Friday, 21 November 2008

My Last Day As A Volunteer

Well, I have survived my time here in Nepal.,and in flying colours,I think!
The day started with me feeling shattered .I slept fitfully last night because the loud noises in the distance were continuing till deep in the night.I was fantasysing the crowds breaking down the wrought iron gate and coming in to attack us in the orphanage. Silly ideas with an overactive mind....

In the absence of any news on telly, we decided that things must be back to normal. So I set out a little earlier just before 9 o'clock. Everything appeared to be back to normal with the usual chaotic rush hour traffic . I was happy that I could finish my last day in the way that I have started. Ten minutes into my walk, suddenly I saw a few vans turned sharply and stopped in the middle of the road, blocking the traffic coming from both directions. I noticed the shopkeepers started to pull their shutters down hurriedly. Then a lot of young men started to run towards the junction where I was. I was halfway between home and the Teku hospital. Instinctively, I started to run in the opposite direction to the crowd, towards the hospital. I thought if I get injured, at least I will have some medical care. Joking only , haha .

That was the first time that I felt fear in Nepal. I saw loads of people being deposited by coaches and vans , obviously to join the demonstration further up the road. My half an hour walk to the hospital took me only 15 minutes. I ran like clappers. It was a record time. Admittedy, many of the young men joining the protest were quite well dressed. They appeared to be the local youths, and some students . Apparently, the Nepali people are trying to get the Maoist government to have a round table meeting . They are trying to thrash through the major conflicting issues with regards to the Maoist culture(communist) integrating with the somewhat feudal culture of the majority of the Nepali people. The demonstration is a show of strength, and not threat by the Nepali people asking the government to listen to them.

Thankfully,I reached the hospital without any incident. It was a great relief .I silently thanked the Hindu and Buddhist Superior Beings for looking after my welfare. Phew !! And I am not an atheist after all

I did not do much work today.I only helped with the monthly Stats Return. It is amazing the amount of manual counts the poor nurses have to do each day/ week /month. And then they all have to tally with the stock take to the last tablet. I have tentatively made suggestions to the Medical Director that they should computerise the data and information collected to reduce the amount of duplication which is being repeated in 6 different books at any one time.

At 12.30, I was invited to the hospital conference room , for a formal presentation by the Hospital Director. All the 'hoi polloy (? spelling ) were there .The Director and the senior hospital staff wanted to show their appreciation of the donations I brought with me. It has made the purchase of the resuscitation equipments a reality.The only thing which is yet to be delivered is the trolley, upon which all the resuscitaion equipments will sit. I have to say I did not expect this formal bit. And it is not my style to stand in front ot staff to spout. I did it reluctantly because all you donors out there deserve a big hand. I was presented with a large framed 'Certificate of Appreciation' (they forgot that I have to fly) which you will see when you come to tea in the new year

I was thanked and blessed with a ' Tika ', a red dot on my forehead by the director. I was then given a garland of very fragant orange ( ?marigold ) and purple flowers. Then the variuos senior staff came forward and blessed me again with additional Tika. This was repeated 6/7 times, until my forehead was caked thickly in Tika. I was very proud of my Tika. I walked home in full sight of the locals. I did notice a few second looks on my forehead as I ambled home. Nice...

In the last few days, I have to turn down several invitations to lunch /tea /dinner by various medical staff. I recognised that I have to manage their expectations. I have told everyone I met that I will do my best to help , but I am not in a position to promise anything

My speech of thanks went like this
'Namaste !
It is a privilege for me to be here.Thank you for invitimg me to the presentation.I just want to say that its the generosity of my friends and colleagues in UK and Malaysia which has made this possible. I am only the messenger. I am pleased that the equipment purchased will help to save lives in the future.
I would like to pay tribute to all the staff especially the nurses and doctors who have helped to make my time at the hospital a very welcomed and pleasant one. A special thank you to Nani. Mohan and Gyani, the 3 nurses in the 'ART' clinic.They have made my 2 weeks with them very special and worthwhile. I have learnt a lot from you .So, thank you'

I have mixed feelings about finishing my time here.I will be happy to continue to work at the HIV/ Aids clinic, but I will not be sorry to leave the chaotic traffic in Kathmandu. I will be tying up the loose ends at the orphanage as well tomorrow. and John will join me here on sunday. I shall have a spot of 5* luxury for a week. Aaah, bisto.........

So what happens now ? I can hear you asking the question. Well, I will take stock of what I have learnt here. There are alot of work to do still. However, I will post further blogs once things are clear for me .If anyone of you is interested in supporting me in whatever way, I would love to hear from you with your ideas.

Till then, my heartfelt thanks for the very generous support you have given me. And the very encouraging comments I have received while I have been blogging.It is the first time I have learnt to blog..It has been an interesting journey for me too. I discovered that I can be creative (I know Gill has told me this before )

Bye for now and thank you

Lai See from Kathmandu 22/11/2008

Wednesday, 19 November 2008

A Free Day

I am staying at home today. A free day because there is a mass demonstration planned for this morning. It started yesterday when some local youths set fire to some tyres.Cars were diverted (not sure where to ) and police was on site to control the disorder.

I did catch glimpses of the scene on telly in the clinic yesterday morning.With the sound turn down , the nurses and I did wonder where the disorder was taking place.We then thought no more about it. We were then out to lunch at one of the girls' house later that afternoon.As I was walking home @ 4 pm,I did notice quite a few shops were closed with the shutters down. I did think that its odd on a wednesday afternoon, maybe they also have the ancient custom of early closing on a wednesday ( like when I first came to UK in the late 60s.). A relic of colonialism of years goneby, maybe ? . It was only when I got home I realised I have put poor Uma through an agonising afternoon , worrying whether I managed to miss the trouble spot on my way home. She knew I was going out to lunch, but didn't have the contact number of the nurse concerned. She was very relieved to see me back safe and well.

Apparently the Maoist soldiers killed 2 local youths recently.Nothing was done about it . They denied that they were involved. Feelings are running high for a while now. It sparked off the burning of the tyres yesterday by the local youths protesting against the injustice and frustration of it all.The police advised the shopkeepers to close their shops today as well. I have been living in such a cocoon that I have not been aware of anything amiss. As the children were getting ready for school, the message came through to say that all schools are closed for the day.The children are very happy to have an unexpected holiday today . And the sun is shinning..
After my usual breakfast of 2 egg omelette and toasts (Uma insists everyday ), washed down by nice milky coffee, I started to put my gear on for work. It did cross my mind that whether I ought to walk to work like I usually do. Then I thought it is too easy to just give in. Afterall, I only have 2 more days left to do. However , beforeI set out, I did check with Uma whether it will be safe for me to walk this morning. She told me to keep my eyes peel on anything untoward, to turn back if anytime I do not feel happy about continuing my journey

As I walked down the lane, admittedly there were less people about and much less cars on the road. However, there were enough people about who appeared to be making their ways to work. Many of the shops in the lane were closed. There were little crowds gathered here and there, talking .There was an air of excitement ? /festival ? I was reassured.

