tag:blogger.com,1999:blog-76396548624031278112024-03-21T14:25:42.263-07:00Nurse Neuf goes to IndiaNPNeufhttp://www.blogger.com/profile/05604092977382675562noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-7639654862403127811.post-52257590415841419622016-01-24T07:08:00.001-08:002016-01-24T07:12:16.496-08:00South to chennaiThe gonging of the bell could be heard blocks away, mixed with the sounds of singing voices and blasting instruments like trumpets and clarinets. I step out of my auto rickshaw in front of the oldest temple in the city. Sadly, the gorgeous colourful temple spires are draped in tarps as they restore and repaint. (For that I'm grateful, but it's sad I won't see it) I walk a few circles around the inside of the temple, watching people pray, light oil in tiny clay pots, prostrate, and just sit. I see gurus in bright orange wraps and long beards giving blessings to the temple goers. Today I send my own bit of gratitude up for the "all clear" on my brothers CT scan. <div>And then I'm on foot, through the small streets of the 'old part' of chennai....past fruit and veg stands, where I buy a small bunch of small sweet bananas to munch on. Past temples of various sizes and colours; weaving through people, bikes, cars and of course cows. I stand on a corner and look up. There is a spotless white cathedral, towering into the sky. I walk into this place of worship too, and light a candle of gratitude for my brother, my family, and my friends. As I wander out, and the light is turning to the dusky part of day, these bells ring out too. </div><div>I attempt to walk at the beach, but it is filthy, and not at all pleasant there. So I find myself an auto and sit back as the streets come alive even more. Lights and music come on, the temples seem crowded now and it feels like every vehicle in the city is now on the streets. My driver is getting frustrated in the insane traffic, but I feel quite content to sit in the back and take in all the chaos.</div><div><br></div><div>The next morning I wake before the sun. I have a sand coloured royal enfield 500cc Classic motorcycle waiting for me in the driveway. My host sees me out, and as the first light of day hits the streets, I'm on my way out of town. Turns out Sunday mornings are a fantastic time of day to drive here.... Only a handful of vehicles on the road make it easy. But I still get it. I give a little honk to tell the bike I'm coming by, I inch over to the left when I hear a car or bus do the same to me. I watch as people and bikes and cows inch onto the road....timing their entrance just so. (Ok, the cows don't time anything ....they are just there) and every so often, the road opens up and I can push the bike just a little bit faster (which is not even close to Canadian highway speeds....cause you never know what's going to pop up next). I catch glimpses of the ocean on my left and pass many a beach resort. I wind through banyan and palm tree lined roads, past rice patties and over rivers. And I come to the old French colony of Pondicherry. At this point the clouds have opened up and I'm soaked as I duck into a restaurant for some breakfast, and by time I'm done, the rain is done. The clouds keep moving and the promenade is bathed in warm sunlight. A walk in the sunny sea breeze quickly dries me and spend a pleasant morning wandering the streets of old French architecture. I am ever so pleased to realize that this is also coffee country, and I indulge in more than one cup.</div><div>My ride home is split by a visit to the ancient temples of mahabalipadam, carved out of huge monolith rocks. Of course by late afternoon, the streets are more crowded now, and my ride back into the city takes a little bit longer. But I make it back to the shop with both me and the bike in one piece. Success!</div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6yWN-ikLbyUe2024YVLk7rtyM5D68dYfvehmMKCzvAX-I3fwJRRwjZlXtwtqcYKe8B9u8Rj7dmhdyYw6XvYkA19PLopVobJT2W7JmRQYf9pwXIoRLFfy0kZnw0F_8txzGWoeQpMcCds8/s640/blogger-image--1966444974.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6yWN-ikLbyUe2024YVLk7rtyM5D68dYfvehmMKCzvAX-I3fwJRRwjZlXtwtqcYKe8B9u8Rj7dmhdyYw6XvYkA19PLopVobJT2W7JmRQYf9pwXIoRLFfy0kZnw0F_8txzGWoeQpMcCds8/s640/blogger-image--1966444974.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC16HlV29I4Kmrqvl87sv9AQ3GSpM2sZlvPpJTGcfhg9i8DU140fiQPSAjcSFWK29Wkkv_G6l7j8MCNkJo3Y7lw0opE_63C7rqGTDNa_I4YZ7wWJ8PwHZmFjHiY4TCBjSVFeuR8UYm3r8/s640/blogger-image-487248716.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC16HlV29I4Kmrqvl87sv9AQ3GSpM2sZlvPpJTGcfhg9i8DU140fiQPSAjcSFWK29Wkkv_G6l7j8MCNkJo3Y7lw0opE_63C7rqGTDNa_I4YZ7wWJ8PwHZmFjHiY4TCBjSVFeuR8UYm3r8/s640/blogger-image-487248716.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7jU17byJNt-YByMdcu61qixKllpl9-dgTTns1BTvHBCdMQwSi6CsNfCOLR0U94DmS83hNG4LxxPBg2Pjl60n3JPMbffsicOUU6ipmacJ1Bl1Xo4nHz2kJKQGN7If90OcLb5zxzbLB8lw/s640/blogger-image--1583052403.jpg" imageanchor="1" style="margin-left: 1em; 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margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZdUrYNfY8fzW8NOQKaDNFZPMjezbILnQimpj7XLJlarPxZ0A_5Y5VOXGD2D13DuR30ZmpQw1COzlelCnEu7ZWTEEAKhN5cYiK7-vaTXg3vgdvTA4H2JQiPp8zguYsn84FzLkDW2NTyY4/s640/blogger-image-2073731669.jpg"></a></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-11398401308469011992016-01-22T00:38:00.001-08:002016-01-22T00:38:52.400-08:00Second week of workWe parked on a small side street and walked another 400m down a narrow alley, and at the first corner on the right, stepped up to our clients home. Here we find a small two room home; a kitchen and a bed. A young women, very thin and tiny is writhing on the bed in pain. She is able to answer some questions if prodded, but most of the time she is lost in her world of pain. Her young daughter is looking after her, along with her own small child and husband. This woman has a feeding tube because of cancer in her esophagus and this tube is coming out. Her daughter knows that it's time to stop using the tube and make her mother comfortable. She doesn't have much time left. <div>My home care nurse gets the information about this woman's condition, what is happening now, and how things have changed in the last 2 days. A doctor is contacted and orders received. The nurse inserts and butterfly needle into the woman's thin arm and administers morphine. Within 10mins we can see the start of the woman beginning to settle... The pain is not gone yet, but it's improving. The nurse gives her a medication to settle her restlessness. And another dose of morphine. All the while, counselling the daughter about what the options are and what would be the best thing for her mother. </div><div>An hour and a half later, we leave the daughter with some more doses of morphine and a promise to check in again later. This woman is now resting calmly. The daughter asks "how much time ?" We answer as gently as we can "not much time". </div><div>This woman dies peacefully 4hrs later with a daughter grateful for the nurses expertise and support.