This weekend is the Tihar festival of lights and New Year's day on the Nepalese calendar.

During the Tihar festival houses and buildings are decorated with marigold garlands and lights.

The pyramid-shaped mountain behind the ridge is Mt. Everest.

We have now completed our service at the hospital in Banepa and have a few days off before returning home. We just returned from an Everest Express sightseeing flight on Yeti Airlines. We had clear skies and a great view of Everest and several of the other highest mountains in the world! Having visited in May the town of Jericho, the lowest point on earth, it was thrilling to now see the highest point on this beautiful earth and contemplate all that Jesus Christ has created under the direction of our Heavenly Father. Nameste!

Today we completed the final surgeries. In all, we performed 19 surgeries this week. So far all the patients have done very well.

The most prominent peak left of center is Gauri Shankar which is 23,442 feet tall

The Rice Harvest

Brian at the Kathmandu Branch chapel

Misty mountains of Nepal

Jr. Doctor Grover

New Beanie Baby Owners

Brian Visits the Operating Room and I Visit the School

Today Brian visited the operating room for the first time. Our first patient was a 55-year-old woman with a 12 cm ovarian cyst. We opened up her abdomen and removed the large mass that was causing her a lot of pain. I asked Brian if he wanted to observe the surgery. He was very interested; so before school started, he dressed in scrubs, and joined us. I warned him that if he felt sick, he should be sure and speak up or sit down on the floor. As it turned out, he did great, and was fascinated to see the cantaloupe-sized mass come out of the patient's abdomen. Hopefully, she will have a good recovery and be relieved of her pain, and--who knows--maybe we have a budding surgeon: Brian!

Later in the day between surgeries, I visited the school where some surplus Beanie Babies found a new home, thanks to Brian. As he presented the toys to the children, he quizzed them on the names of all the animals, as they are all learning English. He also played kickball with the kids today.

Sunrise Over the Himalayas

Preop Clinic Sunday and Surgery Monday; School is in Session

Preop Clinic on Sunday and Surgery on Monday; School is in Session

On Sunday we held our preop clinic at the hospital. I saw 19 patients who had been prescreened by the local doctors and felt that 9 of them would be good surgical candidates. The patients, who are from Southern Nepal, speak Thauru but not Nepali, so I asked my questions to one of the nurses who speaks English and Nepali, and then she interpreted to Nepali my question to the daughter of one of the patients who speaks Nepali and Thauru who then spoke to the patient in Thauru. With each of the patient's answers it was back around the translation chain again, so I could understand her responses. One of the patients was having a problem with very heavy periods and had an enlarged uterus, the other patients had prolapse symptoms. We scheduled 4 patients for surgery on Monday. I got a call from the hospital on Sunday evening that the patient who had been having abnormal uterine bleeding was severely anemic with a hemoglobin of 7.2! (normal is 12). We gave her a blood transfusion over night to prepare her for surgery.

On Monday we performed 4 surgeries. A volunteer Ob/Gyn from Germany sponsored by Rotary assisted me in the first 2 cases. I also saw 7 new patients. 6 of whom are surgical candidates.

Brian began his service in the school on Sunday, as Sunday is a regular school day here. The children are adorable. They wear uniforms with light blue shirts and ties. Brian is working with the science teacher. He shared the photos of home with the kids; their favorite was the one from pack meeting where Brian has an albino python around his neck. He also taught the kids the game "Duck, Duck, Goose" and the song "Old McDonald Had a Farm."

Visiting the Kathmandu Branch and Bhaktapur

Today Brian and I awoke very early (4 am!) as we are still adjusting to the 11 hour and 45 minute time difference (yes, Nepal is 15 min different than Delhi). From our window, we saw a beautiful sunrise gradually illuminate the Himalayan peaks in the distance. We hired a driver to take us back to Kathmandu and there met up with an LDS missionary couple from Oregon. They have been here for 19 months and will serve for 5 more months. A second retired couple has just arrived from St. Louis. We arrived at the chapel complex where about 90 people attend. Today was a special day because the mission president who is based in New Delhi was visiting the branch. He is a wonderful dynamic and enthusiastic individual who is a retired physician. He spent his career working as an embassy physician for the US State Department. Brian and I were both asked to speak in Sacrament Meeting. Brian did a nice job bearing his testimony and also passed the sacrament along with two Nepalese teenagers. I was asked to be the concluding speaker in the meeting, and I was grateful to testify of the Savior, a privilege I have now had on five continents. A young American missionary (who has been serving in New Delhi and is now traveling with his parents) taught Sabbath School (church in Nepal is held on Saturday as that is the only day that school is not held). His mom shared with us some dramatic experiences that he had where he was divinely protected during his mission. President Jackson instructed us during the final hour of the meetings.
On the way back to our lodge, we stopped at Bhaktapur, which is the best preserved medival city in Nepal. It has three squares with temples built in the pagoda style dating back to the 1400's. In addition to climbing the steps of several of the temples (Nyatapola, built in 1702, is the tallest at 100 feet with 5 pagoda roofs), we also visited Potter's Square where we saw potters working as well as the straw kilns. Since it is harvest season, many of the surfaces in the square were covered by drying rice. Most impressive were the intricate wood carvings adorning the buildings and the stone sculptures of elephants, lions, griffins, and of the various Hindu gods.

