Showing posts with label Nepal. Show all posts
Showing posts with label Nepal. Show all posts

Nov 5, 2018

Fall, the Flu & a Fiasco or Two....


Yes, it's that most wonderful time of the year when the monsoon clouds recede and breezy, balmy, mild, and dry days prevail. The tourists arrive to enjoy the spectacular weather and the festivities of the Hindu and Buddhist high holidays. What could possibly go wrong??? Read on for the rant!



You know it's October when you can see the mountains again here in Nepal. This was the glimpse of the Annapurnas from our backyard last week. Gone is the fetid, festering heat and humidity of the Monsoon season. Unfortunately, the agricultural burning starts in October and continues through March. The influx of tourists bringing microbes from around the world combined with the persistent smoke lead to a host of respiratory problems.



And so it happened that the Sheikh (my husband) came down with the nastiest flu. What started with simple allergic rhinitis (a runny nose) gradually escalated to an acute viral respiratory infection. High fevers (103F/39C) alternating with chills, cough, headache, and horrendous body aches. So I sent the Sheikh to clinic to get blood work done. I wanted to make sure he wasn't having a typhoid relapse (we are all due for a typhoid vaccine booster and typhoid is endemic here ) and rule out a secondary bacterial infection or pneumonia. An executive blood panel includes screening for dengue, malaria parasite, leptospirosis, and four strains of typhoid. The bloodwork came back fine but the physician on duty at the clinic wanted to admit him due to his high fever. We decided to try the clinic's new home health care option. Most westerners do not realize that if you are hospitalized in South Asia someone is going to have to bring your meals to you, buy your medications at the pharmacy, and buy/bring any supplies such as bandages or syringes. They don't send you a bill at the end of your hospitalization like in the US, it is more a "pay as you go" sort of system. So the home health nurse came to our house and installed the intravenous port in the Sheikh's hand as you see in the above photo.


The home health nurse arrived by scooter, looked to be about 20 years old, and wore a hoodie over pajamas. Not the most professional of presentations. She proceeded to take the Sheikh's temperature, pulse, and blood pressure. She never washed her hands, used a hand sanitizer nor wore gloves. The home health care physician recommended a triple whammy cocktail of antibiotics, lots of paracetamol to bring down the fever, and the antiviral peramivir. (I was surprised they even had peramivir here - I guess they're thinking the next permutation of Swine Flu is going to be truly vicious.) I thought the triple antibiotic regimen was overdoing it but I was glad they had the antiviral. So then the pajama-clad nurse looks around and asks where the pole to hang the IV is. I replied, "You didn't bring a pole or anything to hang the IV on?" Whatever. Above you see Bibi's "jugaadi" (make-do or hack) IV rig. A sturdy clothes hanger affixed to the curtain rod over the sofa. The clips on the clothes hanger can also be used to hang the patient's chart. The cord you see the drip suspended on is the drawstring from a pair of my salwars (trousers).

Oh, I love a parade! (Except when it is through my living room.) This is actually the Indian Border Securities Forces Camel Cavalry in the Republic day parade. Camels and pompoms- what's not to love?

Culture Clash: If you are sick in South Asia you can expect a parade of well-wishing visitors possibly bearing fruit or fruit juices as gifts. It doesn't matter if what you have is dire, deadly, and or contagious. It doesn't matter if you really don't feel up to having visitors. You must invite them in to sit around you, express concern,  and cheerfully chat up your morale. Your medical chart may be passed about for all and sundry to peruse too. I don't know about you but the last thing I want around when I'm spiking 103F/39C fevers and am miserably ill is any sort of guest.


And you are obliged to serve those well-wishing visitors tea, coffee, and snacks. So in addition to caring for the Sheikh whilst he is miserably ill - I get to be hostess, barista, and chaatwala. The type of tea and coffee served here both require boiling milk and must be served scalding hot. This means you can't stray far from the stove while making them lest the milk boil over. No drip machine for the coffee and the tea leaves are boiled separately.  The snacks are easier to manage as they're usually just packaged biscuits and chaat mixes placed on a tray. We averaged about 20 to 30 guests a day.


