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Thursday, March 31, 2011

Random thoughts

I am in Room #5 in Shalom and their Internet wifi access code is five 5s! recently when traveling, the number that kept coming up was 3 - Amy's faourite number. 5 is mine!

I am addicted to Nutella. I brought it with me so I would have a good source of protein for breakfast and something sweet. I basically dream about how long it will be until I can get up and eat it.

I cannot believe how much food in general and how much rice in particular people here eat! And they are so tiny! I ordered dal bhat at lunch today and I swear they served me 3 cups of rice and dal and a side thing of veggies (tarkari) and pickled veggies(achar).


There are sheep out back of the hospital and we think maybe they are used for something by the hospital...

I saw my first cat here in Nepal...at the back of the hospital once again...

I had a chance Skype conversation with my sister Amy (and Fran!) last night! It was so great! Nice to be in touch with home. I'm looking forward to more Skype chats and hopefully with Olivia, Liam and Ruby!

I am finding it hard to get used to there being no toilet paper in washrooms anywhere.

I am sharing an office with Prasil. Thanks to him for having me right after Richard moved out!

I am still addicted to Nutella. I have to ration it because I realize that if and when I finish it, there will not be anymore here!

Rock climbing in Thamel

One other thing! Andy told me about a climbing wall in Thamel at the Belgian embassy. Anyone can go and they have all of the gear and he said it's pretty good. I think I'll have to check it out sometime. Might be something fun to do with Alex and Adeline!
Apparently the Belgian embassy has a rock wall and a cafe right as you walk brought the gates. Sounds pretty inviting!

Good-bye Shalom Guesthouse!

I spent my last night here in Shalom Guesthouse. I am just starting to really love it here. I love my room! It is bright and cheery and has lots of windows. I am waiting here for Ram to come and take me over to my new flat where I will spending the rest of my stay. It will be nice to be able to unpack and settle in.
I went out for dinner last night with Ross and Andy, two fellow Shalom people. Andy is also an NMP student here on an elective at Patan Hospital. They took me to Downtown Restaurant and it was really good. I had palak paneer and naan. It was delicious! Andy is leaving for home today and Ross is leaving in a week. Feels like everyone is leaving Nepal just as I arrive!
Katie is taking me to Dhulikhel this afternoon after work via bus. It will take about 2 hours to go 30 kms. We will stay overnight with one of her friends and then do a small hike Saturday then head home. I am looking forward to getting away from Kathmandu for a bit and breathing some cleaner air! It is already getting to me. Last time I was here I spent more time in places like Nagarkot and Godivari so it wasn't quite so bad. Kathmandu is dusty and smoky and polluted by cars and motorcycles. I can't stop sneezing!
So I won't be blogging tonight and not until later tomorrow. I know you will miss me. :)







Famous person on my plane from Bangkok to Kathmandu

I completely forgot to mention that on my flight from Bangkok to Kathmandu there was definitely someone very famous. I was sitting at the gate and suddenly I could see everyone staring at these men who had come in. Then someone asked to get her photo taken with him, men approached and shook the one main guys hand and then it snowballed. Soon everyone was piling up and getting their photo taken with him! I could not figure out who he was and I tried to ask a few people but their English was not very good. Anyway, I figured I would not be able to figure it out.

When I arrived here in Kathmandu, I contacted Alex, a 4th year IMP student who is in Thamel right now with Adeline doing an elective. We discussed how we might arrange to meet up next week for dinner. She mentioned that she might head over to Patan to go to the zoo so maybe we could meet up there and then. I decided to google the zoo to find out a bit more about it. In the process I read a few posts about the zoo being terrible and that there were many issues with the treatment of the animals. There is conflicting information about this however, and many people say it is a good zoo. Anyway, I was referred to a blog on this same blogspot site that could give me some more information. Who do I find..?

