Wednesday, March 30, 2005

Foster Factor strikes...

My friends will know that the "foster factor" is the unexplainable force which causes anything that could possibly wrong to go wrong in all matters relating to me (and sometimes the people unfortunate enough to associate with me). Some may recognise this as the familiar "law according to Mr. Sod", but this is not sufficiently specific enough to refer solely to me.

Anyway, after a month of living in Kathmandu, I finally get ill. There is much speculation about what it could be - Nhish is still adamant I had an acute seroconversion illness (HIV) after my blood donating session (another story) - but I know it I was ill before I gave blood, and that HIV usually takes about 2-4 weeks (min) to seroconvert.

Infinitely more likely is that I have a case of food poisoning, which, I hear you all cry, is hardly a case of the foster factor striking – until you hear the reasons:

1) Having been ‘studying’ at the hospital for a month, I could easily have been ill. Having four or 5 days off then would have been almost enjoyable. However, to get crook on the LAST DAY of my placement is clearly unfortunate.
2) Factor into that the fact that I had just, only the day before, confirmed my tickets for Chitwan – a 300 USD jungle safari extravaganza (more later + piccies!)
3) And of course, I am due to start my Everest (base camp) trek in only 5 days (from time of illness.

So, I think you’ll agree this is a trip-threatening turn of events, easily qualifying of foster factor status!

My illness comprised mostly of terrible colicky abdominal pain (worst, surprisingly, at night) and a swinging, high grade fever the likes of which I cannot remember ever having (no mother, I don’t remember the infantile febrile convulsions, ok?).

However, after one day of inability to leave the house, I ventured out – to Chitwan! Took things a little easy, and tried to stay relatively close to the toilet. And keep a bottle of water with me at all times. And it didn’t really ruin the trip. I had decided that if I was not much better by the time I got back (5-6 days into the illness) I would run along and pick myself up some ciprofloxacin, but the illness I had the day I flew back to Kathmandu (yesterday) was mostly alcohol related – a couple of auzzy guys and English gals showed up at the Jungle Island resort on my last night and insisted we ‘celebrate’ something or other…

So I guess I’m ok now; stomach still a little delicate. But nothing to stop me embarking on my Everest (base camp) adventure first thing on the 1st April.

I have had a last minute thought though – this isn’t all an incredibly elaborate April Fools joke is it…?

See you all soon(ish).

Nx

Yak and Yeti

Today is Nhish’s birthday (unbeknownst to me) and so he suggests we go to the Yak and Yeti (a top hotel) for dinner. Mostly because of the name and partl because of our Kilroy’s and K-Too experiences, I am expecting a not-so-posh, themed hotel with taxidermised yaks and fake yetis; I am amazed at the luxuriousness of the place and impressed with the architecture – the hotel has a side street all to itself, is a massive complex of buildings and has 2 swimming pools and 4 restaurants.

The taxi drops us off at the casino (only tourists allowed and only in hotels) and we are directed to the Chimney Restaurant, which, according to the guidebooks, is supposed to be the ‘bistro’ (read: more sensibly priced). As we enter, I catch a glimpse of the menu at the door and manage to read: Sizzling duck breast, 1400 Rs (10.37 GBP); oh boy – I’m not even hungry…

We are led into a subtly lit, circular room with a central copper column, candle-lit from beneath, which I assume is the “chimney”. Around the circumference are tables nestled into brick-arched alcoves. The tables are highly polished, light-coloured wood, with shiny silverware arranged on woven silk place mats. We are ushered to a table, the candle is lit, and immediately we are brought hot flannels. We are given the wine list, and, whilst I see a few of my favourites, we settle for beers (Everest of course).

The menu is specially bound in orange rice card, and beautifully printed in perfect English (a rarity here!). It is also extensive, with a page each for hors d’oeuvres, soup, fish, steak and desserts. Nhish, predictably, chooses a smoked fish dish and I go for the tenderloin béarnaise – medium rare. When it arrives, it is on the rare side of rare, but that’s ok. Nhish’s fish is plain, with equally plain boiled vegetables, but he says excellent nonetheless.

I do miraculously well considering I’m not even vaguely hungry, and Nhish clears his plate, though refuses to have a slice of my steak as he is saving room for dessert. He tells me it would be rude not to – and who am I to argue with his customs…?! I opt for the flambéed baked Alaska (mostly because I wonder how it can be both flambéed and baked) and Nhish chooses the apple crepes (most like his favourite: apple crumble). We also order coffee, which is brought along with dessert after a suitable interlude.

The service is impeccable. We are one of six guests in the restaurant the whole evening, and are easily outnumbered by the subtly attentive staff. We are even visited by the scented, suited hotel manager, who unreservedly offers us his service. I almost ask him to waive the bill, but think better of it at the last minute.

After we have finished dessert, but before the coffee is gone, we are brought a plate of homemade truffles but neither of us can manage more than one!

The bill arrives, and is less than we thought - which is always nice; a three-course meal for 2 with beer in a 7 star hotel cost less than 30GBP!

Wednesday, March 23, 2005

Night out with the locals...

Having got on swimmingly with the local students posted in the ER for the majority of my stay, we decided to celebrate their moving on to internal medicine rotation by having a social evening...

Nhish and I were keen to do the local thing and get a taster of medical student social life here - purely for comparative purposes, you must understand. We were a little baffled when Surya and Sumit were unable to think of anything to do... Eventually we decide on a time to meet and wander down the road to a local "hotel". A few brief exchanges with the waiter in Nepali later and there arrives some snacky things and a bottle of gin... oh dear! Lime gin, no less.

Having sampled it on its own, Nhish and I were rather glad when a bottle of mixer arrived - "mountain dew" (for those of you who don't know or can't remember, this is basically sickly, caffeinated lemonade).

(At this point, I should probably explain that Nhish and I were planning to visit Nagarkot - a small tourist-based village in the mountains on the east border of the Kathmandu valley with panoramic views of the Himalaya - this weekend, and that, ideally, it required us to leave by taxi that evening to catch the sunrise on Saturday and get back to be in the hospital again on Sunday... Suffice it to say, the local students persuaded us that this was "dangerous" - read silly - and that we had to stay with them that night...)

After a few sips, when the conversation started flowing, we (naturally enough for medical students, I suppose) got talking about alcohol dehydrogenase, and more specifically, whether or not Nepali people have any: judging by their performance, I would hazard perhaps not!? ;)

The rest of the evening was spent being grilled on the relative virtues of "upper and lower F" ("upper F" apparently being french kissing...) and having our apparently legendary alcohol tolerance tested to the limits.

