Tansen at last

Hello to all.

We arrived in Tansen, Palpa District, Nepal, monday night the 22nd after flying from Katmandu to Baiharawa, and got picked up in the hospital jeep. Climbed about 4000 feet

on a narrow road in the dark and our driver scooted around a stuck Lorrie, ( big truck) in the middle of the road with a 500 foot drop just outside the wheels. The picture you see has nothing to do with that, ( its a shot from Thailand's

Phang Nga bay) with the famous stone karsts that come out of the sea) My buddy back home, Kevin Walsh, would want to cycle up this climb to Tansen probably, but it would be a suicide mission for sure. Don't tell him Im sucking air playing field hockey which I did yesterday. We are at about 4700 feet or so, but it feels higher than that to me. We are settled in a small apt with a small kitchen but I know its much roomier than most Nepali families have. Amber is enjoying some new friends at being out of the craziness of Katmandu. Looks like Im the senior doctor for maternity ward and also working in the outpatient clinic ( women only) . Im sure it will be quite a challenge. Today we saw a hypercalcemia case ( 14.0 Ca) , high output heart failure in a recently pregnant woman with valvular heart disease, and a woman with nephrotic syndrome.

Looks like the surgeons here do all the sections, so while a bit disappointed in that, I hope to make a contribution on the Nepali FMC. ( = family maternity center back home in toppenish. )

I will work on getting pictures to take home to show you all at some point. Guess what? No fetal monitors!! Laurie got introduced to the community health team here today and will see what develops there. Thanks for your prayers and support wherever you are.

Mark