Peaceful Pokhara

Hát a végén nem lett Holi fesztivál, mert azt a napot (is) a wc-n töltöttem. Azóta leszoktam a fött krumpli - banán kombinációról, új esélyt adva a baktériumoknak újabb nepáli kaják által. Idöközben átbuszoztam röpke 8 óra alatt (200 km) a “VIP deluxe” busszal Kathmanduból Pokharába, ami sokkal nyugisabb és kicsit nyugatiasabb hely mint Kathmandu. Itt egy újabb, föleg rehabilitációra specializálódott kórházban vagyok. Eddig valahogy egy plasztikai sebészt sikerült követnem valami oknál fogva. Eléggé kaotikus minden és nem úgy tünik, hogy bármilyen beosztás szerint dolgoznának, de maga a kórház sokkal modernebb, mint az elözö. Legalább a szállás totál nyugis helyen van. Néha már-már félelmetesen is. A reggeli mindig omlett és toast kenyér, rttentö izgis. Lentebb látható a teljes utiterv.

So at the end it was no Holi festival for me at all as I underestimated the stomach problem a little so just when I thought it’s over, I just couldn’t leave the room and got weak even to go up to the rooftop terasse. So for several days I was living on potato and banana, but now I give new possibility to new bacterias again so started to eat some nepali food. The whole thing got a bit scary when even my eyes got swollen, first the right one, then when it disappeared, it went to the left one. So I started to google symptoms (shouldn’t have) and found out it is either cancer or some worm. Thank God google was wrong and eventually it disappeared. So the day after (friday) I was circulating around the area in Patan just to gain some energy, didn’t do too much otherwise.

On saturday I took the bus to Pokhara from Kathmandu which is about 200 km, took 8 hours. I booked the bus after Marie recommended one which I had to book via a whatsup message to an unknown person. I could choose between “deluxe” and “VIP deluxe”. As the price difference was about 25 svenska kronor I went for VIP. And this time it was for sure VIP. Never seen such seats in bus before. Although it couldn’t take away the constant bumps on the road. It was quite a unique experience, but somehow relaxing. The whole bus ride costed almost the same (around 100 SEK) as the taxi from my hostel to the bus stop, interesting.

So we got to Pokhara, the next stop on my hospital holiday where I will spend about 2 weeks again in a hospital which is called Green Pastures (which is not equal with “green pasthors” as I previously misinterpreted). The first night I spent in Pokhara city, the area called Lake side, here you can see why.

I think I like Pokhara better than Kathmandu. Much calmer and less noisy and the mountains are very near. Though the whole city is built on turists going trekking so there are only trekking shops and companies, souvenirshops and a lot of western restaurants. One more plus is that the tap water is never brown! Also the weather is much warmer, nearly 30 degrees. On sunday I moved in to the hospitals guest house which is a bit outside of the city but the whole area is incredibly peaceful. The breakfast is always an omlette with toast bread, sometimes with spoon and knife or spoon and fork but never with a fork and knife.. I don’t think I will ever eat omlette again after I get back home.

This hospital mostly takes care of rehab of patients with spinal chord injuries and stroke. They also do some spinal surgeries and some hand, reconstructive surgeries, again partly for leprosy patients. The hospital itself is much more modern than the previous one with better facilities and equipment but somehow for me it is hard to understand the structure. Probably because they didn’t really take time to explain it. Somehow I ended up following a plastic surgeon who actually does all kind of surgeries. I don’t really understand what ortho does and who are they despite I asked a couple of times. Even hand surgery and various wound surgeries are done by this plastic surgeon who is just running around the whole time without any schedule (what I can see). So when he decides he wants to operate something then the patient is there in 10 mins (which means they are really not that busy at op). Verrry chaotic to me. I am just trying to run after him without knowing any plans for the day. Sometimes he forgets to collect me after he leaves me somewhere... My contact person here is Josh, a rehab doctor from the US. Yesterday we went together to have a dinner in a nearby restaurant with his family, for which they collected even a swedish person exclusively for me “as I am coming from Sweden”.  They were a bit disappointed when I said it is not entirely true.. Otherwise it was a nice evening despite of that we couldn’t hear each other because of the constant loud raining on the plexi roof, which made the whole thing kind of funny.

