by Britta Das
Back in Canada, my parents were less than enthusiastic about my ideas and plans.
“But you don’t have to go for a whole year,” my father tried to caution me. “That’s such a long time. Have you really thought about it?”
I had. I had contacted the Bhutanese Ministry of Health and had been told that if I wanted to volunteer, I would have to commit for an entire year. I was twenty-six, bursting with energy, and full of ideals. I said yes.
My father tried another approach: “Now you are a young woman, this is the best time of your life. You should go on dates, fall in love, look for a husband. Who are you going to meet over there?”
I was not worried. After a painful split from the man I had thought I would marry, a serious romance was not what I yearned for.
“Please don’t think that you have to stay there for the whole year, just because you are too proud to come back if things don’t work out,” were my father’s departing words. I realized that my parents were worried beyond measure, and yet I was determined to go. So, in February of 1997, after months of preparation and tearful goodbyes from my family, I stuffed my two hockey bags full of clothing, thermal underwear, physiotherapy books, spare batteries, and a year’s supply of female hygiene products, took a plane to Bangkok, and bought a one-way ticket to Bhutan.
In Bhutan’s capital Thimphu, Voluntary Services Overseas, a non-governmental organization that places volunteers in developing countries, recruited me, giving me the chance to live and work in this mystical country. Through them, the Royal Government of Bhutan considered my enthusiasm and skills and found an opening for me in the physiotherapy sector of the country’s health care system.
During my orientation in Thimphu, I learned that over the last twenty-five years Bhutan had worked hard to develop a new and surprisingly active health care network. In the past, this landlocked Himalayan kingdom relied mainly on traditional medicine and village healers. In the mid-1970s, leprosy missions came and set up permanent buildings for admitting and treating patients. Now there were hospitals in most major towns in the country, and many small villages were served by little outposts called Basic Health Units, which offered rudimentary treatments, basic medications, and vaccinations.
Although the first physiotherapists came together with the leprosy missions, most of the mission staff have now retreated, leprosy being more or less under control. Physiotherapy for non-leprosy cases is a relatively new idea in Bhutan and far from universally recognized.
When I arrived, there were three qualified physiotherapists working in the country. Two of them, one Bhutanese and one American UN volunteer, worked in the large national referral hospital in Thimphu. One Finnish therapist still works with the leprosy mission in Gidakom, a tiny village only about a forty-five-minute drive from the capital. In addition, eight trained physiotherapy assistants (or “technicians,” as they are called here) were spread throughout the country. Three worked in Thimphu and one with the mission in Gidakom, while four of them were posted in Eastern Bhutan; one in Mongar, one in Yebilapsa near Zhemgang, one in Trashigang, and one in Rizerboo near Pemagatshel.
The Royal Government’s Ministry of Health determined that my responsibility would consist of training the four physiotherapy technicians in the eastern districts. I was to teach them more independent assessment and treatment skills.
I spent several weeks at their Thimphu base while VSO prepared me for my posting in the more remote regions of Eastern Bhutan. Cooking lessons focused on dishes using locally available foods, while discussions about health and hygiene pointed out the dangers of improper meal preparation, poor water quality, and the possibilities of vitamin deficiencies and malnutrition due to a limited diet. Confident that I was prepared for even the remotest of relocations, I went shopping for luxury items such as peanut butter and chocolate bars, read up on the local traditions and customs, and received my first rabies vaccination.
During several days spent in the physiotherapy department of Thimphu hospital, I learned that everyone who works in nursing, physiotherapy or medicine had been trained in English, which would make my communication with hospital staff easy. Understanding my patients would be an entirely different issue. Several different languages are spoken in Eastern Bhutan, corresponding to different geographical regions within the country, as well as dialects that have evolved in isolated valleys. VSO gave me a booklet on Sharchhopkha (also called “Tshangla”), the language spoken most commonly in the region of Mongar and Tashigang. Even some of the simplest words seemed tongue twisters, and since I was eager to start my new job, I convinced VSO that I should skip the language course offered in the capital and instead pick it up once I was immersed in my work and confronted with patients.
