New Year’s Eve

Happy New Year’s everyone. It is not New Year’s here as Nepal uses a different calendar. New Year’s is some time around April (right now, it is the year 2062). Losar, the Tibetan New Year is in February and the Newari New Year was last month...but each and every New Year requires some sort of party...so we're headed off to a party..

We are staying at a very nice hotel called Hotel Barahi—named after the local temple for Barahi, a goddess who accepts sacrifices of goat, chicken and duck. Our hotel is in good company, across the road from Hotel Holy Heaven, down the road from Fewa Lake, and in the shadow of Macchepucchre—a Himalayan peak that stands 2400m higher than the Swiss Matterhorn. It is the only peak in Nepal that is prohibited to climbers. The kids have gradually started to run wild, making friends on the road, finding a litter of puppies (never too difficult), and running a tab for naan and coke at the closest restaurant...

My day starts at the government hospital in the maternity ward and some afternoons teaching newborn resuscitation in the classroom. The first school I taught at has the cumbersome name of Pokara Technical Multipurpose Health Institute. It is a private school which teaches certificate level nurses and heath assistants.

The newborn resuscitation class is divided into a lecture, a CD-ROM session and then a practical session for the students. The lecture gives them an idea about how babies are born, and what you can do if the baby doesn’t breathe right away. The American Pediatric Association has published a programme in textbook and CD-ROM format with straight forward steps on the immediate care of the newborn. In Canada, heath care providers like midwives are required to recertify in this programme each year. Here, there are no regulatory requirements for ongoing practice. I feel like I am spreading the gospel of newborn resuscitation...and I’m trying to not be too preachy...more on that another day.

I taught a few classes of newborn resuscitation at the government school. This school has no resources, and there are triple the number of students per class than at the private schools. The school uniform is the dated sari (try bustling around a Nepali hospital and staying clean in a white sari...) Students are bachelor level—so they have volunteered or worked for at least two years after finishing their certificate level nursing—these students gave me a snap shot into practices in maternity care outside regional centres. One thing I find confusing is my perception of this healthcare dichotomy going on between the acceptance of fate and heroic measures—or any measures for that matter. Howard noticed this as well, working in IUC at the private hospital. Here, the doctors do not talk to the family about not performing CPR on a very sick patient if their heart stops (a do-not-resuscitate order), They go ahead and attempt to resuscitate everyone (heroic measures). On the other hand, there is the pervasive Ke garne? which means ‘What to do?’ accompanied by a shrug and inaction (acceptance of fate or perhaps waiting for orders from higher up). But maybe there is no conflict, maybe the gods’ plan involves heroic measures or inaction on the part of the heath care provider...this is your healthcare provider, this is your fate... Howard’s patient told the staff doctor that he had a dream, and God told him to leave the hospital. The staff doctors said, that’s fine, but until God gives me a dream telling me to discharge you, you’ll need to stay...Then again, not treating a patient because they don’t have the money for further treatment requires inaction on the part of the healthcare provider—healthcare is not provided for free. One student asked, ‘Ma’am, how long do you help the baby?’ I said, ‘After 15 minute of no heart beat, you can stop the resuscitation, the baby has expired. Why? How long do you continue?’ ‘Hours and hours ma’am...’ I’m no closer to an understanding.

But without further delay, to announce the winners of the 2nd Annual Tibetan Carpet Raffle...
2nd prize of the pashmina shaw goes to Bridget, a Toronto midwife...
And 1st prize of the Tibetan carpet goes to Maggie, a Toronto unicyclist, (of the 168 kgs of donated equipment and supplies that I brought with me, a portion of it was made up of 2 donated unicycles for Shree Mangal orphanage. They already had one, and had requested two more).

The Endearing Nature of a Basketcase

Well, due to technical difficulties, the first blog entry has been delayed. We’ve been here almost three weeks, and time has whizzed by...
But first, I feel that I should start with a short update on the political situation here in Nepal.

