(Trekking) Map of Nepal: It's kind of interactive and good quality

This is the best map of Nepal on the entire Internet. Well Google maps is there but currently there is very little information about place names or trails on that. This maps gives an excellent overview of the mountain geography of the country. The map has been made by Himalaya Map House to show the Great Himalaya Trail route as proposed by Robin Boustead. See http://www.thegreathimalayatrail.org/ for more about the long distance path, or long distance trail which extends across the Nepal Himalaya.

Anyway, enjoy the map. Click below and give a few seconds for it to load.  

Transparency and technology and Nepal

I have little idea what politicians do here in Nepal. I read mainly negative things about them, perhaps due to the fact that the press report mainly negative things: a slap of a civil servant here, an attack on a doctor there, a trip to a hospital in Singapore for treatment at the tax payer's expense; a bit (or a lot) of nepotism and obviously some corruption (because its a perk of the job).

But then if the subject of politicians is raised in conversation, reactions range from frustration to rage. Their reputation among the public (that I speak to) is poor. There is a little praise reserved for a couple of young hopes: Gagan Thapa is one who is often mentioned.

Nawaraj Silwal, Siddhartha Rana, Ashmi Rana, Ashutosh Tiwari, Santosh Shah

I attended a conference around a month ago. It was hastily organised apparently, the audience was stuffed with students from one of the speaker's hospitality college. The questions from the youth audience were limited and required to be 'brief and to the point' while the speakers were allowed to waffle on, off the point.

With one bright exception (though I missed the first speaker). One of the speakers there was Santosh Shah. He is well known in Nepal for his Today's Youth Asia initiative which comprises of a TV show, magazine run by youth and an education program which has trained hundreds of teenagers in personal development. The theme of his talk was institutions. His argument was that a) institutions are important, obviously, but b) that no individual should be, or think themselves bigger than an institution.

And this is the case with many Nepali politicians, some seem to believe themselves to be bigger than the institution that they work for.

As someone with a background in web development, one organisation I admire is MySociety. One of their collection of websites, it called 'They work for you'.

Essentially it aggregates information about MPs in the UK using some clever technology which 'scrapes' published documents, such as Hansard, and collates information in an accessible way.

I have seen the fruits of this on several occasions where a journalist has asked a question of an MP who's answer is flatly contradicted by the evidence available on the site. It's powerful.

Could something like this work and benefit the public and journalists in Nepal? Possibly, but it would be quite different. The main reason would be that information could not be collated automatically.

But perhaps something could be done as a collaboration between journalists. If journalists reporting on politics and events could post information on a site and categorise it simply, perhaps a public picture can be built up of that politician. Logging where they go, their public comments and public promises, the slaps, the assaults and the gaffs should be easy. Assimilating information on their performance, how they vote, how often they turn up to work, their expenses and outside business interests would be a little more difficult. Perhaps the website would encourage whistle-blowers to bring new information to the table. Perhaps some kind of scoring system could rank their performance and distinguish the wheat from the chaff. Possibly it would be difficult to keep the postings impartial, but not impossible, and who would manage that?

Any thoughts on this anyone?

Dil Bahadur Kidney Transplantee - an update

One of my hobbies is trying to get people to laugh on photos. Its pretty easy in Nepal I think. While having your photo taken is becoming more common, as there are many snapping mobile phones about, having photos printed is relatively expensive and, if not a luxury, something reserved for serious applications to officialdom.

If you can imagine pictures of your great, great grandparents when the world was still sepia coloured, or your youthful great grandparents when the world had turned black white, and then if you can picture the serious scowls they wore on their faces, add colour some colour and you have an idea of how portrait photography is most of the time Nepal.

Anyway, during the few seconds of overbearing stress while waiting for the photographer to click the button, its is really easy to make people explode into laughter.

There you go. Laughter therapy is free. The straight face behind the mask is Dil Bahadur and this tells something of our relationship. For him, because of the donations that have been collected, I am his (small g) god - a term I hate. But given the context of a culture with millions of Gods, I can see where he's coming from: out of the dust and smog comes someone who agrees to help you (by asking his friends and family to part with some cash). But this luck has just been the cherry on the cake. Dil has done more than his best to get to this point: a great deal of fund-raising in his home town, representation in the press (Journo seeks support) and support from his colleagues, his family came to Kathmandu to help him through dialysis (and his wife donated a kidney), and recently becoming one of the very lucky few in Nepal to reach the operating table in Bir Hospital (which incidentally celebrated one year of successful transplantation on the 12th December 2009).

Back to the photo. Among the family there is a palpable sense of relief, but with Dil, constantly wearing a mask to minimise the risk of infection with his permanently weakened immune system, he knows this is a long term thing. He faces up to the cost of his treatment every time he goes to the pharmacy and parts with cold hard cash. So far, generous donations brought in around 1,300 Euro. This has paid for one of the (two recommended) doses of chronically expensive Zena-pax which increases organ acceptance by up to 40%, plus the initially high doses of immunosuppressants. So far so very good. Still another 600 Euro would required to get to a maintenance state, where the daily dose of drugs becomes much cheaper and (more or less) manageable.

After that the challenge changes: to earn enough money to feed the family and pay the pharmacist. Its possible. A group of patients are looking at a programme where they set up their own specialist pharmacy to cut out the middleman and save around 15% of the cost. A group of people connected with UNDP are planning a training course on how to "Start and Improve Your Business" so that families can improve their income to cover their increase expenditure. Its early days, but there must be some way found to make this self-sustainable otherwise transplantation remains only for the rich.

