ROAD BLOG AHEAD

I have been working on several blog posts over the past week or so, most of them on fairly serious subjects were more abstract than is my usual wont. I suppose you could call it writer’s block, but mostly it seems that so much has been going on around here lately that it’s hard to find blocks of time to give those posts the attention those subjects are due. Really, much has been going on which means there is no lack of things to write about, pictures to show you, ideas, projects, etc. etc. etc. and yet I have yet to complete and publish one of those blog posts. Today handed a break the trend — not with one of the heavy posts or the in-depth analyses, but with a quick look at some of what has been happening around here.

Probably the biggest — or rather the most complex project has been starting to plan our next trip to North America. This involves responding to the many teaching requests we’ve had for Lama Lena from both individuals and centers coast-to-coast and as far away as Brazil, contacting those we haven’t yet heard from and then scheduling teachings accordingly. Trying to coordinate a teaching tour that balances the needs of both teacher and students and the schedules of the centers themselves, is a kind of jigsaw puzzle in action, albeit one in which the pieces are constantly shifting. I’ve been doing this for over 20 years now for both my lamas and know how to make the puzzle come together. Well, more or less anyway. I’ve often referred to it as juggling flaming chainsaws while rollerskating on a sea of ball bearings! It’s quite a project and I am really grateful for all the help I’ve had so far. There are still many puzzle pieces to be fit and many factors to juggle and anyone reading here on a regular basis will probably hear me pleading for additional assistance from time to time.

In addition to burning up the ‘net with e-mail, Lama Lena herself has been really busy wearing her doctor’s hat. We’re smack in the middle of winter now, which means all the usual seasonal colds, flu and sore throats plus myriad aches and pains due to the weather. It also means - especially for a lot of the old folks among the refugees - illnesses brought on through poor nutrition or lack of money for pursuing good nutrition as well as a lack of heat and warm shelter. Emergency Fund resources are tight as we start 2010 since I haven’t been exactly beating the bushes this past year due to my own illnesses. Between reaching into our own pockets and the kindness of several compassionate friends who have helped out, we have still been able to make sure that the worst off people have vitamins and the essentials of rice and beans, tsampa, cooking oil etc. This very local area is preparing for a drought which means prices have gone up so it’s even harder for a lot of folks (this relates to one of the blog posts I’m actually working on that will come along sometime in the near future.) Even for those who have a bit of money, some days there just isn’t a whole lot available in the market and what there is cost more than the poorest folks can afford. Sometimes taking care of community health means taking care of lunch.

There’s plenty of specific health crises too. For whatever reason, we’ve seen a lot of uncontrolled type II diabetes this year, a lot of it among people you really wouldn’t expect to be diabetic. What we’ve learned is that those diabetic supplies that are plentiful and relatively cheap in the Western world are often beyond the means of our patients here. Glucometer test strips have been a prime example. What seems a little pricey in America for a simple strip to test a person’s blood sugar once or twice a day, is the equivalent of a day’s wages here. That pretty staggering and doesn’t include the actual pills or insulin injections to control the diabetes itself. One of our patients as a farmer and laborer who earns maybe two American dollars a day for working really really hard. He doesn’t fit the profile of a typical diabetic: he’s lean and not prone to overeating, he not only does hard manual labor as a farmer and in the other jobs he picks up to supplement his family’s income, but he does a daily yoga routine as well. And yet, for all his apparently healthy lifestyle when his diabetes flared up last month he was in really bad shape. He had skin infections, pneumonia and it became necessary to hospitalize him to try and get his blood sugar control. Two months later was still working on controlling it. We’ve been lucky and had donations of diabetic supplies that will get them through this initial crisis, but his need Is lifelong. Hopefully once he’s gotten stabilized he won’t have to test himself quite as frequently and be able to go back on oral medication rather than insulin and that will drop the costs.

Then there’s Nana, a wonderful 70-year-old who Lena has treated for other things over the years. Readers of this blog might remember her as the lady who makes the best soda bread in town. Unfortunately she’s not going to be making any bread at all for a little while. A few weeks ago she fell coming out of a shop on the main drag and broke her hip.Here’s Nana back in October, before her accident:

Now, back home in Tibet, for a person to break their hip is essentially a death sentence. Without any way to repair the break, the individual will lay in her bed, unable to walk or fend for herself. Eventually she will succumb to an infection or - most likely - bedsores. Not very nice way to go. So Nana and her family — including her 20 something step-grandson who absolutely adores her — spent the first 24 hours after she fell in denial that it was actually broken. Sunday afternoon they finally called Lena to come down and take a look. She went down to town, already pretty sure from their description, what she would find and very concerned. Because even around here (which has more medical resources than rural Tibet) getting a broken hip properly taken care of wasn’t going to be an easy proposition. Once she examined the patient and saw for herself the almost sure evidence of a fracture, getting it x-rayed was a real challenge on Sunday night! There are simply no emergency resources in town except us and Ankush the paramedic pharmacist who lives next door. We checked in with our various resources in Mandi, the nearest sizable town, and, as expected, there was no x-ray facility open. Even if there had been, the Mandi hospitals informed us that they did not have facilities for surgically pinning and setting a broken hip. They too would have simply put the patient to bed and she would never walk again. At that point, we were prepared to find a way to transport Nana to Chandigarh, six hours away, where there are excellent, state-of-the-art medical facilities. It was going to be a very long, painful and expensive journey for Nana - and for Lena. However, at the last minute, as I was online trying to get directions to the hospital in Chandigarh, one of Lena’s doctor friends remembered that a new clinic had opened in another nearby town not very many months ago and thought maybe they might have x-ray facilities. He gave her the number, she called and lo and behold — the Dr. there are (the only doctor there) turned out to be - get this - an orthopedic surgeon who knew how to surgically repair a broken hip! Nobody, but nobody knew about this clinic’s existence until that phone call. It’s way underutilized - new and off in an industrial area, but as convenient for us as Mandi. I still consider it totally serendipitous that he turned up just when we needed that particular miracle.

