ARRIVAL IN NEPAL

On approach to Kathmandu, the rugged snowy peaks of the Himalaya sparkle above the horizon of green hills protecting the Kathmandu valley. A magnificent sight marred only by thick fumes pouring from open fires and smoke stacks.

Traffic
The traffic problems of the city, and I suspect of the country, are an inadequate road system in 1)quantity for the rapidly growing amount of traffic and 2) structural quality so that what little is available is rather more a detriment than a conduit for travel. Walking is a nightmare of avoiding both the torn up sidewalks, if there are any, and the vehicles whose sole goal has nothing to do with extending one's longevity. The roads can not be widened and no attempt has been made to repair or repave them. 99% of the hordes of careening motorcycles are driven by young men without either licenses or regard. They could well be seconds for any scene from Mad Max.

The city is filthy in litter, plastic bags, dust, and pollution. Foul smells of organic waste abound, mixed with chemical irritants. In short it is not a friendly city, liberally spiked with all manner of difficulties in getting from point A to point B. However, the home Dr.Chakra Pandey and his family have offered me is off the main street in as quiet and peaceful a setting as one can imagine in a noisy Asian city. (Night dogs still require ear plugs.) At 06:00, first light, pigeons and house crows awaken along with a 20 second lilting wake-up song by an unseen bulbul type of bird, who rouses the sparrows who chirp off and on all day. Mango, persimmon, orange, papaya, and kumquat trees line the garden parterres along with clay pots of marigolds and chrysanthemums. Cannonballs of pommelos hang from a neighbor's tree over one wall. The temperature hovers around 55-60° at night, warming in the sun to a cool bright 75°.

I have been given a pleasant sunny upstairs bedroom in a house adjacent to the Pandey's, but on their compound. The first floor's spacious entrance room has little furniture and its smooth wood floor and open space allow an exuberant, daily Tai Chi ritual. All in all a perfect place.

Fitted for Shalwar-Kamis
I thought I needed a shalwar/kamis, something a little lighter, a bit dressier than my expedition gear. I was also looking for clothing for warmer weather than the one I imagined from snowy Montana, and chosen with the thought of surviving a Himalayan December. I pictured some cheap clothes, but in the ready made stores there wasn't much without beads and sequins or gold glitter. The local tailor has pre-made sets of color and pattern coordinated cloth pieces suitable for top and bottom and a shawl that are then made up in the style one chooses from a picture book. I picked out all the components and dimensions for my sartorial masterpiece-- a round neck opening large enough so there's no need for a zip or buttons, long sleeves, kamis length to below knee, shalwar of thin legs bunched up at the ankles and elastic waist band. The picture book showing the various styles looked like the book I used in Sierra Leone for a wedding party dress--a mix and match guide of possibilities. It was quite exciting creating what I think I wanted, though I'm sure that when I try it on, I will find something not quite right. Sapana, Chakra's accommodating wife, did all the talking for the transaction. How wonderful to watch someone who understands how to get what she wants.

Nepali style Anarchy
Thurs afternoon, the day I arrived, 5 Nov, a bus ran into 3 people buying radishes beside the street, killing them. The driver ran away, knowing he'd be held accountable to some sort of public "justice". People destroyed the bus (similar to killing the messenger) and a big demonstration took over the street which the police closed, snarling traffic for the next 24 hours.

The hospital in Dharan was recently closed for a week because a patient's relatives had beat up some doctors when something untoward happened to the patient. Chakra attributed it to the general anarchy, since the state offers no security or justice and the hospital can't provide it either because the hired guards aren't trained, have no authority, and run away when trouble starts. Like the bus driver.

Friday the road to Chakra's hospital was closed, even ambulances weren't allowed to pass the barricades. One of the servants drove us until we couldn't go further because of a traffic jam, so we walked among the stalled cars, over a bridge, down a dirt embankment, up and around to the hospital. From the orthopaedic clinic windows I watched demonstrators march on the street, shouting slogans. The road was finally opened late in the afternoon.

5 Nov,
NEW YORK AND THE RUBIN MUSEUM OF ART

A couple weeks ago I came upon the name and description of this museum and a coupon from the internet for a free pass to accompany a person paying full price. I thought this would be something worthwhile to prime a trip to Nepal and Bhutan. Dick Freeman and I spent an informative afternoon in this tasteful, new museum. One of the organization's goals is to inform and educate people about the art one finds in the Himalayan areas, concentrating on a Tibetan Buddhism. This it does very well.

At the suggestion of the ticket seller, we joined a small tour group run by a white-haired gentleman who by picking a few exhibits gave the half dozen in the group the barest beginnings of an education. He was wonderfully knowledgeable and able to answer questions without losing us on detail. He made the many arms of the gods less threatening, despite the weapons wielded in each.

