Getting there.

As you probably know, by mere virtue of the fact that the Himalayan Mountains dominate the northern border of Nepal- this is a country with a diverse and rugged landscape.  The lower plains of Nepal along the Indian boarder are referred to as the "Terai"- it ranges from flat to rolling hills and it's climate is hot, humid and at times quite wet.  As you head north toward the Chinese border, the topography becomes increasingly rugged - from the "Lower Hills" to the "High Hills" to the "Mountain" areas.  And while man has conquered Mountains by skiing down them, boring thru them and climbing up them, the mountains and hills of Nepal are anything but tame.

Despite all this 'hoopla' about tough geography, remote villages, lack of this or that, blah, blah, blah... a team of eight of us (plus drivers) was setting off in three vehicles to a remote area of the country that would take us from the terai through the hills to the edge of the Himalayas with the intention of answering a host of questions that would inform our approach to improving access, managing cost and enhancing the quality of healthcare in the remote areas of this mysterious, yet captivating country.

In this rigorous landscape, the word 'remote' takes on new meaning.  It means you get your water from the rain, the river or the melting snow-capped mountains.  It means you get your electricity from power that is generated from harnessed water that rushes through channels in the mountains or from solar panels atop your south-facing, mud-hut roof.  It means that when kids head off to school it's a 4 hour trek before school and another 4 hours after.  'Remote' also means that if you want to ... make that NEED to see a doctor, you can walk up to 3 days (yes, DAYS) to get to a health post and then pray that the doctor showed up that day - if there is a doctor posted there at all.  It means you can't call in advance to make an appointment; you can't select your provider; you can't expect that medicine will be there when you need it and you'd better have friends or relatives with strong backs (who love you a LOT) in case you need someone to haul you up or down a mountain to a health post to see if you can find someone who might be in a position to tend to your needs.  [Never mind have the tools necessary to address them.]

Imagine for a moment there is only one road that leads to your village - it is subject to heavy rains, erosion, landslides and the stress that tractors, busses and other vehicles put on it.  Noone in your village owns a car - noone!  The road to your village is like the coronary arteries that feed the muscle that pumps life through your body and if it should suddenly close - just like your heart can arrest, this paroxysmal collapse of life-sustaining nutrients can end life as you know it as it threatened to for me and my team when we visited the remote village of Manma in Kalikot District - located in the upper hills of mid-western Nepal in early May of 2011.  The horror is still fresh in my mind and will remain there for years to come.

Our driver overlooks Kalikot district upon arrival.

It was Sunday night, we had just completed a 12 hour drive deep into what must be one of the most remote locations on the planet.  The views en route, while treacherous, were spectacular and awe-inspiring.  The last 30 or so kilometers of our trip took nearly 2 hours (on the Autobahn, 30 km would take roughly 12 minutes) - through water, over rocks, in mud requiring periodic stops to 'road repair', assess risk and slowly migrate toward our destination.  There were times we held our breath, held silent vigil and negotiated with our ultimate judge for one more kilometer.

 Just as we arrived, the rains began (although it's pre-monsoon season, when the rains hit, they hit hard).  They began slowly at first and increased in intensity as we listened to the thunderous drumming on the corrugated metal roof of what I began to refer to as the 'dungeon hotel'.  The "White Guest House" in Kalikot is no rural resort, no upgraded safari bungalow and no place for someone of your caliber to spend a single day of your blessed life.  It was...well, let me just say it was an experience I shall never forget and lest any one of us should ever complain that the thread-count in our bed sheets does not exceed 500, a visit to the White Guest House might be just the right prescription to ensure that such trivialities no longer register as we consider what really matters in life.  I'll be the first to admit that this experience was long overdue for me.

Stairway within the 'Dungeon Hotel'

We fell asleep to the sound of thunder and awoke to the news that a landslide had closed the road and might not be opened for days - or weeks.  We were literally trapped.  The only way out was to head north, deep into the Himalayan Mountains toward China where the roads are less traveled and expectedly worse than what we had already experienced.  Unimaginable at best. Downright isolating at worst.  The thought of becoming a long-term resident of Manma village was a thought I preferred not to entertain, but there I was considering the unimaginable.

But we had just arrived and fully expected that this would be open before the day was out because that's exactly what would have happened had this occurred in the civilized world that some of us can call 'home'.  Unfortunately, but not surprisingly, the road did not open that day, or the next...or the day after that. Ugh.

(To be continued.)