Trip plans for Ladakh

I am excited!  This is a picture of Pangong Lake - I hope my pictures are as beautiful as this. Tomorrow I head out for a 6 day trip to Ladakh, India Himalayas.  During my fellowship I cannot take vacation but arranged that I work on Saturdays. I have already worked two Saturdays, so only one more- which I will more than make up.  My short travel time forces me to make use of every day. It involves lots of driving time but hopefully the rewards will be worth it.  I do get to spend one night camping (supplied by tour) in Nubra valley which I am looking forward to.  Not much trekking, but more exploration.  I can think of it as a reconnaissance mission to see if it is worth visiting again for a lengthy backpacking trip.  Leh, capital of Ladakh sits at 10,000 feet, it is recommended that people stay in Leh for two days exploring before taking excursions that put you at higher altitude.  I was able to pick up diamox at the pharmacy, no prescription necessary, and will take it if I feel I need to.  I have not had major problems with altitude before as the approach to higher elevation was done slowly by walking, but this will be a big change from Delhi, 700 feet, up to 10,000 feet. Below is the itinerary.

ITINERARY

day 01 / 26 Jul: arrive leh

welcome arrival at leh airport and transfer to hotel. complete day for rest and leisure to acclimatize. evening visit leh market & shanti stupa. overnight at hotel in leh.

  day 02 / 27 Jul:: leh - excursion to monasteries

post breakfast we proceed for the indus valley monastery tour including shey, the ancient capital of ladakh, thiksey an impressive complex rising tier upon tier on a hill above the village and stok palace the present residence of the royal family. enjoy packed lunch at sindhu ghat. overnight at hotel in leh.

  day 03 / 28 Jul: leh - excursion to pangong lake (290 kms / 10 hrs)

after an early breakfast we leave for pangong lake through changla pass 5486 mtrs. pangong lake, situated at 14,000 feet (4,267 m) is a long narrow basin of inland drainage, hardly six to seven kilometer at its widest point and over 130km in length, it is bisected by the international border between india and china. after spending some time at pangong we drive back to hotel in leh.

  day 04 / 29 Jul: leh to nubra valley (120 kms / 5 hrs)

after an early breakfast we drive to nubra valley crossing khardung-la-pass - the highest motorable road in the world at 18,380 ft. nubra valley is popularly known as ldorma or the valley of flowers. it is situated to the north of ladakh between the karakoram and ladakh ranges of the himalayas. check in at the resort and later visit the samstaling monastery. enjoy your evening at the campsite.

  day 05 / 30 Jul: nubra valley – leh (190 kms / 7 hrs)

after your breakfast at the camp, visit the diskit monastery and the sand dunes to enjoy a camel safari (optional). later we drive to leh over khardung la. afternoon rest and relax or take a walk to the local market. overnight at hotel in leh

  day 06 / 31 Jul: depart leh

tour concludes. ladakhsafari thank you for your patronage and ensure a punctual transfer to the domestic airport.

My Saturday

Finally got a good night sleep.  Pain in my shoulder has prevented me from sleeping through the night, as soon as I move the pain usually wakes me up. I asked the Dr for painkillers and yesterday got the prescription. It worked!
This morning got up, had a wonderful cup of coffee and was ready for the day.  Headed to Nature's Basket, a local store that has great fruit and vegetables along with many items that are not common in India. 
I thought I would see which of the puppies were around.  My two favorite were there, Nimba and Spritey.  They are looking good.  Growing!  Soon they won't be puppies any more.

Fresh fish anyone?  I captured this shot along a residential area of a man cutting and cleaning fish.  Not sure what they do with the insides - maybe leave them for the dogs to munch on.  I am sure that would be a treat for any dog or cat!

They lay out a towel and set up their knife. Someone comes along to look in their coolers, selects a fish and Viola - cut to your liking. People don't even have to leave their homes.  A woman called down to them, selected a fish, and it was delivered ready to cook. I don't think I am brave enough to order fish this way, but maybe in the future.  Not sure how to cook the fish, but anything cooked in curry is usually delicious!




