More pictures of the New Year Celebration.

More pictures of the New Year Celebration.

   We have spent a quiet day reading by the pool.  I think this idea of Silent Day is one we could all copy!  Part of the "belief" is that since the ogoh-ogoh have been burned, the world is clean and by being silent, Bali is telling the evil spirits that no one lives here.  The lack of sound almost makes it seem possible!

3 pictures for you

Offerings at the temple

Young girl "anointed" with rice

Procession from the ritual washing at the sea

Ogoh Ogoh and morning doves

This would never happen outside of Bali!  The entire island is "closed" today for the celebration of the Hindu New Year.  And closed, means just that.   All shops, businesses, traffic (including motorbikes to our relief), use of fire, use of electricity (except in the hotels and resorts), and even the AIRPORT are closed.  Everyone is required to stay at home between 6 AM this morning and 6 AM tomorrow....and this means us.  No one is allowed outside his/her home and this is actually enforced.  This special day is called a day of silence and it is  to be a time of reflection including reflection on what one has done wrong in the previous year in addition to learning to control oneself and submit to God.  Tomorrow some of the shops are still closed and according to the hotel information sheet some of the banks.  We are hoping the ATMs that were shut off last night will be turned on tomorrow....there is an exit tax we need to pay to leave tomorrow and we really do need the ATM to work!

So, we woke to peace this morning and the sound of cooing morning doves and no motor bikes.  Even though where we are staying is not in the heart of Ubud, there was road noise which is wonderfully absent.  So...an entire day where we are required to stay in the hotel grounds, there is a reduced staff who will provide us meals and we will e-mail, read, and begin the process of packing.  We are picked up tomorrow at 6 PM, will have lunch on the beach near the airport and are due to leave around 00:45, flying first to Seoul and then on to Chicago.  What an adventure this has been!

But about the Ogoh-Ogoh.  These are huge paper mache monsters unlike any we have ever seen. They are truly terrible looking and many  times they are doing terrible things, like killing babies, stepping on people, basically anything you can imagine.  They represent the evil spirits in the world and in us, are built in all the villages by the young men (no girls allowed), are financed by donation, worked on for months, and then are paraded through the villages on the night before Silent Day.  A platform is constructed of thick bamboo poles in a checkerboard fashion so that depending on the size of the statue 50 plus young men can fit into the framework and carry the monster.  For the tall ones there are men with long poles lifting the electrical wires out of the way.  But really fun was seeing the young boys between 5 and 10 carrying the lighter monsters and having the time of their life.  Cheering each other on, laughing,and over the top excited.

We also believe that this parade/celebration brought out every Westerner in the area and it was great people watching!!  The challenge of the night was pointing out the people we thought were "permanent" expat residents!  We watched a long time, sitting on a shop step, but finally left for a really good dinner and a walk back to De Menut.  We didn't stay for the end which is a huge bonfire during which the ogoh-ogoh are burned (clearing the world of the evil spirits) so that today the world basically starts over clean.

Tomorrow we have been told that people visit family members and apologize and ask for forgiveness as well as head to the beaches.

In the days leading up to Nyepi (the name for this entire celebration) we saw many temple ceremonies (from the outside, but the walls are only 4 feet high).  Men dressed in long white clothes with a head covering of various designs mostly white and the women in an ankle length skirt with beautiful lace tops...smaller versions for the children.  The women walk down the road and into the temple banancing on their heads closed baskets of food  for an offering to God and to receive a blessing.  After the temple ceremony, the baskets are taken home and are part of the feast the family shares today.  I am not sure how the now cooking prohibition is carried out regarding the feast - although I suspect the chickens we have seen go by in crates on the trucks for days play a prominent role.)  The priest sprinkles water on all of the people attending as they kneel and similar to our Ash Wednesday, kernels of cooked rice are placed on their foreheads and at the base of their necks. Life here depends on rice, so this seems VERY appropriate. We saw streams of people returning from "washing" a symbol of God in the ocean or the lake (depending on where we were), in the festival dress over the last few days and will not forget the sight.  For not knowing about this holiday when we made our travel plans, this has been a real bonus.

I should also mention that there are beautiful small offerings in front of every shop, hotel, doorway, and even in the taxi we hired for a day of sightseeing.  Every family has a temple as part of their compound which is visited daily and it is decorated with bamboo, ribbon, offerings for this holiday.  There are literally thousands of temples in Bali. and they receive the greatest attention and money from the family...not the homes --at least traditionally.  The vast majority of the people living in Bali are Hindu and we have been told there are lots of festivals, celebrations on a complicated calendar system (actually 2 systems and there are priests whose responsibility is to determine the appropriate day for each.)

Yesterday we went on a 7 hour bike trip which really was about 2-3 hours of actual biking with the vast majority being a down hill coast.  It is going to be painful to get back in shape!  But it was interesting.  We were in the countryside with lots of small villages, visited a family compound, rode through a rice field and learned about how that crop is raised, and for the third time visited a coffee plantation.  This time we did try the Luwak coffee (also known as poop coffee and supposedly the most expensive coffee in the world).  Thankfully we did not like it!  What a relief.  I am bringing home some ginger coffee, though, and will be happy to share that!

So it is time to head home and we are ready.  We will miss the wonderful flower smells and balmy air especially in the morning and late afternoon/evening but family and friends are beckoning.  We have had contact via e-mail with the friends we left in Sukadana and think of them and their work often and yet it seems far away  Thank goodness for pictures and memories!

