JUL-B-11

THE TANGSTE VALLEY VENUES OF THE LADAKH-03

MEDICAL MISSION, COINCIDING WITH THE

LADAKH FESTIVAL CELEBRATION IN SHACHUKUL

July 25—27, 2003

The day began with the exhilarating run which is my “signature run” at Leh: up at 5:00 AM then running before 5:30 when the buses and heavy diesel trucks load up with passengers and take off up the desert road over the town. The dogs have settled in for their long day’s nap after carousing noisily all night foraging among trash, fighting and making puppies, and we are headed up the brutal desert hillside, carrying my little new Minolta and a water bottle. All along the hillside are quiet men squatting in contemplative silence about fifty meters apart in their morning séance, a rather comical sight if it were not conducted so solemnly. The Halal Market had not yet got into the slaughter mode, and the sheep were in tight clusters all being calmed and stroked by their shepherds who were tenderly petting them with the same hands and bloody jackets that would shortly slit their throats and hang them up on the gutting pole when they stopped kicking at the blood-blackened trough in the desert dirt.

This time, instead of climbing on the slope to the point of turnaround, marked by the kilometer markers from Leh, and the exhortations put on the roadside by Himank “All blood are one spirit” we kept going seeing the outline of Tsemo Gompa on the hilltop in silhouette. The road leading to it is the mark of the turn for the top and we went under the prayer flags and over the cistern where they were building a new retaining wall with strings strung out to guide the masons. We paused for photographs with my Minolta, and I realized that Lee had no camera having used up his two disposables. So, I turned the Minolta over to him along with several rolls of Photoworks film. We ran down toward the irrigated valley with the green refreshing cool streams under the rocks and bowers of vegetation overhead. When we appeared in the town of Leh passing both the police station and the Chief Medical Officers’ station, we abruptly are in the middle of Leh and its “shopping district.” I went to the Gompa and monk’s school in Leh with Lee and showed him the prayer wheels and the Einstein quote about the future of religion as it evolves will most closely resemble Buddhism, without laws, guilt and punishment. Einstein was a great man, but not necessarily a theologian.

A great run! This is a good way to start any day, but especially this one! We are packed up and ready to head out from the relative urban comfort of the town of Leh, where we even had lukewarm water after our run, to head out to campsites in the Tangste Valley, saying farewell to electricity, warm water and showers, and this laptop which will be filled in upon our return to the land of electrons and even intermittent internet café telephone access.

FILING IN AFTERRETURN, THE EVNTS OF THE TANGSTE VALLEY

MEDICAL MISSIONS AND THE LADAKH FESTIVAL

We chugged along in the big old bus that was battered but somehow was able to grind its way through the rough roads and narrow turns. A few of the princesses preferred to ride in the jeeps, as more fitting their lifestyle of special perks in which they could stop and shop periodically for whatever they would like. One of those stops comes along early, as we pass Shey and Thicksay monasteries and reaches the fork in the road that goes to the third highest road pass Chungla—the direction we would be taking, and the other to the second highest road pass- Tanglangla Pass, which leads to Manali, about three days away. We had the usual peppery snacks and a cold drink and sought out the same spots everyone else seeks to relieve themselves, as though no one had ever thought of this heretofore, and it was a brand new inspiration to go behind the wall half constructed sometime ago before it became a smelly ruin.

We climbed through the very rough roads, along the exhortations from Himank about driving slowly and respecting all others, with cautionary notes periodically—my favorite is “Caution: Ice is Frozen Here.” There should be at least one mis-spelling per sign. We saw at that highest point in the pass a field of blue anemone-like followers, which seem to bloom at this time of the year, right out of the arid alpine desert adjacent to the edge of the glacier. The bright blue contrasts with the starkness of the bleak surroundings.

We bailed out at the monument celebrating the third highest road pass on earth, (having gone through the highest at Kardungla two days earlier) and the prayer flags and temple with the TCP “Traffic Check Point” at the marker of 17.620 feet. On the way up this was marked as 34* 07. 43 N 77* 33.94 E and my pulse oximetry bottomed out in the higher seventies in percentage saturation, with others around me on the bus not faring quite as well.

One of the good things about the bus ride is that I got a chance to talk to my seatmate, Jim Campbell, who had known me briefly, since he sat through a number of the medical tutorials and has been busy taking blood pressures and triaging the patients as they come in. Now we could talk seriously about a lot of things, since he both hunts and fishes and has a big bass boat, and is constructing his big garage and office complex for the toys he has which includes a big F-350 pickup truck although he preferred the Dodge Ram diesel he had had before. WE talked a bout deer and bird hunting and identified a few of the bird species along the way seen here. He is married to Shirley, his best friend and they have four daughters. WE have a lot in common, and we may exchange visits when neither of us in homelessness, as Shirley is now living in a trailer on the construction site. We may also work out an excursion for an ibex hunt to Kyrgistan and I put him in touch with George Sevich. We will keep close, and I will help him shop for a souvenir carpet at Leh, and probably carry some of his stuff back with me, while he will contact Virginia and possibly hand carry a letter to her in San Francisco and arrange a visit, since they live in a county for which he works about two hours above San Francisco. Shirley and he may arrange to go down to see the Phantom of the Opera while Virginia is singing it in San Francisco’s.

