Tag Archives: Life and Death

America, Around Town, Earthquake, Kaskikot, Nepal Life, Reflections, Work

A House of Mirrors

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These past few weeks, I increasingly find myself reliving the morning of April 25, 2015, when my phone woke me at 6:30am. I rolled over and Prem was on the line: a 7.8 magnitude earthquake had ripped through Nepal. I stumbled to the kitchen table in my slippers and didn’t move for what seemed like days. The papers were covered with images of fallen temples that were whole in my albums, with tent cities at familiar outdoor intersections in Kathmandu, with maps seen from high above and covered in digital markings. It was a long time before anyone could capture photos of people, especially in the rural expanses of the country, which were accessible only by helicopter for what seemed like ages. But in my mind’s eye the earthquake was a long, long parade of individuals. Today, I reread the email I sent out three days later.

It is a strange feeling to find the whole planet in crisis. Population-level disasters of this scale seem to disproportionately fall upon the shoulders and homes and rivers of the world’s most vulnerable places, while the other places try to help. In the years I have worked in Nepal, Nepali people have plodded on through civil war, three major government transitions, annual landslides and floods and hail, the 2015 earthquake, water shortages and electricity outages up to sixteen hours a day for years on end, and of course, the daily vulnerability of chronic poverty, weak infrastructure, and floppy safety regulations. The road to Kaskikot has had three bus accidents in the time I have considered it my second home. I remember thinking after the earthquake, as I watched messages flood my accounts, that people didn’t realize how often Nepal’s communities were used to seeing things broken, taken, lost, or never having existed in the first place. The earthquake was unthinkably horrible. Yet for those who didn’t lose everything–people, entire villages–that trauma was largely swallowed within a few months by massive shortages of petrol and goods due to political instability and border closings. The summer brought deadly landslides. Six months later, most of the country was no longer discussing the earthquake.

These last few weeks have been an odd, house-of-mirrors experience. While Nepal is facing pandemic, New York City and Milan and Barcelona and Sydney are also facing pandemic. My colleagues are quarantined in Pokhara and Kaskikot and Tilhar, and I’m quarantined in Hartford, and Prince Charles is quarantined in London. The realization that anything could happen to anyone at any moment has set upon us all, a realization that seems to be expanding daily. And amidst a great deal of chaos and uncertainty and worry, I find myself in occasional moments of disconcerting calm. Things were always this way. Now they are simply unveiled. We are all the defenseless Other.

Now as then, there is great beauty to uncover in difficult times. In the months after the earthquake five years ago, we improvised. I have no idea how many kilometers Dilmaya and I walked. Practically speaking, I learned a huge amount about the contributions a small community-based organization like ours can offer in disaster management. At that time we found we were well placed to spend personalized time on unique household and community circumstances, to mitigate challenges that didn’t meet a universal disaster threshold but were extremely destabilizing for the specific individuals facing them. Our focus became “the lower percentage of damage:” the houses that were not fallen, but cracked and indeterminately unsafe. It was a life-changing experience.

Every day this week I’ve joined in a group call with my colleagues in Nepal as they work from home, developing a strategy to redirect our rural health care personnel from dentistry to coronavirus. Since we launched our Dental Hub app in September, hundreds of patients and their phone numbers have been entered in our database, so our first step is having dental technicians replace their weekly clinics with “phone clinics,” calling every patient in the database. We’ve created a script for checking in with each family to see how well they’ve been able to implement isolation guidelines and what if any obstacles are in the way. We don’t yet know how this will go or how useful it will be, but it’s something to do. It’s a way to be in community.

All that said…the 2015 earthquake was irreconcilably different than the looming crisis we are facing now. To begin with, the rest of the planet is occupied with its own emergency, not fundraising and overloading the aid channels in Nepal with variably useful assistance strategies. Second, Nepal’s health care system was inadequate to meet public need before coronavirus, and there is effectively no intensive care available for severe Covid-19 cases. So even though there are so far very few confirmed coronavirus cases in Nepal, I am still trying to understand how “flattening the curve” works in a health care system where the capacity threshold is fairly close to zero. We don’t know the answer, if there is one. I’m not sure yet if anyone does.

Like many of us, I can’t help but wonder how we would understand our society if we felt this vulnerable and interdependent all the time. It is deeply unfamliar to us in the dominant American culture–replacing the community of work-productivity with the community of survival. Confronting the primacy of the nuclear family, when that family is cut off from neighbors, schools, social supports, food production, occupation, and future planning. This discomfort feels worthy of deep and shared reflection. In the mean time, I have made a call list, and have been doing one quality catch-up each day with someone I’ve missed, or who I want to make sure isn’t alone.

For whatever reason I also found myself drawn back this week to this poem, written during the (still unresolved) family separation crisis at the US border in the summer of 2018. I hope to use coming weeks to catch up on past entries and continue posting about the unfolding of this pandemic Nepal on my blog. In the mean time, wishing all of you patience and resilience and comfort as we, as a world, navigate the weeks and months ahead.

*

 

At the Base of a Tree

The cicadas came when I was five
behind the school yard.
I put my finger on one
and then I picked it up
it was like a fig, dark and rough.

At five cicadas were interesting, like figs.

Now I am much bigger
friendly, the little goat nuzzles my shoulder with his warm snout
soft, we are alive, together easily.
And then I press my eyes shut
as I capture the insect that has invaded this carpet, which is mine
because I own it.

Sometimes I wonder how I can find my way back
from the pliant kid to the figs to the cicadas, captivated
with all their legs, their slick ribbed shells, all their songs enchanting
the school yard
all chirping and chirping tickling my ears until my ears overflowed with music
amid the crunching leaves and delicate wings
a symphony, a society, a universe blossom
after seventeen years of silence.

Sometimes I wonder
what we are afraid of
why we crush things, bugs and leaves and oceans and people
when I was five, I used
just one tiny finger
to say hello.

 

 

 

Reflections

Everest Part 2: Sagarmatha

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<–Read Part 1: The Height

Day 4: Joining forces

Thukla—> Lobuche / 5000m (16,404ft) /O2 sats high 60s

When I woke up this morning I felt immensely improved. My sats were still in the low 70s, but my appetite was somewhat back and the nausea and headache were mostly gone. I had originally thought I’d go up to Gorapchep and maybe even Base Camp today, but even I can learn to slow my roll in response to lack of oxygen. I planned instead to make a short hike about 300m higher to Lobuche. 

I decided to first take a walk for an hour or so around the area on the descending route that leads back down toward Dingboche. When I arrived back in Thukla from my short excursion, there were a handful of hikers there on their way to Lobuche. I was feeling the need for company, so I joined in behind them.

Thukla Pass

The indescribable beauty of Thukla Pass

The walk began with a steep rocky climb up to Thukla Pass, which sits in the palm of a stunning panorama of ocean-blue peaks. This site is home to memorials for climbers of many nationalities who have died on peaks in Nepal. The wind comes gusting through the half-crescent pass, keeping hundreds upon hundreds of fresh prayer flags in constant flutter. I was awed by the power and beauty of this place. We found the memorials for Scott Fisher and Rob Hall, who both perished in the famous 1996 Everest climbing disaster that is documented in Into Thin Air. One of my most vivid pre-Nepal memories remains reading that book on the bottom bunk bed in my freshman college dorm room. I placed a stone on each of their memorials, and we went on.

