Past Post: Greetings from Dhangadhi (Originally sent August 2, 2013)

The past few weeks have been incredibly busy and jammed with so many different experiences, emotions, adventures, and more that it has been difficult to keep up with regular updates. We have now moved to a more remote and southern region of Nepal where time runs a bit more slowly, the heat and humidity dulling the urgency to rush and see and do a bit so hopefully there will be more time to catch up, process and connect.

We tried to pack in as much learning and exploring as possible during our Kathmandu tenure, including some time outside of the capital. Outside of Kathmandu, Nepal is green, rural, and beautiful in the heartbreaking way that poor countries are so often are when their physical beauty masks the millenniums of history, culture, wars, and environmental challenges its citizens currently face. Of those we have encountered, Nepalis have been incredibly helpful and welcoming. The timeless scenes of women kneeling in rice paddies in their bright saris, the friendly smiles and “You are very welcome madam” and the eagerness to please and help betray this country’s struggles and triumphs, its ongoing challenges to make sense of the world as we all are and the rapid unending change that, globally, seems to threaten tradition, culture, and what people know and hold dear. This is a continual challenge for anyone traveling and/or working abroad – one that we particularly feel being in these countries for so short a time – to get a glimpse beyond the façade and to demonstrate, not that we understand, but at least acknowledge the struggle and challenges as we all move forward.

 We spent one weekend exploring the medieval kingdom city of Bhaktapur, beautifully restored and well maintained and also caught some glimpses of the Himalayas while Shabbating at Nagarkot, less than 30kms outside of Kathmandu. Traveling around Nepal is less about distance than about the mountains – traveling less than 20 miles outside of Kathmandu can take a couple hours on the winding zigzagging nerve jangling roads that lace the mountains. Nargarkot provided us a better glimpse of rural Nepal with its terraced hills of rice paddies and corn. Having geographically won the lottery, the village now has expanded into tourism and every weekend brings Nepali and foreign visitors to the cool hills to rest, hike, and see the Himalayas. While our views were largely obstructed by clouds, very early one morning we were lucky to get a glimpse of the snowcapped peaks.

Cooling off with our new friend...

While our updates and emails have been very travel heavy, there is work going on as well! As mentioned, our time in Kathmandu was largely for observation and learning how a well-run eye hospital operates on the ground. Zvi has been working with Dr. Anu in her uveitis clinic and also gaining surgical exposure on Small Incision Cataract Surgery (SICS), a low cost/technology procedure that is widely used in the developing world to provide high quality and high volume cataract surgery. Additionally, the end of our Kathmandu stay focused on the 2^nd National Uveitis Conference hosted by Tilganga, where Zvi presented on Ocular Manifestations of HIV. This was an incredibly well-organized and useful conference featuring top uveitis specialists from India, Nepal, Bangladesh, and the United States. The conference provided current general ophthalmologists and residents a much needed chance to gain exposure and share ideas regarding these diseases. The two day conference was a testament to how important exposure and opportunities to share information are, particularly for clinicians working in remote areas who are not often able to access resources as much as they would like. The polish and ease of how the conference was organized is another testament to Tilganga’s focus on efficiency and quality.

Our last full week in Kathmandu brought us a few visitors, Ema and Abba Kresch! Zvi’s folks were a bit jealous after our first email and decided to pop over for a visit. Staying with us at Tenzing and Dadoma’s, they filled their days with exploring the city, tracing our adventure to Bhaktapur and Nagarkot, watching Zvi present at the 2^nd National Uveitis Conference, and adventuring with us to southern Nepal. They have been as enthralled as we have with the cities many temples and religious sites, monkeys, streets, colors, incense and more. With Tenzing as our fearless driver, we went down together to Chitwan and Lumbini in Nepal’s Terai (plains) region in the southeast. The Terai is below the mountains and contain Nepal’s hot, muggy jungles. Successful malaria eradication programs in the late 1950s and 60s have seen the migrants flood the region and much of the jungle deforested for rice paddies. National parks have been established to preserve the jungle and its unique wildlife, including Bengal tigers, elephants, rhinos, wild boar, sloth bears, and more. The jungles here were once the hunting playgrounds of Nepali and British royalty, but now play host to tourists on safari. Together with Ema and Abba, we rode elephants into the jungle and visited the elephant breeding center to see the baby elephants. This being the monsoon season our encounters were limited, though we did see some wild boar, exotic birds and a rhino. 

The highlight for everyone was participating in the elephant bath time!  Around midday the elephant handlers bring the elephants to the river in Chitwan to cool off and scrub down. Participants ride bareback and after saying a few magic words to the elephants got a shower blast from their trunk! It was awesome riding these magnificent animals and also cooling off with them in the river!

A successful mountain flight

We decided to spend our final morning all together experiencing Nepal’s greatest geographical wonder, the Himalaya’s!  While timing won’t allow us a chance to go trekking, a mountain flight was the next best thing. Airlines in Nepal run “mountain flights” that take tourists to see the Himalaya Range and the peak of Everest. During the flight, the crew allows you to join them in the cockpit to take pictures of the range, and you can see the range from the windows. Together with Ema and Abba, two visiting Chabad rabbis, Zvi and I capped off our Kathmandu adventure by seeing the highest snow caps on earth!

Everest

A few hours later, we were back at the same airport for our flight to Dhangadhi, in far western Nepal. We are posted now at Geta Eye Hospital – a busy rural eye hospital near the Indian border. It currently is low season for patients due to the rains and planting time, but during “high” season, this hospital sees thousands daily and conducts anywhere from 300-500 surgeries 6 days a week. The focus here is for Zvi to gain more surgical exposure in SICS training, and I will be analyzing and compiling data I collected in Kathmandu. Hot, muggy and buggy, the hospital has its share of resident monkeys, dogs, spotted deer, and gigantic jungle bee hives that have sprung up near the guest room where we are staying in the hospital. Roughly 80% of their patients are from India (Indian and Nepali nationals can freely cross each others’ borders and the Indian rupee is used and accepted in this part of Nepal). Dhangadhi is the district capital and a city of about 100,000 people; the hospital is located about 10 km away from town. We explored town briefly yesterday and will continue to explore the surrounding areas over the next few weeks. Known as the far west, Dhanghadi does have a wild west feel to it – people here do not seem to be used to seeing foreigners around and we do attract a bit of reserved and polite interest.

Over the next few weeks we’ll be learning how to live in the heat and with the bugs and bees, as well as how a rural eye hospital functions.

More pictures and adventures to come!