Chapter 1

A Road Leading East

Massive monsoon clouds loom before us, barring the path and drowning our sight. The air is a heavy white curtain, dripping with moisture. Thick mist is hanging low in the crooks and crevasses of the mountain ridges, filling the valleys and blanketing the plateaus. Although no rain is falling, the windshield wipers squeak on, busying themselves with the endless task of providing the driver with a small, dirty window into the morning wetness. Everything is cold and dank. At almost 4,000 metres, we are not only driving in the clouds, we are breathing them, feeling them, living within them.

The pickup truck is heavily loaded, its weight pushing it on as the brakes squeal and the car skids around the tight, steep curves. Some corners seem to warrant a loud boast of the horn; others are left to silence and destiny.

Huddled in the front passenger seat, with two people in the back and surrounded by laboratory equipment, my radio and a handful of valuable items that must stay dry, I stare into the illusive milky blankness ahead. Most of my gear and household wares for the forthcoming year are tied onto the loading surface, stacked and stuffed under a brown tarp whose edges and corners are angrily flapping in the wind. The rest of the truck’s load consists of several huge laboratory machines and some boxes containing test tubes and reactants with the same destination as mine: Mongar Hospital in Eastern Bhutan.

The solemn quiet of my fellow passengers lets me contemplate my journey to the East. Bhutan has been my dream since the fall of 1995, less than two years ago. I was 24, and my father, the world traveller, wanted to show me his beloved Himalaya. He had been to Bhutan six times already, and each time he had returned full of enthusiasm – but also with a new worry line on his forehead. ‘What an incredible country!’ he would exclaim, and then invariably update me on the most recent changes he had observed. ‘The traffic in the capital Thimphu must have doubled. They even put up a traffic light,’ he said one year. The next time, he had different concerns. ‘Well, the traffic light is gone again. But the number of tourists I saw in Thimphu! Minibuses full of tourists! You really should see it before it’s too late. I want to show you Bhutan. This is one of the last untouched cultures in the world. And it is bound to change soon. Look at its neighbour Nepal, or even Thailand. They were so different twenty years ago. Why don’t you come with me?’

For a long time, I was sceptical. I was busy establishing my career in physiotherapy, taking postgraduate courses and trying to climb the ladder of success. I looked at my father’s pictures of the Himalaya with interest and studied the map long enough to know that Bhutan was a tiny kingdom south of Tibet and east of Nepal, but it was not until internal problems at my workplace forced me to think about changing jobs that I seriously considered my father’s offer. On his sixtieth birthday, when he again talked about his need for a travel companion, in a sudden flash of daring I said ‘OK, let’s go.’

We packed our bags and off we went, first to India and Nepal, then to Bhutan. My father took me on the trip of a lifetime and indulged me with the sights of a world unknown to me. He opened my eyes, and I opened my heart. Bhutan mesmerised me. The mountains loomed to spectacular heights, a cheerful people welcomed us with sincere generosity, and I felt an undeniable peace in the gentle philosophies of Buddhism.

Suddenly, my ambitions changed.

From the window of a monastery perched on the rocky outcrop of a mountain, my world of materialism and fashionable stress in Canada seemed absurd. I realised that now was the time for me to travel, to experience different cultures, to discover if our globe has more fascinating places to offer. I would go to a place where living still made sense. I wanted to learn and I longed for adventure. In return, I would do something worthwhile, something meaningful, I would offer whatever skills I had to people who were less fortunate – I would become a volunteer. The three weeks travelling with my father had drawn an enormous line between our wealth and the poverty we encountered, and my first exposure to the Haves and Have-nots of a developing country had shocked me deeply. I had always known that my life had been pampered, but now I felt over-privileged. All at once, treating sports injuries in a modern, well-equipped clinic was no longer enough. I wanted to give back, to share what I could. In my imagination, I saw myself surrounded by little dark-skinned children who knew that I had come to help. For the first time ever, I contemplated the possibility of fate. Someone in Bhutan was calling my name.

Back in Canada, my parents were less than enthusiastic about my ideas and plans.

‘But you don’t have to go for a whole year,’ my father tried to caution me. ‘That’s such a long time. Have you really thought about it?’

