Through the looking glass

I'm all packed and about to leave for the New Delhi train station... i'm taking the overnight express train to Mumbai (express is a relative term... it's a 17 hour train, but I guess it's better than going by, say, horse... everything in India is relative...). I wanted to quickly upload a few photographs... it takes a lot of time to upload these (insert vast amounts of technical mumbo jumbo, but in summary: the internet connection works at yak speed, which is just slightly faster than an injured camel on rollerblades...). Here are a few of my favorites, in no particular order.... I promise to post more over the weekend in Mumbai, as well as to write a lengthy post about some of the interesting medical cases we saw... i'm thinking of you all, and please continue to be in touch!



Pahar ganj - this is the, er, neighborhood I speak so highly of
in Delhi, where my first hotel was... you really do have to be there
to smell it, feel it, to really understand the insanity... but hopefully
this provides a little perspective...



At our first clinic, at a small school in Reru...



With village children... everyone in the Himalayas looks
either much younger or much older than their actual ages...

With a Tibetan woman in one of our final villages... (you can see,

I'm getting quite a tan... yes!)

Mess tents doubling as kitchens, living rooms, and clinics...

all at the end of a rainbow :)

Triage, Himalayan style...

Tibetan monastery at the top of the world...

... spirituality spanning the generations...

Home comes, slowly

An overnight, 16 hour bus ride from Manali to Delhi... a four hour drive to Agra... a five hour drive back... that's 3 days on the road (and i use the term "road" very loosely...); 3 days of subsisting on peculiar tomato-flavored potato chips, enormous bottles of cold water, and a dwindling supply of pink toilet paper; 3 days of swerving along cliffs, around cows, and through groups of young men selling key chain Taj Mahals and expired chocolate; 3 days, of, well, India.

We just got back from dinner at a restaurant in Connaught Place... wandering through the heat, the urine-soaked air, the beggars, and, yes, the cows, i had a strange feeling... somehow, coming back from three weeks in the Himalayas, I recognized the insanity of Delhi, and in a strange way, welcomed it. It's not home, far from it... but, on the way to dinner, I found myself feeling strangely at ease navigating the streets and haggling with rickshaw drivers; it seems that, slowly, India is becoming less overwhelming. That being said, we did go to dinner at TGI Friday's... there's nothing like a cold drink and some cheesy nachos to make you feel home again. (I stole the paper place setting... it had a photograph of NYC on it). The dinner was amazing; for a few hours, i felt like I was temporarily transported home... and, when i stepped back outside into the Delhi heat, it wasn't so bad... not so bad, after all.

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There's so much to say about my experience in the Himalayas that it's difficult to know where to begin. So, i've decided to organize my blog entries about the trip into several topics, the first of which i'm calling "Itinerary"...

The premise of the trip was that we would spend approximately three weeks backpacking between remote villages, stopping in each for a day or two to set up medical clinics and treat patients. This particular region of the Himalayas, Zanskar, is mostly populated with Tibetan Buddhist refugees, most of whom fled after China took over Tibet. It's a magnificent region, and due to its remoteness, the villages have retained much of the traditions that the Tibetans have practiced for thousands of years. The people are mainly poor farmers, and due to the harsh geography, 'real' medical care is only available miles away in Leh and Manali, the two relatively major cities flanking the region. Traveling to such care is no small feat - it requires several days of travel by foot or, if they're lucky, on horseback, along narrow roads carved along the sides of steep mountains, and often in extremely hot or cold weather. There are also major social difficulties; how can a mother, no matter how sick, leave her 5 children and field work to go to Manali for a week? The traditional healers and lamas end up being a major source of healthcare, and although many villagers expressed their dissatisfaction with their services, few had any other choice. Clearly, better care is needed... So, HHE created this trek... and so we went...

