hmpg_feature_batwafamilyDear Friends,

If you are like me, you may find that reading through your Facebook feed has become very painful of late.  Right now there is so much frustration, anger, fear, and pain in our country.  These days, we see very few smiles, and feel precious little joy.  It’s easy to become discouraged; it feels like there is so little we can do.

But one thing you can do is support the Batwa people.

The Batwa are a wonderful tribe of pygmies in rural Uganda. Traditionally, they lived in the rainforest and were primitive hunters and gatherers.  All that changed when their government forced them out of the forest, as part of the creation of a world heritage site for silverback gorillas.

When the Batwa were evicted from the only life they have ever known, they were left to fend for themselves with no food, no land, no resources.  As a result, they began dying at an alarming rate, especially children under the age of five. That’s when Dr. Scott Kellermann and his wife Carol were called to Uganda to help save the Batwa.

When Scott and Carol first arrived, the Batwa were suffering and dying.  They held clinics under trees, hanging life-saving IV fluids from the tree branches.

Through the Kellermann Foundation, the organization started by Scott and Carol, the lives of the Batwa are beginning to look bright.  The Kellermann Foundation has created a Batwa Development Program, which has purchased land for the Batwa to live and farm, has built schools and sponsored the education of Batwa children, has built homes for Batwa families, has sponsored water and waste projects, and has set aside a small part of the rainforest where the Batwa can maintain their culture and pass on their traditions to future generations.

The Kellermann Foundation has also built a hospital, the Bwindi Community Hospital, which has been recognized as the top hospital of Uganda.  There, doctors from around the globe come to learn from, work with, and teach Ugandan doctors.  The hospital has had some astounding successes:

  • • In rural Uganda, many women attempt to deliver babies at home.  If their delivery fails, they are left struggling to find a hospital that can perform an emergency cesarean section.  The complications can be significant, such as death of the mother, death of the baby, or vesicovaginal fistula, a communication between the bladder and vagina, which causes continuous leaking of urine.
    • o The Bwindi Community Hospital has created a Women’s Dormatory, where pregnant women can come to stay at the end of their pregnancy to be near the care they require at the end of their pregnancy.
    • o They have created a voucher program where a woman can receive prenatal care and a delivery for the equivalent of 1 US dollar.
    • o The hospital now delivers 1,200 babies annually.
    • o They have built a pediatric ward that not only treats children, but has a demonstration garden where parents can learn how to grow nutritious foods and a test kitchen to teach mothers how to prepare foods to help their children thrive.
    • • The public health efforts of the hospital, and their HIV/AIDS clinic, have brought the HIV/AIDS rate in the community below 5%.
    • • They have built a nursing school—Uganda Nursing School Bwindi—that trains nurses to improve healthcare delivery throughout Uganda. This year, the first Batwa student is entering the nursing school!

But the Batwa, the Kellermann Foundation, and the Bwindi Community Hospital need your help to survive.  We would love for you to visit the hospital and see the work they do; however, if travelling to Uganda is not in your near future, please consider supporting the Kellermann Foundation financially.

    • • $225 can treat a malnourished child.
    • • $750 can provide primary education, materials, uniforms, and transportation for a Batwa child for a year.
    • • $1,250 per year can support a Batwa child through secondary school.
    • • $1,400 can build a house for a Batwa family.
    • • $1,500 per year can provide tuition, housing, and materials for a nursing student.

The Kellermann Foundation is a 501(c)(3) nonprofit charity.   It has received a Gold level from GuideStar, and is a “Top-rated” charity by Greatnonprofits.org.  You can support the Kellermann foundation by direct donation, or can support them through Amazon Smile.

I first met Scott Kellermann in 2015 when he visited Park City, Utah.  I have done medical work all over the world, but was so impressed by the work that they have been doing that I visited the hospital in 2016.  This year, I have decided to volunteer as an unpaid board member to help protect the Batwa, and to improve the state of healthcare in their region of Uganda.  I hope you will support us.

In these tumultuous times, you may not be able to change the results of an election, or correct the wrongs of our society, but you can help the Batwa. And that’s something worth smiling about!

Thank you,

Andrew Nyberg, MD MPH

Board Member

Kellermann Foundation

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Back in Kathmandu

May 19, 2015

Dear Friends,

Thank you for the well wishes, the prayers, the concerns. I am now back in Kathmandu with plans to leave Nepal in the next few days. It has been quite an adventure since the first earthquake hit Nepal on April 26. After assisting the evacuation of the wounded off Everest, we stayed open to be there for all the teams, guides, porters, etc. that were now leaving the region. In spite of this, we saw very few physically sick patients, but some very traumatized people. On May 5 we closed the Pheriche HRA post, as it had become clear to us that our mission for this season was largely concluded, and we were anxious to get on to other things.

After a beautiful walk down to Lukla, and a safe flight out of the Khumbu, I said goodbye to Katie and Reuben, who were headed back to the UK to work on their upcoming wedding.

Mama Bear and Papa Bear, parents to our favorite puppies, Black Bear, Brown Bear, and Grizzly Bear, waking up to say goodbye on the day we left Pheriche.