The Ongoing Melodrama of the Maid: On the second day of all these harried happenings the maid announces that she is leaving for 15 days to Kathmandu. Why? Because she's pregnant and is going to have "treatment." Congratulations and goodbye was all I had to say. I know I sound like a heartless, entitled, and overprivileged meanie. But this maid has just had a 50 day paid holiday this Summer whilst we were on vacation. Then she said she was taking four days off for Dashain and she was gone for seven days. Both times she has asked for cash bonuses and raises. She hasn't even worked here for 8 months yet! She's only here for 2-3 hours a day and usually washes the dishes, cleans the floors, and makes the beds. We are already paying her twice the going rate for a maid. Many households also require their maid to do laundry and cook but I do that myself. Sigh.


With no maid, I now have to do all the dishes for not only our family but all the guests' teacups and whatnot myself. And I'm starting to get low fevers, chills, and nasty body aches too. UGH. Surprisingly, I never seem to get as severe a case of whatever flu is going around anymore. Not sure if that is due to getting the US version of the flu vaccine for 20 years or my sturdy constitution. I didn't spike the high fevers like the Sheikh did. The body aches were so severe I felt like I'd been hit by a truck, even the bottoms of my feet hurt.


Germs? What germs?

As you may surmise, due to this cultural practice of visitation during illness all of our valley now suffers this nasty virus and local clinics and hospitals are filled to capacity. Why does this cultural practice persist despite modern notions of contagion? Well, you will find throughout Asia that they don't truly believe in the "Germ Theory." Illness is believed to be brought about by changes in weather, dietary indiscretions, and cleanliness is considered more of a spiritual matter. Yet despite these erroneous beliefs South Asian physicians prescribe antibiotics like they're handing out candy. Is there any wonder that New Delhi is the birthplace of the latest antibiotic-resistant superbug?



Curiously, there is a commonly held belief here that drinking chilled water or any other cold beverages is unhealthy and can cause illness. Given the lack of sanitation here, I can see where drinking water that has at least been boiled is safer. Conversely, taking a cold shower or bath is preferred and considered good for health. Nepalis believe that a hot shower or bath is bad for the skin. Apparently, this is idea derived from the Nepali practice of pouring boiling hot water over a slaughtered goat or pig to make the skin bubble off. The variety of ancient traditional medical systems here like Ayurveda, Unani, and Siddha probably accounts for many of these practices. Living in Asia has taught me that culture supersedes education, religion, and common sense.


About three days into his illness the Sheikh decides our living room needed refurbishing. Suddenly, amidst the throngs of felicitous guests, he is embarrassed about our worn out 12-year-old carpet and ratty sofa. 
Why now?!? 
The old carpet looked manky when we first moved in 12 years ago and has suffered water damage from an indoor flood (the drains on the roof became clogged during a severe storm and water came streaming out the electrical outlets) and the cats have shredded the edges into oblivion. The sofa has had a hole ripped clean through one end by our cat Spotty for about a year now. We are currently building a new showroom in a new hotel so the Sheikh asks the carpeting crew and upholsterer to stop by. Above you see two of the carpet samples I was shown to choose from. Pretty amazing selection. eh?I believe there was a solid burnt orange sample too but I chose the boring solid brown you see in the background. South Asian home decor has been stuck in stodgy 70's earth tones since forever. So in between serving guests, I managed to dismantle the 3 huge bookcases in our living room so the carpet could be laid. The hole in the sofa has also been repaired so people can sit on it too! Woo Hoo!


And that was the week that was.......
We are all slowly on the mend here now, THANKFULLY.  I eventually convinced the Sheikh to turn the @#$%! phone off so that people would quit coming and he could get some rest. I'm still going through the 700+ photos I took of the wedding in Kashmir- hope to have a post up on that soon. If you made it this far, thank you for listening to my rant! Hope your week went better than ours did!

How are you all faring with the flu and cold season in your area?
Be sure to load up on zinc  and vitamin C to support your immune system!