He started with the art of Gandhara--the melding of Indian-Buddhism symbols and forms with Greco-Macedonian classical conventions starting in the 3rd C. BCE. Greek facial features, classical Greek hair in ringlets topped with a Buddhist topknot of wisdom; classical draping and arrangement of clothes into a toga; Greek sandals; and a short body of un-classical eastern proportions but shielded with a muscled classical chest, standing on a pediment with a frieze of figures such that one would see on a sarcophagus . The example in the museum is quite instructive of the melding of the familiar with the unfamiliar in a specific setting. (There must be other examples of such cultural fusion come to life in the art of the period, but I can't think of any). A fusion that I'm sure made all the sense in the world to the artists of the day, little aware of what came before and after or what they were "suppose to do" or how they were "suppose to do it".

Our guide, George, explained the Buddhist goddess Tara. She comes in various colors, represented by the colors of the rainbow. I don't quite understand what all she does, or how she functions, but she is a helpful deity, one people turn to and she is known to deliver, ready to jump, coming to one's assistance. This pose of readiness is portrayed by the right leg having slid from its folded, seated position so that it hangs dependent over her seat in readiness to come to assistance. The right hand, open-palmed and dependent resting over the knee gives added motion and intent to her willingness. The way George explained this posture, a bit of ignorance was washed away.

HALLOWEEN

Everyone in NYC was in Halloween mood--much in the way of lawn (if there are lawns in Brooklyn) and fence decorations with cotton strew to look like thick cobwebs, pipe cleaner spiders, parts of human skeletons sticking up from the ground and of course pumpkins. Kids out all Saturday morning and afternoon in costume and adults and teens in the evening/night. Ninjas, Chinese princesses, supermen and Ghostbusters filled the subways. All quite glorious to see, everyone having fun, testing new personas. I haven't experienced Halloween with such intensity since I last trick or treated, probably 45 years ago. And that was before many people took the occasion as seriously as they now do.

NYC MARATHON

Sunday, the 1st was the NYC marathon. We saw the start with the elite women going first over the Verrazano Bridge from Staten Island into Brooklyn on TV then walked to the corner of 8th St. and 4th Avenue where we saw the runners run past--all 40,000! The energy was palpable, each runner a part of a larger organism. People around me were calling out, "Go Kate, go Fiona, Go Italy," urging the named runners, their country or the charities they were running for. Energy traveled both ways from runners to bystanders and back, people on the curb held out their hands, slapping palms with the runners. Despite the cold, the wind, the damp, I enjoyed it very much.

The wheelchair participants, the blind, the ones whom you know were out to prove a point were very heroic, including a white haired woman in a wheelchair. Some of the people looked as if they hadn't trained at all and doing grave injustice to their bodies should not have been in the field, their fat jiggling, but still, you have to hand it to them--just to try takes something.

AIRLINE REGULATIONS

Tues 3 Nov--JFK in the early afternoon is almost bare, not the time for flights to Europe or Asia. When I left Billings on Fri I had to remove some SIGN nails from my checked in bag because it was too heavy. So, Dick Freeman and I removed some to a separate box with some clothes to distribute the weight since the allowed check in baggage is 2 bags of 50 lbs each. The box was small, taped up and tied with rope--appropriate with all the roped suitcases on board for the sub continent. The check in people didn't like the box. I think it was too small and their reasoning of it getting wet and ruined didn't make sense. So I was asked to put the box into my red roll-on. After all that work or trying to figure out what is right! Preparing for the next leg to Kathmandu, I've discarded the box since its individual contents are easier to stuff in the red bag. I hope I don't get called again on this.

For the one airport that is the primary eastern gateway to the US, JFK is very tawdry; the people who should be nice are rude, barking orders. In a restroom, I couldn't get hand soap from a whole series of dispensers. The cleaner yelled from her duties, "no soap". I gestured disgust with a shrug and she came out and flicked her hand along the line of soapless sinks, "no soap," she said, as if I was totally clueless and gestured for me to use the other line of sinks. Does the airport have the funds to fill only one line of hand soap dispensers?

DELHI

A night in India, for the 14 hour layover before the flight to Kathmandu.
I'm back in the land of ledger books whose white, colored and carbon papers are of flimsy stuff, so that the ink feathers and is unreadable. How incongruent for a country with a huge computer and informational business. This is also the land of lackeys and gofers--a surfeit of official low level workers who in their attempts to be helpful get in the way.

Return to Balkh and the Salang Tunnel

Southside of the Salang Tunnel





Walls of the Bala Hissar at Balkh, late afternoon.



(I started this final blog about Afghanistan on the 4th of June and became distracted. Please forgive. )

For my last weekend in Mazar I had asked for a trip to walk the walls of Balkh with someone who knew the area. Most of my doctor friends are not particularly interested in the history that fuels these desires and do not feel comfortable in this town that is known to have strong taliban ties. Someone big and knowledgeable about the area--in short a Pashtun protector--was what I was after. On Thursday it seemed that the trip wasn't going to come off but at 08:00 Friday morning Rahimullah called to say he would pick me up at 14:15 to take me to a cross-roads where Dr. Meraj, one of our colleagues, would be waiting to take me to Balkh.

