Daytrips

I have few pictures of our daytrips, because they take place while Don is in OR or clinic, and he takes the digital camera to document his cases. After he leaves for the day, we clean up breakfast. Mornings are spent indoors or with the kids playing outside. We catch up journals and I check email; the morning usually slips away before I can get myself and the kids organized and gathered for an outing. We can go "down" into Thimphu two ways: out the Gadho's compound gate, down their narrow asphalt driveway out onto a steep road, down past (or cutting through) the hospital compound, with its constant foot-traffic of nurses (white kira, black tego jackets), visitors, dogs, the 3 or 4 ambulances parked out front (the silent ambulances: either they don't have sirens, or I never hear the sirens - Don says the ambulances never transport patients with any haste), and a steady in/out flow of taxibuses.

Aside on taxis: Taxis are small vans, with sliding doors on each side, a single bench seat in the back, and a small cargo area behind that. Four children across the back is a tight squeeze, with little room for a parent, so when we grab a taxi as a family Don sits up front and Halle sits on my lap. A little lighted "taxi" sign is on the roof, and Thompson is delighted with something he sees on many taxis: a curved sunshade strip across the top of the windshield that projects three holographic daisies onto the upper windshield. He wishes we could buy such a strip at a car-parts place and take it home and have it installed on our minivan - but of course our minivan is much wider than these taxibuses and it probably wouldn't fit. Taxis are constantly available in Thimphu, simple to hail, and cheap: almost anywhere in town is 30 Nu, rarely more than 40 Nu (about $1), and it usually takes less than 10 minutes to get anywhere. We do use them several times a day, i.e. when it's raining, when we're making a steep vertical climb with heavy packages or tired children, and when it's dark because when it's dark it's very, very dark, and there are dogs and uneven pavement to contend with; sometimes it's just easier to grab a taxi.

Anyway, back to the only two ways we have to get to town. The hospital road ends at a more major road (i.e. designed for two lanes), called Chorten Lam (Lam = Street). Here we must cross to the far side where there is a sidewalk, and then walk along it until we come to a traffic circle in front of a gigantic Tibetan-style flared white chorten built in honor of the king's late father (for whom the hospital is also named, Jigme Dorji Wangchuk). There are people walking clockwise around the chorten - seven times I believe is what one does - at all hours of daylight. We pass by the chorten, and then turn onto the road that heads down a gradual incline into the town proper, past a garden, compound and medical center for Indian army with an elaborate barbed-wire fence that has elicited much conversation with our children about lockjaw. A brisk walk of 10 or 15 minutes brings us to the Hotel 89, the Swiss Bakery, and the little groceries that mark the shops around the lower traffic circle. Almost all our outings take this route.

The other way "down" from the house to the town is, of course, the short way. We climb over the wire fence that surrounds the house, and walk on a very narrow dirt path etched into the slope by lots of daily foot-traffic. Below us is a gigantic sandpile for the new hospital construction project. The path leads through a lot of weeds into a field/community garden just above a sort of cul-de-sac of migrant worker shacks. Our path is at the level of their rooftop, which is a black tarp held down with stones. We can hear the radios inside below us tuned to wailing Hindi music and can sometimes smell curries. We cut through the gardens (chilis, corn, cosmos, greens) to a road that also cuts down to Chorten Lam, closer to the Memorial Chorten, and that has (from the kids' point of view), more interesting roadside water ditches. Where this road meets Chorten Lam, Indian laborers have been laying new asphalt all week long. There is one steamroller, but aside from that it is all by hand, including burning charcoal and boiling the tar to make the asphalt itself, and then spreading it with handshovels. Here is me and the kids passing the asphalt cart along Chorten Lam.

This, then, is the start of any trip down to the town, and also of our trips down in the late afternoon to choose a restaurant for dinner (we have eaten out nearly every night, since it only costs $10 or $12 to take the entire family out for food that is really quite good - so far we have liked every place we have eaten, although it takes a long time for the food to come).

I have tried to have some kind of event each day to get the kids and me out of the house and to see things around Thimphu. I wrote about the painting school. Another day we took a taxi far up into the hill to a district called Motithang, where there is a preserve of the distinctive Bhutanese gnu/cow animal called a takin. They keep a small herd of less than a dozen takin there, in a large wire-fenced shady field. Takin are mountain animals, their own genus not exactly related to anything else. They are something like mountain sheep, something like deer, something like moose. The preserve does have some signs, but mostly it is a path around the enclosure that runs through someone's yard (someone who, at the time we were there, was out doing laundry because it was sunny). Two ladies were in an open-sided shed weaving fabric on backstrap looms. Several bellowing cow were wandering the same path we were, the opposite direction around the takin preserve, and we were entertained trying to decide which noises came from cows and which came from the elusive takins - who weren't clearly visible until we had gone three-quarters of the way around. We got up-close to them just as I ran out of film (naturally). After spending some time there, we walked a good several km down windy switchback roads towards the residential part of Motithang, until a handy empty taxi came by.

Another day we set off in the boiling sun determined to walk all the way down to the river, across the vehicle bridge, and to a handmade paper factory we heard was on the other side. We discovered too late that I had brought water in my tote bag but no umbrella for shade. We were sunscreened, but still were pretty sweaty and red by the time we got to a Western-style hotel on the far side of the river and stopped for lunch. From the hotel dining room we could watch a group of boys or men jumping into the river far below, walking into the center where the current was swift and starting to swim when it was too deep to stand, riding the current downstream some distance until they could stand again. The water is jade-colored with white round rocks and looks very tempting to swim in. We walked uphill from the hotel after lunch and found the paper factory. They were on lunch, of course, so no one was there, but had left the workshop conveniently wide open for us, so we could see something about how their beautiful pale brown bark paper is made. There was someone to open the shop for us, and Jacob bought a blank book to draw in, and I admired the piles and piles of lovely paper, some with embedded flowers.