Justifiably, Nepal has been awarded the “Basketcase of Asia” title from The Economist. And I suspect, if it were not for Swaziland, Nepal could claim that title for the world. The autocratic King suspended the constitution this past February and declared martial law—he placed the government (appointed by HRH) under house arrest. The Maoist rebels in the hills later on declared a cease fire, and joined an alliance of the other six major political parties. Their unified request is for elections. The King has tried to have the audience of foreign governments and the UN—but was snubbed by everyone but Tanzania and Burundi.

In true basketcase form, the Royal Nepali Army receives quiet military aid from the People’s Republic of China (whose present political philosophy is a rendition of Mao’s writings)—and the Maoists, who also claim roots in Mao’s political philosophy, receive money from communists in Northern India and a ‘tax’ they levy on aid projects set up by international non-governmental organizations doing work in their controlled areas.Last week, there was a one-day nationwide strike called by the alliance of political parties due to a military massacre outside of Kathmandu. At a village fair, one soldier became angry with the local boys after they hassled him for bothering the local girls. The soldier returned to the fair later in the evening, and sprayed the crowd with bullets, killing 11 and wounding 19. He was then shot. The leaders of the political parties have questioned whether he acted with or without orders...who killed him...and how could one man acting alone shoot into a crowd from a number of different angles...Since then, there have been demonstrations protesting the shoddy investigation into indiscriminate acts by the military—indiscriminate military acts are usually a little less obvious...

The bandh, or strike, resulted in the delay of a clinic camp at a government school—organized by the SEDIC, The Sherpa Education Development and Information Center. The following alternate date was set and a group of us set out to set up the mobile clinic at the school. Forty children were given treatment for scabies and worms—many more had diarrhea, and a few were identified with developmental delay, infected sores, pneumonia and night blindness due to vitamin A deficiency. The first symptom of vitamin A deficiency is night blindness—then, if left untreated, progressively leads to permanent blindness. It is common for pregnant women to describe severe night blindness as a normal symptom of pregnancy—as the pregnancy exacerbates vitamin A deficiency. All kids tell us that they eat tea, noodles and rice. All of them were stunted in their growth. One nurse’s role was to educate about nutrition—informing the children that a few dehydrated flecks of vegetables in the Japanese instant noodles does not count as a serving of vegetables (just as at home, telling young, pregnant women that the shredded green stuff in their Big Mac does not count as a serving of vegetables).

We’ve since arrived in Pokara, in central Nepal for a one month stint—me at the government hospital and Howard at a private hospital. With the assumption that we are Christian, we’ve been given Sunday off (normally a work day)...Hope everyone is enjoying the holiday season, the snow and the central heat...

The 2nd Annual Tibetan Carpet Raffle

I am heading back to Nepal December 1st...

And it's back...

The 2nd Annual Tibetan Carpet Raffle is back on. If you win, you'll be able to e-shop, with me, in downtown Kathmandu for a Tibetan carpet--colour and design of your choice. 2nd prize is a pashmina (cashmere) shawl--colour of your choice.

Tickets are 20$ or three for 50$...the draw will be December 31st, 2005 and the goods will be delivered back to Canada with me when I return in the spring of 2006 (if you're across the country, I can ship them to you safely with Canada Post versus unsafely with Nepali slippery-fingers post). Your chance of winning will be about 1 in 50...good luck!

All the proceeds go to the midwife-run birthing centre in Boudhanath, Nepal. Interested folks can email me at annlmontgomery@yahoo.ca or mail a cheque to

Ann Montgomery
100 Bain Av, 72 L
Toronto ON
M4K 1E8

Cheques received after my departure but before the draw date will be deposited into an account that I can access by ATM from Kathmandu...

If you'd like to be notified when I've started posting stories about the stay in Nepal, please send me a note at annlmontgomery@yahoo.ca

New Update

Here's a some picture sent to me from Sovita at Nepal Reliance Organization in Kathmandu. She arranged for the last of the fundraising money from friends in Canada to be spent at the health post. The addition of a clinic room above the health post has started and sink basins on the ground floor are being installed. Miracles of miracles, Sovita managed to move beyond the planning stage!

