So, I have been back home two weeks now. Though I am over my jet lag, I am not over my "re-entry shock". After a month in a very different culture, questions arise about my own culture and my own life. Two weeks ago I worked 6.5 hours a day. I got up in the morning and had a leisurely breakfast and two cups of coffee while I read, watched BBC Asia or simply listened to the music at the Ambient Cafe. I went into work at 9:00 and I believe accomplished some meaningful things (something I value), but got home by 4:00 PM and worked on this blog (It is 8:00 PM now!). I then went out and spent 2 hours at dinner with friends (old and new). The dinner conversation was some of the best I have had since college. Now that I am back to working 12 to 15 hour days the question keeps arising - "Why am I doing this?" Why, indeed. I need to keep thinking on this and not just give in and become numb, which I believe is what was happening to me before I left.
So what do I think of Bhutan? First of all, it is stunningly beautiful. It truly is the last Himalayan Kingdom, shangri la if you will. It is not everywhere that you can step on your balcony in the morning and see snow capped mountain peaks. Second, Bhutan wears spirituality on it's sleeve. You cannot walk the streets without passing red robed Buddhist monks. I would challenge anyone to find any place where they could stop and stand and NOT see a prayer flag. All of this serves as a constant reminder that there is more to this universe than what we see. The world is not all about having "things". There is meaning in the universe, and Gross National Happiness is more important than Gross National Product. Third, there was a military presence I never did quite understand. It is a country with very little crime and a kind and gentle people. Why the police or army so prominent, literally on every other street corner? Fourth, I was saddened by the lack of maintenance of buildings, streets, and the hospital. Rubbish in the streets, dirty floors in the hospital, and dangerous holes in the streets all seemed out of place amidst such natural beauty. Fifth, there is a lack of urgency in Bhutan. Things happen at there own pace. You do not see people in a hurry very often. This is wonderful in day to day life, but not always a good thing in a hospital.
In thinking about the hospital and medical care, several observations come to mind. I have developed a new respect for a free market system. In Bhutan the government owns the hospital, employs the care givers. and serves as the payer. The really great thing about the system is that all get care. However, there is little accountability in the system and significant lack of systems and organization. This is evidenced by the lack of outpatient charts and the lack of a centralized section for orders in the inpatient charts. This lack of charts also led to a lack of information. To me this made it more difficult to see patients than the limited hospital formulary. Outpatient appointments are never scheduled. Every one shows up at once. In a very polite way the patients and there families are "pushy". I believe they have to be to get seen. Supplies see to have been purchased in bulk based upon what was available and well priced, rather than maintaining a short-lived inventory which is replaced as used. Providers have little incentive to work past 3:30 PM - after all, they are salaried.
To me the best allegory to the medical care system in Bhutan is their street traffic. They have the technology (cars). However, as near as I could determine there were few traffic rules - "Drive on the left and don't hit any one!" No stop lights and no stop signs. Use your horn liberally when going into curves. That seems to be about it. Needless to say they have plenty of motor vehicle accidents. Unfortunately, the medical care system runs similarly - a good deal of technology is there, but it needs to be organized and used more efficiently. As my friend Ed stated (paraphrasing), "Most of the significant advances in medicine in the Unites States over the last 10 years have been in the development of processes and systems of care rather than new technologies." Bhutan needs standardized pathways and systems of care to ensure that they use their technologies in a standardized and consistent manner to deliver high quality medical care. They have a wonderful opportunity to create a system without the "built in" waste which exists in the US system.
I loved my time in Bhutan and would never trade it away. I went there to give western medicine to Bhutan. Bhutan gave back much more to me.
As they say in Bhutan,
Tashi Delec
(Roughly "May good fortune follow you until we meet again")
Tuesday, April 15, 2014
Sunday, March 30, 2014
Of Takins and Dzongs
Well it's my last weekend in Bhutan and before the long trip home I decided to do some local touring around Thimphu. On Saturday, Ed and I decided to hike up to the Motithang Nature Preserve to see the Bhutanese national animal, the Takin. .Legend has it that the Takin was created by the great saint, the Divine Madman, Llama Drukpa Kunley. While visiting Bhutan in the 15th century the people asked him to use his magical powers to perform a miracle. However, before any magic was to be performed, the Llama asked for a goat and a cow for lunch. He ravenously devoured them both, following which he stuck the goats head onto the bones of the cow and snapped his fingers. The beast jumped up and ran to the meadows to graze. Thus was created (or so legend has it) the dong gyem tsey or takin.