On most outings with Afghans I am generally left in the dark. Though I might request to see certain things, the going, the timing, and much of the execution are up to others. This is unnatural for me. On this trip, I was particularly left in the dark. Afghans aren't the sort to start the trip with a little organizational pow-wow, outlining the details of the agenda. Even among the planners, the details seem to get sorted out, piecemeal, as they arise, and rarely with a "plan B" in place in case plan A fails. I wasn't sure Meraj knew exactly what I wanted, or maybe he correctly thought better to ignore my requests, after all, what person really wants to walk around Balkh's walls when the temperature hovers at 100°F. His English is rough and I often find bits are missing in the translation of words to action. He asked a friend of his, Shah Gawsi, who lives in Balkh and who knows many of the ruins to accompany us. I had badly misjudged Meraj.

On our way into the town, Meraj asked if I knew Jalalludin Rumi. I caught enough to recognize the name of the Sufi poet. The celebrated Rumi had left Balkh at the age of 12, two years before Genghis Khan razed the city and massacred the population in the early 13th century. Shah Gawsi took us on a tour of the shrines to Rumi, plus some other shrines, of which Balkh holds an inordinate number. None of them were particularly beautiful, but all were festive with Friday picnickers. At the first shrine I commented on the majesty of a tall chenar tree. The next shrine was graced with a much larger chenar, a lofty patriarch with many trunks spawned from its ancient roots. It was truly a tree to be worshipped. A rope and wooden-seated swing hung from a stout branch and young bearded men vied with each other to pump for acrobatic height. I was entertained, watching the boy-men swing in the cool shade, being, as well, entertainment as a farangi woman.

We drove to the ruins of Rumi's house and the mosque/madressa of his father Bauhuidin. Only a few preserved ogive arches of baked brick and mud survive. Shah Gawsi said the Turkish government wants to develop this area for tourism, but the villagers have rightly nixed the plan. I could gain little sense of Rumi, but these ruins in the middle of the village's fields and orchards gave a sense of the timelessness of the people and landscape. We continued to drive a further few kilometers on a dusty road through another village of horse carts and people working in their fields to another shrine. The village roofs were stacked with thick, brown rounds of animal fuel, like great loaves of rustic hearth-baked bread.

On this particular shrine, to one of Rumi's teachers I remain completely ignorant. The grave lies in a garden, a true refuge from the heat, among fruit trees. We walked under grape arbors and a haphazard orchard mixed with roses to an unwalled compound, maybe 12 by 12 meters, of flatted packed dirt deep in the shade of surrounding chenars. The old man guardian was smoking hashish in his cool garden on this hot afternoon. We paid our respects and left in peace.

We back tracked to the inner ancient wall of Balkh, and another shrine, this to Shah Nabi, under a huge rip-stop tent. His long grave could have held a dozen or two uncrowded bodies. From there we entered the ancient inner city walls. When I was in Balkh 3 years ago, I wasn't oriented, this time, Meraj pointed out ruins and sights to me and I finally got a sense of the ancient city--the outer walls extending into the orchards and fields, the inner city walls of the Bala Hissar, and finally the walls of the high citadel. Were these the walls Alexander saw? Were these outlines of the Bala Hissar the walls under which he married Roxanne, the 13 year old daughter of a Sogdian warlord? I don't know. The city inside these ruined mounds of mud had been a living, changing entity through its thousands of years of habitation.

From the citadel we drove across the empty space of the old inner city, the Bala Hissar, and through another portal to another shrine and walked along the walls a short way. Meraj wanted to show me the mosque-shrine to Nasra Parsa and the grave of the poetess, Rabia Balkhi, a princess who fell in love with a slave, was imprisoned for her passion, and died writing her final poem in her own blood. We walked through the cool central park of Balkh in the late afternoon. It smelled of deep shaded greenery. The gypsy women were gone. I was walking with two men, one large and the other known in the city and two children. I was looked at, but the stares were not obtrusive because I was protected. For all I know the stares were harsher, longer, but the presence of men beside me, their sauntering attitude, their unhesitancy at approaching the shrines, deflected all the negatives. How remarkable this was. I liked Balkh; the park that before had been filled with luring men, turning, twice, three times to stare at me, no longer existed.


About 18:00 we returned to Shah Gawsi's orchard, picked sour cherries then rested on some carpets, toshaks (thin mattresses),and pillows he had laid out on some well-tamped dirt under a 9-trunked chenar whose leaves grew as large as a man's head. Another magnificent specimen. From this slightly elevated position I sat in the background, out of the conversation, unobtrusive. I watched people slowly, sauntering by or casually pedaling a single-geared bike under the trees and along the walls, returning home in the early evening dusk.

A young man climbed a nearby mulberry, tut, tree, shook it while young boys held a sheet to catch the falling fruit. Like kings, we were handed platters of sweet, soft, white tut that melted in the mouth. This was an Afghan scene I'd read about many times, thinking it bordered on perfection, yet sure I'd never experience it. Meraj handed it to me along with his tour of the walls--like the tut--on a platter, perfectly ripe and without even knowing it is what I most desired.