The toilets at the school in Imadole are completed with running water, plaster and painted.

And we sponsored two children for school, and are looking for anyone interested in sponsoring other kids...

We're home

After living out moments that felt like I was in the movie "Groundhog Day"--a very Buddhist movie apparently--we arrived home safely. My cycle in samsara of the Asian continent has now come to a close for the time being. However, I'll post one last blog in a week with more pics...stay tuned.

Hotel California

Lest anyone think that we're back in Canada soaking in a bath, scrubbing the Goan sand out of our pores, I just wanted you all to know that I won't be available to do coffee at Starbucks this week. We are still trapped in Delhi. Standby out of Delhi to Toronto (which has the largest Indian population outside of India) has turned out to be impossible as well as a wreckless disregard for the health and welfare of my blood pressure (usually low). The lovely East Indian way of doing things...so quaint and calming in Goa, makes something like air travel the equivalent of masocism involving sweaty anger and miscommunication. However, we are safe, well-fed, and not out of money--therefore, life is good...Ooooommmmm, ?*!x*! Ooooooooooommmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm

The last blog entry

The last blog entry for awhile

We landed in Goa, on the west coast of India, and are watching the events of Nepal from there. We were in Colva, a fishing village and were staying at Our Lady Vailankanni Guesthouse, named after the patron saint of health—and after only two days,we were feeling better. Then we moved down the coast to Palolem, found a cluster of beach huts, and have settled here until our departure back to Canada February 26th (of this year of course).

This is what I wrote but could not send the morning we left…due to all the long goodbyes:

Now that we have communications, the extent of the situation is becoming a bit clearer, and I have decided we should leave, for awhile at least. We can observe the unfolding of the conflict between the King and the political parties, and the King and the Maoists, from the safe(r) distance of India. It seems that the next two weeks will be crucial as the political parties have now been able to communicate and organize protests to the Royal Proclamation/martial law/Royal coup/state of emergency—whatever you want to call it. The first protest was yesterday and conflicting reports came out as to what happened exactly—I decided to not go and see for myself. But the gist of the message was to restore the one-of-a-kind Nepali democracy.

But before we leave, I wanted to post more about other, more normal events that have gone on here…

KEBS Academy—The kids said goodbye to their school and their friends. Again, they were astonished with the generosity of kids who have the least. They returned home with humble but meaningful gifts of pens, notebooks, and ribbons. I taught my last English conversation class to the senior students, and we played one last game of Quiz Contest in which answers to questions on when the UN was formed, where Mother Theresa was born, and what is the capital of Denmark were shouted out in the unique English of Nepal.

The Toilets—The work at the toilets at the school in Imadol was interrupted due to “the political situation”. The brickwork and the plaster are done and the doors and vents need to be installed, the plumbing and painting still needs to be completed. Sovita, a woman from Nepal Reliance Organization, is going to continue to oversee the work and has promised photos once it is done.



The Imadol Health Post—The small health post in Imadol needed another clinic room. Despite repeated requests for plans and a quote on the cost, they couldn’t get the information to me. This was not due to their lack of enthusiasm but because it is a government organization and therefore, attached to the dreaded Nepali bureaucracy I have sworn to avoid due to their paralytic approach to things. Since I won’t be here for awhile, I passed on funds (and I am sure the accompanying headache) to Sovita from NRO to get the project started. I hope to be back for the opening.

Thuman Village—we couldn’t head back to Thuman Village as we had planned. We passed along money to purchase 4 pressure cookers for families in the village. Beyond the Kathmandu Valley, where Thuman is, pressure cookers require a permit to own as Maoists can use them for pressure-cooker-bombs. However, their intended use allows women to cook grains and beans faster, using less wood. By using less wood, there is less indoor smoke and less time needed to collect wood and less forests are stripped.

The Stupa Hospital—I am proud to say that the Hospital now owns not one, but two stretchers. One stretcher is a simple one that would be best used in the Birthing Centre since women give birth on a mattress on the floor. So in the event of a transport, a woman can be slipped from the mattress to the waiting stretcher next to her, then lifted and carried to the readied ambulance. The other stretcher is essentially a narrow rolling bed that can also be used for an assessment if the Emergency is busy. I hope these items make a modest contribution in reducing maternal mortality in Nepal.

