Diary of a traveling Student Nurse

At the delivery room!!

2015-10-20 — Wed, 9 Dec 2015 23:27:00 GMT

This week I started to go to the Gyneco/obstetrics department. As in other parts of the hospital I am amaze by the quality of the people who work at the hospital. Everyone is so caring, and they treat each other with respect and care that you give to someone you love. The senior resident worry about the physical and mental health of the junior interns, and they collaborate with each other across all levels. It really does not feel like work, but like family. It is a nurturing environment that reflects the Nepali culture as a whole. Senior residents are also very good teachers and they take the time to answer the questions and to make sure that the inters learned well. I had the opportunity to assist two natural births and I was taught how to cut the baby's umbilical cord!!.

I realized that mothers don't get the amount of analgesic options that we get in the developed countries. Some mother are given moderate amount of analgesic if their health requires it. However, for the most part, birth is very natural. I saw a woman whose baby head was stock on the exit of the vagina. The baby was not getting any amniotic fluid or oxygen during the process, and something needed to be done ASAP. Therefore, the doctor had to elongate the vaginal exit with scissors (called episiotomy), but due to the emergency of the situation there was not time for local anesthesia. That mom was the bravest woman I have ever seen!!.

At the labor and delivery room, I also saw several cases of neural malformation in fetuses, all of them incompatible with life. Unfortunately, these pregnancies were terminated before time. Most of the mothers were very young, and had no previous children. At the time of delivery, the miscarried babies were severely malformed. I cannot imagine the fear of these women regarding the outcome of their future pregnancies, after seeing their malformed baby. So, it was a priority for the doctor to make the experience as non-traumatic as possible for the mothers. The mothers already had the trauma of not having a viable fetus, of seeing the other mothers in the ward carrying their newborn babies, and then; they had to go through the pain of delivery, without the happiness of becoming mothers. The worse thing is that these malformations are preventable by supplementing the mother's diet with folic acid. Therefore, neural defects which are rare in developed countries become a big problem in Nepal due to food insecurity. I guess heaven got several little angels this week. I will pray for them, as I am sure their mothers will.

What Makes Nepal a Joyful Place

2015-10-20 — Wed, 9 Dec 2015 23:25:00 GMT

For the past two keeps I have rotated through the GICU (General Intensive Care Unit) and the haemodialysis unit. At the ICU I help with vital signs and other small things when the nurses are busy. Once again we have a lot of End Stage Cirrhosis of the liver and septic cases ( blood infections that cause multiple organ failure). When I am not busy at the ICU, I help by preparing the machines for the next patients. I am able to connect all the tubing's in the machine, make sure there is no air on the tubing and start the rinsing of the machine. I am really interested in the way the dialysis machine is able to fulfil the job of the kidneys (cleaning the blood from toxic urea products and removing excess water).

By going to the haemodialysis unit , I have been able to realize the impact that kidney disease has in the lives of patients. First, patients need haemodialysis at least twice a week, for about four hours each session. Some of the patients come from very far to undergo this routine procedure. Some patients are scheduled to have their dialysis in the middle of the night as the unit works all night. I am not sure if these patients arrive to the hospital just before their dialysis time or if they arrive early and sleep in the hallways. It is common for the patients and relatives to sleep in mattresses in the hallways of the hospital. The relatives have to be at the hospital at all times in case they need to go buy medications, help with the personal care of the patient, take urine samples to the lab, or go to the blood bank which is located in another part of the city. The family members often do laundry and shower in the garden of the hospital. Therefore dialysis takes a lot of time for the patients and their families. Another factors that neagaivley impacts the patient's life is their very restricted low sodium and potassium diet. Then, they have deformities associated with liquid accumulation in their abdomen, and legs. Tehy also have to deal with other related illness. And finally they have to endure a lot of paina and weekly hemorraghes as their limbs have to be pricked three times a week with one of the biggest needles I have ever seen.

