It was difficult to say goodbye to my dear friends in Nepal.  I feel a special connection with leprosy affected Nepalis.  I have now "worked" on all of the patients with ulcers at READ Nepal, cutting away their necrotic flesh which is like carving on hard cheese that has been sitting out for days, cleaning their ongoing wounds and then dressing their wounds.  The patients love me, and I love them.  This was a new experience for me and the kind nurse worked patiently along side me as I got better at it each time.  Leprosy patients do not feel pain because they lose sensitivity in their limbs if not treated quickly with MDT after being diagnosed with leprosy.  I was never sure how deep to cut and occasionally drew blood.  Drawing blood I was told helped to clean the wound better and was not a problem.




Leaving Nepal was both difficult emotionally and logistically.  A Bhunda had been called on my departure day completely shutting down the Kathmandu valley and surrounding districts.  A full Bhunda not only closes all roads, but also closes all businesses.  To venture out with a vehicle during a bhunda brings the risk that your vehicle may be burned and destroyed.  To open a shop also brings negative consequences.

When I learned of the upcoming bhunda, I did some quick thinking as to how I was going to make my flight.  I had wanted to sleep in the READ Nepal leprosy wound care ward for a long time but hadn't managed to accomplish my goal of sleeping side by side with my leprosy friends yet.  I wanted to experience first hand what life was like for them on a daily basis.  I cannot relate to leprosy as I have never had it, but I can relate to what it is like to lie on a hard mat with mosquito's swarming around and everybody is snoring loudly in an unheated room.



I had a good nights rest with my friends before we piled my bags onto Raj Kumar's "scooty" for the one mile or so walk to the airport.  Nepalis are early risers, I am not...  They usually wake up and get going around 5am.  Nepalis also love music.  When they play music, they like to turn it up just past the distortion point.  The radio was next to my bed so after going to sleep late, I was suddenly awakened to blaring Nepali music just a few inches from my left ear, of course at the distortion level...

After a lot of goodbyes and tears from a few of my leprosy affected friends, we did a round of hugs and Namaste's and then set off for the airport. 



























We walked straight up the middle of Ring Road which is normally bumper to bumper traffic with buses, vehicles, motorcycles, tuk tuks etc weaving through traffic.  We only shared the road with a number of other pedestrians who were also attempting to walk to wherever they were heading that day.





My favorite was the Badeshi (foreigner) on the back of a vegetable cart who was trying to get to the airport.







I have already had emails from many of my friends in Nepal concerned that I reached the USA safely.  They all want to know when I will return of course.  That date is still to be determined.  I will write more this week and include photos from my previous blog as well as complete the Phaplu trip details from the Tilganga eye surgery camp as well as HAND's future plans in Nepal.

I want to give special thanks to Kate Earle for donating 7 weeks of her valuable time to serve Nepalis in need. 

Brian















































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Today marks the halfway point for Kate and I working in Nepal on this trip.  Since arriving on April 4th, we have traveled through many different regions and districts across the country.  Nepal is made up of three regions.  The Himalaya, hill and Terai regions.  Since the technology of Nepal is current with what we had in the USA back in 1980, I figured I would send what I have writtenl since it takes 20+ minutes to load a page.  Plus the keyboards do not have any letters written on the keys.  I am finishing this first blog long after I began it several weeks ago.  I will write more soon, but so far have not had success in loading any pictures onto any ot the computers that I have been attempting to use.

After arriving in Kathmandu, we began the first leg of our journey to the Terai region.  Dr. Vijay, READ Nepal founder Raj Kumar, Kate, myself and nurses Joann and Marion boarded a bus at 5am from Kathmandu.  Thirteen hours later, we arrived in Janakpur.  After unloading five wheelchairs from the top of the bus, we climbed onto rickshaws for a long, hot and dusty ride through the streets of Janakpur to our Nepali hosts house.

The first evening was spent culturally getting to know our new hosts and eating Dal Bhat and drinking tea late into the evening.  After crawling under mosquito nets, we settled in for a hot night.