Students at Stupa College—The nursing students moved from the classroom to the government maternity hospital in Thapatali, a neighbourhood in the south of Kathmandu, about 45 minutes away from Boudhanath. By the way, the ones in this photo are fantastic and in no way connected to the story that follows.

At Thapatali hospital, 60 to 80 deliveries take place within a 24 hour period. For the equivalent of 4 days of an unskilled laborer’s wage, a woman receives care for a normal delivery and 24 hours postpartum. Complications are added costs. For another day’s wage, she is required to buy a bag from the hospital pharmacy with her supplies of a syringe, oxytocin, iv bottle and tubing, suture and xylocaine, and pads. If some of these are not used, she can trade them at the pharmacy for vitamins or whatever else she wants when leaving. If she needs more oxytocin or more iv, for example if she were to hemorrhage, she would have to pay the extra cost for these. The women come from all over the valley, some arriving too early, and some arriving too late. The ones who arrive early, start out in ANC-A (antenatal care A). This ward room has beds for 30, and women in early labor or with complications requiring observation stay here. Once labor is established, they are moved to ANC-B. This is a ward room with 16 beds. There, they labor until ready to deliver. Families are not allowed in but they have to provide meals for the women, so the hallways outside the rooms are packed with families sitting on rolls of bedding, wrapped in blankets, or lined up with tiffins of daal bhaat, crackers, and chai for the women.

Once they are ready to deliver, the women are wheeled in the one wheel chair to the delivery ward. There are four rooms. Three of the rooms have three tables on which to deliver. The fourth room is the clean-up room where instruments are scrubbed and sterilized by female staff in uniform saris. They round up the buckets of instruments soaking in chlorine solution at each delivery table after each delivery. Gloves are washed, powdered and hung to dry before being sterilized again and again.

In the delivery room, the woman climbs out of the wheel chair, and up onto the table. The women wear their own clothes while in the hospital, so helping them unwind from their patuka (5 meter cloth belt), unravel their skirt, and hike up their petticoat, all on a wooden table half a meter wide, is a challenge. Luckily, they are as remarkably agile as I am clumsy. Four (!) students assemble to conduct the delivery, and another 10 may crowd around to observe—if there aren’t nine or so simultaneous deliveries taking place. Two students glove up, one junior and one senior, to catch the baby, one student blankets the women in a flannel to receive the baby, and one student readies herself with a syringe to give the woman a shot of oxytocin once the baby is born (to minimize bleeding) and listens to the fetal heart after every contraction.

In one of the first deliveries I attended of a first-time mother, she was pushing the baby well but everyone joins in coaching her nonetheless. The deafening cacophony of “go-go-go-come-on-go” rises, and I have to raise my voice to give the students instructions. If it were not for the bucket of chlorine at my feet causing my eyeballs to blister, I would be reminded of a particular moment in the Peel Pub involving beer and not birth. The junior student looks at me and says “Ma’am, I think it is too tight (meaning: I think I should do an episiotomy)”. “Really? How can you tell? (meaning: the baby’s head is no where near the woman’s bottom yet, so how could you possibly tell that the perineum is too tight?)". She wobbles her head and goes back to coaching the woman to push harder. “Now Ma’am?” “Now what?” “I do the episiotomy now, Ma’am?” “Little sister, what are the indications of an episiotomy?” Like are star student in Quiz Contest, she lists them verbatim from the World Health Organization’s Manual on Safe Motherhood. One indication is fetal distress. “Well little sister, is there fetal distress? You haven’t listened to the baby’s heart for…10 minutes (a bit too long a wait).” “Yes, Ma’am.” They listen to the baby’s heart with a dented but functional aluminum pinard horn (I am doubtful that one could hear a little baby’s heart beat over the noise in the room). This goes on, and together we rule out all the indications for an episiotomy. Meanwhile, the woman continues to push effectively. But as the baby’s head ploughs towards the woman’s perineum, the student reaches for the episiotomy scissors and blankly looks at me but doesn’t say anything. The others students continue to yell at the woman while looking at one another, worried there will be some sort of obstetric showdown between the foreigner and the star pupil. The chlorine fumes continue to rise from the bucket at my feet and now my trachea feels like it is dissolving. The next contraction begins, the woman gives a push and the student and I snap to attention to deliver the baby’s head, she still holding the scissors, me, blinded by fumes and coughing. Thankfully, the baby was not dropped into the bucket of chlorine and the woman, for her part and not any help from us, sustained only a minor tear.

