Sunday, November 16, 2014

Being Here Now With A Kidney Infection?

It hasn't been long since my last post, but it feels like a lot has happened in that time.  I've gotten to learn some useful phrases in Nepali like "My wallet has been stolen." and "Can you test my urine for a UTI?"  I've spent some time volunteering at an amazing small orphanage here in Pokhara, made some new friends, and experienced the days of groggy pain that happen when the aforementioned UTI turns into a minor kidney infection. 

Actually that last part should be written in present tense.  I am currently in bed experiencing the heavy, nauseating pain of a kidney infection that ebbs and flows, sometimes attacking my lower back and sometimes my lower abdomen.  I don't want to complain here, but it kind of sucks.  I should have put it together a few days earlier, that sharp lower back pain + unabated internal infection + general malaise = kidney issue.  But it took a fever and a new kind of pain to finally convince me to take the $1.50 taxi to the hospital a few evenings ago.

When you picture a hospital in Nepal it's probably something along the lines of Mother Theresa of Calcutta tending to the dying on a throbbing, overcrowded porch of a humid, understaffed old building.  I did visit a few hospitals that were somewhat closer to that image, but with the arrival of foreign tourists and their dollars to Pokhara, the small private hospital I visited was closer to what I'd expect to find in the States.  CIWEC's building is brand-spankin' new.  They only opened a few months ago, and it's the cleanest and most professional space I've seen in this country.  So sterile feeling, in fact, that a few weeks ago I opted to get the Typhoid vaccine injection that I'd neglected to do back at home.  The front desk staff of Nepali women, dressed in impeccable Western style clothes asked me in crisp English to fill out a clipboard's worth of the expected forms.  They don't deal directly with insurance, and payment, by VISA or cash, is due immediately.  A consult with a doctor costs around $70, with additional fees for medication and tests.  A few other foreigners, coughing or on crutches, sat around on the black leather couches and we all took advantage of the free wifi to distract ourselves with our iPhones and avoid eye contact.

I had a quick consult with a Nepali nurse who took my history, reported a fever but otherwise good vitals and offered me tea while I waited for the doctor.  I've heard that without much else to go by, patients generally judge doctors mostly on their bedside manner.  I thought that the chatty and professional local doctor I saw was great.  Aside from the fact that he was wearing sandals, it was easy to forget how far away I was from the safety of The West and our billions of dollars in the medical field.  He repeated the urine test I'd had done a week ago at a sketchy alleyway pharmacy and confirmed that my bladder was indeed unhappy and that my Cipro regimen hadn't helped.  An American doctor, Robbie, joined the conversation.  He'd gone to med school at the same school where my dad did his residency and retained the comforting lilts of a Midwestern accent.  He'd fallen in love with Nepal doing Peace Corps here and had landed back in the country a few years ago with his wife, also a doctor and their kids.  Dr. Robbie asked me an unexpected question; "Do you feel sick?" and I gave a big, relieved, 'Yes!' near tears now because everything hurt and I felt awful and wanted to vomit and curl up but I didn't have the words to describe any of that.  He tapped the spot on my lower back where I'd wrongly assumed I had just a muscle ache, and everything suddenly contorted in pain and my breath got caught in my throat.  Yup- kidney.  But not bad yet.  I am fortunate that I was so close to a great hospital, decided to go in when I did and, mostly, that I could afford the $106 that the tests, antibiotics and consult costs.  They sent me home with a worried Max in a taxi, some different antibiotics, anti-nausea medicine, Valium to sleep, and my promise that I'd return to their 24 hour emergency room if I got any worse.  Since then I've been oscillating between feeling feverish, groggy, nauseated, perfectly fine and utterly exhausted.  The antibiotics went to work immediately and I think I'll be back to myself tomorrow.  That's the kidney infection news.  I'm happy with how un-dramatic that story was, and that to the degree that I'm experiencing it, that "kidney infection" is a lot less exciting than it sounds.

Before I got sick, Vince's friend and coworker in Kathmandu, Rose, put me in touch with the children's home; "Sam's House," on the outskirts of Pokhara, where she volunteered and lived for five months last year.  Before arriving in Nepal, I was vaguely aware of the exploitation and deceit that goes on with many orphanages.  Being here, though, I've seen many examples of how children and 'voluntourists' are exploited in a black market-esque grab for tourist dollars.  It's complicated and I know little about it, other than to steer very clear of about 90% of orphanages in Nepal.  But fortunately, through Rose's connection and getting to know the directors, both Nepali and American, of Sam's House, I'm thrilled to have discovered that this one is moral, loving and respectful of both kids and volunteers.  

