Summer reading for #Globalsurgery

The Sacrament of the Goddess is a great “beach read” for persons who want to be transported to an exotic time ( in the recent past) and place (on the far side of the planet from Boston).

It’s a way to learn the boots-on-the-ground of #Globalhealth and #globalsurgery without wading through a textbook. The story of working in a remote hospital in the Himalaya is told through the eyes of an international crew of medical volunteers working with a team of Nepali and Indian doctors.

Doing surgery is hard enough and it is not the usual experience to be around sick people every day. Taking your skills and offering them to people of another country during a civil war will take the challenge to a new level. Soon you are thinking about commitment, courage and sacrifice in a different way.

This book is available on Amazon.

 

 

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Pre Reading for DHMC Nursing Grand Rounds Feb 19th

UPDATE April 4th, 2016

CCNEPAL will be at #CUGH 2016 in California. If you are in interested in global health in Nepal, find us there! Here are some links to look at before hand….

Pleased to announce that I will be the guest speaker for Nursing Grand Rounds at Dartmouth-Hitchcock Medical Center. The talk will be held at 12 noon in Auditorium F for an hour, Friday February 19th, 2016. DHMC is in Lebanon, NH.

I made a FaceBook event page for this. Tell your friends!

Here is some reading that will enhance the meeting, along with some random photos.

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I got on another bus the next day. we drove past the first one.

I will bring a powerpoint of my favorite pictures from Nepal.

what do nurses want to know……

Nurses want the unvarnished truth, without sentimentality and without the glossy glamor.  Nurses may be picturing themselves there, doing patient care, interacting with the people, living the life, sharing their knowledge with newfound friends. Facing life’s issues – birth, death, sickness, tragedy- in a foreign culture.

blue tarp on hospital floor

This is in Kailali. It is not customary for any hospital to lay out the blue tarp. If tear gas is used, there is a noxious powdery residue. I presume this is the reason.

The main thing is, I do not present the “Fantasy Nepal.” The Nepal I live in when I am there is the one where we work to heal sick people and address human suffering. There are many dimensions.

Here are some things from the Internet to look at before we meet:

Learning about Culture Shock and Re-Entry Shock

http://www2.pacific.edu/sis/culture/. this is a critical resource for personal adjustment pre- and post-deployment on any global health experience, as well as for any disaster response.

My blog entry on How to prepare for global nursing. These are practical tips for how to lead your life as a cosmopolitan citizen of planet earth even if you never do a global health adventure.

Risk Reduction strategies

This is important if you are a newbie. The single most important risk reduction strategy is to eliminate alcohol use.  Click here for a more comprehensive analysis

Nepal-specific information

Subina Shrestha’s video on childbirth in rural Nepal. She has a terrific vimeo channel. She archives all her work for Al Jazeera English, there.

IMG_20150406_064800

This book is a resource for every critical care unit in Kathmandu, and every nurse or nursing student. a Major reference book!

My blog entry on burn care, with all the links.

My blog entry on the differences between USA and Nepal hospitals. I used to use those pics when I did these talks, but I have more interesting stuff to cover these days!

 

marigolds 3

The FaceBook page for CCNEPal. There is also one for each of my two books. Look at the links to the right.

the Web Page for The Center for Medical Simulation. This is Nepal’s only American Heart Association International Training Center. If you are an ACLS or PALS Instructor, they would love to talk with you!

The twenty-minute video that shows what I do when I am in Nepal.

The Event February 19th

Here are the specific goals and format:

Title:

Nursing Grand Rounds in Culture and Global Health

short summary: a quick review of factors in Nepal that impact the
decision to volunteer in a global health nursing role.

objectives:

examine aspects of personal readiness to volunteer in a Low Income Country.

Identify “culture shock” and “re-entry shock”

identify common myths about global health nursing.

create a personal plan to prepare for future role as a Globally Aware Nurse.

format; a slide show of about 40 pictures with minimal text. A
reading/viewing list related to Nepal health system will be available
online for study by attendees. About thirty minutes of the time will
be devoted to Q & A. During the presentation, participants will be
encouraged to text their questions to the presenter.