Looking somewhat like a cross between a moose (I am from Maine!) and a buffalo, the animals winter in the lowland valleys and in summer migrate to subalpine forests to graze and avoid the leeches, mosquitos, and other parasites which arrive with the monsoons. During the summer the takins gain weight on the luxuriant grass and mate. Calves (usually one per cow) are born about 8 months later. Takins are a protected animal. There is apparently little poaching, though minute amounts of the horns are used in traditional Bhutanese medicine to treat women having a difficult child birth.
As an aside, the preserve was disbanded awhile back at the order of the King, as it was felt having these animals in captivity was not consistent with Bhutanese environmental and religious convictions. However, the animals were so tame that they took to wandering the streets of Thimphu looking for food and they had to be put back into captivity.
It took us about 90 minutes to hike up to the preserve. The day was warm, and the takins were quite lackadaisical. I did manage to get several pictures of them (though I am afraid none are very good).
Today I was on my own and decided to walk to the north of the city where Trashi Chhoe Dzong sits on the bank of the Wang Chuu River.
This is not the original dzong, which was built in 1216, but destroyed by fire in 1771. Almost all dzongs have had fires, in part a result of their wood shingle roofs. By that time the present dzong had already been built lower on the hill to house the large numbers of monks and officials present. When the upper site burned, it was abandoned in favor of the present dzong. This dzong, too has had several fires (three since 1866). Tashi Chhoe Dzong translates as Fortress of the Glorious Religion. When King Jigme Dorji Wangchuck moved the capital to Thimphu in 1962, the dzong was renovated. Other than the utse (central tower) and chapels which were not touched, the dzong was entirely rebuilt in the traditional fashion which uses no nails or architectural plans.
This dzong was the site of the coronation of the present and 5th Dragon King in 2008. There are towers at the four corners, with administrative offices at the southern end and monastic quarters at the northern end. This dzong seemed more austere and imposing than the Panakha Dzong. That may have been in part due to the lack of a festival with few visitors and no crowds. There was also a much greater police presence than at Panakha, perhaps because Thimphu is the capital. This served only to increase the imposing nature of the fortress.
Within the northern assembly hall there is a large statue of Sakayamuni (the historic Buddha). In front of this are three thrones for the current king. former king, and Je Khempo (religious leader of the country). Looking up at the ceiling one can see a gorgeous mandela. The entire hall glitters with gold and there are two smaller altars flanking the main altars, with smaller statues. Once again, as a sanctified space pictures are not allowed and one must remove one's shoes to enter.
Outside the meeting hall, numerous murals which I was allowed to photograph adorned the walls.
Upon my return from the dzong I had to pack. Tomorrow morning we travel to Paro to catch an 11:00 AM flight to Bangkok. The forecast is for clear weather which is essential, as Paro is under visual flight rules. This is understandable, as when landing it seemed at one time that there were mountains just feet away thru the windows on either side of the plane. My trip will take me from Bangkok, back to Tokyo on to Chicago and finally to Portland. All told I will spend 46 hours traveling. That is a lot of time in airports. The plan is to somehow stay awake until the flight from Tokyo to Chicago, which will be night hours by EDT, and begin to reset my internal clock.
Though this will be my last post from Bhutan, it will not be my last post. This blog more than anything has been created to keep a record of my experiences for myself. If some of you reading it have found it interesting and occasionally thought provoking, I am pleased. I do want to take some time to develop some reflections upon the past month. Look for one more post in about a week. Hopefully I will find some things to take away from this amazing experience.
Looking somewhat like a cross between a moose (I am from Maine!) and a buffalo, the animals winter in the lowland valleys and in summer migrate to subalpine forests to graze and avoid the leeches, mosquitos, and other parasites which arrive with the monsoons. During the summer the takins gain weight on the luxuriant grass and mate. Calves (usually one per cow) are born about 8 months later. Takins are a protected animal. There is apparently little poaching, though minute amounts of the horns are used in traditional Bhutanese medicine to treat women having a difficult child birth.
As an aside, the preserve was disbanded awhile back at the order of the King, as it was felt having these animals in captivity was not consistent with Bhutanese environmental and religious convictions. However, the animals were so tame that they took to wandering the streets of Thimphu looking for food and they had to be put back into captivity.
It took us about 90 minutes to hike up to the preserve. The day was warm, and the takins were quite lackadaisical. I did manage to get several pictures of them (though I am afraid none are very good).