Click the link below to find out more about the comedian duo who speak out for animal rights!


http://awnnepal.blogspot.com/2010/08/comedian-duo-maha-speaks-out-against.html

Things I Notice About Nepal and PAHS

I just wanted to write down a few of the really unique and interesting things I notice about Nepal.  Before I forget!  One just came up!  I went to the bathroom here at PAHS and the doors are labelled "Ladies" and "Gents" - isn't that sweet?  Love it.
Everyone here orders and drinks just plain hot water all the time.  I notice and think about this because Ann always orders this and many places and people look at her like she is crazy.  In Buenos Aires they seriously could not figure her out!  They charged her full price for coffee.
The men are very affectionate to each other - they walk down the street with their arms around each others' shoulders, rest their hands on other mens' thighs went sitting and so many other very sweet gestures that you would never see in North America.
At Shalom Guesthouse where I am staying now, and then at the flat where I am moving tomorrow morning, there is a didi that washes dishes, makes meals (all except breakfast!), boils and treats the water so there is always clean drinking water, does laundry and makes your bed!  It is a bit unnerving for me to leave dirty dishes and to expect so much from her but this is the culture here and I would offend her if I tried to wash the dishes myself.
I have a real urge to shake hands - I can't help it!  I know that this is not something that they like to do but they put up with me!  :)
SO many men carry around motorcycle helmets!  It's like a woman's purse. 
There is not a lot of facial cues and feedback from people here - and I am always looking for that.  It's one thing to have the head bobble that can mean so many things I can't keep track of, but another to not have facial expressions to go by.  I find that hard.
When they hand you something it is always with their right hand and they place their left hand under their right elbow with a slight nod of the head.  So formal!  This often happens when I "force" them to shake hands... :)
When Nepali people speak there is a...break and a pause in their speech midway through.  Almost for emphasis.  It often happens words like "a" and "the".

Some things that I notice at PAHS in particular:
Everyone always has tea or hot water in their hand at all times.  Maybe this is the same as coffee in Canada...
They have cars and drivers that will pick anyone associated with PAHS up and drive them anywhere - and the cars are very fancy!
They have a didi that will wash dishes and make tea and hot water and clean all day.  This is very helpful!
They are so capable and dedicated and all work together at every step of the curriculum process.  I will elaborate a bit more on this in an upcoming blog.
The brief amount that I have seen the PAHS students, they are friendly and eager and enthusiastic!

I am sure I will continue to add to this list as my trip progresses!

Wednesday, March 30, 2011

A Good-bye and Welcome Dinner

What a great evening! I walked over to Patan Hospital to meet Katie and then we met Anil and Liz and Richard at the PAHS car.NAnol drove us down to Kathmandu to a restaurant where we were meeting members of PAHS. It was the very first restaurant that I ever ate it in Kathmandu when I was here in 2008 and I met Arjun here. The name is Royal something or other and they have delicious momos! We ate so much food tonight and it was fantastic.
Shambu, Babu, Satish and Arjun met us there along with a biostatistician from Harvard and a Nepali woman who has lived in Australia until recntly when she moved back to look after her parents. I can't remember their names, sadly.
It was a great meal with great people and then Arjun asked almost everyone - I was spared thankfully - to give a little speech about their experience at PAHS so far. Richard and Liz started and I had the privilege of hearing everyone else speak as well. Many of these people have been involved with ths project since KUMS (Kathmandu University Medical School) so it was fascinating to listen to. I am so tired so I will have to talk about the details later. But I wanted to make sure that I remembered the feeling that was there this evening when everyone spoke about how much all of this means to them. Just great.
I can still hear the cheers in the distance as people continue to watch the India vs. Pakistan cricket match!
Good night!

