The Taj Mahal in July

To the Taj in the early morning and then on to Jaipur

This journey through Nepal and now India is nearly at its end.  After a short visit to New Delhi, the group visited the famous city of Agra, home to the more famous Taj Mahal.  It is as spectacular as everyone says it is.  After an early morning visit tothe Taj, when the air is cooler and the light more subtle, the group moved on to Jaipur, located to the west of Agra in Rajasthan, home to desert, camels and legendary Rajput palaces, beautiful princesses and kings. 

In the photograph to the left, back row, are Charlie Davisson, Patrick Lowder, Corbin Cleary and Ryan Gott.  The front row includes Jessica Najarian, Megan Kack, Gar Kellom, Jamie Utzinger and Liz Carroll-Anderson.  Patrick, Ryan and Jamie will stay on in Jaipur to teach for a time; the remaining group, joined by Sarah who is still in Kathmandu, will return to the U.S. on Saturday, July 24. 

Reflecting on the experience of these past weeks, Megan Kack writes, “The best journey’s are the ones that answer the questions that you did not think to ask in the beginning.  My trip . . . has led me to ponder, question, grow, and form new perceptions of my everyday situations.  Mostly, traveling to a foreign culture and region, illustrates how the heart can be filled anywhere on earth.   The importance of my upbringing and the values and curiosity instilled in me at a young age remain.   Therefore, I have been contemplating a quote of my hometown author Bill Holm:

‘What in fact had I been taught in Minneota, this dot of former tall grass prairie, I, 1969.204 feet above the sea, midway between oceans, night and day, ice caps and jungles?  I had been taught the possibilities of desire, how its varieties act themselves out in a human life anywhere in the universe, not only in a nondescript small town far from anything that mattered much to the general culture.’

Megan continues, “As I further contemplate the greater difference that I can make, I begin to wonder who I am making a difference for and on what scale I can contribute to others.  In order to even begin to describe my growth  . . . I must express my appreciation to my parents and siblings for their support and encouragement throughout the years.  It took me to travel to East Asia and back and to South Asia away from the comforts and communication of ‘home’ to truly discover one of the most important aspects of my life: my family.”

And so, our thoughts return to those we love most dearly, those who encouraged us to take this journey of learning and self-discovery,  those who we eagerly look to embrace once more.

Tuesday, July 20 – Liz’s Research at Tibetan Nun’s Monastery

Weeks ago you were introduced to Liz and her week long stay at the women’s monastery near Pharping village outside of Kathmandu.  She did a good part of her field research at this site.  Her research objective was to discover more about Buddhist nuns in Nepal.  We hear often about the Dalai Lama and Buddhist monks, but the nuns were her focus - to interact with the nuns and to learn their real reasons of joining the monastery.   Among the many questions she asked, she feels these were the most important:  Why did the nuns enter the monastery?  What are the nuns’ current roles in the monastery?  How are the nuns educated, i.e. what subjects, where, with whom, by whom?  What level of ordination are the majority of nuns?  Is it possible to get ordained to a higher level?

 Liz says, “Ultimately, the most important question that covers all the of these questions is, in a society that tells women their role is to marry and have children, why do some Buddhist women choose the monastery over marrying and creating a family?”  

Liz talking to the nuns; Photo by Megan Kack

“During my first couple of days with the nuns my goal was to orient myself in the monastery, find out what they are comfortable talking about, and to start building a relationship with the girls I was going to talk to.”  At first the girls were a bit shy, but Liz’s warm smile and genuine interest won them over very quickly. 

“Luckily the day after I arrived, the nuns had a holiday, so they did not have class, and I was able to spend more time talking and getting to know them.  I also was lucky enough to talk to one of the first graduates of the Arya Tara School, who had come back to the school on her break from the university to help teach the younger nuns.  

I learned that the school was ten years old, and that they school strongly encourages the young nuns to further their education at a university after they graduate.  The Arya Tara graduate said it is difficult for women in Nepal to go to a university, and there are not that many nuns who go to university, so it was unique that the school had such a strong emphasis on this. 