I continued my walk towards the main trunk road.I did not see any car on the road..Again there were alot of people walking towards the centre of town.There was no sense of fear , disorder or panic. I looked around me and decided that I would continue to walk to the hospital. After 10 minutes or so, I realised that the road has been closed, which explained for the absence of cars on the road. There were alot of youths dressed in black coming from all directions, some used hankies as masks.I began to feel uneasy . I kept looking around me. People were walking past me purposefully on the pavement. I think they are the ones who are intending on going to work regardless. I was less sure about the youths who were dressed in black , walking in the middle of the road .
I hesitated twice on the pavement, and was almost knocked over by someone going past me in a hurry. I kept looking , and in the distance possibly quarter of a mile ahead, I saw a very large crowd forming very quickly. It seemed a small crowd of 60-70 to begin with, then it snowballed into hundreds in minutes,. I could see the crowd ahead is now blocking the road. There was no hesitation on my part. I turned and walked back to Uma's house

I walked quickly, aware that trouble can spread like wild fire when there are large crowds around .It is especially so when they are mainly hot-headed youths. I noticed that the few brave shopkeepers who opened their shops this morning were collecting their ware inside, and closing the shops for the day. An ambulance was being despatched to somewhere. .I began to see a few policeman walking around . The only evidence I saw was a young man aiming his flying kick at another youth who was cycling past.He missed.

As I came round the corner towards Uma's house, I saw groups of "vigilantes' in the lane.There were 2 opposing groups eyeing each other , daring each other to start something . I had to walk past them to get to Uma's house. People were looking out of their houses expecting maybe trouble. I kept walking, looking straight ahead and impassive. I was so very relieved that I got back in one piece , again

My god has been looking after me again !

Tuesday, 18 November 2008

Another Challenge

We had an accident with one of the children here yesterday morning. A large concrete slab came away from the garden wall while the children were playing . It caught the left foot of Rajeish, the oldest child at the orphanage.The edge of the concrete slab caught Rajeish 's left toes .I was almost ready to leave for the hospital whenI heard a loud wail follwed by cries of pain.

Uma has left for work early (first time ), the helper Nabina was there ,getting the children ready for school. I was called to help. Rajeish was writhing in so much pain that he was inconsolable.I felt quite inadequate and helpless.I know I had to find something firm to support his toes, but I couldn't make Nabina understand what I wanted.

We were both running around like headless chicken, trying to contact Uma, as well as finding something firm while doing our best to console Rajeish.I have a first aid box , as advised by the agency. But what a fat lot of use is the malaria tablets, or diarrhoea tablets are in such a situation. I have no splint nor bamdage. EventuallyI found a packet box firm enough to be used to support the dangling toes All I could acertain was that 2 toes were broken. I could see the white bones sticking out .They were hanging by their skin at a very peculiar angle..Thank god the foot is not too vascular, therefore the blood loss was manageable.

In between trying to make each other understood, and comforting Rajeish who is in considerable pain, I decided that I'll give Rajeish one of my paracetamol, at half an adult dosage. I thought it is either kill or cure. thankfully, it did neither Helpful neighbours came, and we ended up carrying him first to a local clinic (a chemist, I think ). He took one look at Rajeish and shook his head, muttering ' nursing home '. I thought it was strange to go to a nursing home (as we understand by nursing home to be one for elderly people, and not emergency treatment following an accident' .

Nabina then decided to call a taxi. She gestured that I should go with Rajeish, seeing that Uma is still uncontactable. It later transpired that the number I gave Nabina to ring is the home number anyway. It is no wonder that she said its constantly engaged. How stupid can one get , I ask you ? As I got into the taxi, I panicked. I cannot speak Nepali. How on earth am I going to make the taxi driver know where we need to go or myself understood at the hospital ? I didn't know where I was supposed to go or do anyway. At the last minute, Nabina muttered something to a very nice young man, and he came with us . I have to tell you I was very grateful .In the event , we were sent from one hospital to another. A total of 3 hospitals later, Rajeish was seen and treated. He sustained 2 fractured toes , one totally severed, and heavy bruising on the others. Its a question of wait and see if the severed toe will knit back together. Otherwise it will be removed.

I was so relieved to see Uma at the second hospital that I was almost emotional like Rajeish. He just hugged her and cried his eyes out, calling ' mummy mummy' I was very pleased when Uma sent me off to work at the hospital, albeit a little later than normal

The clinic was so very busy that I had to start dispensing immediately.I didn't have a chance to think about the morning's traumatic start. All thoughts and concentration were on dispensing the Anti-Retroviral therapy (ART ). I was counting tablets for the different drugs that the whole morning just flew by. It goes to show that if one adopts a pragmatic approach to some situations, life will just carry on.I was shattered though at the end of my shift

An unexpected call came at midday when I was summoned to meet the new director (= Chief Exec in UK ) of the hospital. I asked sister what could possibly be the reason for wanting to meet a lowly volunteer ? It transpired that it is to do with the equipments which we were able to purchase with the funding from the sponsors in UK. She wanted to do a formal presentation to show the hospital's gratitude.... And this is going to happen on my last working day on friday. Help !

I am not into these grand gestures, and I did not do this to get recognition.I was merely combining my lust for travelling with putting something back with the generosity of all the friends and colleagues in UK. I did try to talk to a Registrar on the quiet, ascertaining whether we could dispense with this formality. I was told categorically that it is going to happen . I have better prepared a speech!

Well, here I am , on wednesday evening with not a word written . I think its important that I find out what her name is before anything else, and preferrably before friday.

With all these excitement , if you can call it that, it is no wonder that I am in bed by 9.30 /10 pm on most evenings. John will tell you that it is unheard of in our book. Oh well, ZZZZzzzzzz

Monday, 17 November 2008

The Needs of Teku Hospital

Working in the HIV/AIDs clinic for the second week has helped me to see the pluses and deficiencies of the hospital as a whole. The hospital is the poor relation of the main general hospital sited elsewhere in Kathmandu. The nature of the speciality means that it deals with the very very poor section of the community.It is the hospital for tropical diseases, focusing on treating patients who suffer from D&V, Malaria, Tetanus, dog bites (Rabies ), snake bites , TB, Dengue fever and countless others which I have never heard of.