I am not normally a spirit drinker (rob and iain - you can just shut the hell up!), and so this concoction took its tole on my relatively quickly. The locals were impressed however, that we continued to drink what was put in front of us (I think they stopped after one or two)!

We had lots of nibbles and some fascinating conversations (apparently) about which nurses we found attractive, over a few more "gindews" (or should that be "mountgins"?) before retiring back to the local halls of residence for some more gindews, combined, I seem to remember, with After Eight mints... After that it all gets a little vague, but I have since been reassured that I was "entertaining"! hmm.

Apparently it is "local tradition" (read: you can't argue with that) that guests do not get out their wallets under any circumstances; I dread to imagine how many month's budgets Nhish and I drank, but we certainly wouldn't have had so much if we realised we wouldn't be allowed to pay for it. But then again, refusing a drink (or any hospitality) is incredibly rude here...

Anyway, in order to compensate the local students, and because it was actually all very fun, Nhish and I have insisted on returning their hospitality (we insisted it was customary in England!) and have arranged to take them out this coming weekend. We will go to Thamel and try to find as British a 'bar' as possible. We debated taking them to Kilroy's (a rather posh international themed restaurant, owned by the same people as K-Too - see previous post), but decided that this might work out a little expensive, even for us westerners.

So I’ll let you know how that goes too, I guess.

Oh yeah - and I’ve been working hard and learning lots; and I’m not worried about finals in the slightest(!)

Love to all.

Nx

Monday, March 21, 2005

photos...

These photos have been moved...

I have created another blog for my photos, so those of you with dial up (mother) can look at photos when you want, and not have to wait for them to load to see the rest of my blog (ie text).

I will link to new photo posts when i upload them.

The first lot of photos (thanks againg big G) can be found here:

  • photos
  • Wednesday, March 16, 2005

    At Ang Rita’s request…

    Ang Rita visited our floor the other night – he does this every other day or so just to check we are all right and have everything we need I guess. We were watching some film on HBO and again he offered for us to go downstairs and watch it on the bigger telly. We decline, more for fear of being plied with millet whisky again than anything, explaining that this is more than adequate, and that we should really be working anyway…

    He then proceeded to ask us a favour, and, as is often the case, it was difficult to tell exactly what he meant (his English, while being infinitely better than my Nepali, is self-learnt and heavily-accented), but the gist of it was that he’d like us to visit a school he sponsors in the north of the city. Well of course we were more than happy to do him a favour to thank him for his generosity, and it would be interesting to see some more local culture. Keen for it not to interrupt our hospital placements, he agreed for it to take place on Saturday afternoon (after our mountain flight).

    When he left us to our film, Nhish turned to me and we both simultaneously asked each other what we had just agreed to!?

    On returning from our mountain flight, Ang Rita asked if we could take our white coats and stethoscopes to the school with us, and Nhish and I decided to “dress up” for the occasion and both donned ties with our regular hospital shirt-and-trouser combinations (a tie in the hospital would look very much out of place next to the jeans-and-t-shirt-under-white-coat attire of the local docs)!

    Still non-the wiser about our activities on reaching the hospital, Ngima accompanied us there and we were introduced to the principal: Mr Chinawa (or something like that). It is then that we asked what we were to be doing, and were told the kids were coming in especially for us to “teach them something about medicine” – we had no idea and hence had nothing prepared!

    After the initial shock and fear had subsided, I quickly wrote a list of topics to cover: strategies for preventing illness (basic personal and food hygiene); home management of simple illness (fever, colds, etc); basic first aid (management of cuts, scrapes, bleeding, fractures); recognising an unconscious patient and opening an airway; and the recovery position. We thought we could then fill some time with playing with the steths and pen torches by listening to each others’ heart and breath sounds and looking at tonsils. We had from 1300 – 1600, and I reckon we could pad out what we had to maybe 2 hours at most…

    There were about 40 kids, ranging in age from 2 or 3 up to about 18. While they are taught English very early on in their schooling, it is by no means their first language, and it was apparent that throughout the theory section (never the favourite with kids) that most of it was above their heads.

    Nepali kids differ significantly from the English kids I have taught (CPRiS project, etc) in that there are much more shy. There were 2 or 3 really bright kids asking questions and writing notes, but even these keen ones took about half an our before they were brave enough.

    We tried to make the theory interactive by asking the kids what experiences they had had with the various things we were talking about, but it seemed that none of them had ever been ill and never witness illness nor injury!

    After about 15 minutes or so, I decided enough was enough, and moved swiftly on to some more practical stuff: we had asked for some simple props from the school infirmary/shop and had been given some bandages, tape and a small bottle of dettol. So I asked for a volunteer (had to pretty much pick one of them – but tried to steer away from the really timid-looking ones) and we went through a big, dramatic enactment of them cutting themselves and me getting covered in blood. I was amazed, however, when I asked for suggestions on how to managed the ‘patient’ that many of the kids not only had understood out ramblings for the past 10 minutes, but had remembered it too and were able to put into practice. I think my silly acting encouraged their involvement a little too and soon they were calling out: “apply pressure”, “clean the wound” and “put on a bandage”. We had some fun with bandaging a couple of the kids up and stealing their shoes and things. That went down well.

    Then I moved on to the recovery position, which I demonstrated on Nhish. We were out in the dusty playground in the heat of the day and he got a little mucky – but that was all part of the fun! It brushed off – was only dust! So I showed them how to call out an instruction, to open the airway (I encouraged gentleness, but didn’t go on about c-spine protection – it only confuses and scares them off actually helping at this level), to check for breathing and then to put the patient into the recovery position. I used my “SUPERMAN!” technique, which involves putting both the patient’s arms straight out above their head like they are flying, which only serves to remind the kids what order to do things in.

    After I had finished my demonstration, I asked for another volunteer and had three had shoot into the air – finally I was engaging them! Then I insisted that Mr. Chinawa get involved and be the patient – they loved that! I got the smallest volunteer to do it, to demonstrate that you don’t have to be big or strong to save someone’s life. Again, I was impressed with their recall as the other kids helped the volunteer with suggestions.

    Then we spilt the kids into groups of three or four and got them to take turns practicing it on each other. Nhish and I wandered around critiquing and making sure everyone was having a go to the occasional background calls of “SUPERMAN!”. It is truly gratifying to see that the children actually learnt something – that they can recall what you have told them and put it into practice is rewarding indeed.

    We then spent a further half hour or so, after a much-needed brief interval for soft drinks, passing around our medical toys and getting the kids to listen to each other’s chests. During this, I’d pick on kids at random and “test” them with a scenario from earlier (bleeding, fracture, fever, unconsciousness, etc) and see if they could remember what to do. They were very good, and required little prompting – much better than the English kids I’ve taught.

