas Day dinner was vegetable Thukpa which is a noodle soup and a real favourite of ours.  Min joined us for dinner.  After dinner we gave out our presents and stuck to the tradition of the youngest gives the presents out!  Min received a blanket, a jumper and some aftershave.  Lisa received, a snow dome, a Nepal bag and some jewellery.  Charlotte received a purse, a Nepal bag and a toy smurfette.  I received a scarf, a notebook and a photo frame, All really lovely presents.  Min was so proud to have his first Christmas in the guest house.

Dr Koju (Santa)

Chicken Kiev nepali style

Wednesday or Boxing Day (why is it called boxing day?) I was back at work.  The Christmas feel was still in the air as we had planned secret Santa today.  The morning was spent fishing off reports and finalising a few fine details.  The whole physio department was then collected in a hospital vehicle to go for lunch with Dr Koju who is 2^nd in command of the hospital as his way of saying goodbye to Michel who is also leaving this week and has been here for 10 months.  At the Himalayan Horizon hotel we did Secret Santa and Dr Koju played the part of Santa although we did not sit on his knee!  I ordered the best looking Chicken Kiev I have ever had and spent the rest of the afternoon stinking of garlic!

Back at the hospital I took part in Pulmonary Rehab, and it was brilliant to see the programme coming together.  There are many teething problems, but the team are gradually working them out and I think the project will be a big success.

Wednesday and Thursday evenings were spent packing and trying to work out how to get everything back to the UK.  5 bags later………

Friday morning I finished up at the hospital, having final meetings with Sumana and Ranjeeta.  The physio team held a farewell party and had bought food, cake and drink as a treat.  Sumana and her mother had made sweet and savoury Yomari as today was a festival day in the Newari calendar called Yomari Punhi. These were delicious.

At 2.30pm Bimika and I were collected by a hospital jeep to go to the guest house to pick up my bags and Lisa and them Michel en route, before taking us into Kathmandu the Kathmandu guest house.  It was not nice to leave the Hospital or the guesthouse, even though I know I will visit soon with my sister, I felt very emotional.

Bimika

Gill, Bimika and me

On arriving at KGH I checked into a plusher room than normal, using Elizabeth’s arrival as the excuse!  Gill joined us and Bimika then spent the next 2 hours getting me and Gill ready in our saris for Sachit’s wedding reception.  Bimika did the complete make-over on us, helping with make-up, hair and dressing.  
 It was such a tricky job that she even called her sister-in-law for back up!  Eventually we were pinned and secure and ready to head off.

Sachit and his new wife

Physio girls, Michel behind the lens

Walking in a sari is different, but I felt very elegant and glamorous and 2 westerners in saris certainly got heads turning.  As short cab ride and we made our grand if not slightly late entrance.

Sachit looked very debonair in his outfit and Harsimran looked beautiful, dressed head to foot in red and covered in sparkly beads and jewellery.  At a Nepali wedding reception they spend most of the time sitting up on a stage meeting their guests, and we had lots of photos with them there.  I am pleased that they were able to come down from the stage and have a good dance with us for some of the time.  The evening was spent chatting, eating, drinking and dancing and it was a lovely event that I was so pleased to have been invited to.  It was an opportunity for the physio team to get all dressed up (and they certainly know how to do that!) and also to meet Sachit’s family and new wife.  I hope to see Sachit again before I leave but I am not sure I will so saying goodbye was sad.

Thanks to Bimika’s hard work the saris stayed intact all night.  I absolutely loved wearing it and skyped my parents, my aunt and uncle, my sister and Ian before taking it off!

Saturday I had a lovely lay in.  My room is heated and I have electricity all the time this is sheer luxury!  I met with Noga and her parents briefly before they departed for Israel, for some tea.  Noga and I then headed off to new road to find material and a tailor to make Noga a Chinese dress.  Unfortunately Noga wasn’t feeling too well, so we headed back to KGH for her to relax and me to tackle packing bags again!

Today I am sat in Pumpernickel my favourite place to have breakfast and it is now 1.15pm.  Elizabeth arrives in 5 hours and we then head to Pokhara tomorrow to celebrate New Year.  It all feels like it moving very fast towards the end now and although I am looking forward to going home I am not ready to leave.

Happy New Year to you all and I will see you in 2013 x 

Week 8 Dhulikhel – Nearly the last week at work!

Our students have been on placement for 4 weeks and this is their last week which has come around so fast.  The world is also supposed to end this week, which frankly would have been a bit annoying as I’m looking forward to our Christmas dinner next Monday!