A few days after this trip to Balkh I left Mazar on the bus to Kabul over the Salang Pass and tunnel. I Bought bus tickets for myself and Amy Son, who was in Mazar visiting from Kabul, the day before. I wanted two window seats so we could both have unobstructed views of the countryside, but the man wouldn't sell them; the two foreign women had to sit together. When I protested, the ticket seller looked at me with furrowed forehead and explained to Rahimullah, "But who will sit next to them?" No lone male would sit beside us and no lone female travels--they always have someone with them.

The bus hit the road at 04:20. People were already working in the fields. It was still a bit dark and the window at our seat was clouded with something between the two panes, so I didn't get the sort of view I expected. South of Tashqurgan we passed through a narrow, windy gorge of red rock. Despite the clouded window and the early light, the red gorge was quite spectacular--the sort of pass a caravan master would not attempt without being accompanied by armed guards. Traveling through the pass, I had a better feel for the difference between the flatness of the extensive plain around Mazar and points north and the significant barrier made by the wall of mountains to its south. After about 10 kms the pass opened into a 1-2 km wide valley ringed with low hills. It was heavily cultivated and the grass of the hills was just beginning to turn brown from summer heat.

We climbed through wheat fields and pasture lands; the higher we went the greener the landscape became, as if going back in time. We passed through the town of Puli-Kumrei after two hours travel and from there started to climb into the mountains, through wide, green, cultivated valleys and mud houses piled one on top of the other. Flowering tamarisk blossomed along the river, surrounded by rocky, treeless mountains. The sweep of wide, vertical "footprints" left by the cascading waters that had come down the mountains in the snow melt played out in a lighter shade of brown against the rock and were zig-zagged with sheep and goat trails. We passed nomadic koochi encampments tucked into the valley offshoots, each made up of a half dozen tents (a couple of which were inevitably stamped, "UN"), hundreds of sheep, and a few camels. Groups of nomads were on the move, the small children perched on camels, slowly, sedately taking-up their portion of the road, the trucks and buses moving around them. As we climbed a thin overcast dulled the sky. The mountains became sheer rock faces and the river divided into innumerable streams of frothy white water rushing through treeless, alpine bog dotted with spikes of yellow red-hot pokers. The air was cool and smelled of fresh of water and mint.

Before we entered the Salang tunnel, (at 3400 meters altitude and 2.6. km long) we passed through a series of roofed, partly open "half-tunnels" that protect the road from avalanche. We came out of the dark Salang tunnel to snow and bright light, speeding down the hair pin turns. Fresh spring was in full brightness on the south side of the tunnel. Poplar leaves shimmered in the sun, and a much earlier green graced the terraced hillsides on the cooler south slopes of the Hindu Kush. The Shomali plains north of Kabul were still lush, unbeaten by the heat that had swiftly turned the plains of north Afghanistan into baked fields ready for harvest.

Many farangis try to pass unobtrusively in Afghanistan. Women especially go to great lengths in dress and manner to be like Afghan women. Though it is true that with my skin and hair color I could on first glance be mistaken for an Afghan, there is something in the way I stand and walk that shouts out: "foreigner." Plus I have no desire to be treated like an Afghan woman--I can think of nothing more degrading. Instead I use and have become dependent on the courtesy extended to me by this foreignness. This stems from the responsibility Afghans automatically assume for the protection of the guest in their midst. For the conductor and even for the ticket seller, who would not give me two window seats, my being a guest was never questioned. I was never asked to show a ticket, but the conductor knew where my seat wase--he had been warned about the two farangi women traveling on the morning bus. He kept track of us, showing us the toilet facilities when we stopped for a tea break. He remembered which side of the bus my luggage had been placed and retrieved it as soon as we arrived in Kabul.

Full summer in Mazar

Life starts very early in my neighborhood. The day's light is saved, not to be savored in the late evening, but for use when it arrives as naturally ordained in what I would normally call the middle of the night. The chawkidars, the guards of the IAM (International Assistance Mission) guesthouse where I live, are up at 03:30 opening and closing metal doors, washing cars, revving motors; Zambol, the furry crop-eared dog has a few thoughts he is not shy to voice; the birds have started chirping their morning accountability; and the muezzins, their watches asynchronized, call in succession from the three surrounding mosques. At that time the light is just barely strong enough to outline the mountains to the south. A slightly cool breeze filters through my open window and by half 04:00 I am usually awake.

The temperature during the day is now well over 100° F. under an intense sun and a pall of dust. In any other country, people would be wearing light-weight clothing that allowed the air to circulate. Men working on the street wear an undershirt, a buttoned, long-sleeved cotton or rayon long tunic over baggy pants, and a lheavy wool vest. Women are smothered in layers of long sleeves, (most often of unbreathable synthetic fabrics) sweaters and dark coats, or burkas and always the scarf wrapped protectively around the neck. The smell of dirty human bodies and accumulated sweat permeates through the layers of the hospital's already noxious smells.