 

 

 

 

E

“Bride Burning” in Nepal and burn injuries

From Sushma Koirala Memorial Hospital web page. The subject of burn care in Nepal has many facets.

From Sushma Koirala Memorial Hospital web page. The subject of burn care in Nepal has many facets.

On my DailyKOS blog, I relayed the  news of a motorcycle driver set on fire trying to sneak past protesters with petrol in his tank destined for black market sale. As an aside, I reminded the readers that “Bride Burning” is still an issue in South Asia. Including Nepal. A couple of readers expressed their horror at this. I thought about a DailyKOS blog entry, but I’m sure I will need to update such a blog after writing, and I also want to see the analytics. so – this is a better home for it.

Update, Here is a paragraph for links to news stories, starting Jan 20th 2016

I think I will use this paragraph to update as news stories are published. So you think it never happens? click here. Or, for a Jan 21st account of how a child got burned intetionally, click here.

Update, August 9th

I’m teaching my course at Kirtipur Hospital, and I found this video about burn care at that location. highly worthwhile https://youtu.be/6gWR010kn_A

Before we go any further,

view this video. Why? because it presents burn injuries, and the dedication required to treat them, with compassion and dignity. It shows Sushma Koirala Memorial Hospital in Sangkhu, which is especially dedicated to burn care and plastic surgery.

Also this, and this other from the International Nepal Fellowship.  The first is about a young girl with burn injury care, and the second is an intro to INF. It’s quite tastefully done. The second one shows scenes of Mugu, a place in Nepal where tourists are not often seen.

I had not really worked with burn injury victims until I came to Nepal. About a third of my first book is devoted to my experiences on the burn ward in 2007; and a  significant episode in my second book also addresses the reaction of the main characters as they care for a victim of “bride burning”.  Part of my motivation  for writing the first book was to exorcise the PTSD of doing this work.

Executive Summary

Watch this piece by Subina Shrestha about Dowry violence and bride burning.

img_20161230_073310

“Agni Pariksha” of Sita ( or of Maya Sita if you prefer metaphor)

Above – from a puja poster depicting scenes from the Ramayana – the “Agni Pariksha” of Sita. A test of chastity and truthfulness. https://en.wikipedia.org/wiki/Maya_Sita

Bride-Burning is also descended from “Suttee,” a practice in South Asia for centuries.

The practice was initially legalized by the colonial British officials specifying conditions when sati was allowed;[2] then the practice was outlawed in 1829 in their territories in India (the collected statistics from their own regions suggesting an estimated 500–600 instances of sati per year), followed up by laws in the same directions by the authorities in the princely states of India in the ensuing decades, with a general ban for the whole of India issued by Queen Victoria in 1861. In Nepal, sati was banned in 1920 B.S.(1863 AD) The Indian Sati Prevention Act from 1988 further criminalised any type of aiding, abetting, and glorifying of sati. from Wikipedia https://en.wikipedia.org/wiki/Sati_(practice)

IMG_20141126_130136

At the inner gate of the palace in Jodhpur, India commemorating the suttee of the Maharaja’s wives after his death. I got the audio tour for this fort, and the account of this was riveting and heart-wrenching. Before they left the palace for the final time, each wife dipped her hand in ochre and left a print. Note: I am well aware that this is a reference to Indian culture, as opposed to Nepali.

To learn more about the above, go to  http://www.atlasobscura.com/places/sati-handprints

A suttee event forms one of the climactic scenes of the book, The Far Pavilions, a best-selling novel in USA in 1978.

Bride-Burning

Bride-burning is still a “thing” in South Asia. It’s related to the dowry system. At the time of marriage, the parents of the bride give gifts to the groom and his family. If the groom is dissatisfied with the woman or with the size of the gift, he may return and demand more. If at that time the bride’s family is not able to give an additional gift, the bride is punished. The ultimate form of punishment is brideburning. It is an extreme form of domestic abuse.

nov 28 dowry system

From:

http://gitaghatimagar.blogspot.com/2015/02/dowry-system-in-nepal.html

Up to 2,500 women a year are affected throughout South Asia.

