Pharmacy and Hospital Adventures

19 10 2010

I’m getting to know Kathmandu hospitals very well because my mother-in-law has been in and out of them frequently in the last couple months since I’ve been here. I don’t mean to paint a negative picture, but let me just explain a couple aspects that are strange in comparison to American hospitals from my own experience.

Even in American hospitals, and especially in emergency rooms, it can be difficult to maintain complete privacy (those open-backed hospital gowns are a prime example) but people try, or at least I hope they try. Here, privacy is a different matter. We took my mother-in-law (“sasu” in Nepali) to the emergency room in the middle of the night recently. After she was stabilized, a young man was brought in by his family. Once the doctor finished examining him, the doctor chuckled and began telling my husband Suresh and I how this young man and our mother were admitted for the same problem but from different causes – and then he proceeded to tell us all about the other guy’s causes and symptoms. A similar incident occurred the last time she was admitted. We arrived in time to see the head doctor during his rounds. He explained sasu’s condition, very loudly, while approximately 10 people formed an eavesdropping huddle around us.

There are private hospital rooms but they’re more expensive and get snapped up quickly. Consequently, you’re forced to share a room with at least 3 other patients and sometimes, if you get stuck in the general ward, you might have 20 other patients beside you.

But the privacy thing isn’t as unfortunate (in my opinion) as the fact that patients are expected to have someone besides hospital staff attending them nearly 24 hours each day. And let me just say that this is strange from my perspective as an American with a background where the family unit is defined as immediate family (i.e. parent(s) and any offspring). The round-the-clock expectation works in Nepali society because the family unit includes extended family and unrelated people who are like family. In the United States, if the nurses or doctors think the patient needs a saline drip, they’ll bring the saline, hook it up and add the cost to the final bill. In Nepal, if the doctor or nurse decides that the patient needs saline, they’ll tell the family member or attendant and that person must go to the pharmacy next door and buy the saline before it can be administered. If the patient needs a shot, the family even has to buy the syringes/needles first.  The hospital staff gets really mad at the family if there’s no one there and they can actually refuse to admit a patient if no one is available to stay overnight and throughout the day. What do people do if they’re truly alone in the world? I have no idea. Now you understand why there were 10 people eavesdropping on our conversation with the doctor, because there were all these non-patients milling about and sleeping on room cots. This doesn’t make for a sterile environment, and I don’t see how patients can get any rest because most of the extended family and friends are talking on their cell phones the whole time or idly chatting with one another.

And maybe I’m sick for the second time in the last 2 weeks from being in these unsterile environments, but it’s abnormal to get a cold twice in a row that includes dizziness. I decided I had a minor sinus infection and, rather than seek the above hospital’s help (you can understand why), I took the self-diagnosis route and used the internet. It’s possible here in Nepal to buy just about anything without a prescription at any pharmacy, and that could be why so many people here suffer from liver and kidney disease. I haven’t tested the drug purchasing limits yet except for buying antibiotics to keep my late cat alive a little longer (may “Slipper” rest in peace). On the internet, I Googled “sinusitis remedies”, found a list of possible medicines to take, and sent Suresh to the above mentioned hospital pharmacy. He returned with an antibiotic and a nose spray to clear my congestion. But the nose spray chemical was unfamiliar so I read the instructions and used the trusty internet again to double-check it. Turns out, the nose spray is for treating chronic bed-wetting and prevents you from accidentally urinating at night! SO glad I looked that one up first, but we had a good laugh over it. What’s not funny is that I was able to quickly answer my drug questions but what about a Nepali citizen without home internet. I could easily read the English instructions, but what would a Nepali who doesn’t read English do?

In future, maybe I won’t complain so much about the American healthcare system. But I probably will anyway.