This week has been spent planning and informing everyone about the new clinics and Pulmonary Rehab services that commence next week.  I have also been finishing off other reports and projects so that next week that will be mainly taken up with Christmas won’t be too stressful.

Tuesday afternoon Gill and I took our Saris and material to the local ladies tailor to order the blouse and underskirts to be made.  It is really hard deciding how long you want the sleeves, or how low you want the front to be, we are so used to just picking it off the shelf.  They should be ready next week in time for Sachit’s wedding.

Our tree

Wednesday afternoon we went into Banepa top buy some Christmas decorations and Christmas presents for Min.  When we got back we went to the “Department Store” as called by the locals, known as the local shop to us and bought a 1m high Christmas tree and some Santa hats that Raj and his father has got especially for us from the wholesaler.  After dinner we decorated the guest house with all our purchases and put up the lights and decorations left over from Tihar, whilst listening to Cheesy Christmas music – Perfect.

Thursday evening Charlotte, Lisa and I went to a local restaurant with the Interns.  It was the same place we had been to before Niv left for China.  It serves fantastic momos and sequoia (deep fried buffalo), it also serves the local home brew called Rucksi which is lethal, or so I hear as I have successfully avoided it so far!  Isabelle, who is the other Luxembourger in town, and a couple of her friends joined us as well.  The Nepali Interns are getting used to the fact that western girls drink and stay out late, I think we have been a bit of an education for them.  The evening was spent with Isabelle impressing the Interns with her Nepalese which is excellent as she has been here for 3 years, and talking about football (which I obviously had a lot to say about-not!). The conversation always turns to talking about life in the UK, they are really interested in how our lives are different.  These guys really want to travel to the west, but the value of the Nepalese rupee is so small that it really feels impossible to them.  It was a really fun evening, and we were all home by 11pm – which is a really late night here! There are no rules about smoking indoors in Nepal so sitting for the evening in the smoke fog probably contributed to the sore throat and blocked nose I woke up with on Friday.  I did go into work, and selfishly ate the advent Chocolate as I needed the pick me up, but headed home a little early to bed. I have promised Michel he can have to chocolate on Monday.

Saturday morning was an early start as the Physiotherapy students had organised a picnic in Dolalghat.  This is about 2 hours from Dhulikhel towards the China Border and is a popular spot by the river for picnics Nepali style.  This means the bus was loaded up with enormous sound systems and generators, benches and mats, half the catering staff from the hospital, large gas cylinders and burners, lecturers, and students from all 3 years.  We stopped at various points to pick up food supplies, bags of tomatoes, meat, and veg.  The bus was pumping all the way there – Gangman style and the like blaring out at top volume while the students stood in the gangway and danced – even though it was only 8am and not a drop of alcohol had been consumed. 

Buses and speakers on the beach

When we arrived the bus made its way down the dusty narrow and in some places not bus friendly road and parked up down by the river.  There were already 4 other buses here all kitted out with the same sound systems etc – I could see this was not going to be a quiet day by the river.

Food on the beach

Boating

Whilst the kitchen staff were preparing breakfast we went out in a dugout boat which took us up stream against the strong current - no mean feat, and then allowed us to drift back to the bank.  These boats are pretty unstable and it was a slightly scary ride not helped by Michel standing up and unbalancing the boat half way through!!

3rd year students

The only time my brolly has been used for sun!

Drying soggy bottoms

Back on the bank we lounged and waited for breakfast.  After breakfast we took a rafting ride which was nothing like the Trisuli trip Sarah and I took in October as it was very sedate, and no amount of jumping up and down and screaming by us really improved this although we probably helped the rafting guys get some good trade with our efforts to make it look exciting!  The sun was out by this time and so we lay in the sun drying our now soggy bottoms (and we all know this is not a good thing Mary Berry).  All this time the students had the music on which was a mix of Gangnam Style and Hindi music.  Hindi music is very deceptive.  It often starts off sounding like a western song I think I know and then dives off into a Hindi track.  Gill and I spent some time learning some essential Hindi and Nepali moves ready for Sachit’s wedding reception next week.  Then lunch which was beaten rice, chicken chilli, curried veg, poppadum’s, prawn crackers and tomato pickle.  All prepared from scratch and all delicious.

Sumana won!

Or was it designed just to make us look silly?!

Missed!

The afternoon was spent playing games such as spoon and marble (like egg and spoon but held in the mouth and using marbles), bash the pot (being blindfolded, spun and then given a minute to find the pot and hit it with the stick – much harder than it sounds), dancing and singing, oh and with more eating as the snacks appeared mid-afternoon.