Clearly this is a crime deserving of the highest punishment for the perpetrator. It is a bitter truth that it often goes unpunished.

Click here for a three-minute video.  (disclosure: it includes still photos of women who survived burning, with disfigurement).

WOREC NEPAL

WOREC is an NGO that promotes women’s rights and empowerment. This includes anti-trafficking, but also ending the dowry system. Here is their page specific to Violence Against Women in Nepal.

Mass weddings

Here is another description of  a way to combat the dowry phenomenon in Nepal.

Teen Marriage

This is part of the puzzle. Here is a place to read more.

Chaupadi

Here is a link to issues related to menstruation.

Treatment of Burn injuries in Nepal

In November 2015, a description of rehabilitation after burn injury.

Picture 190

the baby was a burn victim, and an indelible memory of my first trip to teach nursing in Nepal. I had not given burn care much thought before that. Risk reduction efforts are needed nationwide in Nepal.

Burn Violence Survivors Nepal

There is an NGO that deals specifically with this issue. It’s Burn Violence Survivors Nepal. They have a YouTube Channel, of course. I viewed some of their short clips; I recommend “Gudiya” and also “Mina” – this latter one described a person who attempted suicide by self-immolation but survived. As you might imagine, a person who chooses suicide by this method has generally internalized severe self-hatred and desperation.

Treatment of burn injuries

There is a FaceBook group for the Nepal Burn Society.  After I joined that group, I learned about a workshop in Nepal led by an international NGO that brings reconstructive surgery to Low Income Countries named ReSurge International.  They have one video titled “About Us” that gives a summary of their work worldwide.  “ReThink Burns: A Solvable Global Health Crisis” is another good summary of their specific work. (The video shows some persons with burn scars that may be – unsettling). Also, I recommend the thirty-minute video titled “A Story of Healing” – it describes the rewards of doing the work from the perspective of the surgeons and nurses. I just don’t think any nurse or doctor would be capable of watching this without tearing up.

Epidemiology of Pediatric Burns in Low Income Countries worldwide

The Consortium of Universities for Global Health  includes a module on epidemiology of pediatric burns on the resources section of their webpage.

The psychological challenge for those who deliver burn care

Burn Unit: Saving Lives after the Flames is a book about nurses at Massachusetts General Hospital. I haven’t read it, myself.  Sounds like a good place to start. I wrote about victims in each of my books about Nepal health care.

9781632100085-SOTG-Nepalt.indd

The back cover of the USA edition was a short synopsis. By the time we printed the Nepal edition, there were some reviews to quote and they were more colorful. In a bookstore, people make decisions to buy based on the first page and back cover, or so they say.

The book is about medical care in the hill country. you can get it on Amazon https://goo.gl/PGTW30

The Art of Criticism and the Greatest Book Review Ever Written

http://abroad62talkative.channelseven.org/

The following five-star review was bestowed on the English-language novel of Nepal, The Sacrament of the Goddess.

Written in 2014 to explore the aspects of Nepali culture that go beyond the temples and trinkets. The day-to-day life in Nepal is not easy. You can get this book at Vajra Books on Jyatha in Thamel, or Tibet Books. Or Amazon http://www.amazon.com/Sacrament-Goddess-Joe-Niemczura/dp/1632100029/

Written in 2014 to explore the aspects of Nepali culture that go beyond the temples and trinkets. The day-to-day life in Nepal is not easy. You can get this book at Vajra Books on Jyatha in Thamel, or Tibet Books. Or Amazon http://www.amazon.com/Sacrament-Goddess-Joe-Niemczura/dp/1632100029/

I believe this is a positive review, more or less….. you read it for yourself and decide…….