The other thing I need to get pictures of are the men working on building houses. It's all done with manual labor, no machinery - unbelievable. These guys are out in the middle of the day when it's over 100F lifting bags of sand/stone/brick up a few flights of ladders. Tough work.
Sue (aussie) and I had plans on Skyping to coordinate her trip here.  Can't wait to see her!  We chatted for about 1 1/2 hours - it was great.  Technology has been wonderful. Sue will visit and I am sooo looking forward to that.  I am sure we can get time to travel together.
Wajit came to cook me chicken curry.  I was on the call with Sue and he just started cooking.  Wow- can you imagine what life would be like with a cook, someone to clean and a driver?  I am experiencing it right now!  I hope this experience doesn't ruin me for my life back in New York! 

Finally, I believe I have "adapted" to my life in India.  I like being able to walk to the market to pick up a banana or mango for breakfast. There are fruit and vegetable carts all over,so easy to find fresh items.  I can walk out on the street and easily find an auto rickshaw to take me where I want to go.  The food is fabulous.  I like seeing all the things that are so different from home - the fish being cut up on the street, the builders and the separation of class (this is something I am not used to in America as we are taught that everyone are equals - here that is DEFINITELY not the case). This is culture, and it's a great opportunity to be part of this life in India.  I have traveled quite a bit but have never had extended time in any country.  Today, I am glad to be given this opportunity.

Out to dinner

I am going to meet one of the people I am traveling to Ladakh with. A friend, Pryia, whom I met in Yoga class put me in contact with this woman, Romila because she was interested in going to Ladakh. I had plans with Vishwa, from the office, to visit Ladakh. Romila is very good at trip planning also! It's fun doing the planning with someone I haven't ever met, but we seemed to be on the same page for things to do. Unfortunately for me as I don't have the extra days, she is staying for an extra two days to do another awesome excursion. This has made me think of the saying "You can take the girl out of the country but you can't take the country out of the girl". Even though I don't have any friends with much history, I am always willing and open to building them. Friends and companions make this world a Better place. I have said in the past that one of the things I would do when I retire is become a trip planner. Off to dinner....

Outings

2012 Mango festival last week in Delhi. Over 500 varieties of mangoes but none to eat! There was no taste testing and they only sold Mangoes by the case. Very disappointing on the Mango front, but nice to go with Melinda and Kristin for an outing. We bought one case and split among 3. I was expecting something like the Saugerties Garlic Festival, where there are tons of tastings from salad dressings, to raw garlic, to dips, even they have garlic ice cream. I have gone with Christopher for the past couple of years and we always enjoy ourselves. I recommend the Garlic festival to everyone.

The Mango Festival had many booths of food and crafts. These fennel sweets were on display, so colorful.  Indian after-meal snack or digestive aid made primarily of fennel seeds, anise seeds, coconut, and sesame seeds. They are sweet in flavor and highly aromatic due to added sugar and the addition of various essential oils, including peppermint oil. The seeds are often also coated in sugar and brightly colored.
Vishwa, from the office had a party celebrating his brothers wedding. It was nice as I met a few people who have worked at PH, we had something in common.  A good evening.

Sunday I went to the mall to see Madagascar 3.   At the beginning of the movie I was concerned that my eyes were failing me because it was a bit blurry.  Then I remembered that the movie was 3D and once I put on the glasses everything was clear.   Bought a couple of puzzle books - one was Sudoku.  I don't watch TV anymore but have become a regular at the Sudoku in the local paper.  I continue my quest for coffee - there was a place that had an extensive coffee menu.  Took a seat in the restaurant with my puzzle book, coffee and dessert - not a bad way to spend a afternoon (in the city).  The coffee was very good and asked to buy it BUT they only serve no sell. I ended up buying two different varieties from various stores. One was very good. Yea! I can relax when my coffee supply starts dwindling.

