"There was a foreigner here once before ..."

A day's journey brought me to the town of Gelephu, where a 60 bed regional hospital serving the population of Southern Bhutan was the site of my students' 2 week long clinical affiliations. Stepping off of the Bumpa Coaster without a clue as to where I'd stay that night or how I'd find my students or the hospital the next day, I discovered that a 2 minute walk oriented me just fine to this small town. I checked into a hotel and sat down with the owner to enjoy a cup of coffee and offer my advice regarding his father's recovery after having suffered a stroke several months back.

The following morning I was welcomed to the Gelephu Hospital with warmth and a bit of wonder. Travel to this region of Bhutan was opened up to foreigners a few years ago, but history of political unrest, conflicts with neighboring India, and a lack of tourist attractions has kept nearly all ex-pats and tourists away. However, my week in Gelephu was full of some of the most rewarding experiences I've had thus far in Bhutan. Together with my students, I evaluated and treated patients with diagnoses and clinical presentations I was very familiar with. I taught my students techniques to reduce shoulder pain in a middle aged woman from a nearby village who had sustained a stroke, and my students taught me how to use a simple scarf to function as an arm sling (note to all the PT's out there: try this! Scarves can easily be tied over the arm to give support, but even more importantly, maintain scapula retraction and humeral external rotation ... economical and much more effective than a givmor!). However, I was also faced with the challenge to work on patient cases I had never seen or heard of before. I was stumped when two young women entered the clinic, heavily aided by their husbands and walking sticks, with diagnoses of "post-partum neuropathy" lending to the inability to walk following labor and delivery. Evidently this is a condition not uncommon to Bhutanese women, and my research regarding possible causes of it has begun in earnest.

The time I spent treating the local villagers with my students was productive from a clinical standpoint, and I was grateful to have bonded with them on a personal level as well. One day after work they showed me to the town's main attraction, a fishing pond complete with a piggery. I felt a profound sense of peace as the sun was setting, being surrounded by the beauty of this land and having been given the opportunity to get to know my students on a deeper level. We talked about our personal lives and perspectives on various issues in Bhutan and America. Caught in the middle of apprecation and struggle though, I couldn't stave off the repeated question going through my mind ... "Bernadette, what are you doing at a fishing pond that could be full of mosquitos in a malaria infested area when you are not on malaria pills?!" I guess I'm still working on how to be at ease and let things go ... or, am I warranted in just asking myself logical questions???

My last afternoon at the hospital was spent enjoying tea and cake with the physiotherapist and hospital administrator. "There was a foreigner here once before ..." they mused, but without being able to recall any additional details, officially thanked me for being the first foreigner to volunteer my time at the Gelephu Hospital. I was invited to return, and if I can find some malaria pills, then I just may! Despite the lack of hot water, bugs in the hotel rooms, and difficulty digesting food from the local restaurants, the opportunity to treat these patients in Gelephu would undoubtedly make this experience worthwhile once again.