Hard to see, but there is a takin in the trees
Just resting against the fence
Same takin, different view
Entrance to the preserve
This is not the original dzong, which was built in 1216, but destroyed by fire in 1771. Almost all dzongs have had fires, in part a result of their wood shingle roofs. By that time the present dzong had already been built lower on the hill to house the large numbers of monks and officials present. When the upper site burned, it was abandoned in favor of the present dzong. This dzong, too has had several fires (three since 1866). Tashi Chhoe Dzong translates as Fortress of the Glorious Religion. When King Jigme Dorji Wangchuck moved the capital to Thimphu in 1962, the dzong was renovated. Other than the utse (central tower) and chapels which were not touched, the dzong was entirely rebuilt in the traditional fashion which uses no nails or architectural plans.
This dzong was the site of the coronation of the present and 5th Dragon King in 2008. There are towers at the four corners, with administrative offices at the southern end and monastic quarters at the northern end. This dzong seemed more austere and imposing than the Panakha Dzong. That may have been in part due to the lack of a festival with few visitors and no crowds. There was also a much greater police presence than at Panakha, perhaps because Thimphu is the capital. This served only to increase the imposing nature of the fortress.
Northern courtyard
Entrance to the northern assembly hall
The utse (central tower) seen in the background from the steps of the assembly hall.
Southern entrance to the administrative wing (not open to the public)
Outside the meeting hall, numerous murals which I was allowed to photograph adorned the walls.
Upon my return from the dzong I had to pack. Tomorrow morning we travel to Paro to catch an 11:00 AM flight to Bangkok. The forecast is for clear weather which is essential, as Paro is under visual flight rules. This is understandable, as when landing it seemed at one time that there were mountains just feet away thru the windows on either side of the plane. My trip will take me from Bangkok, back to Tokyo on to Chicago and finally to Portland. All told I will spend 46 hours traveling. That is a lot of time in airports. The plan is to somehow stay awake until the flight from Tokyo to Chicago, which will be night hours by EDT, and begin to reset my internal clock.
Though this will be my last post from Bhutan, it will not be my last post. This blog more than anything has been created to keep a record of my experiences for myself. If some of you reading it have found it interesting and occasionally thought provoking, I am pleased. I do want to take some time to develop some reflections upon the past month. Look for one more post in about a week. Hopefully I will find some things to take away from this amazing experience.
Thursday, March 27, 2014
Random Observations of Bhutan
There have been no major trips or happenings in Thimphu this week. Life has settled into a routine. I get up, spend some personal time reading and meditating and at about 8:30 AM go to the Ambient Café ad have a light breakfast with a good cup of coffee (The Ambient is the only place in town I can find good coffee - this is "Tea Country"). I then head into the hospital at 9AM and work there until 3:30 before heading home. I spend some time answering email and writing this blog before heading out to dinner with Ed at about 6:15. After dinner it is back to my room for some more reading and writing.
Given the lack of recent major happenings, I thought I would simply do some free associating and make a few random observations form my month here, interspersed with some pictures I have taken while walking to work or in town. The hope is to give you a sense of what Thimphu is like.
This is a much more colorful world than home. Scarlet and gold stand out most prominently to me. Houses are sometimes brightly painted, yellow not being unusual, and they are decorated. A goendhar or prayer flag is erected on the top of most Buddhist homes. Besides the front door are large paintings of mythical animals or large red phalluses. The phalluses are not fertility symbols, but are associated with Llama Drukpa Kunley, one of Bhutan's favorite saints and an example of the Tibetan tradition of "crazy wisdom". Trucks are bright painted, often with inspirational messages.
I walk faster than everyone else here. I don't try to.....even when I slow down I pass everyone. It must be a western thing. To me it just says something about the pace of life here. Everything just happens slower here. That is wonderful in day to day life. It is not so wonderful in a hospital. There are times when something needs to be done, and needs to be done soon and it can be hard to create a sense of urgency.
Buddhist monk giving blessings on a crowded hospital ward
Traffic rules are very different here. First of all, they have neither stop signs nor traffic lights. Apparently a traffic light was put in a couple of years ago and objections were so fierce they had to take it down. Crossing a street has different rules. If you wait for traffic to clear in both directions you will wait a long time. Rather, when there is any kind of opening on your side of the street you step into traffic and the cars stop for you. However as soon as you are past the stopped traffic they drive right behind you in the position you were just located. You can find yourself in the middle of the street with traffic going both ways. One bravely plunges ahead and the traffic in the other direction stops until you get past. All of this requires a great deal of trust, which surprisingly I have developed.