</div><div><br></div><div>This is the work this team in Hyderabad does. This is the work we try to support. We are attempting to raise excellence so this team can continue to serve their community with dignified and quality end of life care. </div><div>What a privilege to see them at work and walk side by side in this journey of learning palliative care. I take my leave renewed in hope of world wide pain and symptom management and expert end of life care. </div><div><br></div><div>Thank you mnj and palliative care society for welcoming us into your world. Thank you Two Worlds Cancer Collaboration for the amazing opportunity and for your support of this team and many others!</div><div><br></div><div>Jagratada undu! </div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjK3sd7D-SgNs3kZDFBmXsWGGdZ6XZdeB5jEOfWPky6kXR1VWsb4y3Q4nOX1makrZRur2xrhyphenhyphensYKHnHZKj10S-aY_YcoyahYn6RKnxzznNmUOU5YjN3o6P37H0_aGs86z9PbWTtvLpfC7I/s640/blogger-image--1330540492.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjK3sd7D-SgNs3kZDFBmXsWGGdZ6XZdeB5jEOfWPky6kXR1VWsb4y3Q4nOX1makrZRur2xrhyphenhyphensYKHnHZKj10S-aY_YcoyahYn6RKnxzznNmUOU5YjN3o6P37H0_aGs86z9PbWTtvLpfC7I/s640/blogger-image--1330540492.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6iPYH25HUJjbaF8FEffKWDqH1pz0dp_05YwGVS74w_3vygAIbcf1stu7_VGNvdldST8j8Jh-oJyl06ON6CC40FNNvRWgk-iHelLerWP-6hB11y8ULsvATvDPnEqc3ni9mbTdMsLkJMJo/s640/blogger-image-2021406395.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6iPYH25HUJjbaF8FEffKWDqH1pz0dp_05YwGVS74w_3vygAIbcf1stu7_VGNvdldST8j8Jh-oJyl06ON6CC40FNNvRWgk-iHelLerWP-6hB11y8ULsvATvDPnEqc3ni9mbTdMsLkJMJo/s640/blogger-image-2021406395.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggfgqbQqPdw_FhGMnOiIxTUJv9eM-fjTv9v8tbphDDivY1xvJ5km_ZvgPLs5Uu4yUWtE79kMDp_QRARnq-0H5suEpLoz1Mgv-LtJUCrc9tOxhWVUStEuU9yGgmirnwXCPBgn7VYdw7lhc/s640/blogger-image--214755766.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggfgqbQqPdw_FhGMnOiIxTUJv9eM-fjTv9v8tbphDDivY1xvJ5km_ZvgPLs5Uu4yUWtE79kMDp_QRARnq-0H5suEpLoz1Mgv-LtJUCrc9tOxhWVUStEuU9yGgmirnwXCPBgn7VYdw7lhc/s640/blogger-image--214755766.jpg"></a></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-26799433601669170752016-01-16T03:55:00.001-08:002016-01-16T03:55:17.250-08:00Rural programToday we traipsed along with the team to some rural villages as part of the pain and palliative care society program.... Providing medical and symptom management. It was lovely getting out into some villages for a change from the city. We saw some brothers struggling with living with muscular dystrophy, children with diabetes or seizure disorders and of course patients with cancer needing pain control and wound care management. We met such beautiful people in these villages and it's so nice to see a program that is trying to support them (growing from 10 villages to 30!) <br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpFmA8zumJLf_fsto6MuaE9aXX68sHRvOhCJ4yF2GUeHanmYxxEwMEyWI9y_D705cHwbou7J1pTebjJ4JAopq_Z0RCWJefQsAZP28vtN4SmOLLqfganne5F87Sp2TN5kmGZ0R2Hxx0Pp8/s640/blogger-image-273768380.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpFmA8zumJLf_fsto6MuaE9aXX68sHRvOhCJ4yF2GUeHanmYxxEwMEyWI9y_D705cHwbou7J1pTebjJ4JAopq_Z0RCWJefQsAZP28vtN4SmOLLqfganne5F87Sp2TN5kmGZ0R2Hxx0Pp8/s640/blogger-image-273768380.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjeoZtEKR3zRvR_k00KMHFKtZ3GUby_w6eP7R6H7zYT3IwjquZ0GDM2EivAAX227D7HcfbxNVjxDQ6qCQaaqHbrzKNhdnGfY5OCGyCb0naBKTRScDx1iRUoI3c4s6jR8JoTBmSA4UmStE/s640/blogger-image--1398683353.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjeoZtEKR3zRvR_k00KMHFKtZ3GUby_w6eP7R6H7zYT3IwjquZ0GDM2EivAAX227D7HcfbxNVjxDQ6qCQaaqHbrzKNhdnGfY5OCGyCb0naBKTRScDx1iRUoI3c4s6jR8JoTBmSA4UmStE/s640/blogger-image--1398683353.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf6gqBxCmKz7UxgQc_WreAn4VJBdcNoBtkg_9DtTFuSUW4fLl5EN4GXPoVcvfSrH5jPvW86koJnIG-qeiieYY9HH0PTPZh5IgPt5MhyphenhyphennAQWO58QrZx6gVJ_6Upb9nrpSppLxAcgEizFyo/s640/blogger-image-167472172.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf6gqBxCmKz7UxgQc_WreAn4VJBdcNoBtkg_9DtTFuSUW4fLl5EN4GXPoVcvfSrH5jPvW86koJnIG-qeiieYY9HH0PTPZh5IgPt5MhyphenhyphennAQWO58QrZx6gVJ_6Upb9nrpSppLxAcgEizFyo/s640/blogger-image-167472172.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCdv2oT1bX4S5nOuCxfai9kOAFJgwT7lJ61yCs71-kRL6iZfoAJClMGf0FHInPa9RGMSZ6eVibDG7R0JlPAJsS-fTqJvnXqDAxVBu1nqE0XvW2LJVBkFoeoHRJVKF1VyGZD8vlyzeLCVo/s640/blogger-image--784176866.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCdv2oT1bX4S5nOuCxfai9kOAFJgwT7lJ61yCs71-kRL6iZfoAJClMGf0FHInPa9RGMSZ6eVibDG7R0JlPAJsS-fTqJvnXqDAxVBu1nqE0XvW2LJVBkFoeoHRJVKF1VyGZD8vlyzeLCVo/s640/blogger-image--784176866.jpg"></a></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-46411720755714738572016-01-16T03:41:00.001-08:002016-01-16T03:41:07.531-08:00Teaching, kites and more foodYesterday was festival day; a holiday for Hindu harvest and a kite festival. But education gets no rest. We all spent the day at the hospice..... I, with my home care nurses and others teaching the month long intensive palliative care course. <div>My day was spent reviewing assessment skills for nurses. What questions to ask and how to organize all the information for sharing it with docs or coworkers. We reviewed case studies and did role play. We discussed follow up and how to document effectively. We reviewed universal precautions and how to catch hypo active delirium. </div><div>What a great group of ladies this team has! All were eager to learn and able to express knowledge they already have. It was such a great day spent with that bunch!</div><div><br></div><div>And of course we ate! 😉 another delicious lunch was served with dhal and chutney, curry and sweets. After which we drove out to the edge of the city to a kite festival where tons of people were flying a variety of kites.... With a variety of skill level! Good fun, great way to end a busy day.</div><br><div class="separator" style="clear: both;"><br></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOXszDS3IzQs7aVL4j-G4n5-IUnVb4748iUgWB_IKcv5r1tBzXe8pirdD5FjHoQPQRBSZ-9eZ0HWeNiIEEFZ5gohHaB5yBKtGpWqx50phtZBPhARhzFaGuINyM3xrecbpIlM8syOD8LG8/s640/blogger-image-1420195444.