In response to the heat juice sellers have cropped up along the sidewalks. Mounds of sour cherries piled on blocks of ice offer the most mouth-watering refreshment, mangos from Pakistan, the same. But I only look. A recent revolt of the intestines has forced me to boxed juices--cherry and pomegranate are my immediate favorites. The further I retreat from the reality of the cramps and dizziness, the more enticing the iced fresh juices look.

Fresh ice cream is made in front of small shop fronts in 3 gallon deep, metal tubs embedded in troughs of shaved ice. The ice cream maker physically swirls and twirls the tubs back and forth within the packed ice, occasionally scrapping down the sides. No dashers, no motors, only the soft grating of the metal against ice and a spurt of human labor. This ice cream is soft and sweet. Light tan in color, but of no recognizable flavor, it remains the sensual combination of sweet-soft-cold. I asked Rahimullah if the flavor had a name. He shrugged, "Just Afghan ice-cream."

The guesthouse garden reflects the increasing high temperatures. The roses have not been dead-headed; their dusty spent blossoms make the garden look derelict. They remind me of Afghan women, desiccated before their time, ill handled. The lettuces have gone to seed, the leaves thick to the tooth, bitter. Zinnias are now beginning to take over. The gardeners are transforming the garden into its summer form. A few days ago a cat's cradle of purple plastic strings was suspended from an upright rectangular metal frame to encourage some nearby nasturtiums in their ascent to the roof. Every day a new pole or string is added to manage the easy growth of the hyacinth bean runners.

A lone holly hock has grown an additional 6 feet since my arrival; its lower pink blossoms have already become seed buttons. The figs are plumping, the sunflower leaves have been badly decimated by hungry insects, the datura's white trumpets flower and fade with regularity, and the ovaries of the pomegranate flowers are swelling into miniature fruits, the stamens and petals dried reminders of their waxy blossoms. Is it any wonder they are a Persian symbol of fertility? Seedling weeds and dust have overtaken the bed of eggplant and its solanacae siblings of pepper and tomato. The gardeners do not weeks. Their true vocation seems to be the daily resetting of the garden, revamping it into some inner idea of paradise.

When I go to the garden at 06:00 the language classes in the downstairs class rooms have already been in session for an hour. I walk outside to a sea of shoes scattered on the linoleum of the porch. The women's shoes are usually black high heels, often studded with rhinestones and bows, tartish and uncomfortable to my thinking, the sort of shoe I cannot imagine ever wearing. Yet in Afghanistan, this is the norm to be worn daily through the mud and the dust of the unpaved streets to school. The men come in sandals or the very pointed-toe shoes that are the de rigueur fashion statement for the Afghan peacock.

At the hospital I have come across the Afghan cane--a long, straight hardwood stick with a sharp metal point grasped with both hands of the lame person and used as if poling a boat. Semi effective in dirt, which is most of Afghanistan, the pointed metal end slips on the sidewalk or the cement floor. This is the exact same assistive device one sees in religious pictures of the halt and crippled coming to Jesus for help. It looks so clumsy and doesn't unweight the hip or any part of the lower extremity. My substitution of 2 elbow or axillary crutches is looked on with suspicion and I see the patients discard them, returning with their old Biblical sticks.

An Afghan Picnic

I went with Dr. Rahimullah and his family to the shrine at the town of Sari-Pul (Pul is the Dari word for bridge) early Friday morning. We had spent Thursday in Shebergan, about 130 kms. west of Mazar-i-Sharif doing two SIGN nail cases with the local orthopaedic surgeon. Sari-Pul is green with abundant trees and gardens, watered by the river. The shrine, commemorating a 9th c. CE martyred saint is uncommonly ugly--an example of the present state of religious architecture in the country--shoddy materials, shoddy workmanship, a careless assemblage thrown together without pride.

Shrines, it seems, are not always for worship and most people seem not particularly disturbed by the unprepossessing architecture and decoration. Shrines are simply an excuse; an excuse for a picnic. Picnic is the generic word for any Afghan outing. And all outings are picnics, since you would never leave home without food and a large thermos of tea. For the women who don't often leave home, a visit to a shrine is the best excuse to go out for the day. Already at 08:00 blankets lay on the open hillside between clumps of thorns and brilliant black-throated red poppies, the tea thermos propped against a stubby bush, and piles of naan bread distributed as trenchers.

Dr. Rahimullah's family had not come for a picnic. His wife wanted to sacrifice a chicken at the shrine. I never found out the exact reason for this sacrifice, whether it was in thanks, or contrition, or a request. Rahimullah was also in the dark on this, but being a dutiful husband, he bought a chicken, had it blessed by the mullah (who will resell it later in the day), and reestablished marital accord. He figured the bird had already been sold over a hundred times, so there was no sacrifice, only giving money to some vendor of birds who is in cahoots with the mullahs.

