The Annapurna Circuit

My final blog post, and written from the US!  The Annapurna Circuit was a significant part of my final travel days, so I thought it important to include it. When I planned this trip, my main interests were to work my way through South America and to hike the Annapurna Circuit. I had been in Nepal, briefly, in 2003 and knew I wanted to come back specifically to do some trekking. This particular trek is the one everyone raves about. It is supposed to take between 2 and 3 weeks and passes through the Annapurnas - all in the 7000 meter range and goes up to a height of 5400 meters at the Thorong La pass. Well, I didn't want to do this on my own (too many trekkers "gone missing" and landslide stories), but didn't want to go on a guided trip either. How I hate the tour group! It ended up somewhere in the middle and was just perfect. I met Ash from the UK and we set out together, then met Edward from NYC on the bus, picked up Matias from Buenos Aires on Day 2 and then Day 4, a couple from Vancouver joined our group. Actually, since this was hut to hut trekking through tiny Tibetan villages it was so easy to meet other trekkers. We knew everyone on the trail by the end - lots of collections of solo travellers, sticking together to help each other out. Quite a nice community really. And you do need a supportive community out in the middle of nowhere with little access to ANYTHING! Some got altitude sickness, some got Giardia, lots had GI problems - water and food were a little sketchy and well, you name it. My medical advice was called in several times and I even required a little assistance myself (came close to helicoptering out when I came down with a flu-like illness and I fell behind my trekking partners.) Thankfully, everyone in our group made it. 

The pass at 5416 meters (17,769 feet!) was tough, unlike anything I have experienced. The body feels so strange at high altitude - it is like an "out of body experience". I kept saying that I felt like I had been invaded by aliens. 

A few steps, breathe, a few steps, breathe, wow those clouds looks so pretty, I just want to sit down and not get up. I've heard that from others - that is a common experience of mountain climbers, you just want to sit down and not continue, and you don't care. This definitely happened to me! I stopped to put on more clothes near the top and fell behind my friends. I looked at them and thought - oh, they are so far, I'll never catch up. That's ok, I'll just stay here. Weird how it works on the brain like that. Thankfully, I saw Michelle waving me on - we're at the top! (after many false summits). OK, I thought, I just have to make it that far, I can do it. Whew! We did the same for a Swiss couple coming behind us who were struggling. Everyone over the pass that day had a big dinner together that night. And we proceeded to celebrate for several days with big steak dinners. Amazing experience!

Meditating in McCleodganj

McCleodganj - Dalai Lama's home in exile.  It is also home to many people from around the world and travelers hoping to rub shoulders with His Holiness, or just capture some of the spiritual sense that surrounds him and his fellow Tibetan monks.  So, while in McCleodganj, there are activity choices like: meditation classes, meditation retreats, massage, massage classes, sound massage (?), astrology, reiki, yoga (SO much YOGA) - yoga classes, yoga teacher training, yoga retreats... I actually met a group making a Documentary about travelers in India seeking spirituality.  They all come to McCleodganj.  Well, of course, I didn't want to get left on the sidelines! So, I signed up for a silent meditation retreat.  There was a Vipassana meditation center which holds a 10 day silent retreat.  But it sounded so intimidating - no reading, no journal writing, no listening to music on your ipod, no eye contact!  I opted instead for the 3 day meditation retreat at Tushita. 

  And it was - great.  When in our lives do we get to slow down like that?  And it turns out, even for an extrovert like me, silence isn't so bad.  It's funny, when you know you can't talk, and neither can anybody else, it takes the pressure off.  Like, whew, kind of nice to not have to make small talk with this person right now.  Also funny that you can connect with people in silence - of course eye contact helps, and I liked the thumbs up. 

Meditating on your own is one thing, but there is something extraordinary about a roomful of people meditating together.  Very powerful.  And when we chanted together - Wow.  Amazing experience, and I think I can take on the 10 day course now!  Oh, one thing I forgot to mention about the retreat.  This center was in the middle of the woods and surrounded by monkeys! They had caught on to the fact that there were humans hanging out at this place every day and had become very aggressive and creative in trying to get food.  Needless to say it was a constant challenge to meditation practice.  They ran around on the tin roof, whizzed past the windows and once even opened the door of the meditation room and grabbed a participant's purse to get her chocolate croissant! 