I learned to move the chlorine bucket away from my feet and towards someone else with iron lungs.

We leave today and we are so sad about it. Aaryn said last night that he wishes he could bring Nepal to Canada or Canada to Nepal. I understand what he means. Right now, we are headed to the Stupa before catching our plane. Everything is completely calm in our neighbourhood. Losar, the Tibetan New Year, is going ahead unhampered. The Stupa is packed and new prayer flags are being raised for the New Year…

Here are some pics of the folks who have been so helpful…

The canteen staff who made the production of lentils and rice an act of love each and every day and used precious gas to make the Lipton Noodle Soup sent from grandparents in Canada.
< The guard and his family who took telephone messages, received packages, swept the dust from the stairs, emptied our garbage (never once commenting on the plethora of Toblerone wrappers) and retrieved badminton birdies from high hedges. The students at the Stupa Girls’ Hostel who immediately treated us like family, giving us up-to-date cultural interpretations of the events around.

Rushme in the financial office at Kai and Aaryn’s school, who helped the kids settle in and became our friend.

Ranjit and Changa’s family for also helping us to get settled and turning us onto badminton.

The canteen staff at the school who fed the kids well—homemade samosas, noodles, fried chips and of course, chai.

The Stupa Tibetan bread women—who provided nutritious snacks on the way home from school.

The porter, a.k.a. the patron saint of panicking mothers of feverish girls on high mountains, who carried Kai up a vertical ascent the equivalent of a double black diamond ski hill in the Rockies.

The women at the internet shop who provided service during strikes, provided cheap international phone calls, and stayed open late once communications were restored.

Sovita and the rest of the staff from Nepal Reliance Organization who got us settled and oriented because arriving in Nepal can be a little disorienting.

Alvin Sim in Ottawa who posted photos because I was too lazy to learn how to do it myself.

My dad, who helped me get to Kathmandu, and raised money once back in Canada for toilets for village children…

The staff at the Stupa Hospital who take care of women in a country where the profound event of birth is a polluted event, celebrated only if the baby is a boy—and therefore, the honourable profession of midwives is reduced to—at best, handmaiden to the doctor, and at worse, in the category of the untouchables.

Leaving Nepal

We've left Nepal for India in order to watch events unfold from a safer distance...we'll update everyone once we have a minute.

State of Emergency

Tuesday February 1, the Nepali King placed the government under house arrest, declared a state of emergency, closed the airport, cut phone and internet, and broadcast himself (repeatedly) making an unmoving speech saying that for the next three years—he was the government as the one (he previously appointed) was corrupt and did nothing to remedy the present ‘political situation’. The next day, he appointed new ministers. Five days later, there was an hour or so of local calling, and today, international calls and internet has (temporarily?) resumed. During this time, we were safe, and managed one satellite phone call home to reassure everyone that we were fine…Because of the change in the ‘political situation’, we are planning to come home earlier than planned.