From Thukla Pass I clomped along behind my new companions, who included two Nepali guides and porters, a German, a Brit, an Italian and me the American (“there must be a war joke in here somewhere,” says the German). We reached Lobuche by 1:00 and I had the whole afternoon to rest. 

My head had a dull throb and my body felt oddly heavy. I lay back in my bed. My room was warmed by a buttery sun pouring through the window. I stayed like that for a few hours, picturing my blood circulating delicious air. In the evening, we all clustered around the heating stove in the dining hall, and ate light meals that our altitude-confused stomachs would accept, and played cards.

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Day 5: Sagarmatha

Lobuche —> Gorapshep—> Everest base camp / 5364m (17,598ft) / O2 sats 65

I have borrowed a fantastic pair of hiking pants from my long time friend Pemba Sherpa, but the button has broken. However, I am my father’s daughter, and you can be sure that I have a random collection of safety pins with me, because you never know when the button on your hiking pants is going to abandon you on exactly the day you are going to Everest Base Camp.

I arrived with my pants pinned at 6:30 for breakfast. I hadn’t been able to get a phone signal to send out any messages of my well being in two days, all liquid everywhere was frozen; hot cups of tea, once served, quickly threw off the efforts of the hard-working stove and turned to water, then ice. We ate small amounts of porridge and eggs and set off through a glacial valley at 5000 meters above sea level. I didn’t think to check the temperature, but once we got going, it actually wasn’t intolerably cold. And once we crossed the horizon line of ecstatic clear sun that was making its way toward us, we let out sighs of gratitude and I put my big futzy gloves away.

On the way to Gorapshep

The hike to Gorapshep was only about 2.5 hours and maybe 150m of climbing. It took us over rocky glacier bed dressed with ice and snow. We arrived at Gorapshep, where we’ll stay for the night, around ten in the morning. I clomped heavily up a wooden staircase to my room, emptied most things out of my backpack, and came down for a cup of tea. Even tea looked intimidating to digest; my O2 sats would sit around 65 for the next day. It feels like all the cells in your body are concentrating on breathing and nothing else.

Before we could get too content resting in warm sunlight outside, the German and I set off for Base Camp with his guide, Dinesh. But Thorsten and Dinesh were a few hundred meters ahead of me for most of the way, and I walked the hour and a half up to base camp mostly in the quiet of my own steps, boots grinding on ice and rocks. We had long since left behind anything green. It is amazing to think that nearly 800 people a day come through this way in the trekking season. In February, that number is about twenty, and I might just as well have been on the moon.

The first thing I recognized was the Ice Fall. Anyone who has spent any time learning about Everest has spent many imaginary hours scrambling precariously across ladders lashed together and fixed over the dangerous crevices that separate Base Camp from Camp One. In real life, the Ice Fall is far more otherworldly than I had understood. It is not a smooth cracked glacier but an enormous army of aqua-blue ice walls, lined up one to the next as far as the eye can see. 

And there in the distance, next to the base of the Ice Fall I spotted a cluster of yellow tents. Base camp. (In a few months, there will be about 2000 people here, but now the area is empty except for a dozen tents huddled together in the wilderness.). The arrival is marked by a large rock with EVEREST BASE CAMP 5364m spray painted across it. 

Climbing teams before the ice fall

Two intrepid winter climbing teams at Base Camp are dwarfed by Everest’s mighty Icefall.

Before I could do any normal tourist things, such as the obvious thing of taking a picture next to the spray painted rock, I got to chatting in Nepali with Norbu, a Sherpa climber with the German expedition.

Well, then this happened. Norbu Sherpa—who has summited all 8000m peaks in the world except for one in Tibet—invited me over to the German climbing camp. Normally tourists aren’t permitted in the expedition areas. But next thing I knew I was sitting in the dining tent, having a peek at the shower and sleeping quarters, drinking some coffee hot off the stove, and discussing the impending winter summit attempts with a combined group of Sherpa climbers from the two expeditions. One of them was the guy – the ACTUAL HUMAN – in charge of deciding where to lash ladders across the Ice Fall. So that’s how I got the selfie below of me and a group of world class Sherpa climbers hanging out and shooting the breeze at Everest Base Camp and now my life is complete.

Chillin with winter expedition Sherpa climbers

There was some discussion about coronavirus and whether or not the Nepal government would close climbing from the Tibet/China side of Everest (apparently the ministry of tourism is reluctant to lose the income, but the consensus among the climbers was that nobody wants coronavirus). And then Norbu Sherpa and the gang took me over to the Spanish camp, which is a much bigger team of 14 people and led by renowned Spanish climber Alex Txikon, who is making his fourth attempt at a winter summit, something that hasn’t been done on Everest since 1993. 

So this takes us to me hanging out with Alex Txikon in the Spanish kitchen, while the cook prepares imported Spanish meat over the propane stove. Actually, at that moment I didn’t really realize how well known Alex Txikon is, partly because I was so amazed by the fantastic Spanish cooking extravaganza before my eyes. (It smelled amazing; how did they get all this stuff here; who can eat at this altitude?) Txikon has made winter climbing his trademark calling and has succeeded in numerous winter summits. His team had arrived at Everest just two days ago and planned to be there for the next month.

I asked Txikon what they do on the days they aren’t climbing. I was thinking, probably lots of pushups and rope-skipping.

“Read, write, relax,” he said. “Be in nature.” And though I didn’t ask, he added (and I paraphrase), “Here on Everest, they just put people in the summit. That’s not what it’s about. It’s about working with nature. It’s about planning, not luck. It’s not about the summit. So many people who come here, they aren’t climbers. They don’t understand or appreciate what is to plan and interact with the mountain.” I filed away how he used the word “plan,” so many times. It was, in a way, plain to see what he meant. All these people living here all winter at 17,500 feet—where I survived a few hours mostly on adrenaline—did not have an ounce of entitlement about them. They were gently in a relationship, one of respect and diligence and patience.

Seek the summit, yes; but you shouldn’t be here if the summit is what matters to you the most.

“Hello,” said an enormously tall, fresh-faced German man as he popped into the Spanish kitchen tent. 

“Hi,” I said. 

Actually this man was climber Jost Kobusch, who like Txikon can be found in the newspaper, and who told me he’s attempting a route that hasn’t been taken up Everest in 40 years. 

“So, um, what are you doing today?” I asked. 

“Oh, fixing a thing,” he said. “It broke up there.” That was about the extent of our discussion, but Kobusch had a gentleness and authentic exuberance about him. He looked as happy to be fixing a thing up on a cliff over the ice fall at Mount Everest as some people look fixing their cars in the driveway with a beer on Saturday. 

I ended up spending about two hours at base camp—quadruple my planned time. Thorsten had long since headed back. I asked Anup, one of my new Sherpa besties, to take my obligatory photos on the “base camp” rock. And then finally, before leaving, I took some time to myself, outside of the adventure. To be with the Mountain.

I sat down across from Everest, whose summit just pokes out between Nuptse (so recognizable) and Lhola. An icononic plume of snow drifted from its peak. A mid-day half moon floated in the endless, empty galaxy of sky just above, as if to say: Everything Else, This Way. I built a cairn. And suddenly I heard myself think to this mountain, “You set the path for my whole life.” And it is true. If not for Everest, I don’t know if I’d have been in Nepal.

