MY MESSAGE TO ALLEN MELLICOR REGARDING
NEPAL
AND THE SAFETY OF PLANS TO WORK THERE AFTER THE
ROYAL FAMILY MASSACRE
From: Glenn Geelhoed
To: "abmbknon@mozcom.com".IA4GW.Harper
Date: 6/25/01 11:33AM
Subject: Re: Fwd: Re: Going to Ladakh!
Wonderful! Keep me in mind for a future Vietnam visit!
RESPONSE REGARDING NEPAL TRIPS
Yes, things have quieted down in Nepal. I enclose two notices regarding the safety and current stability of going to Nepal, which I would encourage you to continue planning, since you will be there in September, while I am in Spiti Valley in the Himalayas, and then I go from Delhi to Kathmandu on October 1 to go up to Lukla for the medical camp on the Everest Trek route. I had previously done the Everest trek (see attached for description of the Nepal Lukla clinic and the trek) so I will be needing to bail out at Namche Bazar around October 7 to make my way back to New Orleans for October 9 to the ACS Clinical Congress at which I am giving a presentation on medical missions.
So, I am first giving you a description from a climbing company, pasted below this note:
THE ASSESSMENT OF A CLIMBING COMPANY AND THEIR LIFTING
OF WARNING S
ON NEPAL‑‑‑AND COINCIDENTALLY, THEIR PLANS TO BE SCOUTING
THE
AREA OF THE REMOTE SPITI VALLEY, WHERE I WILL BE IN September,
AS WELL AS THEIR ROUTES IN CLIMBING STOK KANGRI, FOR WHICH I HAD
(POSTPONED) PLANS FOR THIS OCCASION IN LADAKH IN July FROM LEI
JAGGED GLOBE NEWS ‑ June 2001
‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑‑
==[ NEPAL OPEN TO VISITORS ]==
‑‑‑This week, the advice not to visit Nepal has been lifted
by the Foreign & Commonwealth office which is a great relief to all those
who are planning to trek or climb there this autumn:
"Following the killings of members of the Royal Family on the night of
1 June and the subsequent period of court mourning and wide social unrest, Nepal
has now returned to normality. Most visits to Nepal remain trouble‑free."
+ More info http://www.fco.gov.uk/travel/countryadvice.asp?NP
_______________________________________________________________
==[ ALPINE COURSES FULL ]==
‑‑‑Our 2001 Alpine course programme is now fully subscribed.
If you would like to join a course next year, either as preparation for an expedition,
or to develop your skills for your own climbing, the 2002 dates are available
to pencil in your diary. We are really looking forward to this season,which
kicks off in the first week of July. There are climbers testing out our new
courses; Chamonix Climber and Zermatt Giants as well as those joining our Guides
on the tried and tested ones such as Alpine Introduction and Mont Blanc Summit.
Normally, we would post up some interim reports of conditions and how each week
has gone, but as I will be in Greenland throughout the whole of July, you will
have to wait until August for a full update! Of course, you are free to call
the office at any time for information.
+ http://www.jagged‑globe.co.uk/course/alps.html
_______________________________________________________________
==[ EXPEDITIONS IN PROGRESS ]==
‑‑‑Some brief updates on Jagged Globe expeditions currently in progress:
~Gasherbrum II
The team reached base camp last Friday and should now be making progress through
the icefall to establish camp 1. Expedition leader, David Hamilton, sent a
report through at the start of the week saying that they had a very hot trek
in up the Baltoro valley, but the last few days have seen some rain low down
and snow fall higher up. David expects about a dozen teams to arrive in base
camp over the next couple of weeks, a Japanese group are already making good
progress and have fixed some ropes lower down on the mountain.
Gasherbrum II is the most popular 8000m peak in the Karakoram which we have
climbed twice previously in 1998 and 1999. We hope to have some more news of
the team's progress soon.
http://www.jagged‑globe.co.uk/news/despatches_list.html?id=9
~Denali
Our third Denali group are on the mountain at the moment and hoping to have
the same level of success as the first two teams this season, in which all climbers
summited. Experience, preparation and patience is the key to North America's
highest with its notoriously bad weather, which can pin a team down for days
in one of the high camps. A season round‑up will follow at the beginning
of August.
http://www.jagged‑globe.co.uk/exp/itinerary/denali.html
~Spiti Reconnaissance
The team are all set and will fly into Delhi this weekend. John Eames and
Bonny Masson are leading the group into this remote and little known region
close to the Tibetan border, which has been closed to foreigners until very
recently.
http://www.jagged‑globe.co.uk/exp/recon.html
+ Contribute an expedition report: http://www.jagged‑globe.co.uk/exp/reports_form.html
_______________________________________________________________
==[ WINTER ICE CLIMBING IN THE ALPS ]==
‑‑‑This December and January, we are running a small programme of Winter Ice
Climbing in the Chamonix area. Dates and prices have yet to be finalised,
but with only 12 places available over a three week period, we're advising anyone
who might be interested to get in touch and let us know
mailto:expeditions@jagged‑globe.co.uk. More details will follow.