Even though dialysis seems to be a big sacrifice, I get amazed by its powerful nature. Without this wonderful artificial kidney, these pateints would not survive for more than one week. We have patients of all ages who come to the dialysis room, aided by their relatives at each step. I can see the love and care that the family puts in bringing the patient to the hospital. To them, the procedure is not a sacrifice, but a joy, because each day is a gift. After my visit to the dialysis ward, I don't think there is anyone who appreciates more the gift of life than a dialysis patient.

The unconditional love that I see in the Nepalese families contracts to the general idea of the Canadian culture where the sick are often alone in the hospital with no-one to visit them. I can see the individualistic nature of the North American culture where children place the elders in nursing homes, because their quality of life has to be sacrificed when a love one is sick. In Nepal, relatives sleep by the side of their sick family member, and care for them until it is humanly possible, disregarding geographic and economical barriers .I think solidarity is the strength of the Nepalese people. They held each other's hands in the times of hardship and assure themselves that better times are yet to come. They remain joyful because they are together. However, there is no more truth that in times of hardship you must "Hope for the best, but prepare for the worst". I feel that hope needs to be accompanied by social action. Someone needs to stop waiting for things to change, and start doing something about it. In the case of the gas crisis, my iwhish id for the Nepale people to stop waiting for the gas crisis to be over, and to start developing clean energy in alternatives like biodiesel, and biogas. I have been trying to organize a group of people to help me built a DIY biogas generator, but, I often find answers like: it is too difficult, it might not work, it is too time consuming, I dont know where to get the materials etc. When I walk in the street, I see the potential that this country has for such thing, as they have plenty of agricultural land and the weather needed for biodiesel crops.

LAMA

2015-10-20 — Fri, 20 Nov 2015 23:38:00 GMT

This week I spent most of my time at the ICU. The Doctors and the Nurses are great. Although they are allocated to different patients they seem to work together at all times and they help each other. I find this very good when someone has doubts or when they just need some more help. The family is still a resource when the patients need to change position or be feed.

However, something really horrible happened this week. I was at the ICU when I saw the family coming with a stretcher and standing by the bedside of a patient who was intubated. Intubation is done when patients cannot breath by themselves. So, a tube is put inside their lungs and a machine inserts a determinate quantity of oxygen and air to the lungs. I asked one of the Nurses what was happening and she told me that the family had decided to take the patient home. I could not believe it!!. I told her that they could not take the patient home because the patient could not breath on its own, and would die if disconnected from the machine. The Nurse said that it happened all the time and that the called it LAMA (Leaving Against Medical Advice). I tried to find a doctor who could talk to the family and make them understand the severity of their decision but there was no-one, and I don't speak Nepali. In less than one minute the family had the patient in the stretcher and out of the door. The only thing I could do at the time was to teach one family members how to give breaths to the patient (with my non-existent Nepali, and only universal sign language), and to ensure the oxygen tank was well connected, had enough oxygen, and that the patient was not losing consciousness. However, I am not sure what happened after they left.

I asked one of the doctors what had happened. The answer was that the family wanted to take the patient out of the ventilator, but the doctors realized that the patient could not breath on its own. So, the Doctors said they would not disconnect the patient because she would die. But, the family couldn't longer afford the expenses of the hospital, so they decided to go "LAMA". At least one more week in the ICU was needed for recovery, but it was possible. The ICU is very costly for the patients, and they cannot afford it. Even if this is one of the cheapest hospitals in the city. The government hospitals are very basic and do not have the facilities for the treatment of patients with higher needs. The doctors mentioned that LAMA was something that happened in the daily bases. That maybe he could pay for one or two of the patients but that was about it. Unfortunately it is something that everyone at the hospital has seen way too many times, and they are sort of used to it. A single day at the ICU can be equivalent to a moth salary for a family. Sometimes families have to sell their land, and their animals, and be left without a way to sustains themselves.

