August 9 – Powerful Deterrents

So today, we went back to Patan Hospital to sign Dr. Bishnu’s training agreement. I also found out that Director Shrestha, while the Patan Birthing Center undergoes renovation, is working as coordinator of the night shift nurses. Unfortunately, that means that I have to show up either really late at night or really early in the morning. (I’ll be going at night, since there’s no way I’m waking up at 5AM).

To finally put some closure to the MDGP scholarships, I also went to NSI (The Nick Simons Institute) to sign our agreement with Dr. Zimmerman (and pick his brain about some clinic legal issues). One of the issues we discussed was medicolegal aspects of the clinic: how to deal with malpractice suits. Personally, I was curious about this as well, since I knew that Nepal was not a sue-happy place like America. Dr. Z enlightened me about the way things are done here: no doctors have malpractice insurance. The Nepalese don’t really sue in this department, and the law is somewhat loose as well. Apparently, until 15 years ago, medical malpractice had to be tried under assault and battery statutes. Even now, cases are seen more in the sense of consumer protection laws.

On the other hand, the Nepalese are more willing to take matters into their own hands. Should an egregious case of malpractice occur, threats, vigilante action, and out-of-court monetary demands are common. A more powerful deterrent is the press: families with connections can publish articles defaming physicians for their negligence. On top of being completely in the hands of the writers, such measures ensure humiliation and the fact that the doctor will probably be unable to practice in that city again.

That’s some scary stuff.

August 4 – The Man on the Mountain, Part II

After our meeting, Dr. Sedhain informed us that he would be traveling to Sanfe today on his way to Kathmandu. As such, he dropped by to pick us up at the Mangalsen Guest House at 6AM. The trek was downhill almost all the way this time, and resulted in an extremely pleasant, insightful journey, completely unlike the grim uphill battle of yesterday. Since he had made the trip many times before, Sedhain also showed us the easiest, most picturesque of the routes.

As we passed by riverside Chettri hamlets and cliffside cornfields, he showed us the land to which he was so dedicated. An amateur movie-maker, he would stop at lengths to shoot some footage of a humming woman washing clothes and early-rising children making their way up the mountain to go to school. Everywhere he passed, residents would go out of their way to say a salutation to him. It was clear that Dr. Sedhain is very well-liked by his community.

“Life is hard in Achham,” he said, while watching a woman old enough to be my grandmother carry a bundle of firewood twice her size down the mountain. His eyes grew sad as he watched her hunched form totter down the rocks.

Part of the problem was the lack of roads and the difficulty of travel. Due to the difficulty of getting from villages to clinics, more than 80% of births in the region are performed at home, often without the aid of a midwife.

“This is why PMTCT (Prevention of HIV from Mother to Child) training needs to be deprofessionalized.” Sedhain notes. “What use is it to have a few highly-trained PMCT doctors if the nearest birthing clinic is hours away? Nobody will go.”

As such, Dr. Sedhain often brings the hospital to the people. Every few months, he holds health camps at the most remote villages. Hearing that the DHO was passing through, local authorities even came out to our travel party to ask Sedhain to see some patients. With Dr. Bishnu, Dr. Sedhain observed a gaunt man, his eyes yellow and his tongue extremely swollen. “It may be TB… Maybe even AIDS.” Even as we were eating, an elderly shopkeeper came to beg the doctors to see his wife. She had had a series of epileptic seizures this month that had never before occurred.

Despite the promise we saw in some these places, Dr. Sedhain noted, however, that custom and history was holding the region back.

“Achham almost exclusively practices Chaupati Goth.” He said. “Nobody knows why, but 90% of the families here do.”

Chaupati is the practice of forcing a menstruating woman to sleep in a cowshed. Unfortunately, even the cowshed is too glamorous. The actual structure the woman sleeps in is a 3.5ft by 3.5ft by 3.5ft hutch reserved for this occasion.

“The people believe that if the women are not separated, fire will burn down their homes or tigers will eat their livestock.”

“These are the types of problems we must deal with,” he noted. “There are many problems in Achham,” he mused. “They are not big problems, but they are complicated problems.”