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOXszDS3IzQs7aVL4j-G4n5-IUnVb4748iUgWB_IKcv5r1tBzXe8pirdD5FjHoQPQRBSZ-9eZ0HWeNiIEEFZ5gohHaB5yBKtGpWqx50phtZBPhARhzFaGuINyM3xrecbpIlM8syOD8LG8/s640/blogger-image-1420195444.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7SwY7vo7kmklzw0rnbmNXJSDqT_RMD1xgPGNrJDzojoCRBq8mXlAiaemWRkgRnhTJpUpzi8_OdXh22EOKb6qCpZ1-FkE_0p1WqF_ycmaUmjmXGKd7TS-KR92Rihk7QSTQ5EVtRYP5HeA/s640/blogger-image-235315157.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7SwY7vo7kmklzw0rnbmNXJSDqT_RMD1xgPGNrJDzojoCRBq8mXlAiaemWRkgRnhTJpUpzi8_OdXh22EOKb6qCpZ1-FkE_0p1WqF_ycmaUmjmXGKd7TS-KR92Rihk7QSTQ5EVtRYP5HeA/s640/blogger-image-235315157.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQEgXv3pfRimht-sS9dTLJ00rLMpM9Dge9MUjYIox9ejpN4gwRv2_R9kd_km7l7MU-5HiluBosPE_ub-Bm04vgj5hThP3mhwBTzfqpLhvhvOuXhesrfi2dEZXIGW9JN-LdGc0LTOuOF9Q/s640/blogger-image-351744931.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQEgXv3pfRimht-sS9dTLJ00rLMpM9Dge9MUjYIox9ejpN4gwRv2_R9kd_km7l7MU-5HiluBosPE_ub-Bm04vgj5hThP3mhwBTzfqpLhvhvOuXhesrfi2dEZXIGW9JN-LdGc0LTOuOF9Q/s640/blogger-image-351744931.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihY_BapWtkXdzd8qRQfloWJRbKF1faAKjQPkrMFDGIH8I1uG3BcgHYHBJMGdDKLHQvX1UFjL6zpTIzaXR85_3pkpRSxxXz1Of5TPv5xjxVsqGPApexCcMXMuP8C8T_JiSO8QlAX8CAia0/s640/blogger-image--1170266900.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihY_BapWtkXdzd8qRQfloWJRbKF1faAKjQPkrMFDGIH8I1uG3BcgHYHBJMGdDKLHQvX1UFjL6zpTIzaXR85_3pkpRSxxXz1Of5TPv5xjxVsqGPApexCcMXMuP8C8T_JiSO8QlAX8CAia0/s640/blogger-image--1170266900.jpg"></a></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-2245828056884872952016-01-13T18:34:00.001-08:002016-01-13T18:44:12.082-08:00The swing of thingsWe have been in Hyderabad for 3 full days now and i have to say it's been pretty easy getting back into the swing of things. It feels good to be back! The warm air, frangipani trees, chaotic traffic, and 'Indian time' have a familiarity that is nice to me. (Considering this is the first time going back to the same place twice)<div>It has also been very nice to know a little about what I'm stepping in to. Yes, there are some new faces, but plenty of familiar ones too. </div><div>Our first day at the hospital included education sessions on radiotherapy, meeting the docs that head the home care team to sort out what my plan and goal was for my time here, meeting the director et al of the hospital, and of course eating . Man! I love the food!</div><div><br></div><div>The last two days I was riding along with the home care team like last year. This year I see them using the assessment form I created last year, and using the sharps containers in the vans!!!! Both those make me a very happy girl! </div><div><br></div><div>And last night we were whisked about in cars with drivers (thanks to our influential Doctor) to shopping for nice outfits, then to the home of the rich benefactor of our home care program to change into our new outfits and then on to this home of a doctor who happens to live in indias high society but volunteers her time for our home care teams for a lovely evening and dinner! I saw the opposite side of India than we see doing home care visits that for sure!!</div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM2THxdjGSn9dtKkzJGXIMh2ZF6ptaLwUR94TkbpKQgrkA10AH0Qmfu8ujbO9UkkCJOcU1v3J2k48aYJXAhPo2Ysqdhvk2QMAb4f-B2f_sxTRtK1CtxhcqAq_ns2fqH4r784D1_0dwajo/s640/blogger-image-61045658.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM2THxdjGSn9dtKkzJGXIMh2ZF6ptaLwUR94TkbpKQgrkA10AH0Qmfu8ujbO9UkkCJOcU1v3J2k48aYJXAhPo2Ysqdhvk2QMAb4f-B2f_sxTRtK1CtxhcqAq_ns2fqH4r784D1_0dwajo/s640/blogger-image-61045658.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNTF78ZroAsdkfwMfHnaqG_6uvkqVzsmRwX-5pktBBC45DdNEIMICANEufJ6ZocpxI51iYcxvvQbDhG_1FBL6_cymopFWvE1Fbw3z1OpiNuCfWEMLBCdL0kmEqMjJlk-oRmEfd9JroEDY/s640/blogger-image--713656585.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNTF78ZroAsdkfwMfHnaqG_6uvkqVzsmRwX-5pktBBC45DdNEIMICANEufJ6ZocpxI51iYcxvvQbDhG_1FBL6_cymopFWvE1Fbw3z1OpiNuCfWEMLBCdL0kmEqMjJlk-oRmEfd9JroEDY/s640/blogger-image--713656585.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwEp0e-niJiJgc-f6LtLiYiadZsSyhkUcfUW9bfSY1FLANTf-6P17o6KXct96OmdnMpC7OBkxylgwzcdvU7C-IZ1V4hckBEfOrKE7fMQehV5m-xxsqu0l2TQODbwKktLbK1TOapz8261U/s640/blogger-image-651545981.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwEp0e-niJiJgc-f6LtLiYiadZsSyhkUcfUW9bfSY1FLANTf-6P17o6KXct96OmdnMpC7OBkxylgwzcdvU7C-IZ1V4hckBEfOrKE7fMQehV5m-xxsqu0l2TQODbwKktLbK1TOapz8261U/s640/blogger-image-651545981.jpg"></a></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUcbMKHpKL8Zbok1Yxs_RRa6j94JqCgtvsDKgJSDJryVR3bmf8Y3im1Au328zDkCM6-_piV4alXaWtpjh5B8ig2wZZkIunPUC6FRvkJGX8bFI9Jfyi2kuXAjd-xW_yy67lZuBbkFJ-Y_4/s640/blogger-image-1411193904.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUcbMKHpKL8Zbok1Yxs_RRa6j94JqCgtvsDKgJSDJryVR3bmf8Y3im1Au328zDkCM6-_piV4alXaWtpjh5B8ig2wZZkIunPUC6FRvkJGX8bFI9Jfyi2kuXAjd-xW_yy67lZuBbkFJ-Y_4/s640/blogger-image-1411193904.jpg"></a></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-71153067794749950662016-01-06T18:52:00.001-08:002016-01-06T18:52:52.557-08:00Here I go againWell folks, I'm off to India again. I will be going back to the same cancer hospital in Hyderabad India. I will be working with the same community palliative nursing team but this time I am bringing along two other nurses: One is a palliative care nurse I work with here in Kelowna and the other is a nursing professor from UBCO that has lots of experience working in Zambia: in fact both of them do. I'm very much looking forward to working with these two and gaining from their knowledge as well.I will attempt to update this blog again like last year and share on Facebook. Please feel free to share with any other people that may be interested.<div>I'm so excited to be doing this again and feel so fortunate to have the ability and wherewithal to be able to go. This year I will only be gone for about a month. So stay tuned, adventure awaits!</div><br><div class="separator" style="clear: both;"><br></div><br><div class="separator" style="clear: both;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFg4Efo39j2X9VL9rileVP_6BoeIsPr4BqZ6rOVs3WWH-N_K0o18g6vGUtx3GCQIrDKkF5ByAxXBBlK97HnvSu5xa9jKq8Fo1y7ZfOzyX3o6IzzFLCL2ZvyI4eBxRKEKI9Nja6Uet6who/s640/blogger-image--885780491.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFg4Efo39j2X9VL9rileVP_6BoeIsPr4BqZ6rOVs3WWH-N_K0o18g6vGUtx3GCQIrDKkF5ByAxXBBlK97HnvSu5xa9jKq8Fo1y7ZfOzyX3o6IzzFLCL2ZvyI4eBxRKEKI9Nja6Uet6who/s640/blogger-image--885780491.jpg"></a></div>Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-7639654862403127811.post-62409730571847582552015-03-23T03:55:00.001-07:002016-01-06T18:44:24.898-08:00Catching up...varanasi<p dir="ltr">After agra we got on another train to varanasi...which turned into 20hrs on the train! ! :p but we had a lovely quiet guest houae booked with a great little courtyard garden space. It's amazing how a little green can make such a huge difference when you dont have it for so long. <br>