I was overjoyed at the prospect of my new job and packed my bags in Thimphu to start my long journey eastwards.
After fifteen hours crammed into the car, feeling wrinkled and edgy, now more than ever I question my wisdom. My only overseas working experience is a three-month locum at a regional hospital in Australia, and yet here I am travelling towards one of the most remote corners of the inhabited globe. “I would like to help wherever it is most needed,” I had told my parents heroically. Mongar Hospital was the place that the Health division of the Royal Government of Bhutan deemed worthy for my cause.
Suddenly, the question of accommodation torments me. I was told that it would be basic. But how basic? Will it be bright? Or dark? Running water? Hot water? No water? I recall terrible stories about Mongar, the construction site around the hospital, the overcrowded housing.
The journey seems to offer a taste of what is to come, and the arduous two-day car ride from Thimphu to the eastern district of Mongar takes me farther and farther into the unknown world of the Himalaya. Our speed never exceeds twenty miles an hour, but we are flying. To my left, rocky cliffs rise steeply out of sight. Short stumpy trees grow from overhanging boulders and cling onto their narrow crags. To the right, too close for comfort, the edge of the road drops hundreds of metres into bottomless gorges. The narrow strip of tarmac is flooded with water, rivulets turning into little streams, waves of rainwater washing the road ahead. The occasional swollen creek that has overgrown its drainpipe and escaped onto the road blends in completely, announced only by the splattering and gurgling of its waterfall at the roadside. To quiet my nerves, I trick myself into believing that this is an ordinary road in the mountains, simply boasting a lot of bends. The Gravol I took earlier helps. Fear makes the fog a welcome obstacle to the view, obliterating the spectacle of what otherwise must be one of the world’s most awesome roads.
A little white chorten, a religious stone monument, protects the tip of one particularly tight curve. It must be a good luck sign, a protector of the wary traveller. Behind it, only some trees and grasses obstruct the near vertical tumble into the valley.
We have leftTrumsing La, at 3,800 metres (12,400 feet) the highest pass on the road traversing Bhutan from Thimphu to Mongar, and continue our descent, spanning one and a half kilometres in altitude over several hours. Rocks and shrubs change into a deciduous forest. After the cold climate of the higher elevations, the thermometer now rises until we are surrounded by hot and sticky tropics. Huge vines cover the jagged edges of the road. Bamboo, banana trees, and cacti dominate the scenery. The dampness becomes almost oppressive. I open my window all the way but the air seems to hang motionless.
In Lingmithang, our descent bottoms out at 650 metres before we immediately resume our climb, and the truck huffs and puffs its way up the opposite mountain. The road is uneven at the best of times and often spiked with potholes. At every jolt of the truck, a dull headache thuds at my nerves and makes coherent thinking impossible. I am tired and hungry, and a little bit afraid.
The clouds refuse to budge, and we continue to plough through them, one bend after another. Several times we nearly collide with the huge orange, Indian-made TATA trucks, fully loaded with logs or stones or sometimes people. The result is always much honking an
d manoeuvring; then somehow we manage to squeeze by.
Oddly enough, over these last few hours of the journey the traffic has increased and I wonder where everyone is going. As far as I can tell, there are only a few houses scattered along the slopes, and we left the last town of any size eight or more hours behind in Bumthang, where we spent the night in a tiny guesthouse.
Perhaps the fog is hiding glorious old settlements and picturesque villages that I will soon discover and explore. My imagination paints colourful pictures to pass the time.
“Here Mongar,” the driver gleefully announces, and I squint into the mist to take in the first impression of my new home. I imagine a vibrant market to meet plenty of friendly villagers, a quaint hospital, and perhaps even a small house for myself.
