11-13 February 2012
Three nights at a Buddhist Monastery
I was sure I had the flu when I woke up that morning in Manali. My entire body was sore from shivering throughout the night and lying curled up in the fetal position. I had tossed and turned, at times feeling like I was burning hot too-clearly I had had a fever. The hotel room was still frightfully cold when I woke up, so cold, in fact, that I needed to psych myself up to just emerge from the bed covers. I forced down some porridge in the cold dining room. When one of the servers asked me how I was doing that morning, I responded that I was cold. He agreed and said, "Too much cold, ma'am!"
It was a 45 minute drive from Manali to the site of our clinic that day. We were headed for a government-funded Buddhist cultural school to do check-ups on the children there. Our cars stopped at the bank of a river, just next to a narrow suspension bridge over a crevice at least 4 stories deep. We were instructed to take our belongings and walk across the bridge and down hill a short distance to the school.
When we arrived, we found a long table set out in the sun. The school teachers greeted us with warm, sweet chai and an assortment of biscuits. We reveled in these treats while basking the the late morning sun. Ravi took us on a short tour of the facilities. Besides the classrooms and dormitories, there was also the beginnings of a clinic on site. Ravi had been working closely with a local doctor to set up a general medicine clinic to service not only the Buddhist and Tibetan refugee population but also any local indigent patients. It was a basic but clean clinic and Ravi promised that on future trips, we could work there.
After the tour everyone scattered to different stations. I had Vik working with me for the day and together we did mostly a lot of well-child exams. I have to give credit to Vik for doing the majority of the work, and doing it well, because half the time I felt sickly and exhausted. Throughout the course of the day, we saw a lot of children with fungal skin infections resulting in hair loss, scabies bites, and awful dentition. The children were quite shy but adorable. They looked a lot more Asian than Indian, or at least what one normally thinks of as an Indian-looking person.
There were half a dozen people doing manual labor at the school while we worked at the clinic. There were a few women carrying large rocks from one area to another and a couple of ragamuffin children running around or staring at us westerners. I had noticed that one of the women appeared to be pregnant as I saw her transporting the large rocks on her shoulder and head. Right as we got ready to close up the clinic for the day, I was sent one final patient; it was the pregnant worker.
I could tell that the female teachers at the school were quite worried about her. They informed me that she had never seen a doctor before for her pregnancy and that everyday she was doing heavy labor. "Please give her some good medicines!" they women pleaded.
According to the pregnant woman, she was about 27 weeks gestation. Fortunately she had no complaints at all and had had 3 other normal healthy pregnancies. I was the first and likely only OBGYN she would ever see. I measured the height of her uterine fundus, easily felt the position of the fetus through her thin abdominal wall, and was just barely able to hear the fetal heart beat through my stethoscope. I reassured her, and the teachers, that everything seemed to be fine. We loaded her up with prenatal vitamins and recommended she see a local doctor. The teachers kept asking me if it was okay for her to keep working. How do you tell a poor woman to cut out her source of income when she has 3 other children to feed? The fact of the matter is that her body is used to this level of manual labor and thus it was unlikely to pose much of an ill effect on her. Sometimes reassurance goes a lot further than any medical treatment. I was glad I got to meet her.
At the day's end, we took another hour long drive to Dhakpo Monastery where we would be spending the next three nights. It was a simple and fairly small monastery complex located in the Kullu valley surrounded by snow-capped mountains. We found the place quite quiet when we arrived and we were told that this was due to the soon approaching Tibetan new year celebrations. Some Tibetans celebrated for up to 15 days for the new year and so many of the monks, or lamas, had left for bigger monasteries or others were home for holiday.
Beth and I had a simple room consisting of two twin beds with thin foam mattresses and a shared bathroom without hot water. After we dropped off our bags, some of us took a tour with one of the lamas. He brought us into the main temple; it was colorful and ornate with large gold statues of Buddha and big photographs of the Dalai Lama and other important head lamas. The temple was littered with many offerings to Buddha, mostly in the form of food items.
After our tour of the temple, I few of us lingered to wander around. In the basement of the building, we found about thirty young monks chanting methodically. A few of us peer back at us while we watched them. They were clearly just as curious about us as we were about them.
It wasn't long before they all broke out of their chants and went from solemn Buddhist monks to mischievous little boys. They all ran out of the room, fooling around, hitting each other with their books or cushions as they rushed out. A few minutes later a bell sounded and a few of us followed the noise. It was the dinner bell and slowly the monks all lined up with their own respective eating utensils. Some had large colorful bowls, others had plates, and one even had a bucket. Some older lamas served up dinner out of huge vats. The amount of white rice they were given was quite impressive. In addition, they also received lentils and spinach and potatoes. There wasn't much protein in this diet.