I'd been hoping to spend more time at Sam's House, but with my brewing infection and my time in Nepal coming shockingly close to an end, I haven't been able to dedicate the time I would have hoped to.  I've learned though, that putting my dollars towards a solid organization will have a more meaningful impact than my short-term volunteering could.  I've thought back to JOIN, and how I didn't know the first thing about homelessess or who was who in the first month of working there.  By comparison, it seems hugely arrogant to assume that I can effect any change in such a short amount of time here.  With the exceptions of having value as a native English speaker and of being open to the immersive cultural experience that traveling offers; I'm pessimistic about a short term gig offering more to a community than just being a good experience for the volunteer.  Anyways.  I'll get off my soapbox.

Getting to hang out with the 22 kids at Sam's House was amazing.  I didn't blame them the first two days for being cautiously friendly towards the latest "ghora", but announcing that Rose was ''mero saati'' (my friend) gave me major street cred. It wasn't long before they were battling for my attention, the youngest one, 3 year old Siistaa, on my lap and a rotating cast on either side, proudly showing off their English homework, trying to teach me Nepali words for animals, or asking about nightmarish fractions.  I've never been to an orphanage before (Do we still have them in the US?) and didn't know what to expect, or how depressed I'd be afterwards.  Turns out that what struck me wasn't what these kids lacked, but what the house provided.  I noticed little things, like the house organizer, Shiva, smiling quietly and genuinely to himself when 'the battalion' of kids came through the front gate together, singing and dancing around in their school uniforms.  And how proudly the kids showed off their academic awards, displayed around the house, and confided in me that their hopes to become a doctor, a driver, or a NASA physicist.  Or how a five year old, wearing glasses and red ribbons in her braids, noticed one of the three 'house mommies' sitting alone in the gazebo and confidently skipped over to crawl onto her lap for a long, smiling, rocking hug.  I know that I only saw the smallest sliver of daily life at Sam's House, but I was deeply moved by how familial, comfortable and joyful the house was.  It felt good to be there, absorbed in the chatter and clatter and smells of a central kitchen.  I'm hoping I'll be up for going back again soon.  (Side note: If you happen to be considering an awesome volunteer opportunity that lasts more than a month and is in a beautiful and safe area, email me.)

I'm donating half the money from my CrowdFunding campaign I did to Sam's House, receive no support from the Nepali government and cover all of the children's medical, educational and living expenses.   

The other half of the funds I plan to donate to a small organization an American nurse here formed to conduct diabetes testing and education to the villages of Nepal. Diabetes is a large and often undiagnosed problem in Nepal.  With a diet high in carbohydrates (rice, potatoes) and a population drifting away from a more traditional and active lifestyle, a large number of Nepalis will die of complications from diabetes without ever having heard of the disease.  I was supposed to have spent the day today out at a village clinic, helping conduct the diabetes screenings, but, major bummer, spent most of the day in bed instead.

Oh yeah, I guess I could have lost a day to stressing about my lost/stolen wallet, but once I knew it was gone it was a sunk cost and not worth the stress.  Losing a small amount of cash is an inevitable part of traveling, and planning ahead, like carrying a backup card and the phone number to cancel the lost one, made the whole thing remarkably stress-free.  It was a cute wallet though.  But in the words of the great Dr. Jerome Sinsky (who likely plagiarized it from someone else), "The more you own, the more it owns you."

Thursday, November 6, 2014

The Things I'm Not Photographing

After a fair amount of wondering 'what's next?', waffling around potential options and beginning to feel the first hints of restlessness, I'm happy that volunteering at a small orphanage here is going to work out and will start soon.  So far details are totally unconfirmed, but I'm sure I'll have plenty to blog about there soon.

I haven't taken a photo in five days.  It's an incredible feeling to get to exist in this beautiful lakeside town at the base of the Annapurna range for enough time that I stopped feeling the pressure to document it.  It's similar to hiking well-loved trails in the Columbia River Gorge or visiting Multnomah Falls, where I've already captured all of the expected photos and can instead wander around without subconsciously thinking of my iPhone.  

It's freeing to wander this incredibly photogenic place and appreciate the unique beauty for it's own sake, in that moment, rather than giving into my natural instinct which involves more Instagramming than I'm proud of.

The things I'm not photographing:

A few hours kayaking alone on glassy Fewa Lake while the sun set and the jagged Fish Tail peak above turned from white to fiery pink and faded back to white.  There were osprey-like birds diving for tiny fish around me, clusters of floating lily pads that hosted a miniature explosion of biodiversity and a flock of egrets flying in formation low enough over me that I could hear the wind in their feathers.  

Watching weavers magically turn thousands of colored threads into cashmere scarves while casually yawning and chatting with other women.

Spicy masala milk tea with a scoop of brown sugar that's replaced my black coffee morning habit, and a new, colorful curry dish each day.  Deep fried yak cheese balls, muesli & curd, and an unhealthy number of banana lassis.  Discovering tongba- an awesome beer-esque beverage of fermented millet, served hot in metal containers, but realizing that the one thing I miss from home is a good, hoppy IPA.

