Journal of Elective 2004

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Saturday, July 24, 2004

Day 17: Photos!

Just a quick entry this time. No major news to report, except that I can now show some photos from Kanti!

http://nepalelective.fotopic.net

Huge thanks to Pam who has allowed me to use her digital photos for this. It’s made the process much much easier.

I’m not sure if I’ll get any more photos online before I return... but hope you enjoy these ones in the meantime.

Namaste!

Monday, July 26, 2004

Day 19: More Photos

Just a quick message - more photos available at:

http://nepalelective.fotopic.net

More will be added to it in dribs and drabs.

Monday, July 26, 2004

Day 19: On Cows

Cows are sacred in Nepal. This affects me in several ways, but not least the amusing sights in the morning during the taxi ride to Kanti where cows stand in the middle of the road causing chaotic traffic plans. They look blissfully unaware of the surrounding mayhem... but I’m sure that really they know what they’re doing and are just enjoying their status in front of the daily rush hour!

The last few days have been filled with more adventures. I lied when I said there wasn’t much news from Friday - unfortunately our night out didn’t happen due to a mixture of Kathmandu Kalamities (with particular apologies to Ally’s Glesga group who spent ages searching for Jazz Upstairs). Therefore there was even more reason to try again for Saturday evening, and thankfully this resulted in a truly chilled nicht oot, accompanied by cool jazz - live.

It was a good end to a relaxing afternoon spent in Patan, despite being haranged by so many people offering to show us round when we disembarked from the taxi. We declined them all, but shortly afterwards on our wanders through the city, we were greeted by Ohm... a 13 year old with an amazing insight into Nepal and who seemed very happy to take us round the main sites. He explained everything in great English and there’s no doubt we benefitted from his help over using the Lonely Planet guide.

Patan is a great place to do in the afternoon, although really it deserves more time. It’s the “2^nd city” of the Kathmandu Vally, yet it took only 20 minutes by taxi from Kathmandu. The main - Durbar - Square is on the UNESCO world heritage site list (like so many other landmarks we’ve visited) and it was awesome - even with the oxymoronic patrols of soldiers who kept a lookout from the many temples in the square.

Sunday and today have been mostly spent in the hospital. It’s been great but I won’t bore with the countless new conditions that I’m seeing! This morning I was in OPD where 340 patients were seen between 9.30am and 1pm. The doctor encouraged me to examine and diagnose some of the patients, a great opportunity considering the competition from other students to gain the same experience. Taking a history is still difficult, but again Shaq was really helpful and so we had a really useful morning.

This afternoon we went up to our new base (probably for the next 2 weeks) in general medicine. One patient there had an incredibly advanced rheumatic heart disease (Grade 4 pansystolic murmur radiating to the axilla, with significant cardiomegaly) and it brought home again the differences in threshold that exist between here and the UK for presenting to a hospital for treatment.

Back to the cows, and I’ve been meaning to mention the “status thing” for some time. Doctors here rely on their status to some extent, in order to get good service. It’s therefore not uncommon for them to go to the nearby cafe still in their white coats and stethescopes... surely with all the bugs that go with it.

Being white has also attracted attention, and when I walk along the corridor people often greet me with “namaste” when normally they wouldn’t to others. On Friday it became quite serious, when a family in Observation insisted that I examine their child as they thought I’d have more knowledge than the (qualified) doctors who were already treating their child. They were persistent (even when it was explained that I was a student), and so I ended up doing a full examination and reporting that I thought the doctors had made the right decision and supported their treatment regime. It was a difficult situation.

