After the blood comes the tears

“After the blood comes the tears”

This was a quote by a Nepali villager who was attending a unique photographic exhibit of images that chronicled the 10 years of war in Nepal.  This quote was selected to be on the cover of one of a trilogy of books* edited by Kunda Dixit (Editor of Nepali Times) and now displayed in a unique gallery in a corner of Patan Doka.  Kunda was kind enough to invite myself, Jason, Bibiana, Darren and Shona for a guided tour of the gallery.

*

p://www.nepa-laya.com/eventdetail.php?id=60

The images below are a sample of how the gallery is set up.  The framed prints were published in the first book [A People’s War].  These images were toured around the country where scores of Nepali people wrote comments as they viewed the images.  The second book [Never Again] was a compilation of the written comments (including the quote above).  While touring the images people identified people in the original pictures.  The third book [People After War] pairs the original images with updated photos and stories of the people ten years later.  The story of Gita Giri is one poignant example.  In the original image she is photographed grieving over the body of her husband.  Ten years later she recounts the vividness of the memory of that day.

To fully understand Nepal it is necessary to understand the reality of the legacy of a decade of violence and to believe that the path leads to sustained peace.  A trip to the Dixit Gallery in Patan is a good start.

Mero Mutu Mero Kala

I announced the  “Mero Mutu Mero Kala” (My Heart, My Art) contest at the lecture this week.   This is an opportunity for the students to conceptualize artistically what they are learning about the cardiovascular system.   Last year we had 35 entries from the class of 60 students.   They submitted amazing paintings, sketches, poetry and a spectacular music video that summarized one of our PBL Cases (www.youtube.com/watch?v=HlZ0aDS2TfE).   

I’m excited to see what this year will bring in terms of artistic creativity.  I have also asked the students to submit a logo for the contest and we will select the best one to adopt for this contest.   I’ll keep you posted.

Kakani National Park

We have Wednesdays and Saturdays off.   Last year when we were here Bibiana, Jason and I got in the habit of going into the surrounding hills for a few hours to clear our heads of the smog and noise. 

Our close friend Bishnu Rai (Himalayan Sunrise Trekking) organizes our day walks.  On Wednesday he picked up myself, Jason, Bibiana, and Sushila Rai (our colleague from PAHS) and we drove about an hour outside of the city.  The road, like most outside of the city, becomes quickly steep, narrow and windy.  It is still raining as the monsoon tails off and so from time to time we were slipping in and out of ruts of mud.  I was thankful Bishnu had organized a four-wheel drive jeep as there are no guard rails and these roads are barely perched on the steep hillsides.   

We arrived at a National park called Kokani (yes it is pronounced like the beer in BC).  Our first stop was a monument to the hundreds of people who lost their lives in the crash of a Thai Airlines jet in the 80’s.  It was both chilling (to see how many died) and a stark reminder of the fact that air travel into and out of such a mountainous country retains a certain amount of risk.

The first half of the trek was literally slashing our way along a tiny jungle-like path that was completely overgrown with vines and undergrowth.  As expected we all had a few stray leeches in our socks and on any exposed skin.   The cicadas were deafening and the temperature ricocheted from steamy and hot to cool and pleasant when we got out on the ridge in the breeze.

We walked for about 5 hours along a ridge.  Mostly thick clouds that drifted around us like thick smoke embraced us.  Occasionally we caught glimpses of Kathmandu city.  From that high up the city looks beautiful if you ignore the yellow haze of chronic air pollution.   It is easy to see why early visitors to Nepal called this valley Shangri-La.

Chics and other diversions on our day off.

Chics!

A pond on the royal grounds, filled with squirming eels!

Street scene in Thamel (tourist district in KTM)

Street sign for copies of the Toronto Medical School Notes!!!!

On our day off Bibiana, Jason and I decided to take advantage of a Banda (a strike that bans local motorized traffic) and walk  from Patan to Thamel, the tourist region of KTM.  We left at 8am and it is about a 60 minute walk.  When there is no traffic and the air is clean and rain-washed it harkens back to the KTM of about 30 years ago.

