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Chang Thang Plateau July 27, 2006

Posted by jaotte in India, Medical School, Medicine, Travel, Volunteering.
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If all goes according to plan, this post [written before my departure] should still be accurate today.

We take jeeps towards Tso-Morari and the Chang-Thang Plateau today. Clinics as usual and some amazing views of the Himalayas and hopefully some encounters with the unusual local fauna. Next we set off to Karzok and meet some Changpas. We are rounding out our healthcare delivery here and head back to Leh for an extra day (in case there have been delays at any point in the trip).

I am probably well used to life in the mountains and a bit sad that this part of my journey is coming to a close. We will have seen a hundred-times more patients in these few weeks than I saw in my first year of medical school. I can’t imagine a better way to learn than to immerse myself in diagnosis and treatment, surrounded by other students and experienced physicians, using only basic tools and having to overcome language, geographical, economical, and cultural barriers. I’m sure I’ll have a lot more to say about all this.

Back to the blazing heat of Delhi on August 3rd.

To Tangste July 22, 2006

Posted by jaotte in Healthcare, Himalayas, Humour, India, Medical School, Medicine, Travel, Volunteering.
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If all goes according to plan, this post [written before my departure] should still be accurate today.

For 4 days, we set up clinic in Tangste. On the way here, we have crossed the Changla Passat 17, 500 ft. It is the third-highest motorable pass in the world and I’ll bet the view was spectacular if I wasn’t passed out due to being unable to breath at this altitude. Let’s just assume I was very tough and even managed to take a picture.

We will make field visits to nearby nomadic villages, using Tangste as our base. Maybe I’ll see some TB, Leprosy, or other disease uncommon to North American in this region. I hope some patients are agreeable to having their picture taken because I’d really like to remember that man with a contagious hearty laugh or the child who really liked the Hello Kitty bandaid I gave her. 

Brrr! I’m glad I got the sleeping bag rated to -7C. On our way back to Leh, we visit Panggong lake at 15 000 ft.

I hope I get a shot as gorgeous as this one:

Camp at Angling and Menhle July 19, 2006

Posted by jaotte in Healthcare, Himalayas, Humour, India, Medical School, Medicine, Travel, Volunteering.
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If all goes according to plan, this post [written before my departure] should still be accurate today.

We have had the chance to acclimatize and learn about Ladakh. Now it is time to set up our first camp in the Tibetan settlements of Angling and Menhle. I’m very glad we have translators but I’m probably a bit scared about dealing with 8-10 patients an hour. Perhaps I am not doing it on my own but working closely with a physician. At this point, I doubt I have any idea what I’m doing or even what I am supposed to be doing. Probably feeling a bit icky still and maybe somewhat jet-lagged; it may be tiring to have a 7 hour day of treatment in the low-oxygen atmosphere, but we get a lunch break and a tea break on each of the 3 days of this camp.

Now I get to see how long my otoscope can work on one charge and what exactly constitutes the hand-washing regime here. Probably getting used to the toilet facilities by now. Probably glad I packed anti-diarrheal medications. I hope my tent-mate isn’t a snorer.

Alive in Leh July 18, 2006

Posted by jaotte in Medicine.
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Namaste, Ju-laa (spelling?)

I am top of the Himalayas. Seriously. Here in Leh. It’s sunny and hot but not dissimilar to a nice day in Vancouver or Thunder Bay. I can see Gompas (Buddhist shrines) on the hills around me. When we flew in, we could see this little green paradise surrounded by dusty mountains and snow-capped peaks.

Other than being dehydrated and sleepy, I’m feeling well. I totally pigged out on various paneer/potato/eggplant curries and naan and rice, while the fainter few poked a bit of plain rice across their plates. I drank about 4 L of water today already and peed like a race horse. The altitude sickness medication (Diamox/Acetezolamide) that I am taking seems to be working but it is responsible for the epic urination (it is amild diuretic).

Every bit made it through the bazillion airports during my 24 hours in transit from London. Body is getting used to the jet-lag, culture-shock, rapid heart rate, etc here at 12 000 ft.