Lastly, a wee joke - courtesy of an article I read in the Journal of the Nepal Medical Association. I thought it was quite funny:

A planning committee asked a group of doctors to contribute to plans for a new wing for the hospital. They responded thus:

• The dermatologists favoured no rash moves
• The gastroenterologists had a gut feeling about the proposal
• The neurologists thought the admin had a lot of nerve to consider it
• The obstetricians said the committee were labouring over a misconception
• The ophthalmologists decided the idea was short-sighted
• The pathologists exclaimed “over my dead body
• The orthopods issued a joint statement
• The paediatricians said “grow up
• The proctologists were in arrears

• The psychiatrists thought the proposal was madness
• The surgeons washed their hands of it
• The radiologists could see right through it
• The internists thought it would be a hard pill to swallow
• The plastic surgeons said the suggestion put a whole new face on the matter
• The podiatrists enthused it would be a big step forward
• The urologists worried it wouldn’t hold water
• The cardiologists didn’t have the heart to say no.

Namaste!

Wednesday, July 28, 2004

Day 21: Kanti International Gang

The lack of daily postings recently has been due to so much going on - in a good way! Where do I start?

Firstly, I meant to expand a bit on the cow issue. Did you know that when you knock someone over in your car in Nepal, you have to pay for the upkeep of that person for the rest of their life (medical expenses, loss of income etc.). However, if they die the costs are much less, as the funeral costs and a low fine is due. The result... it’s not uncommon for people to “finish off the job” in the event of an accident.

Apologies if this isn’t the full story... especially as I haven’t verified it with the authorities (!). I also find it a bit hard to believe given the generosity and all-round decentness of Nepali people that I experience every day. But apparently it is true. The cows come into the story in that knocking over a cow means a 15-year prison sentence - seen as a significantly higher price to pay not least because of the prison conditions here. Hence why they do seem to dominate the roads so much (and don’t suffer much from the chaos they cause each morning rush-hour).

On the subject of road accidents, the continuous news of bus “mishaps” (as they always call them in the local press) was brought a bit closer to home. Several friends from Kanti went river rafting at the weekend, but unfortunately the rafting company used a local bus company for the return journey. The local companies are notorious for accidents compared to the tourist companies. And this was proven when their bus veered off the road, overturned several times and left a significant number of people seriously injured. Thankfully the students from Kanti were unhurt, as they were seated at the back of the bus - consequently they were able to help with the immediate aid of the other passengers.

We’d all considered joining them on the trip, but some of us had other things to do and personally I was reluctant due to the high monsoon. I am also compelled to return here again in the future and so I don’t feel the same pressure to do everything that people expect of Nepal in a single trip. They had a fantastic time rafting but obviously very unlucky to have experienced the accident. Thankfully there were no fatalities.

On a lighter note, it’s been a full last few days. The hospital has been full of new patients, and yesterday we worked in a winning formula team. Shaq is a key member, being able to speak Nepali and translate for us... and between Pam (Germany), Leroy (Holland) and me (Scotland!) there’s a huge breadth of experience and knowledge to knock up a comprehensive differential diagnosis for each patient. Thus we now conduct our own ward rounds in the morning, learning from each other’s input and interspersed with juggling, magic and balloons (in which the team has also become collectively accomplished!). We even managed to get on the right side of the nursing team - an important diplomatic move as any med student will atest - by providing them with balloons too.

And so this morning we (minus Pam who was in Cardio today) saw a collection of conditions - juvenile arthritis, nephrotic syndrome, rheumatic heart disease, measles and leukaemia. After a major balloon session and lunch, we went to Emergency where we also found ourselves busy till 5pm seeing loads of conditions. The team work was even more evident in the case of a 8 year old with fever, but no other significant symptoms. Leroy & I puzzled over the DD, and we’d just diagnosed a possible viral encephalitis in another patient so we were thinking on the meningitis direction anyway. But we don’t have much experience of tropical conditions, and it was Shaq who helped out in suggesting Typhoid Fever, which can present with minimal clinical features other than the temperature.

Unfortunately Tou (Glasgow) hasn’t had such a great experience... he’s been down with fever for the last few days and not able to come into Kanti. It’s a real shame that he’s been away for so long.

