Last days in Bhutan

I’ve spent today packing and cleaning the apartment.  Early tomorrow morning I go to the Paro airport to begin my travels to Chiang Mai, Thailand where I will have a week-long vacation before heading home to Portland.  A couple of friends I know from Mexico have been living and loving it there for several years, and I look forward to spending time with them and checking out possible places to rent for Terry’s and my escape from the cold PNW winter this December.  (You won’t be seeing this blog entry for several more days because I’m without internet until I get to CM.)

The past few days have been filled with many bittersweet goodbyes.  I have more friends and know more people here in Thimphu than I do back in Portland!  My last week had many memorable moments.  Thursday was another Auspicious Day and I was invited to attend a ceremony for the enthronement of the child proclaimed to be the reincarnation of an internationally renowned lama.  Here’s a few photos from the day:

Offerings from the people that later are shared with all

Big audience in attendance for the morning ceremonies

Young monk monkeying around

Joy and friend Rinzin having their own fun

Traditional lute player

Musicians performing in the afternoon

Friday was my last day at the hospital.  The staff brought lunch and I brought a decadent chocolate cake. They gifted me with a beautiful woven bag made of yak wool. I will miss the staff (and even some of the patients!) very much.  They were all so warm, welcoming, and helpful.  I hope my time with them was as helpful as it was meaningful for me. 

Farewell lunch

I enjoyed a home-cooked meal that evening with my neighbors who own this apartment building, and then joined them the next day for their daughter’s first birthday party with all their family at Centennary Park. The picnic was later followed by a night on the town with my co-workers from JDWNRH.

The next morning I met a very dear friend for breakfast.  She and I bonded so much in my time here that I call her my Bhutanese daughter.  Yeshey came back from school in Punakha just to wish me well before I head home. 

My neighbors and owners of my apartment building: Jigme, Kuenden, Rinchen with baby Kitso, and Ugyen.        

Grandma Ugyen and "baby in a box"

Family picnic for Kitso's 1st birthday

Yeshey and Joy in handicraft shop

Kitso and her mom, Rinchen

And so, with less than 24 hours left in Bhutan, I thought I’d post a few photos of this ‘n that that haven’t yet made it into the blog.  Next stop: Chiang Mai!

The Bhutanese love chewing this nasty stuff called doma.  It's composed of betel nut wrapped in some kind of leaf with a dab of lime paste (the mineral lime, not the fruit).  It smells nasty and turns the chewer's mouth and teeth red.

The excess lime paste can be seen smeared on walls everywhere.

Doma chewers frequently spit the red liquid it generates.  

Many of the big trucks are from India and are painted in happy designs like this.

These cows were strolling down the main road through Thimphu.

Artists working on a mural at the National Painting School

   

One of Bhutan's great mysteries I have yet to solve:
Amidst all the sacred murals and relics, why is Spiderman painted on the hills above Thimphu?

 

Last night in Thimphu dinner with friends from work: Darren, Ugyen, Joy, and Sangay

A Day in the Life

My time here in Bhutan is quickly coming to an end.  With only two weeks left, I've done all the touring I’m going to do and am busy wrapping things up and beginning to say my goodbyes.  Mostly I've written about the sightseeing I've done, and I thought today I’d write a bit about how I spend most of my time – working at the psychiatric ward of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). 

Typical Thimphu sidewalk

That's marijuana on that thar hill!

 I leave my apartment each weekday around 8:45 for a ¼-mile walk uphill to the hospital.  I travel along sidewalks that mostly look like this one, past a small hillside growing wild marijuana, up this dirt path to a raised sidewalk that eventually takes me past the main hospital to the psychiatric ward. There I’m enthusiastically greeted by Bella, the clinic mascot who knows I keep a bag of treats hidden away for her.

Dirt path leading up to raised sidewalk

Raised sidewalk leading to JDWNRH

Main hospital buildings

Fountain in front of new hospital building

Psychiatric ward

Bella, happy after getting her daily chewstick

Downstairs are the psychiatric patients, 4 rooms that accommodate 2 patients each.   Upstairs is the detox unit with 5 rooms for 10 patients.  The accommodations are not exactly five-star. Each patient is required to have an attendant (usually a spouse, parent, or sibling) stay with them.  If all beds are full, the patient and attendant share a bed.  Sometimes male and female patients share the same room. 