July 31 – Getting There, Part II

Dr. Bishnu and I spent the night in Silgadhi, the district headquarters of Doti (the district adjacent to Achham) with Dr. Prakash Thapa, alumnus of Bishnu’s medical college. Apparently, the two were extremely good friends back in school, so Prakash took amazing care of us and showed me photos of the two doctors (partying) during their college days. Sigadhi, perched on the mountaintops (“hilly region” by Nepali standards) has a much milder, pleasant climate than the pressure-cooker environment of Dangadhi. Anyways, we made arrangements with Prakash to meet again in Kathmandu the following week and continued on our 9-hour jeep ride into Sanfe Bagar.

Travel there was interesting, since we traversed some of the rockiest passes in the region. The road was winding and twisted, and was full of oozing mud and jolting potholes. We wound our way around the mountains, experiencing major climate change from cold evergreen forest to sweltering jungle (then back again). We passed dozens of tiny mud houses and thatched straw huts, watching as disheveled children hopped in and out of the thick mist.

Eventually, our jeep drivers (who insisted on blasting Hindi pop at deafening levels and spitting chewing tobacco out my window at regular intervals) announced that we were nearing the village. The road then promptly proceeded to end. We got stuck in some thick mud, and ended up having to walk the remaining half-hour into town.

The trek offered us an interesting view of the town, though. First, we passed through Haat Bazaar, a precarious assortment of small tin shacks in which many Bagarians ply their wares. Considered the poorer side of Sanfe, Haat is populated with younger people and seems to have a fair crime rate. The Haat side ended when we crossed an iron suspension bridge for which Sanfe is named. The bridge spans the Seti River, one of Nepal’s largest rivers, and is the result of an early American development project. The name Sanfe Bagar is actually somewhat of an inside joke among Achhamis, which I don’t understand but the locals find hilarious. Here’s my best attempt at explaining this:

Originally, the village was divided in two by the river, but the US project promised to link the two sides. Unfortunately, the project moved along rather slowly, and the Achhamis began to joke that it would never happen. As such, they named the village “Napnu Bagar,” which roughly means “where the river reaches its banks.” Due to the peculiar local dialect, the name soon became “Sapnu Bagar.” And since humans are lazy, the people eventually defaulted to a simpler pronunciation of the word, “Sanfe Bagar” (say it out loud, it’s easier to say). Think of it as a country drawl, only Nepali.

Anyways, crossing the bridge leads us to the Airport Bazaar side of town. This name comes from the fact that there was once a small landing strip laid on this side of the river. It hadn’t seen much use, though, and what remained of it had been destroyed in the Maoist rebellion. The airport side of Sanfe is believed to have older, more established community members, and the fact that the houses are a bit nicer reflects this claim. Our lodgings were at the SEBAC House, a nice guest house on this side of the river.

Once we settled ourselves in, we decided to call up Rajan Kumwar, a young local political leader and our chief ally in town. Rajan, who went to school in Kathmandu and speaks solid English, was one of the first people to help out the clinic efforts, and is currently overseeing renovations of our clinic. Unfortunately, Rajan wouldn’t pick up his phone. A brief questioning of the residents confirmed our fears—he had unexpectedly left for Nepalgunj, a 14-hour drive from Sanfe. Nevertheless, he plans on returning tomorrow, and we will hopefully see him then. The majority of our business in town involves communicating with him about the status of infrastructure.

July 28 – TANTRIC SEX!

No, I’m not kidding. That was today’s theme. Chris and I had been planning on biking down to Bhaktapur, a town 13km from Kathmandu valley for the past week. Alas, it rained today, so no bike. Nevertheless, we took a cab and did just fine. The appeal of Bhaktapur is that the city looks virtually the way it did pre-modernization. The town, already considered holy, was restored in the 1970s by a German development organization—on the condition that it remain largely untouched. As such, automated transportation (buses, cars, motorbikes) are not allowed within town limits, except for teachers, certain key businesses, and law-enforcement.

As the guidebook explained, the majority of the temples were constructed between the 14^th and 17^th centuries by the Newari people. The Newari are known for their eccentric sense of humor, and it definitely shows in their carvings. At first glance, all you see is gorgeously-intricate woodwork. A closer look, however, reveals a peculiarly literal interpretation of kama sutra. Their Pashupatinath temple, dedicated to Shiva, bears “the most obscene depictions of tantric sex found in Kathmandu valley.” Sure enough, the building’s struts had all sorts of… peculiar erotic artwork. Men and women are in all sorts of different positions (I won’t go into detail, check out my photos when I upload them), but the highlight was described in the guidebook as the beam where you “shouldn’t even ask what the midget with the bowl is doing.”

