I forgot to mention, that even though I am back, I’m not seeing patients yet, only emergencies. I plan to reopen my clinic in the beginning of September. If you need someone in the meantime you can look at the web site www.sohoherbs.com. thanks

Well, I’m back. A good friend of mine sat me down before I left and gave me a serious talking to. It came as a bit of a surprise for me, but as I traveled the essence of the talk slowly began to reverberate through me. It really hit me about midway into the trip. A slow feeling of desperation was beginning to overcome me. I was treating people wherever I went, and I was always left with the feeling of leaving unfinished business behind. I was feeling a frantic need to help. How could I leave when there were so many people who still needed help? I was planning my post-trip vacations and how I would use them to go back to such and such a place. After the fourth place was added to my list I realized that I was going to run into a problem, there’s not enough time for me to go everywhere. What could I do?

The conversation that had originally seemed absurd started to grow. My friend had told me that he expected me to do something bigger than myself. To use my influence in the community to create something. At the time I didn’t understand what the implications of those ideas would be but gradually things began to coalesce – to take form.

My experiences in South East Asia helped me reach the realization that Chinese medicine is a perfect match for people suffering in impoverished/medically-underserved areas. It is a “rural” medicine. It needs very few supplies, and it relies mostly on the bodies own healing ability (very low cost). Juxtapose that with Western medicine which is reliant on medications, machines, and operations to achieve its objectives. Let’s take diarrhea for example. What can western medicine due in the absence of antidiarrheal medications? Chinese medicine however, can do a lot, from certain ways to massage the abdomen, to common household substances like salt or eggshells to astringe the bowels.

Don’t get me wrong. I’m not knocking Western medicine, just making an honest observation. In a situation where supplies are limited, and access to modern equipment is non-existent, Chinese medicine shines. Just like when I was in Indonesia where the tsunami hit. This group of local traveling doctors would come through once in a while to treat the people. In the beginning they steered as far from me as possible, but every once in a while someone would come in that they couldn’t help and then they’d send them to me. I’d treat them and they’d get better. It only took a few times of that sort of thing to have them start asking me if I could help this person who wasn’t responding, or that person that was having difficulties. They were able to observe, firsthand, the power of Chinese medicine and were grudgingly (at least in the beginning) forced to respect and admire it. By the end of my stay they were all seeking treatment.

Anyway, I digress. The upshot of the whole thing is that I realized that I could do far more good by setting up a network, where other people can come and help as well, than I could ever do alone. That said, my trip suddenly took a turn for the worse. Whereas before I would just waltz into a place and offer my services, now I need to have actual contacts that I could refer people to. All that became much more difficult as I moved into more developed countries. The bottom line being, more developed equals more bureaucracy. It really hit in South Africa. I arrived and was seeking an opportunity to help, but was stonewalled every way I turned. The need there is enormous. From shelters for battered women, the orphanages were children who have AIDS are left by their families. They all need help. Getting to them, giving them the help they need turns out to be an industry in and of itself. Not as one would expect, a nonprofit industry, but the opposite, a for-profit industry. How crazy is that? You have people arriving with amazing skill sets that are asked to do menial office work, and pay for it. Absolutely ludicrous. My first impulse was to begin traveling north. There, in Kenya, Sudan, where they need is greater, the opportunities for direct aid are numerous. Then I realized, if I really am interested in trying to create something bigger, sooner or later I was going to need to deal with this bureaucratic nightmare. I could choose to only go where the path was easiest, or I could go where they need is greatest. How could I turn away from these people who have such need just because it was a hassle for me? So I decided to stay and try and work my way through the bureaucratic haze. Halfway through that (which was weeks long), I decided that I could do a far better job from home than I could on the road. I already had so many contacts that just to consolidate and organize them would be a handful of work. So home I came, and here I am. Trying to work my way through this pile of rubble, and hoping there some gold in this sand. Wish me luck.

Nepal seems to be the overall poorest country I’ve visited so far, and although the street urchins are absolutely filthy, the kind of filth that’s hard to imagine, they look pretty healthy.

I think I’m missing a day somewhere? Somewhere with a *beni in it…

Ps – don’t shoot me, but at this point things look a lot like the Alps, without the comfort and food. Maybe with a porter things will look better…

* – It’s really cold, be prepared. It staying above freezing but since there’s no heat so you never get warm. There are no heaters where you sleep. Even if you find hot water, no matter what you think sitting in your warm room in the west, you’re not getting naked in a room that’s 34 degrees to wash off. Test the hot water, they all say they have it, 90% don’t. That’s not completely true. They have their version. We would call it cool. No where near warm. It’s very high altitude, it takes a few days to acclimate, don’t start by going straight up. Hire a porter and guide. If it’s low season you can get two in one. I’m here at the lowest point in the season. During other months 150 people a day are coming through (I’m glad it’s not that time!)

Bangkok – no where near as sleazy as I would have imagined. Malls, movies, and unpaved roads. It was actually really nice.

Katmandu – one version of hell, must be ring number three or four from Dante’s Inferno. The sheer pandemonium was kind of shocking. Cars going every way you can imagine, bicycles, and rickshaws on top of that. It made me realize how used to rules we are in the West. Even in Indonesia there were rules, bendable, even option but everyone had a notion of them. Not here.