Scheer Memorial Hospital and Namoboudha

Upon arrival in Kathmandu we traveled to Banepa and met the staff and took a tour of the hospital and the adjoining school (see http://www.scheermemorialhospital.org/). Brian met the principal and some of the students. It is a nice school with 6 classrooms located around the periphery of a large gymnasium. The grounds around the hospital and school are meticulously maintained with hedges and flowers around each path. There is a central courtyard with two large trees. While we were there, we met an American general surgeon from Minnesota who is working here. He has spent most of his career serving in Adventist hospitals around the world. Next we separated the school supplies and vitamins that our team brought from the medical and surgical supplies in our bags. Part of the team will go out to some villages and set up a clinic and distribute the community health supplis that we have donated. The rest of us will begin surgeries on Monday. The patients who need surgery this week are from a region in southern Nepal calld Terai.

After making these preparations at the hospital, we dropped off our luggage at the hotel and then drove out to the Namoboudha shrine. It is one of the holiest shrines in Tibetan Buddhism. (Tibet is just over the mountains from us.) To get to it, we hiked up a steep trail through the forest marked by red, blue, yellow, white and green prayer flags and many giant spider webs with large green-bodied spiders poised for their prey. While we were there, a large ceremony was taking place at the monastery. All the monks (both male and female--all with heads shaved and all in maroon robes) gathered together for dancing, music, and chanting. The leader of the monastery, the Rinmposhay (sp.?) was in attendance as well. He is apparently one of the most prominent leaders in Tibetan Buddhism second only to the Dalai Lama. The monks danced in elaborately embroidered costumes and in a variety of masks. They danced around a central stone along circles of white paint which were incorporated into an 8 pointed star. Three of them seem to play the role of clowns. The music played by their traditional instruments and the chanting was certainly like nothing I've ever heard before. All this played out with a back ground of green terraced hills and with the snow-capped Himalayas off in the distance. It was a beautiful clear day.

We are making our way to Kathmandu. We first flew to Chicago. The winds were so severe in the Windy City that we couldn't land and were in a holding pattern for an extra hour. During our layover we took the L to the Loop with the plan of visiting the observation deck of the Sears (now called Willis) Tower, however when we got there we were informed that it was closed due to the high winds, so we got a bite to eat and then headed back to our flight to Delhi. We flew over Canada, then over the Atlantic and over Scotland. I thought of Geoff who is serving in Tonsberg, Norway, as we flew over Scandinavia. While we slept, we flew over Warsaw and then just south of Kiev, where the new temple is located. Next we passed over the Black Sea and the expansive Caspian Sea (caught a good view) and then over the -Stan countries. After flying over Afghanistan and Pakistan, we have now arrived in Delhi. The 2010 Commonwealth games have just concluded, so there are many signs heralding the games. The airport is very modern. We will spend the night here and then head to Nepal in the morning. Nameste!

Small world
On our flight from Delhi to Kathmandu we met a group of LDS single adults who are doing a humanitarian project in Nepal with www.choicehumanitarian.org. It turns out that the branch president of the Church of Jesus Christ of Latter-day Saints in Kathmandu is employed as the country director for Choice Humanitarian. He will be out in a rural area working with this group of volunteers who will do a construction project and hold clinics. When I emailed him to find out about Church services in Kathmandu, he mentioned that he would be out of town this weekend, but we have arranged to meet the missionary couple based in Kathmandu who will help us find the Church building; the mission president in New Delhi referred us to them for assistance since, "street addressees are a novelty in Kathmandu." Church services in Kathmandu are held on Saturday rather than Sunday, since that is the day most people have off from work. One of the Choice Humanitarian participants we met, Eric, is an ER physician. Many of the people in the group working with Choice Humanitarian are from Washington, DC. One sister we met is an attorney in New York City.

Our plane today is also full of many Europeans who are likely going trekking judging by their gear. We are hoping for a glimpse at the Himalayas as we fly into Kathmandu. Hopefully it will be clear.

We are making our way to Kathmandu. We first flew to Chicago. The winds were so severe in the Windy City that we couldn't land and were in a holding pattern for an extra hour. During our layover we took the L to the Loop with the plan of visiting the observation deck of the Sears (now called Willis) Tower, however when we got there we were informed that it was closed due to the high winds, so we got a bite to eat and then headed back to our flight to Delhi. We flew over Canada, then over the Atlantic and over Scotland. I thought of Geoff who is serving in Tonsberg, Norway, as we flew over Scandinavia. While we slept, we flew over Warsaw and then just south of Kiev, where the new temple is located. Next we passed over the Black Sea and the expansive Caspian Sea (caught a good view) and then over the -Stan countries. After flying over Afghanistan and Pakistan, we have now arrived in Delhi. The 2010 Commonwealth games have just concluded, so there are many signs heralding the games. The airport is very modern. We will spend the night here and then head to Nepal in the morning. Nameste!