So that I’m not being completely negative or one-sided, let me just say that Nepali doctors and nurses, in my observation, don’t have to deal with the same sense of entitlement that some American patients (and Americans in general) angrily express. Maybe that will change as Nepal’s middle-class steadily grows. Given the available resources, the doctors and nurses do their jobs with humor and hope. The emergency room doctor in my first anecdote amused himself with the similarities between my sasu’s condition and that of the young man in the next bed. Perhaps he was trying to make both of them laugh at their predicaments. (Insert cliché here about laughter being the best medicine).





Earthquake Update

18 10 2010

As I wrote my last post in the early morning hours, I thought I felt an earthquake. Turns out, it was an earthquake. Guess it wasn’t my imagination after all. The quake measured 4.9 on the Richter scale – not huge but enough to make things shake a little. For more info, read here.





Vijaya Dashami (Happy Dashain)

17 10 2010

 

Tika puja accoutrements, including the jamara barley sprouts

Tika puja accoutrements, including the jamara barley sprouts

 

Today is the 10th day and culmination of the Dashain festival, or what I like to call “Nepalese Christmas”. The holiday is also referred to as Durga Puja because people worship the Goddess Durga in her many avatars or manifestations. Dashain is the most auspicious time of the year in Nepal and it’s a much bigger holiday for Nepali Hindus than it is for Indian Hindus for whom Diwali/Dipawali is even bigger. For Nepalis, the last night of tika is most important, whereas in other Hindu cultures other auspicious days within the holiday may be more important. For example, the 9th night of Durga Puja, when animals are sacrificed, is most important for Hindu Bengalis because Durga is an important Goddess to them. One of Durga’s manifestations is the Goddess Kali, and she is quite bloodthirsty. Animal rights activists do not like Dashain because on the 9th day thousands of male animals are sacrificed to appease Kali/Durga, and then eaten that night or the next day during the final celebrations. Hindus only kill and eat male animals because females replenish life through birth. The parade of animals into Kathmandu markets began last week and it’s been a painful week of walking streets lined with cute goats ready for slaughter. Not all the animals are killed in religious  sacrifices. After all, people need to eat, too (especially during big family holidays). For animals that are being religiously sacrificed, a priest conducts the sacrifice at a temple. For those who just want to eat the animal, the eldest male relative, another respected male family member, or whoever is least turned off by killing animals would slit the animal’s neck.

The type of animal you sacrifice in temple depends on which gods are most important to you and your family as well as what you can afford. Non-religious slaughters depend on what you like to eat, as well as what you can afford. Durga/Kali likes water buffaloes, but she’s bloodthirsty so she’ll take what she can get. Other gods might require other animals such as ducks, roosters, pigeons, goats and others. And the gods don’t need the whole sacrificed animal or whatever food you offer them. You get to take the “leftovers” home as prasad because your offerings retain the blessings of the gods. Getting back to animals, the going rate for live roosters from Kathmandu’s Durbar Square was 1500 rupees, or about $21. I have no idea how much buffaloes cost, but you can probably take a guess based on the rooster price. By the way, buffalo meat is called “buff” here and when you order a burger in a restaurant, you’re probably getting buff meat since cows are sacred to Nepal’s Hindus. I don’t eat red meat so I stay away from buff and goat meat. However, when I’m traveling and living abroad (or even when I’m at someone’s house for dinner back in the U.S. and don’t want to appear rude) I eat more adventurously. So yes, I’ve tried both buff and goat.

During Dashain, many return to their ancestral homes or wherever their families live for tika (blessing of powdered pigment and rice on forehead), feasts, and gambling to honor Laxmi, the Hindu Goddess of wealth. This week, Kathmandu is actually quiet and pollution-free since at least one-third of the population returned to their villages for the final celebrations. My husband arrived in Kathmandu from Iowa last week and he’s been busy conducting the daily puja (worship) of planting and watering the barley seeds that grew, by today, into the sacred sprouts of jamara given by elders to younger family members as a token of Durga’s blessing during the family tika ceremony. There are several important days during Dashain when certain pujas must be performed at astrologically auspicious times determined by Hindu priests.