We awoke early the next morning, loaded into a jeep owned by a government official and drove several long and dusty hours to our first village.  The village was anxious for our arrival, with tea ready to drink.  We unloaded and prepared the wheel chair for the new pround owner, a man who had been paralized from the waist down for many years.  His only form of mobility was to be carried by a fellow villager.

After a final round of tea, we loaded back into the jeep to find the next village.  After unloading the 2nd wheel chair, a girl came walking out of the village on her hands.  She was very excited to have a new form of transportation to give her increased independence and mobility.

Our next stop of the day was another remote village several hours from the first village.  The road was impassible as we neared the village, so we walked the last mile or so while several villagers carried the wheel chair.  The new proud owner was a girl in her 20's who had Downs Syndrome but was not able to walk.  Our last image of the village was the children pushing her down the dirt street as they ran along behind all jostling for a position to be able to push her.

After stopping into a final village late in the evening for tea, we returned to our host families home for a late dinner of Dal Bhat.

The next morning we headed off to Dr. Vijay and Raj's home village, an hour drive or so from Janakpur.  I found it truly amazing that Raj would want to return to his childhood village, where he and his family suffered a lot of discrimination because of Raj and his two sisters having leprosy.  We distributed our final two wheel chairs to teenage boys who could not walk and then Kate, Joann and Marion did a health education workshop for 50 or so villagers.  Marion focused on nutrition, while Kate focused on hand washing.  It was interesting to hear the questions and comments from the villagers.  One villager said "if we have no soap, we just rub our hands in the dirt like this."

After meeting Raj and Dr. Vijay's father we visited a little as Dr. Vijay explained his plan to build the villages first health care clinic.  The clinic will serve 35 villages in the region.  I was truly amazed at how far both Raj and Dr. Vijay have come after growing up in such a poor and remote region and working their way up to Raj being a pharacist and Vijay becoming a doctor.

The Terai is currently experiencing a lot of political unrest and some violence.  The Madeshi on the eastern side of the Terai want an independent state, while the Tharu to the west also want the same.  Since all goods and products come into Nepal from India through the Terai, both groups can completely strangle Kathmandu by calling a "bunda" and shutting down the region.  We learned that an election was planned for the next day with all roads in the region to close at 6am.  We decided that the safest thing to do would be to leave the area.  Marion and Joann departed on the night bus for Kathmandu, while Dr. Vijay, Raj, Kate and I took a 6am bus for Chitwan. 

The following morning we took Raj on his first elephant ride as we spent a couple days recovering from the heat and dust of Janakpur.  I called my friend Jason who picked us up in Chitwan for a long ride to Nepalgunj in the west.  Nepalgunj is also on the border with India and very hot.  On the way to Nepalgunj, we came across yet another bunda.  Jason, Raju and I got out of the car to go further into the village and try to figure out what the challenge was.  As I came around a number of trucks parked in the road, what I saw next made me sick.  There was a bicycle that had been completely crushed under the wheels of a truck.  We learned that a 17 year old girl was riding the bike when she was hit by the truck driver.  As is sometimes custom in Nepal, the truck driver backed his truck back over the girl and killed her so that he would not have to pay her medical bills.  The village was understandably furious and had indefinately closed the road.  They had caught the truck driver and would most likely kill him while seeking payment from the trucking company.  I will never forget the images of the girls bicycle. 

As a truck load of surly youth out looking for trouble passed by us, we decided it best to leave the area and find an alternate route.  Several Nepalis moved the stones blocking another road to let us get through to a detour.  Soon after getting back onto the main road again, we came across another accident.  A microbus had gone off the road and rolled.  The deceased driver was still lying on the side of the road.

As darkness set in, it became harder to dodge the many bicycles, cows, goats, people walking and other vehicles that filled the East-West Road that we traveled.  Jason was doing a great job dodging when I noticed from the back seat that we were on a collision course with a Nepali riding a bike.  I was able to croak out  "bike, bike, bike" catching Jason's attention just in time for him to swing the car back into traffic, avoiding an enevitable collision and bunda.