Sep 24, 2018

Have a HART: Himalayan Animal Rescue Trust (Part Two)

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Our new baby Tux tells it like it is.
 In part two of my post on HART (Himalayan Animal Rescue Trust), I'll be sharing with you the first ever feline sterilization day held at the clinic! Our tomcat Spotty was one of the patients being surged upon here in Pokhara. The Himalayan Animal Rescue Trust works to improve the lives of animals throughout Nepal with public education, rescue, treatment, neutering, and anti-rabies vaccination clinics daily.

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No dogs were scheduled to be seen that day at the facility due to potential conflict with feline patients. There were a few canine malingerers outside in the clinic courtyard like this sad fellow wearing his "cone of shame" though.

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And the kitties began arriving for surgery in baskets, bags, and blankets! The only other time there had ever been anything like a kitty sterilization day was in 2010 when HART had just started and we begged them to neuter all 5 of our cats. Back then HART was so busy sterilizing dogs they simply did not have time to deal with cats.

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This lady brought her beloved cat to be spayed in a shopping bag. No Problem! Whatever works!

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Soon the entire waiting area in the office was full of ladies and their cats! It was quite warm on this misty Monsoon morning in late July.  In total there were 5 female cats and two males brought in by their owners for sterilization. I was really amazed because keeping pets is a new thing South Asia and cats aren't particularly well thought of here.

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One by one all the kitties were sedated, shaved, and prepared for surgery. This cat is female so her belly and side have been shorn, washed, and swabbed with Betadine.

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The waiting room became a little jugaadi (make-do) post-surgery recovery room. Flattened cardboard boxes, old newspapers, old towels, and even the owner's shawls were used as blankets and mattresses. This is definitely a "no frills" sort of clinic but it got the job done!

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And then it was our Spotty's turn! He is put in a special cage to receive his injection for sedation. The red plastic coated bars are attached to the floor of the cage which can be lifted to press uncooperative patients' bodies against the side of the cage. When the cat is secured against the side of the cage for injection it is safer for all parties involved.

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It was really heartwarming seeing the love and genuine concern these "pawrents" had for their cats. The lady in the red sweater is the one who brought her cat in a shopping bag. She is cradling her female kitty who just came out of surgery with her shawl.

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A veterinary technician attended the little improvised post-op recovery unit. She oversaw the recoveries diligently.

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Spotty was the third cat to be operated on. Here he is getting his temperature checked by the technician. (He peed on the tech after having his temperature taken.) One other male cat and three more female cats where successfully sterilized that day! YAY!

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Spotty & Tux!
And here's our healthy, happy, and neutered Spotty fully recovered! He's hugging his newly adopted little brother Tux (short for tuxedo.) Tux had a bit of tummy trouble when we first brought him home from Catmandu Lovers Cat Hotel & Spa .  We took Tux for a visit with the vets at HART  and he was soon on the mend!

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The important work  Himalayan Animal Rescue Trust is funded solely by donations.  HART needs funds, equipment, expertise and a lot of hard work to make a lasting difference in animals' lives. An online donation can be made here.  Whatever gift you choose will help save animals from suffering and give them the treatment and care they need. Any qualified vets and vet nurses who can volunteer their time and expertise are more than welcome. To find out more about this, please contact Khageshwaar Sharma. If you are traveling to Nepal and can bring a few items, please contact Barbara Webb. The cost of shipping to Nepal is high and delivery is not always certain, so a kindly carrier can assist enormously. Please see HART's "wish list"  for items they always need.

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And meows too!
Any pawrents out there? Tell me about your furbabies!
And how are you on this second day of Autumn? 
We're still scorching at 93F/34C daily although the Monsoon rains have tapered off and balmy breezes have started.
 Bella ciao, Bibi ;)

Sep 10, 2018

Have a HART: Himalayan Animal Rescue Trust (Part One)

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"No Babies, No Rabies" is the motto of our local nonprofit veterinary charitable organization here in Nepal. The Himalayan Animal Rescue Trust works to improve the lives of animals throughout Nepal with public education, rescue, treatment, neutering, and anti-rabies vaccination clinics daily.