This evening the errand en route to dinner was to locate a medical shop or pharmacy, and to try to procure something similar to Sudafed. Both Don and I have had daily massive allergic reactions to something in the house... dust, dried mouse dropping, yak dander, who knows... and the black wheezing of the ancient trucks puffing by us on the street is not helping. I am going around with red eyes and dripping nose much of the time, and we have some fabulous sneezing fits, especially in the late evening. I had not seen Kleenex for sale here so was using the coarse yellow TP and my nose was unhappy. Yesterday, though, Don and I went together to a larger "supermarket" (it had a computer register scanner!) and I actually saw Kleenex for sale and bought a precious box. We thought to bring lots of stomach-ailment tablets to Bhutan, thinking this would be our major discomfort, but only one small box of Sudafed and we were going through it fast. There were three medical shops within two blocks in the center of town. We bought a foil bubble-pack strip of 12 or 15 something-like-Benadryl from one shop for 3 rupees (i.e. less than 5 cents!) and something-she-claimed-was-nondrowsy from another for about the same; we estimate that each dose costs a fraction of a penny. I hope they work. Ah-choo!

Rocking the House

Without any public fanfare, a significant event has been going on now for 4 days here in Thimphu: a Christian youth fellowship conference, involving teenagers from all over western Bhutan. Ratna, our housekeeper, has tried to get us to go, and on Wednesday evening we set off after she gets off work at the other house, around 4:30. We walk straight up the mountain from our house, into a steeply pitched neighborhood that is under construction and so is an odd blend of tin-roof shacks with matting for walls, new 8-unit cement apartment houses, paved and unpaved roads, ditches full of skinny waterpipes with attachments running off every which way as new residences take their share of the water, and a few small grocery shops. One of the topmost houses is a light-yellow apartment building, the 4th floor attic of which is the Christian meeting house - of course, nothing on the outside indicates this. We are greeted on the porch by people whose faces have become a little familiar to us from the previous meeting or from encountering them on the street, and three flights up we take off our shoes on the exterior balcony and leave them there.

Even on the third floor, the pounding and the rock-beat are loud, and as we climb the last flight to the small doors that lead into the attic, a wave of humid heat, sweaty air, and packed humanity pours down on us. Inside, the lighting comes from green corrugated fiberglass laid over the skylights, giving everything a kind of underwater glow, and it must be 100 degrees inside with 110 percent humidity: condensation is pouring down from the low acoustic-tile ceiling, and probably a hundred teenagers are rocking to a beat from a three-piece band: drumset, electric guitar, and tamborine. The song (and indeed, everything we hear tonight) is in Nepali, so I don't get most of it, but it involves some hallelujahs and lots of shouted responses, and the kids are packed in tightly, jumping up and down to the beat. It's a youth dance not unlike those in our church, with grownups and younger kids on the outside of the room, sitting close to the fans and trying to breathe.

After a while the band takes a break, to get some fresh air and water. The kids sit down, covering the entire floor of the space, and teens wearing "Worship Team" or "Volunteer" badges walk among them, handing out bottles of Sprite or water to share. Brother Simon preaches from Ephesians (I am told) vigorously, with lots of Amens and Hallelujahs to punctuate his Nepali address. We stay about an hour and then head down into the fresh air. Ratna is disappointed we are leaving so soon - she has dug in to stay all night if necessary, and these kids have been at the revival since early morning until late at night, for 3 days straight with another day to go.

Out in the yard, in a small shack with a big woodfire at the back of it, a group of people is making dinner in the largest pots I have ever, ever seen. There is one huge pot of yellow dal, another of curry, another of Indian-style aloo (potatoes), and one of white rice. Here's the picture from that - everyone cheerfully working to feed the hundreds who are upstairs or on their way. The next day I hear from Ratna that before dinner everyone, including herself, was "slain in the Spirit" stretched out on the floor in religious ecstasy. I don't know what our kids would have thought of that, I'm kind of glad they missed it.

A Day in the Life

I've been trying to go on morning runs when it's not raining. It's nice to get out and see the street early and enjoy the surroundings. Of course when I run, I have on my heartrate monitor, a footpod to tell distance and speed, an altimeter, and occasionally my I-pod. All this helps me to get in touch with the nature here. I don't see a lot of Bhutanese running for exercise; walking up and down the sides of a mountain to go to shopping or to work, just life itself, is enough exercise in Thimphu. As I attempt to go out of our door, the big black dog Shadow is asleep on the stoop and I literally have to slide him off the porch with the screen door so that I can exit. When I run, I am often accompanied by various packs of dogs. Usually they are pretty friendly, but sometimes I pick up a rock for extra security. I start my run through a field of cannabis. A woman burns a stack of this on the hill below me and strange odors come across my path (...I don't inhale).

There are two types of terrain in Thimphu: up and down, so it makes distance running somewhat difficult. I run past a group of Indian laborers hauling bricks in a carrier made out of a bamboo pole, rope, and burlap. They are barefoot, and stop to watch me run by. On my I-pod I am listening to Jimmy Cliff sing reggae songs of redemption, overcoming oppression, and freedom... and I wish for a moment that my I-pod had speakers, so I could play some words of encouragement to them.