I also went to buy a syringe at the pharmacy and it was $130 rupees, which was too expensive considering that my lunch was $180 rupees. It was just a little tiny syringe!!. I can't imagine the cost for the families who have to pay for each medicine, each syringe, every lab test. :(((. The worst part is that some of the nurses at the hospital don't even get paid. One of the best nurses I met told me that she is working 12 hours shifts/6 days a week, because she need the experience before she can apply to a Bachelors of Nursing. :O.

So, I haven't written because I am trying to process this on my mind. I still cannot understand. I dont see how my presence changes anything. I wish there was a way out. I wish I could speak Nepali to talk to the families and figure out ways to help them. This trip has confirmed by extreme hate towards private health care :(.

Car Accidents and Hospital Transports

2015-10-20 — Sat, 14 Nov 2015 01:49:00 GMT

I have been living in a Nepali house for the last week. Everyone is really nice in the family. Mom is the head of the Nursing faculty, and the eldest daughter is a Nurse as well. The other daughter Krity is super nice. She is here in the house for Vacations but she lives in Kathmandu. There is also a super nice girl who helps around the house after school. She is smiling all the time. Dad is a very nice gentleman who is always doing tasks around the house including cooking and sweeping ( I was not expecting to see such industrious men), and Grandpa who only speaks Nepali. This week is the equivalent of Christmas in Nepal, so everyone is celebrating. There is a day for the dog, one for the cow and one for the bother. Unfortunately we are not celebrating in this house because Grandma passes away less than a year ago.

In the hospital, I worked in the ER for a number of days. There I saw a lot of stroke cases and numerous intracranial hemorrhages (mainly due to car accidents), and sepsis cases. In the worse cases it seemed like the patients waited too long before coming to the hospital. There was a person who had been unconscious for three days!!. There was also a pediatric patient who had a motorized accident. I think a long time passed before they brought the child to the hospital because the wounds had bangages. Normally after a car accident in Canada, the ambulance is called and the patient is immobilized to avoid movement of the head. The patients is then quickly taken to the nearest hospital. However, in Nepal the family is the first responder in most cases, and they don't have the knowledge to safely move the patient. I think that given the high rate of traffic accidents, it will be good to implement a health campaign teaching people how to appraocha patient who has been in a car accident and how to respond. For instance, the pediatric patient needed transport to a bigger hospital, but ambulances were not available. So, the parents hired a motor bike/carriage to transfer the patient. When the car arrived, a desperated family member took the kid from the bed moving her head vigorously, not knowing that movement could worsen the patient's condition. I run behind, trying to tell them to be careful but, I am not sure if they understood due to the language barrier.

After working at the ER, I moved to the ICU. The ICU has many more resources than the ER. There are gowns for the patients and the visitors, all the nurses use gloves and hand sanitizer is available. There is also a sink to wash the hands each time you leave the ward ( the ER also had a sink :)). We still have no IV pumps and everything is calculated with drip rate. There is only one blood pressure cuff :(. I think it will be nice to have another one (at least). The nurses and doctors are super nice! I saw lots of intubations and I helped giving manual breaths whenever it was needed. However, the ventilators at the ICU are automatic so it is much easier :). The doctors are super knowledgeable. They are always around, they are happy to answer questions and they help with the patient when it is needed.

Doctors and Nurses generally speak English. Sometimes their English is limited and they cannot understand me (or maybe I am speaking too fast/quiet as usual). So, I try to stick by the nurses I understand better. I have no problems communicating with the doctors for the most part. I help with whatever they need, but sometimes when things are really hectic I feel like and I am in the way. So, when things get crazy, I move away to give the doctors and nurses space to do their thing. Normally at this point all the conversations happen in Nepali and I have no clue of what is happening. I feel like I still have a lot to learn, and the help I provide is very limited. This week I mainly helped with basic vital signs, giving respirations to patients and organizing stuff. I hope to be able to help more in the weeks to come. I also feel like I need to study lots!!!!!!!!!!