“During the weekend I was able to see the nuns dance their traditional dance of the goddesses, and although they did not dress up to practice, they gave me a picture of the traditional outfits they wear when they perform the dance.  I was also able to hear the nuns practice their singing and practice their traditional Nepali instruments. . . . There is a strong sense of community in the school.  This helped explain why the young nuns were okay leaving their families to go to school; they really support each other, and become each other’s families.”  

Nuns doing their morning prayers; Photo by Sarah Mahowald

 

Saturday, July 17 – Jamie’s Nepal Research – Women Creating Change

Jamie Utzinger is focusing her ASIANetwork-Freeman student-faculty fellowship research on the scope of influence of five extraordinary women.   She says, “They have done a great deal already, and they continue to influence changes in society.  Each is working in a different way to usher in a new era for Nepali citizens – especially women, from creating employment opportunities for the poor to eradicating human trafficking.  The women I interview share their life stories with me: how they got to where they are today, how they help create change, and how they continue to foster an equitable society for Nepal.”

While the majority of women in Nepal are from rural areas with little opportunity outside their homes, and the center of life is in the home where their influence is greatest, there is a growing number of women who push for more than just influence in the home.  Jamie’s research objective is to learn how these specific women create opportunities for other woman to be independent; how they change lives; how they influence and empower other women.

Jamie writes, “My first interview was with Anuradha Koilara, founder of MAITI Nepal, an organization that rescues women and children from Indian brothels, helps restore their livelihood and dignity, and helps them get on their feet again to start a new life.  I also learned that Ms. Koilara was also a 2010 CNN Hero nominee.”  Some of Jamie’s conversation with Anuradha Koilara was featured previously in this blog.

Dr. Kundu discusses medical care in Nepal.

Dr. Kundu approaches empowering women in a different way.  As a surgeon and the chief of the OB-GYN Department at Patan Hospital, “she guides her doctors and nurses to meet the needs of over a thousand patients a day.  I found that her colleagues have so much respect and admiration for her, it appeared to be more like reverence.  The reason she became a doctor, not surprisingly, was to help people, to heal their pains.  As a Tibetan refugee, she had opportunities to leave Nepal, but she chose to remain to help others with her skills.”  Through her efforts, the hospital has grown and improved steadily.  She has,  as chief administrator for the hospital in previous years, secured a steady stream of funds to expand services, build new hospital departments, and guide the enterprise carefully into the 21st Century.

Reflecting upon her research thus far, Jamie adds, “With an open heart and an open mind, I embarked on an adventure to meet incredible, influential women and learn their stories. . . .  What I am discovering is women with dreams larger than life, with a passion to help people unconditionally and improve the quality and equality of their sisters’ lives.  They are true heroes – brave crusaders for equality in a world with strong patriarchal customs and systems.  Each woman has taught me something different to take back to the West: a new attitude, a new belief, a new appreciation for the world.”

Friday, July 16 – In Search of the Perfect Banana

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On a hunt for the perfect banana, our first attempt driving away from Pokhara yielded only so-so results.  Going up from the Pokhara Valley into the higher mountains, we found fruit stands along the slim slice of roadway.  Three women sitting on the stoop of a little house sporting pineapples and beautiful bananas caught our eye.  “Stop the van!”

It was hot; some of us were suffering from stiffening, sore muscles; Megan Kack leeped out of the van on a hunt for the best bunch of bananas to ease the healing process from that 53+ mile walk.  Potassium, you know.  

Fresh, just off the tree - you rarely taste anything so terrific as a perfectly ripe, fresh banana.  Each little 5 inch long fruit cost 5 Nepali Rupees – - – approximately 7 cents.  What a treat!

So on we went, returning once again to Kathmandu – to commit research results to writing, crunch data, analyze, synthesize, and reflect.

Wednesday, July 14 – “There are no words . . . “

Today  - some of the photographs taken by Corbin Cleary, a member of our group that went up to 13,000+ feet into the mountains to see the more remote villages.  While there are literally thousands of photographs of their walking journey of nearly 53 miles, by far the most stunning are of the high mountains.   Following the slideshow below, I include some of their reflections as their tired, sore muscles joined us again to heal and their minds try to absorb all that was seen, heard, smelled, tasted and felt over those unforgettable six days.

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“I pushed myself way beyond what I thought I could ever do!  It was way beyond my imagination.”

