Traditional Bhutaneses Medicine Expressed on the Leaves of a Lotus Tree
       
          I'm attending a conference, established 18 years ago by my mentor, Karen Olness.  Dr. Olness wears two hats.  Wearing her hypnosis hat, she and her colleague Dan Kohen literally wrote the book on pediatric hypnosis. Her accomplishments in this field add up to more than any of us achieve in a lifetime. But she wears a second hat:  that of an expert in international health - specifically, helping out children after humanitarian disasters.  After decades spent helping out kids and their families after wars, floods and famine all over the world, she established this conference, "Management of Humanitarian Emergencies:  Focus on Children, Women and Families.  A Course in Disaster Preparedness."
         Fortunately, Bhutan has not seen the kind of humanitarian emergencies that have risen geometrically in the last few decades.   But with the total number of people at risk for humanitarian emergencies at 2-3 billion, with 50 countries either facing long term humanitarian crises or at serious risk of them, with over 51 million refugees in the world, the largest since World War II, and natural disasters in the United States happening on a regular basis since the first really big one - Hurricane Katrina, it makes sense for a pediatrician to learn how to help out.   And the earthquake in Nepal, which killed 9000 people and left 3 million homeless, occurred on the same narrow Himalayan seismic shelf which Bhutan sits on. The earth is folded up like an accordion in this region.  
           Since bringing her husband and young children to a refugee camp in Laos in the 1980's, then establishing the first pediatric residency in that country, Dr. Olness began Health Frontiers, an NGO that specializes in tending to the psychological and emotional needs of children and their families affected by natural disasters, war, and famine.  The faculty and participants here reflect her selflessness, creativity and courage.  I've become friends this week with Dr. Hem Sagar Rimal, the first developmental pediatrician in Nepal, his wife Archana, the only psychologist in their hospital in the east of the country, and Raj Pandey, a neonatology fellow here at Rainbow Babies and Children's Hospital.  Raj's town, in the Gandaki district, was at the the epicenter of the earthquake.  He flew back a week after the quake to help out. 
           Over dinner at a restaurant in Cleveland's Little Italy with the three of them, Raj recounted farms being cut up into slices with big rifts down the middle, and advising villagers on how to start rebuilding homes. 
         "Do you have an engineering degree as well?" I asked.
         "No," he smiled.  "It's called being a doctor in Nepal.  I take care of premature infants here," he said "but back home I took care of a 91 year old woman.  If there is no one else you do what you can."
         And what does he want to do next?   His dream is to establish a system of primary care medicine in his home country.  As in most developing countries, there is only acute medical care.  "So people wait until they are too sick to seek care, or go to emergency facilities" Raj explained.  (Sounded like the health care system in too much of the United States, still, I thought)  He wants to help build a system where preventative health care will be paramount.

         Dr. Hem as vice principal of the Nobel Medical College Teaching Hospital organized relief efforts in his area.
         "But the communication was very bad," he said.  "We had neurosurgeons and all sorts of specialists, only to find that the government was flying all the victims to Kathmandu."
         He and Archana most wanted to talk about their two sons.  As specialists in child development, they thought it was not surprising that their younger son mainly showed fear after the earthquake, but their older 16 year old son, mainly wanted to DO something.  Rather than study for his final exams, he insisted on organizing relief efforts among fellow students, that resulted in truckloads of supplies being sent to earthquake victims.
        When Dr. Hem described this to the group in the lecture hall, his eyes glassed over with emotion.  This is the only time I saw any of them display outward grief over the destruction and suffering they had witnessed.
        Dr. Hem and his wife preferred to talk about the previous four weeks.  This was their first trip to the United States.  They had been to Los Angeles, San Francisco, Las Vegas, Louisville, New York, and Washington before coming here.
        "What is your favorite city?" I asked.
        "Well we really liked visiting the White House," he said. "but our favorite place was Las Vegas."
        "Las Vegas?"  I asked "… do you gamble?"
        "No," he replied. "But we loved the way the city rises out of the desert, with the mountains and the sun in the background."
        And they were enchanted by the Grand Canyon.
        "That was fabulous," he and Archana said.

        They were mostly interested in hearing about my life, and my travels and work in Bhutan. In passing, I described the incidents (depicted in a previous blog) about the nursing students who laughed over the obese girl's crying when I showed the film "Fed Up", and the young man with cerebral palsy, who laughed, along with his friends when he fell walking to the hospital.   They looked at me with curiosity.   
            I said that one of my Bhutanese friends explained that since, in their Bhuddist tradition, they believe life is suffering, we need to be able to laugh at ourselves when we endure pain or sadness.  I immediately regretted telling this story, for obvious reasons. 
          "We are not like that," they explained --- a response which gave me more admiration for the good humor and generosity of spirit they displayed in the face of so much adversity.
           We talked about the history of Bhutan and how many people of Nepalese origin were expelled from the kingdom.  
           "60,000 of them were accepted by the United States" Dr. Hem said - a laudable gesture which led to other countries welcoming them as well.  
           The ethinic Nepalis from Bhutan are "more Nepali than the Nepalis" he laughed.  I told him that the Irish say this about Irish Americans in our country.
           He seemed to harbor no resentment towards the way his countrymen were treated in Bhutan.
           "They (the Bhutanese) are our brothers and sisters," he said.
And he said that the Nepalese people greatly appreciated that the government of Bhutan, led by its prime minister had sent a delegation to their country with one million dollars (US) in aide.
         
          But Bhutan was also busy this past month achieving a milestone, according to a facebook post by my friend Namgay Dorji. The kingdom set the Guinness World Record by planting 49,672 saplings in 57 minutes!  These 100 volunteers, working at breakneck speed, broke the previous record held by the Indian state of Assam. How each of these volunteers planted about 496 trees in one hour is anyone's guess!

           Our lectures have concentrated on disaster relief, but all the speakers have acknowledged that long term reconstruction, building of infrastructure, and maintaining a safe and healthy environment are what is needed in the long term.   Bhutan's policy of Gross National Happiness is the perfect example of this philosophy.