Varanasi is a smallish city along the banks of the holy river Ganga. Im not sure how many people know already, but the Ganga has actually been proven to have a microbial uniqueness with higher than normal oxygen levels which actually maintains a "cleanliness" to it....despite the obvious uncleaniness it is subjected to every day. Not only is the water severely littered with the usual garbage, but it is also the place to bathe and perform morning puja, the final resting place of the cremated bodies, the bath for the cows, a toilet, and a swimming pool. Truthfully, its not the most inviting water, despite knowing the science. <br>
However.... the morning and evening pujas to shiva (creator god) are colourful and somewhat inspiring. The candles and flowers in the water are even pretty. I tried to imagine what the opposite banks would be like during the MASSIVE holy festival, where tens of thousands of pilgrims cram into a very small looking place for a chance to dunk in the river. But I know my imagination doesn't even come close.<br>
We took both a sunrise and evening boat ride along the river...watching the activities along the ghats.<br>
This is a city of steps. The whole river front is one set of stairs after another (ghats). We spent hours wandering up and down the ghats...watching children play cricket or badminton, holy men in bright orange wraps heading to or from temples (of which there are tons as well), laundry being washed and laid out to dry, and people just plain loitering. <br>
Then there are the burning ghats. The place where a persons body is brought to the river, placed on a wood pyre and after holy ceremony, is burned. The ashes are then carried down to the water and washed into the river. Cremation is of course a very natural form of body disposal. And I have to say im glad most indians dont waste precious amounts of land in the overcrowded country. One of my first observations however, was how matter of fact the final process is/was. There was a part of me that like that. The person is no longer there and they are disposing of the earthly body. But there didnt seem to be much in the way of emotion....either celebrating or grieving. That makes me think that sort of thing has already happened elsewhere. There were also never any women in these families. It is something I need to learn more about because we only saw the outside. There were a few graphic moments here and in the river that took a little processing...but im not going into details here. If you're interested in the stories please just let me know and I would be happy to discuss further.</p>
<p dir="ltr">This city by far had the most cow poop in the steets out of any one we were in, and it got old fast to constantly be sidestepping it. (The rain one day didnt help either) <br>
The one contradiction I couldn't get my head around was for such a holy city and reverence for the river etc...there seemed to be zero attempt at keeping the place remotely clean.<br>
Which is so sad to me because it is such a cool little place. It really was an unforgettable experience.....</p>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-84696839757400071702015-03-15T03:58:00.001-07:002015-03-16T01:05:14.225-07:00Agra photos 2<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDeodiXCoRhTPNDY_vIQtKhwZdFSG16Scq526-EzP07hJpc8Mcf6yTciapoXHgoz_xkZjVKJHC-bB9w39dJYOS4LnO5ykZPimzobvH7aoL8Jzdo9PoUg5lXoG1CtR7KdBipR7-9T3CNJI/s1600/20150313_122024.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDeodiXCoRhTPNDY_vIQtKhwZdFSG16Scq526-EzP07hJpc8Mcf6yTciapoXHgoz_xkZjVKJHC-bB9w39dJYOS4LnO5ykZPimzobvH7aoL8Jzdo9PoUg5lXoG1CtR7KdBipR7-9T3CNJI/s640/20150313_122024.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhlZYM_BeCE5vfv3M-F0h3mXUV2ZixtmO2wg3V3D86p_2IFTgwqPQAr3CHn9w_knDcPALdgwTyaGw_vxmsxO2QcUnAXy4vwk5gzKOzygIlw-RpdecdlzhUmnpG3q6r5kMpqsgXfr2UnLTM/s1600/20150313_125233.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhlZYM_BeCE5vfv3M-F0h3mXUV2ZixtmO2wg3V3D86p_2IFTgwqPQAr3CHn9w_knDcPALdgwTyaGw_vxmsxO2QcUnAXy4vwk5gzKOzygIlw-RpdecdlzhUmnpG3q6r5kMpqsgXfr2UnLTM/s640/20150313_125233.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPIc_mkHLiffYl9vOE8P2eHgBtRdytTzb06x8AOR-njnqyPQcWU-7QuIg4ZptVxQYYh5T43yYz6WnGdDGegPCPCjmf_QFnu5mple2VVg5LWAevqPwkrvWMIDJofTx1YNk-jtJy1gf3CMs/s1600/20150313_140113.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPIc_mkHLiffYl9vOE8P2eHgBtRdytTzb06x8AOR-njnqyPQcWU-7QuIg4ZptVxQYYh5T43yYz6WnGdDGegPCPCjmf_QFnu5mple2VVg5LWAevqPwkrvWMIDJofTx1YNk-jtJy1gf3CMs/s640/20150313_140113.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0DarIMq20axBCFWJjuq2XBy5tSrFF8RnA_kLQtxzbW1UcyD_kufqzjvEY6dFM2g3Er8bwNzKVEqvFCIBUXhVTFRms5xaPim1ZNuuXhHc8UDEW_ZBh5VX-Tbizyuindm3aXY17L_BMsag/s1600/20150313_141532.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0DarIMq20axBCFWJjuq2XBy5tSrFF8RnA_kLQtxzbW1UcyD_kufqzjvEY6dFM2g3Er8bwNzKVEqvFCIBUXhVTFRms5xaPim1ZNuuXhHc8UDEW_ZBh5VX-Tbizyuindm3aXY17L_BMsag/s640/20150313_141532.jpg"> </a> </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-20761179165028896222015-03-15T00:55:00.001-07:002015-03-15T03:44:18.337-07:00Agra photos<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsllWmMXv2RPFOnGjSTu3cCSvhGfy6h3PNmrvBMLbMJ1-YvhNu9CtU6Xhz_H7mHdm21VlPu-RMf56PDP5S7-EU-0_7zfEu60YMXlhs8Gxi6vwzqpn3_XgVFqKO57M2lgMf1hx49mHZs7E/s1600/20150313_110145.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsllWmMXv2RPFOnGjSTu3cCSvhGfy6h3PNmrvBMLbMJ1-YvhNu9CtU6Xhz_H7mHdm21VlPu-RMf56PDP5S7-EU-0_7zfEu60YMXlhs8Gxi6vwzqpn3_XgVFqKO57M2lgMf1hx49mHZs7E/s640/20150313_110145.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwHdNn5X5uWJ_bfdlhBbhgfiMmeOSj_1KZD4yh68AeS9qy9xYwuS54QS87rqvi1aYpKAf7IaqAqiJIal5UxICsnctCM2Vru6EaO_629SlWdKhjsow9sMoxdpOkHgbcRHXGt7tgGuSAkFI/s1600/20150313_115035.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwHdNn5X5uWJ_bfdlhBbhgfiMmeOSj_1KZD4yh68AeS9qy9xYwuS54QS87rqvi1aYpKAf7IaqAqiJIal5UxICsnctCM2Vru6EaO_629SlWdKhjsow9sMoxdpOkHgbcRHXGt7tgGuSAkFI/s640/20150313_115035.jpg"> </a> </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-6556158149884581502015-03-13T21:46:00.001-07:002015-03-13T22:00:34.071-07:00Agra<p dir="ltr">After a fairly uneventful flight and a train ride that was actually on time, we arrived in agra. Home of the famour Taj Mahal. Our guest house had a distant view of it from the rooftop, although the smog and haze blurred the lines of the beautiful white building. That night and into the morning we were welcomed with thunderstorms and rain. Thankfully it let off by mid morning and we were able to spend the day wandering UNESCO sites. <br>