Monday, Wednesday, and Friday mornings we have rounds.  The psychiatric staff, including the psychiatrist from the main part of the hospital, all gather around a big table (actually about eight small desks pushed together in a large rectangle).  Each patient comes in by turn with their attendant, and we discuss their progress and needs. Most of the discussion is in Dzongka or Nepali.

On alternate mornings, the patients attend exercise group.  There are also psychoeducation groups for the detox patients who are trying to recover from alcohol and other drugs (most commonly pain meds brought in from India and marijuana), as well as art therapy and meditation groups for all the patients.

Individual therapy is a challenge.  Only a handful of the patients speak enough English to talk in depth.  I generally work with those with the most English, often working with either the lone Bhutanese counselor or our young intern.  Both have only bachelors-level training, so part of my job is training and mentoring their clinical skills as well.  Clinical issues tend to have very different presentations than anything I worked with in the States or Mexico: depression and anxiety with fainting, somatoform and conversion disorders, amnesia, psychosis, and a host of other serious problems.  

In addition to the inpatients, we see outpatients (who drop in throughout the day without appointments) referred by the psychiatrist and conduct a weekly anxiety group.  I’ve also got a few private patients that I see outside of the hospital.  Every day brings new challenges and surprises, but it’s all been an incredibly gratifying learning experience.

Haa Valley

This has been a very international week:  Had dinner one evening at the home of a French couple who are here teaching French and German at the local college. Also there was a woman from Germany, another from Mexico City, and an India/American. Needless to say, the company and conversation were great.  

The next day was the 4^th of July, and I went to a holiday bash that has been an annual event for many years at the home of a couple who are the US Consular Wardens here in Bhutan.  We had hamburgers, hot dogs, and plenty of other food while sitting around a campfire along with a video of fireworks displayed on a huge screen in their beautiful backyard.

Waiting for the road crew to take a break before we could pass.

The next morning I was up early for a visit to Haa Valley where they were having their annual Summer  Festival.  There were lots of native dancers, traditional foods, and exhibits of nomadic farmers and the many products they make from the yak herds they tend. 

Traditional dancers

Nomadic yak farmer in full yak herder costume 

Inside a typical nomadic farmers tent

Shooting the breeze Bhutanese style

Adjusting her kira and tego

Traditional boots -- awesome, aren't they?

Traditional dancers

Young dancer practicing her moves

Dancer in beautiful traditional outfit

My second morning there, while the rest of the

I can't imagine a more scenic setting for a home!

group I was traveling with were hiking, I was treated to a visit at the home of the in-laws of our guide.  They live about 8 miles out of Haa town and farm wheat along with their herd of about 100 yaks (the yaks are “vacationing” for the summer months in the highlands).

The house in the photo is actually two homes. While I was visiting the family living in the left half, there was a "puja" going on in the home on the right.  Pujas are religious ceremonies performed by lamas for healing the sick, driving out evil spirits, blessing new homes, and annual general blessings of every Buddhist home. I could hear the chanting, drums beating, and blowing of the long trumpets throughout my visit.

Having tea with Tshering's mother-in-law and niece.

Wooden stairway leading to upstairs living quarters.

Tshering in the food storage room downstairs.

Saying farewell.

Family farming together

Roadside kids

Haa town sits at about 9000 feet elevation. 

That's over 13,000 feet elevation.

Our route back to Thimphu took us over Chelela Pass which, at just over 13,000 feet, is the highest motorable road in Bhutan.  All of the roads here in in Bhutan are narrow, winding roads, with constant hairpin turns, and panoramic views of the Himalayas.  It is said that the runway at Paro airport is the longest stretch of straight road in the entire country!

On top of the world!

Every view is amazing!

The only straight stretch of road in the whole country is the Paro airport runway!

Rice paddies in the valley near Paro