As for leisure, there’s been tons of that too. My own ‘time out’ recently has been in the form of the book Into Thin Air by Jon Krakauer. In sum, it’s about the 1996 Mount Everest Disaster when many climbers died due to a bottleneck at one of the key climbs to the summit. It’s a compelling read by any measure... but all the more so because I come home from hospital and sit on our balcony looking over towards the Himalayas for an hour, whilst reading the book. Every so often he mentions Kathmandu, and I can understand exactly what he’s describing. Every so often I look up, amazed that I am so close to the world’s most famous mountain.

Tonight also promises to be a good time too. Annie - a premed volunteer from Canada, who features in the gallery wearing operating theatre greens - leaves tomorrow and so we’re sending her off with another great night in Jazz Upstairs. There’s going to be a good crowd from Kanti so apologies if there’s no entry tomorrow due to the after-effects! We’re keeping fingers-crossed that there won’t be the same power cuts that happened last night - when the whole of Kathmandu is plunged into darkness in quite an eery way. It’s bizarre how the lights go, the sound of dogs and crying babies increases and then it all resolves when the power returns! Electricity is usually restored within 30 minutes, but so far it hasn’t caused major problems.

Keep the messages coming - I do like to hear all the news although I realise that my replies aren’t always quick... internet access isn’t the best out here.

Namaste!

Thursday, July 29, 2004

Day 22: Audiovisualolfactory KTM

Photos are good. But today I realised that there is so much more that cannot be recorded for future memories. For example a walk through Thamel, the main tourist area, is a sensory experience that is difficult to describe. Imagine constant street-sellers enticing you to buy Tibetan jewellery, trek guides asking where you are (and making generous comments about Switzerland when I say I’m from Scotland... must be the accent!) and taxi drivers tooting on the offchance that you’re looking for a lift.

Then there’s the smells - ranging from sweet and sickly from bakeries and confectioners, to the pungent fumes of pollution, vomit and other sewage-belonging products.

Admittedly I could attempt to record some of the sounds to tape, but the hassle in finding the equipment is too great when time is ticking by. Anyway - it would be fickle, and a tad over-ambitious, to think that it is possible to bring more than a slice of the ambience out here.

Last night went very well, and I think Annie should be proud of the massive turnout to bid farewell. We started in Jazz Upstairs but the night went on to Tom & Jerry’s and then Funky Buddha... finishing at 2.30am with a taxi back to our accommodation. Funky Buddha was another amusing time to reflect that I seriously missed out on the genes for dancing, but by that time most of us were so inebriated that taking in the music was pleasure enough!

And despite the blood alcohol levels, surprisingly I had no problem with being in Kanti for the 9.30am ward round. Again, today we ended up doing our own round although it wasn’t as comprehensive as yesterday. However, one case that perplexed us was a five-year old boy in with some kind of fever. We’d met him yesterday and he was incredibly chatty and playful - behaviour which we saw again this morning when seeing another child in the same room. However, within 30 minutes he became worryingly inattentive and disinterested, and the sudden change in mood really surprised myself and Leroy. One of the most useful things in paediatrics is that - in general - well children are happy to play, and ill children won’t. It’s therefore important to take such changes in mood seriously. We followed him up for the rest of the day, and our guess is that he had become very dehydrated... a common problem in many patients who we have seen during our time here. By the end of the day (after being encouraged to drink more by his parents) he seemed to be better.

The rest of the hospital day was spent seeing other patients, and a very in-depth review of a new case on the cardiology ward with Dr. Basnet.

Yesterday I was scolded - quite deservingly - by Pam for not having walked around Kathmandu very much! It is so easy to pick up cheap taxis and most of the time I’m heading from A to B. But today I attempted to change some of that by strolling into Thamel from the hospital, stopping in various shops and getting my bearings on places that I usually whizz by in a taxi. A wander around Thamel bagged me a couple of bargains on more mountaineering books and my original plan to see Swayambhunath (a stupa on a hill on the outskirts of KTM) didn’t materialise because of distractions from ice cream and book shops. However, this will be my plan for tomorrow.