Turns out the taj is closed on fridays but we saw the outside of it from just about every angle. Including a lovely garden on the opposite side of the river that was built in 1520 with the intention of being the site for the black taj...which never happened. <br>
We wandered thru the agra fort which has seen many a battle over its control. There were grand marble buildings, sweeping courtyards, hidden stairs, and ornately carved archways.</p>
<p dir="ltr">The town itself is tired and filthy (despite actually spotting a recycling bin program). There are all kinds of rules and government signs to appear like they are trying to clean up these cities but practice and reality are very different. (In fact the hospital in Hyderabad didnt even have an incinerator for bio waste.) </p>
<p dir="ltr">However, our guesthouse was pleasant and we enjoyed our stay.</p>
<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXoHabDg9Uq9KH6zHwhJFLsabWKC0e1ksBNBGEIozriCRbQhY4q6kaazVdtpg9jR_1PfLWKDVNa2FCefqSO3mnxvV_Jjmvg7w4dvn1lzh7emtP_S1Z7UgzSvFCRVfLegBlBMBSUdJO4hk/s1600/20150313_095721.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXoHabDg9Uq9KH6zHwhJFLsabWKC0e1ksBNBGEIozriCRbQhY4q6kaazVdtpg9jR_1PfLWKDVNa2FCefqSO3mnxvV_Jjmvg7w4dvn1lzh7emtP_S1Z7UgzSvFCRVfLegBlBMBSUdJO4hk/s640/20150313_095721.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYcvQoX_YItHSm8eVhmKb2iLj5gOKAQw1UuLloH4XJtCbuDA-FRh7T9Wxehnwx-l1tvoaRwVOz2NeJSR6CxsFiZVEMrOO9lmUfdOO0q3vC6JUh31Af_Q6Nxz5E0gPNNNHQM7rYkTLoSXI/s1600/20150313_101349.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYcvQoX_YItHSm8eVhmKb2iLj5gOKAQw1UuLloH4XJtCbuDA-FRh7T9Wxehnwx-l1tvoaRwVOz2NeJSR6CxsFiZVEMrOO9lmUfdOO0q3vC6JUh31Af_Q6Nxz5E0gPNNNHQM7rYkTLoSXI/s640/20150313_101349.jpg"> </a> </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-8678977088388586342015-03-11T04:43:00.001-07:002015-03-11T05:01:26.394-07:00So long Hyderabad<p dir="ltr">We are saying goodbye to Hyderabad tomorrow. This is an insanely busy, crowded, loud city with some cool people who work their little butts off to make it a better place. </p>
<p dir="ltr">We played "holi" festival of colours with the staff one morning, caking everyone in powdered colours. (Some of which didn't come off rosemary' s face for about 3 days! !) This is now my favourite festival for obvious reasons.</p>
<p dir="ltr">We visited the golconda fort amd tombs. (Which of course we paid 10 times the amount...just for being a foreigner) Large beautiful mausoleums to sit on muslim graves and ancient walled forts that have seen many battles over its control.</p>
<p dir="ltr">We saw a huge white marble temple and many brightly coloured temples scattered all over the city. My favourite is ganesh who gives good karma to new beginnings. (Again, for obvious reasons)</p>
<p dir="ltr">We wondered thru some of the parks ....if we could ever find the entrance. And of course we would be gawked at and even leered at, so never really stayed long.</p>
<p dir="ltr">But most of all we enjoyed working with this team. Last week I taught several sessions of palliative symptom management to a new class taking the one month palliative course. Rosemary cleaned and organized/inventoried the home care vans after we bought them some drawers etc. We created symptom management protocols, new assessment forms and a new protocol for sharps disposal (which was non existent).</p>
<p dir="ltr">And overall, we are astounded at the care, compassion and pure will this staff has to do this job! Well done everyone! I am looking forward to coming back! </p>
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They have 3 teams that are based out of the MNJ cancer hospital, with 3 vans. The vans are driven by a driver, and the team consists of a social worker and a nurse (ideally). <br>
Each day the social worker does the case management and decides who needs to be seen that day based on priority or who phoned the night before. The driver helps decide according to geographic area. This city is huge and CROWDED. These teams cover anyone within 40kms of the hospital, and 30kms in this city will take 1-1.5hrs to drive! Because of this, seeing 3-4 patients is a full day often. Sometimes only 2 and sometimes if they're close...5. <br>
Last year they had a total of about 90 patients for 3 teams. They now have 120. And since he conference and the advertising that came with it, there has been a HUGE influx of new referrals that want morphine for pain control. You might think this is drug seeking but its not. Most of these patients have cancer and cannot get morphine anywhere else. Pharmacies do not carry <b>any</b> opioid and they must come to MNJ in order to get any. (Which has only been avail for 7-8yrs now). Doctors are scared or don't have the knowledge to order morphine (indian laws could land you in jail on the suspicion of misuse...without evidence). The cancers we see are often late stage and obviously painful.</p>
<p dir=ltr>This has now led to these teams and the palliative clinic and the hospice to be overwhelmed and inundated with patients. But to hear where they came  from 8yrs ago is amazing. The growth has been exponential. </p>
<p dir=ltr>The teams are very knowledgeable of palliative symptom management and the care for these people is astounding.  They work 6 days a week from 0930-1730 (ish...in true indian form) often working well past that. Sunday is their only day off (except holidays) and they are paid a modest monthly salary. (No overtime for those late days). On top of that the counselor and nurse carry an after hours phone for 15 days each and answer phone calls 24 hrs a day. So even if they get called during the night, they come to work in the am. There are no evening or night visits however....as women are not safe out after dark.</p>
<p dir=ltr>The nurses will do just about anything in the homes from injections to ascities taps. The counselors do amazing work with pyschosocial issues as well as communicating medications and procedures and end of life processes. (They are incredible people). One cultural issue that I am having trouble with is that most patients are not told their diagnosis let alone prognosis! The norm seems to be all information is communicated to a family member.  Therefore, the team must ask/seek permission from the family before discussing this with the patient. And if the family says no, the team (including doctor) must find ways to support the patient without saying anything about the real problem! This has made me so grateful for our culture of autonomy as being paramount.</p>