So, nearly there, nearly out of the woods. Thanks very much indeed for your support to get to this point.

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Donations already received can be seen here: 
http://spreadsheets.google.com/pub?key=tdOFgjwTUeKCSow9L40a0qQ&single=true&gid=2&output=html

If you wish to contribute, please do so using this button below. It will take you to a secure Paypal site where you can use a credit card to make a donation. The account used is my own, it is currently empty and I will publish (anonymously, dates and amounts only) at a later date. Alternatively, Account name: R. P. Bull Bank name / Address: ABN AMRO / Leidseplein 25, Amsterdam; Account No: 519969626; IBAN: NL44ABNA0519969626; BIC / SWIFT Code: ABNANL2A. Thanks for your support!

If in any doubt the screen you should see on clicking the button above looks like this: Paypal screen

And now the doctors are going on strike...

“My life is under threat now,” says Dr Nil Mani Upadhyaya, registrar of the Nepal Medical Council (NMC).
On December 15th, two men were waiting for him at his gate on returning from work and attacked him with a khukuri knife. Dr Upadhyaya is lucky to have suffered only minor cuts. The men then fled on motorbikes and could not be followed.

Why was he attacked? “That is the main question for me,” he explains, “I have no single enemy after 25 years of practicing medicine. There has been no demand for money. There has not even been a bad conversation on the telephone.”

“Part of our role at NMC is licensing doctors. There are some people who have trained outside Nepal, in Russia, or India who have failed the licensing exam to practice in Nepal. Some have failed so many times, up to 14, 15 times. Our guess is that it might have come from that group – but we really don’t know, we’re just speculating.”

The attack was a trigger for the NMC’s sister organisation, the Nepal Medical Association (NMA), to threaten a one day bandh on 28th December unless their demands were met. The NMA represent the interests of medical professionals in Nepal. The bandh will result in a voluntary stopping of work in all departments except emergency.

Dr Kedar K.C., president of the NMA explained that the primary demand was for measures to increase safety of doctors in the workplace. Apparently there have been up to 40 attacks on doctors in the last 2 years across Nepal. Bundled in with this are a call for increased health budget, increase in the number of doctors, better equipment, abolishing 5% tax on salaries (which is anyway passed on to the consumer) all the way to setting up Bir Hospital as a centre of excellence and the foundation of a new medical university.

This is a worthy list but already the NMA’s strategy has fallen apart before it has started. Firstly it has diluted the issue of violence against doctors with many other complicated issues, including some self-serving ones (tax reductions, increase in private hours allowance). It could be perceived as using the frightening attack on a senior doctor to force through an increase in their benefits.

Secondly it is using the thuggish tactic of the bandh. While this could be justified in extreme cases, and after all other options have been explored, here the NMA is offering the public punishment as a kneejerk reaction to an event of 13 days earlier that additionally didn’t happen in a hospital. In calling a bandh, while not blocking roads, it puts itself in the same camp as all of the other flag-waving, violent, tyre-burning, unwilling-to-negotiate rock-heads.

What does the head of the NMC think about the bandh? “From a personal point of view, and that of registrar, I would not support it, but then I am a victim too. From a medical ethics point of view, I should not support it. It is a very crucial question for me.”

If Dr Upadhyaya has his reservations, it would seem unlikely that the long-suffering public are going to be offering their unswerving support. And there is the third point – never call a strike of a public service unless you have built up firm public support for your case beforehand.

How does Dr Upadhyaya he see the best way to improve the protection for medical staff in Nepal? “It is very difficult question. If the whole country is going in one direction, how can you protect [anything]. We are in the same direction as Afghanistan; there is no law and order here.”

“The home minister said about a year ago ‘I cannot safeguard my own life, how can I safeguard the lives of others?’.”

So then what good is this bandh going to do? Let’s wait and see. Perhaps the government will shrug their shoulders and call their bluff.

The NMA has missed a great opportunity for developing public relations. It could have detailed the terrible cases of violence against doctors, the dedication that medical staff show, the long hours, awful equipment, weak management and the fact that hospital budgets are lower than WHO minimum recommended levels. They could have played on the fact that ministers often use the public purse to get treatment overseas. Or wheeled out some happy, satisfied patients to rally support for doctors. It could have managed the expectations of the public, that doctors always do their best for patients, but that they cannot work miracles and sadly some patients will die.

It could have opened a conversation with the public about why doctors (and society at large) are suffering violence and what should be done. And then, importantly, show that they’re actually listening and thank them for engaging.

Instead, tomorrow, doctors will further loose favour with the public and strengthen the choking culture of the bandh as the only way to fix problems. In many ways, they will have just made the problem worse.

Smallest buddhist in the house. Seto Gomba, Kathmandu.

Smallest buddhist in the house. Seto Gomba, Kathmandu., originally uploaded by rpb1001.

I am lucky. I complain about a lot of things, but life for me is interesting and life for me is good. This evening, Christmas eve (although this has little meaning for me), was spent as the fourth attendee of a Buddhist wedding. The other three were the bride, groom and their young daughter.

The wedding took place under the auspices of a particular Ringpoche (name escapes me) in the Seto Gomba, the White Monastery, near Boudha in Kathmandu.

In this picture, the wedding is over and formalities are being completed in the office. Every monk in the house, and all employees too, are receiving a 100 rupee gift from the groom from a rather thick wad of cash managed by Tenzin Chopel (hand outstretched, right).