It is difficult to understand the politics of management here. The director of the hospital (equiv to Chief Execs in UK ) changes every 3 to 6 months. What that means is that there is constant upheaval and changes of direction in the way the hospital is run, or rather not run. It is not my place to judge. Suffice to say , the front line staff are working as hard as they can , with no support from the senior management. And we think NHS is bad. Well, you aint see nothing yet

To cut a long story short, there is an Emergency department in the hospital. However, there is no basic resuscitation equipment here. If a patient is brought in following a snake bite. and collapsed as a result.There is no airway, mask or anything at the hospital to revive and keep the patient alive. S/he will be packed off in an ambulance to the main hospital. Often s/he does not survive the journey. life is cheap here

It is only natural that I have alot of questions like' How can a hospital function for how long ? without the most basic equipments ?' , 'You call this a hospital? ', 'What is the government doing about it ? ', ' What is the director doing ?' ,'I can't believe you can have an Emergency department , and not have the most basic stuff to sustain life ', and so on.

Having met with the senior doctor( =Medical Director ) Dr Pandey, we agreed that we would spend the funding raised from the sponsors to purchase the equipments for the resuscitation trolley, plus a printer for him .He has just acquired a computer, but the money didn't quite stretch enough to include a printer.So there you go

The way things are done here suit my approach totally.I have sights of the purchase, and checking through the list to make sure that nothing is amiss. We purchased a suction machine with tubes x4 for both adults and children, Ambu bag, cloth masks x2, laryngoscope , auriscope with connectors for children and adults , nebuliser with relevant tubes, sphymometer with cuffs for adults and children and some other items I cannot remember. Last but not least, a trolley to put all these euipment on .In addition, 2 heaters for the nurses working in the clinic.

This lot has come to approximate 550 pounds give or take the plunging forex.It was 123 Rupes to a pound when I first arrived on 28/10. Last week it went down to 112. I will need to do an average of the 2 in order to get a fair rate.

It is a rather emotional experience when I have been going round the hospital with Dr Pandey .There are patients who were brought in and not being visited by a soul. No treatment can commence because they are unable to verbalise or they were unconscious. They just lie there day after day, incontinent of both systems. Its pretty horrendous for the poor nurses as well. I am pretty sure I have been in contact with TB patients. So I need to check out with my GP on my return to UK

The poor nurses are working in the most extreme conditions here. In the clinic where I have been based, there is a window missing. One of the nurses is seated there everyday, dispensing the drugs for Retroviral therapy . The winter mornings are very cold now. There is no such thing as central heating in Nepal. Period. The weather has been getting colder in the past week. She is getting a stiff neck and shoulder through the exposure. .There is nothing the hospital will or can do about it. Without realising it, I was sitting there helping her dispensing this morning. Though I was only there for 3 hours, I was frozen stiff. They don't complain because they have given up trying to get things done, because nothing ever gets done. So I told her to go and buy a large clear plastic sheet. Tomorrow we will double it and pin it to the window frame. And I'll find the money for it. She was very happy.

The nurses here work very very hard , under the most difficult conditions . Yet they gave me time, explained things to me repeatedly and very patiently.. I must admit at times I wonder where my grey matters have disappeared to. The second week have seen me in a better position to help more intelligently. We are now working as a team , according to them ! Fast work if you can call it that.There are so much unmet needs here, at every level. I have to accept that they can never be totally met.

My time to leave is fast approaching. I have 3 more days at the clinic.I have had a good run for my money.I have learnt a great deal, gained better underatanding of how and why things happened in Nepal.For that I am grateful

Saturday, 15 November 2008

Interesting Observations

I am now more than half way through my time in Nepal. I only have one more week in the hospital before I finish on next friday, then to be followed by a week of pure indulgence in a 5 star hotel when John joins me on 23/11 .

We all (kids as well ) went out celebrating last evening.We went to a modern shopping mall where it has a food court with a children's play area.We had momo (like chinese dumplings), pizza, black lentil omelette (yum ), chicken byriani and so on. We all came away stuffed.

We went there by a local cab . In order to save money, we managed to squeeze 3 adults (2 big ones ) and 6 kids (aged 4 to 10 ) into what I would call a smallish car by UK standard but big by Nepali standard. The suspension of the poor car must have taken a hammering last night. Not an easy way to make a living. It was a round trip where he waited for us to finish our meals before bringing us home during the rush hour . And I think it was all for no more than a fiver.

It is the first time that the children went out socially as a group. Some of the younger ones were fascinated by brightly lit bakery and cafes during the journey. Their needs are simple . Their lives are as well .They follow a routine whereby they go to school in the morning, and get fetched back home at around 3pm.They then have ' Tiffin'. This, I believe is a relic of the old british colonialsm, meaning tea time.

Each child has a tiffin carrier (tupperware box to be precise ) where they keep their snacks for during their school breaks. I took a variety of coconut sweets and cookies (from Malaysia) as well as chocolate gold coins from M&S for them . When they were given to eat them one evening , all 6 of them unanimously voted to keep them for next day's school tiffin . It was so touching to see them jumping up and down, really excited that they are taking the goodies to show off to their friends the next day. I gulped down my emotions...

The traffic in kathmandu is somewhat like those in Vietnam. No one respects or probably not understanding the significance of pedestrian crossings . I have to cross the road everyday, because Teku hospital is on the other side of town .It is about a mile and a half away from where I am staying.

After trial and error, I have worked out the safest (if there is such a thing ) way of crossing the road. Whenever there is oncoming traffic, I will make sure that there are other people (preferably 3 or 4 thick ) in front of me as we cross.The reason being if we all get hit by the cars, the initial impact will be on those in front on me.The likelihood of me being seriously injured is thus reduced. Smart eh ?

The other thing that I do, like everyone else (not that I have noticed that many ) is to cross the road in steps. That means I 'll find a gap in the traffic, stand very very still (making my intentions very clear -I am here and I am not moving ), allow the cars to come at me and weave around me until a gap is available again for me to take the next step. Sometimes I am able to cross the road in 2 steps, another time 4 steps. I tend to get quite jittery if I am still in the middle of the road after the third step. But the cars and motor cyclists will just come at you relentlessly no matter what. This is one aspect of Nepal that I shall not miss when I leave here

I have come to the conclusion that Nepal is the only country in the world whereby the ATM (hole in the wall in UK ) is housed in a seperate cubicle with a guard posted outside. The first time I saw it in Thamel (tourist part of town ), I was gobsmacked! Imagine, a guard with a gun (of course, its not a gurkhas soldier) standing outside the spacious cubicle while you take your time to draw out your cash, counted them and put them away safely before you emerged from it. I have to say I like that very much.I shall miss it when I leave

One of the things I have missed is to have a chair, a proper chair to sit in.I tended to sit on my ankles now with knees bent. While it is quite comfortable, I get pins and needles in my calves after 30 minutes or so. Thats the only time I think I really feel my age -21 and rising !