Now, another relaxing evening is to be relished back with my host family, the Joshis. I haven’t mentioned them very much but their continuing hospitality and fun is the biggest reason why I’ve been able to gain so much from my time here so far.

Namaste!

Friday, July 30, 2004

Day 23: Tranquillity in Kopan

This instalment comes from a magical paradise, a spiritual retreat in the hills surrounding Kathmandu. For Alex, Pam and I are spending this weekend at Kopan Monastery, the largest Tibetan Buddhist monastery in Nepal.

Here, they allow you to stay and participate as much or as little as you choose, for a very reasonable price. For the cost of a pizza in the UK, we are given clean accommodation (with hot showers!) and meals throughout the day. The only requirement is that we are respectful of the monks’ way of life, and that we abide by the 5 precepts of the monastery whilst staying here: no killing, stealing, lying, sexual activity or use of intoxicants.

The monastery is home to some 300 monks, from the age of 6 to 80 years. We’ve come to Nepal during the quiet season, so there’s only 6 visitors staying, even though there’s space for at least twenty times that - especially when courses are run for converts to the religion. Tonight we met Michelle, a Canadian journalist who has worked in Cambodia for several years and is taking some time out to relax and refocus - just like us.

Already we’ve shared dinner with the monks, and I’m currently looking over night-time Kathmandu with the ostenato rhythms of mantra floating through the otherwise peaceful night. The best aspect however is the escape from polluted and noisy Kathmandu, and indeed it has actually taken a while to get used to the sound of silence.

In the darkness we have just walked round the campus, with fairy-tale-like illuminated gardens and a chance to acclimatise to the non-judgemental, honest and selfless ambience. Tomorrow we rise at 5.30am to take part in prayers for 2 hours, before going to breakfast at 7.30am.

It’s the perfect mid-trip break and it’s thanks to an Irish traveller on the bus from Pokhara that we have been so lucky in finding Kopan. It is now clear to me why relatively high numbers of visitors to Nepal become embellished by Buddhism, and why many join the religion for months or years. My own plans to return to the UK will likely remain as before, but it still looks set to be an insightful, reflecting and amazing weekend to remember.

Namaste!

Saturday, July 31, 2004

Day 24: The relaxation continues

A truly tranquil time has been had. We attended morning prayers at 5.30am and listed whilst the mantras were recited by a group of over 40 monks, accompanied by cymbals, drums and the vocal leadership of the choral director. Amusingly, two senior monks patrolled around to abruptly waken any monks who fell asleep - which happened quite a few times.

The hospitality has also continued, with us being included with the rice and ‘butter tea’ which is served at half-time. Despite the early hour, repetitive chants were relaxing to absorb, and it was a very enriching experience. Nevertheless, it was with some relief that we were encouraged to leave slightly earlier than the monks at 7.30am in order to catch breakfast with the others.

The following hours were hazy, as a combination of laziness, peacefulness and inner-sanctity prevailed, accepted as the means to achieving our aim of enjoying the calm and unhurried ambience. After another (hot!) shower, I headed to the top of the campus hillock, and began my latest acquisition - Doctor on Everest.

However, before reading very much, I was joined by several groups of schoolchildren. They were all really keen to practise their English, and were equally inquisitive about who I might be and determined to be photographed. It is amazing to think that while many have heard of Scotland, they know of it only as a distant land, unreachable except by the most determined of dreamers. Probably very similar to the way that I thought of Nepal at the same age!

The disappearing hankie made more appearances (and obviously disappearances) - and yet whilst never failing to delight, there seemed to be a spate of particularly alert and observant groups today! I was also invited by one group to visit their school in the afternoon, with additional offers of teaching me Nepali - probably due to my very poor grasp of it thus far!

