Off to Pokhara!

Greetings! I want to let all of you loyal blog-readers to know that we are leaving for Pokhara tomorrow and the likelihood of further blog posts before returning to the states is low. Please google Pohkara and Poon Hill so you know what we'll be experiencing! We're taking a 7 hour bus ride to Pokhara on Sunday and then begins our four day trek to Poon Hill- where the views of the Annapurna mountains are touted to be the best! The first two days of the trek, according to Aarti, consist of a very steep uphill climb so we'll be feeling the burn! Then we're flying back to Kathmandu on Friday afternoon before our departure for the states Saturday at 8pm local time...scheduled arrival is 1pm on Sunday, March 4th in Chicago.

I want to thank you all for reading my blog. I have had a wonderful time here in Nepal and it has been even more enjoyable because I was able to share my experiences with you. If I happen to have more posts before we leave Nepal I will announce it on facebook. Hugs and kisses to you, I will see you soon! xoxo

Oh the views!

We took our sweet time waking up on Saturday, after having beers and playing American drinking games with our Nepali friends- they thoroughly enjoyed the games! We had some tea, instant coffee, granola bars, oatmeal and hobnobs (our favorite imported oatmeal cookie). At 11am we then took off for Nagargot, a town known for it’s spectacular views of the Himalayas- especially at sunrise. We ended up taking the trail with steep terrain and 1000+ steps that were up to my knees. To make the trek even more difficult, there were no villages for 4 hours straight during the most intense part of our hike, thus, no water. We stopped a couple of times along the way to chug what water we had and eat more hobnobs. We had, by far, the best weather during our trip so far. The skies were clear and the view of the mountains even clearer! The valleys were sprinkled with mustard fields and terrace farming was visible in every direction.

By the time we reached Nagarkot it was 4:30pm and we were parched and starving. We stopped at a fantastic restaurant and treated ourselves with anything our hearts desired- from ginger tea to egg chowmein to mo mo’s(steamed dumplings filled with veggies and/or meat) to pancakes with honey. We stayed at a hotel that Aarti had visited years ago called “Hotel at the end of the Universe.” What a spot! We woke up at 5:50am the next morning, put on a few layers and walked up 20 stairs to the hotel’s look-out. Stunning. Fantastic. Wonderful. Phenomenal. Worth-every-ache-and-sore-muscle-from-those-1000+-steps!

After drooling over the sunrise for about an hour, we headed to the guest house’s restaurant where we inhaled drip coffee, banana porridge (amazing!), eggs, potatoes and chapatti, the popular flat bread, with honey and jam. After giving our tastebuds the time of their lives, we packed up and trekked 3 more hours (with much easier, but still uphill, terrain) to Changu Narayan, a Unesco World Heritage site, where one of Nepal’s only Vishnu temples exists. Vishnu is one of the main Hindu gods commonly depicted in Nepali art and architecture. The temple (built/created from the 4^th-9^th centuries) depicts Vishnu in 10 of his reincarnations mostly via intricate woodcarvings. After taking in all of the temple’s glory, we decided our legs had had enough so we bused it back to Dhulikhel. It was such an awesome weekend trek. Even though I busted my butt and I was in pain, it was so enjoyable! It was good practice for our 4-day trek in Pokhara, beginning this Monday. According to Aarti, we’re attempting to complete this trek in less days than suggested by travel guides…we’ll see how that turns out! A few more days at Dhulikhel hospital before we’re off to KTM to bus to Pokhara for our trek (thankfully we were able to move our schedule around to fit in this much anticipated Annapurna trek to Poon Hill). Until then, xoxo.

Take from the rich, give to the poor!

February 20, 2012

Our action packed weekends unfortunately delay new blog postings…please accept my sincerest apology!