Another interesting observation I have made is that my bedroom is now a really cosy place to be .Nothing has changed in terms of decor or anything . I think it is to do with my internal state. Having gone through the horrendous trekking experience, everything else does look more rosier now . I reflected on the 2 days' mental and physical challenge when I thought 'this is it ', then to be able to come back to civilisation in one piece, wow!

I think I have done enough rambling for an afternoon. I have found it quite therapeutic to be able to share my time here through the generosity of all of you. In fact, its been a privilege.

I hope to purchase some basic resuscitation equipment in the next day or so for the Teku hospital.They have an Emergency department, but no basic resuscitation equipment. One of the doctors is taking me in an ambulance (don't panic, its for transporting purposes only) on monday to purchase what our money can buy= approx 500 pounds worth (no pound sign on this pc, american ,ah! ) I will certainly keep you posted

Thursday, 13 November 2008

Bits and Pieces

I have now graduated to dispensing tablets for HIV/AIDs patients. I did feel a little uneasy to begin with. However, I was really into it by the end of yesterday afternoon.I suppose its a case of having to do it, when 2 of the 3 nurse specialists were away. Its called good planning. And I was the next best thing. I guess beggars can't be choosers. I satisfied myself each time I dispensed by going over with the nurse.I think I became a bit of pain in the neck to her. Well , its the cost of professional practice. This would never be allowed in UK. But then we are in Nepal......

At my request, Uma took me to the largest orphanage in Nepal . There are 295 children aged from 2/12 to 14 years living there. Ithas been established since 1964. The Nepal Children Centre (it is called) is housed in an old palace, residence of a prime minister of a goneby age. Walking around with a member of staff reminded me of a simplified version of Hampton court. We were shown some of the rooms where the younger children were sleeping and playing. It was around 1pm, a resting time for all.

In one room, there were 15 children (approx) aged @2 years napping on the carpeted floor .They were sleeping closely together, (for warmth I guess) ,with heads at both ends and feet touching in the middle.They have a lot of blankets cover them on top. I have to admit that they looked very snug and cosy. We have to tiptoe quietly so as not to wake them

In another room, there were 8 babies aged from 2 months to 8 months together with 10 toddlers around 18 months - 2 years of age. Most of the babies were asleep, but majority of the toddlers were awake.The minute they saw us ,they were reaching out with their arms, wanting to be picked up.One of them wound his little arms round Uma like an octopus tentacles, and would not let go. I suppose its crying out for some human contact and warmth. The 4 helpers in the room looked so overwhelmed.They provide good care, but the logistics of forming relationship and bonding fly out of the window when one tries to feed, clean and cloth these babies in record time .I asked 'what happens if all babies cry simultaneously and needing attention?'. I received a look from the member of staff, as if to say 'don't ask question which we have no answer for, stupid '

25% of the children are under school age. therefore there is a nursery and kindergarten in the centre itself. The older children go to the local lower (primary ) and higher (secondary ) schools.
Children are discharged, or rather leave at 18 after they have acquired an academic or vocatonal qualification. They then live in a supported enviroment with their peers

The main reasons for the childrem to be there are several. Children are orphaned, or abandoned through conflict. Children are abandond everywhere, at the bus stops, in the streets , train stations and so on. Sometimes its to do with the fact that the parents can't afford to feed them, others is step family problem, or parents have addiction issues. In some cases, the parents were imprisoned with no one to care for the children. During the long years of conflict between the Maoist guerillas and the previous government,many children were abandoned by their parents. The parents risked being killed because they were accused by both sides of being spies to the other. Now that peace is here, efforts are being made to reunite them with their families

The building was bequeathed to the centre through the passion of the late queen. The government made no contribution to the running of the centre.. There is a volunteer program at the centre.You have to pay for the privilege of working in that environment.I saw a wish list on the wall in one of the rooms we went in. It is asking for sponsors to provide basic things like milk powder, warm blankets and so on. Its pretty heart rendering stuff I tell you

Comparing the set up with Uma's, I think Uma's children stand a pretty good chance of developing into balanced adults because they are able tobond with one constant figure. They are able to have normal emotional attachment, thus developing trust in a relatioship. The poor children , especially the babies living in such a big institution are on a losing battle here with a staff ratio of 1 to 5/6/7. The problem is compounded by the presence of at least 2 youngsters with learning difficulties in each room . It is the modern ethos of intergrating children of all abilities.The poor helpers....

I feel pretty overwhelmed by this visit. I was asked to be a sponsor om the spot. I promised that I will seriously consider it on my return to UK. What they are asking for is"how long is a piece of string' I find myself wishing I have won the lottery. But then again it still would not solve the problem here. In Nepal, the problem is bigger and a lot more complex than just money

Tuesday, 11 November 2008

The HIV/Aids Outpatient clinic

I started at the clinic today, full of trepidation, unsure how I will cope in this new area of work. Well, I did, 40 patients later, and with a great sense of achievement at the end.

There are 3 clinical nurse specialists working there. They provide the primary and secondary care to the newly diagnosed and the returnees. They provide counselling and information as and when required.There appeared to be a lot of duplicating information being collected in various formats .One for HIV testing , another for CD4 blood count, and another for dispensing the tablets . So it goes on ...

The nurses work 6 hours shift x 6 days, sunday to friday. Saturday is their weekly holiday.They work similar hours to UK nurses except that we do ours in 5 days, with an hour less. Their shifts are 8/9am to2/3pm.I am less clear now about the shift pattern in UK

The background to the huge rise in HIV patients are mainly through sexual transmision .And the drug addiction to a lesser extent.Nepali men needs to go abroad to seek better paid jobs in order to support their families. Majority of men tended to go to India across the border to find their fortune. Nepal is surrounded by India on 3 sides and China ,on the other. Many Nepali young girls (10 years onwards ) have been kidnapped and sold into prostitution along the border to service the men .By the time the girls/young women showed signs and symptoms of the conditon, they were discarded back to Nepal . Their families are ashamed of them and shunned them .In the same token, the Nepali men became infected through their many years away from their wives. Majority of the patients are males from19 -40 years of age They in turn infected their wives on their glorious return from India

I booked 7 chidren in for CD4 blood test today. They ranged from 4 years to 10 years, from an orphanage. They all seemed happy enough in the corridor. I was thrown in the deep end .I had to find out their names and address in English because all notes were written in Nepali language.
The Nepalis have their own calendar for the year , month and day.It is like the chinese with our own lunar calendar. According to the Nepali calendar, today is 2065/7/26 and not 2008/11/11. To confuse the matter further, the Nepali 1 2 3 4 and so on do not resemble anything like the Roman 1 2 3 4 as we know it. I have to do a crash course to recognise the 1 2 3 4 in Nepali. it was fun and games.