We were spellbound by the Royal Ponds filled with squirming, splashing eels.  On the far right on the "cute scale" from eels we also saw boxes of fluffy chics for sale.

Like Cindarella at midnight however the spell was broken and at 10am the Banda was lifted and the  traffic and pollution returned.

Lights Out

When you have limited electricity you make the most of daylight. 

Here people are asleep early and awake at first light. 

Really first light. 

The rooster wakes us up at 4:45am and we roll out of our beds and by 5:30am we go out for a morning walk through Patan.  The light is that grainy pre-dawn monochrome and it is clear we are already late comers to the street party.  Students in their school uniforms and back packs are already on their way to schools, shop keepers are open for business,  if you walk through the street markets pungent meat is already slaughtered and colourful vegetables and flowers are artfully displayed for sale.

Daylight is a precious commodity when rolling brownouts limit electricity every day.   During monsoon, with lots of hydro-electricity available, the times without electricity are limited to two 4-hour periods a day.  A schedule on the wall tells you on any given day which hours it’s on and off.  Once the monsoon rains stop however and Nepal needs to rely on India to import power, the cuts can be up to an astounding 16 hours per day.  Rumours are swirling that this winter it may be up to 20 hours per day without power.

If you are a student that leaves little time for studying outside of daylight hours.  Access to Internet and searching for resources online are similarly restricted.  If you are lucky you live in a residence or your parents home, that has an inverter and you are supplied with auxiliary power during the cuts.   If you aren’t, you study before the sun goes down or in the few hours that power flows into your house.

Try it sometime.  Limit yourself to 16 hours of electricity and to make it more realistic make at least 8 of them in the middle of the night. 

Now I know why I get emails from my Nepali colleagues in the middle of the night.

Day One

Day one

Nine expectant faces in a decidedly hot tutorial room.  We introduced ourselves: what will we each bring as a strength to the discussion and what will we each need help with.  Strengths were varied: love of physiology or pharmacology, drawing diagrams on the board, creating summaries or flow charts, good listening skills, asking good questions.   On the flip side they would need help from each other with physiology, pharmacology, drawing on the board, speaking English.  Commonalities were established and the beginnings of rapport were established.

They established ground rules for our group (pretty standard PBL behaviors) and we were into our first case.  Their enthusiasm was wonderful.  No shortage of discussion and definitely no lapses into silence.

An hour later I gave my first lecture.  The classroom is hot and small and three students share small tables lined up in three tight rows.  Fans are running constantly to move the hot air around but that means that we need to use a hand held microphone that is awkward for teaching and the acoutistics are marginal at best.  Despite that the students seemed remarkably attentive and we took frequent “speaking Nepali” breaks where they could discuss in their own language what I had just taught them in English.  Those islands of comprehension were vital as it gave them some time to test their understanding and to be more active in the learning process. 

Meeting a new class for the first time is always a bit daunting; until you take each other’s pulse (figuratively) and get the temperature of the room; warm reception or cool, serious or relaxed.   I feel that we are off to a good start.  I’m grateful to be here.

That's the funny thing about "shuffle" in iTunes; you never know what will come up.  Here I sit in my apartment in Patan bathed in sweat listening to Bing Crosby sing I'm dreaming of a white Christmas...

Christmas and snow couldn't be further from my mind.  Heading into another round of 5 weeks of teaching is occupying most of my frontal cortex and a fair chunk of my limbic system if I'm being honest.  Last year I approached this with the unbridled enthusiasm of someone doing something brand new.  This time around I am in no way less excited, just a little more daunted by the task ahead.  I know where we fell down last time around and I'm (frankly) scared about making similar mistakes again.  

As if to allay my anxieties I promptly ran into two of my favorite, now second year "Batch 1 students", that I taught last year.  They virtually exploded in delight when I walked down the hall towards them.  "CA mam you're back!!!"  They explained that they were getting ready for their comprehensive exam including cardio and could they sit in on my lectures this year and possibly have some one on one tutorials to cement their cardio???   

Yep this is why I do this.