Mama Bear and Papa Bear, parents to our favorite puppies, Black Bear, Brown Bear, and Grizzly Bear, waking up to say goodbye on the day we left Pheriche.

Mama Bear and Papa Bear lead the way out of Pheriche.

Mama Bear and Papa Bear lead the way out of Pheriche.

Walking out of Pheriche for the last time.

Walking out of Pheriche for the last time.

Ama Dablam and the farm fields of Pangboche.

Ama Dablam and the farm fields of Pangboche.

The heavily damaged monastery at Tangboche.

The heavily damaged monastery at Tangboche.

Gobi and Tan relaxing at a Teahouse.

Gobi and Tan relaxing at a Teahouse.

A teahouse kitchen.

A teahouse kitchen.

The rhododendron in bloom.

The rhododendron in bloom.

Namche Bazaar.

Namche Bazaar.

The dental clinic in Namche suffered heavy damage

The dental clinic in Namche suffered heavy damage

Reuben and Katie at our favorite cafe in Namche.

Reuben and Katie at our favorite cafe in Namche.

The two bridges to Namche Bazaar.

The two bridges to Namche Bazaar.

The author, looking back on the two bridges to Namche Bazaar..

The author, looking back on the two bridges to Namche Bazaar..

The beauty of the Khumbu.

The beauty of the Khumbu.

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A “Bob Ross” waterfall outside of Monjo.

Cherry blossoms in bloom

Cherry blossoms blooming in Phakding.

Renee and I integrated into an awesome group of medical professional from Scripps (San Diego) and Mass General (Boston), who were operating field clinics in the Gorka region on Nepal for International Medical Corps (IMC). I’ve spent the past 10 days working with them, visiting several different sites by helicopter, setting up a clinic and camp, and treating the local population. In my time with them, we have seen well over 600 patients, mostly for common complaints and chronic conditions, but all of these villages have been devastated, and their “healthcare” infrastructure has been devastated, either because the community health worker is no longer their, or the community health post was damaged, or the medical supply line has been severed due to landslides and impassable trails.

The author.

The author and a satisfied customer.

Bringing medical supplies to a village to set up a clinic.

Bringing medical supplies to a village to set up a clinic.

Children playing with a wheel and stick, their favorite activity.

Children playing with a wheel and stick, their favorite activity.

Three Nepali children at play.

Three Nepali children at play.

We were in the town of Ghyachchowk when the second earthquake hit. Thankfully everyone was safe, but the second earthquake has played a major toll on the mental health of the people we are seeing. Their world was devastated after the first quake, and they were just starting to get over the experience and rebuild when the second earthquake hit.

The town of Ghyachchowk.

The town of Ghyachchowk.

Looking into a destroyed house.

Looking into a destroyed house.

The middle school, the pride of the village, ruined by the earthquakes

The middle school, the pride of the village, ruined by the earthquakes

Villagers demolishing a house for rebuilding supplies

Villagers demolishing a house for rebuilding supplies

After the second earthquake many of the Nepalis we saw were suffering from Acute Stress Reactions; fearful that any aftershock could be the next large earthquake. The emotional ramifications of what they have experienced will affect them for the rest of their lives.

A girl and her chick watch the activity at the mobile clinic.

A girl and her chick watch the activity at the mobile clinic.

IMC Nepali volunteers Ocean and Iman singing with the locals.

Nepali volunteers Ocean and Iman singing with the locals.

Our team has finished their deployment, and are now cycling back to the U.S. Another team from Stanford arrived the day before yesterday, and will be going into the field today to continue our work. Other groups from IMC and other aid organizations are in the field, performing medical duties, but also rebuilding water supplies and toilets, helping rebuild structures, identifying areas nutritional deficiency, and working with villages to develop coping strategies and mental health first aid.

IMC Dietary staff member Suzanne and Nepali volunteer Kul assessing the nutritional status of villagers.

IMC Dietary staff member Suzanne and Nepali volunteer Kul assessing the nutritional status of villagers.

In the future, I hope to provide more stories of my experiences since the earthquake, but it has been difficult to wrap my mind around the repercussions of everything that I have bared witness to in this country. In the meantime, please accept this short account of my recent actions and movements.

The night before last I was feeling great. I had been reading articles about climbing mountains online at SummitPost.org, and simultaneously reading out of High Altitude Medicine and Physiology, 5th Edition, a great textbook about what happens to humans at high altitude. I had no sooner put the book down, when I had my own fist had experience of what happens to human bodies at high altitude.

No sooner had I turned out the lights than my feet started to really hurt, specifically the first and second toes of the right foot, and then the second toe of the left foot. Like excruciating pain. I’ve never had gout, but I imagine this is what gouty arthritis felt like. Except I had it in 3 toes! I also had mild pain in the 2nd MCP joint (that’s the first joint on the pointer finger) and the 3rd PIP joint (that’s the second joint on the middle finger). I tried taking ibuprofen, without any improvement in symptoms. I had to reach for the hydrocodone with acetaminophen, which was finally able to control my pain to the point where I could get some sleep.

I have never felt such pain before!