I thought I was doing ok , all things considered when the nurses asked if I could dispense the tablets to the patients as well. Bearing in mind the notes were written in nepali, this was one occasion when I started to sweat. Talked about being put under the pressure. I said smilingly to the nurse that I am in no position to help her out there, because I can't read the notes. Admittedly UKCC Codes of Professioal Conduct did flash through my mind, much good that did me.In the event, the patient dispensed the tablets for himself and one other patient while I look on , bemused. Talk about accountability! However,I did managed to get their signatures in the dispensing book. That I thought was pretty good , under the circumstances.

Dr Pandey came along sometime in the morning. Apparently he stood and watched what I was doing for a considerable time. I was so snowed under, surrounded by 4/5 patients at any one time that I didn't look up until he came close to the booking desk. He then told me thatI am to stay in this clinic for the rest of the week. I have to say I am very happy to do that

All in all, a very satisfying day .This is the first time since arriving in Nepal that I feel I have done something useful. I feel really good walking home through the dust and chaos when I finish my shift. I look forward to going again tomorrow

Monday, 10 November 2008

The Hospital

At long last, I started at the hospital this morning. The very focus of my journey here.

Uma and I met up with the hospital consultant in charge, Dr Pandey. We talked about the things we would like to purchase, with approximate 400 plus pounds.

So far 650 pounds have been spent at the orphanage. A new double bunk bed has been ordered with all the associated furnishing (mattresses and beddings ) in preparation for 2 more children in the new year. They are 2 sisters to 2 of the children who are currently at the orphanage. I am also trying to get a couple of outings for the children organised before I go. There will indeed be some money left, but I would like to keep that flexibility available for the time being.

The hospital is in a big sprawling area consisting of many out buildings for the different departments. It reminds me of a very old victorian hospital in old England.It is specialised in tropical diseases and HIV/Aids management. It is a government hospital where treatment is free, hence catering to the very poor section of the population

Dr Pandey took me round and introduced me to the heads of different departments.I met the various sisters- in charge. I met my equivalence- Matron cum Head of Nursing for the hospital. Initially she eyed me rather warily, wondering what I was doing there, and only for 2 weeks anyway. However, once we warmed up, she was quite welcoming. In any case,I was pleased to escape her meeting with the departmental sisters, rather stilted and formal like in my nursing days on the wards

As luck or lack of luck would have it, the very first patient I saw on the special unit appeared dead to me . She was an emaciated woman . She was admitted the day before with advanced case of tetanus. Dr Pandey apologised as though he could have stopped her from dying because I happened to be there.Tetanus seems to be quite a common condition for hospitalisation here
The fever wards (diarrhea and vomiting and all infectious diseases) is housed on 2 floors with 100 bed capacity. The hospital can take up to a maximum 100 -200 patients during the monsoon season (june - August ). That meant many patients have to be nursed on the floor when the wards run out of bed. However, there were only 15 beds occupied at present because it is the dry season.He said the nurses are having abit of respite now till next year.

The wards are divided into large subsections . Each section can take up to 8-10 beds depending on the number of patients at the time. .There are no curtains round the bed. Privacy is not a primary concern , to be fair in this society. There are large metal bowls filled with ? lime water for disinfecting used masks, ?equipments etc. They are placed near the nurses station on every ward. They look disgustingly victorian.The mattresses on the bed have seen better days. They are the type we used in the 50s and 60s. They are covered in that horrible black thick plastic -that is, those of us who are old enough to remember. Majority of those mattresses are torn with the sponges or straws, I don't know which, spilling out everywhere. It was quite a sorry sight

I then spent sometime in the admission or rather emergency department with Dr Pandey and his team of Registrars/ Housemen.It reminded me of the vietnamese clinic at Lind. Even though there is a system in place, the people just crowded round the doctors when they tried to give individual consultation to the patients concerned. There was no privacy anywhere, and they didn't expect any. It was quite exasperating to just sit and watch

Every nurse I met today appeared to want to come to England to nurse. I think is to do with the buying power of sterling, comparing that to Nepalee Rupees (1 -123 ). With so much poverty here, and poor pay for the nurses , it is not surprising. So I had to manage their expectations in terms of NMC's strict criterias for practising in the UK

I have been left in the HIV/AidS outpatient clinic for the time being. It does not appear that I will be nursing patients on the wards.I just have to wait and see .I still have 2 weeks here. Otherwise I will need to dispose of the gloves I have brought out with me, thinking that I'll be working on the wards. As a precaution, I put 3 pairs inside my waist pouch this morning, just in case.

All in all , a rather gentle day than I was expecting. And I am grateful ...after the trekking.
Lets see what tomorrow brings

Sunday, 9 November 2008

A Townie Goes Trekking

Before I arrived here,I was told that I must make a point to go out of Kathmandu to see the real Nepal. So, having been here for a week, I decided to book a short trek just outside the city.For various reasons, Uma has the impression that I am a seasoned trekker (a novice actually), and 2 days' trekking was booked at my request.

My preparation included that morning walk round the village, as well as making decisions on what to take and leave behind. For someone who usually take the kitchen sink whenever I packed for my holidays abroad, it was a real challenge to try and squeeze everything in (for just in case ) in the small backpack. I did pack a few samples of cream and stuff for just such an occasion. I even cut a piece of soap and wrapped in plastic bag to help to lighten the load. Then came the essentials like toilet tissue, torchlight, my journal etc.I was proud of myself that I was able to get everything in, including the sleeping bag into that back pack.

I did think its a little heavy when Uma and I set out on friday morning to meet my personal guide.The minute we started walking, I realised that I have 17 km to, not walk , but climb in supposedly 4 hours on the first day and 32 km on the second day. Dilu (my guide ) was shocked that this was to be my first trek. He said a very significant thing to me ' be brave and you'll be alright' . As we travelled in the local van towards our starting point, I had no choice but to believe him.

The high points were several.One was when we stopped at a forest (or jungle, who cares) clearing, I decided to pull out a few things to leave behind to lighten my load. Dilu said he would carry my bag for me , as well as his sleeping bag. In return, I only had to carry his very light satchell.This he did for the 3 days. I did show him my gratitude(obviously not in the way one might think) and he was happy I think. Yesterday we came across 3 school children when we were descending fast into the brow of the mountain. Being typically children they were looking for sweets from passing visitors.In the absence of any sweets, I shared my very precious digetsive biscuits with them. They were very happy.I feel I have done a good deed yesterday

Another high point was the sunrises I saw at both Chisopani and Nagarkot. Of course the camera battery had to die on me at the crucial moment at the second destination. But alas, such is life. I have the memory in my head, thats the most important thing.

The only feeling that I have after I successfully reached both destination was one of relief and nothing else.That I survived the gruelling 2 day trekking without hurting myself . It was much later that I said to myself, well Lai see, all things being equal, you have achieved what you set out to do, even though it was a foolish thing to have embarked on. I must give credit to John for being my number one fan when I feel desperately hopeless and helpless on those 2 days. Moral support , even in the form of texts was very much appreciated. Now we have to wait for the cost of the moral support!