After flying into Leh, the capital of Ladakh, and spending two days relaxing and acclimatizing, we set off on a two day bus journey, stopping in two villages - Padum and Reru - along the way. At the second village, I got my first taste of medicine in the 3rd world. We set up a clinic at a school, screening all of the children for dental and medical problems, providing antibiotics, vitamins, and de-worming everyone on site (we gave out mebendazole like candy). I was assigned to triage, and by the end of the afternoon, i must have seen about 300 children. Although there were some interesting medical cases, the most important lesson of the day was a new, deep appreciation for my own ignorance. I was astounded by the exam schedule posted on the wall; these kids, in addition to learning Ladakhi, the local language, study Hindi, Urdu, and English! These are three very different languages, with different alphabets and origins... and then there are exams in History, "popular culture", and mathematics! Here we are, in a tiny village in the Himalayas, and 8 year old children are learning about the Roman empire. In Ladakhi!

Another interesting observation, driving along the 'road' between villages... at one point, i saw, in amazement, a wall dividing two orchards growing fruit and thought of that Robert Frost poem, "Mending Wall". Frost writes, "There where it is we do not need the wall: He is all pine and I am apple orchard. My apple trees will never get across And eat the cones under his pines, I tell him..." I shook my head and thought, how sad, even here, they build walls, divide themselves... and then, minutes later, driving right past this wall, realized my foolishness... it wasn't a wall after all, but an irrigation system... a canal with water running through it to irrigate both orchards, not divide them. It was not the Ladakhis who had thought to divide themselves, but I who had assumed that they were like us... for the rest of the trip, I suspended such judgements and realized that, in very important ways, they were nothing like us at all. Thank goodness, for them.

After the two days' drive, we started off on our trek. We hiked an average of 1-2 days between villages, stopping in each for one to two days of clinic. The names of the villages, for the curious, are: Ichar, Cha, Purne, Testa, Kargiakh, Lakhong, Zanskar-Sundo, and Chika. I will go into details about the medical and social aspects of the trip in subsequent posts; here, I would like to talk about the trip itself. The logistics are, still, mind-boggling; there were 32 medical and dental students, dentists, and physicians; 10 kitchen workers and animal handlers, about 30 horses and donkeys, and 1 dog (Tazo, also affectionately known as 'poo dog' for his insatiable appetite for, well, poo). Each day, we would pack up our gear, have everything strapped to the animals, and then hike along narrow trails carved along the sides of the imposing mountains... I'm amazing no one tripped and fell, but how the horses manage to avoid toppling to their doom is another feat entirely...

As I know that my mother and grandmother are reading this, I'll mention the food... it was incredible. On what was essentially a bunch of pots cooked over an apparatus closely resembling a Bunsen burner, the cooks created, amongst various Indian dishes, cake (yes, cake - chocolate cake!), pizza, french fries, omelets, pancakes... let's just say that this wasn't a bare-bones mac and cheese kind of trip. Every morning, at 6am, we had a pot of hot Chai; every afternoon, a snack of chai and cookies, followed by hot soup before dinner. Several nights, we had hot water for bucket showers, and on the especially cold nights, hot water bottles to snuggle with in our sleeping bags. Outward Bound, this was not!

Needless to say, without this, er, logistical support, the trip would have been near impossible. The amazing care we got left us free to acclimatize, see patients, and really enjoy the experience, instead of having to worry about cooking and setting up camp ourselves. I'll reiterate again just how great HHE is, how organized and dedicated; I can't imagine having had a similar experience without them.

One more note before I retire to bad movies and air conditioning... one night, about midway through the trip, we hiked up a mountain to the Phugtal Gompa monastery, a famous masse of buildings encompassing a Buddhist school and supporting buildings. The monks served us chai and traditional bread with yak butter (never eat the yak butter... just say no, really). We came in order to set up a clinic there the following day, and were rewarded with the rare opportunity to spend a night at the monastery... fresh urine scents aside (i think 'urinal' is a national air freshener in India), what an experience! Giving us instructions about where to find our rooms, Andy, the physician trip leader remarked, "be careful walking around at night... down that hallway, if you turn right at the corner, you'll die. So, don't do that." (he was referring to the completely un-guarded cliff edge lining the side of the corridor!). In the morning, we sat in for the monks' morning prayers and were served more chai... I have amazing photographs of tiny little boys, 3 or 4 years old, running around in burgundy robes and orange hats... future spiritual leaders, but just kids, being kids.