    Eventually, by 1500, we had run out of things on my list and explained to Mr. Chinawa that we couldn’t think of anything else to talk about right now. I told the kids how impressed we were with them and how much better they were than the English kids and got them all to clap each other. An awkward ten minutes or so then followed during which the kids all silently stared at us, expecting more. Eventually, one of the other teachers called for a group photo and the group then split up.

    Mr. Chinawa thanked us repeatedly and offered to meet us for dinner in Thamel that evening. It being rude to refuse we agreed and met him at 1800. We went to a Chinese buffet place, which was pretty good, and had a fun evening. It turns out he lived in Worcester (near my home town) for two years doing his masters degree!

    So, all together a daunting but enjoyable afternoon. J

    I’m still here!

    Last weekend (read: Saturday - they don't have Sunday off here!), Nhish and i had a mountain flight booked.

    Having heard about it from a travel agent advertising his wares on the street, we asked Ang Rita (who runs his own trekking company and can apparently organise any touristy stuff), and he made all the arrangements for us.

    We went out on Friday night to K-Too (see previous, rather inebriated post!), but, anticipating an early start, and because we have to ring the bell to be let in to the house at night and the family retire early, we weren't too late back: about ten 0'clock or so. It was at this time that Ang Rita finalised the arrangements: we were to be collected by car at 0530hrs, delivered to the airport, where the car would wait for us and take us either back to the house or on to a destination of our choice in Kathmandu.

    So with little over 4 and a half hours sleep, i drag myself out of bed - always much easier when i have something interesting to do that day! It is still dark outside, but more worryingly, there is a thick fog limiting visibility to 20ft! Having not been up at this hour before, i am unsure whether this is normal or if we have chosen the worst day imaginable for our expensive, weather dependent and non-refundable mountain flight experience?!

    The driver and travel agent who collect us don't even make reference to the weather, so Nhish and I assume it is nothing to worry about, and we head off to the airport. During the half hour, the fog appears to improve significantly, though we are not sure if this is just the effect of the rising sun. We arrive to the airport early, and are turned away by the armed guards - the day just gets better and better! After waiting at the side of the road for 15 mins or so, we re-approach the main gates to the airport and, this time, are waved through. By now it is past 0600hrs and the sun has risen. The fog, however, persists and visibility remains poor (20-30ft I’d guess). Security at the airport departure gate is significantly more stringent than at arrivals and we are scanned and searched and our bags are x-rayed with someone actually looking at the screen!

    The check-in gates are quite busy, with a particularly big queue for the Lukla flight - the start of the trek up to Everest. The queue comprises of an interestingly moustached group with an array of expensive-looking equipment - you have to wear as much of your gear as possible because the weight restrictions on luggage are tight, and mountaineering equipment is heavy! A couple are wearing some neon yellow, solid plastic grade 1 mountaineering boots, and i come to the conclusion that either this is a group of Americans with more money than sense, or a serious group of mountaineers attempting the summit of something big and cold (there are 10 or so other decent peaks accessible from Lukla).

    Our travel agent has accompanied us into the building and is now checking us onto the flight - this is the way to do it: we are left to wander around admiring other people's footwear while someone pushes to the front of the queues for us.

    A woman sitting on the floor in the corner with several big thermos(R) flasks seems to be the departure cafe, so we approach her to enquire about cups of tea. Our travel agent materialises at this point, and insists on paying (only a few rupees, but not included in our flight, I’m sure)! The tea is served black, but is not your regular "English breakfast" - this stuff is ginger tea, and while being quite sweet and pleasant, is a little too spicy for me so early in the morning and gives me reflux! It is also incredibly hot - as i found out when i spilt it all over my hand and scalded myself badly!

    Our travel agent approaches with the boarding cards and we are ushered through to the departure lounge (with another body search on the way for good luck).

    The lounge is relatively quiet, we must be among the first 20 here - that’s the advantage of having someone push in queues for you i guess! But there is no sign of a departure time for our flight, and we can't see more than a few feet towards the runway out of the windows. The security guards are sitting reading the paper and so we gather we won’t be leaving any time soon. It is now nearly 0700 and the departure lounge is filling rapidly. We peruse the three tea/coffee/biscuits-cum-bookshop stalls for things to read or drink. Eventually i buy a novel and some coffee to keep me occupied!

    Our flight is eventually called at 0900, and by this time visibility is much improved and the sun has some warmth to it. We are directed towards a bus, which drops us off in front of a tiny little twin prop plane. Eventually we are allowed to board one at a time up the little fold out stairs. The fuselage is only big enough for one seat either side of a very narrow aisle - at least this means everyone gets a window seat! The headroom walking down the aisle is only about 5 feet, so we have to stoop very low. One of the American women is apparently claustrophobic and after 10 minutes of umming and aahing, decides she will stay behind and a scramble ensues to swap seats (one guy with 2 very big cameras didn't have a window)!

    After lots of revving of engines we pull onto the runway and take off smoothly, and the stewardess, who is small enough to walk down the aisle comfortably, hands out cotton wool and boiled sweets.

    After less than ten minutes or so of fantastic views over the city and surrounding 'hills' (most of which being bigger than the highest peaks in the UK), with beautiful terraced landscapes to allow cultivation, we sea our first himal (permanently snow-covered mountain) vistas out of the plane's left side (i am sitting on the right and hope that we will turn around at some point!). The stewardess revisits every one in turn and helps us identify the visible peaks and gives us their names (we have a diagram supplied with our boarding cards, which identifies the prominent peaks). Much camera snapping ensues, and each person in turn is sent off to the cockpit. The views from the cockpit are by far the best, with polarised single-layer and clean glass! From here, Everest is already visible!

    We get nearly as far as Everest before turning around, and finally i can get some unobscured pictures. There is a tiny airport at the foot of the mountains, which I assume, is either Lukla or the other smaller one closer in (whose name i have forgotten), but we pass too quickly for me to get a picture.

    The view is fantastic - well worth both the money and the delay - and i take about 65 photos! In every direction there is another snow-covered peak with amazing ravines and valleys. The photos really can't do it justice. I'd recommend this to anyone visiting Nepal - it really gives you a sense of the grandiosity of the Himalayas (i think they do flights through the Annapurnas too).

    Friday, March 11, 2005

    Steak with Dark and Stormy – in honour of Vicky “f@cking breathe!” Jones

    This afternoon, for no particular reason, we decide to finish early (after lunch); Nish didn’t have much on and I had been in “stupid mode” (where it seems I have forgotten what little I knew anyway and have lost the ability to think on my toes) all day.