Eagerly, I peer out the window—but there is nothing. All I see is a little stretch of road in front of us, a few trees on both sides, and clouds. The driver points ahead and to the left. Again I squint and strain—nothing.
Then suddenly, out of nowhere, a large facade of three-storey houses rises beside the road. There must be eight or ten impressive buildings, their wooden exteriors artfully painted and decorated with carvings. I rejoice at the prospect of such a pretty town, but already the mirage disappears. We take a hairpin turn to the left and bump and rattle down a cracked, gullied side road, leaving all signs of habitation behind us.
The path continues to curve steeply through a treed incline and finally stops in front of a long, white building with a wooden sign: Mongar Hospital, Referral Hospital of Eastern Bhutan.
2
from a distance
My house turns out to be a classroom adjacent to the Mother and Child Health Clinic. Standing amid the clutter of my boxes and bags, I take a first look around. The room is bare and uninviting. On one wall, stacked neatly, are six chairs, a large table, and a white drawing board depicting a chart of various modes of contraception. An x-ray viewer along with two posters of Buddha and a picture of the king of Bhutan decorate the far wall of the room. Beside it, an old bowed metal shelf holds a collection of dusty books. In the opposite corner, a lonely bed awaits my arrival. The hospital’s administrator assures me that I will be moving into my permanent quarters within ten days. Most regrettably, though, at the moment, this modest room is the only available accommodation.
His English is somewhat stiff with a strong accent. He asks me to use the weekend to get settled in and begin my hospital duties on Monday. After introductions to some of the other staff of the hospital, and a quiet “We hope you like it here,” I am left alone.
Tired, my whole body aching as if I had hiked and not driven the 480 kilometres from Thimphu to Mongar, I survey the situation. Outside, the rain pours steadily, drumming on the corrugated iron roof in a monotonous beat. I cannot see more than a few yards into the distance; my world is wrapped in white oblivion. From somewhere below my window drones an insistent clunking of hammers on stones. The fog muffles the sounds, yet the continuous vibration under my feet tells me that the construction cannot be more than a few metres from my doorstep. Behind me, the refrigerator that holds the hospital’s supply of vaccinations is humming like a motor engine. A large black beetle propels itself through the room, crashing into the walls with full force, then resuming its noisy flight.
It is nearly five o’clock, and dusk is creeping through the cracks. I open the door to let the last light into my abode, but instead an impenetrable wall of cloud rolls in and settles on my belongings. The air inside and out is cold and clammy, and I wrap my jacket tightly around me. I ensure that my flashlight is safely stored in my pocket and start digging through my boxes to find a candle and some matches.
There is a knock on the door and two petite women with boyish short haircuts smile at me.
“Kuzuzang po la!” The younger woman introduces herself as Pema Dorji and the other as her cousin Wangmo Dorji.
“I will be working with you, madam. I am physiotechnician. How you like Mongar?”
I am at a loss for words. What might be considered polite conversation in this country? Unprepared to offer premature flattery, I mutter something about “very nice.” Then, just to be on the safe side, I add, “I love Bhutan.” Next I inquire, “Do you live on the hospital campus, too?”
Pema shakes her head. “No. My husband is administrative officer in dzong. We are staying a little bit in town.”
“Have you been in Mongar for a long time?”
Pema tilts her head from side to side in a strange wagging motion. Not the same as the definite negative shake of the head that accompanied her previous “no”; instead it seems to imply agreement.
“My family is living in Bargompa, not far from here,” she affirms.
My visitors look at me quizzically, but there seems to be no need for further formalities. Together the two women seat themselves on my bed and simply admire my packed belongings. They praise my big red hockey bag, my new mattress, my shiny blue plastic “bathtub-bucket,” and my two gas cylinders.
“In Mongar, it is too difficult to get gas! We have terrible waiting list, just to get a cylinder. At least six months,” Pema exclaims. “You are very lucky—you have two cylinders! Sister, when you leave, we may have one of your cylinders?”