We got to a ford in the rock slides where the heavy snow melt had caused the creek to rise. A bus coming the other way had got stuck and there was a struggle to push it out of the ford as the waters swelled higher. Several attempts to pull it with a rope resulted in the snapping of the rope, of course, but not heads, arms or legs were taken off by the back lash. An army recovery vehicle eventually pulled the bus free and a few rocks thrown in to the deep spaces helped “pave” a second pass, and the bus made it in the upslope direction as we made it going down.

During the course of this donnybrook, I found the at my 38—80 mm Nikon lens has, once again, slipped its gear—something I have had repaired four times previously. So, it will be missing in action for the wide angle shots I would like to have for the Lingshed trek.

We arrived at our campsite, along the little stream near the PHC of Tangste and spent our first day their. A large part of our group went to the local school with the pediatrician, and sent back a thirteen year old, with a note that she had acute appendicitis and “Dr. Glenn should see.” I evaluated her, and found she had rather ordinary gastroenteritis, but no surgical abdomen. One of the premedical students who was confidant of her first ever diagnoses, was, and still is, annoyed with me for allowing this poor child’s appendix to burst, since, in her opinion based in a series of one, the child had appendicitis, and I should not contradict a confidant diagnosis agreed upon among them by consensus. That the young girl was bouncing along and feeling much better with no problem at all when seen six hours later did not seem to change her mind. She had asked me a lot of questions that seemed somewhat naïve before, but at this point I began tuning out the rather consistent and insistent pressing on the basis of her overdeveloped compassionate advocacy and rather underdeveloped skills, knowledge and experience. Hem got the later benefit of her endless stream of naïve questions and he patiently responded to them after I had signed off.

Tangste is 13, 065 feet and is at 34* 01.57 N, and 78* 10.01 E. It has only 242 residents, 111 M, 131 F, Under 5’s 14 M, 7 F. The whole of the Tangste Valley seemed to move out of Tangste and go to the neighboring village of Shachukul, where there is a Gompa, and where the parachute tent town that was clustering around the Gompa would be hosting the Ladakh Festival starting the day after our first clinic in Tangste. WE held rather good tutorial sessions with the students’ presentations improving and getting more efficient. WE decided to adjourn and cover the Ladakh Festival where they were celebrating it, and moved our operation to the Community Hall of the Village of Shachukul.

We saw patients in the Hall with several teams spread out, while a number of our group had gone to a local school along with the pediatrician. As truck loads of colorfully dressed Ladakhi nomads converged on the town square, we adjourned for lunch under one of the parachute tents. There we were able to witness a number of the elaborate and colorfully costumed dances of the Ladakhi performers in which the waving of bows and arrows and the twirling of swords were climaxed by the priestess stabbing evil in the heart. A group of red-hatted sect lamas oversaw these festivities and the ritual correctness of the dance, and played the gongs, cymbals and blared the horns at the right moments. It was a swirl of color, and the sights were mingled with the spicy and foul smells as well as the dinning of the repetitive mantras from the monks inside the Gompa reading from their Buddhist Scriptures. It was a very exotic experience, and I was one of the few Westerners present, despite the move of the Ladakhi Festival from mid-winter to the summer in an attempt to get tourist attention. This small village is a long way out of the way, and I was surrounded by throngs of Ladakhi people entranced by this story line in rapt and reverent attention, as they vigorously twirled their prayer wheels and also clasped their hands in blissful ecstasy as the evil was stabbed to death and the good would triumph in some cyclical ongoing Hegira. The parade of colorfully masked dancers were supervised by someone with a very large mask as the king, and behind them there were two people dressed in white sheepskins who spread flour in the pathway and covered the tracks of the dancers who had gone before. All of this was interrupted by the blaring of the horns and the celebration of some cymbals, and antlered animal actors would prance about, and a bogeyman was dragged out not the square as a sacrificial figure.

I believe I should have enough photographs to convince you of the Ladakh Festival’s authenticity!

COMPLETION OF OUR TANGSTE VALLEY MISSION AND RETURN TO LEH

I am now backing up to regroup in Leh, where the availability of this brief moment of electricity gives me a chance to recap these events. I have once again made an exhilarating run at dawn up and over the town, and have greeted four new participants who are going with us to Tso Morari to be “vetted” for the trek to Lingshed, before we are joined by the three GWU students and a number more people I do not know for a total of 15 for the Lingshed Trek. I briefed a group of four—one Scot named Lindsay who is a med student in London at Guys’s and Thomas;’ a pair of Med/Peds residents named Nicky and Yoko from Rochester NY, and Missy from UVA in Charlottesville, a freshman medical student. I know my own three GWU students and hope that the extra additions that Ravi has slipped into to the Lingshed trek will be up to it.

I went to my Kashmiri merchant friend and brought both Lee Dutton and Jim Campbell and helped them buy some genuine antique jewelry amulets, and then helped Jim buy an antique carpet. There is one very fine double knotted wool carpet from Kashmir from a Persian pattern of the hunt, which makes me interested, but I am not sure I need very special small rug but should contract with him to make me the right size when I figure out what size is needed in the newly redone Derwood... It is a special place to get antique Tibetan souvenirs, one of which was a Tibetan sword that looks like an extended Kukri, but I am not sure if anyone would appreciate a half millennium old sword especially if carried aboard an aircraft!

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