    I spend the afternoon reading up on the conditions which had stumped me all day, but draw a blank on the set task of finding out who is William Wuthering (I only have the oxford handbook, BNF and house officers’ guide with me), while Nish watches the cricket – Ang Rita has set us up with a telly on Gavin’s strict instruction. There is talk of a computer or internet connection or something too, but we shall have to see what happens.

    Having spent the afternoon at home, we decide dinner out is in order and combine it with a cyber trip into Thamel. I have been looking forward to a steak dinner, but have not fancied it at lunchtime the previous times we have been in Thamel. So, after a quick blog post, email check, and photo portfolio update (www.photographers.co.uk - and not the most recent stuff as the pendrive failed to work again) we arrived at K-too, a bar and steakhouse. This is the second such venture of an English partnership (the first being “Kilroy’s”, round the corner, hence the name).

    The place is well signposted from the street, but quickly turns into a dingy looking stairwell – just when I am beginning to question whether we are in the right place, we emerge into a balcony with a narrow, closed door overlooking an empty restaurant and bored-looking staff. We are welcomed in and ushered to a corner table, whereupon a candle is lit and menus distributed.

    The place is poorly lit, but with a spherical lantern hanging over every table providing a cosy atmosphere. The blurb in the menu mentions “cheesy” décor, obviously referring to the thatched roofs constructed in rows over the tables. The room has 120 covers easily, and there is a garden full of tables below, too. We are two of only 6 people here tonight though – all obviously English.

    The stereo plays an eclectic mix of British golden oldie ballads by Tom Jones and the like, a little too loud, and the dilapidated, colour-faded telly over the bar is tuned in to live English Premiership football.

    The menu has 6 or 7 different steaks (we had “ol’ surf and turf” and “new Yorker”), various TexMex dishes, a generous veggie page, burgers, curries and the odd Nepali dish thrown in for good measure, along with a variety of bottled and canned beer (we stuck to the local “Everest” beer, with a picture of Tenzing on the summit commemorating the 50th anniversary of the first conquering of The Big One – two years ago…), cocktails, mocktails (non-alcoholic) and desserts.

    After my main course, my eyes peruse a specials menu on the table. At the bottom of the first page, there for everybody to see, it clearly says: Dark and Stormy! I knew right then and there thad it had to be done – if only in memory of Vicky (looking forward to our next late night drinkathon – probably when Dom is back too!)!

    But Nish insisted on a dessert first. A popular local savoury dish are MoMo – rather like dim sum, these are meat-stuffed pasta parcels of buff (water buffalo), chicken, mutton, or vegetable which can be boiled, steamed of deep-fried. Nish chose from the dessert menu a sweet version which where apple and sultana filled, with a cinnamon sugar glaze and some decent vanilla ice cream. I had an Irish coffee crème bruleé – it explained on the menu that this was made in batches, three times a week, from a recipe including, amongst other things, 10L of double cream and 3 bottles of whiskey! We were also offered complimentary Irish coffee with our desserts, which, while unable to refuse, we were determined would not alter our determination to finish with cocktails.

    And then came the Dark and Stormy (for those of you other than Vicky, Dom and Iain, a D&S is a strong mixture of quality – preferably questionably imported – dark rum and good old ginger beer, which is simultaneously reflux-inducingly strong and rather sweet), served a la Vicky, with more rum than ginger beer; it was VERY good. Nish had a “grasshopper”, which, to my taste, was rather similar to Colgate mouthwash to be called a cocktail!

    We asked for the bill – 2022 Nepal rupees! An intern here makes 8000 a month, but literally translated this is about GBP 7 each for a big steak dinner with beers, pudding, coffee and a cocktail! This is definitely one of the more expensive places to eat, but compared to English (particularly London) prices – it is very good!

    Having barely touched a drop of alcohol since leaving London three weeks ago (save for a couple of beers with Gavin and the interesting millet whiskey experience), my tolerance is a little reduced, and this evenings combination leaves me a little light-headed – we roll out of K-Too a little after half nine, anxious that the Rita Sherpas will be asleep by the time we get home – we have to ring the bell to be let in!

    With quiet roads, the taxi drivers have fun throwing the cars round blind corners and scaring the hell out of drunk tourists – we nearly crashed into fleeing dogs, a tractor having its tyre changed and various pushbikes before hurtling through the unpaved half mile or so leading up to the house. This was definitely the worst road journey so far, and usually the problem is competing with the other traffic!

    Anyway – just thought I’d ramble on a little about a nice evening and how it reminded me of various people back home…

    Got to be up for 05:30 tomorrow, when the taxi comes to collect us for our Himalayan mountain flight – hope I am not too hung over to hold my camera still!

    Will let you all know how it goes, and post any pictures to my portfolio accessible by clicking on the link to you right.

    Thanks for listening (or am I just chatting to myself?).

    Love to all.

    Nx

    Wednesday, March 09, 2005

    test....

    sorry about this - just testing a new way of posting where i can email a special address and it posts to my blog...

    fingers crossed...

    ;)

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    Doctors.net.uk is used by over 111,000 UK doctors.

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    ok - so back to basics...

    Having totally failed with my advanced gadgetry-based previous couple of posts, I am now returning to basics and typing this live – the only ‘cyber’ I have found where I can plug in my laptop and browse with that seems totally unable to log me onto my blog page to upload things. L

    Suturing
    Since I last posted – I am sure most of you haven’t made it through all that dribble yet? – I have been in to the hospital everyday from about half nine till 3. I have seen quite a bit more minor trauma now, and had the opportunity not only to practice suturing, but also to teach some basics to the local interns, who, while being far brighter than me in a book-sense, are rather inexperienced and subsequently lack confidence and clinical skills.

    Yesterday was a national festival and all the kids were off school. On the way to the hospital first thing, we were stopped twice by children – some as young as three or four – who were holding up the roads with bits off string tied together and pulled across the carriageway! The little tykes were demanding money to allow vehicles to pass! Suspecting them of having little else to keep them busy while they were off school (though this doesn’t go on at the weekend…) I gave them a few rupees and made my way. On the way home, however, by the fifth or sixth time the taxi was stopped the driver was getting a little frustrated and started just honking and accelerating towards the small kids. I am amazed noone was injured!