This is Nana being prepped for surgery. You’ll note it looks nothing like a Western surgical theater. This is the only picture that I thought would actually suit the blog. The rest of them are the surgery itself and pretty graphic. Fortunately Lena was allowed to scrub up and attend the surgery so she could take care of Nana. The other upside to this was that she was able to take some excellent photos — if you like pictures of big incisions and orthopedic hardware.

And here is Nana at home week later, recovering nicely in her own bed. One of the other great miracles about the situation was the presence in town of marvelous woman who Lena first met when she and Rimpoche taught in Canada. Onalayah herself has the medical background and experience in patient care. She has been an angel - able to see to it that Nana’s home care has been conscientious, compassionate and all round excellent. We fully expect Nana will make a full recovery and be back on her feet by and by, likely sooner than later as she’s doing so well.

Speaking of doing so well, I promised a photo of Sonam Yutron out walking about. Remember Sonam Yutron? Our original “poster girl” for the Emergency Medical Fund” has gone from being completely bedridden for 4 years, crippled with rheumatoid arthritis and nearly blind from cataracts to walking - slowly - around Lotus Lake. Seeing her walking and enjoying the view makes my heart sing!

I could go on and on about all the various situations, but I’ll leave it at that for now. Just a little taste of what we’re doing with our time. Lena far more than me of course.

I am going to leave you all now with one more picture. It’s actually one in a series of pictures that I’ve collected in the process of researching local knitting patterns. I’m working on a book about traditions and techniques in Himalayan knitting, researching and trying to recreate patterns and motifs of the region, most of which haven’t ever been published before or shown in the Western world. There’s some really exciting things to see and learn from these people who have found all sorts of beautiful ways to keep themselves warm and dry in winter. The images I’ll be showing you represent only the tip of the iceberg.

Here is one example of traditional colourwork socks (left) and my first attempt at replicating the technique and patterns I’ve learned (right):

There are also some really ghastly creations by people who never should have been allowed freedom with sticks and string. I’m going to end some of my posts with pictures of these “what were they thinking?” sweaters over the next little while, just to give the knitters among my friends and readers something to giggle over.

Some of the worst atrocities are foisted off on small children. It’s not that this sweater is badly made, it’s just that it’s so…”what was mom thinking?” Okay, so you know how to do bobbles and beads. And stripes. That doesn’t mean that you should do them all at the same time and, if you do, it still doesn’t mean you ought to dress your darling child in the resulting chaos. I’m sure the surly look on this little girl’s face is because she knows that she’s being photographed in something that might better have gone to live in the frog pond:

Remember - this really is just the tip of the iceberg. There’s lots more where this one came from! Stay tuned.

The longer we’re here and the more we get integrated into this community, the more we are making connections with other people, groups and resources who share our goal of providing basic medical care to those who would not otherwise be able to get it. Just as in the West, there’s various reasons for this, from ignorance of the (limited) existing systems to being refugees to being too poor to afford even the very cheapest medicines. Some people, particularly those newly escaped from Tibet, have emotional and psychological traumas that complicate their physical issues. Others live in such isolation in remotive villages that just getting to our little town of Rewalsar is a monumental occasion - there’s no way they are going to find their way to a government-funded hospital or clinic in a “big city” like Mandi.

Both the Himachali government and the offices of H.H. the Dalai Lama recognize this problem to some extent. That’s the positive news. On the downside, like bureaucracies everywhere, there is a limitation on both what they can do as well as how they choose to act on their awareness. In addition, there are individual medical providers, like Dr. Vanayak, the eye surgeon, who choose to use a portion of their skills are resources without recompense to help people who otherwise would fall through the cracks. There is Dr. Malhotra in Mandi, part of a highly trained team of oral and cosmetic surgeons who have agreed to donate cleft palate reconstruction for babies and children of poor families. Slowly, but surely, we are developing a network of like-minded people who care that vital services be available to everyone, whether rural farmers, refugees or tribespeople down from the high mountain places. People such as our neighbor, Ankush, who turns out to be a skillful emergency medic, one young enough to cheerfully get out of bed at midnight and put stitches in a kid’s head. Ankush’s family run a small pharmacy in town and he has also helped us get the most of every dollar the Emergency Fund spends on the medicines and supplies they can get. His willingness to put people above profit has expanded the number of people we can help with your donations!

Another way we have been able to expand outreach and effectiveness has been working with the little “clinic” set up by the Tibetan Government in exile. A space has been donated by one of the monasteries in town.

The resources are stretched verrrry thin, but there is a doctor who comes (or tries to - his territory is pretty huge) for one day a month. The rest of the time, the clinic is staffed by Chokyi Lhamo, a Tibetan woman who has been taught some basic nursing skills - she can take a person’s temperature and blood pressure, explain contraception and simple hygiene, bandage a minor wound and - most important - recognize when something is potentially serious and refer the individual to further care. Mostly she oversees the dispensation of the clinic’s dismally limited supply of simple medicines: Tylenol, Ibuprophen, some cough medicines and decongestants, pills for nausea, antacids for gastric reflux and a handful of asthma inhalers. These are frequently used up by mid month, particularly in the winter when the elderly have greater aches and pains and everyone catches cold, pneumonia or things even more dire. Chokyi Lhamo also checks on people known to be sick and the elderly who have trouble getting around - a great help in a town with many of these.

We’re well aware that the doctor assigned to the clinic is stretched too thin. Like the government he serves, he has a lot of responsibility and not enough resources or time. Just getting from one settlement to another in these mountains is a day’s hard journey. Whatever supplies he might need, he must bring with him since the clinic is most minimally equipped: a blood pressure cuff, a stethoscope, thermometer and maybe a handful of vinyl exam gloves. There’s a room the size of a closet with a cot for doing examinations and a front office with desk, shelves and chairs. I’ve seen inner city schools with more supplies in their first aid kit than these people have to work with on a regular basis. And they are truly doing their best with it, they are helping the refugees, both the new and those who have been here awhile, to the extent possible with limited resources. Still, people were making the trek up the hill to our house several times a week to ask for medical assistance, advice, treatment. A lot of what people here need - and can’t afford -are services or medicines the clinic doesn’t have - and can’t afford.