Things I learned during a state of emergency:
-babies are still born
-as there is no news, and rumours are unreliable, just pack a bag and sit tight, things will probably get better
-in choosing a taxi driver, never, ever, choose a driver who wears his baseball cap backwards. If you don’t die in an accident, you will surely sustain a concussion, or the very least, a broken collarbone from being thrown around the backseat.
-the cost of a taxi ride from an area of high concentration of military to an area of low concentration of military is three times higher. Conversely, the cost of a taxi from an area of low concentration of military to an area of high concentration of military is ten times higher. If a curfew, or rumour of a curfew, is approaching, choose a Buddhist looking taxi driver, as delivering a woman to her children is considered to be excellent karmic points.
-always have enough food and water for 4 days. Although this was never necessary, it was the advice I received from the Canadian Co-operation Office (the mini-embassy) once local calls were restored.
-if the BBC is broadcasting Bush’s State of Union address, updates of the Pope’s health, and whether Beckham has lost his form, nothing really, really bad is happening in Nepal. If the BBC station is replaced with Nepali music, something really bad may be happening Nepal.
-don’t bother with retrospective analysis…such as, “Oh, that is why, just last week, the government of Nepal shut down the Tibetan Office used for processing and settling the 1000 Tibetan refugees who walk over the Himalayas in the winter to escape the Chinese oppressors—so that the Chinese government wouldn’t criticize the King for stepping into the role of dictator…” or “I wondered why I was frisked and politely asked to pass through a metal detector to walk into the bank…it’s the new normal I guess…”
-while pausing what you’re doing, the sound of horns beeping is reassuring and the sounds of no horns beeping is non-reassuring.
-carry cash. ATMs and Visa don’t work.
-don’t waste your cash on a newspaper as you will just read the King’s speech reprinted verbatim. You can also read that journalists are reminded to not criticize the King. Or, you can read reprinted articles from Delhi, Dhaka, and New York about how to lower the fat in your diet (Nepali diet is 90% carbohydrates), improve your study habits, or encouragement to start planning for the wedding season now.
-don’t discuss politics (or religion or sex for that matter) as someone could get in trouble. In King versus the Maoists—one can find oneself in trouble for holding any opinion—it is best to talk about fat in the diet, study habits, and planning for the wedding season. Know that during a state of emergency, the constitution is suspended so Nepalis officially (as opposed to unofficially pre-state of emergency) cannot offer their opinion, cannot demonstrate peacefully, or get together in a group. They can be arrested as a preventative measure. Their property can be confiscated and bank accounts cleaned out. They are, however, safe from being exiled or killed by the state after a fair trial (capital punishment). But if they are an immediate threat, there would be no trial and execution can just take place.

Clinic Camp

About 40 Hindi-speaking families from north India live a short walk from our hostel. They came here to find work (apparently, it is all relative) in the form of begging, shoe shine, and cotton mattress stuffing. Five kids from this camp go to Kai and Aaryn’s school. They receive sponsorship for school fees, uniforms and books. They have all lived here for about 5 years. When one of the boys became sick, I was taken to their home and was introduced to the squalor of living in a tent.



With donations from SEDIC—The Sherpa Education Development and Information Center, a 12 women run community organization—one doctor, one nurse, a security guy and myself, went back to the tents for on-site clinic care with two buckets of medicine. Again, as in Thuman village, looking around, it is easy to become cynical and discouraged because what is the point of treating anyone if they have no clean water, and everyone has something to catch. But at least in Thuman, there is that “poor-village life” “celebrated as the natural, happy domain of man (sic) by thinkers from Lao-tzu to Gandhi”—I read it somewhere.

A latrine has been set up at the edge of the tents. Cooking is done in the tent over a kitchen fire. The tents are open to one side and blue plastic tarp and bamboo stakes form the back and side walls. The tents regularly burn down and need to be built again.



In the center of the tent community is a pump for water. Washing dishes and bathing are done here. Every tent contains an extended family, everyone is called auntie, and many husbands are gone. Women and children make up the begging contingent and young boys, the shoe shiners, and the few men, the mattress stuffers.

Eighty people were assessed for upper respiratory tract infection, worms, diarrhea and vomiting. Two women were referred to hospital for more tests. For those with minor complaints, cough syrup and eye drops were handed out to ease the symptoms of cooking over a kitchen fire.