Meals determined the day’s schedule, which is a pleasant way to plan a day. So lunch was taken at 11.45am with particularly tasty Tibetan food not too dissimilar to Nepali Dal Bhat.

The sun rose high in the afternoon, as did the number of daytime visitors to the monastery. It was an embarrassing feeling that we felt a certain degree of possessiveness about the site given that we were residential. It was even more clear how tolerant the monks are of snap-happy, litter-leaving tourists... especially given our own frustrations felt towards such invaders. The campus really was turned into a tourist bazarre for the afternoon, but the revenue gained was hopefully enough to justify the invasion.

We felt the need to escape for a while, and so I went for a wander into the village to find the school to which i’d been invited. However, the only school to be found was clearly locked up, and despite and extensive search and questioning of the locals, the mission was unsuccessful. However, I did bump into another group of kids who I’d met previously, and another magic and juggling session resulted.

A short while after returning to the monastery, Pam was interested in going for a wander. And so we explored for a bit, taking routes through paddy-fields and the locals’ back gardens on an improvised adventure. The weather remained fantastic and stereotypical photos of Nepal (of brightly clothed workers against a pure-green backdrop of riceplant leaves) were taken. Again, the friendliness of the field-workers was remarkable, almost as if each had been given a pep-talk by the Nepali government of tourism about tourist relations.

And then back to the monastery for drinks and the tragic news that the ice cream was sold out.

The rest of the day has been peppered with insightful conversations with the monks and nuns, and equally interesting discussions with Michelle, who has amazingly diverse life experiences on which to base fascinating viewpoints on world issues. Such ‘random’ encounters with interesting people is one of the aspects of travelling that I find most enjoyable - and addictive.

Tomorrow we plan to rise for prayers at 5.30am again - but watch this space to see if this morning’s enthusiasm in the wee hours was one-off madness or a concerted, convinced effort!

Namaste!

Sunday, August 01, 2004

Day 25: Thank you Kopan

Well, now I’m back in Kathmandu and I can honestly say that Kopan was one of the most relaxing experiences I’ve had, matched only by sailing in Greece. We spent another leisurely morning (after prayers at 5.30am which we made on time!) reading, thinking and watching. However, after lunch we paid our dues and walked back to Kathmandu along a dusty track through villages more typical of Nepali rural life. On Friday we got a taxi to Kopan because of the time, but it was good to have more time to re-adjust to the smells, noise and pace of Kathmandu city.

I’ve just typed up the previous posts which were written at Kopan, so this entry is shorter. Kopan did have an internet cafe, and although there were usually free computers between the many internet-savvy monks, it would have spoiled the weekend to feel the need to be in e-contact.

This week will be another in the hospital, along with more sites to see in Kathmandu that I need to ‘tick off’ before my time is up.

Namaste!

Tuesday, August 03, 2004

Day 27: Reflections without power

This instalment has also been pre-written, due to a long power cut this afternoon. As a result the local internet cafes are out of action. Yet I feel another entry is due, so I’m writing this from the rooftop of our accommodation with the Joshi family.

Monday was a shock - the contrast between relaxing, chilled-out, non-polluted Kopan and being back to the hustle & bustle of Kanti was striking. Also, despite being very tired on Sunday (probably due to the two mornings we were up for prayers at 5.30am) I was keen to meet up with Ally and her friends from Glasgow before they headed off on their 26-hour bus ride to Ilam. I therefore met up with them whilst they were savouring the tourist mod-cons of Thamel for the last time (although unfortunately their hotel didn’t seem to live up to these standards).

Once again I had to acclimatise to the stench of the hospital toilets as I walked past them on my way to the medical ward - where I was met by a bed outside the main ward surrounded by screens and a distressed family. I wondered whether the ward had become so packed for space, that patients had to wait in the corridor for space (not an uncommon site in some Glasgow A&E departments), but then I noticed a blanket covering the body of a young child in the bed.