We’re still here and people are still making that trek. But it’s not an easy track for an old or sick person and many of the Tibetans don’t know or trust or can’t afford the few rupees for the public bus that will trundle them up the mountain several times a day. It got so that, every time Lena went down to town for something - to see a friend, to buy vegetables or have a cup of tea, she ended up surrounded by people who wanted her to come and take a look at their bedridden mom or check the swollen place on their neck or advise them what medicine was needed for arthritis. People who were too shy to come up here and people whose ailments wouldn’t let them come, wouldn’t let them climb our steep stairs. Almost all houses here in India have awful, steep stairs. She’d end up doctoring at the side of the road or in a tea shop. It’s really hard to do a physical examination or check someone’s blood pressure in a tea shop. And she wouldn’t have her equipment with her because she was expecting to buy some bananas and a bunch of cilantro and come right home on the next bus. So she’d take them down to the clinic building which is more or less at street level and at the back end of town. There she already knew Chokyi Lhamo and could use their blood pressure cuff, buy the person the meds they needed and ask Chokyi to look in on them in a couple of days. Well…

So now she spends one scheduled day a week at the clinic seeing people whose conditions are beyond Chokyi’s basic ability to hand out headache remedies and cold pills and who can’t or won’t wait for the day a month when they might get to see the visiting doctor.

Truly serious cases get home follow up or end up in our back bedroom/dispensary during the week or get sent to the hospital in Mandi for the kinds of testing and treatment that is beyond our means in this town. We still see whoever turns up at the door, which is quite a few people in addition to the Tibetans who go to the clinic building. Ankush is terrific backup and will go out at night if necessary on his motorscooter. The network of resources in the larger towns around here keeps expanding for those times when an emergency ultrasound exam is needed or the broken leg needs more than a simple x-ray.

We’re not the only ones trying to pull resources together. Our friend Harish has started an NGO (non-profit organization) to help get assistance for the more severely disabled - mostly children.

Last year they were able to distribute a number of little red wheelchairs to crippled kids. They have the equipment and the training in their office (a former weaving loft above the blacksmith’s shop) to do basic hearing tests and connections to refer people on for further testing and hearing aids if necessary. We recently arranged for Harish to test one of our elderly Tibetan patient’s hearing. It was really good not to have to try to drive the somewhat unsteady old fellow through the mountains to Sundernagar as we’d feared would be necessary.

What our patient didn’t tell us is that he already has a hearing aid, prescribed for him years ago in Dharmsala and which works just fine (when it has batteries in it.) He was hoping, in the way the old and innocent sometimes do, that we could somehow take him in for an operation to get (and this is pretty much a quote) his ears replaced with ones that worked since “they” can do so much these days! No matter how carefully we ask questions, people still manage to surprise us sometimes! This is a backwater in a lot of ways. That’s what makes it so interesting. Where else can you look out of the clinic door and see a few sheep following what appears to be a bush with legs heading up the street past you?

Or have to detour because the walkway to your house is clogged with a herd of goats heading to winter pasture:

Now someone in the government of Himachal Pradesh, the state we are in, is at least peripherally aware that a huge number of its citizens live in isolated farming villages in the mountains, far from access to health care of any sort. They also know it’s fairly impossible to bring health care providers to each and every tiny community and hamlet - even more than the Tibetan clinic, the result is a system that would be spread too thin for effectiveness. So they are trying to create opportunities for as many people to go TO the health care providers by allocating funding for events - medical “fairs” or “camps” where a large number of medical services - physical exams, basic lab tests, chest x-rays, dental exams, eye and ear testing, blood pressure readings, women’s health and contraceptive information and services, come together in one place for several days and people can come from all over the district and get their problems looked at, their kids immunized, their medicines adjusted, their teeth filled, all these quality of life services, free and under one roof. We’d been talking with our eye surgeon friend about doing such an event specifically for eye care when the call went out for interested providers and NGOs that would be willing to do the work of putting it all together.

So Lena called Harish and Harish called his circle of providers and our circle of providers, including the oral surgeons, dentists, optometrists and opthalmologists and his NGO is sponsoring the application for funding for one of these “camps.” It doesn’t take the place of any of the services being provided by the clinic or Ankush or the Emergency Fund. This isn’t a day-to-day healthcare or emergency care situation. It won’t even take place all that near to here, just in the same governmental district. But it will reach the villages where no doctor ever goes. It will get kids seen who might have been written off as stupid when in reality they’re deaf or have poor vision. It’s going to get some people on necessary blood pressure medication, prevent some unwanted pregnancies, save some people a lot of pain and grief. Hopefully, it will help prevent some emergencies we’d otherwise have seen later on. This can only be a good thing. And it’s really wonderful knowing that we’ve helped connect people up so it can happen, that we’ve been able to work together and meet some of these terrific doctors and medics and administrators who genuinely care about helping people - because of the Emergency Fund and the many people who have contributed to it over the past two years. All those gifts are part of an unbroken circle of connections that just keeps growing and doing more and more good in this world. I’m amazed and awed and very, very grateful.

A last comment to another blog post that isn’t what I’d sat down expecting to write: What we really need to add to the circle is some mental health expertise: PTSD, abuse, adolescent issues including anorexia, grief counseling, culture shock, knowledge of psychopharmaceutical treatments. There is nobody locally qualified in these areas; we’ve looked. Anybody out there want to volunteer by phone?