I, however, came in the spirit of an Afghan picnic--the excuse to be out, so see something different. We drove south from Shebergan along a plain that narrowed into a wide flat valley between hills, deepening and narrowing as we approached Sari-Pul. The day was full of brilliant sunshine and we left early enough to enjoy the coolness and the special rosy light of morning. Kingfishers and bee-eaters sparkled in the sunlight and the wheat looked particularly healthy and full with the abundant feel of a fat harvest.


In Shebergan over night I stayed at the local surgeon's home. He had asked what I liked to eat so his wife could make this for me. One cannot escape saddling a wife with such a task, there is no pizza carry-out, and the idea of not going to trouble for the guest seems un-Afghan. The women always act happy that they have just spent 4 hours hand making platters and platters of food that will be decimated in a mere 10 minutes of purposeful eating. To act otherwise would bring shame to the house and family. I always wonder what resentments lurk underneath the smiles. I would not be happy to be told with little notice to prepare a feast for some foreigner I did not know, just to please my husband. A pizza would certainly suit. Obviously my manners would not pass muster in Afghanistan.

I was welcomed to the courtyard of the surgeon's compound by three women squatting around an oilcloth on the ground making aushak. These vegetable filled tortellini were my response to the question what I wanted for dinner. I choose it because it is one of the few names I know and it is vegetable--not so heavy on the stomach. This was the first time I had ever seen aushak made. Though I was ushered into a long cool room away from everyone, I made my way back to the courtyard to sit around the floured oilcloth with the women. Naomi Duguid (a writer of glorious food and travel books) would have felt blessed to be in such company. They worked with the sort of speed and casual gestures one sees in people who long ago mastered the technique and so proceed seemingly to pay little attention. They continued working, chatting away, thinking it humorous that I was interested in their work.

What particularly intrigued me was the way they rolled out the dough. It was like a noodle or pasta dough--firm, but pliable. One of the women started with a dough ball the size one would use for a 9" crust, rolled it with a 3" fat, solid rolling pin, turning the flattened ball in quarter turns every few strokes and sprinkling the surface with flour. When it reached about 10" diameter, the woman changed to a 3' long 1½" diameter pin and began a vigorous rolling, but with the floured dough rolled up on the pin, not flat. I have never seen dough rolled this way and do not know the advantage, though assume that because one is rolling two or three layers of dough it all gets thinned faster. She worked for about five minutes until she had soft sheets of dough about 1-2 mm. thick. I can't wait to try this technique.

To Balkh and Beyond

Seljuk minaret


A week ago Friday, (yes, I am behind) Homayun picked me up in his car for an outing. His children and wife were at her family's village about 40 kms north of Balkh and we planned to arrive there for lunch. But first, we had unfinished business in Balkh.

When I was in Mazar-i-Sharif in early 2006 I wanted to visit the oldest extant mosque in Afghanistan, the 9th century C.E. Noh Gumbad, or Nine-Domed Mosque, at the shrine of Haji Piyada just outside Balkh. I'd read about it in The Road to Balkh, an outdated guide, but valuable historical document I had picked up in Kabul. Homayun had never heard of this mosque and because of car trouble and the afternoon buzkashi game, we never made it.

The mosque is in quite a ruinous state. All the domes, for which it is named, are missing; the one remaining, cracked arch is supported by metal scaffolding. UNESCO has built an ugly but functional metal and plastic structure to protect the site. A new mud wall surrounds the large compound of low scrub and a small grove of chenars (oriental planes) and mulberry trees offer deep shade over a nearby narrow irrigation channel. Swallows, mynahs, and sparrows chatter and whistle in the rafters and the trees; mud dabbers use the ruins as a palace.

The ruins are the remains of baked brick and mud stucco heaped on a mound of mud. The major architectural elements left standing are short double columns, whose capitals are carved stucco in a modified paisley pattern. The undersurface of the remaining bits of arches are decorated with various braided floral and foliage motifs. It looks distinctly unique in its squatness, design and size, but I do not know enough to make architectural or historical sense of the structure. The monotony of dull mud-color, the static, repetitive decoration, and the short, fat columns give the ruins a heavy feeling that is not immediately attractive. For the uninitiated amateur it is easy to find beauty in the pure colors of fine tile work, the majesty of iwans (lofty semicircular vault, generally closed on one side and open on the other, characteristic of Persian architecture.), or the soaring grace of a 16th C. Ottoman minaret. This place is not quite so easy. But why do I think a religious building must be beautiful? The importance of its mud and brick is that it has outlasted the depredations of Genghis Khan, time, and many earthquakes.