To wrap up the end of our academic week, we had general surgery and dermatology. The general surgeon that led our lectures was Dr. Malla- 5 feet tall, bald head, thick rimmed glasses, great sense of humor and adored by the patients…as Ryan would say, this guy was “money.” Nepal’s unique perspective on surgery centers around typhoid fever (a common illness in third world countries caused by a salmonella strain that is common in unsanitary conditions/contaminated drinking water). A late complication of this infection is a perforated ilium (inflammation around a section of small bowel that punctures through the gut, spilling intestinal contents into the abdominal cavity) which leads to “free air” in the abdominal cavity. This causes intense pain, sepsis and can quickly lead to death if not operated on immediately. We actually got to see 3 patients on rounds with this exact complication! As you can imagine, a common complication (of the perforation) is infection of the surgical wound and abscess formation, which almost all of the patients we saw had. We didn’t see the inside of the OR, but according to Katherine there is 1 OR light per room, electricity went off during a case and they had to bring in a light that was battery powered, no disposable drapes, otherwise very modern with up to date anesthesia machines.

Dermatology was great too! Dhulikhel hospital is the first hospital site to have a laser…making them the only hospital in Nepal to provide cosmetic services. Dermatology is the “money-maker” for the hospital and the head of the department said frankly, “we take from the rich and give to the poor!” implying they are able to provide basic services to many people who cannot afford care because their department makes so much money. We joined him in clinic and he did a great job teaching us on the spot about different skin diseases in Nepal and how they might present differently than in the U.S. All of the diseases we saw in clinic were actually diseases seen in America- psoriasis, lupus (I actually have never seen a real case of this in person- she had many of the classic findings!) & eczema. To top it off, we took an “organic coffee break” and had real drip coffee at around 11a.m! It was so delicious and quite the change from the instant coffee we have been having.

That’s all for now but stay tuned for details about our awesome weekend trek! Miss and love you all, xoxo.

An eclectic week so far...

I hope you all had a heart-fluttering Valentine’s Day…I know I did! We treated ourselves to hot chocolate, grilled cheese and soup at one of the fancier restaurants in town (not quite as good as Momma Evans’s grilled cheese though). Prior to our romantic group meal, we babysat Lizzy, Ben & Sarah’s 2 year old daughter so the two of them could have some alone time- we watched Beauty and the Beast, thanks to Elisabeth! Lizzy was very well behaved (as usual) and on a daily basis is having lots of fun memorizing all of our names and saying “wow!”. She’s a little trooper…prior to Ben and his family joining us in Dhulikhel, the three of them (or make that four- Sarah’s 26weeks pregnant!) went trekking in the mountains for 2 weeks!! Brave souls, I tell you.

This week has been a really nice balance of different specialties: 1 day of orthopedics, 2 days of pediatrics, & 1 day of OB/GYN - mostly consisting of rounds-seeing patients in the morning with the team with some teaching here and there and lectures (with lots of tea breaks in between). Here are some interesting tidbits:

Ortho: By far and away one of the busiest services at the hospital- 70-80% of cases due to trauma. The most common traumas are related to RTAs- road traffic accidents. RTAs are also Nepal’s #1 cause of death (in America, it’s heart disease). For more details on ortho, please visit Katherine’s blog as she is our future “haad” (bone) doctor.

Pediatrics: Also a very busy service and very popular among the students. Many of the children in Nepal are faced with similar diseases as American children, the biggest difference is that children here are malnourished and have difficulty fighting off infections, etc. In stark contrast is the prevalence of infectious disease (in both adults and children). An interesting aspect of infectious disease is the presentation of seizures in Nepal. In America, pediatric seizures are usually febrile (high fever causing seizures) or epilepsy (seizure disorder, usually runs in families). In Nepal, infectious causes are always high on the differential diagnosis list. Tuberculosis can present with seizures caused by a tuberculoma in the brain or by way of tuberculosis meningitis/encephalitis. Another infection, by the tinea solium helminth, or worm, can present with seizures. Patients are infected with this worm by ingesting undercooked/infected pork or other meats or by the fecal-oral route (an infected human sheds the worm or larvae in their stool and passes it to another human, possibly by preparing food without washing his/her hands). These little worms work their way up into the brain and can cause seizures, once a patient has proven neurologic disease, the diagnosis of Neurocysticercosis is made. Worldwide, it has been shown that Neurocysticercosis is the #1 cause of new-onset seizures. Crazy!