When I woke yesterday morning, my feet were not nearly as painful, but still quite swollen, but the middle finger on my right hand was so bad that I could not straighten it, and my fingers, especially on my right hand, were quite swollen. My knees ached, and I was generally not feeling well. It is as if I had aged decades overnight.

Yesterday I was on the day shift, and we were steady with 7 patients. I felt like my right hand was a withered, crippled, claw. Everytime I had to shake a customer’s hand it was excruciating.

After the day was through, I pulled down Auerbach’s Wilderness Medicine, 5th Edition (the copy at the HRA post has actually been signed by Paul Auerbach and Ken Zafren, who is one of the medical advisor’s for the HRA), not an easy task in itself! After flipping through Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema, I got to a small one-paragraph section on Peripheral Edema at High Altitude. According to this authoritative text, peripheral edema will occur in 18% of people over 4200 meters, and suggests the use of a diuretic medication for symptom relief. Ah, Acetazolamide (Diamox), you always seem to be near at hand in high altitude. I never needed it for Acute Mountain Sickness, it’s most common use at altitude, but here I am relying on its diuretic properties to let me pee away my peripheral edema.

My hands on the night of March 22.  The knuckle on my right pointer finger is obviously swollen, and I can't straighten my right middle finger much past where it is without significant pain.

My hands on the night of March 22. The knuckle on my right pointer finger is obviously swollen, and I can’t straighten my right middle finger much past where it is without significant pain.

My feet on March 22.  Look how swollen each of the toes look!

My feet on March 22. Look how swollen each of the toes look!

I took 125mg last night, and had two good pees overnight. In the morning, my left hand and toes had greatly improved. My right hand is still being a bit problematic, but acetazolamide and I keep waging our battle against excess fluid. 250mg during the day, and I’ll take another 125mg tonight. I am mostly back to normal, but still can’t quite straighten my right middle finger!

My hands on March 23.  The knuckle on the right 2nd finger is still somewhat swollen, and while I can straighten my right middle finger a lot more than yesterday, I still cannot straighten it completely.

My hands on March 23. The knuckle on the right 2nd finger is still somewhat swollen, and while I can straighten my right middle finger a lot more than yesterday, I still cannot straighten it completely.  My left hand looks pretty much normal.

While my toes look much more splotchy than they did yesterday, they are not swollen and feel much better.  I have a blister on the left 2nd toe from the trip to Ama Dablam, and my right 2nd toe has a bruise on it where a nearly blind guy stepped on my toe today (casualties of wearing flip flops in the HRA clinic!)

While my toes look much more splotchy than they did yesterday, they are not swollen and feel much better. I have a blister on the left 2nd toe from the trip to Ama Dablam, and my right 2nd toe has a bruise on it where a nearly blind guy stepped on my toe today (casualties of wearing flip flops in the HRA clinic!)

A World Lit Only By Dung

March 17, 2015

The front of the HRA clinic in Pheriche, with the Everest Memorial monument out front.  It lists the names of all the known deaths on Everest, currently accurate through 2012.

The front of the HRA clinic in Pheriche, with the Everest Memorial monument out front. It lists the names of all the known deaths on Everest, currently accurate through 2012.

The plaque on the front door of the Pheriche HRA clinic

The plaque on the front door of the Pheriche HRA clinic

We have made it to the HRA post at Pheriche, and are slowly adjusting to our new routines. The valley that contains the small village of Pheriche is absolutely beautiful, with towering spires surrounding the houses, lodges, and farms. After arriving, we assigned ourselves rooms and got to work cleaning the residential side of the clinic. We then spent the next two days, March 13 and 14, cleaning the clinic, and arranging the medical stores.

View of the Pheriche Valley to the Northwest.

View of the Pheriche Valley to the South.

View of the Himalayas surrounding Pheriche.  Looking to the Northwest

View of the Himalayas surrounding Pheriche. Looking to the Northwest

The "business end" of the Pheriche HRA clinic, the reception area for patients, and the shop for selling t-shirts, etc.

The “business end” of the Pheriche HRA clinic, the reception area for patients, and the shop for selling t-shirts, etc.

The examination room, where we see most patients.

The examination room, where we see most patients, still in the process of being cleaned.

Our "Inpatient Ward" where patients staying overnight will sleep.

Our “Inpatient Ward” where patients staying overnight will sleep.

The kitchen, where Jeet keeps us well fed, and where there is an unlimited supply of hot water for drinks (my new favorite being a combination of Hot Chocolate and orange Tang, delicious!)  We sit around the small table for all meals.

The kitchen, where Jeet keeps us well fed, and where there is an unlimited supply of hot water for drinks (my new favorite being a combination of Hot Chocolate and orange Tang, which I call a Terry, after the British company that makes chocolate oranges.  It’s delicious!) We sit around the small table for all meals.

The common room at the HRA clinic in Pheriche.  My room is the door on the right.

The common room at the HRA clinic in Pheriche. My room is the door on the right.

A Panorama of the staff enjoying the heat of the Dung stove in the evening.

A Panorama of the staff enjoying the heat of the Dung stove in the evening.