“You can’t do this looking up at where you’ll end up.  You just put one foot in front of the other.”

“I tried to write, but I couldn’t write.  There are no words to describe what I saw.  To say “beautiful” says nothing.  To say “splendid” is meaningless.”

“What can I say to people back home.  Virtually nothing.  I can tell stories of experiences, but they wouldn’t convey anything.”

“Walking 53 miles through villages that hang on the edge of cliffs, enshrouded in fog, and all you can do is focus on the few feet in front of you, on the slim, little path that is your link to the next set of huts – the next little village.”

“It is a physical endurance test, yes, but more than that — it is more mental.  It is about willing yourself to go on, even when you think you can’t.  And you do.”

“1000 steps straight up!  No way!  Ok, I have to do this.  One step.  OK, good.  Now the next step.  Now the next.  And I did it.  I got to the top.  I now know the meaning of “one step at a time.”  And wow, it was so worth it to be up there.”

“When you are alone with your thoughts, on a little path in the fog for hours at a time – it affects you.  It slows down your mind, your thoughts.  Everything quiets down.  You can’t escape your self.”

“Living on the edge” has a different meaning for me now.”

“We live our lives in a bubble back home.  We all are in little bubbles going to and fro.  Isn’t there something wrong or odd about that?”

“I realized how much guilt I feel – about everything!  My family’s comfort, my ability to come here, my easy life back home, my opportunities, and how much I waste and take for granted.  There is so much to be done – everywhere.  Here and at home.  It’s overwhelming me!  My guilt and what could be done to make people’s lives less harsh, less difficult.  What will I do?”

“I’m caught between two worlds:  on the one hand I see this land as picturesque, full of beautiful images, objects for my camera.  On the other is a sense of the hard life these lovely scenes actually represent.”

“Just when I thought I couldn’t go on, an old woman passed me carrying a big basket of rice and disappeared into the mist.  I said, “OK.  I can do this.”

“All you have is a 1 ft. path with a straight down drop on one side and a straight up mountain on the other.  All you can do to get to the next village is go forward or backward.  All that’s important is right now.  This minute.  Focus.  The path is slippery.  You’re on the edge.”

“When I got to the end of it I had to withdraw a little bit.  For 20 minutes I just bawled. . . . going back to my life and what lies ahead – - – oh, my goodness.”

“There is a huge feeling that I just don’t want to go back – - I don’t want to go back to being connected all the time.  And for what purpose?  It was nice to live without e-mail for a while.”

Tuesday, July 13 – #2 – Megan’s Research

Megan explains to a young father how to care for his young daughter's teeth,while girls from a local school wait to see the dentist.

It’s a good day to feature Megan Kack and her writing about her research, which was featured here around July 4th.  She has now had time to put it into words:  ”My research in this village focused on the oral hygiene and oral health awareness of the people in Sutangal village. . . .  Oral health/dental hygiene is a topic that receives varying levels of attention throughout the world.  Although many tend to think of dental care as a cosmetic treatment, its role as a preventative measure for overall health can be thought of as a way to improve one’s quality of life.  I decided to pursue dentistry as a career because of the medical impact that can be made in an individual’s life as well as the potential for future policy change.  The country of Nepal opened in the early 1950s.  It has a geographic area of approximately 148,000 square kilometers which is divided into four regions: the Kathmandu Valley, East Nepal, Central Nepal, and West Nepal.  In 2008, the population was projected to be 26.9 million and a growth rate of 2.25% with the majority of the population under 30 years old.  For the Nepalese, life expectancy at birth is 64, yet a high infant and maternal mortality remain.  The infrastructure, service, and economy in the country have improved during the last decade, but still many Nepalese live under the poverty line and there is widespread illiteracy.  (1)  Most of the population subsists on small farms with limited access to roads, health and educational systems. (2)

The village of Satungal is situated in Kathmandu District in the Bagmati Zone of central Nepal.  The village is located at an altitude between 1222-1267 m near the Prithni Highway about 3.5 km from Kathmandu Valley.   At the time of the 2001 Nepal census it had a population of 5834 with 1375 households in it.  The majority of the community is Newar. . . .