    I have subsequently read in my lonely planet/rough guide that it is part of the national holiday and the children are collecting money for firewood for their celebratory bonfires later in the evening! If I had known this at the time, I may have been a little more supportive, but I imagine they made themselves a small fortune anyway…

    We decided to go and observe some of the celebrations seeing as the center of it all was only ten minutes away by cab… Needless to say, the streets were jam-packed and we made little headway in the taxi. It only being about 30-40mins walks, we paid and abandoned the driver and wandered off against the throngs of people coming the other way. There was much jubilation with some singing and drums amongst small groups; and some groups of young men were lunging around as if drunk…

    We arrived at the Pushpatinath, which was heralded by a brilliant lighted gateway, with thousands of bright, flickering lights. Obligatory photos out of the way, we continued through the gates and down towards considerable crowds. At the bottom of the hill, a huge queue snaked its way away from us, and while tempted to join, we thought it wise to at least find out what we were letting ourselves in for.

    Having muscled our way towards the front, and still unable to see what the queue was for, we estimated it might take three or four hours to reach the front! So we instead decided to find somewhere for a spot of dinner. We ended up in a restaurant called “Rinky and Dinky”, which I had spotted on the way. We experimented with ‘Buff’, which is local water buffalo – obviously they don’t eat beef over here – in various dishes. It is rather like beef jerky, I guess – quite bland and very dry and chewy – even in a chili sauce!

    Film with the sherpas and millet whiskey
    We were invited down to watch a film with Rita Sherpa family the other night, and, mostly because we felt it rude to refuse, we accepted. The film was about a sherpa community and was, obviously, set in the Himalayas. I actually really enjoyed it, despite having to read the whole thing; the cinematography and scenery were particularly impressive!

    During the brief interlude caused by changing discs, we were offered a drink. Thinking coke or perhaps an Everest beer, I agreed. Ang Rita’s wife brought a red sigg bottle (usually used to contain stove fuel) and some glasses, while he explained that she had made some “millet whisky”! I couldn’t get past the idea of it being stove fuel and so that is all I could taste. Not particularly strong as whisky goes, this still brought tears to the eyes, and with the understandable reflex heartburn came a wave of nausea. “hmm, interesting!”, I said, and put the glass back on the table. Nish actually said he liked it (he has a cold atm), so I guessed we had to finish it! I waited for the nausea to pass and had another sip. This went on for some time until, eventually, just as the credits were rolling, I finished the last bit. Immediately, as if by sixth sense, Mrs Rita Sherpa jumped to her feet and started to offer more. It is very rude to refuse Nepali hospitality, but I thought it more polite than ruining her meticulously clean carpets…

    Planned mountain flight
    I have also arranged with Ang Rita a Himalayan Mountain flight for this Saturday morning – apparently this involves an hour’s early morning viewing of THE big hills from above, in a tiny, poorly maintained aeroplane (only joking mum – they’re quite big actually!). Really looking forward to it, and the photographic opportunities it will hopefully offer.

    Local peak expedition
    Nish and I are also planning a mini trek of our own for one weekend: we plan on conquering one of the small peaks on the west of the city, from whence, apparently, there are wonderful views of the Himalayas. They are about 2600m so will require an overnight at the summit. We still have to negotiate the logistics of this, but I am confident my new sleeping bag will be adequate! More about this later.


    Nx

    Sunday, March 06, 2005

    and finally (for now):

    Today, not having any specific plan, I find it difficult to get out of bed to make it in for 9 (yes, I know, hard to believe isn’t it?!), so I stay dozing for an extra hour. I say dozing because it is difficult to get back to sleep with such bright sunshine pouring through my window and the noise of building over the ‘road’. Obviously not your average British construction involving mechanical noisy things, but lots of banging and sawing nonetheless.

    Finally manage to drag myself out of bed and into hospital by about ten o’clock and head straight to the emergency department to see if I can find anything much going on there. The emergency department is a relatively small room (10m x 10m perhaps) with a stone floor, tiled walls and trolleys pushed into corners. There is some complicated curtain system, but they are all tied up out of the way and don’t seem to correspond to the position of the beds anyway! One corner is walled off, and I imagine this is “resus”, or just an area with three or four beds affording a little extra privacy.

    As far as I can work out, there is no “primary” or “family” health care (equivalent to GP) in Nepal, and patients simply self-refer. I think they have to pick up a ticket at the main door before they are allowed into the various corridors of the building, which are manned by security guards.

    As an example of how this works, I shall use a lumbar puncture I observed earlier today. An elderly lady is brought in by her two sons, obviously unwell and with signs of meningism (fever, photophobia, neck-stiffness, etc) and her history is taken and a cursory examination performed by one of the interns (much like our PRHOs). It is decided that she needs a lumbar puncture to make the diagnosis and one of her sons is given a list of necessary kit, with which he promptly scurries off to the pharmacy. The patient is cleaned with iodine and draped with a “sterile” cloth with a hole torn crudely from the centre, positioned over the small of her back. From the kit her son brought back from the pharmacy, the doctor chooses a needle and syringe, and then draws up some local anaesthetic to numb the entry site. Having done all this, and in “sterile” gloves (taken using tongs, from a huge, shiny metal lidded pot in “resus”) the doctor then searches frantically for the spinal needle… It seems either it has been lost or was not included in the bag of stuff from the pharmacy. Eventually, the doctor has to send the son back to the pharmacy for another – there isn’t a supply in the emergency department! 10mins later, when the son has returned from the busy pharmacy, the procedure can continue!

    As far as I can tell, there is no equipment in the emergency department other than a few portable cardiac monitors, ECG machines and portable, mains-powered suction contraptions. No needles, syringes, bandages, medications or any of the other paraphernalia which overfills storage in your average UK Accident and Emergency Department.

    I spend the whole day following the senior doctor around the room, from patient to patient (in no particular order it seems) and listen to medicine in a foreign language. Occasionally, the barrage of “derka derka jihad” is punctuated by one symptom in English and I am asked to come to a spot diagnosis. This is a little unfair I feel as I don’t get to cross-examine for ten minutes like he does! At least now I am getting used to the accent and can tell when I am being spoken to in English. Medicine is taught here in English, it seems, and when doctors talk between each other it is in a mix of Nepali and English – so, often, I can understand the gist of it at least!

    Today’s mix of patients included (apologies to my non-medical audience):
    · A girl in her twenties with moyamoya disease
    · A 50yo gentleman with a silent anterolateral STEMI
    · An elderly lady with meningitis
    · A 5cm x 5cm meningioma in a 35yo female
    · Only one case of trauma – a “physical assault”, involving a fractured base of skull

    There are a constant stream of patients walking through the door, must of whom have significant pathology; I am impressed by the relative absence of malingerers – a refreshing change from the NHS. But I suppose if we had to pay for every single blood test, investigation and pill, perhaps time-wasters may be deterred to the same extent in England?!