The following day, our clinic was held at a Buddhist nunnery. The girls were all shy and demure and with their shaved heads, it was hard to even distinguish some of them from boys. The site was ridden with puppies and kittens, between that and the young nuns, it was like cute-ness overload. But these nuns were not as innocent as one would think. When we were preparing to leave the clinic for the evening, one of our cars starting blaring loud 1990s music, like the Macarena. A few of the nuns broke into dance which was, at times, quite seductive. The others laughed and cheered them on. A few of the medical students in our group joined in on the fun.
We had our next clinic at the Dhakpo monastery where we saw all of the young lamas and a few of the local villagers. It was a very cold clinic located in the damp ground floor of the temple with no electricity due to heavy rains. We had to wear hats and all of our layers to be comfortable; it didn't make my flu-like illness any better, especially now that the diarrhea had started. I knew a GI bug was inevitable in India! The cold weather seemed to keep a lot of locals away and we heard they got 2 feet of snow in Manali. While there was downtime at the clinic, we huddled around the furnace, read books, and listened to an impromptu drumming and singing session by some of our drivers.
One afternoon, the drivers took us for an outing in the town of Kullu, located, of course, in the Kullu valley of Himachal Pradesh. Kullu valley is often called the Valley of the Gods as it is home to 360 different Hindu temple gods. Kullu valley was largely unknown to the western world until it was discovered by traveling hippies in the 1960s. They were attracted to the region not only for its mountainous splendor, but also for the plentiful cannibas that grew on hillsides. The town of Kullu is not a very exciting or classically picturesque town, but there was still much to observe with its many tiny box-like shops, street food vendors, and grungy alleys. We walked through a produce market where brightly colored fruits and vegetables were sold out of carts. The vendors were happy to pose for pictures too and laughed when I showed them the end result. A visit to the butchery market was fascinating and slightly disgusting. Half a dozen slaughtered goats hung on racks, some of them still dripping blood. Their decapitated heads were available for sale, as were their innards. There was also a nice selection of plump chickens and their feet too. But of course, there was no beef to be found!
Ravi took us all to a confectioner shop where we tried a bunch of Indian sweets. The Indians don't mess around with their sugar, these desserts were sweet enough to actually rot your teeth on the spot. When we looked for our drivers, we found them not at the designated meeting spot but standing outside an open air liquor store where they were watching a cricket game on TV. India was playing against Australia and the game was almost over. Most of us had no idea what was happening with the game, but it was fun just to watch the crowd of men slowly accumulate, pouring into the street to watch the end of the big match. They all had a big cheer when India won the game and then quickly went on their ways.
Three nights at a Buddhist Monastery
I was sure I had the flu when I woke up that morning in Manali. My entire body was sore from shivering throughout the night and lying curled up in the fetal position. I had tossed and turned, at times feeling like I was burning hot too-clearly I had had a fever. The hotel room was still frightfully cold when I woke up, so cold, in fact, that I needed to psych myself up to just emerge from the bed covers. I forced down some porridge in the cold dining room. When one of the servers asked me how I was doing that morning, I responded that I was cold. He agreed and said, "Too much cold, ma'am!"
It was a 45 minute drive from Manali to the site of our clinic that day. We were headed for a government-funded Buddhist cultural school to do check-ups on the children there. Our cars stopped at the bank of a river, just next to a narrow suspension bridge over a crevice at least 4 stories deep. We were instructed to take our belongings and walk across the bridge and down hill a short distance to the school.
When we arrived, we found a long table set out in the sun. The school teachers greeted us with warm, sweet chai and an assortment of biscuits. We reveled in these treats while basking the the late morning sun. Ravi took us on a short tour of the facilities. Besides the classrooms and dormitories, there was also the beginnings of a clinic on site. Ravi had been working closely with a local doctor to set up a general medicine clinic to service not only the Buddhist and Tibetan refugee population but also any local indigent patients. It was a basic but clean clinic and Ravi promised that on future trips, we could work there.
After the tour everyone scattered to different stations. I had Vik working with me for the day and together we did mostly a lot of well-child exams. I have to give credit to Vik for doing the majority of the work, and doing it well, because half the time I felt sickly and exhausted. Throughout the course of the day, we saw a lot of children with fungal skin infections resulting in hair loss, scabies bites, and awful dentition. The children were quite shy but adorable. They looked a lot more Asian than Indian, or at least what one normally thinks of as an Indian-looking person.
There were half a dozen people doing manual labor at the school while we worked at the clinic. There were a few women carrying large rocks from one area to another and a couple of ragamuffin children running around or staring at us westerners. I had noticed that one of the women appeared to be pregnant as I saw her transporting the large rocks on her shoulder and head. Right as we got ready to close up the clinic for the day, I was sent one final patient; it was the pregnant worker.
I could tell that the female teachers at the school were quite worried about her. They informed me that she had never seen a doctor before for her pregnancy and that everyday she was doing heavy labor. "Please give her some good medicines!" they women pleaded.