OB/GYN: The lectures given were fantastic, but the patient-rounding was less than desirable. There are so many OBGYN patients that the team has to do rounds with lightening speed to see them all. Not surprisingly, with the language barrier and less time for teaching, it was not so fruitful for us. On the other hand, the lectures were fantastic! We got to learn all about childbearing and maternal mortality (death in childbirth- before, during, after) in Nepal. As of today, 82% of Nepalese women still deliver their babies at home! Several factors determine this rate: access to care, cultural beliefs. The OBGYN doc lecturing us said that most women would prefer to deliver in the hospital but don't have the means to get there. The government in Nepal has even begun providing substantial monetary compensation for delivering in the hospital to mothers. More training is becoming available so that smaller communities can have “skilled birth attendants,” like a midwife, available for safer deliveries at home.

General surgery is next...then a fun weekend of travel and trekking! Miss and love you all, xoxo.

Happy Valentine's Day!

Much love to the best husband on the planet, Ryan (and cheers to all you lovebirds out there)! Our crew will be celebrating by drinking Everest beers and eating chocolate. xoxo

Lighting a candle at the Namobuddha temple

The girls of the group: Katherine, Katie, Aarti, Elisabeth and myself, surrounded more beautiful scenery!

There’s a chance you may be curious about certain aspects of my experience thus far in Nepal, such as:

1. Food: Most meals consist of a combination of white rice, a lentil soup called daal, and veggies cooked in Nepali spices, together called daal bhaat. The hospital, where we have most our meals, serves this for lunch and dinner. The daal, veggies and spice level vary (Ryan would be so proud of me eating spicy foods!) but overall, the dishes are fairly similar. Breakfast (also served at the hospital) tends to be chia (tea) with one or several of the following: yogurt, eggs (prepared in various ways), dough nuts or French toast (no syrup, just sugar)- overall, pretty close to home. I tend to eat a big breakfast and try to eat smaller portions at lunch and dinner because the daal bhaat can gets a little predictable (and seriously spicy!!!). The meals at the hospital cost us 40NRS~ 50 cents!

2. Weather: It was a bit warmer in Kathmandu, but in Dhulikhel(at a higher elevation than KTM) it has been roughly 60-70 degrees during the day. It’s usually sunny, but fog and clouds roll in from time to time and cool down the temp and obscure our view of the Himalayas. At night, it gets cold. It may only be in the 30’s or so but there’s no heat, so it’s difficult to feel cozy in the evening- thank God for Ryan’s arctic-ready Northface (thanks Loren!) sleeping bag. It has rained once or twice and afterward the environment appears cleaner because it washes the chronic “dustiness” of the mountainside away.

3. Accommodations: We are staying at KUIC guest house (can’t remember what exactly that stands for) and it is affiliated with Dhulikhel hospital. It is a cement building (like most buildings here) and stays cold indoors even when it is warm outside. We have hot water- and is the majority of the reason we are staying here because it is a bit more expensive that other guest houses (~$10 USD/night/room- sharing with Katherine). There is a nice common room where we can all hang out and play card games, read, etc. As mentioned previously, Aarti put a lot of effort into getting the KUIC managers to fix the internet, so that’s a bonus as well. There is a guard that collects our keys every time we leave and always greets us with a giant smile, “Namaste!”

Great News!

We FINALLY have internet at our guest house...hope this lasts! While I prepare my next post, please look at my friends' blogs listed on the righthand side of the screen :)

L to R: Katherine, Me, Elisabeth...with the Himalayas!

Beautiful Namobuddha.

Friday, February 10, 2012

Another great day at Dhulikhel hospital. We had an awesome teaching session with one of the hospital’s cardiologists. One of his patients was there, a 44 yo woman with documented rheumatic heart disease (this is a complication of untreated streptococcal infections- like strep throat causing vegetations on valves leading to heart failure, etc) and he taught us about this condition by having us ask questions about her presenting signs/symptoms, examine her and then watch as he performed an echocardiogram! It was so cool to see the valvular dysfunction that this condition had caused first hand. This is an extremely rare disease to see manifested in the United States because we treat strep throat (even when we don’t have 100% proof that an infection exists). In a developing nation like Nepal, patient education and access to healthcare (among many others) are some issues contributing to nation’s population acquiring this very preventable disease.