Tuesday, March 29, 2011

More thoughts and updates

I got up and ready and out the door by 7:30 am today. It's a beautiful day here and not too hot. I left a message for Andy, an NMP student who I knew was here in Kathmandu doing some electives at Patan Hospital but didn't realize was staying here in Shalom until I saw his name on the whiteboard. As I was walking downstairs there he was brushing his teeth. We are going to meet up at the hospital and go out for dinner tomorrow.
I then headed out to check things out around here. I wanted to see what stores were here, wanted to find a bookstore and see about some food. It was a nice walk and I found myself out at the hospital again. I went past it a bit into a great marketplace and just took some photos and watched the people. I stopped for some groceries and then headed back here.
It's funny how I feel so out of place here and have to wonder how the Nepali people feel about Westerners coming here to teach in the medical school, to trek and to visit. when I went into the little grocery store I felt like I was making them uncomfortable. Or maybe that was just me feeling uncomfortable?
I came back here to make some noodles and met Ross from New Zealand. He has been here for 3 months and is leaving in a week or so. He had tea while I ate my soup and we chatted a bit. He has been coming here for years and knows the language well. I envy that. I wish I knew anything at all.
He gave me a few tips and told me about some shops close by and told me I had to check out the view from the roof. I am going to head up there right now.

Kathmandu-first day

It's really early in the morning here in Kathmandu. Just after 4 am. I fell sound asleep at about 6 or 7 pm after a long few days and had a great sleep! As I type this I can hear the jingle of the bells next door. Someone with their offering. I know someone told me the whole story behind this once but I'll have to ask again. I remember hearing it every morning. I like the idea that someone gets up every morning before sunrise and puts out an offering to the gods (?). So different from what I am used to. It seems like such a positive and beautiful thing to do.
I can also hear the dogs' incessant barking. Something I had almost forgotten about. You need earplugs to sleep well here for sure!
After I arrived here I was driven to Shalom Guesthouse where I will be staying for a few days. It's a nice house with many international people staying here. I was only awake briefly yesterday so have not met many of them yet. I brought my stuff upstairs and then we drove to Patan Hospital. I got to see the hospital again, the new PAHS building and many of the faculty. It was so nice to see everyone! Satish, Shital, Mili, Anupa, Rajesh and many others. The new building is fantastic! Beautiful PBL rooms, labs, a huge library, a computer room for the students, lecture rooms...love it!
Katie showed me her apartment. It's very cute! A nice size with everything you could need and right beside the hospital. She doesn't have far to walk to get to work each morning!
Katie then walked me back here and my reintroduction to Kathmandu began! The sights and sounds (honking) and smells are very overwhelming! The traffic and the driving and the honking! I could never drive here. We saw an accident on our way from the airport actually. That is strangely a rare thing. We walked back here to Shalom so I could figure out my way for when I have to walk to and from work. We got a bit lost. We walked a bit farther than we had to and had to ask for directions a few times. My comments in an earlier post proved true! Many people will tell you they know the way when they really don't. They mean well. then we finally made it. I came in and settled in a bit and promptly went to sleep!
I just realized that while I have been typing this I have not heard a single dog. I guess 4:30 am is a magical hour. I can hear many people walking and running and talking outside in the streets. I am always amazed at how early things get going here.
Today is a holiday at PAHS so I will take the day to get my bearings and check out my home and my surroundings. I have to meet Katie and my ride at Patan Hospital at 5 pm for a special dinner. I am really lookng forward to it!
So my time in Nepal has started off perfectly! Can't wait to see what comes!
I will start work on Thursday morning.
More soon!

Made it to Kathmandu!

Hello everyone! I made it to Kathmandu! I was met at the airport by Katie and Anil! So great and I feel pretty good! I am at PAHS right now and their new building is amazing! It's so nice to see everyone. I am going to walk back with Katie to my place and then they're having a dinner tomorrow to say good-bye to Richard and hello to Katie and I. I better go get some rest but thought I'd check in.

Monday, March 28, 2011

Really interesting...

I have a stats option on this blog so I can see how many people have checked out my blog and from which countries. Suddenly there were 4 views from Thailand as I sit here. And then I checked back again and there are 2 more! I wonder if people in this lounge right now saw me update Facebook that I am here and then found my blog?
I will probably never know!

Slowly but surely

I am sitting in the Thai International Lounge in Bangkok Airport now. I didn't think I'd be saying this but that flight was not bad at all! 17.5 hours even after a lengthy delay went really fast. Watching movies eating food and sleeping did the trick! I can't believe how much I slept!
I feel pretty good for being on the road now for 2 days!
I should have planned a little side trip here in Thailand - I love Thailand!
One last flight and I arrive in Kathmandu! Not much further now.

