A Day in the Life….
Morning comes early in the mountains. People wake and find their way about between 5:30- 6am. It is not easy to sleep much past this, but sometimes my eyes close and my body surrenders until 7:30am. Clinic opens at 9am, but often my translator, Sabina, traveling from 2 hours walk away, does not arrive until later, closer to 10am. As the days are long and many people are finishing up harvest season, this still gives us plenty of time to treat all the patients that come for the day. Many are repeat patients and arrive according to when Sabina will be there.
This delayed start time was my first consistent experience with the lack of time constraints here. I have rarely witnessed anything resembling rushing, hurrying, or really needing to get anything accomplished with much speed. When Devi, the clinic manager, and I take our occasional morning walk together to the peak of the town, we are the fastest things moving besides the dogs running and playing about up and down the meandering pathways or the rare truck or crowded bus with passengers swaying from the top above. The first week it was a struggle to work with this unknown start time, but now I am in the groove and just wait like everyone else. The view is so beautiful that it doesn’t really feel like waiting. You are just there watching and then eventually you will go and do something else. I might have some morning tea and do some reading; all of it is very nice and easy.
In clinic, things ebb and flow with a bit of bustle when we start getting the lineup ready for the day and people find their perch on the beds, benches, or stairs outside. Everyone is chatting, but often it feels like as each needle is placed, the patient and I enter into a bubble that is our own and has a quiet hum. Only on a rare occasion have I had to ask that the extra people in the small treatment room find another place to gather. There is usually awareness in the room that the body mechanics alone of attending to a patient require that I have more space to maneuver.
One, two, three, one, two, three, one, two, three, like a waltz Sabina and I spin in the room from bed to bed. She manages who is next, gets them settled and also helps pull needles when it is time for the treatment to end. Although the tables are thin, hard and sometimes a bit rocky, we manage to safely and successfully treat patient after patient. At the end of the day a feeling of accomplishment permeates the space.
After one month, I have come to know and love many of the patients here. They help me with my ever increasing Nepali language skills and laugh with me as I fumble and confuse things like “hot” and “dandruff”. The girls next door from the women’s co-op come by and bangle me with bracelets, check their facebook on their phones and ask if they can paint my nails. All of this creates an enjoyable although occasionally hectic treatment space. With the patients, it is a joy to witness their increased range of motion week by week, or significant decreases in pain. Their bodies work hard and their living conditions are in constant dialogue with the elements. I am looking forward to the rest of my time here and the assistance that Chinese Medicine can bring to even the furthest reaches of what often feels like the top of the world.
Seasonal Update, October 2013
As the weather shifts from Fall to early Winter, there is a constant chill in the air. On sunny days we still find a warm morning if we are luckily, but the clouds maintain their position of dominance. Patients still wind their way for hours at a time to ascend the climb to the clinic. When they arrive, they are cold and mostly in more pain as they have just walked many miles. Now that we have rearranged the clinic, provided more pillows and bed sheets, as well as the addition of the calming sound of relaxing music, I think it is a nicer experience for them when they do arrive even though they may be weary. However fatigued the patients may be, there is still much joy in our little clinic. Many of the patients I have gotten to know now over the past two months. We are able to laugh and play even more. Today a feisty older woman was even giving me sass. I loved it!
Going on my third month here in Bhotechour brings further depth and appreciation for the staff and patients. I had the great fortune to be here when the Bright Futures Foundation members arrived for their yearly visit. This is Catherine Didi’s (sister) tenth time to Nepal for the Rotary club of Grants Pass, OR. They have been the main supporters of the founding and flourishing of the clinic and the majority of its staff. Learning the history of the making of the health clinic and some of the personal histories that brought various staff to the clinic was awe-inspiring and instilled a great since of gratitude. Many people have worked very hard to make the Bhotechour Health Clinic what it is today. They continue to pursue excellence and have plans to become a fully recognized hospital.
One of the conditions for making Bhotechour clinic a hospital is the availability to electricity. This need should be met by the new massive generator that was a gift of fundraising from the Grants Pass Rotary, but it will still be a significant operational cost to keep it running on diesel fuel. The greatness of this addition is that it will allow for the lab work to maintain function and continuity, a particularly difficult aspect to life in Nepal with electricity coming and going with little regularity. One of the other conditions for making the clinic into a hospital is the need of a full time medical doctor. Currently there are two health assistances who are full time, but a MD only arrives once on Saturdays. A major obstacle to housing a physician is the sense of family and community that is prevalent throughout Nepal. It is nearly impossible to keep a worker from eventually joining their hometown medical facilities or one close to home. The likelihood of having a full time MD almost solely rides on the goal of a person from Bhotechour becoming a physician and returning to the clinic. Although these goals are not unattainable, there is no certainty to their accomplishment and perhaps many years before fruition.