I’m going to plunge right in here and show you all something that I think is truly, deeply, phenomenally wonderful. I’m about to post some pictures that I hope will make everyone who has been reading my blog all along grin from ear to ear and maybe (if you’re like me) tear up a little bit.

It all started last January or so when Lena was brought to see what she could do for an elderly Tibetan lady crippled by severe Rheumatoid Arthritis. Sonam Yutron’s illness was bad enough and had progressed far enough, that she was bedridden and hadn’t been able to leave her dark, dank little room in years.

She hadn’t seen sunlight for four years. Imagine how depressing that would be! So I asked, appealing to friends, to people on mailing lists I belong to and on this blog, for donations to help buy Sonam a wheelchair. We thought that, if she could get out of her bed, even just a little, get out among people again, that it would improve the quality of her life. And they - YOU - responded. People sent $5 and $20 and $50, whatever they could afford. Mostly, that first couple of days, I watched 5 and 10 and 20 dollars turn into the couple hundred that we needed for the wheelchair. Then we hit our goal and I said, okay, you can stop now. But my friends, who knew what we are trying to do here, said, no, keep the money, keep going - this is just the start of something. There are so many many more…

That was the start of the Tso Pema Medical and Emergency Fund. In the past two years we’ve helped literally hundreds of people in our area with health or survival emergencies. I’ve got lots more stories to tell. The biggest thing is that, together, we’ve made a difference in people’s lives. Sonam Yutron got her wheelchair and got out into the daylight.

There are other people walking around alive today because of this phenomenon. There are kids who can hear and read and run because they got medicine or treatment or a pair of glasses that they desperately needed. $5 buys a lot of antibiotics around here.

Today though, was special. Today we have a new picture to show you:

This is Sonam Yutron, 2 years later. Yeah. Walking. Only a few feet and only with assistance, but she’s been able to get out of bed and walk a few steps, to the bathroom, to a chair, to the amazing world outside her front door. Once she got the wheelchair, she got something else. Hope. Optimism. And medical treatment. Lena has been working with her all this time, finding a medication and physical therapy protocol that works for her. Enough that, this summer, she was able to take those few, precious steps for the first time in nearly six years.

There was still an obstacle to be overcome for, at the same time as she began to move more, the cataracts that plague a lot of elderly Tibetans grew bad enough to blind her. Shortly after she was able to walk, she stopped being able to see where she was going. What to do?

That picture above, the one of her coming out her front door, shows her heading for the car to take her to Vinayak Eye Hospital in Ner Chowk, a town about an hour away from Rewalsar. She can walk that far again because, two weeks ago, Lena took her to Dr. Vinayak and he did the first (very successful) cataract operation on Sonam and she now has full vision in her left eye.

Today he performed a second, identical surgery on her right eye.

By this time tomorrow, she’ll be able to see out of both eyes again. That’s a wonderful thing. There was a great moment this past week when Nyondo stopped in to visit Sonam and her husband Lobsang. Lobsang put the kettle on for tea and then someone came to the door so he stepped out. While he was out, Sonam glanced over at the stove from where she sat in her bed. The flame under the kettle was too high so she asked Nyondo to turn it down. Not until Nyondo had done so did it occur to both of them: She could SEE the kettle - on the other side of the room!

You guys rock!

Oh and Dr. Vinayak rocks too. He’s one of the really good guys and on the same page with us - he did both surgeries at cost. He has been doing terrific work because he loves it and because he can and much of it is charity work now as he’s getting closer to retirement. We’ve got some plans together and I’ll write more as they unfold.

I thought, now that we’ve been back a little while, that I’d post some pictures of folks that have been/are being helped by the Medical/Emergency Fund. The contributions have helped so many folks - some of them a little, some of them a lot - and more just keep rolling into our house every week, knowing that, when all else fails, they came come to us and we’ll find some way to help them. Some of that depends on you, kind readers, so please, do keep clicking that donation box on the sidebar and, if you are interested in sponsoring someone to the tune of US $20 per month, please, please, let me know. We found some sponsors while in the U.S. but we got back and discovered lots of folks who had fallen through the cracks or fallen on hard times in our absence. If you offered and didn’t hear back from me, please try again, the journey back and forth between here, Delhi, the U.S. and other points played havoc with some correspondence!

This youngster is Sonam Woser, a student monk from Kinoor who lives at Zigar Monastery. He’s 12 years old, looks 8 and has been struggling ever since he broke his eyeglasses some months ago. He’s one of those people who absolutely needs glasses just to see the world in front of his nose. We took him into Mandi and got him an eye exam (below) and new specs. Because of his age and the seriousness of his vision problems, he’ll have to go back in 3 months for new, stronger lenses. However, the total cost of all of this including the exams, the glasses, future lenses and lunch is around US $20 at local rates. Now he’ll be able to keep up with his classes.

The awe on his face as he beheld the “big city” (Mandi) clearly for the first time was something to see!

Norbu Lhundrup is one of the yogis from the cave community. Many of the Tibetans have difficulties with the Indian summers where temps can get up into the 40’s (that’s centigrade. Translates to the low hundreds Farenheit) with 80-90% humidity before the monsoons. I sympathize totally as I am so not good with hot and humid weather! He ended up going to the emergency hospital for treatment of heat prostration, dehydration and related physical difficulties.

Here we have three nuns from up in the caves at the top of the mountain. Or rather, 2 of them are from the caves and 1 is presently homeless and unsettled. She’s also extremely ill with a variety of problems secondary to her recent escape from occupied Tibet. All 3 have some serious digestive issues related to living in a country with very different climate and foods than the high mountains where they were born. Lena is working with acupuncture, herbs, dietary changes, etc., but also took them in for GI workups at the lab to see what sort of nasties are residing in their guts. Ani Youngchen, on the left, is the one we were most worried about and the one that both Lena and the Mandi hospital doctor is most challenged by. She’s on massive antibiotic therapy for the second time. Ani Tsewang Youngtso, in the middle, has also been pretty danged sick. Lena has had excellent success treating her eye infection and severe allergies (appears to be allergic to India) but we’re still waiting for the endoscopic biopsy results to find out what that thing is in her gut. Ani Nordron, on the right, is one of the strongest women I’ve ever known, a real powerhouse. She, however, has the digestive difficulties that so many of the refugees suffer from even here in the Indian Himalayas. Between the stress of being in exile and the radical change of diet, it’s hard for all of them and we constantly see disabling gastrointestinal problems ranging from stress reactions to infectious gastritis to parasites.

