My 1st week

Today, Sunday, is not taken as a religious day here (although it is in India).  Saturday is taken as a religious day in Nepal.  That being the case, I will be at the hospital today starting my 2d, and last, week.  Today will begin with an ophthalmology resident's presentation and discussion at 7:30 am, followed by seeing patients in clinic.  I don't believe there will be surgery today, but am not certain.  This evening I will give my presentation to the staff and local doctors on use of tPA (tissue plasminogen activator) in the treatment of submacular hemorrhage.

Work here as a retinologist is difficult.  Not only are the pathologies difficult to manage, but the volume of surgery is high.  Nepal has a population of roughly 30 million, with only three retina specialists.  Consider that in the US, there is one retinologist for approximately every hundred thousand people and you can see how the volume of need here is high.  This, on top of performing surgery with equipment that could benefit from being updated.

Most of the patients being seen and treated are from India and this is due to several factors.  One factor is that 100 Indian rupees are worth 160 Nepali rupees, so patients coming across the open border from India get a significant discount vs having the same surgery in their home country.  Other factors that come into play are that the population in nearby India is significantly higher, and also, there is no where closer in India for patients to travel to for their eye care.  I've seen patients that have travelled as long as 9 hours by bus.  For reference/comparison, New Delhi is an 18 hour train ride away (to the west).

Yesterday, Saturday, I was treated with a trip to Lumbini and the birthplace of the Buddha.  I was informed a few days ago that this coming Tuesday is the celebrated birthday of the Buddha, an event that many make a pilgrimage to attend.  The temple which houses the marker stone of Buddha's birth is surrounded in an expansive landscape of Buddhist temples and shrines from various nations.

The Buddha's birthplace.


Below are a few pictures of the various temples we visited.  It is required that all visitors remove their shoes before stepping onto the grounds of the temple, so be sure to wear your sandles if you visit.  Not shown in these pictures, or visible from these sites, is the backdrop to these temples which is highlighted by a highly undeveloped countryside.

This is a picture showing the circle of life (specific to the Buddha), shown as an elaborate painting on the wall of a temple.  History has it that immediately after birth he walked and took seven steps.  Under each of his steps grew a lotus petal.