Unfortunately, with these folks, breastfeeding is not a valued form of infant feeding (unlike everywhere else in Nepal, infants are breastfed until they are two years, and solid foods are introduced at 6 months—just like the World Health Organization recommends). There is a product here called Horlicks—it is a malt drink to which you add water. Many people like to feed it to their children and children like it because it has sugar as the first ingredient. Whether or not there is any special nutritional value—when you add dirty water to it—it will make the child sick. At the tents, mothers like to give it to their babies, and after a few days, the mix is finished, the mother’s milk supply has dropped and the baby often won’t go back to breast. So she needs to get more Horlicks—which is of course, expensive—kind of how I perceive the cocaine situation in Manhattan.

Though as discouraging as it could be, there are little treasures of hope. The five kids going to school work hard and do well. I marvel at their clean uniforms that put my own uniform-washing abilities to shame. In the tent we used as a clinic, there was a poster up of the Devanagari script—used for both Hindi and Nepali—just like any attentive parent at home would have. And they are all a very gentle, scrappy bunch who help each other out when one of the tents burn down or when a windfall of Horlicks or rice come their way.

Thuman Village

We went to Thuman Village with a student from the Health Institute who wanted to go back to visit family and do a health assessment project. Pasang is the first and only girl in her village to receive education beyond grade 3. With the help of sponsors, she is completing her Health Assistant Degree next year and will takeover the health post in her village (presently, it is staffed one day a month by a Nepali-only speaker).

In this district, the majority ethnic group is Tamang. They speak TamIang which is similar to Tibetan, with the same script and very different from Nepali. My guide book describes them as relatively recent arrivals to Nepal, probably Tibetan horse traders. They have kept their Buddhist and folk beliefs due to their isolation.



Thuman Village is in the District of Rasuwa, on the border of Tibet, and at the edge of Nepal’s Langtang National Park. From Kathmandu, it is one day by land cruiser and one day walking. There are 60 family homes clutching the side of a small mountain facing Langtang Peaks. Surrounding the village are terraced fields for wheat, millet, barley, rice, potatoes, radishes, and greens. The homes of another 100 families are scattered around the village. They are farmers and weavers, occasionally portering before the tourist industry collapsed due to the civil war. A days trek away, they buy kerosene for lamps, and oil, salt and red chillies for cooking. They trade rice for cloth and animals in Tibet. It is a children’s paradise as there are many baby farm animals, toilet facilities are in the field, you eat by a kitchen fire, you sleep in your clothes, and you never bathe. However, it is a public health nightmare. Everyone has lice, intestinal worms, runny noses and eye infections.

Each home is two stories, the ground level for farm animals, and the second for the family. The ladder up to the second floor leads to a porch, and into a low-doorway which is more like a long window. The other opening is a small window at the front of the house. Both are closed by wooden door that open inwards in case the village is snowed in. The home is one room, with two platform beds, and a mud hearth on a wood floor. There is no chimney and it is only by Pasang’s mother’s deft fire building and maintenance skills that we were not constantly smoked out. Regardless, everyone in the village complains of eye irritation and chronic upper respiratory infections.



For the trip, we were a cast of characters-the three of us, Pasang, her mother and aunt, her 4 year old nephew and 9 year old niece, her brother on winter holiday from the monastery in Dharmsala…and one porter for, err, my bag (but in my defence, I brought some equipment, supplies, and gifts). Half way up the mountain, Kai became progressively more whiney, and then on a break at the ridge with a beautiful view, I realized she had a fever, and she had that feel of wet noodles-floppy. This gave me pause as we were far from anywhere (not that I have developed any particular faith in the health care in Kathmandu). Aaryn was in good shape and sprinting ahead, sprinting back to us to tell us about the upcoming view or how steep the ascent was around the next corner. So I decided that-and I hesitate to admit to everyone reading this-we would move ahead, with the help of another porter who appeared from nowhere. For 2 hours, he carried her up the steepest part of the trek while she slept on his back. Along the way, Pasang’s aunt collected a bottle of fresh milk to help her recover. When we arrived at the village, I tucked her into her sleeping bag then sat beside her, watching the family get organized, completely dumbfounded as to how primitive it was. Someone handed me a mug of hot balo, a fermented wheat mash with a kick, and then a plate of cooked greens and chillies with tsampa, a cooked barley polenta-like mound. Pasang’s mother, after this 7 hour vertical trek, went and brought back a huge jug of water from the public tap, and continuously had a pot of salted nak butter tea kept hot by the fire. Aaryn was unphased and gradually moved closer to the fire as the temperature dropped to minus 10 Celsius.