Work is starting to pick up. Talked with the manager and mentioned how I would like to have some interaction with the people In the field. He was open to it and said that he would try to facilitate me traveling to the study sites to talk with the heads of health care facilities in the area and learn how care is given to the rural population. Sounds OK. The start of this project has been delayed for a few months. By the time we get started, next month, the first three months we will be developing the training material. I did not plan on spending 6 months in an office. If I knew it was going to be like the past 2 1/2 months I would not have signed on. Once my fellowship is up in October is when their focus will be actual training.

The one thing that I do that keeps me excited is trip planning. Two trips have been planned.  On July 26th, only a few days away, I will be traveling with 2 others to Ladakh - the northern region of India - Himalayas. We will be in the capital, Leh, for a few days to acclimate.  Unfortunately we will not have time for much trekking as I don't have the vacation time.  I hope to share photos and experiences soon.
 After traveling North I will then head South to Kerala, known for the lakes and backwater tours.  There are 4 of us going on this trip.  I will need to start thinking about a trip for September and October.

Safety is not always considered.  This park carosel ride is a perfect example. You can see in the picture how the red airplane swings out into the people walking path.  If the man and child did not move away from the carosel they would have been knocked over.  Never in

America!

Life in India Part II

Lajpat Nagar Market

There are some things I really like about India.  When I walk down the street people don't look very happy.  A smile or or a nod saying Namaste will usually bring a gentleness to their face.  I go for a walk in the neighborhood everyday so there are many familiar faces along my path who now smile back.  Often I go to the same store and it seems that people are nicer and friendlier to me than other folks. Don't have a reason for that but it's good. 
The other thing which I like and have mentioned before is trust, if you don't have the right change they ask you to bring it tomorrow.  Usually it is only a few rupees (a few cents) but still I like the communication and the trust between consumer and seller. 
On the other side, the auto rickshaws are a challenge to find one that offers reasonable fairs. I now have an idea of what fares should cost (I have become a educated consumer!) and I really dislike when they over charge. My response to this is to either walk or find another Rickshaw.

The pups are my highlight for the day. One man I met lives very close to where the dogs hang out. He had his own names for the dogs. I had to laugh as the one that I call Alpha, he called Boss. Very similar. By now I am sure the dogs have many names. When I get there, all I do is call "puppies" and they all come running.
Most of my interaction with people is when I visit my puppies. The other day I walked by and there were two kids playing in the street.  When they saw me - they called the puppies.  This wasn't dinner time but biscuit time.  Many of the children speak English quite well. These two did not.  I asked if they went to school and she said no (did she understand me?). The girl was maybe 8 and the boy 5, they were thin; I realized they probably do not live in the homes in middle class CR Park but might live in a shelter close by. Their parents iron clothes on the street.  This is done by heating coal under a board and then using the board as the table to lay out the clothes. They work outside all day, I do not know where they go at night.  When the children see me feeding the dogs, what do they think?  I realize they are probably hungry also.  As I was on my way to the store, I picked up a box of energy bars to give the kids on the way back.   I showed the bars to the Mom for approval, she nodded and came over to receive one also. I ended up giving them all away. Now I am feeling guilty- I take care of the dogs, but what about the children.  The kids didn't eat the bars right away but looked at them and smiled. Of course we can't help everyone!
Leaving the kids I met up with a boy who was in a school uniform.  They have classes on Saturday. The boy spoke perfect English.  He told me that he went to private school; all the text books are written in English and they speak English In school. He told me that in public schools Hindi is the language and they don't learn English until 5-6 grade. This puts the government educated kids at a disadvantage.  Just that day I was reading an article pertaining to government run schools vs private schools.  It stated that it is a disadvantage not to have English taught in the government schools, but it is difficult to find qualified teachers. Most of the governmental representatives send their kids to private school.

Yesterday the fifth puppy was there but unwelcome from the others. I wish I understood Dog dynamics so I could understand their interactions.   I decided that my favorite is Nimba. He is mellow, sometimes feisty, indifferent at times, but he does love his food and a neck rub. Whiskey is my least favorite as she is a bully, wouldn't want her at home! Now it's a choice between Spritey and Nimba. If I bring two home then at least they would have company while being quarantined at animal security. Who wants one???