This is Ngari Gepo Drakpa (literally, “Drakpa,a the old guy from Ngari”) He’s always been a trooper but, when we got back here, we were alarmed to see how worn out and skinny he’s become. Turns out that his long-time sponsor has stopped sending money and his son (below) has been seriously ill so the family hasn’t been eating and is on the verge of getting turned out of their rental room. We gave him $20 from the emergency fund for food and shelter and a bottle of decent vitamins. Hopefully something better will turn up for them.

Drakpa’s son, Chime Tsering, is just recovered from a years-long bout of treatment for tuberculosis. As the sole support of his family, he’s found a job washing dishes at a local restaurant for which he gets paid $12 a month, not enough to cover the family’s rent, much less food. TB treatment is grueling, the drugs take everything out of a person. He’s scary skinny and weak. He is also getting some money for proper food, vitamins and dry shelter while the family figures out what to do next.

Here’s one of the happy stories. I believe I posted a picture of this guy early this year when he first turned up for treatment. He’s another of the escapees who went through absolute hell to get out to freedom in India. Smart, brave, kind, Sangdhen is just an amazing guy. He’s also supposed to be a big, strong Khampa, the kind who can lift a Volkswagen without trying. Except that, after his ordeals, he was skin and bones. We got him started on the right medicines so he could eat, Lena treated him with acupuncture and, over the course of the months, he’s starting to return to his own self again. He’s gained several kilos, has strength to walk around town and, in general, is coming up really well. His lab tests, medicines and followup care would not have been possible without the Emergency Fund.

Sometimes the answer is simple. Ani Sonam Chodron lives in town now that she’s too old to climb up and down the mountain. She’s got weak eyes that give her a lot of pain and are sensitive to wind and sun. We’ve given her some herbal linament from our medicine chest to try for her arthritis, but mostly what she needed was a good pair of dark glasses to protect those aging eyes!

These are a representative few. Some who come to us, like Ani Youngchen, are dire emergencies whose lives are clearly at stake. We try to move fast in those cases. Others, it’s a matter of quality of life. And there are a few that can’t be saved or fixed. We returned to find that one of the local Indian workmen we’d helped in February had taken sick in our absence with something totally unrelated and died during the summer. A youngish guy with a family. All we could do was contribute something towards the funeral and the welfare of his family.

There are other stories, other emergencies, others in need. We try to help whoever turns up whether they are Tibetan refugees, Indian villagers or Westerners passing through. Our friend David is in Delhi undergoing chemotherapy. Our housekeeper, Malka, needs massive dental work that can no longer be put off. We do what we can.

Before I say anything else, I want to stop, take a deep breath and thank all of you who have so thoughtfully, so wondrously donated to the Medical Emergency Fund. I prostrate to your generousity and compassion. however each of you have found your way here to this blog - through word of mouth, through other people’s blogs (thanks Claudia, thanks Stephanie, thanks to all of you!) through the online communities, or through a shamanistic vision (yes, that too has happened!) you each typify the very best that humanity can aspire to - people who genuinely care about others in difficult circumstances, even though those others are different, speak another language, have different customs, skin colours, beliefs. You are people who DO something about that caring and compassion. Because it’s easy enough to speak, but the actions make a louder noise, penetrating deep into the heart of the Mother Earth, into the hearts of Her children. Thank you for understanding that we are all interconnected in this living organism and that, by helping one, you help all in a fundamental way. It’s a ripple effect, spreading outward, helping to counterbalance the fear and war and hopelessness. Those are the things we hear about in the news - the abuses in Darfur, the poverty in every nation’s ghettos, genocide and infanticide and all the millions of human dramas that go on every day. Each contribution, each gift or sponsorship takes a stand against the helplessness so many of us feel when we hear about all of these things going on all over the planet. Some of them seem - perhaps are - insurmountable by any means an individual can throw against them. What I try to do - what you all have been helping us here to to - is to make daily differences in the lives of other individuals. Seeing those differences keeps me hopeful about the future, not only of each person, but hopeful about the future of this little blue ball we live on together.

For the past few days, there has been a new influx of donations as people like Claudia (who has been sponsoring a student for several years - hi Claudia!) mention what we’re doing in their blogs and people come over here to see what’s going on. This is particularly wonderful because we’ve had rather a lot of needs lately. Right now, as I write this, our house is full of people who have come to see Lena about this medical problem or that. There’s a seriously ill monk in the clinic-to-be room, a nun with sciatica in the bedroom, a Ladakhi mother with excruciating headaches from an old car wreck, an elderly woman on the veranda and a really, really sick farmer waiting next door. We’re taking the monk to Mandi for an uper GI series, getting blood tests and stool tests for the old lady who may have parasites, subsidizing the Indian farmer’s ability to buy the right kind of food in an attempt to control his spiralling type 2 diabetes. Word is getting out and people are turning up at the door, hat in hand and hope in their eyes. Right now we’re trying to take care of as many of the urgent problems as possible so that, when we make our trip back to North America in April, we’ll be able to leave Nyondo in a position to simply administer rather than triage the emergencies as she doesn’t have the medical training that Lena (or even I) have.