Pokhara – Lakeside district nice, food everywhere sucks and it’s really cold. Like everywhere else here, there’s no heat. That wouldn’t be so bad if you could get a place to warm up once in a while… I saw a cow fall down. You’d think with four legs and all it’s be hard…

Trekking* – first really bad idea to go from Phuket, Thailand where it’s 90° F to Nepal, where it’s 60° F in the daytime and around 32° F at night, really bad. I arrive in Jomsum and make my way to Kagbeni – after harrowing 16 seat airplane ride. The plane was almost grounded due to heavy fog and strong winds. They didn’t tell us until after. The plane took off and everything was fine until we started to land. The small plane had to make a 180° turn to land. The only problem was that it had to make the complete turn in a narrow valley. I swear I could have spit out the window onto the mountainside. That coupled with the wind made for an exciting voyage. Only me and one other trekker arrived that day. No one else was able to get in for another 5 days dues to the winds. No one had come in the previous 3 days because the planes were grounded due to fog. Very low season. I decide no porter, no guide, just me and my 40 pound pack. If anyone had questions about my intelligence, let those be gone. It’s confirmed. I am stupid. Not just stupid, but stupid and stubborn – a deadly combination.

Day one – Jomsom to Kagbeni, the first mistake, uphill on my first day. A 2 ½ hour trek takes me six. Not because I’m slow. I was moving at a pace similar to the locals. I just took the “safe” way. The actual path. Then everyone told me afterward that it’s a lot shorter to cut through the dried up river bed. Kagbeni turns out to be my favorite place on the trek. I found a really nice tea house with a family of very clean tea house. The food was good too. A nice place to rest. It’s really cold.

Day two – on to Muktinath. Way too cold. The higher the altitude, the colder and thinner the air. Dirty and completely disgusting. The bed the sheets smell, that sour sweet rancid smell of filth from not being washed in ages. Like a bat out of hell.

Day three – Muktinath to Kagbeni “take a shortcut” in Nepali means let’s see how stupid this westerner is … the 2 ½ hour shortcut takes six hours, climbs to mountains and goes back to where I started from! At least I get a clean place to sleep.

Day four – going down hill now, the hard part is over. So now, of course, hire a porter.

Kagbeni to Kalopeni

Day five Kalopeni – to Tatopani – hot shower, aaahhh

Day six Tatopani to Sikha – famous for its “hot springs” (nasty), no hot water due to hot springs

Day seven Sikha to Ghorepani – dirty, nasty place

Day eight Ghorepani to Nayapul, 6 ½ hours, met guide, had handkerchief stolen, tasted raxi, a rice wine. If I had any worries about parasites, I’m sure this stuff took care of them…

Pokhara – relax and recuperate. Laundry, nice hotel, kind of hot water

Back in Katmandu – a 7 hour bus ride back to the mouth of hell

Ok, so despite my best efforts to dissuade all but the most serious of professional mountain climbers, you still want to visit Nepal. What do you need to make the trip as comfortable, safe, and fun as possible?

a guide – $7 a day, make sure that they agree to feed and bed themselves

a porter – around the same as a guide, same agreements. The little, skinny guy who came with me on the second half of my trek could eat FIVE heaping plates of rice and dahl four times a day!

a sleeping bag – you can rent one in Jomsum

a small electric heater with an adapter plug – wow. It would have been a totally different trip with one of these. Way more pleasant. You would have to pick one up stateside or in Europe. This is part of the reason you need a porter ;^) I’ve seen really small, light weight ones. You can just leave it with your guide/porter after… I would get up around 8 am eat, trek, try and get somewhere by 5 or 6 pm, eat again, and then get in bed (under the smelly covers), and wait for the next day. It was so cold I couldn’t even type, or read! My hands would freeze in minutes…

warm clothes – yes, warm clothes. I used my super light weight, fast drying, travel clothes. Yes, stupid. So stupid. The Himalayas you say? Yes. So stupid… You can rent some of these in Jomsum as well.

Trek for short periods. I think 3 – 4 days would be better than 10. You could do small ones to a bunch of different places, and take breaks in between to recover.

Allow some time to acclimate to the altitude. Smart trekkers go DOWN first for a few days when they get to a high altitude location. Unlike me, who went UP…

Know that the food is uniformly bad (and you’re getting the good stuff!)

September, October is prime time with 4,500 people arriving in Jomsum each month. All the hotels, no matter how crappy, are completely booked by 2 pm. That means you have to be done walking every day by that time. The least busy time is now, January and February. The day I arrived there was only one other person, which explains why I got lost all the time – there was no one to follow.

I don’t know what the word in Nepali is for “shortcut” but it probably is something similar in meaning to “let’s send this guy over a couple of mountains and see if he lives.” Anyway, after the first disastrous day, in which a 2 ½ hour trek took me 6 ½ hours, because I decided I should be able to recognize a marked trail without any help, I decided to ask the locals for directions BEFORE hitting the road. Well needless to say what is a shortcut for some one that is used to walking over mountains regularly isn’t quite the same for a guy with a 40 pound pack on his back. And they do this thing where they just kind of wag their hand in a general direction and say “straight” or “follow the path.” The only problem is there are a million forks in the road, and sometimes the “path” is the wrong way! You’ll be happily walking on a clear “path” and suddenly there’s a sign that points directly away from the path, into nothingness. So which do you choose? I chose to stay on the path. The map said that there was only one town for miles, and I figured the “path” had to lead there. Completely wrong. The “path,” of course, lead to nowhere. Impossible? Not here. I ended up hiking from 4500 meters to 5500 meters (I think that’s around 18,000 feet), and back again. Brutal.