Life in Thimpu

Life has been fairly hectic lately. Surgery, teaching, and clinics have been steady. Cases continue to be challenging in a way that is quite difficult to explain. There are no textbooks that describe the difficulties of working on extremely complex orthopedic challenges without all the tools. We do the best we can and so far our outcomes have been good. Today I operated on a guy who has been in bed in traction for eight months. He will be quite happy when we get him out of bed tomorrow to walk. The bear-mauling guy was discharged. The queen’s mother did not return for follow-up.
Our social calendar has been quite busy. It seems that everyone knows everyone in Thimpu. When we came we could not understand the fact that everyone referred to everyone else as a cousin-brother or cousin-sister. We now realize that it simply means that there is some distant relationship that might bind people together. It is not unusual to spontaneously meet someone and they take the weekend off and take you on a local tour or to their family home. This has happened each weekend that we have been in Thimpu. Access to VIP’s is also unbelievably easy. We had dinner with the assistant Minister of home affairs one night. He wears a lot of hats. He was in charge of the recent census in Bhutan and described the difficulties that were encountered counting nomadic yak herders and their kids. He also is in charge of disaster planning for the country and immigration/naturalization. There is only one road that crosses the country and an earthquake would isolate everyone in an instant. We also talked to the assistant Minister of health who is also our neighbor. He is very excited about a rural clubfoot project I proposed. Might be grounds for a return trip.
Last evening we had dinner with Dorji Wangchuck, one of the people who introduced the infrastructure for television and internet to Bhutan. Strangely enough, the pressure caused by the desire of many people to watch the 1998 Soccer World Cup prompted the introduction of TV. Small satellite dishes were purchased on the black market from India and the rest is history. In retrospect, he has definite reservations about the decision. Bhutan has a rich oral tradition, which has been passed on for centuries. It has very little written history. It is now slowly disintegrating as people spend their time watching some pretty strange stuff. Imagine skipping an archery tournament to watch the PGA playoffs in a country that has one golf course. Mr. Wangchuck has now turned his efforts into documenting the rich traditions of Bhutan on documentary films as he sees some of these traditions disappear.

Getting out of Town

It is rice harvest time in the valley. We visited a friend’s ancestral farmhouse and I did a house call on her dad’s shoulder. I will return back before we leave to inject his shoulder in exchange for some of their freshly harvested red rice. It was really a treat to see their farmhouse, which had implements from century ago. Pigs and cows still occupied the ground floor. Second floor is the granary filled with dried peppers, rice, corn, potatoes, apples, persimmons, etc. The third floor is living space and their personal family shrine. The wooden ladder above led up to the open-air attic. No heat. Running water and electricity added a few years ago. The two seventy year olds seemed very happy as they served up some delicious sweet milk tea.
Last weekend we took a road trip to eastern Bhutan. We hired a driver and drove 300 km to Bumthang for a festival. Hiring a driver was interesting. We had to actually talk him into how much money we were going to pay him. He seemed embarrassed when we paid him more than he had asked. Interesting place! During our trip we saw another distinct representation of the country. I now know why 75% of this place is still virgin forest. It is simply impossible to log. The road is famous for motion sickness. We estimated that there were about 10 hairpin turns per kilometer (no exaggeration). There were three high mountain passes each with its own decorations of prayer flags. The road is one lane, rare guardrails or impediments to a surely fatal 500 meter drop-off, impenetrable forest everywhere. There were waterfalls, small repaired landslides, shrines, and it was raining much of the time. Every once in a while we would come upon a beautiful valley with rice terraces or small farms. Monasteries seem to be built out in the middle of nowhere. In the road we encountered two species of monkeys, cows, goats, horses, the ubiquitous dogs, people milking cows, monks, Nepali and Indian road workers, and one person lying in the middle of the road who had consumed too much arak. This road equals the nail biting we did in northern Pakistan, Nepal, and Tibet. I asked one of the docs I work with about how long it takes him to get to his parents house in eastern Bhutan. It is a three day 10 hour car ride followed by a six-hour hike to get to his village. Narrows bridge traffic will now have a relative perspective for me.
We stayed one night of our trip in the Probjikha Valley in an ice-cold traditional farmhouse. Natalie was not impressed. IT WAS COLD! The valley floor (at 11,000 feet) is filled with small farms and fields of dwarf bamboo. The rare black-necked cranes migrate across the Himalayas from Tibet in December when the valley is snowbound. They know how to get away from it all. All electricity was solar and the kids were fetching water from the communal well in the morning. Thimpu seemed like Manhattan. This is where the bear-mauling guy came from before he was transported by rickety ambulance seven hours over the hairpin turns to the referral center of Thimpu.
In Bumthang, we hoped to go to a festival. Unfortunately, time is relative in the monastery calendar and we only caught the tail end of the dancing and festivities after our ten-hour death defying drive in the rain. Our dates did not correspond with their dates. (This year a couple of months doubled) However, in true Bhutan fashion, the monks at the monastery realized out disappointment and took out their ornate costumes and masks and put on a private show for us. They were laughing and having a great time. Nobody asks for money, which is amazing since the monk allowance is $5.00 per month. We visited a bunch of famous monasteries and dzongs. Natalie is actually getting used to gutteral chanting, incense, thousands of Buddha statues, butter lamps, and monks blowing horns made of human femurs. It is amazing how she acclimated to all this stuff. For me, every monastery is still quite special. They are peaceful and dramatic at the same time. Each one is different. We got the opportunity to visit a 500-year-old monastery that was getting a facelift. The amount of labor and the artistic and architectural talent of the laborers are amazing. All the buildings are built with massive hand hewn timbers without nails. Ornate carvings cover all the wood. It is done the same way now as it was 500 years ago. No machinery or shortcuts. Pretty amazing.

Dark Side of Shangri La

There is one dark side that we have seen in Bhutan. All are not Happy in Shangri La. The king and his ministers seem to have made the decision that you are either Bhutanese or nothing (a refugee). There seems to be an arbitrary reasoning regarding who is granted citizenship. If you are not a citizen you are not afforded all the perks in education and jobs. It is unfortunate if you are ethnic Nepali or Tibetan and you are not a citizen. The Minister of Home Affairs was very excited to explain the concept of Gross National Happiness and the overall future goals of the king, which are quite impressive for all the Bhutanese citizens. For those that are not Bhutanese the outlook is more guarded. There is a definite pecking order here. Most of the laborers are imported from India and Nepal. ManyTibetans are still refugees despite the fact that they have lived here their entire lives.