The low points were essentially about the depression I developed when I realised I took on a challenge way out of my league! I have never experienced such extreme exhaustion in my life. It was the constant fear of me losing my foot hold while so exhausted that I will end up having an accident. Looking back, it was very naive of me to think that walking round Beckenham (a circuit of 3.5 miles ) a few times a week would qualify me to do some serious trekking in Nepal, haha I have neither the fitness, youth, nor reserve to attempt to trek. However, trekking I did go .

All in all, the 17km trek on my first day was completed in 7 hours, instead of the normal 4. In the end, it was a case of putting one foot in front of the other through gritted teeth. I wailed at Dilu and told him I just cannot do it. But what is the alternative ? We were deep in the forest, with ocassional local flying by(they make you sick ) in both directions with such ease .I could throw a temper tantrum, but Dilu is smaller than me. And I feel sure he would not carry me anyway. Why should he ? even though he is paid to be stucked with me for the next 2 days

It was the ultimate challenge I have faced in my life. It tested my physical and mental endurance to its limit. There were times I cursed myself for getting into this situation, then I said to myself "well, you want a challenge, now enjoy it". I was seesawing with extreme motions during the second half of the trek. In addition, the sun was hot, the air was getting thin. I was breathless each time I had to haul myself up to the next level.

The ground is arrid, consists of dry river gorges where melting snow flows in the spring and during the monsoon season.They were strewn with rocks of various sizes, angled hickledy pickledy.Do I need to say more ?

The second day saw us setting out at 6.30. It was due to the fact that the 32 km trek would normally take up to 7 hours to complete. Based on my performance the day before, it would probably take us 10 hours.Thankfully the terrain was more gentle with gradual climb, unlike the day before.I massaged my legs and feet furiously several times the evening before, and it paid dividends. I did feel quite well when I woke up the next morning, all things considered.

The seconday was a test of sheer stamina. This I managed rather well till we got to the 25/26th km mark. My right knee decided that I have abused it long enough. It started to give me trouble. I was hopling on my left leg in increasing pain. Dilu was very patient. We rested intermitently to give the right knee some reprieve. In the end, when we reached the bottom of the hill before climbing up to Nagarkot, I called it a day.Dilu was keen that we climbed to the top. I recognised that unless I listened to my body, I will be left with a damaged knee for a long time to come. In any case,we have trekked 28 km up to that point.So I made a decision- common sense over pride. The last 4 was completed in a local car. It cost me a fiver. It was money very well spent

Now I am back at Uma's, I feel incredibly well. Apart from a slight twinge in my right knee when I climb stairs, I do not appear to be any worse for wear.Tomorrow I will be starting at the hospital. No doubt there will be more tales to tell

Wednesday, 5 November 2008

My FIrst Exercise

I took my first walk yesterday since arriving in Nepal. Its been over a week now since I did anything energetic .It could explain why I have not been sleeping very well.

Uma explained the route through the village/ or town. (I like to know when is a village not a town ?). In view of the fact that I will be trekking on friday, I had better get acclimatised to my new walking boots. The investment was worth it. Though it was a 2 mile walk , it was very comfortable. In fact, they were ideally made for the road surface here.

I must have seem a strange sight to the locals, but there was no sense of malice or prejudice. Admittedly there were a few local men raising their eyebrows, as to what a chinese woman doing walking amongst them at eight o'clock in the morning ? The path winds round the village or town (its a big place ) teeming with smart uniformed school children,housewives/husbands doing their daily marketing,villagers selling their ware on the pavement and the rush hour traffic. The rush hour traffic consist of the endless pedestrians, cyclists, motor cyclists and drivers of cars jostling for position in the narrow road designed originally for the traditional bullock carts.

I noticed that a lot of people tended to stand outside the shops/houses especially in he mornings.Then I realised that it is because of the hot winter sun that everyone is positioning himself in the full sunlight. I was very surprised that the winter here is not one would expect..Since I have been here, we have beautiful warm sunshine everyday till @5pm.It is getting darker obviously with each preceding day. The clothes washed in the morning is dry by midday.Its averaging 24-26 degrees everyday. The door to the lounge is open till ten at night.What a beautiful winter. Admittedly, the Nepali people do not have my peculiar habit of washing everything which has only been on my back fleetingly. And I am learning that the Nepali way is better and environmentally sound. I will probably adopt this on my return to UK

I have noticed that even the dogs here like the sun . When I first arrived here, I thought there were a lot of dead dogs lying around in the road. I did not want to show my alarm, but just kept myself out of the way .However, I did notice that there were no rotten smell anywhere

The reason the dogs look dead is because of the way they sleep, all stretched out and totally relaxed.They are very lethargic. They do not stir even if someone is walking close by, unlike the English dogs. In addition, they all tend to sleep in ditches, or right beside the road, looking really dead .Even when cars honk, they do not move. Cars have to drive around to avoid them. Interesting phenomena

I have been impressed by the pride the youngsters wear their uniforms. They look so smart in red (their national and royal colour) and white. The boys are quite happy to show off their smart outfits. However, I had to persuade ever so gently for the girls to agree( reluctantly) to have their photos taken.

The walk which I took is not one by UK definition. For one thing, I have to dodge between cars, cyclists, animals and people. I was given a vague idea around the village.I had no idea whether I will find my way back or retracing my steps to get back home.

After what appeared to be a long time , I saw the landmark which reassured me that I was on the right road.There were women with sewing machines doing instant repair jobs on the pavement , no doubt charging only a pittance . I was quite proud of myself when I managed to purchase a kilo of oranges from a Nepali woman. She pulled out 40 NR to show me the cost of the oranges. We smiled and nodded our heads and the transaction was made. This is called international sign language which transcends national boundaries and territories. Wonderful !

I saw an unusual sight at a meat shop (butcher's). I thought I saw cows' heads for sale, alongside the chicken heads. Being a Hindu state where cows are sacred, , how could that be ? I thought. Uma laughed her head off when I asked her. Apparently they are buffalo heads, which are quite different. And in my ignorance, I thought they both belong to the same family. Oh well..
The pollution is pretty bad here. It reminded me of the time when I first arrived in UK in the late 60s. My nose and my finger nails were always black after returning from Oxford street. At least its only black nose here

Need to sign off now .Will be away trekking for couple of days. Another new experience to look forward to

Tuesday, 4 November 2008

My Impressions

Having only being away from my usual habitat for a week (today), I am finding hard to remember how to spell correctly.Goodbye, Alzheimer's, please go away from me.There is no spellcheck facilities on the pc here unfortunately

At present, I am receiving daily intensive input in Nepali language and culture averaging 4-5 hours a day. The language is very hard. I keep questioning the validity of why I have to learn grammar in 5 days (transitive and intransitive verbs, fancy that ! ), when I only have less than 3 weeks here. My grey matters are being stretched, so much so that my head really hurts...However I do enjoy learning about the culture of the Nepali people. After 3 days of relentless questioning on my part, the teacher agreed that he won't teach me anymore grammar, but useful phrases in everyday conversation. Phew!