People journey to this place in all kinds of ways. For many it is the adventure of a lifetime. I understand that for me, as much as I delighted in every the walk up and all its color and beauty and fatigue and unobtrusive companionship, this walk was a pilgrimage. It was about sitting face to face with our Earth Mother, Sagarmatha. I have been coming here for so long.

What a gift it is, to be in this world, and to be free.

*

We crossed the horizon line of ecstatic clear sun.
A fellow traveler
Encouragement from past travelers
Gorapshep
The Icefall is far more otherworldly than I had imagined.
The home of brave winter climbers
Chillin with Alex Txikon
Magical Nuptse
Nepal Life, Reflections

Everest Part 1: The Height

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(<–Read Everest Prelude: Pemba)

Day 1 – Not Yaks

Lukla → Namche Bazaar / 3440m / O2 sats 92

The air strip in Lukla is world famous, and for good reason. One end is abutted against a vertical wall of land where the hills leap toward the sky, and the other end is abruptly concluded by an abyss. Takeoff from Lukla literally entails driving down a relatively short motorway and off the side of a cliff. Landing is the reverse: dropping down out of the sky and flying full speed at a meager strip of pavement on the edge of a canyon, at the other end of which is a wall. The cheers that erupt from the passengers after this thrilling landing are almost unwitting, a primal reflex produced by the exhilaration of (still) being alive. It was captured by my new friend Mac from China.

Since flights to Lukla can only occur in near-perfect weather, a handful of us had spent the last two days together ensconced in the Kathmandu airport. Each morning we showed up in the dark at six am as required, and waited the entire day for the weather to clear in Kathmandu and Lukla at the same time. We ate airport snacks, we tried to rent a helicopter together, we bonded through the searing disappointment of dashed efforts to fly to Lukla. And then, poof! On the third day, we were in Lukla by eight in the morning. We exchanged contact information and started a chat group to keep tabs on each other, which was nice because a few of us including me were traveling alone.

Most of the day was a gentle rolling climb without any areas that were too steep. When I saw my first herd of yaks I got so excited I jumped up on a wall, took out both my SLR camera and phone, tried to video and photo the yaks and the same time and didn’t quite accomplish either. Then five minutes later there was another herd of yaks, and then another, and soon I was just trying to stay out of the way of herd after herd of yaks made wide by their rucksacks. Then, late in the afternoon I found out that none of these herds were yaks. They were mules and “jopiya,” a mule-yak blend. Yaks, it turns out, are only at the higher altitudes.

I had thought to maybe stop in Monjo, but after days of sitting in the airport with unemployed adrenaline, I was elated to be outside and free. So at two o’clock I crossed through Monjo and began a challenging two and a half hour climb up to Namche bazaar. This ascent covers about 3000 feet of vertical elevation over the course of four and a half miles. For many travelers, the road from Monjo to Namche is an entire day’s hike. But the truth is that the tireder I got, the better I felt. 

As four o’clock approached, the sky became gauzy and cool. Namche Bazaar is a name you may have heard, recognizable even to people who don’t travel in these mountains, and late in the afternoon it appeared over the crest of a hill, like a dream. I felt something lift off of me, a yearning that has been around since my teens, to lay eyes on this amphitheater that has been the way through for so many travelers . By the time my boots were clomping over its stone-laid alleyways, fog was creeping in around Namche’s edges and over its rooftops.

Modern Namche is quite the trekking hub, but now hotels are closed for the winter and the village is cast with the quiet of hibernation. A few months from now, rooms will be nearly impossible to come by, but there were almost no people around. I found a lodge and set my bag down next to a bed by a window. I excitedly used the oximeter Pemba had given me to test my oxygen saturation. At 11,000 feet this is mostly just for fun, the way my rowing teammates and I used to wear heart rate monitors all day in college for unnecessary interesting data about ourselves. My O2 sats were still quite strong at around 92.

I was the only guest in the hotel. I changed my clothes, put my feet up next to a space heater, and ordered tea.

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Day 2: Real Yaks

Namche –> Tengboche / 3879m/ 12,696ft / O2 sats 92

I woke up and pulled the curtain back to find my room in a cloud. I had expected Namche Bazaar to be announced in glorious morning sunlight, but even the yard of the lodge was veiled in fog. I spent a slow morning in my sleeping bag and then having breakfast and tea. My body had a mild soreness that was rather satisfying after yesterday’s long walk, but the dull persistent ache in my head was less enjoyable. I didn’t realize that that was the beginning of the effects of altitude change. 

I set off late, around ten, and quickly became unsure which of Namche’s many footpaths to follow back to the trail. I had a map on my phone that was to be put to good use throughout the week, but it was no time before a passerby simply pointed me in the right direction. 

After making a pretty long walk from Lukla to Namche yesterday, I had decided on a normal day, a choice I considered leisurely. I chose one of the trails that cuts along the edge of the mountainside, is flatter and easier, and has fewer hotels along the way. It’s still a trekking route but on the map it looked like it might also have more transit by locals going about their everyday business. The clouds hung low all day, making the dusted hills look like black and white etchings.

It wasn’t long before I came upon a man herding yaks—and this time they were real yaks. They look nothing like yesterday’s mules. They have wide bodies and long rugged hair. We said hello to each other. 

So that is how I spent the morning herding yaks around a mountainside with Tenzin Dorje, walking at yak herding pace, a light swirl of snow about us. I learned that Tenzin is a Sherpa climbing guide who has summited Everest twelve times, and many other major summits in Nepal as well. He herds yaks in the off season. The yak bells made a gentle, optimistic clanging music as we walked and he whistled to his herd. After descending down to the valley, we stopped for tea in a wood-paneled house run by a delightful young woman named Dixya. She was delighted that I spoke Nepali, and I was delighted for her to teach me to say “May I please have a cup of tea” in Sherpa.

From the cottage, I bid farewell to Dixya and Tenzin Dorje. The afternoon was a long solo climb up to Tengbuche under a low sky. I had considered going another half hour or so up the road to Debuche, but by the time I crested the deserted, snow-covered ridge in Tengboche, I was feeling the chill of the dusty air. And besides, Tengbuche was too beautiful to rush away. There was a monk on skis. I decided to wake up here tomorrow, and got a room in the only open hotel. Even the monastery appeared shuddered.

In the high season, over eight hundred people a day pass through any given station on the Everest Base Camp route. My hotel had long, empty hallways and a long empty dining room where the hotel staff played cards all evening at one end. I was the only guest. Oxygen saturation is only 64% of sea level in Tengboche, but my O2 sats were still going strong at around 92. 

The bucket in the bathroom was frozen solid.

 

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Day 3: Loner

Tengboche —> Periche—> Thukla / 4640m (15,157 ft) / O2 low to mid 70s

I’ve been feeling quite strong, so today I decided to take a route that many hikers take down, but fewer take up. It took me to a higher elevation, in Thukla, than the more common stop at Dingboche 200m lower. I felt fine hiking all day, but the last bit is a continuous 400m climb to over 15,000 feet, and when I sat down in my room, I definitely felt the altitude. So, point penalty to Spero for over-enthusiasm. 

The day getting to Thukla however was lovely. I awoke to a glorious, shining morning in snow-covered Tengboche. The monastery, dormant and friendless in yesterday’s afternoon’s mist, presided confidently over the sleeping buildings and searing white ground around it. Unlike the hushed mystery of yesterday’s walk in the low hanging clouds and fog, today was a sunglasses and SPF-50 kind of day.