I look forward to the rest of my time with the people in Bhotechour, they are my family now and it is a pleasure to work, eat, and wash clothes alongside them. I don’t know if it is the fact that I am not privy to every conversation in our small family and things are happening in the interpersonal dynamics of which I am unaware, but everyone seems happy to be here. I’m sure it can be just as monotonous as any other job and family life, but they maintain a joyful disposition and we do have great dance parties!
All geared up and ready to go, Dipendra and I set out on our motorcycle adventure to the offsite clinic in the village Chanauti. Our first leg was a challenge to get used to one another on a motorcycle, but eventually I got the hang of being a good passenger. We went up and up and then went down and down to the town of Melamchi. This village has a rather large bazaar with a movie theater and bank. It is a well known tourist spot as it is right on the river. It took us two hours to get there, so we stopped and had some thukpa (noodle soup) and a coke-a-cola. After a quick rest, we got back on the bike and headed another 45 minutes to Chanauti.
When we arrived, Rajendra, one of the board members of the hospital was there to greet us and show us around the place. The hospital is about the same size as the Bhotechaur hospital, but the grounds are more limited in scope and the staff is less. They are also not a 24 hour Emergency hospital, so they have an open and close time. Really they are a medicine dispensary.
I am told that someone will be staying with me and I figure this is just because that is where she lives. I was wondering where her belongings were until I found out in the evening that Mina was just staying there so that I would not be afraid in a new place. I tried to tell her that I would be fine, but she insisted on staying. This is sweet Nepali courtesy. It has the similar tone of when I travel alone on the bus and someone always “adopts” me for the travel. They don’t think it is good for me to travel without a friend.
The next morning we are to have breakfast and get started at 8am. As it goes, Dipendra went to visit some of his family early in the morning and did not return until 8 and everyone demanded that we still eat before getting started. We acquiesced to some fresh made roti (bread) and some curry of peas and potatoes delightfully served up by a Tibetan woman at the Sherpa Lodge. The little white dog didn’t like the look of me and kept barking, but I think it was the hat.
We got started around 9am with many people waiting at the door. I brought an intake sheet for Dipendra to use for quick assessment without need of too much translation. This system worked quite well, but it was still a long day. We ended up treating 23 new patients and there were more waiting. By 4:30pm, however, my body was done and I knew continuing would not be in good service. We decided to pack it up and head to Rajendra’s house for the evening.
His home was a typical Nepali home with a wood fire stove inside, a bed on the porch outside and plenty of family sharing beds to stay warm during the cold season. He showed us lovely hospitality and in the morning kept trying to provide us more tea and food before we could head out. Dipendra needed to get back for the Saturday doctor visit at the hospital, so we got going as early as possible. It was only possible for us to leave, however, after three rounds of tea at two different locations.
Two weeks later Sitaram and I journeyed for the second visit. We went a new route that was a smoother transition from above to below, but our rough time came when the back tire went flat. By the time we really knew that it was a problem, we were luckily not that far from the nearest bazaar. We decided that if he could ride alone it would be better for the bike, so I got off, helmet in hand, and enjoyed a slower version of the view for about a 20 minute walk.
By the time I got to the bazaar, the local maintenance place was replacing the tube and then had to drive down the road a bit to another shop to get enough air in the tire. We made it safely to the clinic and back over to the Sherpa Lodge for dinner. We spent the evening playing the card game Gin and hit the sack early.
The next morning we got started around 8 am with an updated system. I had received different information about whether new or old patients would be there that day, so I prepared for both. As it turned out, we had 18 returning patients and 1 new patient. Rajendra asked if he could call more patients around 1:30pm, but this time we were not staying overnight, so Sitaram and I agreed that we were done taking patients.
It was great to see many of the patients from the last time and hear about how many people had wanted to come this time. Most of the patients had experienced minor to major relief from the first treatment and even some came back reporting that they had no complaints, that they were all better. It was especially nice to see the man who had significant paralysis from a stroke report back how much better he was feeling. His wife was there this time and said that she could really see improvement from one treatment and was wondering when we would be coming back again. It’s those moments that make the bumpy motorcycle ride a bit less wary.
Going to Chanauti was a great experience and another example of how effective and meaningful acupuncture can be in people’s lives. I look forward to seeing where other far off reaches of the world Mindful Medicine Worldwide can spread its influence and generosity. I’m sure it will be filled with love, laughter, and a lot of tea!