That being said, the next attraction, a Buddhist temple, had a sobering reminder of the result of such sexual excesses: depictions of Hell. The woodcarvings on this side of Shiva’s town had some pretty-painful looking images of divine wrath, including constriction by snake and tooth-pulling with a wrench.

Bhaktapur was still gorgeous, and we had the chance to see woodworkers making the city’s famous carvings (many of which had some more urbane images of kama sutra), as well as Nepal’s tallest shrine. We were also joined by an art student named Lama, who gave me a crash-course in Buddhism and showed me some incredible Tibetian paintings (some made entirely from 24-carat gold paint). The lack of vehicles and modern technology in the village make it feel as if time has stopped, and despite the massive amounts of rain we got, we enjoyed the trip immensely.

As all good things have to end, though, we needed to make an appointment. On our way out, however, we had one last chance to observe Newari creativity. One of the temples at the exit of Bhaktapur has all kinds of animals engaging in procreative acts on it. The most memorable of all, however, was “two elephants in the missionary position, their trunks entwined in ecstasy.”

“That's some kinky shi*,” said Chris.

I couldn’t agree more.

Power is the Problem, So We Go for Bananas

Chris and I woke up early today to get some business out of the way. After meeting with Mr. Dhungana to go over tax issues, we booked tickets for my flight with Dr. Kattel to Danghadi (the first stop on the way to Sanfe). The rest of the morning was spent doing research on a tricky issue with the clinic— power. Electricity is not consistent at all in Achham (Chris and Bibhav spent over a week sans energy during a blackout) so it’s absolutely critical we get a generator there. Alas, the 2.5kW diesel generator that we have in mind is nearly impossible to find. We took a list of procurement businesses off the web and went down them, calling everyone. I also took a hike through downtown Patan, stopping at every machine shop on the way back to the guest house. Ten phone calls and eight store visits later, we could sense a pattern: nobody carries diesel generators. Most stores seem to have petrol (gasoline) generators, though, so things are leaning closer to that end. There was a glimmer of hope for a moment, when Rajan called us to let us know that he had found a place—but they only sell larger industrial-grade generators.

In lieu of our disappointing morning, we met up with Bikram to go on the long-delayed sightseeing trip. First stop: Durbar. This square, bounded by the former palace of the royal family, was bursting with temples, buildings, and monuments. Particularly memorable was visiting the Kumari, a nine-year-old girl considered a living goddess (the only living Hindu deity). We weren’t allowed to take photos, but she did peek down from her window. “She doesn’t look very happy,” noted Chris.

“She does this every day for hours,” noted Bikram. “Who could be happy about that?”

Also worrying to the Kumari is the fact that her position is temporary: Upon the onset of menstruation, the reigning goddess is unceremoniously and literally thrown out on the streets. A new girl takes her place and the cycle begins again.

On the way out of Durbar Square, a little man solicited me to buy something from him. The plaza is bursting with peddlers, so I was prepared, but he presented an item I really wanted: a Gurkha knife (khukuri). The huge blades are traditionally made by the residents of the region by the same name and are symbols of Nepal. They also represent the Gurkha army. During the British wars of colonization, their defense of the Terai led to the two year Anglo-Nepali war. Despite the eventual defeat of the Nepalese, the English were so impressed by the Gurkha fighting force that they were regularly called upon in WWI and WWII to serve the queen. Their regiment ended up being awarded 13 Victoria Crosses, the highest British Military honor. In addition, Britain has designated one of its most feared dragoon units the Gurkha Battalion, despite the fact that there are no Gurkhas in it (and of which Prince Harry is a commanding officer). To this day, many Rai and Limbu men still have khukuris (which they always carried with them into war) tucked into their belts.

Anyways, back to this knife, it wasn’t as elaborate or decorated as most I see in gift shops, but when I pulled the sheath back, it had the stamp of the Ghorka Army, complete with a serial number. Needless to say, I made the peddler quite happy. If nothing else, it'll also make an impressive mango slicer for me in Achham ;)

Unfortunately, buying one item in Durbar makes you a salesman magnet. One man harassed me in an attempt to sell me a lock for almost 15 minutes as I repeatedly denied his attempt (not to mention he was asking 400 Rupees [$6+] for an inch-long trinket!). I had learned my lesson. From then on, I kept my mouth shut, letting the peddlers descend on Chris instead.