My bedroom at the HRA clinic

My bedroom at the HRA clinic

When we arrived, we had the bags we carried, plus one bag carried by a porter. The rest of our supplies, including food, medications, and personal effects, were to arrive by Yak train. This hasn’t happened yet….

Supposedly they’ll be here by tomorrow. The clinic has now been open for the past 4 days, and we’ve seen several Nepali locals and guides, and have diagnosed two people with High Altitude Pulmonary Edema. One has been flown out, and the second is spending the night in the clinic tonight, and will be flown out tomorrow.

We have split up the schedule so every day there is a daytime doctor, a nighttime doctor, and a doctor who is off. The night doc is also responsible for our 3pm altitude lecture, which I gave for the first time today. Our schedule is such that you work each shift twice in a row, which ultimately gives each person 2 days off at a time.

So tonight is my first “night shift”. We’ve had good luck in the past not getting patients during the nighttime hours. We’ll see if it holds for tonight. Tomorrow I will also be on overnight, and then will have two days off. If I get good sleep tomorrow, then Reuben and I are planning on trekking down to the Ama Dablam basecamp, which is at approximately the same elevation as Pheriche, and is supposed to be quite spectacular.

It has been cold, and even snowed yesterday. Our building is powered by solar, with a solar water heater, so our ability to function is dependent upon how much sun we get, and how much we need to use the oxygen concentrators for our patients (our major source of energy expenditure).   It’s kind of interesting to have to be so conscious of our energy use. Many Americans and Westerners would probably be well of to have to live by solar for a period of time to have a better understanding of the implications of power use.

But today was sunny and warm, and we got enough of a charge that I could take a nice, hot, shower. This is the first shower I’ve been able to take since leaving Kathmandu on the morning of March 8, 10 days ago. The good news is that it is so cold here that you never really develop the bad smells that you would in more temperate climates, but I was still happy to wash all the days of travel off of me, and change into some fresh clothes.

Our daily routine is such: Jeet, our cook, has breakfast around 8am. We usually lounge, or work on projects until noon when we have lunch. If it is sunny, one or two people can take a shower after lunch, during the warm part of the day. Then at 3 we have our altitude talk. This usually brings with it a small flurry of business, as people realize that they are actually suffering from altitude illness. Dinner is at 6pm. Yesterday they bought a chicken, which was cooked with the Dal Bhat. I have decided that one determination of whether a country is civilized is how they cut up a chicken. Needless to say, I’ve been carefully picking around jagged pieces of bones here. But protein is still good! After dinner is the real treat of the day: Jeet loads the potbellied stove full of dried Yak dung, and we sit in warmth, the only external source of heat we have other than the kitchen’s gas burners, and the very occasional warm shower. For several hours in the evenings, we relax in the common room in comfort. We are only allowed one stove’s full of dung a day, so when it is done and the room starts to cool, people head towards bed. Renee and I have our bedrooms directly off the common room, so we have gotten in the habit of opening our bedroom doors after the others have left, and letting the remaining warmth of the dung stove heat our rooms before bed.

The following are pictures of the clinic, Pheriche, and nearby Dingboche, which Renee and I visited a few days ago.

The author in a PAC bag, which can effectively increase the ambient air pressure by 2 bar.  In Pheriche (4200m), this  simulates the much lower altitude of Lukla (2800m).

The author in a PAC bag, which can effectively increase the ambient air pressure by 2 bar. In Pheriche (4200m), this simulates the much lower altitude of Lukla (2800m).

Practicing with the PAC bag inside the sun room.  The author is currently inside.

Practicing with the PAC bag inside the sun room. The author is currently inside.

The village of Dingboche, a 30-45 minute walk from Pheriche. It is 200m higher than Pheriche, and quite a bit larger.

The village of Dingboche, a 30-45 minute walk from Pheriche. It is 200m higher than Pheriche, and quite a bit larger.

The village of Dingboche with Island Peak (Imja Tse) in the background (looks like a black diamond).  I am planning on climbing that mountain in May.

The village of Dingboche with Island Peak (Imja Tse) in the background (looks like a black diamond). I am planning on climbing that mountain in May.

Returning home to our small village of Pheriche.

Returning home to our small village of Pheriche.  Hard to see, but the HRA clinic is mid picture.

The Stupa in Dingboche.

The Stupa in Dingboche.

An old Stupa above Dingboche

An old Stupa that sits above Dingboche in need of repair.

The helicopter landing to pick up our HAPE patient.

The helicopter landing to pick up our HAPE patient.

The helicopter taking off with our HAPE patient.

The helicopter taking off with our HAPE patient.

Namche to Pheriche

March 12, 2015

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Namche Bazaar is a transition. It is the end of the world, and the start of Khumbu. It is the last place with a reliable power source, free internet, quality bakeries, and stores where you can buy high quality mountaineering equipment. Although most journeys into the region start at Lukla by flight, or Jiri by foot, Namche Bazaar has always been the embarkation point.