The Hospital

2015-10-20 — Sat, 7 Nov 2015 04:01:00 GMT

I left Kathmandu two days ago and came to the city of Chitwan were I will be working at the teaching hospital for the next 2 months. I came with the other 2 French nurses. We slept lots in our 5 hours drive, and we eat somosas at the bus stop. Turns out the somosas were not a good idea since we all got sick with a bad stomach flu (that is why I haven't written anything these days). So, we are resting, having lots of fluids and eating only light food.

I went to work at the hospital before the onset of my stomach flu. I was shadowing the nurses at the ER. The hospital is really poor but they have the basics. They have a several vital signs monitors, we can measure Oxygen saturation, we have one defibrillator and we can do electrocardiograms. we do not have IV pumps ( we use the drip rate)

Things are very different here in comparison to Canada. What stroke me the most is that doctors and nurses rarely use gloves. They keep their hands from touching the blood by being very careful. The needles don't have any security caps, and they have to walk a long way before they reach the nearest sharp's container ( which is not really a sharp container, but a buckle without a lid). They also don't have many stock medications. They only keep a small amount of crash car medicines like adrenaline, which are only used in case someone needs to be resuscitated. They don't keep much of anything else. not even hand sanitizer :( ( I bought my own).

When a patient comes, the family has to go to the pharmacy and buy a bag of medical supplies for the doctor to use. The bag has gloves and needles and catheters ( all the basic stuff that I just take from the hospital shelves in Canada. Things that I normally take for granted). Because this bag has only so many gloves, doctors prefer to use them only when they need them the most.

Also, in Canada we use a lot of disposable catheters kits and dressing kits. Here in Nepal most of the stuff is metallic and can be autoclaved for sterilization. So, you can re-use it safely.

I also find that the family has lots of responsibilities. Each time the a blood test is needed, the doctor sends the family to the lab with the blood and the requisition form. Also, each time the doctors needs a new medicine or IV fluid, the family has to go and buy it from the pharmacy and bring it to the doctor. I find this is extremely inefficient and detrimental to the patient. The family does not know the hospital and they get lost. Therefore, it takes a lot of time to diagnose a patient's condition and to administer the right treatment.

Pain medications are a luxury here. I have not seen any doctor giving pain meds, even if I ask them. Even I asked the doctors if they would give pain meds to a patient who had a stroke, was hypertensive and was susceptible myocardial infarction. I understand that decreasing the pain helps to decrease the demand of the body for oxygen, so there is more blood that goes to the heart, and the chances of heart attack are less. The doctor told me that the patient had no pain and needed no medication (the patient was sweating and moving a lot, and his face gestures seemed like the pain was unbearable) . There was another lady with cholecistitis- stones in the gallbladder- who was also in a lot of pain. She would have gotten opioids for pain in Canada, but she got nothing here in Nepal (I also asked the Doctor if he was going to give her something and he said no). I guess pain management is not part of the protocol, since pain does not kill by itself (In normal circumstances). Here the resources are so scarce that pain becomes a secondary thing. Something that is not life or death.

A good thing of Nepal is that there are a lot of doctors. At the ER we have always a surgical intern, a pediatrician, two emergency inters, and a couple of interns from other units. These interns stay in the floor the whole time. Therefore, they share they expertise among each other and the doctor-nurse communication is really good. (In Canada, I don't even know the doctors who work at my unit. I just document everything in the computer and hope they see it. I only see them during their morning rounds but never really talk to them). The nurses and the interns are also very friendly and they like answering questions about the patient and their medical conditions. They taught me how to place the ECG leads and now I do it every time a patient comes:)

Also, the hospital is very clean! :) They have to ladies that clean it the WHOLE time, EVERYTHING!

Learning the Culture and the Monkey Temple

2015-10-20 — Tue, 3 Nov 2015 03:48:00 GMT

Yesterday , Sunday, all the other volunteers arrived. We have people from Scotland, Australia, Canada, Hong Kong, and France. Three of us will be doing the medical program in the city of Chitwan: Me and two other French Nurses. We are all going to be placed in the same hospital and with the same family homestay. I am excited because the other Nurses have lots of experience. One of them has been in Africa volunteering in Mali!. The other Nurse only speaks basic English, so I might be able to learn some French with her. I am also excited to go to the city of Chitwan because it is close to the jungle where the elephants are.