Lodro Tayes’s mother is back from Chandigarrh, having had gallbladder surgery and some other procedures that we’re not yet clear about, but which appear to have helped. We’ve requested the medical records to review. Her expenses rose to 30,000 INR (somewhere around $800 US) but the glorious thing is that she COULD get the operation due to the generousity of strangers. The carpenter’s grandmother has a cast on her leg and will be evaluated to see if she needs/can be helped by surgery. Sometimes it’s small things that make a huge difference. Liz sent a care package all the way from Virginia with essentials like antibiotic ointment, sanitizing gel and reading glasses. Here’s somebody seeing the nearby world clearly for the first time in years:

She was absolutely amazed by her hands, which have been just a blur for a long, long time! She thinks that the biggest boon will that she can now thread a needle and sew her clothes - the eye of a needle has been invisible to her. She cannot read or write in any language, but reading glasses help, not just with reading, but with the million small tasks of life. Liz, you rock!

There are also a few of you who have inquired about taking on sponsorship for those in need and what that’s all about, so I thought I’d talk a little bit about that today. This is the unpaid work I’ve been doing for the past 20 years, matching individuals - usually Tibetan refugees - in need, with people in the west who are willing to send the equivalent of $20-25 US per month to help those without any other means of support keep body and soul together. It’s amazing what $25 will buy for someone who has nothing: rice and dal, shoes and shelter. Not fancy but far better than the alternative.

In the beginning, our focus was primarily on the nuns, monks, lamas, and yogis of both sexes living lives of meditation and simplicity up in the caves on the top of the mountain. Some of them have been in retreat for years. Many escaped with the clothes they stood up in when the Chinese came to burn and raze the monasteries and nunneries of Tibet. It wasn’t just the practitioners who escaped, though they were the first to settle here in Tso Pema where they could continue their practice in relative safety. Over the years the community of Tso Pema (Lotus Lake) has grown to include families with children, many elders, as well as householders in their prime. It’s a hard life, being a refugee here. The Indians have been incredibly kind and welcoming to permit these homeless refugees to share their land. There are, however, not even enough jobs to keep the Indian population out of poverty. The refugees eke out a living as they are able, families working together to create small businesses where possible, pooling their resources and living many to a room. They are, however, hard pressed for things like medicine and school fees for the kids, even in the best of times. For many, there is the trauma of being displaced, of having seen their families killed, of losing their homeland, of walking across the mountains, of being inprisoned, raped, tortured. Even those born in India are affected by all of these things - the children most of all I think. This is where we also try to help out. It’s actually where we began, the business of finding sponsors whenever Wangdor Rimpoche came to teach in the West. He would bring photos of the neediest folks and stories of those who had no photos and we would do what we could to match them up with people who volunteered to sponsor them. Over the years, scores of people have been helped in this way, but people age, children are born, people continue to escape occupied Tibet, so the need is ongoing. We were able to do a lot of that kind of matching up even when we were living in the U.S. and a lot of my time and energy these past two decades has been given to this grassroots program where 100% of what people donate goes to the individuals who need it. That continues. The medical fund came once we got here, to Tso Pema/Rewalsar and discovered that there were very few medical resources available to the refugees and that, of the resources that are there, many people cannot afford them. We’re also able to see who is falling through the cracks and try to do something about them.
I’ve decided to post about a couple of our more urgent cases for sponsorship in the hopes someone will read this and step forward. We’ll continue to look for sponsors when we’re in the West this spring, but some of these are people who can’t wait several months, whose situation is really critical right now. Generally, sponsorship involves sending a personal check 2 or 3 times a year and keeping up a light correspondence. Some people have formed very close relationships between themselves and their sponsee, others just like to know they’re doing something beneficial, but don’t have the time or attention for much correspondence. Both are fine. Not all of our refugees find it easy to write often - kids in school, the sick, often have to have someone handle things for them as they aren’t able to do much themselves. But I’ve seen some amazingly close ties emerge over the years, some real miracles that bridge cultures and life experiences to benefit all parties concerned. The practitioners, lamas and yogis and nuns and monks, do practice for their sponsors and all share in the merit. Even the lay people here are usually strong Buddist practitioners and hold their sponsors in their thoughts and prayers. We have one middle-aged lama here whose sponsor recently died after a lengthy illness. Nyima is really broken up about her death. He has been rising at 5 a.m. to do special ceremonies and prayers on her behalf and has requested prayers for her from H.H. the Dalai Lama and H.H. Karmapa. This kind of caring and sharing is not uncommon.

I guess I’m rambling here, but I have been so moved by both the need I see around me every day and by the astounding kindness of people I don’t even know trying to help from all the way on the other side of the world, that I tend to wax hyperbolic in my enthusiasm. I think I’ll stop here and just let pictures do most of the talking. Here are the people we’re trying to help in an immediate way:

This is Tenzin Zangmo. She’s 7 and still in kindergarten, despite being exceptionally bright. Why? Because around here, schooling costs money (about $25 a month) and her parents don’t have enough to pay tuition. The local kindergarten (run also through donations) is a wonderful place that really teaches the youngsters something, but Tenzin has learned pretty much everything they have to teach her by now and is ready for a “real” school. Her folks are Magom Dorje and Pema Wangmo:

Dorje is an old cave yogi who fell in love with Pema and married her. Together they have a little stall near the lake where they make and sell prayer flags and beads. They aren’t making it, despite working constantly. They figure they might have to pull the older girl out of school so they can send the little one for awhile. It sucks to have to make those kind of choices. Frankly, whoever gets sponsored in this family, any money will go towards educating the kids. They don’t say it, but you can see the desperation in their eyes despite their smiles when they talk about their kids. We need to get Tenzin Zangmo a sponsor so she can get out of kindergarten.