I wound along the river, and the terrain changed to glacial riverbed warming under an electric blue sky, encircled in mighty peaks. I ran into a number of people portering goods to and from Namche Bazaar to higher elevations. The first was a pair of young men who, when I came upon them as I was crossing a bridge, had set down their loads on the other side and were hysterically laughing while taking photos of each other leaping into the air. They had left Namche the SAME DAY—-the place I hiked from yesterday—and made it here by about 11am, on their way to Periche. (That’s my day and a half of efficient hiking.) They said they were each carrying 96kg and getting paid about .35/kg. 

Next the path moved into the glacier bed and became more vaguely defined. Fortunately, around this time I happened upon a pack of porters carrying sheets of corrugated tin and slabs of faux-wood paneling to Periche. So any time I wanted to confirm the route, all I had to do was look for a walking door moving across the plain. I found this so funny that I took about fifty pictures of doors with legs resting in the gaping wide mountain landscape.

As I left the doors with legs behind, the afternoon became more and more solitary, with only an occasional hiker passing in the opposite direction. I crossed a pass in where the morning sun had given way to theatrical, solitary and proud gusts of wind, and Pheriche appeared in the valley. When I arrived down in Periche, I was utterly gratified to see a hotel with door-loads all around it, awaiting the day’s delivery that was coming along behind me. I stopped in at a hotel and chatted with a few locals who said it would take me about another two hours to hike to Thukla. So up I went. 

The climb was stunning, but there was something lonely about the desolate landscape and the wind gusting up the plain from behind. The afternoon clouds had settled in again, and the skies were no longer optimistic and bright.  I arrived in Thukla around four, feeling far away from everything. And, once I set down my bag, admittedly nauseous. There is a very big difference between 12,700 feet and 15,150 feet. My O2 sats had dropped to the low 70s.

When it was clear I was “feeling the height,” two gentle and matter-of-fact hoteliers made me vegetable soup and filled up my bottles with hot water for free. I knew immediately that tomorrow I’ll have to take it very easy and adjust to the altitude. I invited the hotel dog into my room to stay for company, but he wanted to sleep directly on my pillow, and ended up curling up just outside in the hall instead.

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Bonus: Find the Walking Door on the Way to Pheriche

Aidan and Pascal, Between Worlds, Family, Nepal Life

To Be a Son

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Last night at 11:30 pm, Prem’s mother passed away.

Aidan and Pascal stayed over at my apartment, and in the morning we went to their uncle’s house for the funeral. When we arrived, everything was still new. Aamaa was still upstairs where she had been alive yesterday evening. Besides our Aamaa, the only other person in Nepal I call simply “Aamaa,” instead of “small mother” or “big mother” or some other aunt-related mother-qualifier, is Prem’s mother. She spent most of last summer with us at Didi and Prem’s, sitting quietly cross-legged on the bed, head bowed forward over her ankles, while the kids dangerously hammered a football against the indoor wall of the house, screeching with delight. Many evenings I would come sit next to her, even if there wasn’t much to talk about, to make sure she was part of the fun. Aamaa has been frail for many years now, and often her whole day was spent in near-stillness. Sometimes on those summer evenings I would rub her back, to make movement. At first she’d simply sit while I made circles over her ribs. And then she’d say udo, udo – a little up, a little over. And then she’d say, esari, and lift up her cholo above her shoulder blades, and I’d run my hands back and forth over her papery skin, the half moon of her spine bowed toward the floor like a stone path. 

At Narayan’s house, Prem pulled a sheer red sari back from his mother’s face and I passed a spoonful of scented water between her parted lips. 

As the yard began to fill with callers, Aamaa was moved downstairs and laid on the porch. Her body was wrapped in sheets and covered in garlands, and as they arrived, her adult children and their spouses leaned over her and let out piercing cries. Prem and his brothers shaved their heads, pouring water from brass vases, shivering in the cold. I was transfixed by the first pale stripe of scalp that appeared, like a gash between walls of black hair, which too fell away and curled bodiless and foreign on the ground. A bamboo gurney was prepared in the yard, and Prem’s mother was lifted on to it, her tiny body barely wider than the edges of the narrow stretcher. 

We walked four kilometers, along a length of the lake, and then through the bazaar, where a trailing white sheet pinned to wooden poles announced our procession and was swallowed close behind by vehicles and diesel swirling around our knees. Death in the middle of the mundane. An entire lifetime borne on her sons shoulders through the bus stop, where vendors were selling oranges. 

Pascal had gone home to help Didi pack her things. Didi and Prem will sit kriya for thirteen days back in his home village of Piodi, where Aamaa raised her six children. Pascal would have wanted to walk in the procession at his father’s side, but he was more urgently needed to help Didi prepare for the ritual mourning period. Pascal is our serious boy, a mercurial, old soul, and I felt the sting of his loss at not being able to accompany his grandmother to her last. Bethy and I followed behind Prem and Aidan and his cousins, Suman and Nalin, all roughly 12 years old, all steps behind manhood. One becomes finally a Brahmin son, in some ways, when performing the death rights for his parents. 

Although I’ve been present for the preparation of the funeral procession a handful of times over the years in Kaskikot, I’ve never followed it from house to river before, and I hadn’t realized that it is customary to jog. When I stop to drop off my backpack at a shop I frequent on the corner, where I can ask the proprietor to hold my things until I get back, we are quickly left behind, and we have to sprint to catch up. 

Once the pyre is lit, Prem will not touch anyone for thirteen days. But now, as we make our way toward the banks of the Gandaki River, Aidan is close by his father’s side, watching as men in the family take turns carrying his grandmother, their shoes pounding the asphalt. His cousin Suman is a sensitive, perceptive boy, who wept as his grandmother was lifted from his own father’s home to begin her final worldly journey in this lifetime. But Aidan is as shimmery and light as ever, energized by all the activity and people and the cousins he so loves to play with for endless, exuberant hours.

Then: “I want to try,” Aidan says suddenly. 

The running stops for just a beat. Carefully, the back of the gurney is lowered on to Aidan’s still-childlike bony shoulders. Instantly and without discussion, Suman has taken up the front. Their fathers and uncles stand around them, and my gaze captures this sudden and fleeting coming of age. The two boys struggle slightly under the weight of their grandmother’s body, but the whole rest of the world has fallen away as their only focus becomes carrying her home. After only a few meters of progress, the gurney is handed back, and Aidan is a boy again.

At the banks of the Gandaki, an enormous furnace has been recently built to provide a more efficient and eco-friendly form of cremation than the traditional funeral pyre. All of Aamaa’s jewelry is removed – the gold rings through her earlobes, the bangles around her tiny wrists, which cut in to flesh slightly, producing no blood. She is covered one final time, and Prem and his brothers circle her with copper vases and pour water around her. Then she is lifted in to the furnace, and the door is closed.

Now the thirteen days of kriya begin.

Aamaa, you birthed eight babies and never got to raise two of them. Your 20 grandchildren held each other today as you were carried away to the river under garlands, and your grandsons lifted you beside their fathers.

We will miss you here. 