After breakfast, I head to the OT (Operation Theater), scrubs in hand. As I am scrubbing for my first case, I ask Dr. Tshewang where the water comes from, and if it's filtered. He replies that no, it's not filtered, and it comes directly from the stream, and having seen various activities taking place in and around the stream I wonder why I bother to scrub at all. We don't use any antiseptic solution on our hands; there is one scrub brush that is used for several days in the OR, and one bar of soap to be shared amongst the surgeons. Usually we do about 50 cases a month here. So far in the past week we have completed 21 cases. Here are some highlights from today:

--I operated on a four year old boy who had polydactyly of his small finger (i.e. his small finger was actually three fingers, each complete with fingernails). This is considered very bad luck in Bhutan, so we removed the two smallest fingers and then reattached muscles and ligaments to the remaining finger.

--Next we operated on a 12-year old girl with an elbow that had been dislocated for six months. Then we operated on a ten-year old boy who had exposed tibial bone from osteomyelitis (i.e. a bone infection). In order to cover the bone to allow it to heal, we took a portion of one of his calf muscles and tunneled it under the skin to the front of his shin to cover the exposed bone. This is not the kind of surgery I perform in the US - this type of work would be done by a plastic surgeon.

--Next I debrided a sacroiliac joint in a young child who had an infection. Then I put a metal rod in the humerus bone of a woman who broke her arm after being hit by a stone. Finally, we operated on a disaster of a case: a woman who had an open fracture of her femur, treated in eastern Bhutan in January by a Burmese orthopedic surgeon (there are two or three Burmese orthopedists in Bhutan who work under contract with the government - they are poorly trained, and their work is almost universally bad). He had put an external fixator on this without even attempting to line up the femur fracture; in addition he had missed that she had also fractured her hip on that side, so the hip went totally untreated initially. The external fixator had been revised in April by another doctor, but still with a one-inch gap between the bone ends. An attempt had been made to put an external fixation device on the hip, but since there was no X-ray available, the implant was put in and missed the hip completely. She arrived in Thimphu a few days ago with an obvious infection of her femur. Today we opened her up, took out the hip implant and the external fixator, washed her out, and put her in traction. Basically we will start over by trying to clean up the infection, and in a couple of weeks hopefully I can go in and fix her fractures.

There were other cases, but I will stop here. When I got home, Jamtsho came running into our house to announce that Phoebe, one of the puppies, had died. We did a quick assessment to verify that she was dead, and later heard that she had been seen yesterday eating a dead rat that had been poisoned. Phoebe was a close friend of Jacob's (he is de-ticking her in the photo we posted earlier) and he was stunned that she was dead. He sobbed for a long time on my lap. Then there is the question of what to do with a dead dog in Thimphu. Burial in the small yard was considered and rejected because of possible further contamination of the already-chancy water supply. Jamtsho's mother Tashi said that the usual thing to do is to take the animal down to the river and throw it in, out of sight of the authorities (as if this does less to contaminate the water supply... but it is a very wide and fast-flowing river). We send Jacob off solo, in a car with Uncle Dono, a monk, Jamtsho, and Phoebe in a grease-stained old cardboard box. Jacob returns later, feeling a little better and somehow connecting Phoebe floating down the river with her journey into a better place.

The upper portico of the Thimphu Cinema, showing the signs advertising "Kikhor"
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40 Nu Seats at the Thimphu Cinema

Thimphu boasts a single movie theater, showing one movie at a time. Sometimes it is a Hindi film, otherwise it is a Bhutanese film in Dzongka. The current Bhutanese show, Kikhor ("Fate") had such an enticing hand-painted banner, as seen in the picture, that we thought it would be fun to go. We saw the huge lines to get in on the weekend, so we chose a Tuesday night and headed downtown to the cinema an hour and fifteen minutes before start time. Tickets are sold from a wooden table set up on the porch of the cinema, also hawking CDs and cassette tapes of the soundtrack. The ticket seller had a seating chart of the theater and he was X-ing off the seats as they were purchased. Each ticket was marked with the seat row and number, and had the name of the film printed on it. "Starts at six-thirty sharp," he told us, and though it was barely 5:15, most of the theater was black X-ed out already. Seats cost 80 Nu (aboutt $2), 60 Nu ($1.50) or 40 Nu ($1) depending on where you sit. All the 80 and 60 Nu seats were gone, so we bought 40 Nu tickets for 6 seats in a row (since why would we want to pay twice as much for a film we weren't going to understand anyway?) and pocketed them while we walked around for an hour killing time and buying snacks to take into the movie. We also asked a few people on the porch what the general plotline of the film was, so we might have a rough clue, since it was not subtitled, but no one was very forthcoming.

At 6:00 we filed in to the theater to take our seats. The entrance was an extremely narrow door, where the usher took a flashlight to our stack of tickets and waved us down front. 80 Nu seats are in the balcony, 60 Nu in the back of the floor, and 40 Nu in the front 10 or 12 rows. The seats were painted wooden benches, with small posts between each seat, and the seat number written in black marker on the back. The interior might have appeared spacious if it were not so dimly lit and dirty. At the front was a cement stage, with a gigantic painted white wall, framed by black curtains. The theater was obviously going to be full, and the several ceiling fans in the back weren't doing much to relieve the oppressive closeness of the room. We counted exits, and there seemed to be five, with wooden doors, so it made us feel a little better that we wouldn't have to crush through the tiny front door if there was a panic in the theater. We disaster-obsessed Americans have to think about these things, you know.

We sat in front of a group of teenaged boys, and although they had not seen it before, they were eager to make conversation, touch Halle's hair, and agreed to help us understand the dialogue. As the seats filled up there was some negotiation between the ushers and people trying to get better seats, and we soon figured out that one ticket meant one seat, but as many people as you could fit into that seat. We put 6 people in 5 seats, but in front of us were 14 people in 7 seats, ranging in age from grandma to infant tied onto her mother's back. By the time the lights dimmed even further and the digital projector set onto the balcony railing started up, the theater was packed with what we estimated were probably a thousand people. And yes, we were the only Caucasians in the whole place, which seemed to amuse the people sitting around us.