We stopped briefly for lunch, where I had a buffalo sandwich (buffalo are not considered sacred like cows here), and noted that it tasted just like beef, just a little tougher.

Our next visit was Pashupati, the holiest Hindu site in Nepal. Unfortunately, this meant it was so holy it prevented leather shoes, wallets, and belts (and their hapless non-Hindu owners) from entering. Nevertheless, Bikram wanted to show us the small village that had sprung up around it, and proceeded to buy a bunch of bananas. We quickly found out the reason, as he gave each of us one, bit one himself, then threw the rest into the street. A crowd of monkeys descended onto the pile, squeaking and scrambling for the fruity morsels. I hate to put it this way, but they were definitely among the most charming of the area’s attractions. The rest of the temple was blocked from our entrance, though we were allowed to photograph whatever we could see from outside. We hiked around the gate, though, and caught a glimpse of a gigantic golden bull in the midst of dozens of statues.

There was a funny smell in the air, so I asked Bikram what kind of incense they burned here.

“People.” He replied.

Apparently, the river that runs through the temple is considered holy like the Ganges, and many Nepalis are cremated here.

“Oh.”

Shifting gears in religion, we then took a local bus to the opposite end of Kathmandu to visit Swoyambu, Nepal’s most holy Buddhist site. The Buddhists were more accommodating, and after a rainy 15-minute hike, we made it to the monastery and stupa at the top of the hill. The temple, exploding with tiny statues, was incredible, and offered a stunning view of the entire capital city. We spent a bit of time meditating with the monks and listening to recordings of Nepali chants. To Chris’ amusement, Swoyambu was also overrun by monkeys. No bananas for them, though.

Note: In my haste to get this blog up, I forgot to enable commenting by non-google people. I've since unlocked it so anyone can comment, so feel free. I'll answer. (And thanks to Jordan and Ryan. Much love).

July 22, 2007 – The Family is Wonderful. Mother Nature is not

The Acharyas have been so accommodating in opening up their home to us, and I’ve learned much about Nepali culture and family life from them. Bibhav’s parents are very religious (they’re members of Hare Krishna) so I’ve had a crash course in Hinduism. I can say that I’m now quite proficient at eating with my hands, and had the chance tonight to eat (okay, okay, so I didn’t eat it. I kinda licked it) what is called “Pepper that can set a hundred men’s mouths on fire.” Let’s just say I smelled it and my nose started hurting.

Bibhav’s parents’ religion prevented them from talking to us this morning (they’re in ritual prayer from 3:30AM-7AM), so Mr. and Mrs. Acharya “saw us off” last night. Bibhav walked us to the bus station at 6, though, and we parted until he arrives in Kathmandu to fly back to the States. I’m sure I’ll be seeing a lot of him back at Yale, though, which is awesome since he’s such a cool guy.

Mercilessly, the Himalayas remained hidden from view by huge clouds again. If anything, it was cloudier today than any of the other days we were in Pokhara. Thanks a lot, Nature.

July 20, 2007 – We Become Tourists

Chris and I forced ourselves to wake up at 5:30 this morning to catch a bus. As a background, one of our team members (and incoming Yale med student) Bibhav Acharya invited us to come visit him in his hometown.

Pokhara, which is one of the Top 5 tourist trekking destinations in the world, is certainly deserving of its title. Whereas Kathmandu is loud, polluted, crowded, and smelly; Pokhara is peaceful, clean, and pleasant. Though it’s not as urban the capital, it’s actually nicer since we get all the benefits of electricity, running water, and internet without the annoying city byproducts.

One of the most notable parts about trip thus far, however, has been the ride there. Chris and I took the tourist bus for seven hours through many small mountain hamlets. The landscape is absolutely stunning, with huge cliffs, gaping gorges, and rushing rivers. Residents primarily grow rice in jagged paddies on the mountainside for subsistence, but supplement their income by catering to the bus passengers that stream by between Kathmandu and Pokhara. One of things that encouraged me the most about them, though, was seeing that children were still managing to go to school. Everywhere we stopped, there were uniformed kids of various ages marching (often long distances) down the mountain to go to school in the valleys below.