*

Aamaa, Between Worlds, Didi and Bishnu, Family, Nepal Life, Reflections

Tuli Aamaa

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On December 12, Tuli Aamaa died. She was 94 years old and has been one of the oldest, most endearingly tired people I’ve ever known since I first met her seventeen years ago. Tuli Aamaa means “big mother” – in Nepali culture aunts are mother-figures, and they are either big or small depending on whether they are older or younger than your parent. Bishnu and Didi’s father was the youngest of five brothers, and Tuli Aamaa was his older sister-in-law. So she was our Big Mother.

Tuli Aamaa and her husband had settled down in the valley, just where the jungle path dumps us out on the highway in Pokhara. So when she came to visit us in Kaskikot, it was usually early in the morning, and she walked up the entire jungle path, a route that takes me about an hour of climbing at a good clip.  Tuli Aamaa would arrive with her walking stick and a litany of woes. These woes – and Bishnu will back me up on this – would have us giggling within minutes of her arrival and for a good while after she left. In a breathy exhausted voice, high pitched but only in the range of a dull butter knife, Tuli Aamaa would tell us, and anybody who was around, perhaps even the chicken or a wooden post holding up the porch or, barring these, the morning breeze, that everything was wrong with her, and it was enough already, it was time for her to die. She never looked pleased, and yet this activity brought her such return of satisfaction, or perhaps relief, that she hiked all the way up a mountain to participate in it, and then all the way back down the mountain a few hours later. It was wonderful.

Amazingly, Tuli Aamaa has always been the oldest person in the world, and she never got older. She looked just as old in 2005 as she did when I saw her last February, in 2019.

Tuli Aamaa with baby Pascal in 2005.

Tuli Aamaa with baby Pascal in 2005.

Yesterday, on the solstice, Didi and Pascal and I went out to Tuli Aamaa’s house, where her relatives are sitting kriya, the thirteen days of mourning. We sat outside talking with her son Ram Chandra dai, and found things here and there to help out with as callers came in and out of the house. Didi helped Tuli Aamaa’s daughter in law Tara bouju prepare her daily meal, which has to be cooked in a single pot during the kriya period.

And then the three of us left to walk up the jungle path, along the route that Tuli Aamaa always took to visit us. It’s also the way that Aamaa climbed after she gave birth to Didi 42 years ago in Tuli Aamaa’s fields. Aamaa took refuge briefly in Tuli Aamaa’s buffalo shed, before carrying her newborn, our Didi, up the mountain the very day of her birth. I have always been captivated by this story, but today it seemed phenomenal all over again, the traverses these generations have made over these stones. Pascal bounded up ahead of us, and found some luxurious blue maiyur feathers, and wanted me to take his picture with them behind his mom, standing on the same stones his grandmother once carried her over.

Later, I unearthed a picture of Tuli Aamaa’s field, and her famous buffalo shed, that I took when I was first introduced to these climbs and their histories back in 2005…

…and then I found one I’d taken the same day, in 2005, of Tuli Aamaa in the buffalo shed where Aamaa and Didi spent their first incredible moments together.

She looked just as old in this photo, as ever. As far as we could tell, she was always ready for this day, that to the vast majority of human beings seems a cliff edge, but to her was only another day.

We’ll miss you, and your loving, irrepressible climb through this world, Tuli Aamaa.

*

 

 

 

 

 

 

 

 

 

 

 

Aamaa, America, Dali (Serena), Didi and Bishnu, Family

Baby Oil

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Aamaa and I landed in San Francisco in mid-afternoon, and Youba came to get us at the airport. It’s hard to imagine that exactly two short years since Aamaa’s first visit to the US, Bishnu has gotten married and had a baby. Little Serena Dali is still just a month old and she doesn’t yet weigh six pounds.

Aamaa and Youba, of course, had never met in person before we arrived. Bedraggled, we emerged from the airport, and Aamaa and her son-in-law looked past each other and shuffled their weight, unsure how to introduce themselves without the normal directives of a proper setting or the customary procedure that goes with such a meeting. Nepali mothers don’t meet their son-in-laws for the first time with nobody else around, at Door #4 of airport arrivals.

“So, um…hi,” Youba offered. He had gallantly driven through Bay Area traffic at rush hour to retrieve us, and now we had to get through rush hour Bay Area traffic in order to get home and take a nap. I was tired and grumpy wanted to sit alone being antisocial in the back seat. 

“Aamaa, you sit in front.”

“No way, you sit in front.”

“Come on, you and Youba can—“

“Nope,” Aamaa replied, and annexed the back seat of Youba’s Honda before any further negotiations could be held.

When we arrived at Bishnu’s apartment, of course, baby Dali was all bundled up waiting for us. We immediately took our first US-side family photo.

I am staying in San Francisco for a week before leaving Aamaa and Bishnu and Dali and Youba to head back to Connecticut for the fall. So we’ve got about eight days together to hover over the baby and deploy a non-unified strategy of obsessing over competing certainties about what to do with a baby.

Even though it’s obvious, we’ll state right off the bat that I am on the lowest rung of qualifications in this debate by many orders of magnitude. The baby did not come out of me and I have never raised one. Bishnu comes in at a solid second place since she’s the one who made the human. But in the lead, Aamaa is Aamaa. She raised Bishnu and Didi and two grandsons and she runs shit. The issue is that the shit she runs is usually in Nepal and we are in America and I come in first place at being American, thus resulting in a rare case of circular cross-continent baby-doting logic that cannot be solved.

Let’s take the matter of baby massages. It is traditional for Nepali mothers to massage their babies with mustard oil a few times a day, usually in front of a fire where they can warm the oil and warm their hands. I watched Aamaa drip oil in to Aidan and Pascal’s eyes and ears until they were well past toddlerhood. This is thought to be good for the baby’s development. 

As we were unloading our suitcases, I extracted a few 2-liter sprite bottles that Aamaa had filled with ghee. I admit I knew these illicit items were stowed in my luggage and I consented to the, um—smuggling—for the sake of the baby. But then—Lo!—a two-liter bottle of mustard oil was discovered next to my shirts. 

“You can’t get good mustard oil here,” Bishnu explained. Yes, these two were in cahoots.

“The oil massage is fine, but no oil in the eyes and ears,” Bishnu told Aamaa.

“Oh god, definitely no oil in the ears,” I squirmed. “And the eyes are out of the question.”

“La, la,” Aamaa murmured.

Aamaa set happily to her oil massages. However: we were missing fire. She would sit in a patch of sun in the living room, but it wasn’t the same thing as having fire, and fire was needed.

Are you worried about where this is going? Be worried.

September in San Francisco is temperate to hot. Bishnu’s apartment consists of a small living room attached to the kitchen, and there is one south-facing glass door that collects heat all afternoon. When the door is slid open, it lets through a nice breeze. For fully developed human mammals like me, this nice breeze is refreshing and has other benefits such as abundant availability of breathable oxygen. But for Nepali babies, moving air is considered cold. ANY MOVING AIR. There is a general understanding in Nepali culture that babies should be kept warm, so much so that they are ensconced in multiple layers of clothing and hats even in the middle of the summer. I have tried to free many sweaty babies from their multiple baby hats when I’ve had occasion to visit with said babies in said season in Nepal. It’s futile; the babies are going to be re-swaddled and re-sweated immediately. But I’m intolerably hot and uncomfortable just looking at them in their hot clothes, so I try to free them anyway.