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The Himalayan Animal Rescue Trust was founded in 2010 and is a registered charity based just outside the city of Pokhara, about 200 km from Nepal's capital, Kathmandu. They treat all domestic animals, although most of their patients are dogs. HART strives to build an environment where animals are respected and cared for in their own communities. Through their many educational programs and mobile clinics, they work to eradicate animal distress, disease, neglect, and cruelty in Nepal.


Street dogs are a serious public health and safety menace across India and Nepal. Every year 100 to 200 people die of rabies in Nepal (mostly children) and 35,000 people are treated for dog bites. ( I can't find any numbers on dog maulings of humans or livestock in Nepal but I can say I have seen quite a few in years past.) The normal lifespan of a street dog is estimated to be around three years, due to the dangers of street life most puppies do not survive. It is estimated that there are 22,000 street dogs in the city of Kathmandu alone. In the past, local citizens and city governments here in Nepal would put out meat poisoned with strychnine in attempts to control the street dog population. This is a horrific form of death, throwing the dogs into violent seizures for up to nine hours before they die. The dog carcasses would then be tossed into the nearest river creating a further public health hazard. Thankfully, since the advent of HART and other animal rescue organizations, this inhumane practice has stopped. The mistreatment and neglect of animals in South Asia is really heartbreaking.

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I can recall when I first came to Nepal 20 years ago the packs of feral dogs roaming the street were quite scary. The late-night yowling, growls, barking, and yowls almost made it near impossible to sleep. Today, the street dog situation is vastly improved. Problematic dogs are now captured by a net and transported to the HART clinic for neutering and vaccination.

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This is one of HART's new Mahindra Bolero Campers used to transport both animals and crew members to and from the clinic. If you look carefully at the sticker on the door you can see this vehicle was paid for by Lush's Charity Pot funding program.




Charity Pot is a hand and body lotion made by the UK cosmetics company Lush featuring shea butter, rosewood oil, moringa oil, and ylang-ylang oil. With every purchase of Charity Pot, Lush donates 100% of the price (minus the taxes) to small, grassroots organizations that could use the helping hand to continue the incredible work that they do. It's really great to see those donations put to such good use!

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HART holds anti-rabies vaccination mobile clinics all across Nepal. HART's goal is to vaccinate over 70% of the dog population. This is the level at which statistics determine that the rabies risk to humans becomes minimal. This high level of vaccination coverage is achieved by walking through each ward injecting all the un-immunized animals found. Each jab is recorded in HART's purpose-written mobile phone app. The ward is revisited until the statistics indicate that a minimum of 70% of dogs are vaccinated. The anti-rabies vaccination mobile vaccination clinics are repeated annually and are quite an expensive and time-consuming program.

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HART regularly distributes leaflets on the avoidance of dog bites and rabies information at schools and public events. Basic pet care and respect for animals is also taught to school children in educational programs. HART staff frequently appear at municipal functions to improve public awareness on the humane treatment of animals and the long-term benefits of their sterilization program.

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After the 2012 earthquakes in Nepal HART traveled to the hardest hit region, Sindhupalchowk. The HART team hosted a group of veterinarians from Australia to treat livestock injured in the disaster.  Many livestock animals had been injured suffering everything from broken backs to minor scratches.

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This year the HART team was invited to return to the Everest region to conduct anti-rabies and neutering clinics. That's a long, long way from their home base here in Pokhara. The net, the autoclave, the entire mobile surgery, and a lot of anti-rabies vaccines had to be hauled by human, donkey, and yak up there. Over a hundred dogs were neutered and several vaccinated.







Our beloved kitty Baacha Khan had been feeling poorly, we had to wait for the HART team to return from their trip to the Everest region to take him to clinic. Above you can see him being weighed in on the left. On the right, he's receiving fluids subcutaneously and a blood is drawn for testing. We had to take the blood to a nearby hospital lab to be tested.

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While we were waiting for the results from the blood test I strolled about the open air clinic. As you can see by the sign behind the veterinary technician's head in the above photo the base clinic here in Pokhara is open from 9AM to 2PM daily. (That's only if the team isn't out and about on one of their mobile clinic and vaccination tours.) Having regular daily clinic hours is fairly new, a few years back they were always out about town catching, vaccinating, neutering, and releasing street dogs.