Sunday, March 27, 2011

2 flights down, 2 more to go!

I am sitting in the lounge in LAX. I have a long layover here before my crazy long flight to Bangkok. I had to walk to a different terminal after I got off the plane from Vancouver,then I had to wait 2 hours just to check in-until the Thai counter even opened!
It's okay though...
Eating fried rice and drinking red wine in the lounge is pretty good!
I managed to change my seats on both upcoming flights to bulkhead emergency exits. That's also good news! I was a bit worried about legroom on my 17.5 hour flight.
Anyway, just a quick update. Maybe more from Bangkok.

The Day Has Come

I leave today from Victoria at 12 pm.  The journey begins!  I am excited but feel a bit apprehensive.  Hoping that my cats will be okay, that my flights will all connect properly and that I can stand a 17.5 hour flight from LA to Bangkok!  I am really looking forward to being in Kathmandu and working with PAHS.  I can't wait to meet the students and to see my Nepali colleagues again.  It has been a long time.

Friday, March 25, 2011

Last Day of Work - for a while

I am leaving for Nepal on Sunday.  I can't believe it is already here!  It came up so fast!  I still have a lot to do but I am almost ready.  The packing is what always gets me...

I had a great discussion today with a colleague about international medical education and the impact that "Westernization" of medicine is having on "non-Western" countries.  It's such a fascinating topic.  He pointed out that as I think about and adapt my presentations and lectures to be culturally sensitive for the Nepali students, I end up altering and almost misrepresenting what the "inner circle" of Western medicine really looks like.  It's so true.  Of course I will present something at least slightly different to students in Nepal than what I would present to students at UBC and in Canada.  Is that a good thing or a bad thing?  How will this affect their identity formation as medical professionals?  Do we want them to become similar to Western medical professionals?  What do I know about the profession of medicine in Nepal?  What does it mean for the Nepali students to develop an identity as a medical professional when their mentors and teachers just drop in and then leave?  Is it our goal to Westernize medicine in Nepal?
I am very interested to read the literature about this and to read about what the impact has been on other countries - like China.
Well, I hope you will follow me as I start my journey on Sunday.  It will be a long day with lots of flights so you might hear from me again before I arrive in Kathmandu.  Victoria - Vancouver - Los Angeles - Bangkok - Kathmandu!

Tuesday, March 22, 2011

Monday, March 21, 2011

Cultural Insensitivity

It's funny that I keep catching myself thinking things that are not very culturally sensitive or aware.  One very recent example involved a colleague in Nepal helping me to set up some faculty development workshops and training sessions that Joan and I will be delivering.  We were trying to work out the schedule and I proposed some dates - April 6th and 7th.  She got back to me to tell me that April 6th would not work because Wednesdays are holidays in Nepal - could I suggest some other dates.  I did, but caught myself thinking - "Well that's perfect!  If Wednesday is a holiday, then that would work very well for us to hold a workshop that day - why can't we just do it then?"  I didn't say this to her and I quickly realized that this was my North American mentality kicking in.  Judging others as "lazy" or not using time wisely when really they are doing what is not only appropriate for their culture, but also something that would be much better if we lived and worked in the same manner here!

The things you can learn!

Tuesday, March 15, 2011

A Guide to Trekking in Nepal

I fell asleep reading this book last night and thought there were a few interesting things - especially related to cultural differences in Nepal and how to behave while there.  I picked up "A Guide to Trekking in Nepal" by Stephen Bezruchka (Foreword by Sir Edmund Hillary) used at Russell's Books in Victoria - a great bookstore!!  It is the Fifth Edition from 1985 - so I have to take a lot of this with a grain of salt!  But - I also have to think about it!

Someone named Robin received this book on October 10, 1989 on her 21st birthday, according to the inscription...I wonder if she ever made it to Nepal.  The writer was hoping that she would someday.