<p dir=ltr>The nice part is that if a family come to MNJ for morphine and cant afford any medicine, they can get it for free. If the family have money, they will pay for their medicine. The teams are also carrying small amounts of medications that they can give inital doses to the patient/family until they can get to the hospital to pick up more. </p>
<p dir=ltr>In India, chewing tobacco and/or beetlenut is a common practice, and we see a lot of head and neck cancers, with wounds like we rarely see in Canada.  The other problem is that most people present for diagnosis very late in the disease process and often have little chance of cure. The team does a lot of teaching of proper wound care but see a lot of problems like infections and maggots related to poor care and poor living conditions. Many people we see live in very simple and poor conditions with little to no education. It proves difficult for teaching families and seeing compliance with care or med administration.  And even with good teaching, access to medications and home support, we see patients in pain, not receiving good care. These teams find this very distressing and disheartening.  And with the huge growing numbers of patients, they also feel spread very thin.</p>
<p dir=ltr>We have tried to support the teams with education, encouragement, friendship, action, and supplies to try to make work more efficient. A major barrier is lack of resources. The hospital does not even have a proper incinerator to safely dispose of waste (aka. Needles and sharps etc). So the staff had let that compliance slide because there was no facility support. We are trying (as a whole) to be creative in finding solutions to solve some of these basic problems that are within the reality of practice here. For example: our best practice is to never recap a needle to avoid risk of sticks by the needle. However, here, a lot of garbage ends up being rummaged through, often by children. (Cause the hospital doesn't have proper disposal) so the team decided to use 'safer' recapping so that at least the needles that end up in the garbage would be capped and not stick someone! (Thankfully the hospice now pays for safe and proper disposal of wastes. So at least the palliative team is doing it right!)</p>
<p dir=ltr>Its humbling to work with these amazing people and inspiring to brainstorm ways to improve, build, support. This entire program runs on an NGO support because the government doesn't see palliative care as part of basic health care services. <br>
Huge shout out to the Pain relief and Palliative care Society  <a href="http://palliativecarepartners.in">(www.palliativecarepartners.in)</a><br>
And Two Worlds Cancer Collaboration <a href="http://twoworldscancer.ca">(www.twoworldscancer.ca)</a></p>
<p dir=ltr>Please support them if you feel so moved to do so. </p>
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[Side note: there are no actual addresses around here.... a few streets have names but houses are tucked back into mazes or lanes and alleys with no names. So addresses literally have landmarks such as "across from the sai bubba temple". So we had to get off at the bus stand and wait for her to come and lead us to her house. ]</p>
<p dir=ltr>We arrive at her house, being introduced to all her siblings and mom and their children...had a cup of chai and were entertained by the children with song and dance. <br>
Then we were told to go upstairs to the rooftop where we walked straight into a home church service...in Telugu. Thankfully the brother who was preaching, only put the spotlight on us for a few mins. After the service we were ushered downstairs again to eat with the children, while the adults all sat kn the rooftop and ate. Huh.<br>
Then as we were leaving to find another auto (which we told our college about 4 times).... there were two young men with motorcycles that she told us to go with. We thought they were just taking us to the main street to find an auto, but nope.....they were driving us all the way back to the hotel. So we got the authentic indian experince of riding on the back of a motorcycle, weaving through crazy night time traffic. I enjoyed myself. ...rosa was hanging on for dear life, but was a good sport about it! Hah! </p>
<p dir=ltr>Ps: yesterday I saw a sign on the highway that stated Hyderabad was the worlds #2 tourist place. Votes? </p>
<p dir=ltr>Pps: to add to my previous post....<br>
I like eating with my hand.<br>
I REALLY REALLY dont like all the garbage. This is a serious problem in so many countries I visit .... im starting to feel a serious need to change things. <br>
</p>
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<p dir=ltr>I love the tiny cups of piping hot chai. I love the sparkling bright colours everywhere. I love the head waggle (and im getting pretty good at it!). I have even come to love the conversation of horns in the street. If you really listen, you can hear what they're saying to each other. "Im right here" - "excuse me, I'd like to pass" - "GET OUT OF THE WAY! !!" - "would you like a taxi? " - "move over!" .....<br>
I love biriyani rice and palak paneer. </p>
<p dir=ltr>I don't much like the leering stares, that swivel heads 360 degrees as they stumble into traffic,  but if its purely curiosity, I've started waving and saying hello. That usually makes it stop. ;) I dont much like the constant and utter chaos in the streets All. Day. Long....but again...I've come to sort of enjoy the ebb and flow and pecking order that are the streets, and have gotten pretty good at weaving through it all too! I don't much like that there are indian prices...and then there are foreign prices. </p>
<p dir=ltr>And then there are things that crack me up!  Like an auto rickshaw full of coconuts, or two camels being walked across a bridge. Or a cow dressed up with a floral halo being walked thru busy traffic on a main st in mumbai. Or a family of five on a motorcycle; toddler usually fast asleep on the gas tank, dad driving, kid sandwiched between dad and mom who is riding side saddle holding and infant. A man reading the newspaper on the back of a motorcycle.  A man carrying a dresser on a motorcycle.  Carrying just about anything or everything frankly. Like a huge bunch of balloons or a huge piece of glass.</p>
<p dir=ltr>This is a land of contradictions.  Of tastes and smells and sounds and colours that all delight and don't.  But all in all...I think we're getting along pretty good so far.</p>