The health post serves the surrounding communities.  Shtrii Shakti has suggested that the community work to expand it into an integrated health services center for good health and basic diagnosis.  The lack of proper water has lead to an increase in hygiene problems.  The current health post lacks both doctors and a pathological lab which means many people are forced to go to the city for care.  The VDC and YFC have organized for doctors to come once a week which leads to the service of 350 patients per month.  The major problems are headache, diarrhea, chest infection, rashes, and uterine prolapsed.    Dental problems affect men, women, and child and are a common disease in the community.  FCHV have been trained to extract mobile teeth and treat dental pain if financially acceptable for the patient.   

A dental camp  was conducted in the community of Satungal on Saturday July, 3^rd.  The Satungal Famers Groups was used as a means of community access and a way to spread the messages among the village population. 

In Nepal, dentistry is an occupation that is growing in popularity and professionalism.  Through interviews with dentists, I learned that the first dentists in Nepal were trained in India after a Nepalese had received treatment and decided that his country needed to have access to these services.  Before this, the people used a traditional method of nailing a coin to a piece of wood as an offering of the toothache to a God.  Trade dentists began to establish practices on the same street at the relic.  The skill has been passed from generation to generation and many of the shops continue to serve the population performing mostly palliative procedures and construction of dentures. 

The dental profession has grown tremendously over the past 20 years.  Many foreign trained nationals have received licensure and have established a strong dental presence in the Kathmandu Valley.  Dental services are centralized in the Kathmandu Valley and only serve a limited population.  Facilities for dental treatment rarely exist outside of the valley and dental problems go ignored in remote regions.

Nepal is home to six dental colleges and two hygiene schools which were founded in 2001.  The Nepal Dental Association has helped the profession to grow through its development of a research journal, a network of professionals, and has selected 4 development regions to help spread dentistry across Nepal.  Fluoride was integrated into toothpaste in 2002 and has helped to reduce the rate of decay. 

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Yet, as a more western diet follows tourists to Nepal so do the troubles of tooth decay.  One of the biggest challenges that is faced is the lack of knowledge on the impact of dental care and hygiene.  The urban population is starting to become more conscious about the condition of the mouth and this has increased the number of patients seeking professional care. 

Dentists have taken initiative to provide care to the community in order to spread the message of the importance of oral health.  Dental professionals go to schools to educate on nutrition, dental hygiene, and the importance of seeing the dentist.  Many practices and hospitals also conduct camps as a way to serve people who are in most need of care.   

An assessment of the state of oral health and dental care in the community was conducted through a free dental camp in the community of Satungal.  Satungal has just one dentist that was only been practicing for one year.  Therefore, there is a strong need for care as the nearest treatment facility would be 3.5 kilometers away. 

Most individuals were seen to know that they need to brush the teeth, but proper techniques were not implemented.   Some of the elderly and many people in the remote regions tend to use neem tree twigs to brush or mustard oil and salt.  The majority of those surveyed had never been to the dentist before and were relieved to finally receive treatment after many years of suffering. 

The end product of the research will be to have provided education to a small population in order to improve the oral health situation, collected information on traditional and western oral hygiene usage and remedies, and to find out what the need for oral health care is, what is being done to provide it, and what can be done to improve it for a greater population.  I will have explored the current diet of the population and will know more about whether oral health seems to be affecting overall health.  I will have studied the edge of western dental hygiene educaton, its effects, and how to promote it if it is helping.”

Tuesday, July 13 – Back from the Mountains

With the monsoon comes planting time for rice farmers. The entire family is involved: the plowing done by the elder man in the family, a child may pluck rice seedlings from one paddy as mother, sisters and others plant them in newly prepared ground.

For several days we’ve all been in the mountainous regions of Nepal.  I’m now back here in Pokhara with the rest of our group expected later this afternoon.  We’ve all had stunningly beautiful views of mountains, crashing waterfalls by the dozens, rockslides and landslides too numerous to count (I missed one by an hour or so – it closed the main road for 3 days), a couple of trucks overturned, lots of cows, goats, fog, rain and the birthplace of the Buddha.  Electricity has been an on-again, off-again proposition, with the “on-again” part lasting a good 10-15 minutes at best.  I finally gave up posting until my return here.  

On a steep mountain slope, this woman forages for cattle feed.