If I’m not doing the best job of explaining the holiday, I apologize. Dashain’s origins come from different accounts in the Ramayana Hindu holy text. It’s very complicated and you’ll hear a different version from nearly each person you ask. I’ll quote an explanation from Mary Anderson’s 1988 edition of “The Festivals of Nepal”:

 

Dashain goat

Goat being taken home for Dashain sacrifice and/or meal

 

The festivities of these two weeks glorify the ultimate and inevitable triumph of Virtue over the forces of Evil, commemorating a great victory of the gods over the wicked demons and devils who harassed mankind in ancient times. The Ramayana story is retold of the righteous King Rama, deified in Hindu mythology as an incarnation of Lord Vishnu, or again as God himself, who after epic struggles slaughtered Ravana, the fiendish king of the demon hordes from Lanka, a legendary country believed by many to have been Ceylon [modern day Sri Lanka]. Some say Lord Rama was successful in his battle with the demon only when he evoked Shakti, or Supreme Energy vested in Goddess Durga, the Divine Mother of the Universe. Others have it that Rama’s saintly wife Sita, having been kidnapped by the demon Ravana, assumed the form of the Terrible Destructress, Goddess Kali – otherwise known as Durga – and destroyed this thousand-headed King of the Demons.

Greatly celebrated during Dashain, again glorifying the triumph of Good over Evil, is Goddess Durga’s slaying of the terrible demon Mahisasura, who roamed the earth, terrorizing the population in the guise of a ferocious water buffalo. Other accounts reveal how Lord Rama, having sworn to kill the evil Mahisasura of the Underworld, enlisted the Divine Energy of Goddess Taleju – still another of Durga’s many forms – promising to take her to his Indian capital of Ayodhya and erect there a temple in her honor…No matter how the story is told, victory is celebrated during Dashain fortnight with great rejoicing, and Goddess Durga is adored throughout the land as the Divine Mother Goddess who liberated the suffering people from the miseries of Evil.

After reading this excerpt, you can understand why an easy explanation is impossible! And lest you think the holiday season is over, there’s another 5-day holiday in early November: the Diwali/Dipawali festival that I referred to earlier, or Tihar as it’s called in Nepali.

In late-breaking news as I finish this post, I could swear I just felt a small earthquake. It’s 2:00am here. Hopefully there will be something in the news about it tomorrow. If not, it’s my imagination and I’ve had too much cold medicine.

 

 

Dashain tika

I decided to have a little fun while giving my nephew tika. The tika paste really belongs on the forehead. Note the jamara sprouts behind his ears.

 





Finally, Some Art

6 09 2010

Life in Kathmandu is becoming more normal, despite the continuation of the student strike at one campus and postponement of classes at the other. In the meantime, I’m conducting “workshops” at another university that, for the time being shall remain nameless in order to prevent more political squabbles. It is nice to feel useful and to have the chance to interact with Nepali art students, who just want people to respond to their art. I’m working with a group of 4th-year painting/drawing students, giving them feedback on their works-in-progress and assigning special projects based on art videos I brought with me from the States. The students were very shy at first but I began talking with each one individually about their artwork and they opened up. So, we’re making progress on the teaching front. Baby steps.

Art Studio

Nepali art students break from viewing Sanjeev Maharjan's artwork at KCAC to photograph the sunset.