Our other serious situation is Kangshel Chodron:

Her son is Tsering, a lama in his fifties who has lived in the caves on the mountain for over 30 years now. Tsering has one leg and a terrific sense of humor. His mother has multiple health problems and, as you can see, isn’t very cheerful. She also has no means of support and is too old and ill to do any work now. Tsering has brought her here to live with him in his cave, but he has nothing of his own either. We’re talking her for a bunch of lab tests to see what we can do to improve her health somewhat, but she also needs food and shoes and a blanket and life’s necessities. Her needs only partly fall under the medical fund’s scope. We hope to find someone to help with the rest.
There are others, there will always be others. These two families are simply at the very top of our list at the moment. If you want to help, e-mail me at zangmo@customjuju.com and I’ll tell you more. If you have already helped, thank you again, from the depths of all of our hearts. Blog readers really ought to rule the world!

Bless every single one of you who has contributed to the Emergency Medical Fund. It has helped so many people, from the nun with a sinus infection to the laborer with a wrenched back to a huge number of people who have needed $2 or $5 worth of medicine that we’ve been able to buy for them.

Men cry here. If there was any doubt of that, the generousity of strangers proves that the men of India and Tibet are not afraid to shed tears of gratitude and relief. Sometimes of sorrow because, no matter how much is given, we can’t save everyone, just try to ease their pain. People pass through our lives. It often seems like the work of some karmic power that puts these people in our path. Their Karma. Our Karma. YOUR Karma…
This is Thupten Dolma. She’s Kinoori, the mother of a bright young monk who helps Wangdor Rimpoche with his statue project. If he were in the States, he’d make a brilliant contractor. Here he donates his time and intuitive knack for engineering and managing to the monastery and to Wangdor Rimpoche. He’s helped us a lot in the process of getting our house together since he knows how things work here and where things come from. Thupten Dolma was taken to the hospital last week in extreme pain, vomiting blood. From the local hospital, she was sent up to the big hospital in Chandigarrh, six hours away. At first they said she would die. Lodro Taye, the wonderful young man who has done so much for so many people here, called in tears from the bus depot. In a place with total emphasis on family connections, she is his closest relative. They were abandoned by his father when he was a little boy. Thupten Dolma works as a servant for room and board. The family has no money, but they have much good will. Everyone pooled resources as they were able. We sent 10,000 rupees (US $220) from the fund. She’s had an operation. She survived that. We’re waiting for more tests to see the prognosis. If necessary, we’ll move her into our spare room to recover and hire someone to take care of her.

This morning, the carpenter who has been building furniture and doing all the woodwork in the house came to collect his wages for the past month’s work. Hat in hand, he asked if he could possibly get an advance for the next month’s projects. He’s so good and so honest, we felt no hesitation in giving it to him. Then, over tea, we were able to get the story of what he needed it for: His grandmother who fell and broke her leg. It’s pretty bad and they want to do an operation. Lena is going to look at the hospital reports and x-rays and consult on that. In the meantime, it’s been set and she’s on medication. In this place, a broken leg is a real big deal. Our carpenter is the sole support of his extended family, including grandparents. His grandfather gathers kindling in the forest to help out. The bills so far have come to 5000 ruppees (about $110 US) which is a huge sum and he’s freaked about it. The operation, at 12,000 rupees is so far beyond them that they have been thinking it’s impossible. If they need it, we’ll find the money. We gave him enough to cover Kimi Devi’s expenses so far (that’s her name) and, at first, he protested, saying he worked for a living and wasn’t a beggar. We explained that there was a “Fund” - something he understood. Though the way it is seen is that the money comes from “God” or “the Gods” who have moved in people’s lives to motivate their hearts and give them enough gifts and bounty that they contribute to the fund to share with others. Anyway, he cried too. He’s a really really good man and we’ll give him as much work as we can, but the medical fund will ensure that Kimi Devi gets the care she needs.

Here’s Sonam Yutron in her wheelchair, out for a kora around the lake. Everyone is practically fighting for a chance to push her, so she’s got no lack of assistance in that department. Her husband, Lobsang, had tears in his eyes from happiness as he watched her out in the sunshine for the first time in 4 years. They thank you all from the bottom of their hearts.

This is Ani Chonyid, a nun who lives up in the caves at the top of the mountain. She was one of the first people up there, coming as a young refugee out of Tibet in the early years of the 1960’s and living on pretty much nothing while building a place that other women refugees can come to for safety and retreat. Chonyid is a powerhouse, a force to be reconed with. She’s a powerful practitioner of Chod and usually serves as the “Umsey” (leader of the ceremony or chants) for the cave community during that intense ritual. The air around her crackles and sparks and yet she has a wonderful sense of humor as well as tremendous power. She also has a rotten gallbladder full of stones that needs to be removed before it goes necrotic. She’s had to have fluid drained out of her abdomen and has missed gatherings and ceremonies due to her illness. She’s on our list of people who need assistance with their medical problems. The trick right now is getting her to stop long enough to get the serious operation she needs before it gets any worse.

These are some of the more serious cases we’ve been able to help. There are many more people, Indian, Tibetan, Ladakhi, Kinoori and travellers passing through from all lands, who turn up on our doorstep needing help with medical conditions. Thanks to the kindness of donors, we are able to make some difference. Please, keep on contributing. If you can’t or won’t do PayPal but would like to make a donation, email me at zangmo@customjuju.com and I’ll tell you how. To those who already have contributed (and especially to those who continue to contribute) Thank you. You have the power to make grown people cry.

Oh yes. Here’s one more picture of somebody who came to us out of some sort of karma. We’re calling her “Chime” (rhymes with Jimmy) which is one of the Tibetan words for “cat” in some dialect. I called her that and she answers to it, so I guess that’s her name! For now. She’s moved in pretty thoroughly. Broke the yoghurt dish in the night trying to help herself and chased off another cat who dared to encroach on “her” turf!

Taken in the dark kitchen as she stood by “her” food bowl and requested breakfast!

Since Nyondo and I are sharing the single working cell phone until we can get a replacement for mine, we’re also sharing the posting of what has been happening around here. If you haven’t checked out her blog yet, please go HERE to see the latest on what’s happening with the Emergency Medical Fund. Meanwhile, I’m working on writing blogs offline to post when we have the technology under control again.