Dancing

More dancing and dinner arrived which was delicious again.  3 helpings of curd and fruit later and we all piled back onto the bus to head back as the sun had gone and it was colder and dark.  The music and the dancing continued all the way home the students had no lack of energy.

We took loads of photos by the river at the end of the day, trying to get the perfect team shot!

Charlie's Angels?

Sumana, Inosha, Me, Nishchal, Michel, Gill, Shova, Preeti

I got back at about 7.00pm, waited for the electricity to come on at 8pm, boiled some water and recreated a hot shower, dried my hair and tried to look presentable ready for the first Christmas Skype call home to Ian, Mum, Dad, Sister, Godparents, Cousins(ish) and Maisy the dog.  Then to bed as my cold and throat was really kicking off and after such a busy day I was exhausted.

Sunday was spent finishing booking for the next stage of the trip and packing my excess baggage up ready to ship to Delhi.  I am ready to go home, but I am not ready to leave so I feel like I’m a bit in limbo.  I hope that by getting all these bits sorted today, that I will have less things buzzing in my head that are distracting me from just enjoying the last few proper days here in Dhulikhel.  Fingers crossed.

 

Week 7 Dhulikhel

This week at work I focussed on finalising the planning with Sumana for the new respiratory initiatives of a Bronchiectasis Clinic and an Inpatient Pulmonary Rehabilitation programme.  An outpatient PR programme like we have in the UK is impossible here as the patients come here from all over the region and due to logistics and financial constraints they generally only come once so repeated input is impossible.  We completed the staff training and will be working with the medical doctors next week.

On Friday I arrived at the Hospital at 7am to join the Hospital Jeep going to Dahding outreach centre for the day.  Dhulikhel hospital has 17 outreach centres which support communities in isolated places.  They are usually staffed by a local community nurse, and a medical assistant, and have the facilities to hold clinics and perform minor procedures.  Dahding is a 30min off-road drive from the main road to Pokhara, about 2 hours from Kathmandu.  For an outreach visit there is a doctor and a community nurse, and then they include others such as interns, physiotherapists and visitors like me.  The visit usually has a theme such as Women’s health or Internal medicine.  Dahding this time was Women’s health. 

First stop on the journey was breakfast, which was curried bean soup and Puri which is a puffed up round flat bread. Then we settled for the ride.  Most of the way was on the main road which was generally OK by Nepal standards, just the odd bumpy section that was damaged by landslides etc.  Once we turned off the road it was a real 4x4 experience.  One hand on the ceiling to stop me hitting my head and one hand gripping the seat to stop me leaving it! 

The view from Dahding

The terrain opened up and we drove around the edge of a steep valley to the medical centre, which had amazing views across the gorge.  Dahding is a new facility and it has a small operating theatre, a clinic room, a small ward of 4 beds and a pharmacy.

Dahding Centre

Patients turn up and are seen on a first come first served basis.  As this time of the year is colder the numbers that turn up are less.  The first case was a child who had previously had stitches for a finger laceration, and now had an abscess on the finger.  This was drained and cleaned and antibiotics were given.  The child was only 5 or 6 and she came alone.  The Nurses chose to hold her down to perform the procedure and this was distressing to see but no amount of persuasion was going to make her hold still, and without a parent there, treatment was given in the patient’s best interest

Nurse Education Group

The other cases we saw were mainly gynae, and ante-natal check-ups.  I didn’t understand the assessments as they were all spoken in Nepali, but the notes were written in English so by looking over the shoulder of the doctor I could keep up with what was going on.  One young woman was in early labour, and she was going to stay at the Centre until her baby was born.  Unfortunately this did not happen while we were there.  The community nurse held an education session for the local women about breast and cervical cancer and the attendance for this was good.  After lunch and a few more patients we left and headed back to Kathmandu.  Outreach was a good experience and working with the doctors and the interns for the day was really interesting.

In Kathmandu I met up with Gill and Michel for dinner at La Dolce Vita, an Italian restaurant opposite Kathmandu Guest House.  This is a bizarre place as it is really Italian and I didn’t feel that I was still in Nepal!  Lasagne apparently made with Beef (although not sure how this is possible in a country where that is not allowed) more likely to be Buff (Buffalo).  Still very tasty and no bad after effects!

NEPTA

Saturday morning Michel and I took a cab to Chuchepati near Bodnath to meet with the Nepal Physiotherapy Association (NEPTA).  We were running a workshop for them to look at how they could develop the organisation for the benefit of members and the profession.  They are a fairly new committee, and I hope we were able to give them some ideas and direction.

A quick trip on the back of Nischal’s bike in Convoy with Bimika on the back of another bike, and we headed to New Road for Sari shopping.