Book Summary:

I dont generally read hospital you do so. On the goddess took me they are all beings with nepalese maoist. Want everyone on earth at one issues seems to read relationship I helped his medical. All invited to good medical background and a love eastern side. Low income country known as a nurse volunteering. That I must unravel the top of both familiar and accurate. Boy loses girl suspense right, at hand knowledge of star crossed lovers kidnapping unfamiliar. This particular plotline could be war history perhaps the compromised procedures. Want to capture images of the way. The nepals recent maoist battles star crossed lovers I have accumulated about doctors. If anything interests me a nurse volunteering at registered. Unable to portray a love of, them out of nepal all. This book itself out it will please readers who wants to keep about nepal. Any nurse journalist nyc in usa.

To need to day at a summer coaching nursing in addition. That I learned in nepal civil war between fiction. All the plotline could almost be, bigger and affection how. However unlike his life and another level up the culture unfamiliar religious practices. I helped his love war which, is where am a clinic without being. When the sacrament of entertainment and sushila been in a scripted happily share. I must thank the book revolves around. In nepals recent maoist battles and of his many life the sacrament. Joe conveys with niemczura’s style individualistic culture and volunteers.

The end when you are beautifully, written a trek during the book moments. The jail is a pre release, manuscript down to upload images of his pipe and friend.

If anything interests me I will tell me. Note the country’s civil war shreds group trumps eyes. On the infinite in nepal these days for plot of river and novels. He puts his medical scenes are likely centuries old mr. And its one issues into a small city in nepal this novel bring their. I have a low income country the sacrament of armed police force. It is made of the manuscript down for goddess not only wants. I was a small thing picture. There is so it in beni very same tin the west and anesthetized near. Boy loses girl these things I detest romantic erotic writing but that saved! Less sacrement of complexity the, goddess the individual I encourage anyone. Low water this way beyond the, hospital brings even though they do they. Less you are multiple layers as well a kindness and fruits so precisely. Writer novel to acceptable I met him with clean sheets.

Any Questions?

This review appeared in a foreign site that downloads e-books. The author was channeling James Joyce.

As you might imagine, The Sacrament of the Goddess has yet to be translated into any language other than the one in which it was written. Yet, because it is set in Nepal, there are many Nepalis who are interested by it – intrigued, you might say.

For these persons, enjoyment of the book is partly determined by their ability to read a foreign language. To write a review? even more of a challenge!

The site it appeared on is one that pirates e-books overseas. Yes, they got my novel; and yes, they wrote a review.

For a more coherent review, click here.

 

Petrol Tankers Blocked by Snow? The end of fantasy in Nepal-China oil deal Guest Post from SIngapore Petrochemical Expert

Note from Blog owner: as readers of this blog will know, I recently posted an analysis of the plan to obtain oil for Nepal via the Friendship Highway that goes through Tibet. Then I wrote a second part. Mr. Wilson Chin responded. He is a businessman based in Singapore, and he supplied pertinent information about the “Big Picture” of the Chinese petrochemical endeavor. Prior to his input I had no particular knowledge of where the Chinese oil came from. (turns out that they do not get it from the Persian Gulf. China is piping in oil & gas from Kazakhstan and Turkmenistan. They are however still buying a very large amount of oil from the Middle East. One of the difference is that oil from Middle East is delivered by Tanker vessels to the Chinese East Coast.). I invited him to write a guest post on the Nepal plan to get oil from China. Here it is. Click here to see the location of the original post. Please note that the captions below each photo are mine.

*********************************************

Breaking News! “Read all about it”. For those who had not, then, hear ye, hear ye! China is sending free petrol to Nepal up to 1,000 tons, in 25 oil tankers, the first to arrive next week. Collect your number, queue up.

Those who insist that China would come to the rescue is vindicated. Shame on you, southern neighbor, shame on you that you did not do more to alleviate Nepal’s thirst for petrol.