I am going to ruin the plot for you, so if you plan to see Kikhor in Bhutan and you want to be surprised, stop reading now. The acting was decent, but the production was sort of amateur-video level, and the sound was really choppy, with ambient sounds closer to the microphone coming out very loudly. There was background music composed on synthesizer, and there were three or four music-video-type musical interludes in which the actors lip-synched the songs as a part of the storyline (hence the CDs for sale). The main characters were a close-knit prosperous family from the town of Paro (even the kids recognized the many Paro landmarks): a mother, father, two grown sons, a grown daughter, and a cook and housekeeper who seemed well-integrated into the family business. The cook, apparently, was played by a Bhutanese comedian whom the teenagers recognized, and the audience roared with laughter every time he spoke; he seemed to have the punchline of many of the family scenes. A scene of him cutting white radish in the kitchen was a spoof of "The Good, The Bad & the Ugly" right down to the music. The conflict was centered between the noble, reserved older brother and the somewhat rash, reckless and better-looking younger brother. Older brother, in buff physical condition, beats up a gang of pool-playing hoods who had attacked younger brother (in these carefuly staged fight sequences, the best part of the punch-throwing or bad-guy hurling action was repeated two or three times in slow motion for our further enjoyment). Older brother wanted to get married, and had even seen a girl in town that he liked, but was too shy or polite to speak to her; he only watched her from a distance. Younger brother, meanwhile, without knowing older brother had designs on her, also met the girl, whose name was Tsering, asked her out, and started courting her. No one in the family finds out that they are interested in the same girl until he brings her home to meet his parents, whereupon everyone is very upset but hides it from younger brother so not to ruin his happiness. Older brother sucks it up nobly and drowns his sorrows in beer; he even unselfishly sings a tribute song at younger brother's wedding.

Then the plot thickens... older brother wakes up with blood on his pillow and is diagnosed with leukemia ("blood cancer," explain the young men behind us), but again for some reason the family keeps this knowledge from younger brother. When Tsering gets in an accident and needs a blood transfusion, older brother refuses younger brother's request to donate blood and younger brother flies into a rage and storms out of the house. He ignores older brother on the street when they meet, and refuses to defend older brother in a pool-hall fight in which older brother is so badly injured that he dies in the hospital. Only then does sister spill the family secrets to younger brother, showing him proof of the older brother's admiration for Tsering, and telling him the real reason he wouldn't give blood. Stricken with remorse, younger brother rushes to the hospital bedside, just in time to see older brother dribble his last bit of blood from his mouth and croak. Younger brother and Tsering name their first son after older brother, in a "four years later" epilogue.

The audience seemed to enjoy this production very much; there was a lot of laughing, some applause here and there, and some discussion about the unfolding plot. Babies were crying, people climbed over each other to get in and out of the rows, everyone was packed in tightly, and it got extremely hot and stuffy over the two and a half hours. Luckily they opened all exits at the end, as Thompson was feeling a little green and needed some fresh air, and the theater emptied quickly out into the cool night. We snapped one photo of the theater as people were leaving, but it doesn't really convey the closeness and size of the crowd.

You should have seen us talking to people outside the theater, trying to fill in the gaps in our understanding of the plot. We even asked our taxi driver if he had seen it (he had), and got a few more details from him about the storyline. He was the one who translated the title for us, as "fate," which makes sense. The next time you are looking for local entertainment in Thimphu, I recommend the 40 Nu seats, especially if you have helpful schoolboys behind you to interpret.

Thimphu Christian Fellowship

While Ratna and I are walking to the weekend market, she asks me about my religion. I tell her I am a Christian, and then she surprises me by saying that she is one, too. Buddhism is the only established religion in Bhutan; government and Buddhism are deeply entertwined; taxes support the monastic system and the upkeep of the dzongs; and other religions are not permitted to construct houses of worship or to meet in groups. Religious proselyting is illegal, and we did not think there were many Christians in Bhutan. But apparently Pentecostalism has been making quiet inroads, especially among the economically disadvantaged classes of Nepali and southern Bhutanese immigrants, like Ratna. She invites us to a cottage meeting in English that takes place on a Saturday evening in the neighborhood up above our house. Intrigued, we agree to go.

The Thimphu Christian Fellowship (English meeting) has a small group of devoted lay clergy, a stack of xeroxed songbooks, perhaps a dozen people in attendance. The Bibles I see in evidence are New International Version or King James, wrapped in fabric or repaired with packing tape. It meets in the living room of its pastor, a man from eastern Bhutan who was converted to Christianity while in India. The house is unmarked as a house of worship; there is no sign out front except "Beware of Dogs" although there are none evident. This is an underground meeting conducted in some secrecy. The room is spare, with a Jesus calendar on the wall, and a banner embroidered with a scripture about the lion of Judah. The preacher for the evening is a former Hindu. Everyone in the room, upon their Christian baptism, has taken a Biblical name and they call one another by these names in their meetings: Caleb, Simon, Martha, Naomi, Priscilla, Rebekah, a small child named Moses, etc. They are house-servants, hospital orderlies, simple people without prestigious jobs. Ten people have been baptized earlier in the day, in the bathtub here in this home, but because they speak Nepali they are not here at this small English meeting. We are told that the other pastor of the congregation built a large home with a gigantic attic, large enough for the 300 or 400 Nepali-speaking Christians who meet there on Sundays. Services are conducted throughout the week in Dzongka, Sharchop (the language of eastern Bhutan), Nepali, Hindi and English (the latter being the smallest of the groups); they are launching a youth program, and they spent their free time in meetings, in prayer, in visiting fellow Christians, and in some door-to-door work.