    Just out of interest, a standard plain x-ray costs 200 rupees and a plain CT is 2000 (132 rupees to the pound). It costs 25 rupees (the same amount I pay for lunch today) just to get a ticket to be allowed into the department!

    and another...

    I seem to have lost a day in here somewhere, but I suspect this is probably for the best as no one wants blow-by-blow rantings (except maybe for my mother…? – still haven’t been shot or fallen off anything mum!)

    I’ll try and keep my postings to the interesting happenings now, though my definition and your definition of “interesting” may not necessarily concur!

    First day “working” in hospital
    Ang Rita received a phone call this morning from the hospital confirming my application has been accepted (woohoo!), so we drove in by taxi and did some more paperwork for a couple of hours. Nothing much seems to happen quickly round here, the pace of life being somewhat slower than standstill most of the time. Even the walking pace is slow, I have to dawdle just so I don’t end up 3 miles in front of everyone, and that’s not just cos they’re all too short.

    It occurred to me today (and I appreciate this is a little off topic so I’ll try to keep it brief) why Ang Rita looks so familiar – he looks just like an Umpa Lumpa (?sp)! I realise this isn’t terribly PC, but I also discovered today that he has never been to school and that despite making himself understood more than adequately in English (something I have problems with myself at times), he cannot read or write a word! I am not sure if he is achondroplastic (dwarf), I think probably not because he is not dysmorphic. But I suppose he could be pseudo-achondroplastic (Alex – remember the episode of CSI at the dwarf convention?!). Anyway, I digress…

    After the incredibly slow-paced paperwork (rather like this blog – sorry), I am given a whistle-stop tour of the hospital, which is much smaller than my initial impression, and am then dumped with one of the doctors in the OPD (outpatients). I spend several hours listening intently to consultations in foreign and not really being able to tell when the language changed into English in order for an *explanation/question to be *made/asked *to/of me (*delete as appropriate)! Not sure whether this is simply a poor excuse for having forgotten everything I once knew and being totally thick. We shall probably see over the course of the next month – I’ll let you know how it goes!

    The clinic is amazing: throngs of people, are seen in no particular order, it seems. The only privacy patients get is a thin curtain separating the examination area from the waiting area, and random other patients are so often poking their heads around this that it may as well not even be there at all! The next patient has come in and sat down before the first has even got dressed again! And the previous patients come back at random to discuss their medications (having just collected from pharmacy)!

    The first thing I noticed was the old mercury thermometer sitting in a pot on the desk, with no apparent means of sterilisation… I was relieved to discover (almost instantly as 9 out of ten patients present with fever) that this was used only in the axilla (armpit). Examinations are cursory to say the least: stethoscope (worn back to front) used through 3 layers of clothing (sometimes even fleece-type tops); blood pressure measured in a similar fashion!

    Everyone has fever (one chap with a month-long history) and/or APD, which, despite my medical training so far consisting almost exclusively of Gastroenterology, I did not work out was Acute Peptic Discomfort (or something along those lines) for about 20mins. A quick look in my new edition of the Cheese and Onion (Oxford Handbook of Clinical Medicine, essential synopsis of everything medical and some surgery too – coloured yellow and green and about the size of a packet of crisps) when I get home reveals no such acronym, so I feel a little less stupid –but not much!

    Only one guy in about 20 or so we saw presented with anything other than fever – and he had multiple poorly localised pains, headache, fever (?!) and stuff. Obviously he was depressed, and I was Impressed with the amount of time and privacy we (obviously not me) were able to afford him compared with everyone else.

    I recall at this point, something the Medical Education Centre doctor said to me about the leading causes of death in the country: 1) cancer, 2) Trauma, 3) Heart attack, 4) infective; while in Britain ischaemic heart disease is way out in front. And these guys only eat fried food! Either cancer is way more prevalent here thank in the UK or they know something we don’t about IHD!? She also mentioned IHD was on the increase, however, as is depression (and hence my misguidedly thinking this mind-numbing statistic relevant now!).

    Lunch
    I was taken to lunch by the very same doctor I was having difficulty understanding. He is very nice and friendly, and obviously keen to help, but I really can’t tell when he stops speaking Nepali and starts speaking to me. I hope I get better at this pretty quickly!

    We walk to the cafeteria (one of the few signs in only English) and I am pleased, because this was not included in my aforementioned tour. This room seems even less clean than the rest of the hospital, which really is saying something (quite why they don’t have superbugs here I don’t know – they seem as free if not more free with their antibiotic prescriptions too! Maybe be the enteric fevers, typhoid and things like that keep the nasties at bay?

    But I am encouraged that there are two sinks and a bar of soap at the entrance – having been near (if not directly examining as of yet) some rather dirty/smelly/ill patients for the last 2 hours, and without having seen any sinks ANYWHERE else, I welcome the opportunity to wash my hands before eating!

    It seems one has to choose and pay for one’s food before getting it or even seeing what is available – there goes my hope of pointing at a few things and then being given a bill. This method really requires some knowledge both of the Nepali food and language – aaargh. Is all too much, and so when the doc (I really can’t remember his name) asks if I’m not hungry, I agree a little too easily. He orders me a tea anyway, which I am glad for, and when he brings a spare empty plate (pressed, stainless steel with separate compartments for different foods rather like they have in prison – I imagine!) and offers to share his with me I am very pleased. So I manage to have a small amount of soft noodles with some random veggies chucked in and fried with chilli – very nice – and a dollop of what I think is called dhal, which is essentially a curried chickpea/lentil soup. To accompany this I have a ring donut! No seriously – it looks like one: obviously some kind of deep-fried dough, sans the sugar dusting, but quite sweet tasting nonetheless. It may sound revolting, but a little sweetness offset the spicy other dishes quite nicely. Another row of sinks on the way out (though no soap this time) and we were ready to face the rest of the clinic.

    The end of the clinic is heralded by the onslaught of (and I am not exaggerating here) 15 drug reps trying to sell their products to the doc. They must have queued up outside for ages. We (again, obviously not me) take their free samples and complimentary tea cups (I kid you not) and refused to use their drugs. Nice.

    Thamel
    On finishing the clinic around 15:00 I eagerly take my excuse to escape – well there’s no need to overdo it, right? I mean this is supposed to be a holiday too - most of my friends just bummed around the Caribbean for two months (Rob – yes I do mean you, and I WAS implying you sold your bottom for alcohol…!) So I get into a taxi and headed to Thamel (see previous post).