Here, hesitantly comes the smallest monk of the Gomba into the office to receive his money.

Best viewed large on black, click here

Kathmandu's Bir Hospital celebrates first anniversary of successful kidney transplant.

Dr. Pukar Chandra Shrestha, transplant surgeon, Bir Hospital, Kathmandu, Nepal, originally uploaded by rpb1001.

12 December 2009

Today, the 120 year old Bir hospital in Kathmandu celebrates the anniversary of its first successful kidney transplant.

Bir’s renal transplant department was the brainchild of surgeon Dr. Pukar Shrestha who spent six years training in UK. In his last role he was a senior registrar at the Freeman Hospital in Newcastle before choosing to return to Nepal over promotion to consultant.

“I was thinking, ‘Nepal needs me’,” he recalls. “In the UK there are many like me, but here in Nepal every patient needs doctors like me.”

In the past 12 months 16 patients have been given kidneys donated from family members. “16 is good success over 11 months, however we used to operate on up to 15 patients every week in Newcastle.”

The department’s target is one transplantation per week. But there are major obstacles to achieving this. For instance, the department has no operating theatre. “We have to borrow the theatre from cardiology or neurology and this is a big limitation,” says Shrestha. Additionally there is no facility for tissue cross matching in Nepal and samples need to be sent to India which is both costly and takes 4-6 days. “On the positive side,” adds Dr Shrestha, “we have a really capable and dedicated team here. We’re also lucky to have strong ties with organisations outside Nepal such as Freeman Hospital, Transplant links and Health Exchange Nepal who are helping us with training.”

Previously the only option for those with Chronic Renal Failure (CRF) was to go to India. While there is no official data, it is thought that up to 100 people cross the border every year paying upwards of 8,000 Euro, sometimes purchasing an organ there.

Now Nepali’s have the option of both Bir Hospital and Tribhuvan University Teaching Hospital (TUTH) which had its first transplant success in mid-2008. While the average cost of a transplant in the USA for example is at least US$ 50,000, both hospitals charge less than 3,500 Euro for a transplant using the best available drugs. “I was trained in the UK and want to work in the same way,” says Dr. Shrestha.

Dr Rajani Hada, Associate Professor of Nephrology at Bir is enthusiastic about transplantation. “Over 50% of patients are below 30. With a transplant they can go on to lead normal, productive lives.”

It is estimated that annually 2800 people suffer from CRF in Nepal. Dr Hada believes that while transplants save lives, the most effective way is early screening and thus prevention. “In my ideal world I would screen all children at school. It costs just 25 NRP (23 Euro cents) for a urine test, and we could catch problems early and treat them. We could eventually reduce that number significantly.”

Present at the short ceremony at the hospital is Dinesh Thapa, 22, who was transplanted seven months ago with a kidney donated by his mother. “We have a new life. For us, the transplant is a miracle,” says Dinesh.

The immunosuppressant drugs he takes daily to stop the body rejecting the kidney cost around 150 euro per month, an amount that is equivalent to a good government salary. “We sell our land,” says his mother when asked how they finance this cost. He is studying journalism and in two years hopes to be able to have job and be able to cover this cost himself.

While operations themselves have been very successful, the cost of medication is a major stumbling block. Some organisations such as UNDP are looking into income generation programs to help transplanted patients and their families afford the drugs. Dr Hada called for the government to remove taxes from immunosuppressants and even offer a subsidy to patients.

“We need to do something for these people,” says Shrestha later, “Dinesh is not working, how long can he sustain these costs?”

“We can’t make an emotional bond with patients or we’d end up in a mental hospital,” says Dr Hada. “Making good decisions for all our patients is the best we can do.”

Gadhimai Mela, Nepal

Gadhimai Mela, Nepal, originally uploaded by rpb1001.

Last week I attended the Gadhimai Mela. Mela means festival in Nepal. For me it was like another world entirely. The Mela has gained some notoriety internationally because of the ritual slaughter that takes place there. Approximately 12,000 male buffaloes are ritually sacrificed there and many thousands more are slaughtered in the 5km zone around Gadhimai's temple.

I am writing up this experience for the interested to read. Is hard to get a flavour of how it was from pictures alone, but then I don't guarantee that the text will make it that much clearer.

Meanwhile, see the photos here. Some are bloody but please put your squeamishness to one side.
http://www.flickr.com/photos/rpb1001/sets/72157622780160303/

There is a great reflective piece on this here: http://sushma.blogspot.com/2009/11/are-we-civilised-yet.html

Indra: one kidney lighter than a few days ago

Indra: one kidney lighter than a few days ago, originally uploaded by rpb1001.

This is Indra and she just donated a kidney to her husband. It is interesting that each of the three doctors I have spoken to (two nephrologists and a surgeon) have mentioned that 'rich' people (in Nepal) don't want to donate kidneys. They prefer to buy them from someone, somewhere in India with all the risk that that might entail. It is only the poorer that have family members donate. There is obvious necessity there - they have no choice financially - but equally it is never an issue to find a donor within the family to make this very selfless contribution.

Having said that, in poorer families, it doesn't rule out duty to family before self and pressure from the family hierarchy.

Anyway, a key point here is that you don't have to be biologically related to the recipient to be a live donor. The other point is that donors can and do lead a fully normal life after donating a kidney.

Death or financial ruin, or both.

