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The Elephant Cloud

Namaste

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I Don’t Know

January 30th, 2013 by · Asia, India

I don’t know Hindi, or Marathi, but I learned a little, then took a bus somewhere they don’t speak it. I didn’t realize the bus wouldn’t go all the way to the station and wonder if the driver knew that before we left Mumbai or decided that later, en route. The man behind me was surprised as well, he didn’t know either and had previously assured us it would. I hadn’t realized that Darlene conjured the long forgotten religion of her childhood on government buses that lurched and screeched thru the hyperactive city streets. I was thankful the rickshaw driver got us almost to where we were going, he didn’t know where it was either.

I didn’t know which hotel I would stay in until after I landed at the airport. I didn’t know how long it would take to reach the hotel or that we’d meet two elderly Jewish men on a pilgrimage to the historic synagogue. They didn’t know where the taxi we agreed to share was, or how much I paid for it, and I had to chase after the older of the two when he pushed his suitcase, on a roller, out thru the noisy, pressing crowds and into the mayhem of the streets. I didn’t know if he was senile when I found him, bewildered and surrounded by taxi drivers, hawkers, and the curious. I hadn’t realized it was his birthday or that when he sat in the air conditioned car, his body cooled, and he became excessively talkative. I didn’t know this chatter would last for an hour and a half.

We spend our mornings not knowing if we’ll get a delicious Indian breakfast of idli, puttu, or my favorite dosha masala. We don’t know who we’ll meet, but always love it when someone laughs at our hindi and teaches us something new. I learned that the word for the spicy pickled fruit is achar, but I don’t know in which language and when I asked for it the next day I got chilies. At lunch, in a small cafe full of locals, we don’t know if the sambar or chutney’s will make us sick, but the dosa’s are so good, we go for it. We did not get sick and we don’t know when we will, but it seems reasonable that we will, at some point, get sick.

We do know that the Indian head bobble means yes. And no. And maybe. It also means I-don’t-understand-you-and-maybe-if-I’m-lucky-you’ll-smile-and-go-away as well as I-don’t-know-the-answer-to-your-question-but-will-never-admit-that-ever. I do realize that they know that I wont know until they’ve long gone and cannot be held accountable. I look at my small wooden carving of Ganesh, a revered Hindu deity with the head of an elephant and a sweet tooth. I ask him if he knows and he doesn’t answer, but of course he does. That’s the kind of sense it all makes. So I keep him close.

I do know how much I enjoy not knowing. I don’t have that luxury in the states, and though I don’t know there either, I’m suppose to know. And that, my friends, is stressful.

But here, deep in the not knowing, surrounded by questions and curiosities, curries and fruits, I recline and smile and bask in the mystery of it all, under the lazy heat of the coconut palms by the old basilica just down the road from where the ancient chinese fishing nets dip and rise, in and out of the sea, somewhere in India.

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Writers Paradise

January 22nd, 2013 by · Asia, Thailand


Darlene lowered herself over the side of the boat into the surf and I passed down her bags and leapt in beside her. It had been thirty six hours of travel, thru South Korea, a night in the Bangkok airport, catching the first flight south to Krabi and finally this long tail, outboard motor. The beach before us becomes immediately thick jungle, rising slowly to an enormous crescent of limestone cliffs which blocks out thailand with it’s cars and noise. It is accessible only by sea.

Otherwise traveling lightly, we are reminded of histories of nineteenth century travelers arriving on foreign, tropical beaches with their porters and trunks. Here, we arrive with our own library, a dozen or so carefully selected books of varying inspiration, pens, paper, and a collection of stories in our heads from our previous travels. We have also a duffel bag with climbing shoes, a rope, harnesses, and quick draws, some of which have been in this jungle years before. We will lighten our load when we donate our gear to local route setters, but that will be a couple weeks from now.

Walking ashore, my mind races to Robinson Crusoe, but the bamboo bars and hammocks remind us that we’re not alone. International travelers from all corners, tanned ape men and women, coming ragged out of the jungle and scaling the crags, tribes of their own, insane with tattoos, piercings, and matted dreadlocks, a Lord of the Flies with no antagonist. They are climbing some of the hardest sports routes in the world. Darlene joins the fray, leading the Groove Tube, a natural tube in the limestone’s beautifully pocketed cliffs, dripping with stalactites. The evenings are capped with beer Changs, fiery sunsets over the Andaman Sea, green curries, fresh seafood, pad thai, and Darlene’s favorite, sticky rice with Mango.

Licking her pen, Darlene shifts in her little chair, tucked into a wooden table by the sea, and opens her notebook. Our collection of stories builds, laughing, telling and retelling each other tales of adventure, disbelief, learning, frustrations, thrills and humilities we endured in the few shorts years we’ve know each other. “This is only the first volume,” she teases as we inevitably dream about where else we’ll go.

