Bhaktapur and Shiva-ratri

In Bhaktapur--one of many Mandir (Hindu temple)

Two days ago we visited Bhaktapur, a nearby city with a well preserved center (it's a world heritage site and they charge admission...a bit touristed but very worth seeing). It was also a holiday for Shiva's birthday, and everyone seemed pretty festive! We saw lots of people lighting bonfires in the street in the evening, dancing in masks, and lots of people getting their foreheads dotted red. Katherine and I got seats in the front of the bus on the way back to Dhulikhel, and that was quite the experience. I felt sure we were going to hit a person, but amazingly, that was avoided! Driving requires new levels of skill in some countries...

Yesterday we saw Anandaban, the Leprosy Hospital. It was started by Australians about 70 years ago, and is a Christian hospital. We got to see a lot of patients with leprosy, though the hospital serves patients with any disease as a normal hospital would. I had no idea how complicated the care could be. Many patients were getting orthopedic surgeries, plastic surgeries, and creative solutions to problems like ptosis--taking some tensor fascia lata (in the leg) and attaching it to the temporalis muscle (in the face), so that with chewing motions the eye could blink. It was very interesting--and we also were able to see the mycobacterium under the microscope! Aarti has previously interviewed several patients, and shared some of the stories that people had told her about the social stigmas that exist toward people with leprosy. I am so thankful we got to see this place. They have been collaborating with the University of Washington on research for some time, and I'm looking forward to checking out some of their papers when I return to the States. It has also been revealing to see different hospitals here. Bir hospital, the only public hospital we saw, is quite different than Dhulikhel or Anandaban.

Anandaban, the Leprosy Hospital

Today we had our last day of formal lectures and had a wonderful talk from the community health department about the Nepali healthcare system. I saved the powerpoint, but it was really interesting to hear statistics about how much Nepal spends on healthcare (about $3/person annually), how many doctors they have, what the challenges are...really a great talk. We've had lots of conversations about this in general, but it was awesome to have something formalized.

Discussions here with other international students or Nepali people or just among ourselves often touch on the dangers of international "aid" and non-governmental organizations. It's so difficult to responsibly do good. I want to make sure I'm very thoughtful about how I travel and work as a doctor in the future, and it's really interesting to hear different perspectives on this. As a medical student and really just a student in general, I am learning so much here, and it's hard to imagine being here and being in a position where I wouldn't be a student (even many years into a medical career). Many things are just SO different. If anyone has any suggestions on further reading, please let me know. Things I already have on a list are "Dead Aid" and "The Blue Sweater".

Hope life is grand for everyone...