There is a surprising police and military presence here. There are numerous military compounds, and police and guards are very conspicuous. Given that this is a country with next to no violent crime I find this somewhat surprising. Pat of it may be crowd control. In the hospital there are guards in the stairwells who try to control access to the wards. There are a lot of people wherever one goes and very few formal rules (You should see how people park in parking lots!). I suspect the very visual police and military presence helps to ensure order.
There is not a high premium given to maintenance. There is almost always trash in the streets and I can never find a public trash receptacle. At night all of the shop owners roll metal doors over the front of their shops. This morning I came across an elderly woman seeping the walk in front of what I assume was her shop with a whisk prior to opening it.
Asian Toilets! They bother western women a good deal more than western men who are only bothered half the time.
The streets can seem medieval. At times I can imagine it is 1514 rather than 2014.
This is a beautiful world. Today it was warm and sunny. As I strolled into work after breakfast and coffee the sky was blue and I passed underneath peach trees in full bloom. I had one of those rare moments of epiphany when I am so very grateful to be alive. I am trying to cultivate the ability to appreciate those moments when "Life is good"!
Given the lack of recent major happenings, I thought I would simply do some free associating and make a few random observations form my month here, interspersed with some pictures I have taken while walking to work or in town. The hope is to give you a sense of what Thimphu is like.
This is a much more colorful world than home. Scarlet and gold stand out most prominently to me. Houses are sometimes brightly painted, yellow not being unusual, and they are decorated. A goendhar or prayer flag is erected on the top of most Buddhist homes. Besides the front door are large paintings of mythical animals or large red phalluses. The phalluses are not fertility symbols, but are associated with Llama Drukpa Kunley, one of Bhutan's favorite saints and an example of the Tibetan tradition of "crazy wisdom". Trucks are bright painted, often with inspirational messages.
I walk faster than everyone else here. I don't try to.....even when I slow down I pass everyone. It must be a western thing. To me it just says something about the pace of life here. Everything just happens slower here. That is wonderful in day to day life. It is not so wonderful in a hospital. There are times when something needs to be done, and needs to be done soon and it can be hard to create a sense of urgency.
Traffic rules are very different here. First of all, they have neither stop signs nor traffic lights. Apparently a traffic light was put in a couple of years ago and objections were so fierce they had to take it down. Crossing a street has different rules. If you wait for traffic to clear in both directions you will wait a long time. Rather, when there is any kind of opening on your side of the street you step into traffic and the cars stop for you. However as soon as you are past the stopped traffic they drive right behind you in the position you were just located. You can find yourself in the middle of the street with traffic going both ways. One bravely plunges ahead and the traffic in the other direction stops until you get past. All of this requires a great deal of trust, which surprisingly I have developed.
There is a surprising police and military presence here. There are numerous military compounds, and police and guards are very conspicuous. Given that this is a country with next to no violent crime I find this somewhat surprising. Pat of it may be crowd control. In the hospital there are guards in the stairwells who try to control access to the wards. There are a lot of people wherever one goes and very few formal rules (You should see how people park in parking lots!). I suspect the very visual police and military presence helps to ensure order.
There is not a high premium given to maintenance. There is almost always trash in the streets and I can never find a public trash receptacle. At night all of the shop owners roll metal doors over the front of their shops. This morning I came across an elderly woman seeping the walk in front of what I assume was her shop with a whisk prior to opening it.
Asian Toilets! They bother western women a good deal more than western men who are only bothered half the time.
The streets can seem medieval. At times I can imagine it is 1514 rather than 2014.
This is a beautiful world. Today it was warm and sunny. As I strolled into work after breakfast and coffee the sky was blue and I passed underneath peach trees in full bloom. I had one of those rare moments of epiphany when I am so very grateful to be alive. I am trying to cultivate the ability to appreciate those moments when "Life is good"!