To be honest, I haven’t experienced much death whilst at Kanti, even though there have been several desperate cases where care that should be curative in the West has been terminal at Kanti. My only other experience was on entering the Observation Ward to look for any new/interesting patients with Shaq. On that occasion, doctors were performing CPR on an older child but it would have been insensitive and unacceptable to have become interested in the case at that critical time; I don’t know what the outcome was.

But there have been happier times too! I mentioned on Friday the effervescent, incredibly playful boy who became very quiet and lethargic within 30 minutes of seeing him. We followed him up in the last few days and until today he remained dehydrated, feverish and disinterested. But today - good news! He was back to his usual self, and he even showed an interest in reading my Oxford Handbook of Clinical Specialties, which is not exactly bed-time reading! It’s nice to see that simple medicine (especially rehydration) can bring about such great changes.

Today, after another ‘International Students Ward Round’ we called it a day, and I continued with my ticking-off of the things I still have to see before my departure - which is getting all too close in 2 weeks time. Time flies by when you’re enjoying yourself - for me time has flown by in Mach proportions in the last few weeks!

So after lunch I got another ride on the Shaq-mobile - motorbike is the best way to travel around Kathmandu. We went to Swayambunath which is another stupa at the top of a big hill, reached only by a long and steep stairway. The best thing is the many monkeys who roam freely and are very tame (photos soon!). You even have to be careful that their inquisitiveness doesn’t reach as far as your wallet or camera, which they have been known to ‘borrow’.

On the way up though, some first aid was required on a young boy who had fallen and gashed his head. I had my first aid kit with me, and so with the invaluable help of Shaq’s translations, we bandaged it up (albeit with an overly-impressive-sized bandage!) and gave standard head injury advice to the grandmother. On our return to the bottom he was playing happily again so we assumed he’d be okay.

Swayambunath offers some of the finest views of KTM to be had, and the weather timed itself perfectly to give us the best scene. We had waited for the monsoon downpour to subside before biking from Kanti, but that also meant the air was clean and the skies were clear for a brilliant panorama at the top.

Afterwards, Shaq took me to meet his brother, cousin, mother and other family who stay nearby. I consider such visits to be a real privilege, not least because being welcomed into a Nepali home is quite significant.

And then I travelled back to Dilli Bazaar, including walking from Kantipath through one of the non-tourist areas where being taller and whiter than the majority of the crowd attracts some attention.

I’m now more than half-way through my elective, and I find myself getting more and more reflective about the experience (despite the lack of power). On the one hand, I must admit to some enthusiasm for returning home - where I can listen to music (which I’ve missed the most while over here), get back to normal routine and breathe clean air. I’m also keen to get back because of the other things in store - PEAK in Taunton, which is always great fun; Germany to see Eva in Heidelberg and family in Stuttgart, which will be chilled out and also great fun; and back to final year of medicine, of which we now know our full timetable and in which I’m interested to see how I’ve changed due to my experiences in Nepal.

However, I also have a deep reluctance to leave. When I do depart I’ll be leaving so many friends, experiences and untaken opportunities behind, plus the weather will be improving too to the extent that the Himalayas will become much more prominent in the KTM valley. I’m hoping that a trip to Nagarkot this weekend will allow me to see some Himalayas - maybe even Mount Everest which is one of the main reasons why I wanted to come here in the first place.

But thankfully, if that dream is not possible I’ll still feel that I’ve had one of the best times to be had during my five weeks here. Fingers-crossed it can stay that way for my remaining 12 days here!

Namaste!

Thursday, August 05, 2004

Day 29: Laziness

Just a quick report this time!

Firstly, I forgot to mention my near-death experience on Tuesday evening. I was sitting reading when Rama grabbed my attention with a look of distress on her face... she was pointing to where I was sitting, where I suddenly noticed a centipede crawling along my t-shirt. I didn’t realise what it was, but shook it off quickly, before the rest of the family appeared from other rooms to find out what all the commotion was about.