Today we all had breakfast and then we had Nepali classes. We learned about the different costumes of the country like marriage, religion, eating habits, language etc. I wish we would have had this class earlier, because I did a very stupid thing on the shower. The water of the shower was super hot, and I was hoping to cool it down. So, I mixed cold and hot water in a bucket and bath with it. Once I got out of the shower, I found out that the bucket was used by Nepali people as a substitute of toilet paper. It was horrible! I had to shower again. :(

Then we headed to the Monkey temple (actually it has other name but there are so many monkeys that everyone calls it the monkey temple). There we learned that the flags the we see everywhere are prayer flags and that each color represents a different element ( blue-sky, red-fire, white-water, yellow-sun, and green-earth). We also learned more about the singing bowls and about the "Thanka" paintings. These are paintings that take months to make and they are used for meditations. The artist do not use any tools at all to make the lines and circles. They also differentiate into student, master and grand master by their level of expertise. It take about nine years of practice to get out of the student category, and each student specializes into a single kind of Thanka pattern. All the patterns are used for meditation. Some of them are similar to the lotus flower while others narrate the story of Buddha. To meditate with them, you are supposed to stare in the middle while you try to clear out your mind.

After, we went for dinner, saw different traditional dances, learned to eat with our hands instead of having cutlery (the Nepali) and we drank rice wine. :)

Kathmandu Dubar Square

2015-10-20 — Sun, 1 Nov 2015 01:05:00 GMT

Today was really slow passed. I sleep in because I was not feeling very well.I need to be at my 100% for when I start at my work as a Nurse, and sleeping helps the recovery. I woke up to have Nepali style banana pancake for breakfast. The other volunteers where long gone , so I decided to walk to a Neplali landmark located near the hotel. I headed down to the Kathmandu Dubar Square which was only 22 min away. In my way two individuals approached me. They wore turbans around their heads, orange clothing and a necklace of yellow flowers around their necks. They started pouring blessings over me, placed a red dot on my forehead for good luck and asked me for a 10 dollar donation. I did not have 10 dollars with me , but they kept insisting. I gave them what I could and walked away. The square has many temples and it was where the kings prayed and celebrated the festivities of the city. Still today, a lot of people go to pray there. Unfortunately many temples where destroyed by the earthquake. My guide told me that one of the buildings "The Kasthamandap", had killed many people when it felt down. I also saw a monkey at the "Taleju Temple". I ran out of excitement. When I got closer I saw that the monkey was missing one hand. The guide told me that happened normally when the monkeys jumped in the electricity lines. :(. Poor monkey :(. The monkey was beautiful regardless. I headed back to the hotel before it was too dark. Then, I ate more Nepali food with tons of hot mint lemon tea ( hope it helps with the flu).

Nepal & its gas crisis

2015-10-20 — Sat, 31 Oct 2015 04:03:00 GMT

Fist day in Nepal, I planned to stay at the hotel and rest. But I met the other volunteers and I joined their travel plans. So far we are only four volunteers at the hotel. we are two friends from France, another Canadian -Irish girl and me. The other volunteers will arrive on Sunday night and we will start our volunteer work on Monday. By Monday there will be around 18 of us here.

The guys have been here for a week and have visited many temples. Unfortunately most of them had undergone some type of damage due to a recent earthquake. So, the guys wanted to visit a temple at the other side of the city hoping it would not have been destroyed by the shaking. However, we had to walk there since it is hard to find transportation. It turns out that India stopped selling oil to Nepal for some diplomatic reason and there is a big shortage of gas. Most gasoline has to be bought in the black market and it is expensive. I was lucky I had no troubles last night when they picked me up at the airport. The people at the hotel could not pick up the other girl from Canada because they could not find gas to fill up the car (I am guessing they ran out of gas after picking me up). She had to find a taxi to drive her to the hotel and everything was fine.