_______________________________________________________________
==[ NEW KARAKORAM EXPEDITIONS IN 2002 ]==
~Drifica (6,447m)...A technically demanding expedition for experienced mountaineers.
Grade: 5C‑5D
Dates: 3 August to 31 August 2002
http://www.jagged‑globe.co.uk/exp/recon.html
7~Hanipispur Peak (6,000m)...A rarely climbed snow peak next to the Ogre and
Latok peaks.
Grade: 2B
Dates: 31 August to 28 September 2002
http://www.jagged‑globe.co.uk/exp/itinerary/hanipispur+peak.html
_______________________________________________________________
==[ NEW DEPARTURES & SUMMER AVAILABILITY ]==
‑‑‑Due to popular demand, we are running additional departures for these expeditions in 2001:
~Mera Peak.............Saturday 22 September to Monday 15 October 2001
~Aconcagua (Horcones)..Tuesday 18 December 2001 to Thursday 10 January 2002
Please contact us for further details if you are interested in any of these
expeditions. There are still some places available on these expeditions which
run in July and August:
Stok Kangri........Saturday 4 August to Saturday 25 August
Ecuador Volcanoes..Tuesday 10 July to Sunday 29 July
Ecuador Volcanoes..Tuesday 14 August to Sunday 2 September
Kilimanjaro........Tuesday 24 July to Saturday 4 August
Kilimanjaro........Tuesday 7 August to Saturday 18 August
Muztag Ata.........Saturday 28 July to Saturday 25 August
Spantik............Saturday 28 July to Saturday 25 August
+ Access the itineraries at: http://www.jagged‑globe.co.uk/exp/
_______________________________________________________________
==[ 2002 EXPEDITION AND COURSE DATES ]==
‑‑‑Dates for 2002 are now available on‑line:
http://www.jagged‑globe.co.uk/exp/
Please get in touch if you would like a booklet itinerary for a specific expedition
or course, or if you'd like to chat to someone about a trip that you're interested
in.
Email: mailto:expeditions@jagged‑globe.co.uk
Tel: +44 (0) 114 276 3322
_______________________________________________________________
==[ JAGGED GLOBE MAGAZINE ‑ 'THE SHARP END' ]==
‑‑‑If you haven't received a copy of The Sharp End, then do let us know and we will get one to you. If you'd like to contribute to the next issue, please contact: mailto:tom@jagged‑globe.co.uk.
_______________________________________________________________
=============================
Tom Briggs, Jagged Globe
The Mountaineering Specialist:
http://www.jagged‑globe.co.uk
Second, I am giving you the advice of my own outfitter, Himalayan Spirit, which also has judged the conditions to be safe to return:
HIMALAYAN SPIRIT ASSESSMENT OF OUR RETURN TO NEPAL
Dear Friends,
You all must be aware of the political situation and unrest in Nepal that followed
the royal massacre. The current situation has improved considerably and is not
expected to effect our planned visit. The special investigation that was ordered
by the new king resulted in the Crown Prince being held responsible for murdering
his family. This has brought respite amongst the local people who were asking
for answers from the new ruler. Rioting and clashes with the local police have
stopped. We are keeping a close watch on future developments in Kathmandu,
and in the event of any major changes, we will inform you. Our schedule stays
as originally planned. I will be away on a medical expedition to Ladakh from
July 8 ‑ August 15.
Final flight schedules, international and domestic (within Nepal) will be forwarded
to you by our travel agent.
Please feel free to contact me with any questions or concerns that you may have.
Ravi I Singh
404‑929‑9321
MY OWN ADVICE REGARDING HIMALAYAN HEALTH MISSIONS FOR THE CULTURE AND MEDICAL MILIEU
Third, I will give you advice of my own from extensive experience with these Himalayan enclaves of Buddhist culture tucked into Hindu nations. Some of this advice may be found in the descriptions I have written on each of the trips you can find on my home page: http://home.gwu.edu/~gwg You can check on Dharamsala Apr. 2001, Ladakh July 2000 (and also forthcoming in July 2001), Nepal in September 1999 and Spiti, Himachal, Sep‑Oct. 1998 forthcoming again in Sept. 2001)
First, respect the Buddhist holy places, which means that no one defiles them by exposing the left hand ( the "unclean" side) to them, and like wise the soles of the feet. Therefore, we pass all chortens, Gompas, Mani walls, prayer flags, prayer wheels‑‑on our right side, and do not sit with legs outstretched to expose the soles, rather squatting in lotus position when in or near a holy place. Do not touch anyone but a child upon the head, and respect the modesty of the women‑‑which means we need to have a female to do examinations of women below the waist.