Finally a little bit about the whole grandious plan. I will visit 4 different hospitals, all of them at least 5 hours from each other, as the roads are very shitty.. So on map it is like this. Let’s hope for the best. :)

Dal bhat & Holi

Az elsö kórházas èlményem véget ért Anandabanban és ismét Kathamanduban vagyok a norvég házban. Holnap Nemzeti ünnep itt, ami a Holi névre hallgat és abból áll h emberek színes porokat dobálnak egymásra. Közben az itteni orvosok rájöttek, hogy lehet feladatokat delegálni nekem, így beadtam rengeteg (az indikáción túlmutató) szteroid injekciót, visszaraktam egy könyökficamot és összevartam mindenfélét a mütöben. A múlt hétvégén visszamentem a városba és foglaltam egy hostelt, amit csak sokadszorra sikerült megtalálni, igénybe vettem a helyi motoros-taxit (nyilván bukósisak nélkül) és megnéztem egy marha nagy sztúpát, amit csak egy irányból szabad körbejárni. Sajnos a végzetemet nem kerülhettem el, így pár napot a wc társaságában élveztem leginkább, amíg nem kezdtem el egy antibiotikum kúrát, ami hatásosnak bizonyult. A kaja a képen az egyik gyanusitott, amit egy helyi mama készít minden nap a kórházban.

Days are passing by and soon I am leaving Anandaban Hospital (wow, it’s a rhyme). During this time I have also visited the daycare facility for leprosy patients where they get educated about the disease, for example how to take care of chronic wounds. When they had a session I have been put  in the center of attention (like a show item) and they found it really interesting (a little bit too much interesting) that someone from the western world is visiting them.

Last Friday we had outpatient clinic again (this time without the dog), where I got to relocate an elbow only in local anesthesia (patient was totally silent the whole time) and Dr Ashim realized that he can delegate all the steroid injections in the knee to me and he was really generous with prescribing them..

The area around, hospital is on the right side

For the weekend I went back to the city and booked a hostel which was recommended by my new french friend. The only problem was that there are two hostels with the same name and of course I went to the wrong one. It was already dark and I started to panic a little bit but finally I found the right one after 2-3 circles because the location was not exactly where google maps put it so finally some local man helped me out and called them. During the day I was walking around Thamel the tourist area with the bazaar but after a while I got just too tired of the constant  “hello madam where are you from” and “taxi, madam?” so I had to rest some hours before I could continue. Have also visited one of the biggest stupas in the world, the Boudha Stupa where you can go around only in one direction so every time I found something interesting on the map, I had to go one more circle to not to mess the direction. 

Then I also tried the new transportation method which was also recommended by Marie and is similar to Uber. So there is an app where you give the destination and the car (or the motorbike) picks you up. The only problem that the drivers always ring you immediately for some reason despite they don’t really speak English which makes it a bit complicated. With this system  I also tried riding the motorbike (on the back seat) which was quite an experience (of course without the helmet). In the evening I thought to try out some (in local standards) fancy western pizzeria called Fire and Ice (thank you Alison for the recommendation). The only problem was that after 2 bites I felt so sick that I had to leave so my most expensive food so far went to the waste. Not the food’s fail though, I didn’t feel well before either..

On Sunday I found a local church where probably all the western expats are hiding, there were at least 80 ppl, was a nice experience. After that I was just resting the whole day as I couldn’t escape destiny and stomach problems became worse and lasted a few days until I started to take some antibiotics. Surprisingly this time I succeeded with my empiric therapy. Yeah maybe shouldn’t eat everywhere on the street... or maybe it was the “dal bhat” (rice and lentils which they eat every day here) which I ate always at the hospital prepared by a local old lady whom everybody just calls “mamma”. Unclear hygienic status of the cutlery...

Dal bhat a la mamma (now only by looking at it I am feeling sick...)

This week we had a couple of surgeries partly reconstructive procedures for leprosy patients but also simple things like trigger finger, which I got to perform and also sutured a couple of other things. So much about not being allowed “to touch patients” without nepali work permit.

Today I am back to Kathmandu again as tomorrow is a national holiday here called Holi where people are throwing colourful powders on each other and party all day. Will se how much I will be a part of this.