Seeing Dali bundled in layer upon layer of clothes and blankets in San Francisco raised my sense of temperature regulation distress to a previously unattained level. Clearly, American territory calls for American swaddling to American body temperatures.  Plus, the nurse who came by to check on Dali our second morning told Bishnu that the baby didn’t need to be put under so many layers and that the breeze was good for her. See, that’s what I said too.

So what this means is that each morning, I get up and crack the glass door – or sometimes just throw it open – and Aamaa runs to Dali in the opposite corner of the room to shelter her from the evil hypothermia-inducing fall breeze. Henceforth, we alternately, each when the other isn’t looking, adjust the glass door and Dali’s armor of clothing to our respective levels of comfort. This is of course an implicit pact. I know Aamaa’s going to undo my adjustments, and she knows the same, and the deal is that you have to respect the other person’s catastrophic approach to baby temperature maintenance by executing your improvements on the sly.

Advocating for your method, on the other hand, happens in the open and frequently. This is a lot of where Bishnu comes in. (Remember Bishnu?) Throughout the day, each of us loudly comments to Bishnu on why her baby should be kept hot or breezy. Bishnu tolerates this expertly. Both of our contradictory opinions are correct at all times. Bishnu is both too happy and too tired to care. We have nothing better to perseverate about. Everyone’s fine.

Now, the so-called absence of heat for Dali is particularly problematic during Mustard Oil Massage Time every few hours, due the aforementioned missing open-fire pit. On Wednesday, I go for a run. I breathe a great deal of healthy unimprisoned oxygen wafting off San Francisco Bay.  Hot and refreshed I enter the apartment to find the glass door sealed shut…and Aamaa puttering in front of the floor-to-ceiling central heating unit, which is going at full blast, and where I realize she has just given Dali an oil massage. The apartment is about 10 million degrees.

I stand in the door, probably with a friendly look on my face.

“What?” Aamaa asks.

“Are you serious, you turned on the central heat in the middle of summer and closed the door and we’re all gonna cook and die in here!”

“Oh, it’s warm for the baby,” Aamaa says innocently.

“Oh my God, Aamaa, ok…Listen!” I throw open the glass door. “In a week, I’m gonna be in Connecticut and you guys are going to do whatever you want. But for the love of God, while I’m here, can we have air for the grown ups to breathe?”

“La, la,” Aamaa says, satisfied. I do have to hand it to her for that round. 

The next day a package shows up from Amazon. Youba, bless his cotton socks, has ordered it.

Space heater.

For the rest of the week, and indeed as she will do for the next six months, every few hours Aamaa sits in front of the space heater in Bishnu’s room, which rises to five thousand degrees, happily massaging her squishy granddaughter. She warms her hand in front of the space heater and dips it in the mustard oil we brought from Nepal and presses it in to Dali’s tiny belly, cooing and giggling over her. Bishnu dotes around the two of them, delighted in their overheating together, and I pop in and out of the room reminding everyone that it’s much too hot for any normal person, and Aamaa answers, “La, la,” but I also have to take some pictures—they are so beautiful together and that space heater is so ridiculous and fantastic—and Youba sits in the living room letting us girls do what we do, and we are utterly content in our Dali’s world.

*

 

America, Didi and Bishnu, Family, Kaskikot, Kaskikot, Nepal Life

To Meet in a Dream

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We are having a family get together in Asheville, North Carolina. My dad is turning 80 this summer, and it’s Father’s Day, and Bishnu is pregnant with a baby girl. She and Youba arrive on a red-eye from San Francisco, Bethy and I fly in from Connecticut, and my parents drive over from Chapel Hill with Ricky and Julie and the kids. We plop our bags in a cluster of wood-paneled cabins shaded by rustling trees. It is the first time we have all been together since Bishnu got married last year. Now she is Bishnu Subedi Bhatta.

Bishnu and Youba have made the questionable decision of asking for name suggestions. We bat around ideas as we eat ice cream and go to the playground and climb Chimney Rock, where, even though there is an elevator, Bishnu takes the stone staircase up to the top, plodding along step by step while Youba fawns hopelessly over her. At the summit we take a family photo, the North Carolina hills yawning green in to the distance, an endless rustle that is too far off to hear from the top of Chimney Rock, giving way to blue.

In the six years after I first showed up in Kaskikot and before Bishnu came to the US, we would talk on the phone from time to time. It was always morning on one continent, and evening on the other, and in the decade since then I can’t say the phone connection has improved much. Through the static I’d hear about how Saano didi and Mahendra’s families were doing, and whether the millet or corn stalks with their stacked Groucho Marx mustaches had recently been planted or cut down. I’d tell her about New York City, where I was living, and say that Mom and Dad and Ricky were fine. We ended most of our conversations the same way.

“Ok then, well let’s meet in a dream.”

“Where should we go this time?”

And then we’d plan a meeting at the Kalika Temple, or in the kitchen with Aamaa, or on a mat in the yard to paint our nails, or at the festival of Teej. And then we’d say goodbye, and go to sleep to meet in a dream. And always in Nepal.

It has always seemed to me that Bishnu and I were born in to this world with a thread between us, translucent, like the kind used in mobiles or dental floss or to catch carp, because it is unassuming, tensile, and indestructible. The kind that seems as if it can be spooled out forever without reaching the other end that’s buried somewhere in its bottomless coils.

I decide to print the Chimney Rock photo for Father’s Day, which requires sneaking away in to Asheville. We need three copies of the photo for Dad, Ricky and Youba. While I’m out in Asheville I send a text to the family chat to ask if I need to pick up any ingredients for dinner. My mom replies.

Bishnu is cooking dal Bhatta.

I giggle at auto-correct, which has apparently learned Youba’s last name already. My mom means “dal bhaat,” traditional Nepali food–but the more I look at this, the funnier I find it anyway. My fingers tap over the keys.

Does this mean they picked a name for the baby?

It is Youba who replies.

Dal sounds like a boy. Shouldn’t it be Dali?

My mother and I become ecstatic over this. Bishnu’s kid is immediately christened Dali Bhatta. Mostly it is only my mom and me who think this is brilliant. It could be worse, though. My mom called me Loolie-tabooli-tabootznicky…and by “called” I mean “calls.” This is a true story. I was named for my grandfather Louis, and my family turned it turned into Tabootznicky.

We spend the rest of the weekend fishing in the pond, making s’mores on the porch, and turning the kids upside down. Bethy and I are staying in a cabin with Youba and Bishnu, and my mom has brought Bishnu an old notebook along with a pile of belongings from her now-“old” room in Bethesda. We flip through its pages, mystified and awed, like the Dead Sea Scrolls. It contains, in Bishnu’s handwriting: a list of instruments needed for the prehistoric version of the Kaskikot Dental Clinic; draft text for a sticker about fluoride toothpaste to be printed and posted in Kaskikot shops for vendor outreach; and practice answers to questions Bishnu expected to be asked at her visa interview with the US Embassy in 2008. She does a dramatic reading in the living room.

I remember when we bought Bishnu’s first pair of jeans. She looked as out of condition in jeans then as I did in my floppy kurta salwaars, each of us yet to learn to fit our bodies to these foreign garments that we irrevocably longed to inhabit. The more time Bishnu spent attending different trainings and programs that year, the more time I spent at the house with Aamaa alone, learning to move the goats about and cook and plant and cut. When Bishnu was away, Aamaa and I developed a quiet and comfortable flow together. Then Bishnu would come back for a day, arriving on the last bus at 7:30 at night, and I would feel a pang of sadness. The loss of the illusion that I was useful. I would fall back in to following Bishnu around and learning from her for the next twenty four hours. The spool would turn inward, we were drawn together, arguing, sitting in the kitchen, going to the temple, teaching each other about our worlds.