    This time, I have the opportunity to explore and shop, because I am not with Neima (Ang Rita’s daughter – should have mentioned her earlier, I guess). I spend four or five hours in total, wandering around the streets and in and out of shops looking for a couple of things in particular: I want a swanky down-filled sleeping bag. I have made do with my cheapo blacks synthetic-filled bag on alpine club trips nearly every weekend for the past 5 years, sometimes enduring sub-zero temperatures, and I have had enough. I will need something far more substantial for the harsh –20C of base camp. Having looked in the sales in the UK, and found nothing for less than 200GBP (yes I know it’s nice Clare, but will it keep out the draught from the hole it has made in your wallet?!), I was encouraged by friends who have been to Kathmandu before that I would be able to find them far more cheaply over here. (have borrowed one from a friend that will do - thanks Ben! - but my own would be better!) I am also desperate for a power socket adapter so I can use this thing (laptop) for longer than 2 hours having lugged it half way across the world!

    Every few metres along most of the shopping roads in Thamel is situated a shop selling mountaineering equipment. Mostly only waterproofs, down jackets, sleeping bags and rucksacks, but the occasional one selling reels of rope (Harriet – does the club need cheap rope by the 200m reel?!), crampons, down suits (I sooo want one!), decent-looking boots, and other such tempting paraphernalia. I am pleased to have the time to wander into most (pretty much all, actually) of them. The first one has a gortex-shelled, down-filled sleeping bag, rated to –20C for about 50quid! And I discover, after several hours of browsing, that this shop was the most expensive in Thamel!

    However, largely due to the enormous fluctuations in price, and some obvious differences in quality (not to mention Will’s warnings – thanks!), I am suspicious that at least some of this gear (mostly of The North Face label) may be fake. A few shops stock both locally made stuff (cheaper) and the known brands side-by-side. One shop was selling jackets made of Sherpa-Tex (in the same font as the better-known Gore-Tex!) – they actually look quite good, but I have no idea how well they keep out the water, and doubt there’d be a refund if they didn’t match up to my demanding standards!

    I visit every shop and gauge the range of prices, hopefully, when the decision comes to buy, I will be able to remember which shop offered me the best deal for the most genuine stuff! But with sleeping bags, waterproof trousers and some kind of warm jacket all required, I think this is too much for my memory to master – ho hum, will just have to spend another half a day wandering when the time comes.

    I do manage to spend a few rupees on a nice top and some Nepal badges I know people want. Also have my eye on some Yak fur jackets with pointy, tasselled hoods, amongst other things…

    The taxi ride home from Thamel is difficult – I know the route between the hospital and home well now, and even the route from hospital to Thamel and back, but the route between Thamel and home got me lost – especially because it is dark! The problem is, once you get out of the main streets of Kathmandu/Thamel, there are no street names or numbers, so I couldn’t give the driver an address to take me. I tell him the nearest big thing to the house, and pray I recognise something on the way and can redirect him. Needless to say, I didn’t recognise anything and we arrive at the big landmark in the middle of nowhere! I have a map, but it is next to useless once you are off the main roads. Eventually I persuade the driver to backtrack a little and head north until I finally recognise something and direct him to the door. The journey was meant to cost about 200NPR, but I had nothing smaller than 500 and he didn’t want to give me change… L

    When I finally walk through the door, I discover the new student (listen to me – I’ve only been here 2 days!) has arrived and been given the room next door – a double! Grr. He seems nice enough though, despite being the enemy.

    Dinner with the Sherpas
    Tonight, because Nish (new student) hasn’t had time to buy food, we eat with the family. Turns out not to be quite the cultural experience I was expecting – we have spaghetti Bolognese! It was very good actually, but it felt quite odd to be in Nepal and eating Italian food. I suppose it’s not that odd actually, a little disappointing perhaps?

    hooray - it works

    don't know what i've done to get this to work, but here are my updates:

    …Sorry about that, time ran out at the internet café and I had to dash. I shall carry on from
    where I left off, more or less…

    As I walk out into the sunshine, I am glad I stuck to the guidebook and kept on my shorts.
    Despite getting funny looks boarding the plane at 03:30 in shorts and a t-shirt (though the stains
    of where I dribbled free-springroll-juice may be drawing the looks, I admit), I was adamant that
    Nepal's climate is often in the mid 20s at this time of year. And leaving the airport, my research
    proved correct – blazing sunshine and at least 20, despite only being 10:00. ?

    Gavin (the mountaineer and head honcho of the charity ad trekking company who organised my
    trip) promised I would be collected from the airport by Ang Rita Sherpa, his head Sherpa of
    many years, and that I would recognise him by the sign he was carrying. I must admit, I was
    chuffed to be collected from the airport with a sign – just like in the movies – but I couldn't
    imagine for a moment how it would actually happen:

    I finally see my sign among the sea of others: Nick Foster, in large, bold, laser-printed text, with
    Gavin Bates' name emblazoned beneath and then "medical student" – great, announce to
    everyone my lowliness! After brief introductions (turns out Ang Rita sent someone else), I am
    festooned with one of those flower necklaces you see on the telly and have my luggage trolley
    snatched from me, while being frogmarched away from the crowds… At this point I feel like
    royalty, and obviously the porter who pushed my trolley to the car must have thought I was: in
    his demanding of a tip, he showed me a £20 (GBP) note and said, "like this". I gave him a fiver
    and thought even that was generous for the 3-second walk to the car and lifting bag into boot!
    Am I stingy?!

    So, a little dazed that I have managed to meet the people I am supposed to meet in the right
    country and I didn't screw anything up, off to Kathmandu we go.

    I am staying in Ang Rita's house in Thamel, north Kathmandu, described in my Lonely Planet as
    "the budget tourist accommodation and restaurant ghetto 15 or 20mins walk from central
    Kathmandu".

    I thought the traffic and manner that people negotiated it in Dubai was bad enough – mirror,
    signal, and manoeuvre my arse! Random lane changing, flamboyant overuse of the horn and
    ridiculous numbers of vehicles is just a start. In Kathmandu, this was combined with numerous
    randomly meandering pedestrians, potholed roads and a total absence of signals, rights of way or
    signage. And nobody wears a seatbelt – I am amazed the death- or at least injury- toll is not
    through the roof. I certainly wouldn't drive here - or in Dubai for that matter!

    We pass numerous dilapidated-looking buildings and shop fronts and kids in school uniform
    walking four and five abreast (it is a Sunday – why were these kids in school?!). Eventually we
    pull up outside a posh looking, polished red brick 4 story building amidst the squalor, and I'm
    embarrassed to feel relieved it looks so "normal" – far more "western" than my Dubai hotel
    even!