Reading the latest National Geographic on the balcony on a warm, lazy afternoon and wondering which of the colorful paragliders above me is Max.  Having a fuzzy fellow around who makes this distant town feel like home and enjoys sharing an exciting scooter ride through the mountains or quietly listening to a RadioLab podcast together while it rains outside.

A photo wouldn't do justice to "my" alley where I feel more like a local than I did in Portland- where shopkeepers turned friends invite me in for tea and curiosity and friendliness override language barriers.  

Getting to feel a tiny bit grateful for this minor knee injury for really forcing me to slow down for what feels like the first time in my life.  Having time to reflect and read and journal and enjoy conversations for their own sake.

I'm also not photographing the scene of sudden diarrhea at 2am, scrabbling around for the Immodium, praying I've got enough toilet paper to make it until the store opens and wondering which banana lassi I can blame. 

(Okay fine, I took this picture.)

Saturday, November 1, 2014

Back in Pokhara

So I didn't go to the Khumbu/Everest region for the planned Sherpa Critical Incident Debriefing portion of my trip.  As I mentioned before, I'd hurt my knee during a rough Jeep ride and overuse during our trek.  The physical therapist I saw (thanks again Matt!) said that I have "patellofemoral syndrome" if you're keeping track.  It's very common and with physical therapy, supportive tape, and minimizing activity, will eventually heal itself.  Huge relief, because I was naturally going into Worst Case Scenario Mode imagining grinding bones and early arthritis.  It's painful, but less bad than I'd thought- of course.

I'm bummed about not being able to do one of the major goals of my Nepal trip, and going to the Everest area has been a goal of mine.  What's keeping me from being completely bummed out is feeling a mix of emotions about the purpose of that trip that I'm choosing to not blog about.  I'll be saving a lot of money in not doing it and am now looking independently at plugging in somewhere where I can be effective in a different part of Nepal.  That update will happen soon but right now it's looking like I'll be spending the next 35 days or so volunteering at a small orphanage here in Pokhara.  I'm generally skeptical about voluntourism type opportunities in developing countries and I know that exploiting children is sadly common.  This opportunity though, is coming through an American friend who lives here in Nepal and spent 5 months volunteering at Sam's House.  We'll see.  If that falls through I have a few other options...the common theme in which is a desire to be more engaged in the culture and less of a tourist skimming the surface of Nepal.

Since my last post, I traveled back to Kathmandu for a few days to meet with the Critical Incident Debrief volunteer team from the Mazamas of Portland.  It was great to see everyone so far from the context where I've known them before.  We spent a day meeting with Sherpas who had lost family members in April's avalanche and facilitated a debrief/grief support gathering.  It was heartbreaking to hear the intimate details from the family members whose husbands, brothers and sons had been killed on Mt Everest that day.  While the details aren't for blogging, it gave me an opportunity to contrast their motivations for being on the mountain compared to Westerners'.  In my last post, I worried about whether it was selfish of me to put myself at some level of risk by choosing to recreate out here.  Sherpa climbers on the other hand, have chosen (or really- been economically forced) to put themselves at risk on the same mountains that we play on because no other options exist for their family.  My Sherpa friend back in Portland, whose father was a great high-alititude guide said "My dad climbed so I don't have to."

Again, while I'm not attempting some 8,000+ meter peak, the role that privilege plays in my recreation opportunities and ability to choose risk is difficult to ignore.  

(Durbar Square in Kathmandu)

(Remember when I said I was craving Cap'n Crunch? Drew, my new best friend brought me a whole box all the way from the USA!!!  It was amazing.  Thanks Drew!)

Several hours on a bus later, I'm back in Pokhara, a place that is quickly beginning to feel like home.  When I left last week, thinking it was for good, my Nepali didi (big sister) and I shared a tearful goodbye in the street during festival.  Being able to return here has made me grateful for her family's consistently welcoming presence and generosity of sharing meals with us.  Last night we had dal bhat with Monn (my didi's brother) and his family.  He, his wife, and three kids share a room with two twin beds and a basic kitchen in the other half.  Dinner tastes better than any restaurant and we laugh and chat with what little vocabulary we share.

(Physical therapist told me to do yoga, so I did. Lakeside at sunset.)

Yesterday a few of us rented scooters to explore the area around Pokhara.  Once we made it through the smoggy, crowded city streets, our trio switchbacked up a local hill to a gorgeous sunset view of the valley and lake.  I was surprised to scoot through a small farming village of terraced rice paddies and water buffalo that felt relatively quaint and untouched-feeling, considering it was perched on a hill above such a major tourist destination.

(Some kids let me try their Dasain swing.)

We look like a Colgate commercial.