View from roof top over Durbur Sq

Communist March in Durbur Sq

Bimika and I met with Gill and bumped into Charlotte, and went to the rooftop café in Durbur Square for lunch, before heading into deepest New Road for shopping.  New Road is the local place to shop.  It is busy and needs stamina – a bit like Oxford Street at Christmas!  Bimika, with her local knowledge took us to the right shops.  In the first Gill found the perfect Sari in navy blue chiffon with gold, red and white bling around the edge.  We tried on various other Sari’s as the trick with bargaining is not to look too keen.  We decided to go to a couple of other shops to try as there were so many varieties and we didn’t really know what we were looking for.  A trip to Bimika’s cousin’s shop found a potential Sari for me in red and gold, but by this time we were reaching saturation and needed to step away for a while.  We stopped off at Bimika’s aunt’s house for a drink, and whilst there she showed us some sari’s that were bought but not used for a wedding.  Amongst them was a bottle green one with gold and brown decoration.  It suited me well so I bought it, having been wrapped up in it and paraded around the living room!

Gill

Inosha another Dhulikhel physio joined us here, so we hopped into her car and drove back to Thamel to visit another of Bimika’s relative’s shops to buy Sachit a Jumper and a scarf as a leaving present.  Michel, who had successfully avoided Sari shopping by visiting Bodnath, re-joined us and we drove to Bhumi restaurant for Sachit’s leaving dinner.  Sachit was one of the lecturers at Dhulikhel and he is leaving to move to Canada in January.  He has been at Dhulikhel for many years and will be missed.  Dinner was lovely and there was lots of talk about saris and all the accessories, and visits to the tailors for blouses and petticoats that we would now need.

Sachit (flanked by Michel and Gill

After dinner, Michel, Gill and I walked back to Thamel and came across the “Mandala Street Festival 2012”.  One of the pedestrian side streets had been taken over by food stalls and a stage where a band called Kumbala were playing.  The band had drums, wooden flutes, and were creating a good sound, and the Nepali (mainly boys) were having a good dance and sing to the music.  The atmosphere was really buzzing and it was great to be there.

 

Sunday morning I had a lie in.  Gill and I then met up to go back to the first sari shop (isn’t it always the way) to buy Gill’s navy sari.  We bargained a reasonable price (although I am sure Bimika would be disappointed with us) of 5,500 (about 38 quid) and then went to bangle alley to try and find the accessories.  Neither of us are people that usually wear much bling, but with a sari, this is compulsory.  We tried various combinations, but we didn’t manage to find what we wanted.  We walked back to the cashmere shop from yesterday, and bought various jumpers etc. for ourselves and as presents for home, before meeting up with Michel for lunch.

From here we parted company and I tool a cab back to Bimika’s cousin’s shop to buy the red and gold sari I had seen the day before.  I know I didn’t really need 2 saris but I couldn’t get it out of my head……….

The rest of the afternoon was spent buying souvenirs and things to take home.  Now I have decided to ship a bag to Delhi instead of carrying everything around India I do not need to be so restrained with my purchases, also as I only had this weekend clear before Elizabeth arrives I thought I should crack on! (since when did I ever need an excuse to shop?)

At 5.30pm I met Deepa, another physio from Dhulikhel.  She took me shopping for the material that Gill and I would need for the blouses and petticoats that go with the saris.  This was followed by bangle and Tikka (the spot you stick on your forehead) shopping.  Deepa and was able to bargain and get good local prices for me.  The bangles we bought were red and gold and so very bling.  An attempt at shoe shopping was not fruitful as the electricity cut out at this time and we couldn’t really see what we were buying!

Back at the guesthouse I met with Rajesh from Himalayan Encounters as he was putting me in touch with a guy to help me with my Indian visa application.  Indian visas are notoriously difficult to get sorted.  They only open Monday to Friday and you need 3 visits that can take the whole day.  I made the decision to pay someone to have the hassle on my behalf.  I met with the guy who took my passport, application form, and photos, and who was going to get the visa for me for a fee.  A fee which I decided was well worth paying.

Monday morning I met with him again and we completed the first stage of the visa process.  I now do not need to go back to the embassy.  He will call me when it is complete.  It is a bit scary not having my passport in my sights, but I completely trust the guys at Himalayan Encounters so I can rest easy.

Monday afternoon was spent shopping for shoes, nail varnish, and a necklace to wear with the sari. I took the local bus back to Dhulikhel, and sat next to a boy carrying 2 very cute black and white puppies, and arrived in time for dinner totally shopped out and in need of an early night.