I’ve also attended several art functions and appeared at other events advertised in the English language newspapers. Since I don’t/can’t subscribe to any of these newspapers, I’ve taken to camping out in a hotel lounge every Thursday and devouring their stock of free newspapers and weeklies advertising weekend happenings.  The Kathmandu Contemporary Arts Centre (KCAC) is one space that hosts a variety of events including a panel discussion I heard the other day entitled, Should Contemporary Nepali Art be Imbued with or Reflect an Innate Nepaliness? Of course, the discussion was entirely in Nepali but I managed to get the overall idea and will need to interview attendees for their feedback as part of my research. The topic fits perfectly with my research into contemporary Nepalese art and how Nepalese artists situate themselves between cultural traditions and the impact of globalism. Between this lecture and the other one I attended last week on Hybridity & Negotiation in Contemporary Nepali Painting, it’s clear that Nepali artists are experiencing the growing pains of the wider culture as it struggles to define itself. As difficult as that sounds, it’s also an exciting time because of possibly profound results (think American or French Revolutions, or any number of other historical upheavals).

Much of the worry is over the adoption of Western Modernism (and to some extent, Postmodernism). These movements were a response to their contexts and they developed regional characteristics, even if the broader definition of these movements was or is similar. To some, the application of modernism to Nepali art is like a veneer that doesn’t enmesh with cultural artistic traditions (but hey, that would be postmodernism, right?). Therefore, these questions about “innate Nepaliness” and “hybridity and negotiation” are central to the debate. Nepal was never colonized by a Western power, but the questions are very postcolonial. It will be interesting to see what happens!





Getting to Nepal

15 08 2010

Having been stranded overnight in Chicago-O’Hare in June (on return from Fulbright orientation) and delayed on a recent 18-hour return flight from Sydney, Australia, the flight to Nepal wasn’t that bad. There was just a bit of turbulence that made people who hadn’t fastened their seatbelts fly up into the air, but I don’t think anyone was hurt.

I flew from Cedar Rapids, Iowa to Chicago to Delhi, India before taking the next day’s flight to Kathmandu. My overnight experience in Delhi’s Indira Ghandi airport was much better than last time (in 2006) because the international terminal is brand new — completed last month. They even have chaise lounges sprinkled throughout the airport, so you can actually stretch out instead of sleeping upright in hard chairs!

While waiting in the transit area for the next day’s flight, I saw someone I knew from Davenport, Iowa. She and her mother were returning from a summer in Nepal so she could resume classes at St. Ambrose University. The cliche of a small world is really true. I also met some nice Nepalese people who’d been on the same Chicago flight on their way to Nepal. We helped one another get to the gate and watched each others’ bags during bathroom breaks.

After landing and getting a temporary visa, I was met by my husband’s older brother Subash and his wife Archana. I will spend the first couple days with them until my Fulbright apartment is ready.





Pre-Departure Orientation

8 08 2010
Fulbright Orientation

One of the many informative sessions for South and Central Asian Fulbrighters

Thank God the State Department sponsors a pre-departure orientation for all of us, because I had so many questions and was anxious to meet the other scholars and students going to Nepal. Although I wish it had been earlier, the orientation was in June and it was held in Washington DC (another grant perk is airfare, hotel and a stipend to cover food/transportation).

Altogether, there are 24 of us going to Nepal, some all year and others (like me) for part of the year. Each of the country sessions was run by Fulbright Directors and staff from those countries, who’d made the trip to Washington DC for this event. These people basically function as our host country saviors for any questions or assistance.

Besides meeting the Nepal crew, it was so great to connect with people across disciplines who will be in the other South and Central Asia regions. I met the most interesting and amazing people conducting research in areas like malaria eradication, health problems (like diabetes) resulting from the obesity of Western-influenced diets, and architecture of ancient water wells.

And the larger Fulbright sessions themselves were extremely informative and even funny at times. The presenter of the accident and sickness program wanted to make sure we knew that if we should happen to die while overseas, their program would pay to ship our bodies back to the United States, but not our personal belongings! Other sessions included cross-cultural communication, personal safety and security, opportunities for Fulbright alumni, and special sessions for students, scholars and any dependents who might be accompanying scholars.

Fulbright Orientation

(Left to right) Here I am with other Nepal Fulbright Scholars Deborah Merola, Vaidyanadhan Krishnan and Lakshmaiah Sreerama