After leaving the monastery, our group temporarily acquired a friend... a beautiful black dog nicknamed 'doggie lama' (he left the monastery to follow us after I fed and played with him... i know, i know, but i swear, he was the most spiritual dog i've ever hugged...).

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More to come in future posts, and soon, photographs.... until then, good night... thanks for reading, and please keep writing! I love hearing from all of you, and miss you all very much!

Massage in Manali

Namaste, everyone!

I'm sitting at an internet cafe in Manali, trying to catch my breath... there is so much to say, so much to explain about these past three weeks... and yet, I sincerely doubt that any words can do my experience justice. How can anything I write explain the trill of climbing over an 18,000 foot pass, or the tranquility of having tea with Buddhist monks during their morning prayers? I will write about it all, of course, but please forgive me if I cannot find the language to explain how grateful I am to have had the opportunity to not just travel in Zanskar, but to feel the people and the region from the inside...

I did, of course, also take hundreds of photographs, and i'll be posting some of those in the next few weeks as well, but again, there's no doubt in my mind that my little 35mm lens won't be able to convey the majesty of the Himalayas and the beauty of the people who live there.

In any case, let me just briefly begin by saying that every medical student should go on a medical trek with HHE... the organization, from start to finish, was incredible; the food was amazing (how do they bake pizza - yes, pizza! - on a 16,000 foot peak?!); the medical experience, extraordinary; and, of course, the scenery was enough to make your eyes water in wonder... I have never been to such a majestic place in my life... I can only hope to go back, again and again, in service of the people and my unending awe that such beauty still exists in the world.

Over the next few days, i'll post individual entries about the medicine, the people, and the trek itself, along with my reflections... I apologize for the delay in writing, but I've spent the entire day running errands, buying amazing Tibetan jewellery, and... going for an afternoon at a spa! That's right... a spa, including a facial and eyebrow threading... all in a little town nestled in the Himalayas! Who says I can't be girly once in a while? Besides, my poor blistered feet were begging for a little relief... :).

I have all of you in my thoughts, all the time... I miss everyone and will post again soon...

Final thoughts...

Leh is incredible... we flew in yesturday morning, with the most spectacular view of the himalayas below. Our hotel is unbelievable; it's as though the forest created it... everything is wood, and blends beautifully into the background of the town. The area is so different from Delhi... it's peacefulness resonates everywhere... you can feel the Buddhism all around. The Dali Lama is in town actually, but we have to leave for the villages before we get a chance to see him...

It was starting to pour on our last night in Delhi... today i checked the newspapers and read that several hundred people had died in the flooding in the north... pretty incredible, nature just coming down and deciding who gets to live or die. I don't have many good thoughts about Delhi - I felt it was dirty, congested, cold... everything that's wrong with modern cities, and none of the positives. But to read about death, and death so close you can touch it, wade through it... it's a chilly feeling, one that makes you stop, makes you wonder if perhaps you saw someone on the street, or met someone along the way, who is no longer here. Rain, heavy rain... and then, nothing.

On another note, in my last few minutes with the internet... there's a saying I read somewhere, goes something like, "the further away you are from home, the closer you feel to it". The more I travel, the more people I meet, the more I feel like a New Yorker, like a Jew, like an American... it's funny that years of living in NYC made me feel further from it, but just a few days in a completely different world, and I find myself telling everyone how "amazing" central park is, how great the medical training in the Bronx is... I suppose that when everything is foreign, the things you know become so much more dear.

Well, this is it... tomorrow we set out on a two-day bus trip to our first village clinic in Padum, after which we will be trekking to get to our other clinic sites. If anyone's interested in finding out more about the program i'm doing, I posted a link in a previous blog to the Himalayan Health Exchange. I still can't believe we're going to be treating 1500 patients in just 13 days of clinics!!! I'm going to keep a journal of my experiences, and then post my entires when I get back...

Thank you all for reading this and writing to me often... a short letter from home is like a hot cup of tea in the freezing cold...