ROAD BLOG AHEAD

I’ve mentioned before that I don’t get out and about a lot here these days due to some health problems. Fortunately, we have plenty of visitors and the house we live in has an open veranda overlooking Lotus Lake and the mountains to the East and North. I can step out onto the long balcony and say hi to my neighbors as they pass by, feel the sun on my face and see sweeping vistas.

Thursday, however, was one of those exception days. We had a bunch of errands in Mandi, our nearest “city” of any appreciable size. That means that they have things like ATMs, appliance stores and other modern outlets that most people born and raised in the mountain hamlets hereabouts don’t even know exist. We’ve met plenty of villagers who have never been as far away as Mandi (about 32 kilometers) and many others for whom such a trip is a really major event that happens seldom. When you grow up in a tiny farming hamlet

and consider Rewalsar (the village surrounding the lake) to be “town,” the idea of going into city of thousands of people can be overwhelming. For Lena, Nyondo and I, raised respectively in New York, Los Angeles and Chicago, Mandi is a quaint, charming small town, albeit an Indian town which means much more colour, noise, scent and people than a similar place in Europe or North America. I hadn’t been in there for months because of my unpredictable health, but I needed to go into one of the local hospital labs and get a whole bunch of blood drawn and sent off to the state-of-the-art medical facilities in Chandigarrh. There’s an itsy bitsy stall that functions as a laboratory in Rewalsar (when the lab guy feels like going in) but really, the best they can offer is to check blood to see if you’re anemic or have some sort of infection and possibly a routine urine analysis. I need to figure out just what the heck is going on in this body of mine and, for that, it means Mandi.

The ride down from our mountain home to the lower elevations at which Mandi sits is worth the price of the taxi ride. At first, it’s mostly stark, sweeping mountains and pine forests. On a clearer day, you can really see the glint of sunlight on the snowy Himalayan peaks. With the winter rains so far behind schedule, the air is hazy, full of both dust and the smoke of thousands of wood and dung fires lit morning and evening in every farmhouse and hut in the region. It’s still a remarkable vista:

The world we live in is as much vertical as horizontal, distances measured both by altitude and kilometers. Agriculture is seriously vertical: as we descend towards the valley the air warms noticeably and the land around us gets greener. Not flatter, just greener - the Himachali people have been terracing arable land in these mountains just about forever and they have their farms clustered wherever there is soil and water worth using.

What isn’t obvious in these pictures that show such vivid green is that much of this crop is winter wheat and most of it is far far too short and stunted. While we’ve had a couple of days of rain in the past week, we’re still many inches short of the norm for this place and season. Farmers are getting panicky as they watch one major cash crop after another shrink in the dry air. It really hit home to me when I saw the river outside of Mandi. It’s not a huge, rushing river, but it does flow and it is a water source. At least it always has been. This is how it looks today and that’s pretty alarming:

There are shrines along the road to various of the Hindu deities. Some I recognize, some I don’t, but all of them are colourful and well-tended and just sort of pop unexpectedly out of the landscape as we round corners:

And we round lots and lots of corners. Just as the farmland is not flat, neither is the road we travel. The grab bars in our vehicle are more than just a nice idea around here - they’re a necessity if we don’t want to find ourselves thrown left and right and even righter as our driver, Ramesh, takes the curves at speed.  You can do this if you’ve grown up around here as he has and know every twisty centimeter of this, the “main” road:

At its best, two cars can carefully pass, but it is rarely its best. Each time we come around another curve, there is the danger of meeting another vehicle at a point too narrow for passing. Then one of them must back up - without backing off the road and over the cliffs - until there is passing room. The narrowness of the roads is one of the reasons why scooters and motorcycles are the preferred private vehicles around here. You can almost always squeak by on a scooter, not so in a jeep or a truck. Much as I miss the independence of having my own car, as we tear through these mountains, I find it reassuring to have Ramesh at the wheel; we’ve ridden with him many times and he’s the best professional driver in this part of India. And a great guy as well so that journeys with him are always enjoyable.

Eventually we got to Mandi and Ramesh let us off at the hospital. It’s not much to see really and I didn’t think to take pictures there until we were in the lab itself and then it was to take photos of two of the lab employees who were wearing handknit sweaters. But this isn’t a sweater blog today so we’ll see those another time. Mostly, it was the view and the open sky that I wanted to share. I hadn’t realized just how much I needed a change of environment or to just go somewhere, anywhere different. We had lunch and then went for coffee on one of the squares and it was such a treat just to see people I don’t know and shops selling things that weren’t the same thing I see every day.

I need to do this more often! Of course, by the time I got home, I was exhausted and went right to bed, but my mood and enthusiasm have been great ever since. And, hopefully, we’ll get some information from the lab tests that will solve the health puzzles and actually enable me to get out and about on a regular basis. Just the sweater-watching along was worth the trip and there is so much more to see and do and explore around here while the weather is good. Oh, I guess I should comment that, for me, “good” weather means cold weather, somewhere around 60 degrees F is ideal. Once we hit spring here in Himachal and the temps rise, it’ll be too hot for this gal. Fortunately, that’s the time we’ll be heading towards the U.S. for our annual visit. I’m looking forward to that as well. I have some very very special little people waiting for me there!

    

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.