Once we reached Pokhara, Bibhav took us to Gupteshwor Mahadev, an awesome limestone cave with a long-hidden shrine. The lingam, which people are not allowed to take photos of, is actually a stalagmite that bears a likeness to Shiva’s “terrifying” or “great” form. There I paid tribute to the manifestation, and dabbed some red paint on my forehead (tika). That actually allowed me to get the local rate at the next attraction, Devi’s Falls (a huge waterfall that apparently swept a Swiss couple away in 1961), since I totally pass for a local (Bibhav’s dad noted that I looked just like the guy who used to do IT for his hospital). In fact, when we were on the bus to the central town square, a woman asked me to move aside since she wasn’t uncomfortable about sitting next to the “American” (Chris). I awkwardly had to explain in bad Nepali that I was from Korea. Chris did his best in the opposite direction as me and bought a brilliant hat which, coupled with his camera bag, made him the ultimate tourist.

Before returning to the Acharya residence, we spent some time wandering around the heart of the city, which was just urban enough to be pleasant. When I ducked into a music/movie store, I was surprised to find tons of Korean movies, an entire section by themselves! I had a great time translating some of the more hilarious titles for Bibhav. Again, small world…

July 19, 2007 – Chow Chow

Though we were planning a trip to the Social Welfare Council and having Bikram show us the holy Hindu temple of Pashupati, but endeavors fell through. Nevertheless, we still managed to pass by some notable landmarks such as the (outside of the) Royal Palace and the Queen’s Lake. We ducked into a small bookstore where Chris bought “Forget Kathmandu” and I picked up a long-overdue copy of “The End of Poverty.”

Since not much happened today, here’s a little update on Nepali food. Though most people are Hindu, meat is not difficult to find (called “masu”) and I’m at a guest house, which means they’re used to barbaric foreigners ordering chicken and pork and... buffalo? In addition, Nepal’s location between India and China means that it’s easy to get food of either region. Curry is a daily staple, and chow mein, fried rice, and chop suey are everywhere. I found Korean cup ramen at the local grocery store, but didn’t end up getting it. Apparently, you can even get Chinese food in Achham as well— according to Chris, there’s a vendor who just sits there and fries up tons of noodles every day. The domestic Nepali ramen (chow chow/ wai wai) market has boomed recently, and actually advertises it as a health food— the company Mayo enriches theirs with Vitamin A and has the slogan “One a Day.” Other than the fact that the whole thing is still just a brick of flour and sodium, I guess they’re not that far off…

My favorite Nepali dish (which is actually Tibetian) is a soup noodle dish called “thukpa.” It features thick noodles in broth and vegetables, and though a little heavy sometimes, is really good. In addition, a popular dish called momo is quite familiar to me since it looks and tastes very much like East Asian dumplings (Chinese dim sum/ Korean mandu/ Japanese gyoza).

Despite the wide array of foods, the traditional meal that all Nepalis eat is called “dhaalbhat.” Dhaal is a soup of varying thickness made with lentils and grains, and bhat is long grain white rice. Add a side of vegetable curry and chutney, and there you have it. Bon apetit.

July 16, 2007 – Earning My Keep

This morning, I woke up to loud shouting of Nepali over a megaphone. When I poked my head out the window, I saw a government vehicle rolling down the street, loudspeakers blaring. A man was throwing pamphlets out the window. A closer look at a sign on the front of the car read “HERPES”. My grasp of the language is terrible, so it may have been something other than an STD campaign, but it remains an intriguing possibility of a pretty frank method of public health education.

Anyways, today was my first day of official duties, and Chris has been amazing in helping me get used to the work. First, we visited Patan Hospital (one of the best state-run hospitals) to request special Peds/Obs training for our MBBS doctor. We next dropped by the National Center for AIDS and STD Control and spoke with the Deputy Director there. Dr. Pant (who did his MPH at Johns Hopkins) seemed quite optimistic about providing our clinic with both documentation and supplies to help us set up a Prevention of Mother to Child HIV Transmission (PTMCT) program, something both exciting and encouraging.

As part of the “detective work” involved in securing medical resources, Chris and I went to Teku in search of the elusive Dr. Upreti, Chief of Immunization and Health Services in the Dept. of Health Services in Nepal. We had originally believed that he worked for the Ministry of Health, but that search proved fruitless, as the main office informed us he wasn’t under their direct organization. Since UNICEF is one of major provider of vaccines, we then attempted to locate him there, but that was a false lead as well. Finally, after wandering about the government buildings in town, we found his signature on a form in the Child Health Division. A quick meeting with him then provided us with more good news: all the vaccines for the major diseases are already present at the district hospital; we just need to talk to the local District Health Officer to procure them. Mission success!