GERD, Goats and Ganj: Medical Care in Himachal Pradesh

Volunteering in Himachal Pradesh, Take Two. The medical side of the month was an interesting challenge in it's own right. HHE has been in existence for many years and is a tightly run operation. There are designated sites - rural villages that are remote to get to and, therefore, have limited access to medical care. Our entourage, a caravan of 8 loaded white 4x4 vehicles which looked, unfortunately, a bit like the UN, rolled in, set up our mobile medical unit and went to work. We did see a lot of patients and I think, I hope, we helped some of them. We were a bit limited in diagnostic tools, but did our best. We treated lots of GERD (acid reflux) and osteoarthritis. For complicated problems we gave our recommendations and hoped that the patient would follow up with an Indian specialist. One neurologic patient even was given some money to ensure they did, fingers crossed. The medical students were amazing - smart and dedicated and, well, we all had to be flexible and creative. Gyn and rectal exams behind makeshift curtains, delivering nebulizer treatments to asthma patients with precarious electrical outlet connections, running instruments back and forth to each other. We saw patients in a variety of settings. One memorable site had a baby goat rolling around in the medical tent while we were seeing patients and, at the very same site, marijuana was growing wild everywhere including in the medical tents! I wish I had a photo of that scene - patient care in the midst of goats and ganj! The patients were quite diverse despite being in the same region. Besides patients from traditional Indian mountain villages, we treated monks at two different monasteries and spent 3 days seeing Muslim goat herders from Kashmir. At all of the sites we were close to breathtaking views of the Himalayas!

From Sahoo down to Chamba: Life on the Road with HHE

For the month of April I had signed up to volunteer with a US-based group, Himalayan Health Exchange, which provides medical care to rural villages in Himachal Pradesh, India. I was a bit apprehensive about returning to medicine (after 6 months away), teaching medical students and travelling with a big tour group after so many months on my own. Well, it turned out to be a great month, though not without it's challenges, of course!
The toughest adjustment did not turn out to be working in medicine again, or teaching students, it was being part of a group of 40 people and being told what to do all the time. So tough after 6 months of living the care-free life of a solo traveller! Not only were we travelling together, eating together, working together, but we lived in tents back to back. So much togetherness! So little privacy! Despite this harsh adjustment, they really were a great group of people to be "stuck" with. I enjoyed them all and we had (sometimes too much) fun. Bonfires every night, whisky always being passed around and, if we were lucky, we got a music performance by our drivers/interpreters which occasionally errupted into a dance party.

Our typical work day... Up early for hot water bucket baths in the shower tents (This was luxury camping!). Giant breakfast - our cooks were phenomenal. I think I gained 10 lbs this month, no exaggeration. Off to clinic - patient care all morning, lunch break, patient care all afternoon. Sometimes we finished early and had time for day hikes, jumping in the river, checking out the mountain village near our campsite, afternoon chai. Then dinner, sometimes a medical "lecture" and, of course, bonfire party time.
Well, even though we had drivers and cooks, who did nearly everything for us, we did have to do our own laundry in the river and put up with the joys of pit toilets. Can you imagine?

A couple of my favorite vignettes from the month...

The month did not have the most auspicious start... I arrived in Delhi, spent the night at the "assigned" hotel and got up early the next morning to meet the group. We hadn't actually had time to meet, but were hustled into jeeps to the train station. In the bustle of the train station, and trying to introduce ourselves to each other, some names were called out, mine included, and we were told to go to our assigned car. One of my "car mates" looked at the number on the train and on the ticket, which were the same, and was convinced that the train sitting there was our train. I was sceptical since it seemed like a local train and was early, but he said he was travelling in India for the last month, so I trusted him. The six of us got onto the train, stored our bags and, moments later, it started to move. We then see the rest of our group on the platform waving their arms indicating that this was not our train. The same guy who told us to get on the train now said we should jump off - now! But wait, guy that I just met who is telling me what to do, the train is moving! The other 3 women jumped and were successful. So, I went ahead, bags in hand. I was not so successful. In retrospect, I now know how NOT to jump off a moving train, that is for sure. But, since this was my first time... well, it's not as easy as it looks in the movies! First of all, don't jump with heavy bags in your hands. And second of all, don't just jump onto your feet as if the train were standing still - you have to run! I fell hard on my elbow and knee and was sure I broke my arm. Great, what a way to start off the month! I was able to move my arm later that day, though now I am convinced it was a hairline fracture as 2 months later I still have trouble leaning on it. We later found out that the guy who told us to jump has jumped on and off trains many times in his life and he said we were at the "upper limit" of possible. Nice!

One of my favorite moments of the trip was a day I didn't go to clinic because I wasn't feeling well. I was walking down the road and passed a group of women sitting by the side. They were road workers (all the heavy laborers here seem to be women) and were on their lunch break. They called me over to join them, and I did. We had a lovely time, laughing. It is amazing how you can communicate without language! I took some pictures and they made fun of the pictures of each other. It was all fun and games until the boss-man came over and told them to go back to work!