In addition, I learnt a lot about the socio-economic history of the country. I came to have a better understanding of why Nepal is so poor. In fact, from the many people I have met and spoken to, the reason why Nepal is going backwards over the years.

One of the things I am learning to do is to sit cross legged on a cushion on the floor. The lounge is a big square room with lots of light. It has a big square table(its too big to be called a coffee table ) where eating , socialising , reading, relaxing and writing are done. Its low like a Japanese table, except that there is no space or hole underneath to put your legs. One has to learn to sit cross legged or on one's ankle with bended knees in order to do anything . I am quite clumsy, so I balance myself by leaning on my left elbow with my legs crossed whenever I sit down, which is very often. To my surprise, I developed a big blister underneath my left elbow. I didn't know about it until the skin broke yesterday. Ouch.....I need to use the alternative way to sit I think, on my bended knees

I have been behaving rather selfishly. I have not let anyone know that I have some yummy digestive biscuits in my back pack, under lock and key.The reason being its my umbilical cord to 58 Durban road. Its only a small pack of less than 10 biscuits. With 6 children ,Uma and the helper, there won't be any left to sustain me for the next 3 weeks if I were to share them. Yes, I have seen them in the local shops, but unsure whether they will taste the same. So, its status quo for me- no sharing!

This week is a rather leisurely one for me. Therefore I am able to blog more often. One tends not to go out in the evening. That suits me fine . Walking in the dark on narrow uneven stony dirt roads is not my idea of fun, especially when cars coming in the opposite direction are not being polite to each other. And this is only walking to get a taxi (if you can find one, that is ) to go out somewhere. Having said all that, it is amazing how the locals seem stoic and happy when they are out.
It was an experience for me when we went out to the local night market to purchase the children's winter clothes. We went to the places which I would not dream of going normally. I was hanging on to Uma so tightly that I hope she didn't have any funny ideas about me. Abject poverty with its associated squalor were dotted with sparkling jewellery shops here and there. Its quite amazing to see very well dressed people going into the shops happily mingled with what I think were the down and outs. Sorry I am judging from a western perspective. I have promised myself not to do that

Till the next time, happy reading

Shoppimg Spree

Uma and I have been doing a spot of bargain huntimg at the local night market last evening. We managed to purchase warm winter tracksuits x6; woollen tights/leggins to wear under troussers and skirts x6 ;light weight woollen trousers x6 ; thick woollen socks x6 ,6 vests and pencil boxes as a treat. The whole packet came to approximately 70 pounds, based on the fluctuating forex.

I took some photos of the children when they were given it. It was like xmas came early, even though they don't celebrate it.The interesting difference with them and us is they folded everything given to them, and put them all in the same bag very tidily . They did not tear into the wrappings like we do because of the excitement

The biggest expense is installing the small generator in the orphanage. With the rapid growth in Kathmandu, the demand for power outstrip the supply. There is no gas here, only electricity. In order to reduce the demand, every district is on rotation for a power cut each day.It usually lasts for 2.5 to 3 hours. So far, its been in the evenings. One evening I was caught in the middle of a shower. It was not funny to say the least.Poor Uma kept apologising.We had a discussion and decided that money will be well spent if we could get one installed. It cost 30,000 Nepali Rupees. It has been done today and paid for. We are all very happy here. Uma wants me to say thank you on her behalf to all you sponsors.

What it means for the children is that they will be able to do their homework in the evenings .At present, the power cut tends to be either from 6-8.30 or 9pm , or 7 -9 or 10pm. Uma is not happy to give the children candles to help them with their homework. And I agreed with her totally. The other factor is that the power cut will be increased to twice a day for 4 hours each time in the very near future.That means 8 hours a day without electricity. An orphanage will not be able to function when that happens

There are 2 more things we hope to purchase before we call it a day. One is a double bunk bed , and the other is a proper desk and chair for Uma to work well. At present, I am sitting on a cushion on the floor doing the blog. My back suffers and my eyes go funny. It is important that the orphanage has good basic equipment in order to function well. There is a website for the orphanage which I will pass on .Part of Uma 's plan is to receive 2 more children early next year. They are sisters of 2 children who are with her at present. Hence the bunk bed
By the time we purchase all these things, there won't be much of 650 pounds left, maybe a little more will be required.

I'll sign off now in case the power cut happens, then I'll start again on another one. The other night I lost the whole blog because of the cut. I had to redo the whole thing 2 hours later

Sunday, 2 November 2008

The Orphanage

On arrival, I was greeted with smiling and happy children. I have a large but Spartan room. Still trying to get used to the cold dark room at night. My comfort blanket is Reading the October edition of Woman and Home via torchlight.One night is about the recipes on coffee n walnut cake, another night is how to do a perfect roast duck.

I have had bouts of doubts of 'what am I doing here? who am I trying to kid ? ' I have had my cultural shocks, but I won't go into details here. Suffice to say, I am surviving, and each day I feel a little more optimistic that I am playing a minute part in making a little difference to the children here, thanks to the generosity of all the sponsors. and John's text certainly helps to keep me going

I have 3 vegetarian meals a day.I have been trying to convince Uma (my host) that I don't eat b/fast (a lie) and that I only need some light snack for lunch, just one meal a day will be enough.So far, I have managed to do without b/fast.I have a secret store of digestive biscuit and dark chocolate which I purchased at Abu Dhabi airport.They help to keep me from being homesick

I went out shopping for grocery with Uma today.We spent about 70 pounds on :amongst other things, 90 kilo of rice 11 litres of cooking oil, cooking gas, over 30 kilos of beans and lentils and the essentials like salt , sugar etc. There are no frills here

We plan to spend the money on other essential things like a small generator for the orphanage.The daily power cut each evening is being increased to 4 hours twice a day. the children needs light to study. It is unsafe to have candles where there are children.

The Orphanage

My arrival was greeted by 6 smiling and happy nepali children. I am sleeping on the ground floor next to the children .