We ended up walking for about 2 hrs in order to get to the Bouddhanath Stuppa temple which is sacred to Buddhism. The guys used a map to navigate the city. I was glad they were there because the streets are not marked with names and I would not have known where to turn. We passed residential areas, main roads, markets, commercial areas, schools, etc. There were many tiny temples in the way, in between the houses. There were dogs sleeping everywhere. Having naps in the middle of the road, oblivious to the cars around them. There were several baby cows that didn't have any issue letting me take pictures of them (I tried to take a picture of calves in Canada once but they ran away when they saw me :(). Our walk really gave me a sense of the city and the culture.

We also stopped to eat because the guys wanted some "Momo". It looked like perogies. It was super spicy to me but not to the rest of the group. I also had some hot tea which really help with the spice, but it burned my tongue. I hope to get used to the flavour over time since I am going to be here for 2 months, and all the food seems to be hot. I had some "Lassia" which is a fruit drink with goat milk. I really enjoyed that one :).

When we arrived to the temple it had been damaged by the earthquake. There were lots of monks praying and walking around. The highlight was that I learned to use a singing bowl. It is a metal bowl with a wooden stick. It looks like a mortar but it makes a beautiful sound if you softly touch its edges with a wooden stick. You are supposed to focus on the sound and let all the other noises disappear the background. It is used for meditation.

We also met a guy who wanted to walk with us because he was learning English, and he wanted to practice. He said he would not ask us for money. He explained lots of things about the temple and he was nice. But, when we said goodbye he wanted us to buy him some rice at some store. We agreed (since he had been so helpful) and walked towards the grocery of his choice. When we got to the store he ordered rice + cooking oil + milk. The total price was $37.0 U.S. dollars. The milk alone was only $22 U.S!!!. That is the most expensive milk I have ever seen. In Canada a litter of milk is about $4 dollars. It was such a rip off :(. We ended up buying him only the milk because he said that he needed it the most! He told us that the milk was for his baby sister, that his parents had died a couple of years ago and that he had no money for food. The total price of his desired groceries was enough to feed all four of us at a nice restaurant. Now, I figure he had it all planned with the man who was selling the groceries. He probably knew we would take us there and make us buy the stuff at an inflated price, and split the money. It feel so stupid now! How did I fall in the scam!

Here, you really have to be careful because people sell you stuff at very inflated prices and then you find out they took advantage of you. It is bad!. It makes me feel like I don't really want to buy anything just to avoid being ripped off . It is an awful feeling to know that someone has taken advantage of your good will.

I also got to ride on a cab. It was a crazy experience. There are no light signals in the streets, so people and cars mix together. People just cross anywhere on the road and cars just go around them. Vehicles honk to tell you to move out of their way. At one point, we had a bus coming directly towards us (apparently that is normal). Also buses are so full of people that you can see their cheeks stuck to the window, hanging on the doors and sitting on the ceiling.

I was worried about pollution but it was not bad during our walk to the temple ( probably because of the gas crisis decreasing the number of cars, and because it was not rush hour). Pollution started to become a real problem around 6pm. I started coughing, and my throat started being sore when I spoke. I guess that is why I saw a lot of people wearing face masks on the street. Tomorrow, I will wear a scarf to cover my mouth during rush hour because I hate the face mask!!

It is terrible how oil controls the world but it is so harmful to us. Everyone was freaking out about not having gas but no-body cares about having to wear a face mask?. Or about not having potable water?. What is wrong with us people? Restaurants here in Nepal are running out of certain foods because there is no gas for the trucks that transport food products. Is this the future we want? Do we know that oil is eventually and inevitable going to ran out? Do we know that oil causes pollution and makes us sick?

I think back about Canada where oil prices are down and many people lost their jobs. Gas is too unstable and is bound to be gone. I think our livelihood has to come from something other than oil. SO much unrest is not want the future needs. I hope this crisis serves like a wakeup call for us to start working about alternative clean energies. I believe that Canada has the brain power to make it happen!! We just need to make renewable energies our goal. We could combine the efforts of so many intelligent people in order to make it happen. It should be a priority. Developing clean energies will benefit our economy, and will also have a big effect in poor countries like Nepal.