I have been keeping a journal and taking lots of photos so I won’t write too much now about how odd it was to be a pale white person in the Bahrain airport or what Delhi sounds, feels, and smells like at 2 AM. My ‘full report’ will be much wittier I hope.

Today is just a resting day and many of my team members are sick [mostly food poisoning from their early adventures in Delhi]. A few from Kingston (Queen’s university) so I’m not the only Canadian, some dentists from Scotland/N. Ireland, and a few medical students from London. The rest are Yanks, but very kind (and some very Southern!) Yanks they are.

I don’t know when we’ll be back in Leh but I will contact you again soon I hope. Take care everyone and watch out for donkies *honk honk*

To Delhi July 16, 2006

Posted by jaotte in India, Travel.
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If all goes according to plan, this post [written before my departure] should still be accurate today.

Today I am meeting a fellow Himalayan Health Exchange participant at Heathrow and we will fly through Bahrain to Delhi. The HHE has generously provided some hotel rooms so we can crash for a few hours before getting our early morning flight to Leh. I’m glad I won’t have to sleep in the airport, but if you are ever destined to do so, check out The Budget Traveller’s Guide to Sleeping in Airports first. 

After a nap and (maybe our last for 3 weeks) shower, we will transfer to the domestic terminal and make the quick ascent to ~11 000 ft.

If I was a smart girl, I should already have started taking my Diamox in preparation for the yuck of altitude sickness. I’ll have to drink lots of fluids and tell my peers if I’m feeling really awful; the best (only?) cure is descent a few hundred feet but I sure hope it doesn’t come to that.

I’ll let you know how it goes!

Goodbye, Thank You July 7, 2006

Posted by jaotte in Culture, Healthcare, Himalayas, India, Medical School, Medicine, Nepal, Travel, Volunteering.
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My flight, direct to London, leaves at 20:50 tonight. I am flying super-budget-cheapest-flight-available so I’m not sure if/what they’ll feed me. Given that I’ve been working very hard to use up the last contents of the fridge and have naught but celery and hoisin sauce left, I think I’ll indulge in some disgustingly greasy Western airport food. I’m not expecting to have anything outside of dahl/naan/rice for breakfast, lunch, and dinner for most of the summer so I should get a last dose of veggie burger or the like before I go.

I know not what fascinating medical cases await or what cultural insights I’ll gain, but I hope I make it back in good shape to tell you and show you all about them.

I sent out a mass e-mail to friends and family about my trip, and below is an excerpt which provides a nice summary of what I’m doing for those new to my site:

The first part of the trip will be to Northern India with the Himalayan Health Exchange (HHE). After some time in London, I’ll arrive in Delhi, relax for a few hours, and then fly to Leh at 11000ft. We are given some time to acclimatize ( i.e. attempt to overcome the wretchedness of altitude sickness) and then start our clinical days, setting up shop in monasteries or schools. We will work out of Leh for a bit, but we will usually venture closer towards the Tibet border, set up camp, sleep in tents, and treat the Changpas (nomads) and other locals. Each night we have teaching sessions and there are a few ‘touristy’ side-trips to get us to know about the people, the culture and language, and the diseases that are common in the area. It should be a fantastic learning experience and will hopefully carry me well to my time in Nepal.

After the HHE, I’ll return to Delhi and take the train to Agra, site of the Taj Mahal and the Agra Fort. I have the time to kill “in between gigs” and I think I might as well see one of the 7 wonders of the world since I’ll be so close and may never get the chance again. Back to Delhi and then I fly off to Kathmandu, Nepal to work with an organization (strangely) named the Community Upliftment Society (CUS) for Nepal. They will meet me at the airport and give me a bit of an orientation at their offices in Kathmandu. Then I’ll be driven to the remote clinic at which I am to work for two weeks, somewhere in the Kathmandu Valley. For those aware of the recent conflict in Nepal, you will know why I was previously concerned for my safety there. The situation has fortunately stabilized to the point that the Canadian government has removed its recommendation against non-essential travel to the region. I have been assured by experts inside and out of the country that now is a very stable time. I am glad that I will be able to feel safe there, as there are so few physicians (1 per 100 000 people in the rural areas – my favourite statistic!). Even my mediocre medical skills and some of the medical supplies that I am bringing will be welcomed.