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On our acclimatization day, Katie, Reuben, and I visit two villages further up the hill from Namche: the villages of Khumjung and Khunde. Both villages are known for having green rooftops, to reflect the fertile farmland of the valley in which they reside. From the path to Khumjung, we get our first real look at Everest, Lhoste, and Ama Dablam. The village itself has spectacular views of Ama Dablam, which is one of the most incredible mountains I have ever seen.

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Khunde is home to a clinic whose clientele is 98% Nepali. The doctor who runs the clinic, Dr. Kami, is very famous in the region. It is important for us to visit this place, because this is where we will be sending many of our Nepali patients throughout the season.

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The trek to Khumjung and Khunde is arduous, however, as the snow is melting in the warm air and the trails turn to mud. By the time we make it back to Namche, we are very hungry, and an exquisite piece of apple pie and an cappuccino at one of the local bakeries hits the spot nicely, then we head over to a bar that shows a documentary called “The Sherpas: The True Heroes of Everest” every day at 3pm. The movie highlights a group of Sherpas, and the work they do to prepare the way for Westerners to climb Everest. It is truly remarkable how these people toil and prepare so that people from a far away place can bask in the glory of standing on the highest point on Earth.

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After the movie, we return to the Panorama lodge for some Dal Bhat, which is the local staple. Dal Bhat is a combination of white rice, a liquid called Dal, and stewed vegetables, sometimes with meat. It’s actually very good, and there is always a lot of it, because it is traditional and expected for you to get seconds when you are eating Dal Bhat.

The next morning we have a last delicious breakfast at the Panorama Lodge.  It is more pricy than the other places we stay, but it is well worth it because the proprietors treat you like family.  Before leaving, they blessed us each by presenting us with prayer scarfs to take on our journey with us.

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We start off early to take advantage of the night’s cold to cover some distance before the heat of the day brings back muddy trails. Again transition: below Namche, the terrain was pine forests familiar feeling to many parts of America. Above Namche, the terrain transitions into an alpine zone, where trees become more like tall bushes and life becomes harsher.DSCN0404

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Our goal for the day is the hilltop outpost of Tengboche, which is most famous for its Buddhist monastery, and also has a few rugged lodges for guests. After a long, seemingly never ending, uphill hike, we reach Tengboche. After checking into the lodge, we make our way over to the Monastery to have a look. Respecting the wishes of the monastery, I took no photos inside. The main room houses a large Buddha statue, and places for the monks to sit. The walls are adorned with colorful images of gods and scenes that hold no meaning to me, and I walk away with little understanding of what stories and lessons were being taught on the walls of the Tengboche Monastery.

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The accommodations at the lodge were extremely crude, and the difference in quality between the lodges of Namche and those of Tengboche is striking. However the Sherpa stew is good, albeit being made with some unknown overcooked meat. The secret jewel of the stay, however, was being able to eat dinner watching the sun set on Everest and Ama Dablam. The whole room was silent as we watched these mountains transition from white to gold, to rose.

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The next morning began early. Our porters wanted to be off with our bags by 6am. Their goal was to drop our luggage off at Pheriche, and then be back to Lukla. These three young men make their money carrying goods uphill, and when they reach their destination, they want to spend as little time as possible on the return journey. There’s simply no profit on the way back. Starting early again allows us to benefit from walking on frozen ground, instead of mud.

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The trail continues to get higher, the air continues to get thinner, and the trains of animals carrying goods, so frequent below Namche, has become a rare sight.   Reaching the stone mounds and prayer flags that mark the top of the pass before entering Pheriche is a cause for celebration. We now just have a short downhill hike before entering the town that will become our new home for the next couple of months. The hours cramped in an airline; the days breathing dust and exhaust in Kathmandu; the miles of hiking have all been for this: to reach the Himalayan Rescue Association aid-post at Pheriche.DSCN0477

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Today our journey really begins. Waking up at 0415, I take one last shower, and pack the last of my things, and say goodbye to my internal room (so weird) before heading down to the waiting taxi, which takes us to the domestic terminal of the Kathmandu Airport. There we board the first flight of the day, which takes us to Lukla in approximately 40 minutes. The flight is absolutely spectacular, and Reuben Renee, and I are sitting on the left side, where we can watch the Himalayas the entire time. It beats any in flight movie you’ll ever see.

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The Lukla airport is notorious, with good reason. It is known as the most dangerous airport in the world, because of its short runway, which begins at the edge of a precipice, and ends with the stone retaining walls of the hill and the town. The runway is tilted to help deceleration during landing, and to increase speed during takeoff.  If you google the Lukla Airport, you will see several examples of planes landing and taking off at this small airport. DSCN0132

 

After landing, we gather our gear, praise God for our safe return to Terra Firma, and have breakfast in Lukla before heading into the field. Today’s hike is very pleasant, still at relatively low altitude, with beautiful glimpses of the Himalayas, which I have been so longing for since arriving in Kathmandu. We pass several small villages, and I am continuously impressed with the neatness of each village, and the beautiful stone buildings that we pass by. Amenities are basic, and everything is al a carte, from toilet paper, to hot showers, to electricity or WiFi. I am glad that once we get to the HRA, these basics will be provided for us by our little outpost.