I have a very large but sparten room to myself. Its a case of living out of the sausage bag on the floor with no wardrobe /storage space. I am still trying to get used to the cold and dark room at night. Just as well I brought a torch light with me to keep me company. My comfort blanket is reading the October edition of Women and Home magazine via the torch light. One night is about the recipes on coffee n walnut cake, another night is how to do a perfect roast duck. I really fantasized about what I'll be cooking and eating if I were to be in UK

The definition of an orphan here is somewhat different from the west (so I am told ). It not only means children without parents, but it includes also the very very poor families (who live in the remote mountainous part of Nepal) who just cannot afford to feed their children, as well as those with abusive /drunken /mentally ill parents, as well as those who have been imprisoned for whatever reason

I am having intensive lessons in Nepalise language and culture. Talk about grey cells being stretched. It is a very painful process . I have had couple bouts of cultural shocks, which I won't go into detail here . Suffice to say , I am surviving, at times almost enjoying it.I am having 3 vegetarian meals a day, trying to convince Uma (my host ) that I don't take breakfat normally (a lie) and that lunch for me in UK is usually consist of a couple slices of bread only. There is no need to go to all that trouble really. However, I do have a secret store of digestive biscuits and dark chocolate which I bought at the Abu Dhabi airport. They should last me for a bit

We went shopping this evening and spent eighty pounds on two months grocery for the orphanage. They include ninety kilos of rice. We are putting plans to have a small scale generator put in because of the daily powercut(usually 3-4 hours a time) Its going to increase to four hours twice a day soon. We are also going to buy a double bunkbeds because Uma is hoping to have two new children early next year They are the older sisters to two of the children here.We are going to buy winter clothing for the chlden tomorrow.They all look pretty tatty from what I can see The above will probably account for a large chunk of five hundred pounds. Hopefully the overall expense won't cost more than that

Thursday, 30 October 2008

I Am Here

After a long drawn out journey, I have arrived in Nepal.

I thought all the airports in the Gulf States would be plush and wonderful. Regret to say, Abu Dhabi aierport is like a cattle market. It was utter chaos heppening on 2 levels .Maybe Bahrain and Dubai are the modern , state of the art airports I so often read about ,with the world's first 6 and 7 star rated hotels. I nearly missed the connecting flight because I was directed to the wrong gate!

I have been staying in Boudanath area, a Tibetan Buddhist stronghold, in order to experience some pure spiritual enlightenment .It would appear that I arrived on a very auspicious day by accident, the Nepali New Year.The place is teeming with visitors, worshippers and Buddhist monks of variuos grades, walking in clockwise direction around the stupa (Buddhist monument )endlessly. It is more so in the evening, a kind of evening walk, I suppose. It is said( not sure how true this is ) that all devout Buddhists have @131,000 rounds to do in a lifetime to achieve their goal, a bit like the Muslims who have one life time ambition to go to Mecca to pay their pilgrimage as good Muslims. I have done one round so far

Weather has been good so far.Its been sunny and warm.I have been able to walk around with just a tshirt.
The hotel is basic but clean with flushing toilet. The only fault is the towels. Just as well I brought mine as advised! The food is very salty, taking a bit of getting used to. My tummy has tried to rebel couple of times, but so far so good

A lot of visitors came to this part to undertake some Tibetan cultural studies including Dalai Lama's teaching. Some Americans staying in my hotel were talking about wanting to save the world last night. They were exploring the different ways of how they can achieve that, via singing around the stupa,or linking hands, or ask for special permission to go into the temple and chant, so it went on. In the end , they went for a lemon soda ! How sweet.

Being picked by Uma (my host whom I'll be staying with for the next 3 weeks ) at 11 today, thus ending my freedom here for a bit till John comes out on 23/11

Sunday, 26 October 2008

Almost There

Well, its only 2 more days before I fly out.I am beginning to get slight butterflys- in - the - tummy feeling. John has commented that I have had a couple of nighttime wobbles in the last few nights.They are sounds I made in my sleep when I am anxious about things / events....just like my mother. And I blame her for the genes....

What with everyone wanting to meet up before I go, its like xmas has come early . I have been having meals out almost everyday for the past 3 weeks. On some days I have been to lunch and then dinner on the same day ! I am reaching saturation point for eating out I think

The journey is going to be long & drawn out .Its 7 hours to Abu Dhabi with 4 hours transit there, followed by a further 4 hours flight before arriving at Kathmandu in the evening on the following day. I need to find out the difference in time between UK and Nepal. Otherwise John won't be too happy if I were to text him @2 o'clock in the morning, full of excitement about my discoveries in Nepal.

Well, the packing is almost done. Arrangements made for the pickup, and accomodation organised. To date, £1260 has been collected from family, friends, neighbours and colleaques I used to work with.. Everybody has been most supportive and generous.Travellers' cheques are ready for collection, mainly in USD, so I was advised. It pains me to see the dramatic slide of sterling against the USD after I have placed the order last week !!

Wednesday, 15 October 2008

Nursing Skills Refreshed

It is such a relief to be shown how to take a pulse effectively when it's too feeble to be felt at the wrist.. phew !! I know its probably funny, but it was reassuring to know that I was not out of my head when I say I can't feel my pulse! ' Walking dead ' did flash through my mind though

I have been on the Terence Higgins website to try and glean the relevant bits of information to update my knowledge base etc. It is important, but was reminded appropriately by close friends that good nursing care is what its about, and less of the technical stuff. So Lai See, you have been told!

I have been given some rubber gloves for nursing the HIV&Aids patients . I have to work out the logistics of how to make them last till the end of my placement .It could be tricky, I may not be able to do a one to one. I may have to double up.Whatever happens, I suppose its better than nothing. I just need to be flexible, under the circumstances

There are questions , for example-do volunteers wear aprons, overalls or just in their muftis ? Do the volunteers have chaperones who are bilingual ? How do I do health promotion about spread of disease if I cannot communicate with the patients ? Ah,I just remember I'll be expected to do a crash course in basic Nepali language (in 3 days ) ! Ha, thats funny.

I am sure I will have all the answers soon, fingers crossed (again).

Sunday, 12 October 2008

Am I Ready ?

I only have about two and a half weeks left before I leave for Nepal, there is a long list of things I need to do, what do I do first ? Help....... panic station !!

Take a deep breath, and count to ten. Thats what I would tell others, but its not so easy when its yours truly.Ok, lets prioritise as a manager would- seems such a long time ago when I was vaguely one of them. Make a list, I always feel I have achieved something when I have made a list.So here it goes :

-collect sponsorship money.£940 so far with half a dozen outstanding and a few more reminders to do

-Explore setting up a blog for interested sponsors to keep up to date with the trip

-Do a complete list of all sponsors to be posted on my blog- has started

-create a medical kit to include antibiotics, Malarone for Malaria, antihistamine, Immodium, sterilizing tablets plus all the usual suspects.I am half way there on this

-take little pressies from M'sia for the children in the orphanage. Found lots of useful knicknacks in the most unlikely places in the cupboards.I didn't realise that I am such a hoarder.......come in useful sometimes I suppose

-Need to read up all about HIV &Aids and practise my injection technique. Its been years.........Help !

-I can't find my pulse ? Help, someone !

I am just about reaching saturation point about lists.I guess I need to start packing sometime