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Zach and his girlfriend Aimee recently participated in a Tibetan Children’s Education Foundation (TCEF) service trip to provide medical care and education to local healthcare providers in Zanskar, India. As part of the trip, they joined other volunteers on a 5-day trek to outlying villages to spread the word about the health center and medical camp in Padum.
Winding my way through a narrow passageway between mud brick walls I climb a small set of stairs and reach a doorway framed by rough cut timber worn smooth with time. “Please watch head,” a voice calls out from some corner of the room inside. I duck my head and leave the heat of the sun behind me, entering the respite of cool darkness. I’m immediately hit by the comforting smell of a thousand fires that have burned in this small space. I slide my shoes off at the entryway, as is the custom, and as my eyes adjust from the bright sunlight outside the details of the room slowly begin to reveal themselves to me.
Coals glow warmly from a small rectangular iron stove that sits at the center of the room and a stack of dried yak dung, fuel for the fire, lays piled nearby. A rickety log shelf behind the fire reflects the blurred metal sheen of pots and pans dented and scratched by years of use. Various strainers and metal spoons dangle from rusty nails. Next to the shelf, a two-burner propane stove sits atop a waist-high cabinet blackened with soot. A low blue flame on the stove lets me know that our host is already in the process of simmering yak milk for tea.
The woman making tea is short and slender, and despite the heat outside she’s dressed in layer upon layer of loose fitting, once brightly colored linen clothing. Her young daughter, wearing a bluish-grey baseball cap with Tweety Bird on it, clings to her side as she moves about the dark room preparing lunch. “Jullay,” she says kindly, lazily dragging out the “ay” into a “Jullaaaayy” as most locals seem to do. “Jullay,” I respond using this handy Zanskari catch-all phrase that means hello, goodbye and thank you.
“Please, come,” she motions to me as I take off my sweat dampened pack and rest it on top of a large pile of blankets, also made blackened and musty with years of hearth fires.
I duck my head again, entering a starkly different room, brightly lit by pink gardenia-lined windows that face out towards the dazzling terrain that surrounds us. I am greeted with a big, toothy smile by Dolma, our trekking guide and interpreter for this leg of the trip. A local to the area, Dolma is from Purny, the final and furthest village we will visit on our trek, but most importantly, she is an Amchi, or Tibetan healer.
The Amchi healers are highly respected individuals and the Zanskaris place a lot of faith in their treatments, but there are gaps in their medical capabilities. It is our goal to help fill in those gaps, but in a way that does not impose our ways on hundreds of years of tradition. Do no harm is the first rule of medicine that guides our volunteer medical team, but it quickly becomes the mantra by which we consider the impact of each of our actions and our involvement working with this long-isolated fragile culture.
Working with Dolma and the other Amchi’s as close allies, it is our hope, and hers, to integrate modern western treatments into her repertoire, not to indoctrinate the pharmacopeia as gospel. She is an eager colleague, taking and reviewing notes on uses and doses of potentially life-changing medicines, like basic antibiotics, that are simply not readily available here.
Joining my fellow trekkers, who have already seated themselves, I find an open space to sit myself down cross-legged on the vibrantly colored rugs that cover the floor. Looking around at the people who surround me and the place where I have ended up I’m truly astonished. It is like a dream.
I have finally made it to the Zanskar Valley, a mythical stretch of Himalayan landscape in the far-flung reaches of northern India, and we’ve stopped for lunch and a break from hiking in the tiny village of Anmu. Consisting of five or so boxy mud brick houses, I will come to learn that Anmu is a fairly typical and in fact quite ordinary village for the region. But to me it is completely foreign.
Compared to the initial travelers who began exploring this part of the world by yak and horseback when the region was opened to outsiders in 1974, my journey has been relatively easy, but it is by far the most effort I have ever had to put into reaching a destination. It has taken me six days (6 days!) to get to where I am and I’m still in total shock. At one moment I was getting a last minute pre-flight cup of coffee with a friend at the Missoula farmer’s market and the next day I found myself in New Delhi – literally the opposite side of the globe. From Delhi, a short flight took me directly over the snowy Himalayas to the tiny mountain town of Leh, where I spent two days acclimatizing to the 12,000’ altitude. Finally, a 16-hour push of driving would get me to my destination, the tiny town of Padum and the newly built clinic.
But these mountain roads would prove to be no easy task to navigate. Filled with wandering cows and unmarked road construction detritus as obstacles, nearly unbearable diesel truck fumes, countless hairpin turns and glacial runoff crossings – one that had us driving against a current with water reaching over the top of our car’s tires – this was the most treacherous, terrifying, yet stunningly beautiful drive of my life.
This is not a place I thought I would find myself. Ever.
Arriving in Padum around 7 p.m., my nerves still completely frayed from the drive, I learned that rest would be fleeting. I’d be leaving at 6 the next morning to join a group of TCEF volunteers on a 5-day trek to outlying villages to spread the word about the health center and our medical camp in Padum.
Another 2-hour drive on a single-lane dirt road dropped us on a hike that followed a narrow scree trail perched unsteadily above the milk chocolate colored, fast moving Tsarap River. I had developed a cold on arrival, and the dryness of the air mixed with the altitude made my labored breathing feel like inhaling razor blades, but the jaw-dropping scenery more than made up for the discomfort.