Saturday, Feb 11th, 2012

We took a day trek to the beautiful Namobuddha, a destination that is about 3 hours away by foot. Legend has it that years ago at the current site of this stupa, a Buddhist discovered a starving tigress that couldn’t feed her cubs and so he sacrificed himself and was thus transported to a higher realm of existence. The hike was great...intense for me considering I have not hiked longer than 2-3 hours at once (we left at 9am and got back at 5:30pm!). I loved every minute...this was no lazy Saturday! We trekked the mountainside, passing several quaint villages with baby goats, chickens, cows and people greeting us along the way. After 3.5 hours, reached Namobhudda- with prayer flags painting the sky, small prayer areas filled with hundreds of candles (I got to light one!) and beautiful painted pillars describing the experience the Buddhist had as he sacrificed himself and reached Nirvana. We got to see another beautiful monastery too and got to listen to monks playing instruments and singing chants in Tibetan- very cool. It was a wonderful Saturday and our buns and thighs are aching- totally worth it! Loving Nepal, day by day. Talk to you soon, xoxo.

So much has happened since my last post…I apologize to those of you who have been waiting so desperately for an update (hehe)! We thought we struck gold when Katherine got a wifi password to the hospital’s source but we are still having major issues in connecting.

**warning: some mild medical jargon and/or descriptions of unpleasant or unsettling things may be used below (or in any further posts).

A typical work day at the hospital is as follows: 8am morning report, 8:20 break for tea, 9am rounds in respective departments (this part is tricky- we haven’t really been assigned yet because our first 2 weeks revolve around tropical medicine lectures and the 2^nd 2 weeks will be more clinical), 10:30 am lecture, at noon we break for lunch to beat the rush of the 1pm hospital-wide lunch break, 2pm lecture, 3:30 more tea, and at 4:30 we’re usually on our way back to the hostel to relax before dinner. This may sound extremely laid back but a lot of our time and some frustration is spent figuring out what/when/where exactly we’re supposed to be doing thing.

The lovely part is that everyone has been very receptive and flexible. These difficulties and frustrations we’re facing are to be expected considering we are guinea pigs in establishing this international rotation

On Wednesday we took a field trip to the Nepal Tuberculosis Centre and Bir, the oldest government-run hospital in Nepal. The TB center is actually just a place where patients who were diagnosed/suspected of TB in the community are referred to for confirmatory testing, teaching materials and information on where to receive their DOTS treatment. DOTS: Directly Observed Treatment Schedule- designed for countries like Nepal to keep track of the masses of people infected with TB and how they’re adhering to their treatment. As you can imagine, after starting treatment for TB, patients start to feel great and they stop taking their medications…leading to the infection not being cleared and on a larger scale- scary multi-drug resistant forms of TB. The second hospital site, Bir, is a 400 bed hospital with every department imaginable. It is so very different than the fairly new, clean, controlled environment of Dhilikhel hospital. In addition to ill-lit corridors, there is a distinct smell of urine and feces emanating from Bir. On the other hand, the hospital has designed a pretty sophisticated waste management program providing many functions from autoclaving & selling many of the used containers (which makes money for the hospital considering 50% of the patients cannot pay for their care) to production of fertilizer made by worms that digest used gauze and bandages. Sounds crazy but the Nepali people are aware of their resources (or lack there of) and come up with clever ways to improve their situation.

Thursday was fantastic! We traveled 1.5 hours from Dhulikhel to a village outpost. The mountainside road we traveled by truck was interesting to say the least. You might be aware of my anxiety when driving in less than perfect conditions…let’s just say I was put to the test today. When on the road, one would think there would be no way more than one car could fit on it, but SURPRISE, we were playing chicken with buses and trucks around blind corners. After a while, I just shut my eyes and pretended it wasn’t happening.