Forrest hears us asking about whether they are harassed much by the police, and he begins to get worried, envisioning the door being broken down by AK-47 wielding officers ready to fire upon any Bible-carrying Christians, but although the curtains are drawn the meeting does not feel threatened. Thompson thinks it is like ancient Rome, when Christians were persecuted and met secretly in homes... suddenly his New Testament studies come alive for him. The meeting lasts about an hour. There are prayers (typically as in American Pentecostalism, one person is called on to pray but while he or she does so, everyone else prays out loud in a cacophonous murmur, with hands uplifted), songs (we try to follow the tunes, since they are not written, we have only the words in front of us), an offering basket, and an extemporaneous sermon from a brother speaking from his well-thumbed Bible. We are introduced as Christians from America, and invited to say something about our church there and give a short message. Don bears simple testimony about Christ and says how much we enjoy the opportunity to meet with other Christians in this beautiful country. He tells them a little about his responsibilities as a bishop in the US, as a lay church leader like their own, and about our desire to serve the Bhutanese people as volunteers. I read to them from Matthew 20 about how Jesus walked on the earth as a servant, not to be ministered to but to minister, and how much he loves the simple and the servants of the earth. Along with our children we sing them a children's song ("As I Have Loved You") which brings tears.

The scripture for the evening is Luke 10: 30-36 (parable of the Good Samaritan). The brother reads it to us, and then explains it in his own words. The account of the Samaritans - being downtrodden, second-class citizens, rings utterly true to these people whose ethnicity and religion make them lesser in the eyes of most Bhutanese. He compares the priest to the high lamas and lopens of the country. He compares the Levite to the monks and officials of the local monasteries. And he compares the Samaritans to the lower-caste Hindus (i.e. untouchables) from his own background as a Hindu. He urges them to be good Samaritans, since they are labeled as something like Samaritans by outsiders, this story calls them to be good ones and to share the joy of Christ and what meager substance they have, with those who suffer lacking physical and spiritual nourishment. I have never heard the story explained with quite the same emphasis; it has never seemed so immediate. At the end of the sermon he speaks about Revelations 8, about the coffers of prayer in heaven that we fill with our constant and sincere petitions, until when full they overflow back onto us raining blessings from God.

The senior pastor arrives towards the end of the meeting, just back from a Unity meeting of the Christian pastors in the region. We are amazed to learn that there are Catholics, Brethren, Emmanual, and Pentecostal leaders all meeting together to pray and work for the opportunity to spread Christianity legally in Bhutan. He says a long prayer naming trouble spots in the world far from Bhutan - their minds are not focused on their own problems - praying for peace between the two sides of the Nepali rebellion, for tsunami victims, for victims of carbombings in Iraq, for world leaders by name, for hungry people in Darfor Sudan, for peace in the Middle East, on and on with great detail. Juice and crackers are served afterwards to everyone present.
We walk home in a sort of stunned silence. What a tremendous blessing to attend such a meeting! What a fascinating side of Bhutan that we have never had the opportunity to see before. It is a complete inversion from the US, where Christianity is often prestigious and taken-for-granted, to be in a place where it is neither. The core essence of Christianity - that every human life is important, that none is too insignificant to be blessed by God, and that all are equal in his sight despite what worldly social position has been assigned by others - is here joyfully received by the "poor in spirit" and the gospel is being taught by honest practitioners in the true spirit of its message. We took the pastor's card and asked him what we might send him to help in his ministry. He just looked at me and said, "God will lead you."

Prayer wheel chorten
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Painting and Drawing

Don is off to the operating room and the sun is shining, and we have something of a free morning, so the kids and I walk and then grab a taxibus to the eastern neighborhood of Thimphu, where there is the National Library (we save this for another day), and the Traditional Painting School, a high school for artists in training. Public schooling goes to the 8th grade, and then there are academic, vocational, and other kinds of specialized high schools by competitive admission. At the Traditional Painting School, students train to produce religious statuary, decorative carved panels of wood or slate, tankha paintings, embroidered silk panels for handmade yak-felt boots, metalwork bowls and religious objects, etc, in a four-year program. Also they learn to produce the exquisite building adornments that make every surface special - here is a small prayer-wheel house in the Botanical Garden, an "ordinary" sight here with all its wonderful detailed paintwork.

The first workshop we see with an open door turns out to be the woodworking shop. Four or five young men are at work making screwdrivers. They have blacksmithed iron nails into straight screwdriver points, have set the blades into a block of wood, and are using a sharp machete to carve the handles. We are attracted to a workbench of 12" square dark slate panels, each with a carving in progress of a seated Buddha or a lotus flower. One young man comes over and spends quite some time with us, explaining how to transfer the design onto the slate and then he shows us how to carve it with the corner of a sharp chisel, gently tapping the back of the chisel with a wooden mallet, and slowly carving out the edge of a delicate flower petal. He even gives us a piece of scrap slate to practice on at home.

From there we peek into the statuary workshop: complicated, very detailed hero or demon images are being made in what looks like clay, but no one looks up to talk to us, so we quietly move on.