Many tinseled horse-drawn gharries ply Balkh's wide tree-lined streets. It would be a pleasant small town except that the Taliban still holds some sway and the atmosphere for outsiders, let alone farangis (Europeans) is not at all friendly. Homayun was not all that interested in stopping, but I wanted to see again the green domed mosque and shrine to Khoja Parsa, in its shady garden. The mid-15th century ribbed dome looks significantly more dilapidated than when I saw it 3 years ago. Grass grows in the spaces between the missing tiles giving the dome a hazy aura and, along with the dust, dulling the original brilliant turquoise-green. All is faded and sad.

When we first entered the shady garden of the shrine we passed a half dozen thin, dark, fine-featured women selling sparkly, plastic wrist spangles from pieces of material laid on the ground. They wore simple loose scarves, and were quite forward in their attempts to interest us in their cheap wares. Not at all like typical Afghan women. My first thought was, "gypsies." When I asked, Homayun said they were "Jugui" (pronounced jeu-gee)--typically dark-skinned, semi-nomadic people who hustle to make a living and are known as dangerous. Lurid myths exist about their indiscriminate sex lives and taste for the flesh of children. Funny how these common accusations are so easily branded on outsiders, indiscriminately repeated, just as I'm repeating them now, without authentification.

We drove north from Balkh to Daulatabad along a flat plain on a fine paved road, past wheat fields and large walled compounds whose buldings are often domed. The walls of the houses are a meter thick and the gardens are filled with shade and fruit trees. It is a world of small hamlets or villages composed of relatives farming and herding together. The landscape includes many one-humped camels grazing and hauling as well as herds of sheep and goats, often tended by children and dogs. The shimmer of sunlight off the sequined and glittered dresses worn by the little girls as they tend the animals looks most incongruous. Winter and spring moisture was generous this year and the wheat is almost ready for harvest.

On the outskirts of Daulatabad Homayun parked the car and led me into a maze between 10-12' high mud walls into a warren of interconnected living compounds. The featureless walls, the twisting and turning through shadowless midday sun, and the blind alleys all gave me the disorienting sense that this was not a place welcome to outsiders. No windows, no hint of color indicated that we were following the right path until the walls opened up to a small pond (more cesspool) shaded by a few trees where the children were playing. We were taken through another series of doors and walls into an open compound and a long room ringed with pillows and thin mattresses along the walls. A cool room, wonderfully dark compared to the sun glare outside. Safe and welcoming

The children ran in happy to see their father, received their hugs, and ran out again to play in the water and race along the walls and over the roofs shouting and screaming with their cousins. I was introduced to Homayun's in-laws not by name, but by title, "This is my mother-in-law, this is my mother-in-law's sister." For another, he said, "I don't think you have name in English, but she is the second wife of my aunt's husband." People came and went, happy to see Homayun, curious about me. After tea and a short nap, the large plastic cloth was laid on the floor and we were served aushauk, one of my favorite dishes, a type of vegetable tortellini, and raison and carrot studded fragrant qabli pillao (rice).

The evening before this outing, I had seen on the map that near Daulatabad were the ruins of a Seljuk Minaret, I asked if we might see it. Ten of us piled in the Toyota sedan on a hot dusty, slow 40 minute drive to the village of Zodyan. I felt sorry for Homayun, being stuck with a person like myself, with unnatural desires to see all the strange things. I said he must look at me as igniting a spark of interest in his children to be archeologists, something the country needs (along with the enforceable laws to protect the sites). There is no country so in need of a viable archeological program and no country so under-explored.

The Seljuk minaret sits in a small oasis just outside the large village of Zodyan on a flat plain. The map indicated only Seljuk, and I'm guessing it was built during the time of Sultan Sinjar--in the mid 12th C. I also assume this was the site of a large city to have had a mosque with such a grand minaret. Two-three story high segments of brick and mud wall ruins stand outside the village, but I couldn’t make heads or tails (or tales) out of them. The whole of northern Afghanistan is covered with tepes, round archeological mounds. Few have been explored and the locals know nothing of the history. All the more reason one of Homayun's children should become an archeologist.

The minaret, whose top has been lopped off, stands now about 50-60 meters. It is made of well baked brick formed into monotone repetitive decorative patterns including one 2 meter high row circling the monument in majestic Arabic script. A steep circular staircase winds up the dark interior and opens suddenly without the protection of railing or wall. I sat well away from the edge and enjoyed the bird's eye view of the village in the middle of the vast plain.

The village is populated by Turkmen--a vaguely mongoloid people with wind and sun-reddened faces, I quite liked their appearance and their unconcealed timid curiosity. A shrine was also present at the minaret. For whom, I do not know and I suspect the name or the story is lost in time. Sharifa took all the children into the shrine, touched the posts and the green, velvet covering, prayed and all the children knelt quietly for two minutes in this dark cool place. Other worshippers, all women and children came and went, kissing parts of the shrine, praying.

Before we left Daulatabad, I saw a flash of blue, a largish bird flying from a wire into a garden. It was the turquoise blue of a kingfisher. It was a most wonderful sighting, but even better, I saw another dozen in our drive to the minaret and back to Mazar.

