Sindure village is one of the old feudal capitals of Nepal, where a king once ruled over Lamjung district before unification in the mid 1700s. The drive from Pokhara takes about 6-7 hours…the last three are very bouncy.
Our day began in a downpour at 6:30am, with the usual wakeup activity: loading a dental chair on to the top of a Landcruiser. We packed in various boxes of medicines, adjustable stools, plastic goggles, and this fancy Hello Kitty timer. Because Virex disinfecting soak is 20 minutes, exactly, and one must have a proper timer.
Also, we had an extra passenger and her little boy who were headed home to their village. They set up in the front seat, and the little boy kept arranging himself with his knees splayed out and the bottoms of his feet together, so Neha quickly named him Laughing Buddha. Mean time, we squashed ourselves in the back of the cruiser and set off in the rain, picking up our senior technician Megnath on the way. And then we were off to our first ever clinic opening in the district of Lamjung.
We settled in and the cruiser bounced joyously along. It was strange to be headed off to Lamjung again, where we spent many long hot days after the earthquake at this time last year. I was apprehensive about how our clinic setup would go, if the whether would clear, if the road would be passable, if a lot of things. And it was Sunday the 26th, exactly one year after my beloved friend Mary passed away on another rainy and pregnant day last summer. I stared out at the passing rain and fog, thinking about each moment I’d spent on this morning last June, checking my phone for updates from the other side of the world, stunned and devastated by a sudden change of events.
Then again, the bracing car ride left minimal opportunity for rumination. A few hours in, we stopped for tea, and shortly afterwards, Laughing Buddha barfed all over Gaurab in the front seat.
Well, the best part is yet to come.
We arrived at the Health Post in Sindure at 2pm to find that, while work had been done on the clinic room, such as making sure it had a roof over the entryway, the room itself was filthy. To give you a frame of reference, here are pictures from main room of the Health Post, which sees patients regularly to distribute medicine and make referrals. Unlike our dental clinic, the Health Post is not performing surgical-type procedures—nevertheless, setting up a dental clinic with rigorous infection control is, well, basically up to us.
Still, there’s a reason we rely on rooms provided by the community instead of building ourselves new facilities. I’ve seen how that can be the difference between imposing new resources haphazardly, and mobilizing existing capacities to raise things to the next level first. Then it’s a good time to push the boundary, which in this case as in many others, has not yet been approached. After all, with some sweeping and a few buckets of water and phenol, our dreary clinic room started looking a lot better. There’s no water source at this Health Post, so Dilmaya, Neha, and the Health Post Assistant good-naturedly hauled buckets of water from a “nearby” house at least a quarter mile away.
A few hours of washing, drying, and setup, and things are improving already. This room will need a nice bright coat of paint on its stained walls – we provide the paint, the team does the labor – but for now, here is JOHC Technician Jagat Dura in his new office! And we’re not even at the best part yet.
During our pre-opening day, a veteran technician and our medical field officer go over everything from top to bottom with the new technician (who’s already had weeks of training before this) and clinic assistant. It was awesome watching Megnath Adhikari, who started with us in 2013 and now runs the Puranchaur clinic, reviewing with the new clinic team everything from how to put the top on the autoclave to how to fill out the patient forms to when to change their gloves. Our infection control protocol, when followed, is stricter than that observed by many field teams and local hospitals. The new teams always look so new and wide-eyed that it throws me off every time. To be fair, imagine if you took a few weeks of training in dental medicine, and then, say, your congressman came in and asked you to pull their tooth out?! But then, as the months go by, inevitably these green clinical teams turn in to people like Megnath, who started out with sagging jeans and a quizzical look, too. This growth in skill and confidence, which I’ve witnessed over and over, is one of the coolest things about this program. It inspires me to believe that this is a system that could be deployed widely by the government with the right investment in training and resources.
Senior technician Megnath Adhikari reviewing use of the autoclave with the Sindure team
In the evening we stayed at the home of our technician, Jagat. His mother cooked heaps of food and poured us one cup of local moonshine after the next. I was so tired I kept falling asleep and had to get out of bed for each succeeding round of dinner. And still…the best part is yet to come.
Sindure is a predominantly Gurung area with different traditions of respect than many of the other areas where we’ve worked. The local President had spent the evening with us, and after everyone was overfed, it was time to sit around and sing for a while. I’m not a very good traditional Nepali folk singer, but I’m a decent self-taught drummer and chime-player. So, having secured an empty plastic bottle and a set of tin cups, I am confident saying my role in this process was solid, although you can’t hear it in this video cause I was filming.
The next morning dawned in a downpour, which cleared as we made our way to the clinic for opening day. The clouds nestled down in to the hills like cotton and we climbed up over them. Sindure was too beautiful to leave out a scenic photo.
In an opening ceremony, we were each given gifts, and I received the finest one, a magnificent Gurung-style ornament made by our technician’s grandmother. These shiny dangles are made from cracker and candy wrappers! I love this thing.
The door to the clinic was officially opened by the Singing President, who had apparently recovered from last night’s revelry and lay down honorably as the first patient. Jagat performed his inaugural checkup, supervisor standing by, with a crowd peering in the door and looking very enthusiastic about this whole thing. Who knew dentistry could be this entertaining?! And we’re still not at the best part yet.
Now then…nothing like showing off your new filling!
It is currently the busy rice planting season, which is about the worst time of year to open a dental clinic because everybody is in their fields. Nevertheless, we had a pretty solid attendance from a fleet of Female Community Health Volunteers (official women’s health workers trained by the government) and some other folks here and there.
We plucked various people off the road, such as one man walking by on his way to plant rice. All in all, the new clinic was inaugurated with about 25 patients, with Megnath carefully supervising the new team, and seeing that was especially gratifying.
As our day was coming to an end, I happened to look up at the sky. And for only the second time in my life – the first time being on the sacred day thirteen after Mary passed away – I saw the following sight:
Look! I cried, look! Everyone turned their faces up and let out a collective breath of delight. I ran over to a clear patch of ground to try to get a picture, but my camera was having trouble focusing while pointed directly in to the sun.
“It looks just like a roti!” exclaimed the man who had stopped by on his way to plant rice.
Now then, my mind chirped, this must happen a lot. Weather patterns are repetitive; I mean, I know where to find all the rainbows in Kaskikot, and in what sort of light. It’s so predictable that I’ve usually climbed a hill and pointed my camera already by the time a rainbow is emerging. Still, I consigned, how lucky for me to receive this lovely gift today in a brand new place.
“Do you see this kind of rainbow often?” I casually asked the man who had stopped by on his way to plant rice. To confirm my suspicions.
“I see rainbows all the time,” he said, “bent sideways like this. But I’ve never seen this kind of round rainbow in my life!”
I clicked and clicked in to the sun, and the shutter went off only one time. Almost immediately, the clouds moved back in and the wonderful roti faded away.
Later that night, after a long, bouncy and exhausting ride home, back in bed in Pokhara, I lay in the dark and pulled the photo up on my phone. I turned it this way and that, looking for something. I kept thinking of Mary saying trying to show me the big hand in the sky, and how I couldn’t find a thing until much later. I zoomed the photo in and out and scoured for clues. Then, tired and lonely for her, I held the phone back and sighed. And there, right where I couldn’t miss it, was a perfect Buddha, the sun shining from its heart.
Once I saw it, I couldn’t not see it.
As a little extra flourish, an unmistakable smiley face, etched off to the right hand side, grinned at me as if to say: how obvious do you want me to get, you little shit? I clicked my phone off and fell asleep with it lying near me on the bed.
Welcome to Sindure, world.
A Life of Love