In our remote clinics, we do mainly the kind of screening that you just did in the Vietnam mission, seeing about 1500 patients per visit. The categories of illness are usually of three fixable kinds‑‑‑1)aches and pains of osteoarthritis from severe hard work climbing mountains, but usually only brought to our attention when it involves the knees, since it is disabling (have you seen an Asian "toilet?" The other remarkable relief comes from freeing frozen shoulders after injection of supraspinatus tendinitis 2) Peptic or biliary abdominal pain, because there is a lot of endemic Helicobacter pylori. Carry a lot of H2 blockers and antacids. 3) Infections ranging from otitis, to pneumonia in kids, and cystitis to abscesses in adults.
Of the kinds of diagnoses I have made that need specialty attention include a lot of ophthalmologic problem such as cataracts and pterygium‑‑we have carried an ophthalmologist from Simla and kept him busy and I have picked up a few glaucoma patients I have sent to him. Dentistry is a full‑time job, and I have had the medical students with me pull abscessed teeth as an exercise each one of them should be familiar with. I am trying to carry the kits that Al Respicci made me familiar with for fluoride prophylaxis, as well as cases of toothpaste and toothbrushes which we distribute to school children in a very formal public health program of instruction. The biggest disease that needs finding and continuing follow‑up treatment is TB‑‑‑and we see a lot of that. There is allegedly a government program to follow that, but I try to hook up with the local group, and work with the health worker in the Himalayan Foundation that Hillary started for Sherpas, and also link them to the Foundation's hospital in the Everest area to get multiple drug therapy. I have found a few ( but fewer than you would expect) malignancies‑‑most notably, lymphoma, which we referred, without much confidence for their followup treatment. What I have found by the HUNDREDS, and have longed to treat the simpler of them, have been untreated congenital malformations and late neglected adult conditions. These include especially talipes eguino vera, the adult clefts with which you are so familiar, and —‑of course‑‑‑goiters, parotid tumors, hernias, and advanced cutaneous conditions such as basal cell ca, cutaneous horn, and SCC from the high altitude sun exposure.
The chronic conditions do not have a long life here, yet there is a triple hit for pulmonary disease, form crowded conditions in huts for long wieners with limited fuel giving high TB incidence and propagation, yet they also have the hypoxia of altitude and beyond that‑‑they somehow find a way to smoke! For these reasons, I am packing a battery operated pulse oximeter for each of the missions.
There are few facilities to do anything in the remote clinics. We fixed a hernia in Kinnaur Valley under stressful circumstances with a disastrous result. We should not try to invent a surgical suite, but help the nearest one to which we can transport the patients, even if it is a long way away. I would recommend that you get in touch with a superb physician Dr. Buddha Basnyat (nic@naxal.wlink.com.np) who is a pulmonologist, trained in Arizona, and the onsite medical director of the HRA (Himalayan Rescue Association) who works out of Kathmandu at the mission hospital there, an institution I would like to continue to support.
You may find some hostility along the trek routes for someone who is visiting and intending to operate. I may have had one of my own unlicenced trip members who was released from our group for inappropriate unsupervised activity who hung on for months promising casual medical care and disappointing a number of people who believed the empty promises of Western care freebies, devaluing the local health care facilities. The Himalayan Foundation Hospital along the Everest Trek Route had several experiences that sensitized them to write a blistering opinion about "Medical Tourism"‑‑which states that if "First of All, Do No Harm" is the axiom, any medical personnel who are breezing through without a carefully integrated plan of support to the local institutions are doing harm by "one off" disposable treatment as they go along. I will get you this opinion and attach it with further mailings on this subject.
I have found the MAP packs to be very helpful in our treatment of the most frequently encountered problems. They can be augmented with medicines for the specific conditions seen in prior experience in the area, and we have added anti‑diarrheals, Cipro, vitamins, skin creams and antibiotic ointments along with steroid skin creams, and vitamins. I would think Iron and Iodine repletion would also be a good idea.
I will answer further specific questions you may have, but recommend that you look over the Nepal‑99 book ‑‑as part of my series "HIMALAYAN HIGH: A Trilogy of treks and medical missions Along the Roof of the World" I have written on the experiences there which I will attach in a separate mailing.
I now have four people eager to jin me in the Mission to Mindanoa in Feb 2‑‑16, particularly since it seems I might be coming from Goa to Southern Africa and a mission to Malawi in late January coupled with a Southern hemisphere circumnavigation to make my way to Mindanoa. One is a surgeon, one a plastic surgeon, and one a family physician with a need for surgical training as a medical missionary, with another generalist. There are also two senior students eager, but before you count on my taking over the whole mission, remember that all of these folk are subject to the same drop out rate I have expereinced with many highly enthusiastic people in the past!
Meanwhile, do not hesitate to consider Nepal safe, even though it is a somewhat complex area to do good medicine in, particularly since it is so popular that everyone wants to come out to putter in health care casually while turning their eyes toward the Himalayan Massif with another motive in mind
I hope we can pull together the medical missions we have planned while life, and skill and health are still gifts we can share from their abundance! You know that is why I continue to get out of bed each morning!
Cheers!
GWG