    Brief tour of the building, followed by a coke (is there nowhere the evil has not permeated?) and
    I am left to settle in, with the promise that in a couple of hours we'd go to the hospital so I can
    learn the taxi route! It seems I have a floor to myself, comprising bedroom, sitting room, kitchen
    (with another bed) and bathroom), all very cool and shady with stone floors (?marble). and a
    huge south-facing balcony! As you would expect, there are beautiful views in 360 degrees with
    mountains peeking through the haze and multicoloured buildings everywhere, some surrounded
    by lush greed fields of wheat.

    In every internal doorway hangs an embroidered sheet, which, while rather pretty, does take
    some getting used to, especially when carrying cups of tea around…! (don't worry mother – I
    didn't make a mess!)

    It seems from tomorrow I may be sharing my room (and, I suppose, the rest of the floor) as there
    is another elective student coming. I sneaked a peep at his documents and he is from St. Georges
    (London) – booo!

    Transport, food and accommodation is supposed to be included in the price I have already paid
    for the elective and Ang Rita says I won't have to pay for the cabs. He has, however me given
    me 200USD in cash so that I can sort my own eating arrangements. I was a little disappointed as
    I was expecting to be fed with the rest of the family, and while this does not afford one any
    fussiness, it would have been a rare privilege and insight into Nepali (or more specifically:
    Sherpa) culture and lifestyle – though I don't suppose I would have understood anything!

    Having unpacked my bags (cleaned up chemical leak from an exploded instant-coolpak in my
    first aid bag), and finally had a shave (sorry Sarah – it just wasn't looking Bonnington enough,
    more vagabond wino!), I lay down with my book…

    5 hours later, Ang Rita woke me up to take me to the hospital – I am sure he had been by earlier
    but decided to leave me be. I hadn't slept at all the night before, what with flying at silly time in
    the morning so was a little out of whack. We drove the 6km to the hospital on his motorbike –
    one of millions in the city; the journey being infinitely more scary than the ride from the airport
    with a metal box to protect us. That said, Ang Rita is a very conservative driver, and he only
    rides a piddly 125 – and with two up it was barely moving!

    We arrive safely at a hospital – admittedly not the one I was expecting, but a large(ish) teaching
    hospital nonetheless – and I am introduced to someone who will "sort out the paperwork". Little
    beknown to me, I actually have to apply for this placement (thought I had done all that through
    the agency already…), including submitting a form, a current CV and 2 passport photographs
    along with a letter of good standing from my college. This being the first I knew of any of this,
    there was a brief panic while I wondered just how the hell I was gonna manage all the
    documentation on the spot, but it turns out Ang Rita has a copy of the letter from the college I
    sent to the agency. He also says – though I'm not sure he really understood properly – that if I
    couldn't get my CV quickly, he doubted they cost very much!

    On my trip into Thamel to get passport photos (8 cost me 125 rupees – exchange rate being
    1GBP to 132NPR!) I realised I may have a copy of my CV on my key ring USB pendrive, and
    failing that I had saved a copy, though a little out of date by now, onto an accessible page on the
    intrameweb a few months back for precisely this kind of reason. (brief stop at internet café in
    Thamel, hence previous quick post)

    The people at the hospital looked blankly at me when I showed them the pendrive and had a
    conversation between themselves for about 10 mins (I did hear mentioned the phrase "USB
    pendrive"), resulting in a brief explanation that Nepal is a little behind on the technology front.
    Eventually managed to get the copy off the web, and they were all very impressed.

    We got chatting about my research and presentations on patient satisfaction, and they made the
    point that there is no such thing here in Nepal! It turns our care here is very much more
    paternalistic than back in the UK, with success measured purely on the recovery of the patient
    and satisfaction of the doctor. Not surprising really, but an interesting discussion nonetheless!

    The doctor at the medical education centre (barely more than a dishevelled, 3-story mud hut)
    who completed my application documentation then started rabbitting on about some fantastic
    new cure-all herb called "red-mushroom" – anyone heard of it? Apparently it can be used to
    treat/cure (depending who you talk to) anything from asthma and allergies to sterility and cancer.
    I couldn't really get much of a sensible answer about its mechanism of action either, just
    something wishy-washy about storing oxygen and releasing it to the body – oh yeah and
    antioxidant properties and full of essential vitamins. It is apparently available in about 20
    different preparations from tablets to tea/coffee and even soap and shampoo. All seems a little to
    unrealistic, but perhaps I am just a pessimist? Perhaps someone out there with the
    time/inclination could look it up and post back to inform the rest of us? Ta.

    After all the paperwork was complete, I was told I would be informed in a couple of days
    whether or not my application was successful (this could all go horribly wrong yet, seeing as I
    cannot qualify without completing an elective…), Ang Rita took me to the "supermarket" where
    I am supposed to do all my shopping. Not knowing how to cook the local cuisine, it seems my
    diet will be considerably more western than I had perhaps hoped. Bought some bare essentials,
    though couldn't find any fresh fruit or vegetables (I'm glad I brought my multivitamins – must
    dig them out at some point!). Ang assured me that I could get fresh milk in the tiny shop
    opposite the house in the morning. What he didn't tell me was that it comes in a BAG - a square,
    sealed plastic bag! I got into it by biting the corner off (no mother, I don't know where its been,
    but needs must!) and squeezing the required amount onto my bran flakes and dried fruit. The
    packet, with "BOIL BEFORE USE" emblazoned across the side (sod that!), is now balanced
    precariously in the fridge!

    Saturday, March 05, 2005

    some piccies...

    this totally didn't work.

    will try again some other time (G?!)


    x

    Finally found USB and internet., but...

    Hooray - i have finally found a "cyber" with a reasonable connection speed and accessible USB ports.

    However, the documents saved to my pendrive seem to be corrupt, so i cannot open them on this machine.


    AAAAARGH!


    i was able to get some photos from the pendrive though, and these will be posted soon...


    :)

    watch this space, i am working on it!


    nx

    Thursday, March 03, 2005

    dammit!

    I have two lengthy additions to the blog with my impressions of the hospital and experiences so far among other things. I managed to write them on my laptop at 'home' and save them onto my pen drive for the next time i was in a intramewebcafe to check my email - but does ANYWHERE have accessible USB ports?!? HELL NO!

    Grr.

    Not going to write it all out now, will have to find somewhere a little more technologically advanced! I know the place in Thamel had USB extensions, so if all else fails, i'll have to wait till the next time i'm in Thamel - shouldn't be too long!

    Nothing important to report; not been shot or fallen off anything yet - just checking in!

    Nx