Kai slept through the night, and her fever broke by the morning. She slept through the sight of snow that had fallen and didn’t participate in the snowball fight with the kids wearing only their sweaters-no jackets, no mitts. Pasang’s grandmother arrived with 6 precious eggs to help Kai get better, and a brew of greens from a plant that brings down fevers. She ate some eggs and slept. She awoke that night with gifts of peanuts from Tibet, candies from Kathmandu, and coveted instant Japanese noodles next to her bed.

Aaryn, meanwhile, disappeared into the fields with various relatives to bring back the remnants of an ox for next day’s meal, and herd chicks that had wandered too far from the house.

Our arrival had been announced at the Gompa, the two-room monastery perched dangerously close to edge of nothing. There was an evening of chanting and bell ringing and candle lighting going on. I was introduced and people were told we were there for a needs-assessment health study (I have no idea how that was exactly translated into Tamang by Pasang). They laughed and stretched their arms around-as if to say, “What do you think?”

From interviewing the women, Pasang came up with a list of immediate and long-term plans. As with anywhere you go, medicine was expected to solve the problem and looking at larger issues, such as sanitation and the respiratory ravages of a kitchen fire are not obvious to the community since this is the way it has always been. One guy explained to me that every time he drank balo, he’d throw up-did I have any medicine for him? “Well…” the monk/translator looked at me “…even I could figure that out,” he said.


There is no recognition of a need for maternity care, as it is not considered a ‘sickness event’. Postpartum care, as is the case everywhere in Nepal, is non-existent, yet 60% of women who die of maternity complications do so in the first few days postpartum. Discussing maternity care was embarrassing for them, and the whole birth, as with the Hindus to the south, is one big polluted event, and everyone has to have a good clean-up afterward-though in this village, the woman is not supposed to bathe until 7 days after the birth.

We made plans for a return trip to the village with more useful items. We made the trek down after receiving gifts of rice, corn, potatoes, and walnuts. Pasang’s mother had packed us food for the hike, roasted soy beans and popcorn, and cooked potatoes. We were hesitant to leave, not only because of the bone-crushing, concussion-inducing, vomit-producing land cruiser ride ahead of us, but because these people were so welcoming and kind to us. We look forward to the going back…

Imadol Toilets

Prior to construction, the view from the latrines at High View School.

As the money from my dad’s internet fundraising campaign entitled “Toilets by Monty” or CRAPCAN—as spin off from RAPCAN (Retired Airline Pilots from Air Canada)—arrived quickly, sufficient funds were available to start work. Plans were drawn up by the engineer who designed the Stupa Saangha Hospital.

The construction on the toilets began last Sunday. There will 4 toilets, septic, and taps with water coming out of them. The brick work from the existing latrine was taken down and a new foundation was laid. Bricks in good condition are scraped and stacked for reuse.
The framing for the doors have been put up and the hole for the septic has been dug. Water is pumped in from a well and taps will spurt water for washing—drinking water will still need to be brought from homes—already boiled and filtered.



Everything is done by hand—the taking down, the putting up, the digging and the scraping—and yet moving along at a pace that the Nepali government bureaucracy could learn from (I renewed our visas and with the different departments, and the confusion that Kai’s birthday caused—she’s now 10 and therefore I have to pay but only for the time that she has been 10 which would be a percentage of the time for which I am renewing the visa which would be how much? Who should we ask? We have to wait for the supervisor to come and then the supervisor could ask another supervisor…Ma’am do you want chai?...Once home, I note that each stamp in each of our passports bears a different re-renewal date (?)). Ke garne? What to do? This is the Nepali National slogan, said with a head wobble that means “yes, no, maybe” to indicate that life overwhelms, and it is time to order chai again.