I don’t think the enormity of what I am doing has quite settled in yet. I’ve done my best to prepare and to take this very seriously, but I’m not very well-traveled so my only expectation is for shock. Thanks again for all of your kind words and generous shows of support; these have made all the difference in my approach to this journey.

Please check back occasionally for some post-dated updates and, with any luck and available Internet access, a live update or two over the next 51 days. See you on the other side!

Conversions of Electricity July 7, 2006

Posted by jaotte in Travel.
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Time, money, and energy: all great forces in our world and all very different from country to country. I have a number of electrical devices that I need or want to take along, and it has been a challenge to figure out my best options in terms of powering them up.

There is my otoscope with its Lithium battery handle [2 prong plug, 50-60/Hz, 110V] , my iPod (for those long plane rides)[2 prong plug, 50-60/Hz, 110V-220V], my digital camera (which takes 4 x AA batteries) and its battery charger [2 prong plug, 50-60/Hz, 110V-220V].

My main priority is keeping the otoscope, a handheld light device mainly used to look in patient’s ears, powered up. What it boiled down to was purchasing the adaptor plugs for India and England to convert the plug shapes of the outlets. In order not to fry my otoscope battery which only works at 110V, I got a hi-lo step-down switch (for appliances from 0-50 Watts and 50-~1500 Watts); technically it isn’t a transformer, but it does the job so long as I only charge stuff for 4 hours at a time. The transformers at the travel shop were absolutely massive and heavy to match. I really didn’t desire the burden of one such beast on my back, so I think the smaller, lighter switch I got is the next best thing.

For my camera, I just bought a tonne of AA batteries and some NiMH ones. I have the charger ready to pack but I’m not sure I want to drag it along all that way. Stupid techno gadgets! I wouldn’t bother with all this, except the primary souvenir I’d like to return with is a camera full of photos, the better to share my experiences with everyone.

Conversions of Currency, Time July 5, 2006

Posted by jaotte in Culture, India, Nepal, Travel.
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Currency:

Here’s a little conversion table I made a few days ago for those currencies relevant to my trip:

thing.jpg

So basically, during my extended stopover in England, every price multiplied by 2 is what I’m paying in Canadian. When in India, 100 rupees is about $2.50 Canadian. When in Nepal, 300 NPRs is about 200 INRs or $ 4.50 CDN.

It’s pretty scary to work in so many currencies, and having to add in American Dollars for exchange conveniences (even though I will not be in the USA at all) only makes it more complicated. Fortunately, other than a little food here and there, a couple of train rides, and any souvenirs [I already have requests for a N. Indian wool shawl, Maoist objects, funky beads, and so on], I shouldn’t have to do to much conversion estimation in my head.

Time:

There is also the trouble of time zones. I doubt I’ll attempt to make many phone calls on my journey, but if I do, I’ll have to keep this in mind. It will also be important to set my watch appropriately, so it was with great relief that I discovered it can display two zones. I’ll keep one on GMT and the other on the local time.

Vancouver, BC:       GMT – 8        eg) 12:00 noon
London, England:    GMT             eg) 20:00
Delhi, India:            GMT + 5:30  eg) 01:30   <– 1/2 hr ahead, just like the Newfies
Kathmandu, Nepal:  GMT + 5:45  eg) 01:45   <– just to be different, they had to add 15 mins!

I usually change my watch to the local time when a plane makes a stop, but I think that would be a little over-the-top for anything beyond a short hop across the country.

Getting Ready for Nepal July 4, 2006

Posted by jaotte in Humour, Nepal, Travel.
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Nepal is no longer present on the list of countries Canadians are advised against traveling to. Hurray! I did still out the “Registration of Canadians Abroad” form just in case of spontaneous turmoil. I’ve also sent all my contact info at various checkpoints to my mom and dad, who have always been able to arrange a rescue for me in the past, no matter the situation. As optimistic as I am about the political climate in Nepal, I am a stupid foreigner who does not understand the cultural intricacies or complicated history of the region. From those who send me encouraging e-mails to a taxi driver last week, everyone is urging me to be safe. I think I do have the advantage of a huge amount of planning and reading about culture & customs, transportation, language and so on, but I have so much to learn once I’m there.  At least my travel medical insurance will now cover me whilst there, but still no word from my doctor on the ‘needlestick’ (HIV prevention) kit.