India and China have a history of rivalry. Ongoing border disputes occur at Jammu, Kashmir, Ladakh and Arunachal Pradesh. Some believe that Nepal’s 1,700 km buffer separating India and China’s province of Tibet prevented the dispute-philiac pair from having more disputed areas. After the Central Tibetan Administration went into exile in Dharamsala, India, the 14th Dalai Lama has been an excruciatingly painful thorn in China’s side. The issue of Nepal’s new constitution laid bare their rivalry. One could picture China rubbing its hands with glee . When the Constitution was signed, India, openly irked, “noted its significance”. At the same time China “noted its significance with delight”, praising the Nepali Government. When India was denounced for blockading fuel from entering Nepal (India officially denied that), China agreed to send 1,000 tons of petrol FREE OF CHARGE. India was almost silent over China’s generous gift. India was stunned but not defeated

Kathmandu, a month ago when petrol was being rationed. The weather was warmer at that time.

Kathmandu, a month ago when petrol was being rationed. The weather was warmer at that time.

Since 2013, when China mooted the New Silk Road, it did not expect to fast track a route that some believed was too ambitious. Emergency relief to Nepal’s earthquake in April 2015 showed cracks in logistical support from across Nepal’s border. How could that be possible from a giant, the second richest country in the world and in its own backyard? Six months on, the Friendship Bridge linking both countries is still un-passable. China and Nepal remain friends electronically when physical, feely touchy friendship proved difficult.

The road to Rasuwa travels through steep terrain on the Nepal side and landslides are common.

The road to Rasuwa travels through steep terrain on the Nepal side and landslides are common.

Tibet is one of China’s poorest provinces. At a GDP of $4,000/- per capita, it is only one fourth that of Beijing. In Tibet, all trains lead to Lhasa, the capital of Tibet, all trains to Lhasa come from Xining – the nearest City 2,000 km away, all trains run on the only railway line, the Qinghai-Tibet Railway, except for a new line joining Lhasa to Xigatse . China needs to develop Tibet – desperately. There are only two restive regions in China, Tibet is one of them. Tibet is Nepal’s northern neighbor. Tibet is Nepal’s hope. To reach Nepal, Chinese supply must first pass through Tibet

The Himalaya as seen from the North. It does not look so tall because the Tibetan Plateau starts at 12,000 feet elevation.

The Himalaya as seen from the North. It does not look so tall because the Tibetan Plateau starts at 12,000 feet elevation.

Tibet is Rich in tradition, rich in culture, rich in water, rich in sand, but hydrocarbon poor. As a result, a gas pipeline is planned to channel fuel to Lhasa over 1,400 km from Qinghai to make up for its hydrocarbon deficiency Nationalists, secessionists have been criticizing China Central Government for not developing Tibet, the same people are also complaining of over-development, accusing the Government of planning to populate the region with Chinese immigrants and diluting the Tibetan race. Still, development must proceed, even if such developments do not make economic sense like the loss making Qinghai – Lhasa railway.

The New Silk Road as many suspected is more than a “road”. It is the Chinese safety valve out of its growth stagnation, it is Chinese quantitative easing, it is a means to spend its way out of deflation. Cities are saturated with new ghost towns; there is only one way left to build, horizontally. Railways are the next poster boys, roads the next poster girls and pipelines the next supermodels. Money is no problem, finance least of its worries; China has billions of dollars in its New Silk Road Fund. When Nepal asked China to build a railway linking China to Nepal, China with no hesitation, went straight to the drawing board, and came up with an audacious plan to tunnel under Mount Everest – as if to say ” Match me if you can”. China is ready. With the merger of its Railway Companies into a mega – CRRC Corp, the second largest industrial company in the world, tunneling under Mount Everest could be its Expo to showcase its technical abilities; India’s troubles with Nepal was the opportunity China needed. With a broad stroke, Tibet is primed for a makeover. It stands to benefit from all the possible spillover economic activities made possible after India’s diplomacy with Nepal blinked. Solving Tibet’s secession tendency once and for all looks like a Fait Accompli.

China’s overcapacity needs more than Tibet, a vast province with a population of just 3 million. China’s New Silk Road initiative needs more than Nepal, another small nation by China’s standard. Roads, railways, pipelines would end up as white elephants if they all end in Tibet or Nepal. It would be a monumental economical coup if they all continue on to India and Pakistan. That card is however held by India and it is a wild card.

High Speed trains in a Chinese railyard.