It’s around midday as I wander through the maze of dark, grey corridors in Bir Hospital in Kathmandu. Outside it is busy and colourful like a bus station as people sit crammed together on covered benches as if they were waiting for a journey to commence. But they have all arrived from ‘the village’ (the collective term for rural Nepal where over 85% of the population lives), potentially many days away, to get treatment or to accompany family members. Where does everyone sleep?

I am looking for bed number one in the ‘special ward’ where transplant patients wait. Well, there is only one patient at the moment. A sign points to the visitors’ waiting room. Through the window I see his family sitting patiently in this small, bare room. They smile their best smiles when I enter, and I sit down with them and ask where their son is.

Dil Badhur Shahi looking pensive as many Nepali's do on photographs

I met Dil Badhur Shahi, a 28-year-old journalist, in May this year as I was trying to burrow through some bureaucracy to get a journalist’s visa to extend my stay in Nepal. While waiting for several hours on a collapsing beige couch for a bureaucrat to return from lunch, we talked a little in his ramshackle English and my shameful Nepali. When all the talking that could be done was done, we exchanged business cards and said goodbye, both giving up on the chance of the bureaucrat’s return.

Eldest daughter Monika

Youngest daughter Melina

Several weeks later he called me asking to meet up and we met next to the Bhimsen tower, a white phallic structure in the heart of Kathmandu which, at 50m tall, pokes just above the smog and allows you a breath of almost clean air (which in itself is worth the ticket price) as you gaze over sprawling, choking Kathmandu. I couldn’t really remember who I was meeting until I saw his face. I’d only agreed to meet up with this caller because the mention of a ‘kidney problem’ awakened my curiosity.

I’d once been involved with a friend’s project called Tackers, which brought children with organ transplants together for a week in Switzerland. There I learned a little of the world of organ transplantation: the emotional rollercoaster ride of hope and heartbreak, the patience and resolutely positive outlook required; the daily, colourful heaps of pills to be swallowed; the incredible level of expertise involved and accompanying cost. It could only be interesting to see how the situation compared in Nepal.

Over a milky tea we talked and I learned that Dil Badhur means ‘brave heart’; he’s from just west of Pokhara, where he runs a small district newspaper; that he has two young daughters, Monika and Melina; and that he has kidney failure from undiagnosed hypertension. Life had changed from being an accepted normality to being organised around half-day dialysis sessions twice per week in Kathmandu and finding the money to pay for it. He didn’t laugh that much but given his circumstances, I could see why. “Can you help me?” he wanted, not unreasonably, to know.

I agreed to try, but since then I am ashamed to say my efforts to help have been half-hearted at best. While I wished him well, he seemed to be in a hopeless situation. But then I was discounting his will to live and his will to not leave his young family fatherless.

The bottom line is of course that kidney failure is untreatable. Dialysis is needed, ideally, three times per week just to keep alive. But while dialysis maintains life, it kills financially. It costs around 20 Euro per session and perhaps up to 30 Euro by the time lab tests, equipment and consultations have been taken into account. There are very few jobs in the entire country paying salaries that could sustain these outgoings for long. These fees get paid from savings, from collections among friends, family and community and eventually selling any possessions, property and land owned.

The only escape from dialysis is a kidney transplant. Previously, the nearest hospitals performing transplants were in India and the operation would cost upwards of 8000 Euro that is, if you have a compatible kidney lined up to receive, or someone to buy one from. For many this amount poses an insurmountable barrier and this is the real tragedy.

The top dialysis organisation in Nepal is the National Kidney Centre (NKC) headed by chief Nephrologist Dr Rishi Kumar Kafle. He was an inspiring man trying to save as many lives as he could in the face of impressive adversity: scheduled power cuts of up to 16 hours per day; getting enough clean water in dehydrated, polluted Kathmandu; a general lack of funding and the difficulty, universal to all patients, of affording to stay alive. He is well aware that not many of his patients will ever get a transplant, but some do and that’s the point – from his centre around two people per week have been making the journey to India.

The head of nursing at the NKC told that a number of her staff had resigned, as they can no longer emotionally handle the heartbreaking stories patients routinely have to tell. They’ve funded their own dialysis for as long as they could and when all of the savings were gone, valuable possessions pawned and the family’s house and land were sold, then their only remains the inevitable and a literally impoverished family left behind.

The hurdles don’t stop at a successful transplant. For those who can find the means to get a transplant, there remains the life-long need for immunosuppressant drugs to stop the body rejecting the foreign kidney. The cost of these Swiss or Japanese drugs can, depending on which combination of drugs is prescribed, outstrip the cost of dialysis. While generics are available from India, the cost can still reach 200 Euro per month. To put this in perspective, that’s more than the monthly salary of Nepal’s only qualified transplant surgeon. There’s certainly work to be done here in the medium-term to reduce costs through tax exemptions and bulk purchases.

Several days ago I was surprised to get a text message from Dil Badhur saying that he is booked in for his transplantation operation in the government-run Bir hospital. His wife, Indra, will be the one donating the life-saving kidney. Nothing is impossible, it seems, if you try hard enough.

The cost of the operation is a bargain, if you can call it such, at 3,500 Euro. Just 1,000 Euro of this is the hospital fee while the rest pays for medical equipment and state-of-the-art drugs for during and the days immediately after surgery.

He’s already paid as much as he has been able to raise through contributions from family, friends, his journalists’ union and his home community. Still 2,500 Euro has to be found, and it will be.