I had. I had contacted the Bhutanese Ministry of Health and had been told that if I wanted to volunteer, I would have to commit for an entire year. I was 26, bursting with energy, and full of ideals. I said yes.

My father tried another approach: ‘Now you are a young woman, this is the best time of your life. You should go on dates, fall in love, look for a husband. Who are you going to meet over there?’

I was not worried. After a painful split from the man I had thought I would marry, a serious romance was not what I yearned for.

‘Please don’t think that you have to stay there for the whole year, just because you are too proud to come back if things don’t work out,’ were my father’s departing words. I realised that my parents were worried beyond measure, and yet I was determined to go. So, in February of 1997, after months of preparation and tearful goodbyes from my family, I stuffed my two hockey bags full of clothing, thermal underwear, physiotherapy books, spare batteries and a year’s supply of female hygiene products, took a plane to Bangkok and bought a one-way ticket to Bhutan.

In Bhutan’s capital Thimphu, Voluntary Services Overseas, a non-governmental organisation that places volunteers in developing countries, recruited me, giving me the chance to live and work in this mystical country. Through them, the Royal Government of Bhutan considered my enthusiasm and skills and found an opening for me in the physiotherapy sector of the country’s health care system.

During my orientation in Thimphu, I learned that over the last 25 years, Bhutan had worked hard to develop a new and surprisingly active health care network. In the past, this landlocked Himalayan kingdom relied mainly on traditional medicine and village healers. In the mid 1970s, leprosy missions came and set up permanent buildings for admitting and treating patients. Now there were hospitals in most major towns in the country, and many small villages were served by little outposts called Basic Health Units, which offered rudimentary treatments, basic medications and vaccinations.

Although the first physiotherapists came together with the leprosy missions, most of the mission staff have now retreated, leprosy being more or less under control. Physiotherapy for non-leprosy cases is a relatively new idea in Bhutan and far from universally recognised.

When I arrived, there were three qualified physiotherapists working in the country. Two of them, one Bhutanese and one American UN volunteer, worked in the large national referral hospital in Thimphu. One Finnish therapist still works with the Leprosy Mission in Gidakom, a tiny village only about a 45-minute drive from the capital. In addition, eight trained physiotherapy assistants (or ‘technicians’ as they are called here) were spread throughout the country. Three worked in Thimphu and one with the mission in Gidakom, while four of them were posted in Eastern Bhutan; one in Mongar, one in Yebilapsa near Zhemgang, one in Trashigang, and one in Rizerboo near Pemagatsel.

The Royal Government’s Ministry of Health determined that my responsibility would consist of training the four physiotherapy technicians in the eastern districts. I was to teach them more independent assessment and treatment skills.

Spending several weeks training at their Thimpu base, VSO prepared me for my posting in the more remote regions of Eastern Bhutan. Cooking lessons focused on dishes using locally available foods, while discussions about health and hygiene pointed out the dangers of improper meal preparation, poor water quality, and the possibilities of vitamin deficiencies and malnutrition due to a limited diet. Confident that I was prepared for even the remotest of relocations, I went shopping for luxury items such as peanut butter and chocolate bars, read up on the local traditions and customs, and received my first rabies vaccination.

During several days spent in the physiotherapy department of Thimphu hospital, I learned that everyone who works in nursing, physiotherapy or medicine had received their training in English, which would make my communication with hospital staff easy. Understanding my patients would be an entirely different issue. Several different languages are spoken in Eastern Bhutan, corresponding to different geographical regions within the country as well as dialects that have evolved in isolated valleys. VSO gave me a booklet on Sharchhopkha (also called Tshangla), the language spoken most commonly in the region of Mongar and Tashigang. Even some of the simplest words seemed tongue twisters, and since I was eager to start my new job, I convinced VSO that I should skip the language course offered in the capital and instead pick it up once I was immersed in my work and confronted with patients.

I was overjoyed at the prospect of my new job and packed my bags in Thimphu to start my long journey eastwards.