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We eat lunch in a nice hotel in Phakding, where they had some very good chicken fried rice, and delicious lemon tea. I am trying to get as much protein as possible in the lower villages, because the higher you get, the harder it is to find things like chicken, beef, or eggs. Everything that comes to these villages, comes up by trains of donkeys or Zopkyo, which are a cross between a Yak and a Cow. Before leaving the restaurant, I was asked to talk with an Aussie who had hurt his ankle several days before and was having some mild pain posterior to his medial malleolus. This could be an area of concern for fracture, however he really didn’t have any swelling or bruising. He said his pain was only minor, that he had been seen by two Indian doctors a few days before, and that he was ACE wrapping, icing, elevating, and using ibuprofen and a Tylenol / codeine combination. I told him he could try some tape, which he said he knew how to apply, and that he could probably continue onward, at least to Namche Bazaar, so as not to lose his whole trip, however the guy seemed perfectly happy to sit in the warm hotel watching cricket on TV. I’m not really sure how he wanted me to help him, but as Katie said later, some people are just looking for a reason to not have to continue onward. The guy reminded me of Katz from Bill Bryson’s story A Walk in the Woods.

 

DSCN0201We continued climbing, and ended up in Monjo, which is where we spent the night. Monjo is a small community literally built into the hillside that surrounds the main hiking trail. Although I wouldn’t know it until morning, Monjo has beautiful views of Kusum Khangkaru, a 6,000m peak that we would continue to see most of the next day. The hotel we stayed at was very basic, although Reuben and I each had a good Sherpa Stew, called Shakpa, for supper. Renee had only got two hours of sleep the night before, and so went to bed immediately, skipping dinner. She must have slept for 14 hours. She later told me she is a “professional sleeper”, which I believe.

Blessings for my trip

March 7, 2015

Many people come to the Himalayas seeking enlightenment and blessing from the Hindu and Buddhist masters who reside there. Before starting out on my great journey into the Himalayas, I also sought spiritual enlightenment.

 

The church I attend in Park City, Mountain Life Church, has partnered with a church in Kathmandu, Nepal. In fact, the weekend my parents and I first came to Utah to look for a place for me to live, Pastor Rajan was meeting with a group of men from the church I would start attending 6 months later for breakfast at the same place my parents and I were meeting. So while I had not met the man, I had seen him and heard his story.

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The Greater Grace Church is located in a district of Kathmandu called Pepsi Cola, and when I told the taxi driver I wanted to go to Pepsi Cola, he looked at me strange, then asked why I was going there. I told him I was going to visit a church, and then asked him why the area was called Pepsi Cola. He told me that this was where Pepsi Cola was bottled for the country of Nepal.

 

The church is located just down the road from the bottling plant, and true to form for all churches in countries where Christianity is in the minority; they make do with what they have. But in reality, it looks like they are thriving! On top of the local pastor, they also have a missionary from Baltimore Maryland who is running a Bible College with approximately 25 young men learning how to teach the Word. They also have an active women’s ministry that met after the main worship service. Like many Protestant churches around the world, young adults lead worship with guitars, bass, and a drum set.

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The biggest surprise of my visit, however, was when Pastor Rajan and Pastor Jon took me to the orphanage the church has started. They provide a home for 20 children who would otherwise be out on the streets. Pastor Rajan told me the story of one boy who had learned to fill a water bottle with sand and water because it made his stomach feel more full. At the orphanage, the children receive a safe place to live, water from a reverse osmosis filter system, vegetables, and occasionally eggs and chicken. They also attend a school where they are taught English along with Nepali, so that when they become adults, they will have greater opportunities. By American standards, these children don’t have much, but what they do have is a foundation from which they can build a successful life.

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I was able to make a short film of these little orphans singing in both Nepali and English.  If you’d like to watch it, you can see it here.

 

Happy Holi!

March 5, 2015

High-Noon

So there is this Hindu story of an ancient battle High Noon style battle between good and evil, Vishnu and Hiranyakashipu.  It is said that after Vishnu defeated Hiranyakashipu, he created color in celebration.

Each year around this time, the festival of Holi, or the Color Festival, is celebrated by Hindus all over the world.  We had been hearing about this festival for a few days, and of course were planning on attending, however the Holi festival ended up being one of the most surprisingly awesome experiences of the trip, and a great time for the Manang and Pheriche groups to bond and have fun before our departure to our respective aid posts.  What follows is a series of photos, each going a bit further down the rabbit hole.

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This is our “pre-festival” formal shot.  From L to R: Remi (Manang volunteer), me (Pheriche volunteer), Katie (Pheriche volunteer), Reuben (Pheriche, spouse of Katie), Renee (Pheriche, volunteer), Emily (Manang), Lara (Manang volunteer), Christina (friend).

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Reuben and I at the start of the festival.

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Kind of a color beard, still looking pretty clean.

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Lara excited about color.

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Christina, Renee, and me

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We followed the crowds to the Basantapur Durbar Square, where this Rave was going on.  Spontaneously fun party of thousands of people full of color and dancing.  Watch my video of the party on YouTube here.

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Lara getting a better view.