We climb a flight of steps into another building and encounter a drawing class. This is a class of 4th year students, preparing for their exams on July 7th, hard at work drafting the multi-armed hero and his consort whose name I can't remember just now. To draft this image takes careful measurement. Tankha painting is very precise: the proportions and the measurement are extremely important in making the final product look correct and pleasing. These students can sketch anything, all in the same flowing style, with little individualization of the artwork (of course this is a completely different mindset about artisitic production than in the West). Their instructor is not in the room at present. One young man tells me that they work at their desks from 9-12 with one bathroom break, and then again from 1-4, and they stay at a "hostel" next to the school... they have come from all over the country to study here and the work is obviously very rigorous. But they are glad of the diversion that our little family provides, and they let us sit at the vacant desks and draw. He digs in the drawer of his desk and comes up with a couple of images of the Guru Rinpoche, a common tankha subject, and a couple of pencils, and Jacob and Forrest set to work copying the images with remarkable detail. To amuse Halle, he draws in the curious stylized manner a deer, a dog, and a lotus flower (the pema). This is a quiet interlude; we are in no hurry to leave, and the students are entertained by the children's serious and careful attention to making copies of the Guru.

After some time, we drift into a classroom across the hall, where two girls are doing the tiniest embroidery I have ever seen - beautiful phoenixes and flowing flowers - without any hoops.
In the nearby shops, which sell the student work, we ask about where to purchase thick handmade paper, paints, and brushes, but we are told we have to go back downtown for those items. Later that afternoon we find the art shop, tucked into a handicraft gallery in the clock tower plaza, and we buy little sets of watercolors for 21Nu and fine animal-hair brushes, and the rest of the afternoon is spent pleasantly in the guest house with Jamtsho and our kids making paintings and drawings using the new paints and the watercolor sets we have brought from home. Jacob copies another image of the Guru and tries to master the "endless knot," a Buddhist symbol that looks like an angular Celtic knot, symbolizing the union of wisdom and compassion. Jamtsho shows the boys how to fold origami flowers and Halle paints lots of rainbows. We have drying paintings sitting on every horizontal surface in the living room.

Doma

One of the more enlightened things the king has done is to ban tobacco from Bhutan. Cigarettes are not for sale here, not even in the duty-free shop I believe, and there is a very prohibitive tax on bringing them into the country for personal use. It is illegal to bring them in for resale. Consequently, in contrast to many other Asian countries, there are few smokers (I haven't seen anyone smoking since we arrived), and no butts on the sidewalk. Rising smoke in the air comes from burning trash, or from cooking fires, or from incense. Interestingly, one of the most prolific weeds here is, well, weed, and although I think that a few people smoke the dried leaves of the marijuana plant that grows roadside here in abundance, it is not widely used.

However, they do have doma. The king & royalty have a PR campaign going that doma is a nasty habit, harmful to one's health, and it may be less common in the younger generation than in their parents, but it is still a frequent sight and has been a fixture here for centuries. Doma is betel nut, something that looks like an ungrated nutmeg. It is wrapped in a large, heart-shaped green leaf along with a smear of white lime-powder paste, and then rolled up into a small bundle and chewed. Once chewed, the doma turns into a bright red pasty lump, turning the mouth, lips, and teeth a bright red color. Doma chewers of many years have blackened teeth. Red spittle and used-up doma chews liberally dot the sidewalks and streets; sometimes you must watch where you step.

We spoke at length to one shop-keeper about doma. She said she began chewing it when she was about 20, and although she doesn't like what it does to her teeth, and she knows it probably increases her risk of things like stomach cancer, she says she can't stop, that she feels sick when she doesn't chew it. She has a chew in her mouth almost constantly - she told us that she chews 30 or 40 doma a day, sometimes as many as 50. I don't know what that costs; here we have taken a picture of doma for sale at a counter inside a small grocery: a leaf, the white lime, several betel nuts, all wrapped in someone's old geometry homework from a school exercise book. You see doma sellers on the sidewalk too, and hawking it from small baskets at sporting events, but I haven't seen too many of the young, Westernized, cellphone-chatting young adults chewing it, so I think that may be a good sign. If they can gradually eradicate doma, continue to ignore the weed, and keep out tobacco, then this bodes well for the king's program of measuring his nation's progress by its "gross national happiness."

The Diglop on his Damyan
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First Operating Day In Bhutan

Although we've been here for a number of days I thought it important to write an entry about my first operating day at the Jigme Dorji Wangchuk National Referral Hospital (JDWNRH to you). I had heard from the previous volunteer that there was a challenging case ahead, so I showed up a day early in the operating room. The attached picture shows the operative list for the day. It's not unusual to walk into the OR, never having seen the patient or even knowing what operation the patient needs, and figuring it out on the spot by looking at the chart and x-rays.

I tend to bring my own scrubs into the OR, because the Bhutanese scrubs only reach to my elbows and knees. They now have a supply of disposable gloves, although when I was first here, gloves were washed and re-used until they had holes in them. Sterility is still very lacking; the operative field is draped with sheets that have large holes in them, and oftentimes the anesthesia staff is working inches away from the operative field. Flies still inhabit the OR and I find myself shooing them away during the case, but at least we no longer have dogs outside the OR doors sleeping in the hallway. It's not uncommon to have relatives waiting right outside the OR, chanting and burning incense. I feel like I need the right karma in this environment and I appreciate any help they might give.

My first case was a 13-year old boy with a massive tumor in his thigh. The Bhutanese orthopedic surgeon was planning a hip disarticulation (i.e. amputating the leg at the hip socket). The boy had had a previous biopsy that was read in India, and as we were getting ready for the case, I looked at the pathology report, and realized that although the tumor was huge, it was likely benign and not malignant. The boy had had an MRI in India, too, but it was of such poor quality that it gave no useful information. I convinced the Bhutanese orthopedic surgeon that we should try to save the leg. The young boy was very happy with this suggestion, and wanted to be operated on by the American. We ended up removing a tumor that literally filled a bucket. We had to dissect out the major nerves and arteries in the leg, which was very challenging, but we were able to save his leg, and he's actually doing quite well. When he first woke up, he kept asking to see his leg to make sure it was still attached. Today, on post-op day #5, I put him on crutches, and allowed him to walk.