To end a long day of trekking, we went to check out a big mall in a central plaza—and almost forgot we were in Nepal. The complex looks like a shopping center in the US (complete with glass elevators and AC) albeit a bit smaller. Puma and Nike sneakers cram storefront windows, while Beckham soccer jerseys and Armani slacks hang by the rackful. Young people with Ray Bans and iPods shuffled past in the consumer paradise we Americans know so well. Sometimes you realize what a small world it is.

July 15, 2007 – How to be Nepali, How to be Fat

I crashed inadvertently at 8PM last night, so I woke up at 5AM this morning. After spending some time staring out the window at the early-risers on the streets below, I embarked upon my first adventure— the hotel bathroom.

The toilet here doesn’t really… flush. It basically trickles water for a few minutes until you give up. I also decided to take my first shower upon entering the country. There’s a small problem. Most places only know one setting of shower: cold. Nevertheless, I managed to shiver my way through it and get clean.

Once I hit the streets, the first thing that struck me was the huge diversity of complexion in the Nepalese population. At one end of the spectrum, the people are very dark and South-Indo-looking. At the other end, individuals have highly East-Asian features. While I was standing in the visa application line, a Nepalese man approached me. “You look Nepali, but have an American visa,” he noted. He had seen the navy-blue booklet poking out of my pocket. When I explained that I was Korean, he asked, “Oh, so one of your grandparents is Korean?”

Apparently, I pass as Nepalese, which has its benefits and downsides. For one, I blend in well so nobody finds me out of the ordinary. On the other hand, unless I introduce myself as American, people will launch into Nepali when I approach them. Nevertheless, most folks here speak bits of English and some people are quite fluent.

Chris got a call from one of the kids he met in Sanfe earlier this month. Bikram, the cousin of a political figure in the town the hospital is in, met us at the guest house that afternoon. The nineteen-year-old sociology student spoke very good English, even picking up on bits of slang Chris and I tossed around. I was delighted to exchange pieces of cultural knowledge with him, as he proved an enthusiastic and friendly conversationalist.

At one point in the conversation, though, Bikram suddenly turned to us and said “how can I be like you and Andrew, Chris?”
Chris, with his dry humor, leaned back and answered with a grin, “it’s not easy.”

When prompted further about what exactly he meant, Bikram replied, “How can I be fat like you?”

(Note: Regardless of our personal opinions on our physiques, we’re definitely not fat).

After our initial laughter, he explained in detail: “I’m too skinny. My parents worry so much, because I keep losing weight too.”

I made some lame first world references to TV dinners and driving instead of walking, but there was no getting away from the truth of the matter— the American way of life is vastly different from an Achhami’s.

July 14, 2007 – Stranger in a Strange Land

True to the country’s reputation, the first thing that appeared on my initial descent into Nepal was a huge mountain poking its peaks through the clouds. As we broke the puffy cover, they were soon followed by rolling hills, dense forests, and pastures so green my eyes hurt. Before touchdown, Kathmandu, the capital city, exploded in a cluster of houses, factories, and phone towers.

When I finally made my way out of Tribhuvan International, I met Chris, my coworker. As he noted in his e-mail, he was easy to find— the only white person at the gate. He grimly noted upon our meeting that the taxi driver union was on strike again today. As such, we were forced to settle for a renegade cabbie who would only give us the 20-minute trip to our guest house… for 1500 Rupees. That’s about $23 US Dollars. I was getting better rates in NYC :/

The taxi ride afforded me an intriguing look at Nepal’s capital, though, and it really cemented in the realization that it’s developing. Women wash clothes by hand in ditches by the side of the road while Toyota SUVs thunder past. Momo-vendors cook dumplings off open coals under massive billboards advertising Motorola mobile phones. The streets are exploding with microbuses, motorcycles, and rickshaws, but there are almost no traffic lights. Dogs, goats, and cows freely roam the streets. “It’s two years in prison for killing a cow,” said Chris, punctuating my thoughts. That’s right. We’re in a Hindu country now.

Despite the glaring inequities of this heavily urban center, there’s a certain charm about the city. Everything is a mix of old and new (technology, buildings, culture, and people), and it works. As my guidebook notes, Kathmandu is a sensory overload of strange sights, sounds, and smells; but a fascinating place to be.