Tuesday, March 25, 2014
Gross National Happiness
March 20th was "Gross National Happiness Day". It is hard to be in Bhutan without learning of Gross National Happiness. The term was coined in 1972 by the then 16 year old fourth Dragon King, Jigme Singye Wangchuck as an attempt to define an indicator and concept that measures quality of life and social progress in more holistic terms than is found in a strictly economic indicator such as GNP (Gross National Product). Initially an offhand comment, it was taken seriously and the "Center for Bhutan Studies" was created. A GNH index has been proposed as a means to measure GNH by taking quantitative measurements in seven different domains and then taking the average per capita from these domains. (Reference: Wikipedia)
- Economic Wellness: Indicated via direct survey and statistical measurement of economic metrics such as consumer debt, average income to consumer price index ratio and income distribution
- Environmental Wellness: Indicated via direct survey and statistical measurement of environmental metrics such as pollution, noise and traffic
- Physical Wellness: Indicated via statistical measurement of physical health metrics such as severe illnesses
- Mental Wellness: Indicated via direct survey and statistical measurement of mental health metrics such as usage of antidepressants and rise or decline of psychotherapy patients
- Workplace Wellness: Indicated via direct survey and statistical measurement of labor metrics such as jobless claims, job change, workplace complaints and lawsuits
- Social Wellness: Indicated via direct survey and statistical measurement of social metrics such as discrimination, safety, divorce rates, complaints of domestic conflicts and family lawsuits, public lawsuits, crime rates
- Political Wellness: Indicated via direct survey and statistical measurement of political metrics such as the quality of local democracy, individual freedom, and foreign conflicts.
Gross National Happiness has been criticized as too subjective and potentially able to be manipulated by individual governments in ways which suit their interests. That being said, many measurements of individual well being seem to be transcultural, such as strong social ties, living in healthy ecosystems, individual freedom, and good governance.
In my mind, with an admittedly limited perspective of having worked in Bhutan for only a little over three weeks, Gross National Happiness is a reflection of Buddhist spiritual values and an attempt to define a "middle way" which promotes sustainable development while maintaining the environment as well as maintaining the spiritual values and cultural identity of the country. One sees this reflected every day while walking the streets. All one needs to do is raise one's head and he/she is likely to see prayer flags. I did a count of 100 consecutive people I passed on the streets and approximately 5% of them were Buddhist monks. One constantly sees a mix of the traditional and the modern - a monk on a cell phone, or as I saw the other day, an elderly man in traditional Gho and argyle socks with an Oakland Athletics Baseball cap on.
What got me to thinking about all of this was walking past the large National Memorial Chorten on my way home from the hospital this afternoon. Every day I see large numbers of people circumambulating clockwise around the chorten in worship. Others spin the prayer wheels within the complex. There is clearly an attempt here to value more than the simply material. Spirituality is evident here, constantly displayed in day to day life. The pace is slower, there is little to no violent crime, the work week is shorter, and yes, productivity is less. None of this is to say that there are not problems. Like all societies, there are social problems - alcohol abuse, unemployment for young males, significant poverty, and remnants of a feudal society only abolished a half century ago. I miss my own country and culture, yet I believe there is much of value to learn from Bhutan.
Monday, March 24, 2014
Changangkha Lhakhang Monastery
After the effort to reach Taktshang on Saturday, Sunday was largely a quiet day. We did take a brief hike up to Changangkha Lhakhang Monastery. This fortress like temple overlooks downtown Thimphu. It was built in the 12th century on a site chosen by Llama Phajo Drukgom Shigpo. While we were there numerous parents brought their babies and young children in to the inner sanctum and handed them to a monk. The child is apparently given an auspicious name or blessing from the protector deity Tamdrin. I believe it was Tamdrin's image we saw in the sanctum.
From the back of the temple there was an excellent view of downtown Thimphu. Thee were also numerous black and gold prayer wheels. Though the script on the prayer wheels was Tibetan which I can not read, it did look the same on each prayer wheel. I am uncertain of the significance of that.
From the back of the temple there was an excellent view of downtown Thimphu. Thee were also numerous black and gold prayer wheels. Though the script on the prayer wheels was Tibetan which I can not read, it did look the same on each prayer wheel. I am uncertain of the significance of that.
Downtown Thimphu from Changangkha Lhakhang Monastery
The lack and gold payer wheels being spun by an elderly pilgrim
A view of the court yard with the prayer wheels
Another court yard within the temple
The kitchen
It was a short hike (only about an hour round trip), but a nice follow-up to Taktshang.
Sunday, March 23, 2014
Taktshang Goemba
Finally, the day arrived for my most anticipated day trip - Taktshang Goemba Monastery or Tiger's Nest. Taktshang is one of Bhutan's most venerated religious sites. Legend has it that Guru Rinpoche flew to this site on the back of a tigress to subdue a local demon, Singey Samdrup, following which he meditated in a cave for three months. Taktshang is periously perched atop a 900 meter sheerr cliff above the floor of the Paro valley. The monastery dates to 1692. Tradition says that the monastery was anchored to the cliff by the hairs of celestial female beings known as khandroma who transported the building materials up onto the cliff.