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The operating room for large animals (at least bigger than a cat) is also open air so I watched a dog's wounds being cleaned, debrided, and stitched closed.

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It was amazing to see so many Nepalis bringing their pets to the HART clinic. Pet ownership is fairly new in Nepal and a medical facility that treats pets is a new idea also. These women brought their pet dog to be seen at clinic. He's receiving fluids on a table in the fenced courtyard.

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Another concerned lady brought in a neighborhood street dog in for treatment that had a horrible case of mange. Street dogs often suffer severe skin infections and diseases here in Nepal.

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 A caring new pet owner also brought her healthy dog to clinic to be vaccinated.

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A concerned lady brought in this terribly emaciated pup from her neighborhood. Turns out he has a really bad case of gastritis and can't keep his food down very well.

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A cat! I have never seen anyone bring a cat to the HART clinic besides us. Poor kitty looks to be in bad shape and her owner was quite distraught. People kept bringing animals so they actually had to extend clinic hours that day.


Unfortunately, the Baacha Khan's blood work determined that he was positive for feline immunodeficiency virus (FIV) in addition to a severe liver infection and advanced kidney failure. The FIV had destroyed his immune system to the point that he could no longer fight off infection like a normal, healthy cat.  FIV is very rare in western countries but is unfortunately common in South Asia. The controversial FIV vaccine is not available in Nepal yet. To our surprise, HART now offers humane euthanasia at no cost and that is what the veterinarian recommended. So we said goodbye to our best and most handsome kitty and stayed with him until he passed. His Imperial Majesty will always reign supreme in our hearts.

HART, himalayan animal rescue team, pokhara, nepal, sterilization, vaccination, animal rescue, dogs, cats, rescue, treatment, charity, non profit,

The important work  done by Himalayan Animal Rescue Trust is funded solely by donations.  HART needs funds, equipment, expertise and a lot of hard work to make a lasting difference in animals' lives. An online donation can be made here.  Whatever gift you choose will help save animals from suffering and give them the treatment and care they need. Any qualified vets and vet nurses who can volunteer their time and expertise are more than welcome. To find out more about this, please contact Khageshwaar Sharma. If you are traveling to Nepal and can bring a few items, please contact Barbara Webb. The cost of shipping to Nepal is high and delivery is not always certain, so a kindly carrier can assist enormously. Please see HART's "wish list"  for items they always need.

HART, himalayan animal rescue team, pokhara, nepal, sterilization, vaccination, animal rescue, dogs, cats, rescue, treatment, charity, non profit,
To be continued!!!!

Yep, after 50+ day hiatus, I'm back to blogging! Coming at you via a brand-spankin' new fiber optic cable internet connection that's tripping the light fantastic too! Hope all is well with you and yours and I look forward to sharing my adventures with y'all just as soon as I get my photos sorted and about 3 tonnes of laundry done. And of course, I've got lots more new recipes to post!
So how have you been?
What's your favorite animal-related charity?
Anyone else go abroad for their summer vacation? Do share!
Whew,
Bibi  ;)

Jul 2, 2018

Please Stand By...


This last week has been a doozy. The other night after dinner our house started smelling like melted plastic. Then the air conditioning units wouldn't work. Then smoke began filling the rooms. So we shut everything off, called the electrician, and sat in the dark. It seems the Nepal Electric Authority was cranking out an alarming 370V current instead of their usual 220V.


This went on for four hours so we had to completely shut off all electrical items in the house. We've spent the weekend praising Allah that our house didn't catch fire, airing out the house, and replacing all the melted light fixtures, ceiling fans, and air conditioning units. Our neighbors all suffered the same problem and have had televisions and computers ruined too. (Luckily, our computers and televisions are routed through the invertor so they don't seem to have incurred any damage.) Still, I'm surprised there weren't any fires in our district.


All that and two sick kitties too.  We haven't heard anything from the Nepal Electric Authority, there were no lightning storms in our area either. I shall try to get a "real" post up next week. Sigh.

What next?
Hope things are going better where you're at!
Inshallah,
Bibi

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