Dealing with patients the Afghan way

A doctor in a poor, crowded, public, Central Asian hospital is like an oriental potentate. People petition you as to weave your way through the crowds blocking the entrance and plead with you to see them, thrusting their rolled-up x-rays in your face. They all have an injury, pain, or deformity, but know only the loudest, most persistent, or the one who has cultivated a powerful interlocutor will be seen. These are not always the most severe cases or those that if treated will produce good results. It looks like chaos to me, but it is a system, as systems go, based on patronage, power, and persistence.

I had forgotten how difficult it is to extract a medical history from the Afghans. When I first wrote the chapter about Afghanistan for A Leg to Stand On my experience in the country was still fresh in my mind but the frustrations of working in this ahistorical medical fashion had left a conflict that I had a difficult time putting into words that people familiar to a Western system could understand. I did not do a very good job of explaining that the history is the most important aspect of evaluating a patient for further treatment. I was taught that at the end of a good history I should have in my mind a working diagnosis, which my exam and clinical tests narrow in number or confirm. This is one of the beauties of clinical medicine and is also one way to cement the doctor-patient relationship, by talking with the patient.

Looking at the x-ray without a history is also, to my mind, a form of "cheating." A good orthopaedic surgeon should be able to make a reasonable differential diagnosis based on history and physical. And not only is a first look at the x-ray unfair, it is a spurious goad into forgetting about the rest of the patient. It can lead one down a blind alley of shadows that look quite out of the ordinary, but in fact have nothing to do with the problem at hand. One must first establish the problem; x-rays are not problems.

Orty was very impatient with me when he edited this part of my story a long time ago; he did not believe that patients would lie, the word I used to describe their answers to my questions. "Why would or should they?" He asked. Perhaps lying was the wrong verb, though I felt that many of the patients blatantly used my naïve ignorance to counter their own needs. They thought their lies would qualify them for care, or better care, or even admission to a hospital whose admission criteria they knew they did not fit. My husband's insistent red marks, indicating that all my words trying to sort out this incongruity were boring and no doubt a figment of my overly-intrusive nature, caused me to change the thrust of that part of the chapter. But I never felt that I adequately examined this need of patients to dissemble, either with frank lying or selected, resolute silence.

The Afghan doctors at the Emergency Hospital in Kabul and here at Balkh Civilian Hospital in Mazar make no bones that the patients' histories are suspect and not to be trusted. This, I think is one reason they have systematically skipped this whole segment in the diagnostic process. They go straight to the x-ray. To them it is cutting straight to the chase without the back story.This black and white film is the petition necessary to gain recognition, physical evidence that something is wrong, the shadowed reality of all that ails the patient. The x-ray becomes the validation of the pain or the disability.

When I brush aside the x-ray and ask what exactly the problem is, the x-ray is trust into my face again. The picture of an offset fracture or the irregularity of a joint is more real to the family and patient than the fact that the patient has no pain and uses the extremity with full function. When I ask the patient to roll up his sleeves, ask again that both be rolled up, and look first at the uninvolved side for a normal comparison, I'm immediately taken for an idiot while the patient, or all his male relatives, point to the deformity on the other side. I nod, but continue my exam. I ask why, 8 months later, they have now brought the patient to the hospital. What exactly is the problem. I'm handed the x-ray and told they thought the crookedness would straighten out. That is what the shakastabund, the traditional bone setter, said.

Yesterday the "problem of the shakastabund" was made more clear on two separate occasions by two different orthopaedic surgeons. When the patient with a fracture goes to a trained medical doctor, the doctor usually tells the family that they should go to the bone setter. The primary doctors have no high opinion of the local orthopaedic surgeons and do not refer to them. This non-referral may have to do with petty grudges, the vagaries of this culture of hanging onto power at all costs, or just plain pettiness. The bone setter does what he has been taught to do, which is bandage the limb with a tight bandage and splint it with cloth hardened with egg or other stiffening materials and bits of wood slivers. Some of the shakastabunds have an understanding of what they are doing. I have a picture of the most beautifully immobilized leg wrappped in precise overlapping layers of cloth as skillfully as the royal embalmer would wrap a pharoh for mummification. I still have the decorative patterned slats of wood that I was told are typically used by the bone setters. But I've also seen some rather crude and physiologically untenable splinting that have led to severe problems. "Presents from the shakastabund," I call these swollen, blistered extremities, some of which are dead from inappropriate treatment and have to be amputated.

Is it harder to get a history in Afghanistan than Africa? I think so, but maybe this is just my problem with language. I have only worked in Anglophone Africa, where I understand both the patients and doctors better. In any culture traditional healers have little need for a medical history and the patients are not asked such intrusive questions as we are taught to do. Sometimes I think they resent our asking. Taking a history supposes that an order can be sorted out when all the pieces of the puzzle are in place. The "order" in a traditional system--the reasons for disease or injury--have little to with the mechanisms we are trained to consider important. Things just happen, and insha'allah you deal with what lies in front of you. Maybe the history is only something thrown in to confuse us.