Saying Goodbye

Saying goodbyes are always hard, but we've both found it hard to say goodbye to Tansen, the people and the friends that we've made in such a short period of time. Looking back, we would have never thought leaving would be so difficult - those first few weeks where we were unwell and were looking forward to being at home, have passed. Cat has had such a fruitful time working with a team of lovely people, lead by a Christian dentist and Matt has experienced medicine in a third world setting.

It's strange coming to Kathmandu, after having spent 5 weeks in a town, where more focus is on relationships and living more simply - here everything moves faster, is more noisy and you're less conspicuous. We can't imagine what it will be like coming home.

However, we are looking forward to coming home. Cat is longing to see her family in Malaysia and Sydney, as well as the rest of our family and friends.

Please pray for us as we start our holidays, for safe travel between countries, that we enjoy spending time with Cat's extended family and for time to rest. Please pray that we will spend time reflecting on the experience we have had and that we can make sense of it all and how it will change us and our lives.

A Day in Tansen Jail

Fortunately, having not committed any crimes, we were allowed free passage into and around Tansen Jail last Wednesday. We were a part of a small team, going under the banner of a Christian organisation called Missions Nepal. Apart from Matt and I, there was a dentist (Dr Roshan), a dental assistant, a pharmacist, two people from the pastoral care department from the hospital, and the leader of Missions Nepal (who is also an anaesthetist). Before arriving, both of us were slightly worried about our safety, although during our time there we found we had not much to fear.

The prison atmosphere itself was very different to what we had anticipated. The prison was like a small community, where different inmates had different jobs - from administration, to cooking in the kitchen, being a trademan by making stools or weaving, to being the "town" hairdresser. There were large board like games set up inbetween the dorm houses for the men to play as well! Their rooms were cramped and small, having 8-10 beds in one "room" where the only space they had was a bed (no more than 1m x 1.5m) with a mud base and a very thin mattress. Yet we were astonished at how gentle these men were, not only in helping us out form organized lines and waiting patiently for their turn, but also by buying tea and biscuits for us, after we had finished.

While there, we would carry our free dental and medical check-ups, give out some simple medications (such as paracetamol, amoxycillin, metronidazole and omeprazole (for reflux), as well as make referrals to this hospital for follow-up or treatment. Dr Roshan and I also set up an outdoor makeshift dental clinic consisting of two dining room chairs and a spit box and carried out a number of extractions in the jail courtyard. We were expecting to be in a separate room with guards, and have one prisoner come at a time for security purposes. But it was not so! We had all 150 male inmates crowding around our small team plus our two rather casually unarmed guards! It was made more daunting by the fact that we had a lot of sharp instruments spread out on a table. Unfortunately, for security purposes, we were not allowed to take any photos from within the grounds.

As Cat and Roshan got to work, I sat watching on a small stool enjoying the show. It wasn't more than 5 minutes before Roshan asked me to see a patient with chest pain that the hard work started! With no medications, ECG or oxygen, I just sat him down for observation. He didn't look too bad, so I wasn't too worried. Whilst busy with this patient, a small crowd had started gathering by my stool. When I sat down again on my stool I didn't get off it for the next five hours except to examine patients in the prison dorms. The pharmacist acted as an interpreter the entire time and together we saw dozens of patients and made some referrals to the hospital.

The leader of Missions Nepal gave them a short evangelistic talk, telling them of the love of Jesus and how our team was there to serve because Jesus loves them too. The library in the prison has many bibles donated for the men to read, and through other work carried out, some men do become Christians during their stay. We found out that even Christians get sent to jail, mainly for cultural reasons. One Christian man had been in jail because he was making shoes from leather from cows (which is a sacred animal here). Apparently if you kill a cow, even accidentally, you can get a long sentence in jail here.