Despite walking for only two hours before stopping for lunch in Anmu, I was relieved for the break from the sun’s intensity. But it's time to get moving again. Our host, like I found all hosts in the Zanskar Valley, is beyond generous. She serves us more food, tea, and chang (a barley-based alcohol made like beer but with a cider-like acidity) than we can possibly consume – a source of pride for these people who have little to offer but the food that they work so hard to cultivate. Finishing the last of my milk tea, or cha as it is known in Zanskari, and shoveling one final bite of dal and rice into my mouth, we thank our host for her generosity and make our way back through the narrow walkway that led us to lunch, leaving Anmu behind.
Each bend we come around reveals views more extravagant than the last. The high desert terrain is Mars-like, consisting mostly of brown and reddish-purple scree slopes and slick desert-varnished rock broken up by the occasional pink-flowered wild rose bush that tenaciously fought its way through the rock.
All of the terrain around us is so monumental and the air so crisp and clear that it easy to lose sight of the largeness of it all. It is so grandiose that my tiny brain just can’t quite comprehend what I am actually looking at. During the moments that I pause to really take in the view, I’ll see a cow or a person move off in the distance, shifting my perspective on just how massive and steep the mountains actually are. It is truly unbelievable.
Like the terrifying roads we had to travel to reach this place, the trail is a far cry from comforting. More often than not, it is cut through a scree slope steep enough that I can lean my hand on the upslope side without leaning too far over. The trail is typically just wide enough for placing one foot in front of the other and looking down is nausea-inducing. One misstep would send somebody for a tumble that, if it didn’t kill them, they would certainly not be walking away from.
Along many portions, rocks have been painstakingly and expertly stacked by some soul brave enough to build enough of a platform to connect what were most certainly at one point bouldering traverses a hundred feet off the deck. Occasional other airy expanses are bridged by two logs covered in flat rocks to connect the path together. I find that the best tactic is to not think about what I am actually walking across, but just hold my breath and go.
Small villages break up the monochromatic terrain; their bright green stepped barley fields fed by intricately managed canals that take advantage of some long-ago discovered mountain spring. These verdant, Shangri-La like hamlets cling for dear life to the steep canyon walls, seemingly held in place only by the roots of the poplar trees transplanted here for much needed shade (it is too high and dry for trees to grow naturally). The villages act as mile-markers, measuring our progress as we make our way further up the canyon.
By late afternoon, we have reached the village of Cha, where we will be spending the first night of our trek. Aimee, her cousin, Sarah and I will be staying in Dolma’s “office,” a well-lit, 15’ x 15’ room directly above another living quarters that houses our hosts, a family of three. On the rooftop, yak dung is stacked 4’ high around the roof’s perimeter to dry in the sun, making our dwelling look like some kind of dung garrison to passersby.
The vibrant sunset that evening is far from disappointing and our final task of the day, filling up and purifying water, unexpectedly turns into a game of “catch-the-goat” as Aimee and Sarah throw down their water bottles to jump in and help the villagers chase down tiny run-away goats to put them in their pens for the night.
We wake on our carpet beds to cha at 7 a.m., thinking that we will begin to see patients at 8, but an old woman shows up at 7:30 complaining of knee pain and eye trouble while we are still in our pj’s. She is followed by 6 or 7 other people in close procession. We ask for 15 minutes to get together with our team and come up with a game plan, something we admittedly should have done the night before, only to discover that by some miscommunication we only have a stethoscope and three medical kits that we are to leave at the villages.
We are not equipped to help these people in the way that they and we had hoped to be able to. It is disappointing for us and for Dolma, but we pool together the supplies that we have and make a group decision to do the best that we can with what we have. After all, it is all we can do.
We discover that most of the complaints are arthritic aches and pains from years of hard living in this unforgiving environment and strained, itchy eyes from dusty air and being in the bright sun day in and day out without sunglasses. Making the most of what we have, we dole out pain relievers, try to encourage people to drink plenty of water (hardly anyone drank water – only milk tea and butter tea), instill the idea of eating a lot of greens in the growing season to stave off anemia, and, in a capstone triumph of our capabilities, Aimee and Rob, an EMT, perform a minor surgery on a Nepali man with a severely ingrown toenail. With only a pain reliever as anesthesia, this guy sat, unaffected and stalwart as a contemplative Buddha statue as his toenail was trimmed in half vertically to below the cuticle – with a pair of med kit scissors.
Somehow my trekking partners and I found ourselves in one of the farthest reaches of the globe, seemingly in the middle of nowhere. Our team a variegated group of people from all walks of life: Aimee and I, a teacher, two EMT’s, and two pre-med students. We all lead different lives at home, but here we are bound by one thing – the mission of the TCEF to bring much needed and much wanted medical aid to the people of Zanskar.
Was this trek was a success? Ultimately, I think so. We did what we could with the supplies that we had and referred people to the clinic where they could get the help they needed. After all, even if our backpacks had been filled with medical supplies, there is only so much that can be done in the backcountry. We spread the word about the clinic in Padum, met some amazing people, and we maintained our mantra – Do no harm – while taking in some of the most beautiful country I’ve ever laid eyes on.
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