The rhododendrons and me in front of the hospital

Anandaban Hospital

Megérkeztem az elsö kórházba, ami Anandaban névre hallgat és fent van a hegyen, egy órás kátyús útra a várostól. Ez egy föleg leprásokra szakosodott kórház, de sima traumát is el tudnak látni. Itt egy Marie nevü francia építész lánnyal lettem elszállásolva egy házban, aki itt egy építkezési projekten dolgozik már 2 éve. Névjegykártyát meg sípot is kaptam, ha netán bajba kerülnék (?), meg tanácsot, hogy sötétedés után ne nagyon járkáljak kint, mert vannak pl. tigrisek. Elsö nap rendelésen voltam, ahol 3 óra alatt kb 45 bteggel találkoztunk, egy kutya konstans társaságában. Aztán következö nap a mütöben voltam (talán a felszerelés nem sokkal rosszabb,  mint Pesten), viszont vannak érdekes megoldásaik, pl. a fütötest az oxigén mellett. Ma egyedül vagyok, mert Marie házon kívül van, remélem, nem jönnek a tigrisek...

On monday morning I was picked up by a local guy and been transported to the first hospital I should be at, called Anandaban. Took about one hour to get there, mostly because the road is so bad, there are more holes than road. If I ever had kidney stone it is gone now. The place is higher up, around 1600 m, in the mountains. 

It is a hospital mostly for patients with leprosy, there they between other things do reconstructive surgery. Totally they have around 150 beds (80 out of that is for leprosy patients) and they carry out a lot of research work for what they are quite famous in other parts of the world as well. There is an emergency unit too so they do some general trauma surgery also. I have met already with the director of the hospital and Dr Indra (an orthopaedic surgeon) who is friend with some nice people I know from Örebro. I have been given a tour around and introduced me to a french girl Marie whom I will be living together with in a guest house (called Rose Garden). Looks like this:

She is an architect and been here for 2 years now, working on a new emergency building. I even got a welcome flower and a card and a whistle which I should use in case of “I am in trouble”.... hm...

Also I have been informed that I shouldn’t wander around after dark because of animals, for example tigers. First I thought he was joking but no. Otherwise there are even some eagles (which are hard to take a photo of unfortunately..).

I had my first clinic day now which I spent with Dr Ashim who is one of the 3 orthopaedic surgeons here. The mornings start at 08.30 with a devotion. The first day they even introduced me as “the orthopaedic surgeon from Sweden”. Thought it is a bit overkill one week after I became a specialist but what can I say. After the morning session we visited the admitted patients (around 7-8 patients) then we had fika with something which was somewhere between tea and coffee (hard to know) then the outpatient clinic started around 10 am. Between that and 2 pm we have seen around 45 patients (including a one hour lunch break). 80 % of them with knee or back pain. And almost all of them got Arcoxia, Gabapentin, Omeprazol and vitamins prescribed regardless the reason of visit. There is an x-ray in the next room so it took about 5 mins to get the pictures (not like in Örebro...). During the examinations we enjoyed the company of a dog who was present almost the whole time in the room. 

The next day (today) I was in the OR, there was 3 surgeries. The first one was a guy who partially amputated his little finger (sorry non-doctors) which actually could have been done outside the OR, then a leprosy patient with a wound that is not healing and then the last one with a fracture in the knee. The OR from inside:

Not much worse than some hospitals in Hungary... they have some interesting solutions though, using a drill machine from like Media Markt and the little heater on the right with a little open fire in it, just next to the oxigen tanks. Thankfully most of the patients got spinal anestesia (in which the person who does it is quite good and fast at). No ventillation at all. I have seen an AC but probably it was out of order. The C-arm on the right comes from Sweden and has been functioning almost 10 years. Otherwise their operation technics are quite similar to ours just with a bit more simple tools and solutions. The surgeons are also quite skilled I think.