There are only three ways to get to Taktshang - walk, horse back, or on the back of a magical tigress, though the latter is recommended only for tantric gurus. We chose to walk. Unfortunately, it was raining and misty when we left at approximately 10:45 AM. The hike requires 1.75 to 2 hours. Initially, the trail climbed steadily thru a whispering, blue pine forest to a series of switchbacks with a steady gain of altitude. After about an hour we reached the "cafeteria", a small wooden teahouse - restaurant. We met a number of people descending from the top who informed us the mist obscured the view points, but it was still worth the hike to the top. Meals were served, but we chose only to buy some bottled water and greet the local cat.
After treating our impending dehydration (a result of the altitude and work of the climb), we stepped onto the patio from which the famous pictures of "Tiger's Nest" which are on the cover of many travel brochures on Bhutan are taken. Unfortunately, the mist obscured the view, though I did manage to get some brief glimpses.
We pressed on. The way up became increasingly steep. Finally we reached a view point and out of the mist across a ravine hundreds of meters deep arose Taktshang like an ethereal mystic kingdom.
Now the task was to get across the ravine. We had to descend down and then back up a set of steel steps along the side of the cliff. If you look closely you can see them coming up the side of the cliff in the picture immediately above from the lower left corner. I have never been particularly fond of cliff edges. After a quick peek over the railing at the hundreds of meters drop, I decided to just look down and keep concentrating on the next step.
After completing the steps we continued on a path toward a bridge in the distance. The mist made everything look more magical, with moss hanging from the trees.
The monks take a lunch break from 1:00 until 2:00 pm, and we passed their kitchen on our way where some of them were finishing lunch.
We next came across a chapel with butter lamps and then wwent by a waterfall by the Singye Pelphu Lhakhang (Snow Lion Cave) which is associated with the Guru Rinpoche's consort (who was also able to transform herself into the flying tigress!). Standing there and closing my eyes all I could here was the wind and the water.
We crossed the bridge and made our final ascent back up to Taktshang.
I wish that I could somehow show or describe how beautiful the interior of these monasteries are. However, no pictures are allowed. At Taktshang, tourists have to have a guide who has obtained a permit to enter. We were asked where our guide was, and had to explain that we had none because we were volunteers at the hospital in Thimphu. We showed our work visas and were graciously allowed in after locking our cameras and cell phones in a locker and being frisked.
The interior of the monastery has gorgeous wall murals, tapestries and statues. There were numerous chapels. To enter, all must take off their shoes ad have their legs covered. Women must have there head covered with a scarf (which they handed out if you did not bring one) In the chapels, pilgrims prayed and were blessed by priest. Offerings of food (including a box of Ritz Bits) and money were left on the altar. We left some nu (Bhutanese money) in each chapel we visited.
When we left the chapel we were treated to brilliant blue skies. As we departed this spiritual place I turned several times snapping pictures and saying "Good Bye".
I believe this trip will be one of the most memorable days of my life, along with a handful of others. I fear my words and pictures do not do the experience justice.
There are only three ways to get to Taktshang - walk, horse back, or on the back of a magical tigress, though the latter is recommended only for tantric gurus. We chose to walk. Unfortunately, it was raining and misty when we left at approximately 10:45 AM. The hike requires 1.75 to 2 hours. Initially, the trail climbed steadily thru a whispering, blue pine forest to a series of switchbacks with a steady gain of altitude. After about an hour we reached the "cafeteria", a small wooden teahouse - restaurant. We met a number of people descending from the top who informed us the mist obscured the view points, but it was still worth the hike to the top. Meals were served, but we chose only to buy some bottled water and greet the local cat.
After treating our impending dehydration (a result of the altitude and work of the climb), we stepped onto the patio from which the famous pictures of "Tiger's Nest" which are on the cover of many travel brochures on Bhutan are taken. Unfortunately, the mist obscured the view, though I did manage to get some brief glimpses.
We pressed on. The way up became increasingly steep. Finally we reached a view point and out of the mist across a ravine hundreds of meters deep arose Taktshang like an ethereal mystic kingdom.
Now the task was to get across the ravine. We had to descend down and then back up a set of steel steps along the side of the cliff. If you look closely you can see them coming up the side of the cliff in the picture immediately above from the lower left corner. I have never been particularly fond of cliff edges. After a quick peek over the railing at the hundreds of meters drop, I decided to just look down and keep concentrating on the next step.
After completing the steps we continued on a path toward a bridge in the distance. The mist made everything look more magical, with moss hanging from the trees.