"Nepal is there to change you, not for you to change it.  Lose yourself in its essence.  Make your footprints with care and awareness of the precarious balance around you.  Take souvenirs in your mind and spirit, not in your pockets.  Nepal is not only a place on the map, but an experience, a way of life from which we all can learn."

That's the quote at the front of the book.  Something to think about while I am trekking and working there for sure.

Some of my favourite things came from Chapter 4 - INTERACTING WITH NEPAL

"...learn some tips from the Nepalis on patience."

"Nepalis are eager to please Westerners and in their enthusiasm to do so often give incorrect answers to questions."

"Don't always be in a hurry, eager to cover as much ground as possible.  Sometimes, stop at noon and watch village life or explore the surroundings.  Consider spending an entire day in someplace that is not the highest, the most spectacular, the most beautiful, and just let things happen."

Cross-Cultural Clues for the Survival of Trekking in Nepal

"To expect Nepails to conform to and accept outsiders' ways is the most extreme form of cultural arrogance."  Donald Messerschmidt

"Women should attempt to wear long skirts, mid-calf at least, as often as possible.  It is important that women do not expose their legs."

"Hindus are concerned about ritual pollution of food when it is touched by anyone outside their caste or religion.  As a foreigner, you are outside the caste system.  Often you are considered an outcaste or untouchable.  Thus, do not touch any cooked foods on display, though it is usually all right to handle uncooked foods such as fruit and raw vegetables."

"Don't touch food with your left hand."

"To encourage and support begging is an important example of cultural ignorance that characterizes many tourists."

"Sarcasm is not understood in Nepal."

"Treat your porters with respect.  Make sure they have equipment and food sufficient for the undertaking."

"Shoes are considered the most degrading part of your apparel, so keep them on the floor or ground."

"When sitting, do not point the soles of your feet at anyone.  Nepalis will not step over your legs and feet.  Be sure to draw them up to make a path for anyone coming or going."

"While traveling, you may pass Buddhist mani walls containing tablets with prayers carved on them in handsome Tibetan script.  Walk by them, keeping them on your right, as Buddhists would do as a sign of respect."

"Many Western habits are offensive to Nepalis.  Some, such as shaking hands, using dry toilet paper, carrying around a used handkerchief, and eating without washing seem unsanitary to them."

So many things to think about and keep in mind.

Friday, March 11, 2011

Thanks to my colleague in Nepal, I have my answers.  I'm glad that I send the document in the end.  It is very helpful for me to have the answers.  The trip is coming up so fast!  I am actually going to start packing this weekend.
I met with some IMP 1st year students this afternoon to talk about the possibility of them going to Nepal this summer to volunteer as content tutors for the PAHS students during their cardiovascular block.  I am so happy to hear that so many people are interested in this opportunity, in this medical school and in these people.  It will be such a great experience for them.  It's too bad that they won't be there while I am there.

Tuesday, March 8, 2011

Remorse?

This is strange...
I am feeling a bit of remorse right now.  I just sent a document to a colleague in Nepal to ask her about some genetic concepts and terms.  I asked her some questions and am really hoping that she can give me a hand with this.  I need to know that I will not using inappropriate terminology or saying offensive things to the medical students at PAHS.  I also want to make sure that I will be teaching the material within the Nepali context, experience and reality.
Suddenly I feel like just sending the document may have been culturally insensitive.  Is that weird?  I don't think it's unreasonable to try to sort this out, but I feel a bit bad.
Just wanted to share that.

Monday, March 7, 2011

Less than 3 weeks!

I am leaving for Nepal in less than 3 weeks now!  I am excited and it's all starting to come together.  A friend and colleague, Dr. Joan Mitchell, will also be joining me in Nepal to help with faculty development workshops!  How exciting!  A few of my former students will be doing an elective in Kathmandu while I am there too!
I submitted an abstract to the 6th International Conference on Interdisciplinary Social Sciences - "Teaching Medical Genetics in Nepal: Cultural Implications and Teaching Strategies" - it was accepted today for a 30 minute paper presentation in New Orleans, Louisiana!  Great news.