High Speed trains in a Chinese railyard.

China National Highway 318 is perhaps Nepal’s best chance to reach the sea from the northern border. At 5,500 km, it is the longest highway in China. Starting at the Tibetan city of Zhangmu, the highway traverses 8 Chinese provinces and ends in Shanghai. Highway 318 is also dubbed one of the most dangerous highways in the world. Yes, it is a difficult journey, it would take a long time, it is for the brave, for the adventurous. Only the survivors will arrive at the Pacific Ocean

Switchbacks on the Friendship Highway leading into Zhangmu, the town on the Chine side of border.

Switchbacks on the Friendship Highway leading into Zhangmu, the town on the Chine side of border.

Underestimate India at your own peril. Silence is the nature of the Bengal Tiger, watching at a distance, with all access roads covered. The Tiger holds all the aces, Kolkata its ace of spades. The tiger is not giving Friendship Bridge even a second glance, the Tiger is not interested in any entry point into Nepal, knowing very well that all entry points are obstacle courses. They are peaks, troughs, valleys, rivers, snow, ice, cliffs and then sand, more sand and yet more sand. They are earthquake prone, with excellent terrain good for training special forces, training rescue missions, training helicopter pilots and mountain climbing. They are tailor made by nature for endurance testing of trucks, cars, tires and endurance driving. They are part of the highest mountain range in the world, the formidable Himalayas, restricting unwanted riffraffs at the same time restricting the flow of provisions and necessities. Mother Earth does not take sides. The tiger sits pretty and watches; it knows that it does not need to watch its northern flank – the great wall of Himalayas takes care of that.

Chinese workers surveying a landslide site.

Chinese workers surveying a landslide site.

ACE OF SPADES

a port in coastal China. This blog focuses on the land route to Europe but the Chinese are also developing the

Kolkutta port in Bangladesh. This blog focuses on the land route to Europe but the Chinese are also developing the “sea route”.

Never underestimate the tiger as William Blake immortalized it in The Tiger -“Tiger, tiger, burning bright….”

From Mr. Chin's LinkedIn profile.

From Mr. Chin’s LinkedIn profile.

Wilson Chin is a businessman and a consultant in energy. Wilson is totally neutral in climate change, with a passionate leaning towards environmental protection against pollution; similarly he is neutral in Nepal’s politics. He has done a lot of business in India and also in China and understandsthe geo-politics of the region. Wilson is most fascinated by the immense potential of Nepal’s Hydropower potential. His profile is listed in Linkedin.

part two of “What Every Nepali needs to know about petrol from China”

Buckle your seatbelt.

Yesterday’s blog entry about Petrol from China got 16,500 views and lots of comments. It was loaded with maps and statistics. I got lots of feedback.

There were still people who said I was a pessimist.

But it will be fine because -it needs to be fine!

that seemed to be the attitude.

Wishing will not make it so. Throwing a tantrum like a two-year-old, and calling names at anybody who disagrees, will not make it so either.

The Kathmandu Post described the plan to start an actual petrol shipment this week. Click here to read it. It’s possible that some of the oil will get from China to Nepal this week. The question is, whether that can happen every day, in quantities large enough. One kilo-liter of fuel may seem like a lot – but in normal times, it would only fuel the city for two or three days.

Here is the same road I described, with photos and videos.

Artists rendering from Kathmandu Post, showing shiny N.O.C. trucks at Rasuwa border crossing. This week there is a convoy of one million liters of petrol being shipped from China - and Nepal is sending 25 of their smaller petrol transports to bring it to Kathmandu.

Artists rendering from Kathmandu Post, showing shiny N.O.C. trucks at Rasuwa border crossing. This week there is a convoy of one million liters of petrol being shipped from China – and Nepal is sending 25 of their smaller petrol transports to bring it to Kathmandu.

the route is called the Arniko Highway. When gets to Rasuwa, the name changes to Friendship Highway.

Dec 19th update: click here for an article about the effects of the landslide on the two towns.

Friendship Highway first

Click here for an excellent Photo essay.

Here’s one about five minutes long.