The monks take a lunch break from 1:00 until 2:00 pm, and we passed their kitchen on our way where some of them were finishing lunch.
We next came across a chapel with butter lamps and then wwent by a waterfall by the Singye Pelphu Lhakhang (Snow Lion Cave) which is associated with the Guru Rinpoche's consort (who was also able to transform herself into the flying tigress!). Standing there and closing my eyes all I could here was the wind and the water.
We crossed the bridge and made our final ascent back up to Taktshang.
I wish that I could somehow show or describe how beautiful the interior of these monasteries are. However, no pictures are allowed. At Taktshang, tourists have to have a guide who has obtained a permit to enter. We were asked where our guide was, and had to explain that we had none because we were volunteers at the hospital in Thimphu. We showed our work visas and were graciously allowed in after locking our cameras and cell phones in a locker and being frisked.
The interior of the monastery has gorgeous wall murals, tapestries and statues. There were numerous chapels. To enter, all must take off their shoes ad have their legs covered. Women must have there head covered with a scarf (which they handed out if you did not bring one) In the chapels, pilgrims prayed and were blessed by priest. Offerings of food (including a box of Ritz Bits) and money were left on the altar. We left some nu (Bhutanese money) in each chapel we visited.
When we left the chapel we were treated to brilliant blue skies. As we departed this spiritual place I turned several times snapping pictures and saying "Good Bye".
I believe this trip will be one of the most memorable days of my life, along with a handful of others. I fear my words and pictures do not do the experience justice.
Friday, March 21, 2014
Eating in Bhutan
Today was my partner, Annette's last day at JDWNRH (I still have a week left at the hospital). Our local patrons, Dr. Tashi, a surgical oncologist and Dr. Euygen, a gynecologic oncologist took us out to dinner at the Folk Heritage Museum. The museum is a restored three story, rammed earth and timber building replicating a traditional farm house and furnished as it would have been about a century ago. The meal contained all of the traditional Bhutanese dishes, and I do mean ALL (I think I am going to pop!).
We started out with traditional butter tea and zao (fried rice) and sip (fried, beaten corn), both eaten with the fingers. This was accompanied with warm Bhutanese wine (something like Saki). We were properly instructed to dip or fingers in the wine and throw some over our shoulders for the gods. We then had some cucumber slices and cheese, stir-fried beef liver, and of course, momos (a Bhutanese snack). Momos ae small, steamed dumplings stuffed with meat or cheese which are dipped in chili paste and they are delicious.
Did I say chilies? They are a major crop here and the mouth-scorching meals bring tears of joy to chili lovers, I foolishly thought the above food was the entire meal. Imagine my surprise when approximately 10 more dishes were brought out. Included was the national dish - ema datse - green and red chilies prepared as a vegetable.. There was also phak sha laphu (stewed pork with radish), white rice, sha huentseu (stewed beef with spinach), bja sha maroo (chicken in garlic and butter sauce), kewa datse (potatoes with cheese sauce), olo choto (literally "crow beak", a hooked shape broad bean), a salad with banana flowers in it, and a delicious flat bread served with honey. And to top it all off - FIDDLE HEADS! I felt right at home. Desert was an herbal tea and orange slices.
What a feast! The conversation was delightful, centering on various Bhutanese Buddhist traditional practices, many of which are a form of "tantric Buddhism". We also discussed how physicians are trained in Bhutan - They have no medical school, so this as well as residencies and fellowships are generally outside the country. The government pays for the training, so there are no large debts such as American physicians accumulate paying for their training, however, thee is pay back time which is such that many physicians spend most if not all of their careers working in the Bhutanese health system.
All in all, a nice evening.
We started out with traditional butter tea and zao (fried rice) and sip (fried, beaten corn), both eaten with the fingers. This was accompanied with warm Bhutanese wine (something like Saki). We were properly instructed to dip or fingers in the wine and throw some over our shoulders for the gods. We then had some cucumber slices and cheese, stir-fried beef liver, and of course, momos (a Bhutanese snack). Momos ae small, steamed dumplings stuffed with meat or cheese which are dipped in chili paste and they are delicious.
Did I say chilies? They are a major crop here and the mouth-scorching meals bring tears of joy to chili lovers, I foolishly thought the above food was the entire meal. Imagine my surprise when approximately 10 more dishes were brought out. Included was the national dish - ema datse - green and red chilies prepared as a vegetable.. There was also phak sha laphu (stewed pork with radish), white rice, sha huentseu (stewed beef with spinach), bja sha maroo (chicken in garlic and butter sauce), kewa datse (potatoes with cheese sauce), olo choto (literally "crow beak", a hooked shape broad bean), a salad with banana flowers in it, and a delicious flat bread served with honey. And to top it all off - FIDDLE HEADS! I felt right at home. Desert was an herbal tea and orange slices.