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Remi getting into the festival

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Portrait of the artist…IMG_1073

 

 

The Pheriche Crew: Andrew, Katie, Reuben, and Renee.

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The Manang Crew: Remi, Lara, and Emily

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Katie full of color

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Enjoying a beer after the festival.

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The “post festival” formal shot.

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One last selfie before cleaning up.

The second day of the trip started with, not surprisingly a beautiful sunny day.  Sleeping in a hammock can get pretty cold, even when it is not that cold out, because of the lack of insulation below your butt.  In contrast, once the sun rose in the morning, the rays of the sun heats the hammock quickly.

My breakfasts on the trip were called Oat-Fit, and there were a quick oatmeal product, not unlike the Quaker variety, except much higher in quality (although ironically not higher in cost).  I found them at Wal-Mart, but have sense seen similar products at Costco.  They have one that is oatmeal with, get this, real chocolate.  That was my choice for this morning. AWESOME!!!

Packing the boat on day 2 was much easier than day 1, because I knew where everything fit.  Breaking camp kinda sucks because I didn’t have any big bag to carry a bunch of stuff from camp to boat at one time.  At NOLS we had large duffel bags to carry things to the boats.  That would have saved a few trips, which would have been nice.

Today was a BIG day.  The plan was to cross from South Manitou to North Manitou, which is defiantly larger, but more remote.  The crossing is approximately 4 miles, and the islands circumference is approximately 20 miles.  My plan was to paddle across to North Manitou, cross the western side, and the North side, and then make it to the ranger station on the east side, where there is the only campground on the island.  Unlike South Manitou, on North Manitou you can camp in the backcountry, but have to be 300 yards away from the water “so as not to ruin anyone else’s experience”.

The crossing was long, with a Northerly breeze, getting stronger the closer I got to North Manitou.  By the time I reached the island there were frequent white caps and waves breaking over the bow.  Although it is fun to have water crash over my boat while the boat stays remarkably stable and dry, it does get cold, and I decided that in such conditions, I should land on North Manitou, eat some GORP lunch and change into my dry suit.  The dry suit is a new procurement, thanks to the REI Anniversary sale.  The suit is a Kokatat Gore-Tex front entry suit.  To protect the Gore-Tex booties, I put on my Xtra-Tuf boots, which are an Alaska essential.

After a meal and getting into my foulies, I hop back into the kayak and start out on the most grueling paddle of my trip.  The northbound leg up the west side of the island was certainly an interesting paddle.  The western side of both of the Manitou island’s are large sand dunes.  According to Native Legend, the Sleeping Bear Dunes were made when a mother bear and her two cubs tried to cross Lake Michigan from Wisconsin to Michigan.  The mother bear was able to make the crossing, but the two cubs did not.  The cubs became North and South Manitou islands, and the mother stayed along the shore, hoping to reconnect with her cubs, creating the sleeping bear dune, after which the shoreline is named.

Paddling along the dunes was interesting, although it made me acutely aware that if I needed to land, there was a beach to land on, but little shelter to be found.  The wind continued to be against me on this leg of the journey, and fatigue started to set in.  I would continually mark out a feature on the shore line, and try to paddle so I was parallel to that feature before I rested my arms.  Often times, my eyes did not know the limits of my weary arms, but it is always good to set lofty goals.

The most direct goal was to round the corner from a northerly course to an easterly course.  Each time I think, OK, maybe this will be the turn….  Nope.  A little further.  Maybe around this point.  Nope.

But then finally there I was, staring down the long wall of dune that makes the north side of the island.  The NPS ranger on So. Manitou, Sean, had told me that if I got too tired, there is a great camping site on the north-west part of North Manitou that many kayakers used.  I didn’t want to give up early, making tomorrow’s paddle that much harder, but it was tempting to stop after a hard northerly paddle into the wind.

In the end it was a moot point, because I never found the site.  It was for the better, anyway.  Once I turned to the east, I was glad that I hadn’t stopped.  The paddling suddenly became easier.  I warmed up, and was able to take the dry suit off.  I started to really cruise, and before I knew it, I was turning back to the south into a large bay that houses the camp and the ranger station.

This is where things started to get weird.

So the ranger station at North Manitou was not just a shack.  It was more like a small village.  An empty village, with literally only one person, a NPS maintenance worker.  He was a nice enough guy, and even showed me this amazing barn they have on the property, and then pointed me the way to the only campground on the island.  With how beautifully maintained the village was, and considering how nice my campground was last night, I had high expectations for the N. Manitou campground.  Strangely the campground totally sucked.  It was cut into a thicket, and felt more like a POW camp than a place one would like to spend their vacation. Plus there was a high pitched hum of insects ready to suck you dry.  Needless to say this was not an option, and so I started looking for a suitable place to bushwhack.  I was not opposed to breaking the silly regulation about camping near the lake, and even thought of poaching somewhere within the village.  I kept searching, and kept slowly making my way farther south.  It was getting late; after 8pm.  I was leery to camp near the village, lest someone find me and tell me to move along.  Finally I found a pretty nice spot with perfect trees for a hammock close to the beach.  Apparently the park service was aware of how “wonderful” this spot was because they had placed a marker that said “No Camping”.  I thought it was a perfect feature to hang some of my gear.