Bishnu always left to go back to her training programs early in the morning. They got progressively further away- Sarangkot, Pokhara, Damauli. America. (I didn’t know it then, but there would be a time when Bishnu was to wake me early in the morning in Bethesda, before going to work in Virginia.) On these mornings I could never motivate myself to wake up any earlier than necessary. Instead I would close my eyes to stave off departure, and then in the dawning bloom of morning, Bishnu would come take my shoulder to say goodbye, and slip out the door to catch the 7am bus. It always seemed, once she had been here, that she was going terribly far away; suddenly, I would be at a lose end. For a few hours, everything seemed empty.

And inevitably, after some period of months, I would spool away to America, and we would meet in a dream.

It is 2019. In my parents’ cabin, I assign my nephew Jonah, Ricky’s eldest and and a lanky eight, to instruct his three and four year old sisters as to how we are going to surprise three fathers with their family photographs. Jonah orders his sisters about for fifteen minutes, placing them behind the curtain, behind a couch, and practicing a chaotic toddler chorus of “Happy Father’s Day!” It is decided that I am to cue the surprise with a casual unsuspicious phrase, for which Jonah has selected “Wasn’t it nice weather today!” With this, my nephew and nieces are to spring from their hiding places and proclaim the happiness of Father’s Day.

The plan goes remarkably well. Youba’s features spread momentarily in to an arrangement of euphoric surprise: he is going to be a dad. And then, a collage of moments fluttering around us. We coo over Dali Bhatta. Jonah and Eli and Nell swing elatedly in the hammock, laughing hysterically over each other, until my dad and Ricky and Youba take their places. The trees around the cabin fall in to a still sheltering, rustling blessings over us, and the sun drops slowly over the hammock, delayed like a water droplet on velvet. We are gorgeously suspended in time.

Bishnu and Youba have booked a 6am flight. So it is still dark when Bishnu comes in to wake me the next morning. I roll over and can almost feel the straw mat under arm as Bishnu whispers, “Bye Laura, we have to go to the airport.” I wrap my arms around her and Dali Bhatta, suddenly both at peace and without coordinates; it is an old feeling, ancient as the notebook and the Dead Sea Scrolls, bottomless as a whole new human being.

The enormous future seems unimaginable in this pre-dawn, where we stretch away in to a miraculous dream, until we are real again.

*

2004

Kaskikot, Kaskikot, Nepal Life, Oral Health Care Project, Work

Aging

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The second half of our winter professional development is focused on treatment of older adults. Even though a lot of treatment that dental technicians do is in schools, during the weekly dental clinic at the Health Post, they mostly get adult patients. And since most rural adults have had little or no dental care, and likely weren’t exposed to fluoride toothpastes or other preventative measures for their first few decades of life, some of the conditions that present in our rural clinics are pretty extreme. Besides that, tooth loss in older age is common enough that it’s more or less expected.

Of course, our technicians can refer older patients to higher care, and they do. But following up on referrals isn’t always that easy, especially for older folks with reduced mobility. Not to mention that rehabilitation of many mouths we see in elderly patients would require months of ongoing, expensive, complex treatment even in a state-of-the-art dental hospital–something that’s simply is not feasible for the majority population even in a first-world city. So here we are in rural Nepal working in primary care, which is about disease prevention and improving quality of life. But save for the occasional extraction, older adults are mostly left out of the process when it comes to primary oral health care: directly related to the ability to eat, sleep, and participate socially. If we can relieve pain and preserve teeth longer, that seems like a solid contribution.

With this in mind, we wanted to develop a professional development workshop on how the simple techniques that we’re already using – glass ionomer, silver diamine fluoride – can be used to help relieve the diseases experienced in older populations in Nepal. By “we” I mean Bethy since she’s the one obviously who did this because I write stories about teeth and she is a public health dentist. And even if you’re not a dentist or especially interested in cariology, I have to say that how this turned out is really pretty cool.

A few years ago, Bethy and Keri took photos of about 65 people who’d had restorations done in our clinics, and we used these as the basis for a quality-of-care assessment. It resulted in a few different things. One was adding some missing instruments. Another was noticing an apparent pattern among older adults where, around middle adulthood, adult teeth begin to wear rather than decay. It might be caused by anything from an acidic diet, to abrasive brushing with spices, to a lifestyle change like a new medication. The lower part of the tooth near the gums wears down and become loose, causing sensitivity and difficulty eating, and gradually, the teeth simply fall out. These are the adults who, right now, are getting no care at all besides the occasional extraction.  They were the focus of our training.

Our technicians practiced placing glass ionomer restorations on the root-surface lesions, near the gums, that so often lead to tooth loss in older adults. Bethy explained how an event in the life of a middle-aged adult, such as an illness, can cause a simple change like dry mouth that alters the whole environment and leads to deterioration of a previously resilient set of teeth over the next period of years.

I loved this workshop. For the first two hours, instead of looking at teeth, Bethy brought in pictures of older people and the clinical teams simply talked about aging. What makes people old? Are all old people the same? Do they have the same priorities and daily demands and ideas of self? What do we assume when we see someone who we think is “old”? How does a person’s identity factor in to how we work with them to improve their lives? What is our responsibility to someone’s dignity?

In preparing for the workshop, Bethy and I mined our respective photo archives for pictures of elderly people in Nepal and Cambodia. One by one their faces stared out at our group of clinicians, suddenly daring: Who do you think I am?

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In the beginning, most participants had a sort of default position that older people are weaker and less capable of handling dental treatment. But as we went through the photos for well over an hour, stories blossomed. In some cases, they were people whose backgrounds we knew- my neighbors in Kaskikot, steely women I’d photographed during our work after the earthquake in 2015, caretakers and weavers and shopkeepers who’d given interviews in Bethy’s surveys in Cambodia. Bethy used a clever framework called “Go-go, go-slow, no-go” to talk about what each of these people might be expecting or hoping for from a medical professional. I got to laugh about how Hadjur Aamaa has basically no teeth left and gets around pretty slow, but she’ll put one foot in front of the other to get to the house and then frets the entire day, every day, about the dishes or the peas that need to be shelled; it is absolutely vital to her human essence to be busy with something useful. By the end, our clinical teams were musing over what their patients might be thinking about, who they depended on, and who relied on them, what made them human and alive in the world. This was probably a go-slow patient, like Hadjur Aamaa; this one likely a go-go patient ready to sit there all day and get her teeth fixed; this patient probably wasn’t really about treatment, and mainly needed to have his discomfort acknowledged.

The next day, we returned to the same school in Kaskikot to treat patients age 45 and over. (We’re in rural Nepal, 45 is approaching the pre-elderly group…60 is safely considered “aged” and the point is to catch people BEFORE their teeth are gone.) It was exciting to see the same situations we’d learned about the previous day in the real lives of real people and to be able to offer simple treatments that have the potential to forestall tooth loss for years. The teams continued using the App, entering patient data digitally along side the paper forms.