Weekend Market

New to Thimphu? Need plastic dishes, a rice cooker, some ancient cloth, spices, yak cheese, vegetables, or rubber flip flops? Take ye to the weekend market, running all day Friday, Saturday and Sunday down near the river in a big fenced cement lot with corrugated tin roofs. We have, as you have read, braved the Bangkok weekend market, and this one here is much less crowded and much more food-oriented. This is the week's only opportunity to buy fresh produce. Mid-week there can be had some wilted cabbages and sad-looking tomatoes in a handful of the shops in town, but the only good produce makes its appearance at the weekend market and everyone goes there at some point during the weekend to stock up, carrying large burlap tote bags to bring home their wares.

I go to the weekend market twice. The first time is on Friday, with Ratna leading the way, simply for vegetables and fruit. We stop at the Bhutan National Bank to change some travellers checks into Ngultrum, and then she leads me expertly through the mud puddles and the piles of wilted leaves and the pungent smells to her favorite and trusted produce sellers. There is so much food, I have no idea what they do with it at the end of the weekend. The stalls are elevated concrete platforms, each of which holds 10 or 12 vendors and their vegetables; the aisles are crowded with additional vendors and there must be 20 or 30 platforms. I recognize most of what is for sale: plum tomatoes, red-skin potatoes, chilis, cucumbers, eggplant, long white radishes, cabbages, extremely long green beans, shelling peas, broccoli, cilantro, mushrooms, turnips, pumpkin, onions, garlic, apples, plums, pineapple, tiny fingerling bananas, and did I mention chilis? Some of what is on display is bewildering: baskets full of the flat green leaves used for chewing doma (betel), spiny cucumbers, banana root (on Saturday Don and I ask about the tall fronds on display and he says, banana root, and we ask how do you cook it, and he gives us a look like, Dumb Americans, and he says, "In a pot!"), things in husks and pods that I do not recognize and cannot name. Ratna and I are efficient vegetable shoppers, we are not here to browse. She bargains for good prices and turns away easily if the price is too high. A kilo of most kinds of vegetables runs me 20 or 30, and a kilo is determined with a hand scale with a 1-kilo weight in one side, the shopkeeper allowing us to choose our vegetables and put them in the empty side, and then she lifts it and sees if it balances yet. The money is exchanged in a combination of ngultrum and Indian rupees. I buy tomatoes, carrots, potatoes, onions, broccoli (looks like the broccoli rabe at home), a small cabbage, some expensive Thai apples because they are red, a pineapple (for the equivalent of 50 cents!!!), and some very ripe and wonderful-smelling mangoes. This is too much, along with potatoes Ratna has bought, to carry home straight uphill, so we grab a taxibus. The food that won't be peeled I soak in a dish of filtered water and iodine tablets; the rest I just wash well and will peel it before cooking.

The second trip to the market is purely for entertainment, a Saturday stroll with the family (and Thinley along, of course). We look at the Chinese shoes, the blankets, the boars head, the strings of hard yak cheese, the mysterious produce, and then we end up in the corner with the altar bowls, the necklaces, rustic turqouise and coral and silver jewelry, religious statues, betel boxes, handwoven kira. We wait out a sudden downpour under these tarps. Forrest and Thompson purchase a coveted machete in a wooden sheath, and Jacob buys a tiger tooth amulet.

Based on these supplies and what we have bought in the Tshokhang (groceries) which are spaced within doma-spitting distance of one another, I can assemble some meals: a ramen-type soup with onions and carrots (but I add the enclosed "flavoring oil" thinking it is sesame and discover too late it is hot chili oil, rendering the meal nearly inedible)... and several variations on the egg/bread theme for breakfast: hardboiled eggs, toast, and fruit salad; french toast and fruit; hot chocolate and eggs cooked into bread slices; crepes. Snacks are butter cookies ("biscuits" here, baked in West Bengal, India) or "cream crackers," or the very ripe and tiny red plums from the Gadho's tree in the yard. Drinks are mango, apple or pineapple juice, soda (our kids favorite is the orange-flavored "Mirinda"), or filtered water. I can make passable hot chocolate from Cadbury Drinking Chocolate, powdered milk (here called "Nestle Everyday Dairy Whitener"), large-crystal sugar, and filtered water. Lunches are PB&J (both are available here, on the square white sliced bread sold here under the Norbu label) or PB& crackers. Dinners we have taken in hotels: Mid-Point for excellent Indian food (best buttered nan in town); Plums for Bhutanese/Chinese food (we liked the pork tsoem, cubed pork + chilis + vermicelli noodles), and we will try many others throughout the month. We often take a taxi back after dinner, because the walk back up the roads is so steep in the dark, and it costs us about 90 cents to taxi home from anywhere in Thimphu, and takes less than 10 minutes, and we arrive to the chorus of barking Gadho's dogs and tuck everyone in to bed.

Sunday we took an excursion to the Botanical Gardens near Simtokha, about 7 km outside of Thimphu. It was a sunny day and we saw many picnickers. We were invited to join someone's family picnic (would this happen in the US?) and they opened plastic dishes and rice cookers to unveil a hearty but typical Bhutanese supper: white rice, soy-barbecued meat of some kind, chicken curry, Indian-style yellow alloo potatoes, a potato stew, fiddleheads in chili-cheese sauce, emadatsi (the national dish) which is just chilis with melted cheese, and three or four other dishes I can't remember or didn't try, and they washed bowls for us and offered silverware, but they were using their fingers so we did too. Turns out they live below us near the hospital so they are neighbors, but even if they hadn't recognized us we might have been invited to join, I would bet.