For most kidney failure patients in Nepal, as time rolls on, the final outcome will be either death, or financial ruin and likely both. For some though the outcome will be life, despite the unrelenting, exhausting financial burden. Without insurance to fall back on, survival becomes a question of ingenuity, resourcefulness supported with, if some luck is there, others' goodwill.

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I am passing the hat around. I’ll contribute how I can, and I hope if you can make a small contribution, then, with enough people’s help then this life, and the family it is part of, can be prolonged.

Thank you. I’ll keep you posted on how it goes.

If you wish to contribute, please do so using this button below. It will take you to a secure Paypal site where you can use a credit card to make a donation. The account used is my own, it is currently empty and I will publish (anonymously, dates and amounts only) at a later date. Alternatively, Account name: R. P. Bull Bank name / Address: ABN AMRO / Leidseplein 25, Amsterdam; Account No: 519969626; IBAN: NL44ABNA0519969626; BIC / SWIFT Code: ABNANL2A. Thanks for your support!

If in any doubt the screen you should see on clicking the button above looks like this: Paypal screen

Swine flu's travel itinery

click to view large

After more than a month without posting anything, this is just a post to end the drought.

On re-entering Nepal this at the end of September, this banner hung over a window just after entering the airport after crossing the runway. For anyone who has been to Nepal before, despite its serious message, it is a wonderful welcome back to the country. As well as country's names, the banner has ad-hoc and impromptu written all over it which is quite a prominent feature of life in Nepal.

It is also interesting to see how swine-flu has been vacationing: Belgium then Thailand, Kuwait then Iceland - quite some hopping about.

Images of Everest Basecamp and the Himex Expedition 2009

Namche Bazaar at night © Alex Treadway

If you have 5 minutes spare that you can split into 30 seconds and 4 minutes 30 seconds, then take 30 seconds to download Alex's amazing images from Everest basecamp this year. Click the picture or the link below and download the PDF linked to the lower left of the page. 

http://www.alextreadway.co.uk/photography.asp?sid=32&oid=360

Alex spent over a month at the camptaking pictures for his and Billi Bierling's Everest Changes People project. 

If you are lucky, you can get the PDF to give you 4.30 of slideshow - not sure how you do it, just give it a try. If you know anyone who has been to Everest basecamp, forward them the link now. 

Mango season

Mango season, originally uploaded by rpb1001.

I am not exactly sure how this small piece of mango reached the floor, but these ants found it and claimed it and are dragging it up the wall, homeward bound.

On the one hand, it shows the fantastic cooperation of ants: all pulling and pushing together in the right direction with such effectiveness that 30 or so can lift an oh-so-delicious object up a vertical wall.

On the other hand, a couple of hours on, and after a bit of help from me and a spoon, they seem to have just realised that they're never going to be able to get it though the narrow crack between the window and its frame.

Tough as nails

This is the wife of a tough man. She is pretty tough herself. The photo is a rushed shot as I was basically late. The helicopter took two days to come, but I was late when it did. So, a snap of a tough man's wife in her waiting position with two flasks of tea. In the background, a helicopter taking off with a 'kitchen boy' (perhaps in his late 40s) with broken ribs and a 65000 dollar paying client with a couple of frost bitten digits. The shadow lurking in the background is Dr Jeph, the doctor of the two patients' expedition. I have forgotten the name of both patients. I think the man who broke his ribs is called Tsorten or something similar. He was working as, tells Jeph, a 'kitchen boy' - his reverse pejorative term - and I guess it means general all rounder with a large bias towards load carrying. With such a load, a big one, he was decending to basecamp through the ice-fall. On bending down to clip into the fixed (safety) rope lying on the snow, his overly tall load toppled him into the crevasse infront of him before his clip was on the rope. He fell 20-30m and landed on his back on a snow bridge. Subsequently rescued he was carried down to basecamp in a basket, although the story goes he got out to walk the last 3 minutes to save face - same on leaving basecamp, painfully walking until the tents were out of view. For a couple of nights he stayed in the lodge waiting for a helicopter to take him to hospital, pneumonia was a worry. It was interesting to watch him sitting snoozing in a corner of the warm room in the lodge. As breath went in and out of his mouth, his left side remained still, not lifting. A respiratory limp I suppose. Although pain would come with every chest movement, even although he'd been given a good amount of morphine, he never complained or showed the pain on his face. I am sure I saw his wife wipe a tear away as the helicopter rose above its dustcloud - such injuries would normally be very serious in a remote environment. But now the client and the employee were safely off to Kathmandu to get repaired and both, with time, will be ok.

Oh, and this 'kitchen boy' has reportedly summitted Everest several times as well as other high peaks in the area. Tough as nails. 

Database of foreign journalists working in Nepal

Everest marathon 2009 non event report

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I won! And I came last.

Due to a need to put my signature on a piece of paper in Kathmandu, I missed running the official Everest marathon race on the 29th May. I did run the beautiful course, however, 4 days before, alone, in the snow and rain.

The marathon has been run since 2003 aiming to commemorate the historical ascent of Mount Everest by Late Tenzing Norgay Sherpa and Sir Edmund Hillary on May 29, 1953. From the marathon website:

The Marathon Event is to salute these 2 Great Heroes of our Human Civilization, regardless of their Nationality & origin, ventured out into the unknown and carried Human spirit to the TOP of the World or the Summit of Mother Earth, glorifying the success of the entire mankind civilization.

That's quite a lot to salute.

On the other hand it is reasonably good business taking around 50 or so Westerners on a $2200 trek. Perhaps a bit of the profit can be spent on hiring a copywriter for the website.