While patients were waiting outside, the father in law of our local Channeler came by for a checkup. I’ve been to see our Channeler a few times – she lives down near Laushidunga, in the direction of Sada Shiva where I taught primary school for a year.  The story that’s told about the Channeler is that she suffered terribly from a kind of delirium for a period of time. She was treated in a hospital, but nothing helped. Then she began to channel spirits. She rebalanced. People travel from all over to see her; I’ve brought a handful of visitors there to connect with people they’ve lost.  Before Bishnu left for the U.S. in 2008, she went to see the Channeler to connect with her father. The Channeler’s husband has a bum knee, and once I gave him my knee brace from CVS, and he always greets me with an old familiarity when we meet in the road up in Deurali.

Anyway, at some point in the afternoon I couldn’t find our technician K.P., and I walked outside to find he was having his palm read in the waiting area. The Channeler’s father in law spent about an hour reading almost everyone’s palm for fifty rupees each. Everyone–our office staff, the field teams, the schoolteachers and other patients–exclaimed over the things he knew: who’s father had died young, who was still to be married, who was destined to successfully stay with one line of work for a long time (one of our clinic assistants! yay!). I didn’t get a turn because by the time I was ready – I’d had my 50 rupees in my pocket for like an hour – he’d had enough with palm reading. Palm reading was over.

Still, my most favorite patient of the day was a 93 year old woman who arrived alone. She was frail, used a walking stick, and barely spoke to anyone even to ask them to move out of the way as she plodded through clusters of people like Moses parting the sea. She wore a jaunty white knit cap that stuck up boisterously on her head. Her entire mouth was completely empty except for one jutting molar with an expanse of exposed root.

“How can we help you?” Hira, the Deurali technician, asked.

“This tooth hurts,” the woman said simply.

 

Hira treated the one tooth with silver diamine fluoride, a completely painless procedure that will hopefully preserve it a while longer and ease her suffering. Then the woman stood up, picked up her walking stick, parted the seas and went home without a word.

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Reflections, Uncategorized

Worry For My Sons

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I’ve just come back from my third visit to Cambodia, and each time I expect to write about it. I’m no qualified scholar of Cambodian history, but I spent a short time working with Cambodian refugees in Hartford and two months researching the Extraordinary Chambers, or ECCC, the war crimes tribunal created to adjudicate the crimes of the Khmer Rouge.

In August 2017, I visited the Tuol Sleng Genocide Museum in Phnom Penh, where I filled in the mental scaffolding I’d established by standing outside of empty torture rooms and running my eyes over thousands and thousands and thousands of names, knowing they would vanish from my memory. 15,000 people were imprisoned and killed at Tuol Sleng, which had once been a high school. I lit incense in a somber memorial room at the end that is filled with skulls.

Sometimes it seems that the cruelties of history are mostly remembered through their persistent pain, despite our best efforts to know them through redemption.

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“What do you think of Cambodian politics?” asked my tuk tuk driver today, on the way to the airport.

“…What do you think?” I replied carefully.

“No good,” said the driver. “Not much has changed.”

Motorbikes and trucks and cars and luxury sedans jockeyed for space on the highway, pressing in on the open sides of our tuk-tuk, where I had my leg through the strap of my bag after twice having items snatched off of me by passing motorists. It seems hard to argue that not much has changed. When Phnom Penh was reclaimed from the Khmer Rouge in 1979 after four years of destruction and enslavement, the rubbled city no longer had electricity or plumbing or safe water or schools or working telephones; the use of money had been abolished. Nearly a quarter of the Cambodian population and most of the educated class had been slaughtered. There were at total of seven lawyers left in the whole country to rebuild the government. Working off my not-particularly-relevant experience of what it’s like trying to develop infrastructure in Nepal, I find it absolutely astounding what Cambodia has rebuilt in just four decades, albeit under an authoritarian regime.

I guessed my tuk-tuk driver to be in his early fifties, old enough to have been alive during the genocide. I wondered what he wanted to tell me about.

“Where were you during the war?” I asked.

“In the province,” he said. “We planted rice, you know? Planting all day. All the kids slept together in a large area, on a rough surface. My skin got very irritated on my whole body. We had no rice to eat. We only ate porridge.”

“How long did you do that for?”

“Two years,” he said. “I was eight.”

I learned that the driver had one sister and five brothers, and I wanted to ask how they had fared, but didn’t know if I should. Many children whose stories started this way lost their entire families under the Khmer Rouge, sometimes before their eyes.

“What do you think is the biggest problem for Cambodia now?” I asked instead.

“Education,” the driver stated firmly. I learned that he had been able to pick up his studies again in 1982. That Cambodia has struggled to rebuild its education system is no wonder. In 1979, there were so few intellectuals left alive that a former math teacher, Chan Ven, was put in charge of rebuilding the Ministry of Education. The three-decade old United Nations, with its dominant American, British and Chinese powers, opposed the new Cambodian government because it was backed by the Vietnamese. So after receiving more American bombs on its soil during the Vietnam war than Japan received during World War II–an act that won Henry Kissinger the Nobel Peace Prize–a traumatized Cambodian populace was left to prosecute war crimes, reconstruct the government, and reestablish basic institutions without the help of international human rights bodies. During the Cold War, the Hun Sen military regime that liberated Cambodia from the Khmer Rouge was systematically and repeatedly denied U.N. support, which was deferred instead to the Khmer Rouge in exile.  To this day, the regime continues to run the government and suppress opposition.

My tuk tuk driver took his gaze off the road and turned his head toward the side, maybe only because I was seated behind him, but it made it seem like he was looking out at the tall buildings around the highway. “My sons are studying law and engineering,” he said. “I worry about them.”

Last Saturday, a bunch of us took a long ride out to see the new Win-Win monument. The tower was recently built to commemorate the end of civil war in Cambodia in 1998, when outlying factions of the Khmer Rouge finally entered in to an agreement with the Hun Sen government, bringing about the end of decades of violence. The monument is built of intricately carved sandstone and polished granite, and in many places is still under construction even while throngs of mostly Cambodian visitors visit each day.

What most caught our attention, though, was a lengthy retelling of Cambodian history carved in to stone panels around the base of the monument. It starts before the genocide and continues for probably a quarter mile or more. The story is portrayed with a nationalistic fervor that is not subtle, and the monument also sits across the way from a large athletic complex being built for the 2020 ASEAN Games. It is clearly a display of political pride and might. One might say unvarnished propaganda. On the ride home, we found ourselves talking about the importance of uniting narratives in national identity.

But before we left, we trod through the entire narrative display panel by panel by panel, slowly watching sun change its shadows on the carved faces. One, near the beginning, captivated me for some time. It’s intimate brutalities are historically accurate.

“During the war,” said my tuk tuk driver as we reached the airport, “it was just me and my sister. We were separated from our parents. Then my mom had five more children after it was over.”

I expelled a sigh of relief. “So your family survived?”

“Yes,” said the driver. “Five more children!” he chuckled. “And I’m the eldest.” He stared at the road ahead, thinking a swirl of thoughts I couldn’t intuit. He seemed to want to discuss it with me during the thirty minutes we would know one another. “You have freedom in America,” he said, shaking his head. “I just…worry for my sons. And their education.”

“They sound very smart,” I replied. At the time, I assumed he was worried about affording his sons’ education, or about whether they would be successful in their pursuits, and maybe that is he that is what he meant. But it occurred to me later that, maybe not.

We arrived at the airport, and the driver dropped me off, and rode back in to the traffic.

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