After missing our flight the next morning, we finally caught a flight to Simikot Humla.  There are only 2 flights per week into the Humla region.  The landing on a dirt airstrip perched high in the Himalaya made for a very interesting flight.  I asked the pilots if they ever get nervous.  The response was something like "if you get nervous, you crash."

The Humla is one of the more remote regions of Nepal.  It is in the far NW corner of the country.  The villages are much more spread out than I had anticipated, with intense poverty and food shortages.  The World Food Programme makes regular helicopter flights into Simikot with loads of rice.

Our porter Tsering quickly became our friend as Jason, Kate, Amos and I set off up the trail together.  We quickly climbed to an elevation of 11,000 feet as we headed up the valley towards Tibet in search of the apanga (disabled) of the region.  After several hours of walking, Kate found her first patient, a young boy with a badly infected finger.  I followed two boys back to the village Kate was working on the boy in.  As I came into the village I saw a large crowd up on the roof of a home.  Kate did a great job cleaning his wound and dressing it.  It was getting late in the day so we pitched camp in the next village below.

The next morning we set off for the village of Kyrmie further up the valley.  It was a hot day even high in the Himalaya.  Kate was suffering from bad blisters on her feet as the rest of us suffered in the intense sun.  The evening was spent with Kate showing the villagers her master horsemanship while we pitched camp on a narrow terrace.

The next morning we realized that this portion of the Humla was too remote to effectively carry out our mission for the apanga.  We decided to turn back down the valley and explore the Simikot region better.  Our decision was good as the following day we came across a 12 year old boy who had recently chopped into the top of his foot with an axe, leaving a deep laceration.  Kate soaked his foot for an hour or so to clean the wound, applied triple antibiotic and dressed his foot.  We left dressings and instructions with the family with a promise to check in on him again the next day.  We also checked in on Kate's previous patient and were pleased to find his finger healing well.  The next morning Jason and I checked in on our patient with the foot injury and were also pleased to find that he had been taking care of it.  After checking it, I dressed his foot one more time and left more dressings with him.  He had also picked up some Amoxicillan at the local health post to fight infection.

We spent some time back in Simikot with a group of 20 or so disabled Nepalis who were seeking job training.  I found several very interesting cases with a family that has two girls age 15 and 18 with severe club feet.  The family earns less than $100 or so per year so I feel that it will be a good hand project for the future.  Jason and I also met with several families that had 9 and 12 year old children with cerebral palsy.  I was not sure if they were joking or not when they asked me to take their children with me when I left Simikot.

I will attempt to get pictures up soon if I can find a computer that works...  Next project will be to write about Kate and my experience up in the Solu working at a remote eye clinic.

Thank you all for your interest in Nepal's disabled and the projects that H.A.N.D is currently working on.

Brian

Wow, H.A.N.D has come a long ways in the past year.  At this time last year, we were planning for a 3 month move to Nepal with the entire family to begin researching for our vision to begin working with Nepal's disabled.  We really didn't know anybody in Nepal and stepped onto the airplane with faith that God had a plan. 

When it was time to leave Nepal, Chloe and Everest especially had a difficult time boarding the airplane and leaving their new Nepali family and friends behind.  Huge tears streamed down Chloe's face as the plane lifted off and circled Kathmandu, heading west.  Chloe tearfully looked out the window sitting next to me as a city and land that she had come to love passed beneath the plane.

Now a year later, H.A.N.D has expanded with volunteer medic Kate Earle joining me for a return trip to put last years research into action with a leprosy treatment camp, treatable blindness camp and more research to the remote Humla region in the west.

Since last years trip we have learned a lot.  Nepal itself has changed some with the Maoists winning the elections and coming into power while we watched the many demonstrations and struggle for power from the streets of Kathmandu.

Kate Earle and I will be updating the H.A.N.D blog from Nepal this coming month as we send out dispatches of our work with the disabled as technology allows.

Thank you for taking the time to read this entry. 

Brian