Running a marathon on your own is quite different to being part of an event. Firstly, there is no build up to a deadline, a start line or a start time. You can just saunter up to the starting location on any day you please and go. There is no collective excitement or sense of competition or importance and hence people can't really take your proposed activity too seriously as it is just your own private business. And so it is quite pleasant: no nerves, little competitiveness, just a whiff of adventure and a hint that you’re under the direction of your own free-will.

Still, with tired legs from a week of trekking about and tired everything else from poor nights’ sleep at altitude, I had to rely on strength from the pages of a book I had just read. Mike Stroud’s ‘Survival of the fittest’ recounted his months of dragging a sled across the Antarctic on a starvation diet; his and Ranulf Fienes’ 7 marathons in 7 days on 7 continents just months after Fiennes’ near-fatal heart attack; and the story of the 72 year old ultra-marathoning grandmother competing in an 8 day Eco-challenge across the wild west of the United States. Then there is the amazing Lizzy Hawker and team who had trodden this trail some years before with Kathmandu as a destination. The mantra ‘don’t wish it was easier, wish you were tougher’ hung limply in my mind.

So on a glacier at 10:21 on a Monday morning, after several hours of focused procrastination stealing cups of coffee in various expedition mess tents and welcoming climbers back down from up, after slipping on ice and cutting a finger deeply and after chatting with an expedition tired Dawa Stephen Sherpa and about the weather and where the path had gone, I began slowly walking through the thickening snow in the direction of the finish.

The course begins at Everest basecamp, which is a strange and colourful mess of tents planted on the Khumbu glacier. It’s also a sort of psychiatric ward, but that is another story. The stony path winds around the glacial, mini-mountainscape of crumpled ice and meltwater streams. After a kilometre or two, it climbs on to the lateral moraine, the huge pile of debris skirting the glacier. Only after about 5km is solid ground encountered but even then it is far from smooth. This and the following 5km remain over 5000m.

It is this section that the organisers must be referring to when they claim it to be the "World's ultimate race". Yes, its difficult but it is just a limitation. There's less oxygen going to your muscles, including the muscles of your heart and lungs, so it is ever so easy for your oxygen demand to outstrip supply in the heavy blink of an eye leaving you in a crumpled, oxygen-indebted pile needing precious time to recover. To prevent this, I implemented a strict no-running-up-hills policy. I followed it to the letter of the law and it kind of worked: walking is moving and hands-on-knees-panting is not, and it looks silly.

But by jogging here in a careful and controlled manner, it is possible to collect admiring comments from ascending exhausted trekkers, from descending unsummitted mountaineers and even stationary, resting porters who don’t realise what they could also do if they put their baskets down and ran.

Relief, but not much, comes at about 15km where the path heads steeply down hill past Thukla at 4600m and then rolls along looking down on the wide-open Pheriche valley to Dingboche at 4400m. The downhill is wonderful and takes only the minimum of breath to keep you rolling along like a shopping trolley in a sloping car park.

Running your own race you also have to manage your own refreshments. Running on a trekking route makes this easy and you can burst into any lodge and order a cup of hot lemon, black tea or beer of course and hand over your soggy money. This is a slower process that the grab-and-run water station on a marathon course, and out of politeness you'll sit while the tea is made making it a little tricky to start off again, so before you know it you've been stopped for 5 minutes already, longer if the tea is hot.

With the decreased altitude, the 'ultimate race' became simply a beautiful, wet and muddy run in the hills. But the altitude was replaced by rough descents and steep uphills. In Pangboche, just over half way, I was joined by a boy of about 16, who, standing in the doorway of his house, threw down his cigarette and started running. He kept this up for the next 8 kilometres and he was a great help to keep me from stopping to admire the view or re-tie my shoelaces.

At over three-quarters of the way came the first major uphill and it felt like the wobbly change from bike to run in the triathlon as different muscles were asked to wake up. The muddy slope up to Tengboche was like climbing up a greasy pole. Reaching the monastery at the top was a relief but then came 600m of crashing decent to another cup of tea and the realisation that the legs were past their best before date. And then 600m back uphill todo.

The remainder of the marathon was a heavy push up to Kumjung and Khunde where the famous Hillary School is located followed by a decent to Namche Bazaar and the cheering crowds that wouldn’t be there for four more days.

Kumjung and Khunde are beautiful in the rain. Neat and tidy they look like a Welsh holiday village. Not at all like a ‘normal’ Nepali village, whatever that might be, but quiet, litter free, maintained and even with streetlights, though there are no motorable roads. It points to the extensive positive affect Edmund Hillary has had on the area over the last five decades.

And to the final disadvantage of solo marathoning: getting lost. With just 7km to go the stopwatch said 5h15. In actuality, the last 7km would take me 1h30. Some how I left a good trail I believed to be nice but wrong and headed into a pigmy-forest full of pretty, pretty flowers and a rather odd number of animal skulls. The small cattle-trodden paths led in spirals, the branches of the tiny fir branches dropped their caught raindrops onto my legs soaking and quickly chilling me. I thought I saw a ginger bread house for a moment. But it was just a seemingly deserted farm building.

Tired and more than ready for this slow slog to be over, I climbed loose walls and over sun-bleached bones to reach it, hoping that the owner's well worn route to bingo night would also lead to the finish. I was given a helpful shot of adrenaline by a hairy, crazed maniac on a long, but short enough chain who sailed out of his kennel on an upward trajectory. He, or perhaps she, put on a wild show of property-protecting-prowess to earn owner kudos and perhaps a little bit extra food in the bowl after the evidently quiet, trespasser-free recent times.