Photos: pics

2015-10-20 — Fri, 30 Oct 2015 07:08:00 GMT

Pit stop in Hong Kong!

2015-10-20 — Fri, 30 Oct 2015 07:05:00 GMT

When I was in the plane, I kept thinking about all the stuff I wanted to write about Hong Kong. I had a mental image of a city full of skyscrapers, lights, biggest population on earth. Hong Kong was all of that and more. It is the kind of metropolis I imagine will model the future cities of the Word. Geographically it looks a lot like Vancouver. It consist of several islands bridged together by roads and trains. However the weather is much nicer. It was about 26 degrees Celsius and humid. When you step out of the place you get the sticky feeling in our skin that usually lets you know you are near the ocean. Unlike with other humid places, the stickiness is not gross but comforting. The rain is nice and warm just like in Colombia. But, It differs to Colombia in that the rain drops are small and scattered ( similar to the ones in Canada). In Colombia, the rain drops hit you hard, and make a splash in the floor when they fall.

I also expected everyone to speak perfect English since Hong Kong was under British domain for such a long time. But I found some people's English to be broken and I found a couple of individuals who could not speak with my at all (A middle aged woman server at a restaurant and a construction worker) .We tried the Universal sign Language of common sense :). But regardless of their language, everyone was SUPER nice. I went to a restaurant and they served me noodles with chopsticks. So, I called the server and he ran out and got me a fork and a spoon. But, I rejected the western cutlery and asked him if he could show me how to use the chopsticks instead. I can use chopstick ok for big stuff like sushi. But I have major difficulties graving small stuff. He pretty much had to place the chopsticks on my hand :(. It took me a while to master the art of eating, but I was in no hurry. In Canada, I never tried eating noodles (or rice) with chopsticks because I am by nature a slow eater and it would just take forever. But here I had the whole night. I thought it was very nice of the server to teach me :). Hospitality in Hong Kong was 10/10. Also, when I was looking for my hostel I felt at sea. I knew my hotel was in that street but each building in the street was super tall, and each had at least 10 shinny names on it, all in Cantonese. I kept comparing every Cantonese written character I saw in each building with the name of my hostel. It was going to take a long time. Not long after I started a systematically search, a woman asked me if I was lost. Turned out she even worked at my hostel but it was her night off. She was walking by in order to meet one of her friends at the local McDonalds'. Also, since I am obviously not of Asian descent (wavy hair, round eyes), people in the street asked me where I was from and offered me guidance.

I was worried about Hong Kong being polluted and about having lots of allergies since I am very sensitive to dust. I found the city smelled super nice, and was very clean despite its big population. It is very organized and well though. It seems like those who govern are always thinking about ways to keep connecting the islands and improving the infrastructure. There were tons of construction sites. I was pleased to see the eagerness for development but I was also annoyed since all the pedestrian paths were closed due to construction. I was late and I felt the need to Jay walk to cross the street. I failed miserably. I concluded that is impossible to Jay walk in Hong Kong. The sidewalks are fenced off everywhere but in the places where you CAN cross. the fences look sort of like labyrinths that mandatorily direct you to the nearest pedestrian bridge. It is super safe!!, but, took me 20 minutes to cross a single street since there was a major detour in the pedestrian paths due to construction. Therefore, I found it hard to walk in Hong Kong. People mainly use the train. They can buy a card called the Octopus in which you can load money and travel several times. Before I travelled I was wondering why they named the card "octopus". I figured is because the train lines look like and octopus. the train lines look like they are many hands , each going to a different side of the city. Moreover, because the train stations itself look like octopus. Each exit being a tentacle. Train stations in Hong Kong are nothing like anything I have ever seen anywhere. It took me 1.5 hours to navigate my way out of central station. I got blisters in my feet from walking up and down. I was trying to find exit F2. There were exits A,B.C, D, E, F, G, ...L. Train stations look way more like airports, with many terminals and full of shops. I don't even think people in Hong Kong need malls because train stations double as shopping centers. I missed the symphony of light because I got lost at one of the stations.