Most of the living in this part of the world happens in the open.  Homes are for shelter from the rain (or snow at higher elevations) and for sleeping.  Everything else occurs outside, even bathing in the villages. As you move further away from the towns, brick houses turn to mud homes with straw roofs.  As the rain falls, moisture works its way up the mud walls.  You hope they are strong enough to withstand all this water.  No matter how steep the hillside, there is someone crawling up or down to obtain wood, food, farm, or get water. 

In one village, we pass a woman selling fruit.  She is surrounded by water and sitting cross-legged on a five foot-by-five foot raised red-mud table of earth with her wares lying on the ground around her.  How a customer would get to her, I’m not sure.  In the mountains so many homes cling to tiny ledges only wide enough for only a narrow lane of road (no shoulder) and a one-room-wide home.  During this time of year one sees homes that have slid off the ledge or were buried under rocks and mud, or just collapsed from the intrusion of water.  

Rice planting is at every turn. Everybody is out in the paddy – whole villages, whole families.  They pop the little rice seedings into the mud with a dexterity born millenia ago.  There are also sections ready for harvest.  All of this is done by hand, and it is back-breaking work.  In some of the flatter areas nearer to India you’ll see an occasional tractor trying to plow a muddy paddy with just enough room for the tractor to drive around in a circle.   

 Tomorrow is a travel day back up through the mountains to Kathmandu  and then soon we head down to India.

Friday, July 9 – Jessica’s Research on Alzheimer’s Care – an Update

With the help of an excellent interpreter and considering the difficulties with this kind of field research, Jessica was able to obtain an excellent set of survey data. This woman is just one of the 35+ individuals Jessica worked with during the data collection phase of her work.

Jessica Najarian writes:  “The ASIANetwork, Freeman Foundation grant magnanimously presented me with this opportunity to research the impact of Alzheimer’s and dementia in Kathmandu, Nepal.  During these weeks here I’ve been investigating the impact of Alzheimer’s and dementia upon the caregivers as well as the patients within the Kathmandu valley, and surrounding regions.  This experience has changed my life in ways I could have never imagined.  I have gained a new respect for all humans in all walks and ways of life.  Through witnessing both the birth of a Nepali child and the kindness of an elderly Alzheimer’s patient who offered me her last mango, I experienced the importance of human dignity.  I’ve discovered that humanity’s survival lies with each one of us individually, and whether we choose to aid in this work can make all the difference in the world.”

“My research has taught me that each culture embraces the elderly in different ways. However, we will all grow old one day, and our “humanness” will be the same. . . We should take pride in caring for our elders and give them the respect they deserve.  As one caregiver explained; “If I do not care for my father, I mean nothing to this world.  I can do wonderful things, but, if I do not give him the dignity and love he deserves, my life is worth nothing.”  (Krishna.) 

Jessica  continues:  “There is a general lack of knowledge and awareness regarding Alzheimer’s and dementia in Nepal. . . .  when an elderly family member begins to fail to recognize objects it becomes a question of whether or not it is the result of senility, or a mental illness, not Alzheimer’s Disease. . . . The primary objective of my research was to look at the psychological impact Alzheimer’s and dementia have on the caregivers as well as the patients suffering with the disease.” 

 She continues, “I have experienced so much here in Nepal it is hard to even begin telling my story.  I believe however, the experience which impacted me most was my initial day of research.  On this day I traveled to The Geriatric Center Nepal (GNC) in Battisputali to begin my exploration of the care of the elderly suffering from Alzheimer’s and dementia. This is a very new organization which came into being ten months ago.  There I met with Mr. Krishna M. Gautam, one of the founders of the center. This man has a passion for the elderly like no one I have ever met.  The mission of the center is quite moving.  They believe that today’s youth will be the elders of tomorrow, and thus deserve dignified care in their old age.  This care should not come as a charity from the younger generation, but rather as a right.  The elders are a living history of a cherished and valuable society.  We must use the knowledge we can gain from these elderly towards the betterment of both social and economical development.  The mission of GNC consists of many aspects.  They primarily look to change the existing status quo of the values of the Nepali society which does not work towards the aid of the elderly.  Additionally, they look to promote the rights of the elders as well as to create well supported research to guide politicians, students, and organizations in this field of Gerontology.  Finally they wish to abolish all of the abuse and exploitation of susceptible elders in the society (Geriatric Center Nepal). 