The outpost was surprisingly well-equipped and clean. There was a common room where new patients were seen and inpatients were kept, a procedure room, a lab and a room outfitted with stirrups, for gyn exams and deliveries. We got to see about 10 patients with the medical officer (resident) ranging from a woman with an axillary mass to another woman coming in with shoulder pain and decreased range of motion. Most of the patients we saw had to be referred to Dhulikhel hospital d/t a lack of resources(ex. 44 yo female with 1 month vaginal bleeding sent to D hospital for further imaging/workup, 5 yo boy with phimosis- when the foreskin become unretractable in an uncircumsized male, he will have to go under anesthesia and have a circumcision performed). The outpost’s staff prepared a great meal for us too. I felt at home during our outpost visit…I’m not sure if it was because I was finally seeing/examining patients or because the problems that the Nepali people face are so similar to the problems presented by my fellow Americans in my favorite environment- the family medicine clinic! Just a thought. More to come, xoxo.

So much has happened since my last post…I apologize to those of you who have been waiting so desperately for an update (hehe)! We thought we struck gold when Katherine got a wifi password to the hospital’s source but we are still having major issues in connecting.

**warning: some mild medical jargon and/or descriptions of unpleasant or unsettling things may be used below (or in any further posts).

A typical work day at the hospital is as follows: 8am morning report, 8:20 break for tea, 9am rounds in respective departments (this part is tricky- we haven’t really been assigned yet because our first 2 weeks revolve around tropical medicine lectures and the 2^nd 2 weeks will be more clinical), 10:30 am lecture, at noon we break for lunch to beat the rush of the 1pm hospital-wide lunch break, 2pm lecture, 3:30 more tea, and at 4:30 we’re usually on our way back to the hostel to relax before dinner. This may sound extremely laid back but a lot of our time and some frustration is spent figuring out what/when/where exactly we’re supposed to be doing thing.

The lovely part is that everyone has been very receptive and flexible. These difficulties and frustrations we’re facing are to be expected considering we are guinea pigs in establishing this international rotation

On Wednesday we took a field trip to the Nepal Tuberculosis Centre and Bir, the oldest government-run hospital in Nepal. The TB center is actually just a place where patients who were diagnosed/suspected of TB in the community are referred to for confirmatory testing, teaching materials and information on where to receive their DOTS treatment. DOTS: Directly Observed Treatment Schedule- designed for countries like Nepal to keep track of the masses of people infected with TB and how they’re adhering to their treatment. As you can imagine, after starting treatment for TB, patients start to feel great and they stop taking their medications…leading to the infection not being cleared and on a larger scale- scary multi-drug resistant forms of TB. The second hospital site, Bir, is a 400 bed hospital with every department imaginable. It is so very different than the fairly new, clean, controlled environment of Dhilikhel hospital. In addition to ill-lit corridors, there is a distinct smell of urine and feces emanating from Bir. On the other hand, the hospital has designed a pretty sophisticated waste management program providing many functions from autoclaving & selling many of the used containers (which makes money for the hospital considering 50% of the patients cannot pay for their care) to production of fertilizer made by worms that digest used gauze and bandages. Sounds crazy but the Nepali people are aware of their resources (or lack there of) and come up with clever ways to improve their situation.

Thursday was fantastic! We traveled 1.5 hours from Dhulikhel to a village outpost. The mountainside road we traveled by truck was interesting to say the least. You might be aware of my anxiety when driving in less than perfect conditions…let’s just say I was put to the test today. When on the road, one would think there would be no way more than one car could fit on it, but SURPRISE, we were playing chicken with buses and trucks around blind corners. After a while, I just shut my eyes and pretended it wasn’t happening.

The outpost was surprisingly well-equipped and clean. There was a common room where new patients were seen and inpatients were kept, a procedure room, a lab and a room outfitted with stirrups, for gyn exams and deliveries. We got to see about 10 patients with the medical officer (resident) ranging from a woman with an axillary mass to another woman coming in with shoulder pain and decreased range of motion. Most of the patients we saw had to be referred to Dhulikhel hospital d/t a lack of resources(ex. 44 yo female with 1 month vaginal bleeding sent to D hospital for further imaging/workup, 5 yo boy with phimosis- when the foreskin become unretractable in an uncircumsized male, he will have to go under anesthesia and have a circumcision performed). The outpost’s staff prepared a great meal for us too. I felt at home during our outpost visit…I’m not sure if it was because I was finally seeing/examining patients or because the problems that the Nepali people face are so similar to the problems presented by my fellow Americans in my favorite environment- the family medicine clinic! Just a thought. More to come, xoxo.