Give thanks that the gospel is preached so faithfully here in Nepal. Please pray for the men, that they will come to know that Jesus is Lord and that many will be challenged from what they have heard and seen. Please pray for the referrals that we have made, that ways will be made for the men to receive the follow-up care needed (it is a security risk to take them to the hospital, so strategies need to be put into place to keep them secure and separated from the rest of the Tansen community and it is also very expensive for them, as they need to pay for the transportation costs as well as the treatment fees, as well as other government policies that can cause interference).

Off to the Countryside!

Last week we both had the opportunity to join the Tansen Community Health team on a village school visit for the day. It was only 45km away, but the journey took 3hrs by jeep on a precarious single carriage and bumpy road. We reached the end of the line, and then hiked down into a beautiful valley where the village and school was situated. From a distance we could see the thatched roofs of the mud huts and their fields filled with the yellow flowers of the mustard plant.

We were involved in doing health checks: Matt listened to hearts, lungs and palpated tiny tummies, while Cat got to look in 130 kids mouths for various types of dental disease. Even though we were able to write a few referrals for the children we're unsure of whether they will go so far to get medical or dental treatment. Especially regarding dental decay, most families don't care too much about baby teeth as they are aware they will eventually fall out. Although the decay was bad in some children, there were no signs of swelling or abcesses. Matt picked up a few heart murmurs, which are likely to be a result of acute rheumatic fever at some point earlier in their lives. A couple of weeks ago, he saw a 29 year old woman with a heart valve replacement who was taking 10 different medications for heart failure, as a result of the acute rheumatic fever many years ago. He hopes that these children can now receive adequate followup care so that they don't end up in the same situation.

Please give thanks with us for the opportunity to visit these children and for the increasing ability for these isolated communities to access some sort of health care. Praise God that we've also been able to make a full recovery from the tummy bug we had. Please pray that we make full use of the time we have left, as we realise that it's getting closer for us to leave Tansen.

Early Hospital Experiences

Namaste! Today, being Saturday, is a day of rest in Nepal, and the only full day off from hospital duties. We just went for a great short walk up to a vantage point over the Tansen Valley, and the Himalayas in the distance. Earlier on today, we went to Nepali church - 2 hours of not really understanding anything, but a good opportunity to read my bible, and Cat hummed hymns to herself.

I feel like I've finally settled into the hospital routine after about 2 and a half weeks in Tansen. The days start at 7:45 with a short devotion, and then handover from the night interns. The days usually go through til 5, from Sun-Fri, with Wed being a half day sometimes. For the first week and a bit, I was on maternity. Only 1/5 Nepali women give birth in a hospital or clinic of some sort, and very few come for antenatal checkups. I saw one lady who was coming for an antenatal check up, after her last pregnancy was very complicated. She had gone into labour in her village some hours away, however the baby was in a breech presentation (feet first), and the head was too big for the pelvis. For some hours, the baby lay half delivered while her relatives took her to hospital as fast as they could. When she finally presented she was in shock after much bleeding, the baby had long died, and only with extensive resuscitation did she manage to survive the pregnancy. Many women are not so lucky to make it to the hospital when these complications arise. Just coming off O&G in Australia, only emphasised the contrast between maternal health here and at home. It's hard to imagine people wanting a 'natural birth' at home, when so often the natural history of preganancy is death (1/31 Nepali women will die in childbirth).

The hospital here is really well setup despite the shortage of resources. Though I wasn't able to get very involved on the maternity rotation, it has been good to observe a number of interesting things I haven't seen before in Australia and have my eyes opened to the need here in Nepal for better maternal care.

Our dinner is just about ready - daalbhaat!

Starting Week 3 in Tansen

We have suddenly found ourselves flashed forward into the year 2066 and it's only the 7th month in Nepal! Having now settled ourselves into our little "flat" we're getting slightly more accustomed to life in Tansen.

Tansen is a beautiful town situated at the top of a mountain. To the north, we wake up every morning with the sun rising over the Dhaulagiri-Annapurna-Manaslu Himalayan Ranges towering in the distance! There are lots of mountains, trees and greenery (as it's just after the monsoon season). The goats, buffaloes and chickens roam freely around the streets eating whatever they please, while people keep their vegetable gardens in tip top condition. The roads are full of noise and people as they haggle to buy their wares and supplies from tiny little stores!