 

Doctor Visit

When I started taking Exercise/Yoga class, over 1 month ago, I hurt my shoulder. I believe it was doing Wheel position. Since I have been here there is not ONE day that goes by that I don't have same pain somewhere on my body. My back pain has been the least of me complaints. There is a rumor that if you live in Delhi sooner or later your hair starts falling out. My interpretation- that this is not the healthiest place to be.

My approach to my shoulder was to continue with exercise but take it easy. My exercise classes are also a means to meet people and make me feel "part of", which is a positive.

Two doors down the street is an Orthopedic clinic- Dr. Sudhir Seth. Why not go in and have the experience. No appointment necessary. The Dr. would be in at 5 so I should come back then. I was brought to his office, described my pain, he lifted my arm in all directions and wanted Xrays. The office does them right there - very speedy. I had to laugh at the X-ray machine; it must have been 20 years old but still functioned well. Determination - I have arthritis in the joint and a bone spur right under my deltoid. What I liked was that he asked me what I ate, exercise, mental health and general questions. Never have I been to a Dr. in USA that asked about ME and how I live besides drinking and smoking. He gave me 5 prescriptions to fill - Omega 3 fatty acids, a supplement to absorb Calcium, mild pain killer/NSAID -anti-inflammatory that is used to treat arthritis in dogs -hope it is approved for human use), Vitamin D3 and a anti-inflammatory gel with menthol. Gave me 10 sessions of physiotherapy, which they do right in the office - how convenient! He told me I should increase my protein intake. I have been eating dal with vegetables most of the time. Very little animal products - it's been two months in India and maybe I'll start eating chicken and fish.

Cost of visit - $30 USD which included X-rays. This is probably less than my co-insurance would be at home.

Yesterday was the first PT appointment. No appointment necessary, just sit and wait. I liked the guy - Dr. Kahn. Both Drs. spoke English very well. Dr.Kahn sat me in a chair and placed one strap on my upper arm and one at the top of the shoulder. The straps were used to hold the electrodes (electric stimulation) in place. These electrodes were just removed from the previous patient, no individuals ones here. The pulses were large-you could see my muscles contracting as my entire arm shakes - felt good. I then went to have heat. Laid on a table that the previous patient got up on - same sheet and pillow case. The heat pads are attached to a machine which distributes the heat when it gets too hot I am supposed to notify Dr. Kahn. Then ultrasound. Complete rest for the arm for one week, then we will start on exercise in PT.

The equipment has been around for awhile and well used? For exercises there was a bicycle - must have been one of the first stationary bicycles ever made!, a board for balancing and the best was the hot wax tank. The hot wax tank is a waterbath similar to what we use at work, except it would have been replaced due to the rust. The wax is for hand therapy, they use a paintbrush to apply the wax and a large kitchen spatula to remove the wax. BUT overall the treatment is available but not quite to the standards we have in the US.  Cost of visit: $7 USD

Overall a good experience and I hope that my pain goes away.

Street Puppies

 Here is a great shot of all four puppies.  It is very rare that they are all sitting at the same time.  There used to be five...
An the left is Alpha, then Nimba, Whiskey and on the right is the injured girl Spritey.

Because Spritey was so weak I bought a bag of puppy food and a bowl in hopes that she gets some nourishment and can get stronger.  She hardly puts any weight on her left front leg. When I bought the food and one bowl I do not know what I was thinking because all the others have really good noses for food. The three others usually hung around together and she was separate.  Well I gave her the bowl of food and we got bombarded by the other dogs.  I have no idea who got the most of that meal! 
Today I went to buy four plastic storage containers so I can prepare four bowls of dog food at home and all I have to do when I see them is remove the lids.  I need to place the bowls down as fast as I can so they each get their share. It's fun. Priya, a woman I met in Yoga is a street dog lover also.  She came with me and helped me feed them.  We will deworm them next week as Priya has had experience with helping dogs. 
I just hope that I am not hurting the dogs by taking care of them now.  Will they be OK when I leave? 