An Evening with the Diglop

Today, after hours of pleading from Thinley, our frequent visitor and sometimes seventh family member, we visited her home again when her father was home and had the pleasure of meeting him. He has three careers: in his day job he is a diglop, a government-employed protocol specialist (he calls it "display"), teaching people entering official government service at the university level how to dress, eat, drink tea, carry oneself in official capacities. He has tutored members of the royal family in this, despite himself living in the extremely humble home we described earlier. Thinley is obviously very proud of his high position, and the honor that has come to him; he has even received an official government award, as she put it, for being a good father. She thrusts at us pictures of him at ceremonial occasions, with one of the princesses, etc. In his second career he is a movie actor in the thriving Bhutanese film industry. Unfortunately these films are not widely available on video, but he showed us his certificate awarding him the best supporting actor from the Bhutan Motion Picture Association for 2002 for his role in a full-length feature film. But his real love, it turns out, is singing and playing the damyan (?spelling uncertain), a traditional Bhutanese instrument that looks like a lute. It has seven strings and is played with a small pointed piece of ivory that looks like a sharktooth. He has had the honor of traveling throughout Europe performing traditional Bhutanese and Tibetan folk songs.

At Thinley's urging, he lifts the gorgeously carved and painted damyan, with its curved dragon-head scroll, down from its nail in the dirty turquoise-painted plaster wall, and we sit entranced while he plays us several traditional songs. His voice is indeed a lovely one, a trilling baritone, and he plays the damyan beautifully with flying fingers on the place where frets would be on a guitar, plucking the strings so rapidly that the instrument both sings the tune and provides a humming bass line at the same time. His children know the songs well; Thinley's five-year old brother sings bits and pieces as he runs in and out from the house to the garden and back.

His English is, as he put it, "small," and so Thinley does most of the translating between himself and us. He gives us a CD produced here in Bhutan of his singing and damyan-playing. We express our delight with his musicianship, and we marvel at his dignity and talent in the midst of what in the US might seem like squalid conditions. He is hoping to hike with us this weekend to one of the local monasteries (goemba) up in the mountains outside of Thimphu. If so, hopefully we will arrive with our gho and kira in perfect order, and conduct ourselves with politeness and proper Bhutanese decorum. One would expect nothing less when in the company of a diglop.

Why business is good # 2: Bamboo scaffolding on the new hotel construction in Thimphu
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Why business is good on the Orthopaedic Service at Jigme Dorji Wangchuk National Referral Hospital #1
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Warrior King

The King of Bhutan, H.M. Jigme Singye Wangchuck, is western educated and a very modern forward thinking man. (This picture is a copy of the one that hangs in nearly every home. King is on the left, the supreme religious leader Je Kenpo on the right). He has abdicated his legislative powers to an appointed ministry and an elected legislature, but on December 15 of 2004 he returned to his warrior roots and personally led an attack against 31 camps of Indian separatist terrorists along the southern border with India. At 9am precisely, the King hoisted a shoulder-carried mortar and charged into one of the camps of the ULFA (United Liberation Front of Assam) surprising the camp which was in the midst of having a morning meal. The coordinated attack at all 31 camps was carried out by the entire Bhutanese army of 5,000 men armed with AK-47s and small mortars, as well as two thousand of the royal guards. Thirty thousand Indian troops had been offered by the Indian Prime Minister, but declined by the king, who felt that this attack should be carried out only by Bhutanese in defense of their own border. Previous attempts by the Indian army to remove the three terrorist factions from southern Bhutan had ended in tremendous casualties for the Indian army, and some Indian generals had felt that further attempts would be a suicide misison.
The terrorist groups were heavily armed, including heavy mortar, machine guns, and anti-aircraft weapons. They had been fighting in India from their bases in Bhutan, Bangladesh and Burma since the 1980s. The Indian government had been pressuring Bhutan to take action against them and had stopped funding major development projects in Bhutan including the building of a new hospital in Thimphu. The king had personally visited all 31 camps, under the guise of paying tribute money and to try to encourage them to leave peaceably. He had tea with many of the terrorist commanders.

The king also started a program of patrolling southern Bhutan, ostensibly to take a land survey, so the terrorists were accustomed to seeing government officials in their area. A new lakhang (Buddhist temple) was built in southern Bhutan near some of the major terrorist bases, and in early December 2004, the king arrived with many officials and royal guards, ostensibly to dedicate the new lakhang.

The Indian government had evacuated many border hospitals, preparing for Bhutanese casualties, but after touring Jigme Dorji Wangchuk National Referral Hospital in Thimphu to determine available bed space, the king requested only 40 beds be reserved in Thimphu, saying that if he had more than forty wounded, that he would lose the war.

On the morning of the 15th, "surveyors" entered all 31 camps. A loud puja was being held in the lakhang within earshot of some of the camps, and at 9 am the attack began, led by the king himself, defeating all 31 camps within an hour and a half. It took two additional days to capture the remaining stragglers or force the remainder to cross into India where they were captured by the Indian army. Although many hundreds of terrorists were killed, Bhutan lost only 10 men and 30 wounded.

In memory of this battle, and out of gratitude at not having lost the king to it, the four queens have built 108 chortens to commemorate his victory.

I heard this fascinating account from the king's personal physician, who accompanied him on the trip to drive out the ULFA.