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margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRCG8EBmHtc65cDXec0lrVcnqcKLmNmb3Eb3GSJkRqcZlqPKf5v2AQaqhpxhl8-LIV0RqjzVfIvqMCcpke6Knn-qFht2WY8ZqsK8EbrU2qAX5va4hVSusfy6hjC7xez2AOhtSP92_aah0/s640/20150222_164929.jpg"> </a> </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7639654862403127811.post-16773965551830935072015-02-21T08:05:00.001-08:002015-02-21T08:41:41.017-08:00Conference<p dir=ltr>Our first weekend in Hyderabad was spent attending the International Indian Palliative care Conference. We spent 3 days meeting leaders in palliative care from all over the world, working so hard to bring good palliative care to everyone. The theme was innovate, integrate, and influence. We heard about a lot of new studies, both in evidence for new practice and in where and why the palliative care is most needed. One of the big focuses this year was on new indian legislation, improving the access to opioids (which at this point is mainly morphine). There is still a long way to go and a lot of people fighting for the human right to access of palliative care and pain control. I heard about about pediatric palliative care and its limitations. And why we need early screening and intervention ; cultural barriers here in india . We heard about alternative therapies like yoga and blowing bubbles ;) how to incorporate into critical care and emergency medicine; support for caregivers; symptom management ideas; spirituality(which is hugely important here); palliative care in non malignant diseases.... <br>
All in all, it was an excellent gathering of some of the top people in palliative care around the world with poignant things to say, and the most inspiring women!!! A surprising amount of female doctors and other inspiring women making a huge difference in this world! <br>
I feel honoured to have met so many amazing people.</p>
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We arrived at the "bus stop" very early cause we had nothin else to do...and met two pairs heading to bangalore...two different bus companies...but both were due for departure at 730pm. By 8, neither of the buses had shown up. Shortly after the one company's bus rolled right past the stop without slowing down. Thankfully, the girls managed to catch it. Then the other pair's bus rolled by after 9pm and didnt slow down, despite the dude waving the bus down!!! So then they had to wait until the next bus who picked them up and met them with their proper bus at the next stop!!! <br>
Our experience: several buses from the same company came by but none for Hampi. Finally an hour late a decrepit looking bus rolls in. The men running the bus didnt seem to have a clue what they were doing. Then a second nicer bus rolls up and then the dude realizes half the people going to Hampi were on that nicer (aka. A.c.) bus. We get to our spots after another couple vacated to the other bus to find two single sized strips side by side to make a double. No curtain. Bent rail. Drunk russian below us. Excellent. <br>
We did manage to snag same deal but with a curtain across the way but sleeping on a moving bus, crammed side by side did not equal any sleep for me. <br>
Chocking that one up as experience.<br>
But.....we did arrive in a fantastic little location. A large spread out area of ruins of a hindu nation fron the 16th century. Amazing stone work and temples galore! All tucked in among banana fields, rice fields, and a lovely river running among some amazing monolithic rocks!!<br>
We spent the day wandering these ruins and are now spent! Few more hrs tomorrow to finish it off and we'll be on the train to Hyderabad! !!</p>
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An overnight train on a bunk barely wide enough for a person....but the coffee and chai were readily available and cheaper than chips. (They love to say that here...thank you england for the influence ;)<br>
We found ourselves with a beach front room, literally steps from the water. The room is simple but cheap and the surf puts us to sleep each night. <br>
The water is a perfect temperature and the soft sand is throughout the bay. Sure...its filled with tourists but this bay still manages to be quiet and underdeveloped, with simple beach huts and rooms lining the beach. No high rises or big resorts. <br>
I kayaked out to a small island and along the coast dotted with secluded little beaches a couple of times. We had fresh tandoori fish , dining right on the beach. We swam. we sat on lounge chairs under an umbrella. We basked in the warm sun. </p>
<p dir=ltr>Today, however I did something different.  I hired one of many royal enfield motorcycles and went for a ride into the mountain jungle. It was a narrow winding road where you never knew what you would get around each corner. A lori passing a car on a corner; a brightly painted temple; a couple of cows; people walking with huge piles of wood or water on their heads; a monkey. ... <br>
I stopped at a tower lookout near the top of the mtn, where a van full of men happened to also be taking a break. After a nice view of the valley below I head back to the bike...and have no starter. Within a couple of tries on the kick start, I was surrounded by this gaggle of men jabbering away. With their insisted help, we got the bike started and I was on my way again. Later on down the road, I stop for a cold drink. And the bike won't start again. This time the kick start won't work and I enlisted the help of a standerby to push start the thing up again. <br>
At this point I have lost trust in the bike and head back without another stop. Despite the failed bike, I really quite enjoyed the ride...and even the traffic that doesn't seem to follow any rules other than "bigger is better and gets right of way".<br>
A lovely relaxing spot to chill before we head to Hyderabad to start work.  </p>
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Even when it wasn't. </p>
<p dir="ltr">We have now spent 4 days tramping around the streets and neighbourhoods. We have seen everything from posh new high rises to colonial british buildings to the poorest slums in the world. We watched thousands of men doing loads of laundry in the outdoor washermans colony "Dhobighat". We saw muslim mosques and hindu temples. More colourful saris than we can count! <br>
The city practically vibrates with people, horns, black and yellow taxis, dogs some goats in t-shirts and a few cows. </p><p dir="ltr"><br>
I even got the chance to meet up with a gorgeous couple I met ice climbing on a glacier in alaska (as you do) for an evening out. We had drinks at a local watering hole and a delicious meal with these yogurt filled pastries being the favourite.</p>