What a feast! The conversation was delightful, centering on various Bhutanese Buddhist traditional practices, many of which are a form of "tantric Buddhism". We also discussed how physicians are trained in Bhutan - They have no medical school, so this as well as residencies and fellowships are generally outside the country. The government pays for the training, so there are no large debts such as American physicians accumulate paying for their training, however, thee is pay back time which is such that many physicians spend most if not all of their careers working in the Bhutanese health system.
All in all, a nice evening.
Wednesday, March 19, 2014
Haa Valley - Part II
It is raining today in Bhutan, something I have seen very little of. On the bright side, I finally did get to use the collapsible umbrella I brought. Thinking back to this past Sunday when it was sunny and warm (I needed to use sun screen) as we travelled first thru the Haa Valley and then into the mountains will be a pleasant exercise as I write today's blog.
Following lunch, we left the town of Haa and began to ascend into the mountains. After about 30 minutes we came across a Yak herd. I believe this was the first time I have ever seen a Yak (unless I saw one in a zoo as a child and do not recall it). Apparently they can be somewhat aggressive, as Sherab, our guide and driver, cautioned us not to get too close. Fortunately I had a telephoto lens (thank you daughter Megan!) which allowed me to get some decent pictures.
I am hoping that these Yaks were not related to my Monday night dinner!
Following our visit with the Yaks, we headed higher into the mountains ultimately reaching Cheli La. The road to Cheli La is the highest motorable road in Bhutan. When one crests the Cheli La, he/she is supposed to cry "Iha-gey lu!" (May the gods be victorious!). A sign states the elevation of the pass is 3988m, though "Lonely Planet" states it is closer to 3810m. Regardless of which is correct, that is between 12,500 and 13,000 feet above sea level. With the exception of air planes, I believe this is the highest altitude I have ever been. The day was quite clear, with only a slight haze, and the view breathtaking. We could see Tiger's Nest (which I hope to visit this weekend if it does not rain) across the valley. I have included a number of pictures below, but sadly they do not come close to doing the view justice.
I believe hat the higher one is, the more prayer flags one finds.
If you look closely on the left side of the photo, you will see the Himalayans in the distance
Our intrepid guide and driver this month, Sherab. Like much of what you see in Bhutan, his attire is a mix of traditional and modern. He is wearing a traditional Gho (which men wear) and omso (high socks) along with a down vest and sun glasses. It is not unusual to see a red robbed monk speaking on a cell phone.
Dr. Andy at the Cheli La
We left Cheli La and began our descent. After a short distance we stopped at another view point. Across a huge valley we could see the buildings of a Buddhist nunnery clinging to a cliff. The photo below was taken using the telephoto lens.
Following lunch, we left the town of Haa and began to ascend into the mountains. After about 30 minutes we came across a Yak herd. I believe this was the first time I have ever seen a Yak (unless I saw one in a zoo as a child and do not recall it). Apparently they can be somewhat aggressive, as Sherab, our guide and driver, cautioned us not to get too close. Fortunately I had a telephoto lens (thank you daughter Megan!) which allowed me to get some decent pictures.
I am hoping that these Yaks were not related to my Monday night dinner!
Following our visit with the Yaks, we headed higher into the mountains ultimately reaching Cheli La. The road to Cheli La is the highest motorable road in Bhutan. When one crests the Cheli La, he/she is supposed to cry "Iha-gey lu!" (May the gods be victorious!). A sign states the elevation of the pass is 3988m, though "Lonely Planet" states it is closer to 3810m. Regardless of which is correct, that is between 12,500 and 13,000 feet above sea level. With the exception of air planes, I believe this is the highest altitude I have ever been. The day was quite clear, with only a slight haze, and the view breathtaking. We could see Tiger's Nest (which I hope to visit this weekend if it does not rain) across the valley. I have included a number of pictures below, but sadly they do not come close to doing the view justice.
We left Cheli La and began our descent. After a short distance we stopped at another view point. Across a huge valley we could see the buildings of a Buddhist nunnery clinging to a cliff. The photo below was taken using the telephoto lens.
A Buddhist Nunnery
All told a wonderful day. We did end our day with incredible fatigue and pounding headaches, quite possibly due to the decreased oxygen at heights. Well worth the rewards of the trip, however.
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