Within minutes of leaving the dog barking itself hoarse, the coloured rooftops of Namche came into view, sat below in a natural amphitheatre, signalling the near-end of the run. After few hundred steps downhill, a slip and fall that was embarrassing and a few moments of being lost again among winding alleys, I found myself in the heart of an unimpressed Namche Bazaar, wet, cold and wondering what to do next.

From a kind woman at the View Lodge, I borrowed some clothes including a putrid purple tie-dye (tye-die?) ganja t-shirt and a hulk of a down jacket. Dry underpants were not on offer and for that I had to wait for my hired 16-year-old porter to finish the long march he began at 7am that morning with my belongings. He arrived at around 7pm, 12 hours after starting, drenched and smiling claiming that he was just about to turn around and head back to exactly where he came from. I gave him a good tip for his work, happy that he found the lodge given that it had a name different to the one I told him, and sent him off to the cold and bare porter hostel rather than invite him in to share the warmth of the lodge I was in.

And that was the end of it.

I think in the west we hold marathons in pretty high esteem and as ¬¬a benchmark of physical achievement. While there is seemingly mass participation these days, the masses are still in the tiny minority. Most of us spend so much time sitting on our rears for work or leisure and even while moving between the two, that a marathon truly is an achievement of will, coaxing flabby, unconditioned behinds across 42km of paved road for flimsy medals and certificates.

Up in the Khumbu however the marathon seemed more like a quaint fun-run: not particularly necessary nor particularly well understood (where’s the fun). All around you is hard, physical effort on display. Digging fields, planting, grazing cattle, building or repairing houses, hauling firewood. At base camp there are the climbers, the guides, the climbing Sherpas, the ice-fall doctors, the kitchen and cook boys, the load carriers.

The trail itself is not just a pleasant route conjured up by an organising committee but a highway. It’s the main route from village to village and so people are familiar with it as they walk it frequently. Porters, from old to young, male and female, routinely carry baskets along it containing their own bodyweight in goods. Witness young Mr. 90Kg walking through the thin air of basecamp to just above Namche – his walk over two days will be just a few kilometres short of the marathon route. Leisure time sensibly equates to resting time. Apart from the sherpas running the race that is, the winner completing in an amazing 3:40 this year.

So how do I feel after running this ‘ultimate’ marathon? Sub-whatever you might expect, for sure. Neutral, ambivalent, content, could-have-done-better, hungry. It was a beautiful run, and it was for fun, for the experience and really not the extreme event it might have seemed. In contrast to previous marathons, where the next day required negotiating stairs on buttocks and running was out of the question for weeks, this marathon’s surprisingly pain-free morning after brought a 15km jog to Lukla followed by 2 more long days of running to the road head at Jiri 50km further on.

On the first day of my trek into the Everest region I met a girl who turned out to be an ultra-marathoner. She was retreating from a climb after she started hosting a gut soap opera. I asked her how on earth she could manage to run 100 miles in one go. She told me that the legs began to hurt after 15 to 20km but after that the hurt didn’t get much worse. As long as you ate a big burger at 50 miles, was her caveat. Now I see what she meant, and though it would be a veggie burger, keeping going is easier than I ever thought it would be.

It is quite amazing how far what you can do is from what you think you can do. Its about timeI joined the weird extremists and see just how far ‘can do’ can be.

Marathon training.

This morning, inpired by a book I just finished, stolen from Billi Bierling's tent, called 'Survival of the fittest' by (forgotten his name) I tried to run 10km from Gorak Shep to Lobuche and back. Going was just about ok. There is a drop in height of just over 200m (from 5100m). It was snowing a little. I stopped and had two cups of hot lemon in a lodge in Lobuche and spent a while gazing at the photos on the poster of the Croatian Women's 2009 Everest Expedition. Then it was time to return. Going out took 35 minutes and the return took a painful 50 minutes. It seems the legs are fine, it was just a short run after all. What did I learn then about running at altitude? - Arms are surprisingly heavy things to carry. - Running anything remotely uphill 'crashes' the heart - Having conversations with people is hard when breathless but necessary - snow in eyes makes keeping feet on level ground doubly hard while eyes are wobbling in their sockets - Running at altitude gives you a big headache - It feels a bit pathetic to feel so pathetic when a guy walks past, albeit slowly, carrying 4 large, empty gas cylinders on his back. 7 days to go until this Everest Marathon but I fear that boredom will kill me first. There is little entertainment here in artificial Gorak Shep and not much to keep busy with apart from reading and making the hour long trip over to base camp. While it remains misty it is cold and the spectacular views can only be seen on the postcards behind the desk in the lodge. Tomorrow I will go and visit basecamp as Billi returns from summitting yesterday. Looking forward to see her and hear her story. And then I think I will go and visit the Croatian Everest Women's team camp and say hello.