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Ganesh, Our Guide

January 22nd, 2013 by · Egypt, Ethiopia, India, Syria

The Elephant Cloud wakes from a long slumber.

When our story left off, we were separated in the remotes of Ethiopia. Me on the side of the road with an empty tank of gas, Darlene in a hospital with no running water. Being separated from your partner in remote parts of the world is one of the least desirable predicaments to be in.

I made it back to Bahir Dar, an idyllic, verdant lake town, while Darlene finished her tenure. Via cell, she asked me to book a respite trip to Egypt, to relax and process our experiences and our year abroad. I spent a few days negotiating the rescheduling of flights to Dahab, where we previously shared beers with friends after diving in the Red Sea, toes in the sand, watching sunset illuminate Saudi Arabia across the gulf.

Meanwhile, the protests in Tahir Square had grown considerably and tourist travel was strongly discouraged. The Arab Spring was in full swing. I was reminded of six months earlier, when we’d hitchhiked into Syria. Obama had just renewed Bush’s sanctions against the country and there was something in the air. Young, idle men, especially were on edge. Egypt would have to wait. To this day I carry an egyptian one pound coin with me.

This morning we strolled the streets and lanes of Cochin, the old synagogues, churches, hindu temples, and mosques of Kerala. On the streets of the old Jewish Quarter, we bought a small hand carved Ganesh, an omen of good will and mischief to guide us thru India.

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The Road to Mota

February 5th, 2011 by · Africa, Ethiopia

Halfway to Bahir DarThe tire was flat when the car arrived. When I came out to greet him, Mulu was already under the car and surrounded by the neighborhood children, who were better behaved than I’d ever seen them.

There is an adage in Africa that with film and video, it’s best not to linger too long. The gear is expensive and a temptation and over the past few weeks, we’d had it out far too much. There are other, now amusing circumstances as well, better shared over a beer at a later date, but ultimately, it was decided that we needed to get the gear out of this small town and into Bahir Dar. Joni and I were leaving first thing the next morning.

It was my single biggest disappointment of the trip. I did not want to leave Darlene, I had just found a seemingly ideal translator and photo enthusiast in one of the hospitals midwifes, I had plans to watch futbol with an Ethiopian doctor who’d become an increasingly good friend, and, perhaps most important, I was invited to play on the hospital team’s volleyball tournament that Sunday.

We packed all the gear into the land cruiser and set out. About twenty minutes out of town the road starts winding down a breathtaking canyon to a water crossing thousands of feet below. It was market day, again, and the line of merchants streaming into town was also crushing in that I wanted stay in Mota. My heart sank as donkeys, goats, sheep and shepard were all on foot marching toward town. Men and women and children in their gabis and wares, many barefoot, the march of walking sticks and the donkey carts. We head down the canyon and I texted Darlene that we were beyond town, freely on our way.

The blown out tireFreely, that is, until we started to climb out of the canyon and the back tire blew. I’d never heard a tire blow like that. I’m more accustomed to the slow leak.

A local boy helped change our tire, which included he and I rocking the vehicle back and forth so Mulu could wedge the jack in under the body. We eventually gave him a birr for his troubles.

The bald, "healthy" tireI inspected the remaining tires and found that though the spare was completely bald, it was not the worst one. The rear driver-side tire had no rubber at its center and we were two hours from Bahir Dar. The road is a never ending stretch of packed gravel with washboard grooves and sharp loose rocks. It wears a heavy coat of fine grain dust that gets everywhere and as I gazed out into the hot day ahead, I was preparing myself for the inevitable bus ride rescue.

But this is Africa, as they say, and somehow all the pieces more or less held together and after another hour we still had four tires full of air. We pulled into a little village where we patched one of the spares. Once again on our way and forty minutes later, we finally crested a small rise and saw Lake Tana and Bahir Dar spread out before us. It was beautiful. The lake expanse felt like the sea and the town of tree-lined avenues swayed in the breeze. By now the back seat and our gear was full of dirt from the dry countryside and we were looking forward to soothing our sunburned skin under cool, running water.

The spare

As we wound down toward town, we crossed a long flat stretch and slowly, the car decelerated. I pointed to a building under construction as the car rolled to a stop. “What are they building there?” It’s a new hospital, he said, pulling out his cell phone. He apologized, “it is my fault, I forgot when we were in the village, but I will call my friend and he will bring more petrol.” We were seven kilometers out of town and completely out of gas.

POSTSCRIPT: Though I left Mota four days before Darlene, she arrived here with me yesterday. On her return trip, the rear driver-side tire went flat and Mulu received four new tires that afternoon.  Her four days remained challenging in terms of the medical condition of Mota Hospital and it’s patients, but rewarding in the nature of her stay.