Yesterday, a friend offered me his Mao t-shirt to wear on my journey. As funny as it may be, I think it could get me killed during my travels, so I had to politely decline.

Back to packing.

Globe and Mail: ‘Little Tibet’ Lures Trekkers and Seekers July 3, 2006

Posted by jaotte in Medicine.
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I’ve been reading a lot of books about Ladakh as well as the cultural background document from The Himalayan Health Exchange. It sounds like such an amazing place, I can’t wait to get there!

For your reading pleasure, here’s a great article about Ladakh from The Globe and Mail that I’m reposting from its original site.

POSTED ON 18/12/04

‘Little Tibet’ lures trekkers and seekers
Serene monasteries and rugged peaks draw visitors to Ladakh’s
mountainous plateau

ELIZABETH DALZIEL

Whether your interest lies in rugged mountaineering, a spiritual
journey or a trek with nomads, Ladakh’s ethereal beauty is guaranteed
to enchant. Associated Press

LEH, INDIA — They are trekkers and seekers, backpackers and Buddhist
followers, and they come here for both spiritual sustenance and for
rugged hikes amid ancient monasteries and snowcapped mountains.

This northern region of India known as Ladakh is a cold desert
plateau, a western extension of the Tibetan Plateau in the great
Himalayas, on the frontier with China. Local residents include Tibetan
refugees who crossed into the Indian Himalayas through what is known
as “the roof of the world” and settled into an area now known as
Little Tibet.

Monasteries perched atop small hills above the valley attract
surprisingly large groups of Western tourists, including Europeans,
North and South Americans, and a steady stream of young Israelis
looking to decompress after completing their military service.

These visitors come both to immerse themselves in Buddhist teachings
and to master the rugged terrain. But hiking in the region and
reaching the temples is far easier for the locals, who are acclimated
to high altitudes that range from 3,500 to 7,100 metres above sea
level.

The tourists are easy to spot, clad in Bermuda shorts and toting
cameras, sunglasses, colourful hats and water bottles as they fight
the punishing sun while thronging to admire the marvels of
craftsmanship on display at the monasteries, known as gompas.

In contrast, the locals’ attire includes traditional outfits crafted
from yak wool, long gowns or jackets adorned with turquoise jewellery.

The most revered contemporary lama in Ladakh, known as Drukpa, draws a
large following (both Western and local). He is believed to be the
12th reincarnation of Naropa, a revered Buddhist scholar from the 10th
century, who is credited with introducing Buddhism to the region.

This summer, the Hemis monastery near the town of Leh hosted an
extravaganza held once every 12 years: The unveiling of a tanka, a
tall building-size traditional religious painting on silk.

The painting is dedicated to a reincarnation of the 11th Gyalwang
Drukpa. The tanka was accompanied by masked monks representing
Buddhist deities performing tantric dances.

But the Hemis event was just one of many annual religious festivals
that draw both tourists and the Buddhist faithful, who take part in
rituals — known as puyas — with great fervour. These religious
adherents include khampa nomads, who are believed to be the area’s
original settlers; the Brokpas, the last Buddhist Indo-Iranian tribe
left in the world; and the Tibetan immigrants who now populate the
area.

Ladakh is also considered to be safe for travellers, having been
spared the violence that routinely mars the peace in the nearby
insurgency-affected Kashmir Valley. (Ladakh is part of the
Jammu-Kashmir state, but is far removed from the Kashmir Valley, the
hub of the insurgency.)

Pack your bags

GETTING THERE

You can reach the regional airport in Leh via flights from Delhi,
Srinigar and Chandigarh. From the Leh airport, take a taxi into town,
where hotels and tour outfitters abound.

THINGS TO DO

Hotel staff and local outfitters can arrange such excursions as
mountaineering trips led by sherpas and whitewater rafting on the
Indrus River.

MORE INFORMATION

India’s Tourism Office in Toronto: 416-962-6279;

http://tourisminindia.com/