Everest marathon 2009 dilemas

In about 21 days (29th may) I am planning to join the runners doing the Everest Marathon. There are a few dilemmas associated with it besides risk of heart attack. Firstly I am not going to pay the entrance fee: $US 999 just for receiving boiled water on the run seems nonsensically high for an unemployed layabout. So I am going to print my own number, perhaps either '666' or '$US999' would do, and somehow tag a long avoiding the start line, finish lines and shameful cheapskate embarrassment. As far as I can work out it is just a commercial venture, unlike its competing, non-profit Everest Marathon in the autumn, so I don't feel too bad, not at all in fact. The second dilemma is that by doing it I will outstay my visa. I has a chat about this with a man in the immigration office today. He suggested that going over just by one day would be "just a mistake, that's human nature isn't it? We all make mistakes all the time." However if I was 15 days over, then "that would be deliberate and naughty. You would get a 15,000 Rp fine (150 Eur0) and up to 5 years in jail." I'd better buy some good books to read. Training has been going okayly and probably I will make it. As usual the objective will be to get it over with as quickly as possible. 5 hours of pain would be better than 6. Still the altitudes on the route horrify me. As this is not a legitimate entry in a legitimate event, I won't be raising money for charity. However, if you are feeling flush to the tune of one dollar per month, take a look at this: http://nepalwireless.net/ and http://www.himanchal.org/one-dollar-a-month/ Quite amazing and hopefully it'll aid education, and speed up essential communications rather than facilitate moronic chat conversations replete with smilies. Though I guess if your brother is working his ass off in the hot sun of Bahrain and you haven't heard from him in 6 months, a few smilies are ok. I wish me luck. http://www.everestmarathon.com/

Sailendra Kharel

I recently interviewed Sailendra Kharel, a promising Nepali photographer, for a magazine in the UK. It is not yet published and we'll see if it is what the readers want. What I liked about him, and he was very likeable in many ways, was his determination. Its not easy as a photographer in Nepal, though that could be said for any place. But in Nepal press photography is not very developed, the pay is low or none existent and the drive for creative and technical excellence is limited. Two things stand out from his story, apart from the constant refrain of trying harder. Firstly he still uses an old Canon 350D. Many photographers obsess about their equipment, which is the best camera, how is the quality, which lenses should I use, should I upgrade etc etc? And they would look down on a 350D. For Sailendra, the camera represents 4 months' salary. The equipment decision is thus closed and Sailendra views this as an opportunity as he can just focus on being in the right place at the right time and getting the right shot to the best of his ability. Secondly was the story of how he first got into photojournalism. Again, the right place, the right time coupled with energy and determination. Read the draft version (complete with spelling mistakes!) here and the edited, final version here at Photography Monthly. http://www.photographymonthly.com/News-and-Reviews/2009/5/Sailendra-Kharel-interview

In pursuit of profit...

Its the dry season in Nepal. Or rather the very dry season. The vast majority of rain falls in the monsoon period between June and early September. This heavy rainfall recharges the water tables that everybody relies on to supply water until the following year. Some light rain falls in January and February, but in comparison to the monsoon, this is not much to speak of. By April and May the water table is dropping and streams high above the valley floor are drying up. People then have to go hunting for water, or do without. Recently I travelled to Kaskikot, a small village on a panoramic ridge close to Pokhara. They have a huge issue with water supply. To cut a long story short, rainfall is decreasing and temperatures increase, both attributed to climate change. This means that people have access to water for as little as one hour per day, and roughly speaking, the per capita allocation of water is around 10 litres per day. That's one traditional toilet flush to give it some perspective. So that has to function for drinking, cooking, washing and toilet usage. Its a very tough situation. The story is not uncommon in Nepal. A popular perception held by outsiders is that Nepal is a land of snowy mountains and raging rivers, and that that somehow implies that water is in abundance. The former is true, the latter is far from the case. Every week news reports cite another village as being in desperate shortage of water. In Kathmandu it is no different. Many houses, those that can afford it that is, are resorting to having water delivered by tanker. Last week on a short hike up a hill beyond Swayambu I saw children ever so patiently waiting for something no more than a trickle from a standpipe to fill their assorted buckets and bottles. The climate is undeniably changing and the debate on whether industrialisation and consumerism are responsible is all but closed. Imagine the irony then of seeing bottles of Perrier and San Pellegrino mineral water for sale in a nearby supermarket in Kathmandu. Yes it is patronised mainly by tourists, but still, if there was ever a symbol of the profligacy of modern (western) society, it is shipping bottled drinking water long distances. Wine however...

Earth hour: Vote Earth - your light switch is your vote. Ballot box rigged by Nepal Electricity Authority

http://www.earthhour.org/home/ What to say? Just heard this on the FM4, an Austrian internet radio station, about Earth Hour. "We're encouraged to switch off all non-essential lighting for one hour". "VOTE EARTH: your light switch is your vote." Welcome to Kathmandu, where Earth Hour has been going on for many years. Currently the zealously green government has been giving the citizens of Nepal an enforced buy-one-get-16-free option on these votes and stuffing them in the ballot box for on their behalf. Every day, for 16 hours the government turns all of your switches off - both inessential lighting and everything else with it. Additionally they topped up the Earth Hour manifesto with turning off non-essential street lighting, traffic lights, mobile phone company power supplies, all industrial machinery, my local bakery's ovens, power supply for kidney dialysis machines, ECG machines and anything else you can think of that has a cable with a plug at the end somewhere. Long after the world switches its non-essential lighting back on and starts wasting energy again like there is no tomorrow (and that is looking increasingly more likely), we here will be sitting in the dark. Either that or burning Olympic-size swimming pools of imported diesel in generators to keep normal life going. The irony is that the power we are missing would be hydro-power. But due to years of incompetence, rampant theft of power and some dry weather, the system is more than a little creaky. Here's a tip for all Earth Hour participants: at 8.30pm, go the whole hog (not the half hog), flick that big red switch on your fuse box. Enjoy!