I nod and suddenly feel extremely privileged.
After informing me that I need to buy a kerosene lamp as soon as possible and that I should not forget to go to the vegetable market on Sunday morning, Pema starts rearranging the room. She pulls out three of the stacked library chairs and lines them up below the window. Then she advises me to lift up all of my bags and to balance the load on the armrests in order to protect my things from the rats overnight.
The rats! I must indeed be privileged.
“You are hungry, sister?” Pema asks while examining my taped boxes of kitchenware. “You please come to my house.” Abruptly, the two women move towards the door.
“I’ll be okay, thanks,” I stammer—which earns me a disapproving look.
“You must be tired. We are thinking of calling you for dinner. Do you have torch?”
I nod and show them my little flashlight, a Maglite.
“This is torch?” Pema asks with obvious disbelief. “You must have big torch! But no problem. I have one.” She settles the matter by waving an enormous steel flashlight in front of me.
Mongar Hospital as seen from the soccer field.
A little later, wrapped in a raincoat and gripping my umbrella like a shield, I trudge behind Pema and her silent cousin along a muddy road that leads past the hospital to a small settlement of cement houses.
“Careful here!”
We clamber up a precarious staircase cut into the hillside. At its top, we reach a square building with several entrance doors and a row of dilapidated windows, the shutters of which have been closed tightly. Pema opens a door leading to a dark and crammed hallway. We duck into dry warmth. My host disappears behind a blue-and-green-checkered woollen curtain beside a pile of cast-off plastic slippers and rubber boots. Her cousin vanishes.
I pull off my soggy shoes to add to the remarkable pile of plastic, rubber, and leather and search for a place for my dripping umbrella.
“I will take. Please come.” Pema peeps back around the curtain and pulls me into a dimly lit, narrow room, dominated by a rusty woodstove at its centre.
“Kuzuzang po la!” From a bed along the far side of the room, a man with a little boy in his arms unfolds his legs and rises to greet me. Pema introduces us. “This is Karma. My husband.”
“We were waiting for you!” Karma’s soft smile brightens. He bows as far as the toddler in his arms will allow.
“Welcome!”
Pema prods a little girl of about five towards me.
“This is Chimmi. Chimmi say hello.”
“Good evening, auntie!” Chimmi beams.
“And this is Nima.” Pema takes the toddler from Karma and places him on her hips.
I smile at the cute little boy who almost disapp
ears within his loosely crocheted blue jacket. Long lashes frame his beautiful brown eyes; his gaze is focused on something behind me. A small gurgling sound escapes from his throat, and his lips pull into a distraught whimper. Pema lovingly strokes the thin black curls and coos reassuringly.
“Nima needs much care. We are always worried about him.” Without any other explanation, Pema smoothes out the blanket on the bed and places Nima in her daughter’s charge.
“Please sit,” Karma offers. Then both parents leave through the curtained door.
Feeling exhausted, I slouch on the bed and study the two children beside me. Chimmi has started to sing in her little girl’s voice, but Nima is oddly quiet. Hands raised to his face, he busies himself by rolling his lower lip between thumb and index finger. Affectionately, Chimmi takes Nima’s tiny hands in her own, pulls him towards her, and leans over to kiss his cheek. Then she reaches for a tattered teddy bear and parades it up and down on the bed. Still, Nima only rocks himself rhythmically, staring at the wall behind us and rolling his lower lip ceaselessly between his fingers.
Pema returns only long enough to place an assortment of steaming bowls on a wooden stool beside the bed. “Please eat,” she says and disappears again.
Uncomfortably I stare at the dishes and the spoon placed in front of me while Chimmi continues to play with Nima. Am I supposed to eat on my own? I wait until the rising steam dissipates from the bowls, then I tentatively push the rice around on my plate.
Pema slips back around the curtain with a cup of tea in her hand. In surprise, she looks at my untouched food.
