I traveled to Kathmandu, Nepal in early February 2019 in order to tour the HMF clinics, meet with the HMF staff as well as participate in the annual Losar (Tibetan New Year) Festivities. I stayed at the Kathmandu Guest House in Thamel this visit as it is more centrally located to my work. It had been only two years since my last visit but I was unprepared to witness what lay ahead. Since the devastating earthquake of 2015 many familiar buildings and landmarks, some of which are hundreds of years old, were destroyed, now replaced by “more modern” ones. I felt slightly disoriented and left with the feeling of being a “Stranger in a Strange Land”. I knew I would be experiencing air pollution, traffic grid locks and crowds of people but I did not expect that it would take only a few minutes before my eyes and throat would become irritated, so I put on my black air pollution mask (now standard Kathmandu attire) and sunglasses and set off in a cab feeling like Darth Vader. Kathmandu’s air quality is now rated as one of the world’s worst, and air pollution is now listed as one of the major causes of mortality in the world.
It used to take 30 minutes to drive from Thamel to Boudha. After 1 ½ hrs of traveling in slow motion traffic with often 20 minute intersection grid locks without moving I finally arrived at the Boudha Stupa. During my last visit, the stupa was undergoing major repairs due to damage sustained in the earthquake. I was not sure what to expect but I was delighted to see that the Stupa had been repaired and stood as majestically as I remembered it from earlier days.
I was also able to meet with Mingyur and Chokyi Nyima Rinpoche and experience their wonderful and com-passionate energy.
The following day I left the well maintained guest house and walked to the closest intersection to find a cab to start touring our 7 clinics. What I first found was not a cab but one of the thousands of garbage piles which are scattered throughout the city. At first it was not too large but as the week progressed so did the garbage pile to the extent it was starting to block traffic. Quite a few street dogs started to gather which can be a little worrisome, since they can be infected with Rabies. As I proceeded toward Syambunath, the garbage was not only piled on the side of the road but in the sacred Bishnumati River as well.
The water situation in the Kathmandu valley is truly severe and options are limited. The Melamchi River Proj-ect was started in 2000 with Japanese aid and was meant to bring a vast quantity of water to the valley. This project is soon to be completed but the valley has grown so much in the past 20 years that it is now question-able how much this expensive project will ease the chronic water shortages. It would take the whole newsletter to describe the water crisis in Kathmandu, so best to move on.
On the way up the hill to inspect the Osel Ling HMF Clinic, I took a photo of the Syambunath Stupa. How-ever, the air pollution was so bad that you can only see it’s silhouette. I have never experienced such thick pollution before.
Tsoknyi Rinpoche called one day and asked if I, as HMF Medical Director would check on a Tibetan friend, Ledu Dime who had broken his left ankle and lower leg in a motorcycle accident. He was at the B&B Hospi-tal and would need surgery. With the recent addition of auto and motorcycle loan companies, Kathmandu residents can now afford to buy their first vehicle. The number of motor vehicles, especially motorcycles has tripled in the past 10 years in the Kathmandu Valley. I took this photo showing the poor air quality just in front of the B&B Hospital.
As the number of vehicles increases so does the chance for accidents and we are seeing a large increase in motor vehicle injuries in our HMF Clinics.
In the hospital I met with the Orthopedic Surgical Team and they were quite friendly and welcoming to an American Doctor. The post-operative X-ray shows how extensive the damage to Mr. Dime’s ankle/leg from the accident had been but hopefully he will make a full recovery with no disability.
The following day I traveled with Health Assistants Chhiring and Bishnu to our Pharping Clinic. What used to be a rather pleasant and leisurely drive to the edge of the valley is now a taxing 3hr round-trip drive of dust and heavy traffic, which adds to Chhiring’s busy days. The clinic, located on the Benchen Pharping Gompa grounds, is one of the HMF’s busiest facilities and has been open three days a week for 18 years. The clinic is getting so busy that Chhiring is seeing as many as 60 patients by himself in one afternoon. Our vision is to hire a Health Assistant who lives nearby or who can live at the Gompa and run the clinic 5 days per week.
While at Pharping I examined an elder Nepali woman who has COPD and comes in weekly for breathing treatments with a nebulizer. The treatments really help. She also receives medications that help control her symptoms.
Because the air pollution has been increasing in the Valley for over 30 years, there are now a large number of Kathmandu residents (1 in 10) who suffer from some form of Chronic Lung Disease. These numbers will only climb until the air pollution problem is properly addressed and rectified.
Just across the hall from the often chaotic activity of the medical clinic is our Free Standing Dental Clinic run by Dr Karma Drolmo. This past year, the Dental Clinic was able to purchase a Dental X-ray machine with computer linkup, so that Dr. Drolmo is able to provide a very high level of dental care usually found only in first world countries.
Her brother and son of Chhiring Lama, Dr. Karma Tashi is working part time for the HMF running our Por-table Dental Clinic in community schools, orphanages and our more rural locations.
No trip to Kathmandu is complete without a journey up to Nagyi Gompa where the great Dzogchen Master, Tulku Urgyen Rinpoche spent the last 30 years of his life. I first traveled the road up to Nagyi in 1987 and it was terrible then. Moving ahead to 2019, it is still terrible. A Chiropractor could make a good living by sitting up a clinic just below the Gompa. Rather than sit on the back of Bishnu’s motorbike while holding a case of medicines and travel up the extremely bumpy road, we opted to hire a SUV for the day. It was a good idea.
The Yangsi of Tulku Urgyen Rinpoche (now almost age 19) informed me 2 years ago that a large influx of young nuns had moved to Nagyi. Yangsi Rinpoche was certainly correct! We arrived at lunch time and young nuns were everywhere. For quite a while, Nagyi was a quiet hermitage with an aging population. Now…. three foot tall, maroon and gold bundles of energy were running all over the gompa grounds. It was quite the sight to see and it was also inspiring to observe how maternal the older anis are to the younger ones. There are now over 200 nuns at Nagyi Gompa. The oldest Ani is 93 years old and the youngest is 6. Some of the older nuns have been at Nagyi for over 80 Years!! Amazing, is it not?
Medical Clinic Volunteer Ani Tsultrim takes great pride in being in charge of the clinic. The medicine cab-inets and chart racks are all kept very organized and the clinic room is clean and tidy. She also does a great job in managing the chaos that almost always ensues during clinic hours at any of our clinics. However, sometimes the chaos takes over and there are 9 nuns all standing in a very small clinic room at the same time. But everyone is cool, personal space is not an issue, and there is usually smiles and laughter being expressed rather than irritation.
There is one lay female who has lived and worked at Nagyi for over 40 years. She is deaf, mute and perhaps mentally challenged. Yet….she has a pretty good system of communicating.
A great addition to our staff in Pharping is retired Australian Surgical Nurse, Julie Campbell, a student of Tenga Rinpoche who lives at the Gompa and volunteers her time by administering vaccinations to the young monks, keeping a flow sheet with all of their health data and organizing and filing patient charts.
The following day I visited our busiest clinic, the Benchen Free Clinic in Syambunath, which is open 5 days per week. The clinic opens at 8:00AM but patients start arriving around 5:00AM or earlier. Over the years the waiting room has been upgraded. It is now enclosed, heated in the winter months and has a larger and more comfortable sitting area. We have recently added a TV screen that broadcasts Health Topics for our patients to watch as they wait to be seen.
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Our mailing address is:
The HMF, 608 Portside Court, Lafayette, CO 80026
Dr. Gregory Rabold, Founder and Medical Director HMF
Phone: 720 387 8087