There is a site called “World’s Top Ten Most Dangerous Roads” and the Friendship Highway was #2.

#2 Measuring 5,476 km and running from Shanghai to Zhangmu along the Nepal border, Sichuan-Tibet highway is not only China’s longest road but it is also one of the world’s most dangerous roads. The road has a record of more than a whopping 7,500 deaths for every 100,000 motorists who use it every year. The road will take you through vast landscapes with peaks vaulting skyward. Climate here is quiet unpredictable and it could change right in front of you. It is suicidal to driving fast on this road.

The Tibetan Plateau is generally about 14,000 feet or more in elevation above sea level. It is difficult to maintain blacktop in the cold conditions there.

The Tibetan Plateau is generally about 14,000 feet or more in elevation above sea level. It is difficult to maintain blacktop in the cold conditions there.

La Lungma pass is about the same elevation as Thorung La pass, the highest point on the Annapurna Circuit. Snow can fall at any time.

La Lungma pass is abot the same elevation as Thorung La pass, the highest point on the Annapurna Circuit. Snow can fall at any time.

This is on the Chinese side a few Km north of Rasuwa. It gets muddy. The risk of landslide does not end just because you are out of Nepal.

This is on the Chinese side a few Km north of Rasuwa. It gets muddy. The risk of landslide does not end just because you are out of Nepal.

Landslides are one thing. falling rocks are another.

Landslides are one thing. falling rocks are another.

The Border Crossing

The actual bridge from Nepal to China. This town was damaged by nearby landslides.

The actual bridge from Nepal to China. This town was damaged by nearby landslides.

This is a “Tank Farm” – something they do not have at Rasuwa. The policy is to offload the oil from a Chinese Truck to a Nepali truck. Each nation’s trucks stay within their own country or at least close. Without a tank farm the process of transferring is slower. Make you rown guess as to how long it will take to build this in Rasuwa.

Arniko Highway.

Click here for an excellent narrative of the conditions of the Arniko Highway. This was written for a Tour Company, to entice Western tourists to go to Lhasa !

When you find these videos and pictures, you have to be careful to see the year. Here is one from 2012. The road is “better” since then – sort of.

Much of the road follows a deep river gorge. The Nepal portion drops nearly 10,000 feet in 90 miles. Picture a truck loaded with fuel going downhill. Actually, convoys of trucks. The first convoy will be 25 trucks. Kathmandu was getting hundreds of trucks a day from Birgunj.

Much of the road follows a deep river gorge. The Nepal portion drops nearly 10,000 feet in 90 miles. Picture a truck loaded with fuel going downhill. Actually, convoys of trucks. The first convoy will be 25 trucks. Kathmandu was getting hundreds of trucks a day from Birgunj.

Switchbacks on the Chinese side, going down to Zhangmu. You can do your own websearch using “Zhangmu” or any of these terms.

The Kodari Landslide

This was on the Nepal side. crews worked around the clock to fix this road.

The April 2015 earthquake caused landslides that blocked every crossing in to China. The one at Kodari blocked the Arniko highway. it is presently one lane.

The April 2015 earthquake caused landslides that blocked every crossing in to China. The one at Kodari blocked the Arniko highway. it is presently one lane. surprisingly, this photo is from 2006! this is a recurring problem and could happen again. http://www.mountainsoftravelphotos.com/Tibet/Kathmandu%20To%20Nyalam/slides/03%20Landslide%20On%20Arniko%20Highway%20Just%20Before%20Kodari.html

The Potala Palace

Potala Palace, legendary seat of power of the Dalai Lamas. Many refugees from the Chinese takeover of Tibet resettled in Kathmandu. Kathmandu is now a center of Tibetan Buddhist study.

Potala Palace, legendary seat of power of the Dalai Lamas. Many refugees from the Chinese takeover of Tibet resettled in Kathmandu. Kathmandu is now a center of Tibetan Buddhist study.

As I wrote yesterday, the challenges of using the Arniko Highway are formidable. Just from a standpoint of the road conditions I do not think it is possible.