I was also worried about being a woman walking alone at night in the Streets of a foreign country. Looking back is funny I even though about it. Normally cities get quiet at around 9pm. After this time there is normally no people on the street, a few cars only, everything is dark and everyone is sleeping. Not Hong Kong!!. Lucky for me at 11:30pm stores are just closing, people are going out for dinner, the streets are full of cars. I wake up at 4:28am and the streets were still active. I was hungry at 11:39pm and I was able to find a restaurant open within two blocks of my hostel. I saw a guy getting in on a bus with the drawers of a night table, and several pregnant women walking alone (I would think pregnant women would normally be tired and into bed early) and, a bunch of lady friends on a night out. And, this was not even a weekend day (it was Wednesday!). I still don't know if the city ever sleeps. After all, it was only a one day visit. I was truly sorry to leave.

Almost ready for my Trip!!

2015-10-20 — Wed, 21 Oct 2015 16:19:00 GMT

Well, the day of my trip to Nepal is getting closer. It seems it has been a long time since I told people that I was going to volunteer as a Student Nurse to Nepal. My parents had no idea where Nepal was and I had to explain that I was a country close to China and India, that was famous because of the Everest and the monks. So far, I believe this to be true. By my return, I hope to tell you much more.

Now, I have learned that people speak Nepali, and that the week has six business days!! I have only one weekend day :O!. It escapes my comprehension, how a country where people work so hard can be so poor (I hope to understand this later...). I have also learned to say "Namaste" (Hi), and I have a list of other words to memorize. I am confident that I have more than enough time to memorize them in the plane ( total travel time 47hrs, 5min). I just need to finish a couple of online training courses, and then I will be ready to go!!!! :):)

As with every project in life, this trip was encountered a mix of support and set backs. People asked why Nepal and then they were concerned about my safety. Then, there is also the cost of the trip, which is all what I worked this year. And worse of all, the only professor I trusted in University told me that I was irresponsible because I am going to miss one day of classes when I come back (even though she knows that I have attended that class before and that I know the content). I guess she was having a very bad day. Ghost!!, It was not a pretty conversation. Fortunately, I am very persistent, or stubborn, and I did not take a "No" for an answer. I also found my parents, friends, boyfriend and the Dean of Nursing supportive enough to help me fight against the negativism.

Part of the negativity, was people asking me why go so far? This year, I have seen my biggest dream shatter and I feel a little lost. This year I had to take a mandatory break from the books. But, I found that the will of others cannot separate me from the call to help and nurse, and there is no-one who can stop me from doing just that. Also, I could not find a better way to spend my mandatory vacations than "traveling". I really hope to find myself in the service of others. I have found myself in the service of others before, and I am confident that I will do the same this time. The only difference is that this time is a little more extreme and exciting. I am leaving everything I know, and entering a complete new world, and a complete new culture. I will have zero distractions, so I hope to help lots.

But not everything is sacrifices! I have a 22hrs lay over in Hong Kong. I am super excited about this. I will be able to leave the airport and go visit some places. I would really like to see the so called "Symphony of lights" and to visit a couple of monasteries. I will stay there overnight, and I already found a hostel. I will be in a room with 8 other women. I am very happy about this hostel arrangement. In my previous trips, I found that I felt safer this way. I feel that if someone enters our room with bad intentions, I have 8 other women to help me out. (Just in case, my boyfriend is going to teach me some Martial Arts and buy me a pepper spray before the trip :)). And, I always meet interesting people in Hostels!! Maybe someone will like to join my adventures the next day :). PD: At this point I really need to thank my friend JC for teaching me how to say "thank you" and "bye" in Cantonese, and for contacting me with people willing to answer my many questions about Hong Kong (HK). I have planed my only day in HK to the minute, just to maximize my time, and I could not have done it without their precious help. :)-