Hello Everyone,

Welcome to Thimpu, Bhutan and the Jigme Dorji Wangchuck National Referral Hospital. This is our new home for the month and we hope to keep everyone posted on our adventures.

Bhutan is a magical place. One foot in the past and one somewhere in the present. One major road. First telephone 1963, television ten years ago, and first Internet 1999. There are between 600,000 and a million people living here. About half can make it to any health care facility within 2 hours. They are working on a census to come up with a close estimate of the actual population. We live in the capital and there are no traffic signals, less cars than you see in Gig Harbor, very little pollution, and lots and lots of dogs.

We arrived uneventfully from Calcutta four days ago into Paro airport. The Druk Air pilots certainly have the route worked out. The final descent into the Paro Valley skims over tree covered ridges and small valleys with villages and hillside monasteries. I do not know if they consult their Buddhist horoscopes for auspicious days to fly into the valley. The last few days have not been auspicious since we have had constant day and night rain that has cancelled the flights. Apparently they do not fly if they cannot see the trees on the mountaintops and the short runway is wet. We are stuck in Shangri La. Does not seem like we are ate 7900 feet since we are surrounded by mountains not unlike Switzerland. We were picked up at the airport by the old hospital ambulance. Natalie rode shotgun with the stretcher and the oxygen tank until the multiple hairpin turns suggested she might do better in the front seat with the window open. The single lane road winds for 60 km between Thimpu and Paro past small village farmhouses with chilies on the roofs, hillside monasteries, and rope suspension bridges across the rivers. We shared the narrow one and a half lane road for the 1 1/2 hour ride with large Indian TaTa trucks, cows, loaded horses, dogs, other oncoming vehicles, and people. Of course, there were no guardrails and most everyone drives British style on the wrong side of the road. It was an interesting but somewhat rude awakening for Natalie that we were definitely not in Kansas anymore.

We now live in a small modest home a stones throw away from the hospital emergency room. Definitely not anything like Fox Island. We have electricity of variable voltage, hot water in the shower, a water filter, a propane stove and we have inherited five dogs with the house. We stopped waking up at 2am in the morning today and I think we have started to settle into a comfortable routine. We have acclimatized to the altitude. Natalie’s new 11 year old friend Jamstcho comes to play every evening. Many of the kids here speak fluent English. Natalie and BettiAnn are doing well and have not been reincarnated yet as roosters or monkeys so I have them as constant companions when I come home from work.

Work started on Monday with seven cases. It was the first time I ever operated on patients that I only met moments before in a place that I had never done surgery. One of the operative highlights of the first week was the monk mauled by a bear (third one in three months). Lots of acclimatization still needed for conditions in the OR but the staff here are fabulous. The patients are generally fun-loving and vibrant despite the conditions in the hospital. I will continue with updates down the line. We already know that there is too much work to do here in one month...as well as too many great place s to visit. Well, until the next post! Bob BA Nat