So much has happened since my last post…I apologize to those of you who have been waiting so desperately for an update (hehe)! We thought we struck gold when Katherine got a wifi password to the hospital’s source but we are still having major issues in connecting.

**warning: some mild medical jargon and/or descriptions of unpleasant or unsettling things may be used below (or in any further posts).

A typical work day at the hospital is as follows: 8am morning report, 8:20 break for tea, 9am rounds in respective departments (this part is tricky- we haven’t really been assigned yet because our first 2 weeks revolve around tropical medicine lectures and the 2^nd 2 weeks will be more clinical), 10:30 am lecture, at noon we break for lunch to beat the rush of the 1pm hospital-wide lunch break, 2pm lecture, 3:30 more tea, and at 4:30 we’re usually on our way back to the hostel to relax before dinner. This may sound extremely laid back but a lot of our time and some frustration is spent figuring out what/when/where exactly we’re supposed to be doing thing.

The lovely part is that everyone has been very receptive and flexible. These difficulties and frustrations we’re facing are to be expected considering we are guinea pigs in establishing this international rotation

On Wednesday we took a field trip to the Nepal Tuberculosis Centre and Bir, the oldest government-run hospital in Nepal. The TB center is actually just a place where patients who were diagnosed/suspected of TB in the community are referred to for confirmatory testing, teaching materials and information on where to receive their DOTS treatment. DOTS: Directly Observed Treatment Schedule- designed for countries like Nepal to keep track of the masses of people infected with TB and how they’re adhering to their treatment. As you can imagine, after starting treatment for TB, patients start to feel great and they stop taking their medications…leading to the infection not being cleared and on a larger scale- scary multi-drug resistant forms of TB. The second hospital site, Bir, is a 400 bed hospital with every department imaginable. It is so very different than the fairly new, clean, controlled environment of Dhilikhel hospital. In addition to ill-lit corridors, there is a distinct smell of urine and feces emanating from Bir. On the other hand, the hospital has designed a pretty sophisticated waste management program providing many functions from autoclaving & selling many of the used containers (which makes money for the hospital considering 50% of the patients cannot pay for their care) to production of fertilizer made by worms that digest used gauze and bandages. Sounds crazy but the Nepali people are aware of their resources (or lack there of) and come up with clever ways to improve their situation.

Thursday was fantastic! We traveled 1.5 hours from Dhulikhel to a village outpost. The mountainside road we traveled by truck was interesting to say the least. You might be aware of my anxiety when driving in less than perfect conditions…let’s just say I was put to the test today. When on the road, one would think there would be no way more than one car could fit on it, but SURPRISE, we were playing chicken with buses and trucks around blind corners. After a while, I just shut my eyes and pretended it wasn’t happening.

The outpost was surprisingly well-equipped and clean. There was a common room where new patients were seen and inpatients were kept, a procedure room, a lab and a room outfitted with stirrups, for gyn exams and deliveries. We got to see about 10 patients with the medical officer (resident) ranging from a woman with an axillary mass to another woman coming in with shoulder pain and decreased range of motion. Most of the patients we saw had to be referred to Dhulikhel hospital d/t a lack of resources(ex. 44 yo female with 1 month vaginal bleeding sent to D hospital for further imaging/workup, 5 yo boy with phimosis- when the foreskin become unretractable in an uncircumsized male, he will have to go under anesthesia and have a circumcision performed). The outpost’s staff prepared a great meal for us too. I felt at home during our outpost visit…I’m not sure if it was because I was finally seeing/examining patients or because the problems that the Nepali people face are so similar to the problems presented by my fellow Americans in my favorite environment- the family medicine clinic! Just a thought. More to come, xoxo.

Namaste, my friends and loved ones! Sorry for the delay, but internet in Dhulikhel is hard to come by...and a bit of bad news- uploading pics is nearly impossible!