The sun was almost set as I unpacked the kayak, set up camp and finally sat down for some dinner.  The day was long and I decided to treat myself to Mountain House “Chicken ala King”, which received rave reviews on the REI website, and is also one of MH’s most expensive meals.  Sadly I found it lacking.  It was basically chicken noodle casserole.  But still a good end to a strong day of paddling.

Surprisingly, I have not gone on a sea kayaking expedition since the summer of 2007, when I spent a month in the Tongass Wilderness of Southeast Alaska, and spent a week paddling the Massasauga Provincial Park in Onterio.  Five years!  Where has the time gone, and what have I been doing (oh, yeah… medical school, and residency).

But it was time to change that poor track record, and so I have decided to dedicate more time to sea kayaking this year.  I have made several short excursions around the area, including visiting my friends from Riverside Kayak Connection for their Wednesday Night Kayak events,  and had paddled out to Kelly’s Island in Lake Erie, but I’ve been wanting to get back into multi day Kayak camping expeditions.

One of the paddling trips that I kept seeing while researching sea kayaking in the Great Lakes was the paddle to South Manitou Island in the Sleeping Bear Dunes National Lakeshore.  The trip starts with an exposed 8 mile crossing in the middle of Lake Michigan, with cold water, unpredictable conditions and freighter traffic through the shipping lanes.

Click here to see a map of Sleeping Bear Dunes National Lakeshore

As it turned out, I was already planning to attend the Great Lakes Regional Wilderness Medicine Conference in Gaylord, MI, and then had a week of vacation following, so I was already in the neighborhood for a great expedition.

As all accounts will tell you, if you are planning on Kayaking over to South Manitou, it is best to put out from the Glen Haven Canning Co. in Glen Haven, an open-air museum village run by the Park Service.

Thousands of similar pictures exist, but you can trust that I actually TOOK this one, because my trusted Volvo is parked in the “No Parking” area nearby.

After the long, rainy weekend, made worse by the fact that I was the only one at the conference with the bright idea to actually “Commune with the Wilderness” by camping in my tiny REI quarter dome tent next to huge campers at the truly lovely-when-not-rained-out Otsego Lake State Park, the sun was out, the sky was warm and I was ready to dip my P&H Capella into it’s 3rd Great Lake.

It was approximately 5pm by the time that I started, not the safest hour to start a major crossing, but the sun was high, and NOAA had assured me good crossing conditions.  The water started as a vibrant Aqua blue with bottom features easily visible below.  As the water got deeper, the color changed to a most magnificent deep blue, but never quite to black.

Navigationally, it was a very easy paddle, just point to the South Manitou lighthouse, and make corrections as needed.  There was a 5-10 mph northwesterly wind that started kicking up some whitecaps in mid-crossing, and as my arms started to get cold, I reflected on the foolishness of crossing this water without a dry-suit on.  But after 2 hours of paddling, I made it to South Manitou Island.

The end of the crossing: looking at the lighthouse on South Manitou Island, Lake Michigan.

A note of history about South Manitou Island: as the only natural harbor on the east side of Lake Michigan, South Manitou Island was a natural place for cargo and steamer ships to “wait out the storms”.

Obviously not a picture taken by me, but this is an old photo of the US Life Saving Station Crew.

A US Life Saving Station (which actually preceded the creation of the US Coast Guard) was located at the harbor to help stranded vessels.

“The Crib” located off the shoals of North Manitou Island could be seen and heard in the distance throughout the trip.

A lighthouse was built on the island, and a “shoal light” was built off the coast of North Manitou to facilitate shipping through the Manitou Passage.  The Lighthouse was decommissioned in 1958 due to “obsolescence”, and therefore could not help guide the Liberian freighter, the Francisco Morazan, which wrecked off of South Manitou in November of 1960 (Seriously, as the saying goes, “It’s always the Liberians!”).

I landed at the rescue station, and ended up finding Sean, the Park Service Ranger, who I found out was a Federal Agent, professional bad-ass, and regularly carried a firearm during his on-duty hours.  Luckily by 7pm he was off-duty and his fire arm was safely tucked out of view.  He told me he was glad I had gotten across safely, because apparently less than 50% of people who attempt the crossing actually make it, and they end up calling the Coast Guard (that option sounded expensive).  I asked him where the best spot to camp was, and he recommended that site #23 at the Bay Campground.  “Its larger and more secluded.  Out there by the old cemetery.  The only other people at Bay Campground are at site #6, so they shouldn’t bother you at all.”  Great: all the makings of a classic B-rate horror movie.

Location for tent placement. Note the trail leads directly down to the beach.

True to his word, site #23 was a pleasant location right off the beach with trees perfect for setting up my Henessey hammock and a feeling of camping right on the beach.

In what would become a theme for the trip, it was well after 9pm by the time I had unpacked, set up camp and was ready to sit down to dinner, Mexican Chicken and Rice provided by Mountain House.

Stay tuned for our next adventure, and Andrew and the P&H paddle to North Manitou Island.