According to the pregnant woman, she was about 27 weeks gestation. Fortunately she had no complaints at all and had had 3 other normal healthy pregnancies. I was the first and likely only OBGYN she would ever see. I measured the height of her uterine fundus, easily felt the position of the fetus through her thin abdominal wall, and was just barely able to hear the fetal heart beat through my stethoscope. I reassured her, and the teachers, that everything seemed to be fine. We loaded her up with prenatal vitamins and recommended she see a local doctor. The teachers kept asking me if it was okay for her to keep working. How do you tell a poor woman to cut out her source of income when she has 3 other children to feed? The fact of the matter is that her body is used to this level of manual labor and thus it was unlikely to pose much of an ill effect on her. Sometimes reassurance goes a lot further than any medical treatment. I was glad I got to meet her.
At the day's end, we took another hour long drive to Dhakpo Monastery where we would be spending the next three nights. It was a simple and fairly small monastery complex located in the Kullu valley surrounded by snow-capped mountains. We found the place quite quiet when we arrived and we were told that this was due to the soon approaching Tibetan new year celebrations. Some Tibetans celebrated for up to 15 days for the new year and so many of the monks, or lamas, had left for bigger monasteries or others were home for holiday.
Beth and I had a simple room consisting of two twin beds with thin foam mattresses and a shared bathroom without hot water. After we dropped off our bags, some of us took a tour with one of the lamas. He brought us into the main temple; it was colorful and ornate with large gold statues of Buddha and big photographs of the Dalai Lama and other important head lamas. The temple was littered with many offerings to Buddha, mostly in the form of food items.
After our tour of the temple, I few of us lingered to wander around. In the basement of the building, we found about thirty young monks chanting methodically. A few of us peer back at us while we watched them. They were clearly just as curious about us as we were about them.
It wasn't long before they all broke out of their chants and went from solemn Buddhist monks to mischievous little boys. They all ran out of the room, fooling around, hitting each other with their books or cushions as they rushed out. A few minutes later a bell sounded and a few of us followed the noise. It was the dinner bell and slowly the monks all lined up with their own respective eating utensils. Some had large colorful bowls, others had plates, and one even had a bucket. Some older lamas served up dinner out of huge vats. The amount of white rice they were given was quite impressive. In addition, they also received lentils and spinach and potatoes. There wasn't much protein in this diet.
The following day, our clinic was held at a Buddhist nunnery. The girls were all shy and demure and with their shaved heads, it was hard to even distinguish some of them from boys. The site was ridden with puppies and kittens, between that and the young nuns, it was like cute-ness overload. But these nuns were not as innocent as one would think. When we were preparing to leave the clinic for the evening, one of our cars starting blaring loud 1990s music, like the Macarena. A few of the nuns broke into dance which was, at times, quite seductive. The others laughed and cheered them on. A few of the medical students in our group joined in on the fun.
We had our next clinic at the Dhakpo monastery where we saw all of the young lamas and a few of the local villagers. It was a very cold clinic located in the damp ground floor of the temple with no electricity due to heavy rains. We had to wear hats and all of our layers to be comfortable; it didn't make my flu-like illness any better, especially now that the diarrhea had started. I knew a GI bug was inevitable in India! The cold weather seemed to keep a lot of locals away and we heard they got 2 feet of snow in Manali. While there was downtime at the clinic, we huddled around the furnace, read books, and listened to an impromptu drumming and singing session by some of our drivers.
One afternoon, the drivers took us for an outing in the town of Kullu, located, of course, in the Kullu valley of Himachal Pradesh. Kullu valley is often called the Valley of the Gods as it is home to 360 different Hindu temple gods. Kullu valley was largely unknown to the western world until it was discovered by traveling hippies in the 1960s. They were attracted to the region not only for its mountainous splendor, but also for the plentiful cannibas that grew on hillsides. The town of Kullu is not a very exciting or classically picturesque town, but there was still much to observe with its many tiny box-like shops, street food vendors, and grungy alleys. We walked through a produce market where brightly colored fruits and vegetables were sold out of carts. The vendors were happy to pose for pictures too and laughed when I showed them the end result. A visit to the butchery market was fascinating and slightly disgusting. Half a dozen slaughtered goats hung on racks, some of them still dripping blood. Their decapitated heads were available for sale, as were their innards. There was also a nice selection of plump chickens and their feet too. But of course, there was no beef to be found!
Ravi took us all to a confectioner shop where we tried a bunch of Indian sweets. The Indians don't mess around with their sugar, these desserts were sweet enough to actually rot your teeth on the spot. When we looked for our drivers, we found them not at the designated meeting spot but standing outside an open air liquor store where they were watching a cricket game on TV. India was playing against Australia and the game was almost over. Most of us had no idea what was happening with the game, but it was fun just to watch the crowd of men slowly accumulate, pouring into the street to watch the end of the big match. They all had a big cheer when India won the game and then quickly went on their ways.