After fifteen hours crammed into the car, feeling wrinkled and edgy, now more than ever I question my wisdom. My only overseas working experience is a three-month locum at a regional hospital in Australia, and yet here I am travelling towards one of the most remote corners of the inhabited globe. ‘I would like to help wherever it is most needed,’ I had told my parents heroically. Mongar Hospital was the place which the Health division of the Royal Government of Bhutan deemed worthy for my cause.

Suddenly, the question of accommodation torments me. I was told that it would be basic. But how basic? Will it be bright? Or dark? Running water? Hot water? No water? I recall terrible stories about Mongar, the construction site around the hospital, the overcrowded housing.

The journey seems to offer a taste of what is to come, and the arduous two-day car ride from Thimphu to the eastern district of Mongar takes me farther and farther into the unknown world of the Himalaya. Our speed never exceeds 20 miles an hour, but we are flying. To my left, rocky cliffs rise steeply out of sight. Short stumpy trees grow from overhanging boulders and cling onto their narrow crags. To the right, too close for comfort, the edge of the road drops hundreds of metres into bottomless gorges. The narrow strip of tarmac is flooded with water, rivulets turning into little streams, waves of rainwater washing the road ahead. The occasional swollen creek, which has overgrown its drainpipe and escaped onto the road, blends in completely, only announced by the splattering and gurgling of its waterfall at the road side. To quiet my nerves, I trick myself into believing that this is an ordinary road in the mountains, simply boasting a lot of bends. The Gravol helps. Fear makes the fog a welcome obstacle to the view, obliterating the spectacle of what otherwise must be one of the world’s most awesome roads.

A little white chorten, a religious stone monument, protects the tip of one particularly tight curve. It must be a good luck sign, a protector of the wary traveller. Behind it, only some trees and grasses obstruct the near vertical tumble into the valley.

We have left Trumsing La, at 3,800 metres (12,400 ft) the highest pass on the road traversing Bhutan from Thimphu to Mongar, and continue our descent, spanning one and a half kilometers in altitude over several hours. Rocks and shrubs change into a deciduous forest. After the cold climate of the higher elevations, the thermometer now rises until we are surrounded by hot and sticky tropics. Huge vines cover the jagged edges of the road. Bamboo, banana trees and cacti dominate the scenery. The dampness becomes almost oppressive. I open my window all the way but the air seems to hang motionless.

In Lingmithang, our descent bottoms out at 650 metres before we immediately resume our climb, and the truck huffs and puffs its way up the opposite mountain. The road is uneven at the best of times, and often spiked with potholes. At every jolt of the truck, a dull headache thuds at my nerves and makes coherent thinking impossible. I am tired and hungry, and a little bit afraid.

The clouds refuse to budge, and we continue to plough through them, one bend after another. Several times we nearly collide with the huge orange, Indian-made TATA trucks, fully loaded with logs or stones or sometimes people. The result is always much honking and manoeuvring; then somehow we manage to squeeze by.

Oddly enough, over these last few hours of the journey the traffic has increased and I wonder where everyone is going. As far as I can tell, there are only a few houses scattered along the slopes, and we left the last town of any size eight or more hours behind in Bumthang, where we spent the night in a tiny guesthouse.

Perhaps the fog is hiding glorious old settlements and picturesque villages, which I will soon discover and explore. My imagination paints colourful pictures to pass the time.

‘Here Mongar,’ the driver gleefully announces, and I squint into the mist to take in the first impression of my new home. I imagine a vibrant market to meet plenty of friendly villagers, a quaint hospital, and perhaps even a small house for myself.

Eagerly I peer out the window – but there is nothing. All I see is a little stretch of road in front of us, a few trees on both sides, and clouds. The driver points ahead and to the left. Again I squint and strain – nothing.

Then suddenly, out of nowhere, a large façade of three-storey houses rises beside the road. There must be eight or ten impressive buildings, their wooden exteriors artfully painted and decorated with carvings. I rejoice at the prospect of such a pretty town, but already the mirage disappears. We take a hairpin turn to the left, and bump and rattle down a cracked, gullied side road, leaving all signs of habitation behind us.

The path continues to curve steeply through a treed incline and finally stops in front of a long, white building with a wooden sign: Mongar Hospital, Referral Hospital of Eastern Bhutan.