The above is definitely one of those “pictures worth a thousand words.” This is Sonam Yutron in the moment she looked out the window of her dark little room and saw the wheelchair we’d brought her for the first time. So much joy and hope. And all of you who contributed have made this possible. We still have some work to do, modifications, ramping of the steps at her house, figuring out the safest way to get the chair downhill. But it’s happening and one family’s hard life just got a little brighter thanks to several dozen strangers who found it in their hearts to help. We are, all of us, overwhelmed by the kindness and generosity you (you know who you are) have shown to these people on the other side of the world.

Another sweet moment - Sonam’s husband, Lobsang is just as touched and excited as she is. When they unloaded it last evening, he just stood there and sort of petted it in awe:

And so you can see it more clearly, here it is in its native habitat outside the shop in Mandi (down an old alley) where it was bought:

Not only have you contributed enough to get Sonam Yutron her chair and the other things she will need (ramps, bedding, commode, medicines, etc.) but many people sent notes with their donations that said to use it for the medical needs fund as necessary. Which means that we now have some funds to use towards things like Padma’s dental abcess, hygiene equipment for the stump of Tsering’s amputated leg, medicine for the little boy with kidney failure and so much, much more. Nyondo has set up a status bar on the blog to show our progress, she’s also working on getting a PayPal button up there as well to make it easier for those who (as some of you requested) would like to make donations for medical emergencies beyond the wheelchair fund. I promise I’ll keep a careful tally and give reports on how and where donations are spent. I will also, as time and internet permits, be sending each and every one of you a personal thanks.

Sonam Yutron has also sent her thanks. She says to tell you that ’s already begun to do prayers/mantra for the wellbeing and happiness of every single person who has made a contribution. Her intention is to do a million mantra for peace and health dedicated to you all and I am quite sure she will succeed - she is known here as a dedicated practitioner. What she would really love is to have pictures of each person who sent a contribution. It is Tibetan tradition to keep pictures of those who have helped you on your altar so you can visualize them as you do your prayers and dedicate the merit to the wellbeing of all.

I’m asking every person who has sent or does send money to also send me a photo of yourself in jpg fomat. PLEASE make it a small file - nothing over 50K in size as I’m using a very erratic dialup connection and can’t download big files. Send it to me at feraljoy@gmail.com with your name included. When I get enough pictures, I will make up a collage of photos and print it for Sonam Yutron’s altar. She will be really really happy about this.

I also want to thank you all from the very very bottom of our hearts. This outpouring of support and assistance has been literally overwhelming. Forgive me if I’m behind in replying to everyone’s letters and offers, it’s going to take a few days (especially at this internet speed) to go through and answer them all. I will, so be patient.

I also just want to say thanks for affirming my faith in the goodness of people in this world. It’s been a rough month for me in some ways. I’ve been dealing with a lot of post traumatic stress reactions as we approach two years since we so abrubtly and unexpectedly lost our home and the bulk of our lifetime of stuff and memories. There’s so very much to be done here and I’m glad, on a lot of levels, that we came, but it’s been hard to be away from loved ones, hard to feel helpless in the face of changes and loss. Change is the one thing you can count on in this life, but it’s always a shock none the less. It’s been really fantastic to feel so much positive response, so much kindness and compassion and love from people all over the world. That is the best possible kind of surprise.

Hey friends, I’ll keep this brief and hope that nobody is put off because I’m posting this here but we are really in a dilemma . The picture above is of an elderly (65 year old) Tibetan woman named Sonam Yutron. She and her husband live in al room here in Tso Pema. Most of you know that we are living in a small village in the Indian Himalayas where many Tibetan refugees have settled. I administer (voluntarily, I’m not paid in any way except in satisfaction which is high) a sponsorship program that finds people to send a little bit every month to old folks, children, refugee nuns and monks who have no other source of support. Lena, is our translator and doctor. She treats whoever comes to her and is really the only competent medical care in town at this point (occasionally there is a visiting doctor at the monastery, but this only happens a few times a year.) This who effort is totally grassroots, no corporation or sponsoring organization as the bureaucracy of that would be more than we could handle. A lot of the expenses come out of our pockets - we came with a suitcase full of medicines herbs and vitamines we bought and have used most of them. We buy antibiotics on an average of four times a week for those who can’t afford them and subsidize those who can. Lena treats both the Tibetans and the Indians here, whoever is sick. There are huge vitamin deficiencies among other things. So. The immediate problem: A few days ago, Lena was asked by an elderly man if she would come and take a look at his sick wife. Sonam Yutron. Lena went into their tiny room and was overwhelmed by what she found. The woman has crippling and severe rheumatoid arthritis. She’s bedridden and in extreme pain, crippled in her legs, hands and spine. She can’t get to the bathroom, so you can imagine that condition despite her loving husband’s best efforts. She hasn’t been able to leave her house or even see the sunlight in a year. We need to do something here. We’ll get her the necessary anti-inflammatory medicines of course and try to get some lab tests done. But her being bedridden is probably the most serious aspect. It’s causing other associated problems on top of the arthritis, including a really bad quality of life. What we want to do is get her a wheelchair asap so she can get out of bed and out of the house and her bedding can be changed and she can get out in the light and air. Unfortunately, we’ve checked and wheelchairs are almost as expensive here as in the west. So we’re trying to raise the money - we need a minimum of $100 and possibly $200. So I’m putting out an appeal to everyone I know. If people feel able to send even a buck or so via Paypal, we can get Sonam Yutron a wheelchair and she can sit up and see the sun again. A ramp can be built to get her out of the room they live in. Medicines and things like clean linens and bedpan can be obtained. Anything contributed that exceeds the $200 will go into the fund for medicines and vitamins for the refugees and poor villagers. The Paypal address to donate to is: zangmo@customjuju.com. I’ll let everyone know what we’ve collected and post pictures on my blog of Yutron and others we help.