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Ethiopia’s Daughters: Chapter III

February 5th, 2011 by · Africa, Ethiopia

… continued from Chapter Two of Ethiopia’s Daughters

Chapter Three

A small unlocked Nokia cell phone with an Ethiopian SIM card floats between the white pockets of Dr.Dr. Philippa teaching ultrasound Philippa and myself. The number is scribbled on paper taped in the maternity ward. We are on call 24 hours a day, 7 days a week for almost four weeks. Other medical teams before us have stayed for three months, a feat I find holy.

Nurse midwives and doctor’s names fill our phone lists and tonight it is Abraham* who rings us two hours before midnight. ‘There is a woman in the delivery room, we have tried a vacuum delivery twice and still the baby doesn’t come out, there is fetal distress, can you come and help us?’
‘We are leaving now, right away, be there in 5 minutes.’ I pull on my pants, grab my head lamp and retrieve Dr. Philippa from next door. In our tiredness, we stumble over the dark path, rushing to get to the hospital.

Once inside, the scene is portrayed and everyone rushes to play their part. She is on the stirrup table, her legs shaking from long hours of pushing. One defeated midwife holds the vacuum attached inside the mother, another leans into her protruding belly counting the fetal heart rate, 140 beats per minute down to 80, there is fetal distress, this baby needs to be delivered immediately.

I turn to Dr. Philippa, ‘A C-Section, forceps, what shall we do?’ Calmly, she reassures the team, examines the patient and announces the head is transverse, lying sideways and therefore wedged tight. The goal is to turn the head so delivery can happen. It is too late for a C-Section she informs me.

With fifteen years of experience, she works with her hands, the vacuum, limited tools. An episiotomy opens the narrow passage further and within several minutes a head, with cord wrapped tight about the neck, is pulled through the canal. Deftly, Dr. Philippa reaches for clamps and scissors, releasing the cord. She turns, handing the blue, lifeless baby to Malsaman and me.

‘We should order a Neonatal Resuscitation book and leave it at the hospital,’ Philippa mentioned to me in passing a few months back, I took her recommendation to heart and three days later Amazon delivered such a book. I devoured the algorithms, protocols and ratio of compressions to breaths, the book is for high end facilities with oxygen tanks, neonatal bed warmers and medications.  Everything our hospital in Ethiopia is lacking.

Malsaman and I grab the floppy baby, its eyes closed, mouth open, and rest it on the table. An eternity churns before I understand what is before me. ‘I feel a heart beat, its slow, but its here,’ Dr. Philippa presses the umbilical cord, searching for a pulse.
The race begins, from the smallest of compressions, 1 and 2 and , two finger tips thumping the frail chest, the lungs have yet to just bornfill with air and the tiny oxygen mask is held in place, I try to keep the airway open, jaw thrust up. It swollen lumpy head lists to the left, making the ability to maintain an airway difficult. For thirty minutes, I don’t give up, I can’t give up.
A cough, a gasp, the heart beat quickens, we push air into her lungs, ‘come on baby, come on, you can do it,’ my mantra begins. Then it happens, her little chest begins to rise, she takes a breath and then another.
Turning to Malsaman, we are ecstatic and dance around, grasping hands, overcome with joy.

SupportThe mother watches from the delivery table, her feet in stirrups as Philippa delivers the placenta and sews beautifully her torn body back together. Finally, the family is allowed to enter, husband escorts his wife back to bed, there are no wheelchairs. The baby is brought to her side, she is surrounded by four other maternity beds in a small room. Here, there are no monitors, machines or oxygen tanks to keep life viable, only the mother. For she will keep watch, infant at her breast, and hope the spirit of death passes over.

bed from home Not much later, the cell phone rings, another midwife urgently inviting us back. ‘Another baby is stuck, she has been in labor since yesterday, we should go quick,’ Philippa informs me, grabbing her white coat and we walk the well trotted path together. The story parallels the first, only the cord is wrapped around three times, strangling any chance of survival. This time our attempts are futile, the little face is malformed, perhaps a chromosomal defect, an incomplete cleft palate, perhaps it is from pushing, its face lodged against the canal bones for too long.

I can’t fix the oxygen mask, air escapes before passing into underdeveloped lungs. The ailing heart pulses through the cut cord, ‘thump …….. thump.……..’ instead of a healthy 120 beats/min, there is only one every five seconds. More compressions, more oxygen, the heart beat slips further into the heavens, we try and try again. ‘Come on baby, come on, you can do it,’ my mantra begins, only this time no one is listening and over 30 minutes the little soul leaves us.

Looking into Malsaman’s eyes, a wave of defeat overcomes the room. I want to cry, but no one cries in Africa, there is too much sorrow for tears.

‘We have saved the mother,’ he touches my shoulder, now they can have more children, healthy children.’

* names have been changed

healthy baby going home

to be continued…

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