 

 

Jessica visited this home for the elderly (at Pashupatinath) several times during her field work. Most elderly people are taken care of by their families, but there were a few at this location, located right next to the hospice and cremation center.

 Astonishingly, 1 out of every 20 elderly individuals in Nepal has been abused.  The elderly population is rapidly growing (3.4% growth rate), and this affects everyone in the society.  The youth should not pity the elders, but give them the dignity and care they deserve, I was told.  The problem then lies with the youth who are unwilling to take care of their parents and thus do not give them the adequate care needed.   

What impacted me most was that GNC works to give these elderly individuals dignity.  They refuse to take in patients longer than a few weeks or months as they want the families to take care of and help their elderly parents or grandparents.  Instead they provide a place which offers daily prayer, yoga, meditation, and nourishment.  GNC has performed research regarding the needs of the elderly and written books for the community members about families who have done a successful job in helping their elderly family members.  These books serve as a helpful tool and example for the community members to utilize. 

 “I was so impressed at the strong initiative these people had.  They were so passionate about their work and were so willing to aid me in my research.  They advised me to consider the fact that Alzheimer’s and dementia are viewed as mental conditions here in Nepal and such a negative stigma surrounding this issue in the country. 

 There is more to come of Jessica’s writing about her research and her reflections about it.  Stay tuned!

Friday, July 9 – As Pokhara Wakes

Up early this morning, I strode out of town for a long walk.  

Women come to this village source for their water, carrying it from a block to a mile or more.

The mountains were clad in fog; morning chant drifted down to the path from hillside huts and homes, and a few water buffalo slowly trudged off to a waiting rice paddy.  I walked for about 1.5 miles before returning to the town.  Family, the most important social unit in Nepal, is where the day begins.  Families tend to be larger, especially in rural areas like this, and more extended than in the US.  Older members are much respected and expect to be looked after by their sons in old age.  Several generations may live under one roof, with a clear family heirarchy, usually the eldest male. 

Off in the distance (center) a farmer checks his newly established rice plants. This time of year is the most important planting time for rice cultivation.

In general, the Nepalese are up before dawn.  The cacophony begins.  Bells are rung by early worshipers, dogs bark, tradesmen call, pots and pans clatter and there is always some serious clearing of throats going on.  The morning begins at a more leisurely pace than life in the U.S.  An early breakfast consists of chai and some puffed rice or roti.  Schools and offices don’t open until about 10 a.m.  Families therefore have time to enjoy time together.  Soon, after women collect water and make the first or two main meals of the day (usually dhal baat – rice and lentils), and children take care of smaller household chores, the farmer heads to the fields and people head off to work.  As I return to town, some shops begin to open.  A few restaurants that cater to foreigners are already seeing action. 

Several local traditional artists are already at work. 

This young artist is trained (or training) in the traditional style, painting thankas (religious paintings) for this shop. Customers include foreigners, private homes, and local temples. He is painting a Tara, a goddess representing female power and compassion.

Thursday, July 8 – Where the Air is Clean

Mountains are the home of the gods, the home of a great deal of the Nepalese population, and the air is better, albeit thinner above 5,000 feet.  So off our students went this morning at 8 a.m. to visit villages and see for themselves what life is like at 8,000 feet, or above.  They will drive for 2 1/2 hours before getting to their drop-off point.  We are at approximately 2,800 feet in Pokhara. Then they can expect a 5-6 hour walk to approximately the altitude of Kathmandu, or 4,850 feet. The following day they’ll ascend to about 7,000 feet.

The mountains have been hidden the past several days, but this morning they arose and smacked us in the face. One quickly understands that these are the highest mountains in the world, making the Rockies look like foothills.

It will be long today, but not terribly strenuous.  The scenery should be fantastic. 

Meanwhile, Patrick and Craig of the SJU group are in Pokhara, along with Sarah who has a bit of research to continue.  The four CSB researchers who left this morning turned in drafts of their writing for their research projects.  I’ll spend the next few days reading their work and doing a little research of my own.  My interest, unlike Sarah who is exploring modern Nepalese art, is in the traditional arts, especially sacred art traditions and their perpetuation.