Both Matt and I have been fairly unwell, with unsettled stomachs and the rest. We've had to take a couple of days off at the hospital but after medication and a whole lot of bananas and yoghurt we're on the mend. Matt thankfully has regained his full appetite, though I am still feeling the small after effects of the bug.

It's been an interesting time since we've arrived. I've enjoyed my time in the dental department. The care they provide here is first class, where they do lots of root canal to conserve and preserve people's teeth. Even the chairs are newer than the ones that I work with in the ADH! It's amazing the money and equipment that gets donated and then gets put to such good use. I have had a hard time reconciling the constant reuse of what usually is single use items back home, but it makes sense to here, where equipment is so expensive that cleaning and sterilizing these things is a better use of them. The language barrier is what I feel most keenly. Back home I can find out subtly what my patients backgrounds are to help tailor make my treatment work for them… Here I constantly feel like I'm just drilling and filling holes in teeth and hoping my limited Nepali is helping form some sort of bond with my patient.

We'll hopefully let you all know more about what we experience daily in the coming days and Matt will let you know about his time in the hospital. We can't believe that there's only 3 weeks left til we start our journey back home!

Pokhara at last!

Namaste from Lakeside Pokhara!

We have finally arrived in Pokhara after our flight was delayed and then cancelled yesterday morning due to the heavy rains in Pokhara. Apparently the monsoon is a little bit late this season, so it has been raining on and off since we arrived in Nepal. The airport was certainly an interesting experience, unlike anything we have ever encountered! We were whisked this way and that by eager to help Nepalis, who then wanted a dollar tip at the end of it all. We were seperated for the security check and Matt had a bit of a scare when the security man pulled him aside to 'question him'. There was alot of confusion for about a minute, until Matt figured out that he just wanted to know if Cat was Chinese or not - he was just curious!

We were then delayed for 4hrs in this large room with one gate, where they shouted out which aircraft was boarding next. If there wasn't enough noise from all the passengers and the shouting; voice-over messages for the boarding planes would play at the same time! It seemed to us like absolute chaos, but seemingly effective at the same time.

Thankfully, we were able to spend the night again at the guesthouse where we've been staying. Tomorrow we head off for 8 days of hiking towards Annapurna Base Camp and it appears the last day of the monsoon is today (that's the forecast atleast) so we're hopeful for some good mountain views.

Praise God for his faithfulness in taking care of us through this somewhat tumultuous couple of days and for his answer of prayer. Please pray for us as we build relationship with our Nepali guide, that we will be able to share our lives and faith with him over the next 8 days. Please also pray for our health (as we stay in villages and eat new foods) and for Cat's physical and mental stamina on the trek itself. Hopefully some photos when we get back!

Day 2 - Kathmandu

Namaste!

We've arrived safely in Kathmandu after a relaxing night in Singapore. We even saw Mt. Everest on the flight in!

We're currently staying in a Christian Guest House, in a southern suburb of Kathmandu - it's not very touristy, so we stick out like sore thumbs! It's been great staying here. There's been lots of Christian comers and goers, all of whom speak English. So it's like having family in a whole new very different country. We've had the pleasure of making 2 new friends from Norway, Tove and Karen. It's been a great time of encouragement and building friendship.

Highlights have been the cheap food - just came back from having momo (like dumplings) -24 of them for $3AUD!

We're still trying to adjust to Kathmandu - the strange smells from the pollution and incense, chaotic traffic and the loud constant sounds of horns from all the cars caught in traffic. Matt enjoyed going to the numerous mountaineering shops and deciding what was fake and what was the real thing. Cat just had a good time haggling the best price, but still has a long way to go.

Tomorrow we're off to Pokhara by plane to start our trek around the Annapurna Base Camp circuit. We would appreciate prayers as we travel, look for a new porter, and that we continue settling in to this country that God dearly loves.