Today I am without Marie and alone in the whole house, hope no tiger comes... otherwise I am happy if you give some feedback sometimes in any form, so I know that someone reads this. :)

Kathmandu my new home

English below! Bocs mindenkitöl, de most csak összefoglaló lesz magyarul, mivel az olvasóközönség összetetéle idöközben megváltozott. De ajánlom a google translatort, ha a teljes szövegre éheznétek. :) Szóval Nepálba mégse mehetek el blogírás nélkül, és egyelöre még az internet is megoldott. Már 3napja vagyok itt, egyelöre még hasmenés nélkül (!!!). Kathmandu külsö részén lakom, ami kicsit nyugisabb és kevésbé gettós mint ahol szoktam lenni ilyen helyeken... Idö közben megnéztem a helyi föteret (a belvárosét is meg annak a résznek is, ahol lakom). Mint látható a közlekedési lámpa és az áramellátás elég egyszerüen megoldott. A majom és a Buddhák a Majom templomnál voltak, ahol rengeteg majom szabadon garázdálkodik, mert szenteknek vannak nyilvánítva. Holnap elvileg valaki felvesz és elvisz az elsö kórházhoz, ami még itt van a környéken kb 40 percre, Anandaban névre hallgat és elvileg oda is költözök most egy ideig..

Yes. Nepal. A long term dream coming true. A bit difficult to know where to start as last time I wrote in this blog was more than 2 years ago, and in Hungarian. But I am trying to suit it to the audience’s needs which has become more international (or we will see who reads this at all :). 

Ok, so let’s start it from the beginning which was trying to find out how to pack a bag for 2 months when you need everything from everyday clothes to trekking gears and you still need to be able to bear that bag throughout whole Nepal. (Not to mention my survival kit with solar cells, a lot of antibiotics and sutures just in case..) The result:

Big bag weighed “only” 20 kilos so I could have packed 5 kg more.. Whatever, there will be 5 kg souvenirs on the way back. :) . So the whole journey took about 26 hours from door to door. Örebro - Arlanda - Dubai - Kathmandu. Here you can see the Himalaya mountain range from the flight (don’t ask me which mountain is which).

I have been at some airports in my life but I can almost say that Kathmandu was the most chaotic (or I just forgot how was it in India...). I think it was just poor luck I found my luggage just thrown between thousands of others on the ground. Had to go through at least 4 security control where the key of success was to push yourself forward to the front, through other people, otherwise you spend there the whole day. No corona distancing really and no system at all... coming out of the airport as usual I was immediately attacked of taxi drivers who wanted to know all about me and offered “the best price”. At the end I managed to bargain a price which was still twice as much as recommended by google but I just got tired. Surprisingly we reached the goal despite that I almost sit at the drivers seat as I forgot that here they drive on the other side of the road. Now I am at a guest house called Norwegian House (it can only be the best with this name) which Amanda (the swedish doctor who works in Nepal) recommended. It is nice and comfortable, especially if I compare to the places I slept before, for example in (almost the getto of) Delhi. It has a nice cafe attached and a garden and mostly warm shower.

An interesting thing is the time difference which is 4 hours and 45 minutes more compared to Stockholm/Budapest. Don’t know how they figured out this... 

In the evening I had my first nepali meal which is called momo (you can find it in India as well). Dumplings filled with pork (in this case). I managed to choose a restaurant where I was the only guest ( you couldn’t see it from the outside). Thanks to that 3 people from the staff was watching me closely from 2 meters how I eat. I almost felt like in a tasting show. And as the food was so damn spicey I had it difficult to not to cry during the whole time. 

The day after I headed to Patan Durbar Square which is in my area, not exactly downtown Kathmandu, a bit outside. A lot of construction on the way, the square itself as well (maybe bc of the earth quake some years ago?) 

As usual crossing the road is almost equal with a suicide attempt (regardless if there is a zebra). Maybe this traffic “lamp” decribes why. Also an other statement, in Kathmandu electricity cuts are common. Wonder why...

So far I was thinking Kathmandu is not that dirty and chaotic as Delhi but it turned it is only because I have been living in the outskirts. Today I took a taxi to the city and first I visited the Monkey temple. As the name would suggests it is a temple with a lot of monkeys around (as they are thought to be sacred) and huge Buddha statues and a stupa with the Buddhas eye. I also walked to Kathmandus Durbar Square which is similar to the one above just less construction. Then I walked to Thamel which is downtown and basically a huge market where you can buy anything but mostly mountaineering gears and food. Of course you share the streets with motorcyclist from which you have to jump to the side continously. Finally I took a taxi back to Patan (where I live).

Tomorrow someone should come and pick me up from Anandaban Hospital which will be the first place I start, it is about 40 mins from Kathmandu.

So here I will write my updates probably 1-2 times a week so you are welcome back :) Next posts won’t be that long probably.. I know the pictures are not the best but the good ones are on the real camera...