In 2005, when Brian was 8 years old, I had the privilege of having his older brother Geoff serve as my companion as we traveled to Guyana and served with the LDS Neonatal Resuscitation program (see www.humanitarianservices.org). The following year, I was honored to have Brian's older brother Jason serve as my companion when we volunteered with the same program in the Democratic Republic of the Congo in 2006. Next I returned to the Congo in 2007 with Geoff and then in 2008 with Brian's older sister Emma and my wife Cathryn. So it was a natural question for Brian to ask if he would also have a turn to participate in volunteer service in another country. So it was great to learn about the uterine prolapse project in Banepa, Nepal. In Banepa is the Scheer Memorial Hospital and the adjacent elementary school. Here was an opportunity for Brian to serve in the school while I serve at the hospital. We announced to Brian that he would have this opportunity last Christmas when I gave him a Sherpa style wool hat, so we have had a long time to look forward to this opportunity to serve together in a meaningful project.

The problem:

According to UN studies, an estimated 600,000 women in Nepal are suffering from conditions of uterine prolapse. Of this group, 186,000 women are in need of corrective surgery. Many women suffer in silence in this nation that struggles with extreme poverty, only seeking help when symptoms cause them significant distress with their families. Recent surveys have found the prevalence of prolapse in rural villages to be 10-43% of reproductive age women. Women have an important role in Nepali society yet are given a very low status. Not only do they give birth and raise children, they are also responsible for almost all domestic activities, including cooking, cleaning, caring for animals, cultivating and harvesting crops, and generate income for the family. Prolapse can seriously affect a woman’s ability to work and thus deny her that important role. There are heartbreaking stories of women with severe prolapse who are being forced from their homes to sleep with their animals at night due to their unpleasant smell and unsanitary condition. Women in Nepal are more likely to develop this condition due to poor nutrition, early postpartum return to work, and lifting heavy loads. The risk of uterine prolapse also increases with each delivery.

The hospital:

Centura Global Health Initiatives has undertaken an ambitious project in partnership with Scheer Memorial Hospital and ADRA-Nepal, the Nepal Women’s Health Initiative, to provide corrective surgery for women who suffer from this debilitating condition.

This is an expensive undertaking for CGHI. Even though the medical teams volunteer their time and pay for their own expenses to travel to Nepal, there are still the costs for screening patients in the villages, transporting women who need surgery to the hospital along with a family member, lodging and meals for them both before and after surgery, supplies, and Nepali manpower. The estimated cash expense for each uterine prolapse project is approximately $18,000, or $600 per patient.

The School:

Esa Memorial School

The most recent census (2002) reveals that 40% of the population of Kavre District is comprised of children under the age of 14. While the number of children is phenomenal, the lack of educational resources for these children is even more startling. The average teacher of a middle school has only a 12th standard education. The average English middle school teaches all the subjects in Nepali. The tuition of the average school is beyond the reach of the average family. Even local government schools charge a fee that is not always affordable.

While there is nothing wrong in gaining an education in one's mother tongue, it is considered prestigious when a high school graduate is competent in English. English is necessary if he/she desires to pursue quality education or a scholarship. Competing in the job market with graduates of private colleges in India and the upscale colleges in Nepal, the underprivileged students, without the basic mastery of English, find themselves disadvantaged and handicapped. The grasp of English would give these students the edge they deserve.

Realizing that a good-quality English education is a paramount need in the community, Scheer Memorial Hospital found an innovative, inexpensive way to provide this. Using a U.S.-based home-school curriculum that is recognized by the Maryland State Board of Education, Scheer began a Preschool class in September, 2002. Sponsors were secured to cover the $800 for the curriculum and a $75 monthly stipend for a volunteer teacher for the school year. The hospital provided a room and furniture. September, 2003, a Kindergarten class and a second teacher were added. The seventh school year, that began in 2008, has almost 60 students, with all the children from poor families completely sponsored ($200 a year covers tuition, books, two sets of uniforms, and a full meal with a glass of milk each school day). Construction of a new school building was also made possible through a grant from the Seventh-day Adventist Church in Finland and the Finnish Ministry of Foreign Affairs.

The new building consists of a central gymnasium, the size of a basketball half court. On either side of the gymnasium are three classrooms. Along the third wall, facing the entrance are two offices and two sets of bathrooms.

ESA Memorial School is more than about bringing a quality education to the children of Nepal. It is about uplifting the many who see no horizon of hope. Everyone has the right to change one's destiny!

For more information see: http://helpachildwitheducation.com/

Brian and I look forward to meeting the people of Banepa, Nepal, and we look forward to serving together.