After realising it was a centipede, I thought it was a lot of fuss over not very much - and was even going to pick it up to take it outside. However, since then I’ve learnt that while British centipedes are harmless, Nepali ones can actually be quite ferocious and give a good bite... sometimes requiring hospital attention! I’m just glad I didn’t know all this on Tuesday evening.

Last night was eventful too, when we all met up for another great night out starting in Jazz Upstairs. There were so many folk from varied backgrounds that the conversation flowed against the cool background music of the jazz band. The night continued to Tom & Jerry’s where more C2H5OH was consumed.

However, when I returned to the Joshi’s, I realised the lock for the main door had become broken, and the door-chain (openable only from inside) had been used... with no way of getting up to my room and reluctant to wake up anyone at 1.30am, I conceded to the fact that I’d have to sleep on the stairs. And so I slept there till Rama got up and let me in at about 6am. Apart from my makeshift stone bed and the lack of a mosquito net, it was surprisingly comfortable.

Consequently, I slept until late this morning and have declared today a lazy one... I’ll go up to Pashupatinath this afternoon and then some of us are due to meet up again tonight for dinner then (milder) drinks.

Namaste from a lazy day in KTM!

Friday, August 06, 2004

Day 30: Pashupatinath

Tou is gone, Alex is gone, Annie is gone, Kelvin is gone, Chris is gone (I think!), Ash is going, Shaq has moved to another hospital.

Inevitably the departure of new-found friends has made me consider my own departure in a week’s time. It’s been particularly revealing how I considered the students who were here before my arrival as being ‘part of’ Kanti itself. Yet with such a high turnover of students we are really not much more than a passing breeze in the work that happens at Kanti. Perhaps the same is true of life.

Why such a reflective statement? Answer: a visit to Pashupatinath yesterday afternoon - the main cremation site for Hindus in Nepal.

The following observations are not intended to offend, but describe the scene as experienced.

On arriving at Pashupatinath, the large temple (apparently the most important to Hindus in Nepal) stands out against the other buildings and opposite a hillside full of mini-temples. On getting closer, smoke saturates the air with a smell (as commented by several co-students) not unlike a barbecue. It’s a busy place with grieving and non-grieving families, Holy-men and tourists.

I managed to avoid the 250 rupee entrance fee by using my student card, but was soon persuaded to take a guided tour by one of the locals. He explained that there was much more to the customs on show than could be explained by observation or guide book. And soon I was to learn that he was absolutely right.

On one side of the bridge, seven stone platforms lined the banks of the Bagmati river. Another 2 were situated on the other side, directly outside the main temple - reserved for the cremations of royalty and high-caste/class individuals.

There is nearly always a cremation in progress, and during my visit there were at least 10 going on. The body is brought on bamboo stretchers to the river bank, where various rituals are carried out. It is then placed on the funeral pyre (a square-shaped pile of wood) and covered with sticks to aid the cremation process. The body is wrapped in a shroud throughout, but the face is exposed for the rituals and also for starting the fire - by placing a flame in the mouth (as the head is considered to be the most impure part of the body). It’s quite a challenging scene to see a human body in this situation.

The cremation progresses in full view of the public, and tourists are not discouraged from taking discreet photographs (to some extent they are encouraged). It is this refreshingly honest, non-sanitised treatment of death that I find very appealing, especially as I wonder whether our use of doctors, nurses, hospital porters, morticians and undertakers in the west is actually due to our society’s fear of the event of death itself. Undoubtedly the deeply engrained belief of after-life in the Hindu faith must contribute to this attitude of acceptance.

Perhaps I am biased by the scientific study of the human body that I am undertaking as a student, and I would certainly respect others’ beliefs at personal and professional levels. However, today’s visit has made me think about and challenge my Western-style beliefs and assumptions. I feel confident in saying that such challenge can only be a healthy thing.

Namaste!

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