<p dir="ltr">We braved the city trains (which ended up being way easier than we expected) to another up and coming suburb to check out some graffiti. </p>
<p dir="ltr">We took a ferry over to an island with caves filled with ancient carvings of hindu deities. on the way back however, our motor broke on the ferry qnd we sat drifting for about hald an hour until another ferry came along and pulled us back to the harbour. </p>
<p dir="ltr">The air never really clears up. The locals walk on the road with all the crazy traffic instead of the footpaths. (We have managed to get pretty good at dodging traffic as we cross these busy streets. ) pedestrians are very low on the totem pole of importance on the roads. But even the constant honking and weaving and zipping around each other on the roads didn't seem to bother us much. The red lights and lane lines are merely a sugeestion and frankly. ...I think I could quite enjoy driving here! ;)</p>
<p dir="ltr">We loved our little restaurant at the bottom of the hotel where the only english speaker was a manager who always took care of us. Chapati bread, boiled eggs and curd (local yogurt) was our breakfast usual. The small cups of chai for 2 pennies is refreshing and delicious and readily available just about anywhere. </p><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDz8HokWVCOntMK1WPgVAuHsXKTiqQo2HK8frLCi9VnjPLcoMA_0rXzBwHl8wKLAxCF_OSV1ZKW3qbtiyKRZOcjKe3G6aT9a0itY8jhXX1t23f1zShvBPaxSRU2WhD0Zvj3uxDT0zIfJg/s1600/20150131_231955.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDz8HokWVCOntMK1WPgVAuHsXKTiqQo2HK8frLCi9VnjPLcoMA_0rXzBwHl8wKLAxCF_OSV1ZKW3qbtiyKRZOcjKe3G6aT9a0itY8jhXX1t23f1zShvBPaxSRU2WhD0Zvj3uxDT0zIfJg/s640/20150131_231955.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1T4FthOfRIHe2-gEjiueodKhoRWWHRxFg49ga60MvDPjwTgIynLKntuibaHSs7LUb1tEgiHYPgTrG6I_W_hf64sQaVL-_rpnyFC20yy5HJT_qcuA6m4U20p5sI_g3udlCD7IozOfPjyc/s1600/20150131_223500.jpg" imageanchor="1" style="margin-left: 1em; 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<p dir=ltr>But I'll back up. </p>
<p dir=ltr>First we followed a blizzard to new york and spent a day in a freeeeeeezing NYC! But perfect excuse for a broadway matinee.</p>
<p dir=ltr>Our 14 hr flight to Mumbai got us in a bit early and much to our surprise, breezed thru immigration and customs without so much as a glance in our direction.<br>
What we expected as chaos turned into a quiet but long wait for our luggage and both pieces arrived...in tact! Which is always a victory in my mind!<br>
We even prepaid for a taxi, lined up in a quiet cue waiting for a customers voucher (vs the haggling and bombardment we are used to getting at other airports around the world)<br>
Our driver got us to our hotel without straying/getting lost which is another victory! And to top the night off we were shown to our hotel room straight away which was exactly as we had reserved. The final victory in a very long journey.</p>
<p dir=ltr>Today has been an excellent day of wandering thru a fish market first thing in the am when we were attempting to find sonewhere to buy a SIM card for our phones ! Finding a posh organic coffee shop for lunch where we convinced the poor young bloke we were French. Wandering thru street stall markets and poshy artisan shops. And seeing the amazing but seriously out of place english architecture from the old british empire. <br>
I loved the brightly coloured women in saris, the warm sun and the hot chai. I might change my story in a few weeks but today.... it wasnt nearly as overwhelming as I thought it would be. The streets are surprisingly clean , the people are generally polite, the traffice seems perfectly tolerable (even crossing the big roads on foot!) And the smells really havent been that bad.</p>
<p dir=ltr>So all in all we're still a bit weary but in good spirits from our first day. </p>
<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBJxwRDlVMrRp15d5ajLMy577w4H3hYXwTw-Pu9RDPE67PERQDbPvBQWX0waRrv-TMEH_vN22HinOSO2u2B7pEh6x2i4FI31o_AVcketLiqMrQeUC79td4csZM0Tbe-4DW46jAMRuBqlw/s1600/20150130_154259.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBJxwRDlVMrRp15d5ajLMy577w4H3hYXwTw-Pu9RDPE67PERQDbPvBQWX0waRrv-TMEH_vN22HinOSO2u2B7pEh6x2i4FI31o_AVcketLiqMrQeUC79td4csZM0Tbe-4DW46jAMRuBqlw/s640/20150130_154259.jpg"> </a> </div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-7639654862403127811.post-87955297958865626562015-01-23T19:18:00.000-08:002015-01-23T19:18:28.493-08:00another new beginning<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKgyO1xo_A0fEU3K2W7bcp-b6fjtVtFF46jmY9YP7BXzIOh3R1xEwG36s-R6lj5128B9tl6MntpD2gndewBRwPsOMZgBAeTbGu90k1uwNCTWRlll9wndBd1TbEcAOzclzdZaP4vu4JmpQ/s1600/Jappie_eu_Vlies_fotobehang_Indian_Hands_02.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKgyO1xo_A0fEU3K2W7bcp-b6fjtVtFF46jmY9YP7BXzIOh3R1xEwG36s-R6lj5128B9tl6MntpD2gndewBRwPsOMZgBAeTbGu90k1uwNCTWRlll9wndBd1TbEcAOzclzdZaP4vu4JmpQ/s1600/Jappie_eu_Vlies_fotobehang_Indian_Hands_02.jpg" height="250" width="320" /></a></div>
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<span class="Apple-style-span" style="color: #4c1130; font-family: Verdana, sans-serif;">It is with an open heart and mind, I embark on the latest of adventures in this amazing life I get to call my own. </span></div>
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<span class="Apple-style-span" style="color: #4c1130; font-family: Verdana, sans-serif;">Jan, 27th we (rosemary; a nursing friend of mine) will board a plane to Mumbai, India. We will be volunteering in India with an NGO "Two Worlds Cancer Collaboration" (<a href="http://twoworldscancer.ca/">twoworldscancer.ca</a>) for a total of 11wks, aiming to bring knowledge of palliative care to the health care professionals in India and Nepal. </span></div>
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<span class="Apple-style-span" style="color: #4c1130; font-family: Verdana, sans-serif;">I will attempt to keep this as up to date as I can; sharing the journey for those that wish to hear/read/join/see.</span></div>
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<span class="Apple-style-span" style="color: #4c1130; font-family: Verdana, sans-serif;">so stay tuned.... mark this page... keep an eye on facebook....</span></div>
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<span class="Apple-style-span" style="color: #4c1130; font-family: Verdana, sans-serif;">it shall surely be an adventure!</span></div>
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Unknownnoreply@blogger.com0