 Spritey has the injured left front knee.  It is swollen around the knee, she has a bad limp.  I am very happy as I have seen her out and about the last two days and she is acting a bit more lively and can get around faster than she had.

Whiskey- the golden one. This is the best shot I have of her.  Neither she or Alpha are injured as far as I can tell. She sits well and gets to enjoy lots of biscuits.  She beats up on Spritey - I guess she is the dominant female and likes to pick on the weaker ones.  All I can do is raise my voice to stop Whiskey from attacking Spritey as I don't want to get bitten.

 This is Nimba. He has a injured back leg and it is hard for him to sit, but he gets around OK. He is the most aloof of them all but will not pass on biscuits or food 

On the right Spritey is licking her lips after a good meal! She is saying Thanks Sue!

 



I called this one Alpha as he is the strongest of them all, usually at the head of the pack and runs the fastest when he sees me. He is a good boy and also sits well.

I like the photo  below as you can tell a bit about their personalities, how Nimba is mellow while Alpha is alert and ready to go.



Work Follow-up

By Monday morning my temper had waned, good thing! I knocked on Dr. Ps door and asked for a few minutes of his time. I mentioned how I was upset on Friday that he had gone to the meeting, did not invite me nor let me know he was going. His response was that he will be attending many meetings by himself and he does not have to include me if he does not think it is pertinent to what the office does or my participation in PHI. The meeting was a diabetes conference with sessions on new technologies/clinical trends, social aspects/behaviors and health facts/nutrition. All seemed relevant to ME. I believe he did not intentionally exclude me. I wished/thought that as a small group we would work closely together and share information - be a team.
Maybe this is not his plan or that his methodology is different than I am accustomed to. 

I will let it go.

Tomorrow our colleague from Bangalore will be coming to Delhi for the partners meeting to discuss details and expectations from PHFI, PSI and PHI collaborating on the Lilly 5 year NCD program.

What am I learning from this? 
    I need to be more open to different management styles
    I can't always get to do what I think is best
    Patience (this will be a hard one!)
    I will add to the list as time goes on....

Day with Swati - Akshardham Temple

 Spent the day with Swati, a woman I met in exercise class. Unfortunately her job is moving her to Mumbai next week. Great opportunity for her, disappointing for me as I found a friend anyway we had a good day together.  Visited Akshardham temple, went food shopping and Swati cooked dinner for me.  It was a good day!

Akshardham Temple in New Delhi is a beautiful structure with spiritual surroundings.  A temple dedicated by spiritual followers. Its mostly made of pink sandstone, different from the red sand stone used for Agra and the Red Fort.  The hand carvings are amazing and intricate. My favorite are the 148 elephants at the base of the temple, each panel reflects the messages of social harmony, peace and spiritual faith.  We went into the exhibit, which is definitely worth doing, especially as it was air conditioned!  We arrived in the hottest part of the day- 116F with sun which really takes away from the enjoyment so the inside exhibits and boat tour depicting Indian life many years ago.

Pictures attached were taken from the web as one is not allowed to bring in any electronic device - not even headphones.  My recommendation is to deposit everything besides your wallet at the check-in so not to be stopped at the gate search before entry. 
I would definitely return when the day is cooler to be able to appreciate the carvings and go inside the temple. 

Swati and I arrived by auto rickshaw.  I figured as she is a native that the price would be much lower than would be quoted for me.  Not true.  She showed me how to negotiate and walk away if the price is too high.  It's good to learn these tips and see it in action.

Now dinner.  There are certain things at the market that I don't know what they are. There are bunches of greens but nothing looks familiar. I had an education, bought spinach and paneer.  She made a delicious dinner of chickpea dal and spinach/paneer - palak paneer - oh so good.  Probably my best meal so far! 
It was a great day, good company, good activity and followed by dinner.