We arrived in Dhulikhel on Sunday evening and what a change of scenery compared to KTM! Here, the Himalayas are clear as day and paint the sky during our short walk to and from our amazing hospital. Everyone has welcomed us warmly and our first clinic day yesterday was great!

After clinic we went for a breath-taking hike to a look-out and as the sun went down the snowy tops of the Himalayas took on a champagne pink glow- absolutely stunning. We ate at a wonderful restaurant near our hostel (sharing a room and bathroom with the one and only Katherine Gavin!) and we each paid roughly 300 Nepali Rupees= $4 USD!!

That is all for now...I will update as much as I can!!! xoxo

Walking around the Boudhanath- you can't see the temple, but you can see the prayer flags and the spinning Buddhist cylinders.

Our first cup of tea at our guest house Newa Chen.

Our first full day in Nepal

...and what a day it was! We went all over Kathmandu, with the help of Aarti, of course. Aarti wanted to show us the top sites just in case we don't get another weekend in KTM. We started our day out with a wonderful breakfast at our guest house- more like a four course meal! While Aarti, Katherine and Elisabeth went to the airport to fetch their bags (all of us now have our belongings!), Arran and I bummed around Patan square, where our guest house is- there really are not words to describe our surroundings, but I'll try- haphazard motorcycles, cars, tuk-tuks (small gutted out vans) and buses fill the streets, dodging pedestrians left and right, busy store-fronts along every road selling anything from oranges to sandals, gorgeous little Nepali children yelling at us, "hello!" and smiling from ear to ear.

Later on in the morning, we visited Boudhanath, one of the largest buddhist pilgrimage sites in the world- it was breath-taking. It is custom to walk clockwise around the temple, running your fingers along metal tins that spin when you hit them. The colored fabric shown in the pictures are countless prayer flags that are hung up and as they age, bits of cloth unravel and float up to the skies to represent prayers being heard/answered. We were also able to visit a monastery and visit the inside of a buddhist temple (or stupa). It was unreal. 15-foot high gold statues of the buddha with his life and journeys painted on the walls in colorful paint. It was humbling.

Next, we went to Pashupati, one of the largest Hindu pilgrimage sites in the world. There were mini temples dedicated to all the Hindu gods scattered about. The site was split down the middle by the holiest river in KTM where the locals cremate their deceased loved ones and dump their ashes into the river. There were these same rituals occurring while we were there- also extremely humbling and haunting. On a lighter note, there was numerous monkeys climbing all over Pashupati :)

We ended the day by doing some shopping in Thamel. We all bought some Nepali garb at one shop and the shop owner had a cafe next door all bring us chia (not chai) which is "tea" in Nepali- it is so delicious! It is black tea with milk and sugar- MMMMmmmm! After that we had some beer and apps at one of Aarti's favorite local restaurants= more deliciousness. Well that was my day (holy moly!), hope you're enjoying the ride so far, I know I am! xoxo

Arrival

Namaste! (nah-mah-stay) aka 'greetings' from Nepal! We finally made it- we had a 10 hour lay-over in Bahrain but thank the lord I had three good friends (Katherine, Elisabeth and Arran) to keep me company. Unfortunately, only 2 out of our 5 bags made it and by some stroke of luck, one of the two was mine. We'll be heading back to the airport tomorrow AM to reclaim the rest.

When we arrived, we were taken to our first "guest house" in Kathmandu in a UNESCO world heritage site called Newa Chen. It is BEAUTIFUL (pics to come). We'll be staying here 2 nights...learning language and customs and also touring around the KTM area before we head to Dhulikhel where we will be spending the rest of our trip.

Aarti is a classmate of mine who has been here since Jan 3rd (and also spent a semester abroad here in college) and knows the area and speaks fluent Nepali...it is so great to have her to guide us and to cut down on the language barrier. I can't wait to get some major sleep and to wake up to morning tea in Nepal! Goodnight all, or once again namaste (it's like aloha-can be used in more ways that one). XOXO

Getting ready for take-off! Here are some of my most important items: stethoscope, headlight and pepto.