Love to all of you!  And see you soon!  A few pictures coming soon.

Odds and ends post Borneo

We are spending a few days, post Borneo, in Bali so a few additional thoughts and observations:  

Coffee-- Indonesian coffee is ground to a fine powder and stirred into the hot water -- no filtering.  Some of  you know we brought our lexan French press which did make a big difference in the amount of grounds we actually consumed.  Here in Bali, they grow coffee and the most famous (and expensive) is Luwak coffee made from beans that have been eaten by a Asian palm civit, then excreted, cleaned thoroughly and roasted.  (most expensive coffee in the world).  Frankly, I am quite satisfied with the Starbucks I buy at home, so was not even tempted.  And I have had just enough "poop" experience this trip as it is.  Fermentation occurs in their gut which creates more free amino acids -- therefore less acidic.  

Snails-- They are everywhere.  This morning spotted one on the legs of our breakfast table and in Borneo, we had them in and on the squat toilet, the windows, the floor of the bathroom and boxes of toothbrushes (fortunately in wraps).

We had a great evening send-off with the Borneo bunch -- treated some 24 of the clinic crew to supper for all of $40.  We then got hugs from everyone, even the doctors for Lauri.  We will miss their laughter, ready smiles and afternoon "birthday" cappuccino's.  Their dedication is an inspiration to both of us.

Bali is beautiful with mountains, beautiful valleys, tiered rice paddies and a ton of temples (90% HIndu).  But... the traffic is horrible and the crowds (even though it's not peak season) are bad here in Ubud.  Guess we are ready to come home.  We will be here for Nyeti (annual Hindu celebration) where they totally quiet for an entire day to make the evil spirits think Bali is deserted -- everything stops (no flights, nothing open, you stay in your hotel).  That day is preceded by large parades in the evening of these paper mâché ghastly creatures that are being built as we speak and after the parades are burned.  We expect that to be fascinating.  Because of this Hindu event, the temples were a  mass of people praying and milling about yesterday.

And...just to make this Bali stay more interesting, we both got sick last night (who knows from what) and this after Lauri was crowing about how she managed to stay well throughout our time in Borneo, while the weaker member of the family had succumbed to tourista early on.  Guess there is poetic justice after all.

We had planned a bike tour today, but will delay that until tomorrow,  Then, a couple of more days and we are on our way home.  Thanks to all of you for your interest in reading our emails and blog.  Your occasional responses have been greatly appreciated -- especially after a night of battling ants.

Jim

Now, for the last interesting patient:

Now, for the last interesting patient: Earlier this week, we saw an elderly man with a history of diarrhea, some blood in the stools and, at the same time, discovered a bladder obstruction. A foley cath was placed and he returned today for follow-up. Much to our amazement, a rectal exam revealed an impaction of large seeds (he says only langsat, but we wonder about rambutan as well). Ilana and Ronald have been busy removing the impaction (I elected to defer -- have done more than enough over the years) and I am getting periodic updates. Even the orangutans, we noted, spit out the seeds -- don't know why this man decided to do otherwise. Is there a moral to this story?? Suggestions are enouraged.

Saying goodbye

Greetings everyone! This morning as we awoke there was a real sense that we really are leaving tomorrow.  And, unbelievably, it seems as though the 6 weeks has gone quickly.  At the beginning it felt as though time was very slow.  I guess we have finally somewhat adjusted and we REALLY like the people here..both the staff and the patients.  They have been the source of the beauty of this place.  We said our goodbyes at the 8 AM meeting and surprisingly I had to work to not get choked up. This does not mean that we are not looking forward to Bali and after that home, just that we have been in the company of great people with a vision of working for the conservation of the rain forest and its inhabitants which is really working for all of us.

So at the meeting we announced that "it is our birthday" and that dinner at the local noodle place tonight is on us.  The tradition here is that on your birthday YOU treat.  Jim has been having birthdays basically every afternoon which explains how is is so "old" :>) and the medical staff has been enjoying the iced cappuccinos   Today it is my turn with the dinner invite.  We will take our head and tail lights as it will be pitch dark as we head home on our creaky bikes.  And as we ride we will hear for the last time "Hello, MR"...rarely Hello,Miss from basically everyone we pass.

There was lots of talk (when we had some translation) this am about various meetings in Jakarta this month between Hotlin and Kinari (the founders here) and various possible founders for the ASRI program in general as well as the proposed building which is now being called a Community Health Center.  This new designation is in part to increase the potential for funding as well as probably allot more accurate as there will be a limitation on what services they can offer.  There is no X-ray here and getting it here, I think, will be a major challenge.  

I have continued to assist in the dental office and am almost an expert at handling the suction.  So far I have only gagged one patient one time  so Monica keeps saying that I am helpful.  I am learning the set up for the different kinds of procedures and am an expert at drawing up lidocaine/epinephrine  for all the tooth extractions.  Jim continues in his consulting role and has seen a number of very interesting medical cases lately.  The doctors have really appreciated his down to earth experience and ability to teach procedures.  They have had a really good time together and I believe he will miss the camaraderie   HOWEVER, we are both ready to be done with ants.  They continue to plague us, although they haven't been in the bed since we returned from the park .  Interestingly, the Indonesians do not have much arm hair while our supply is functioning as an early warning system for any unwanted movement on our body.  And then, of course,there is the paranoia  If you catch us suspending our dishes of food on little pedestals set in plates of water, you will know that we are confused about where we are.

So, we will be picked up at 5:30 AM tomorrow by a taxi which will beep outside the house and travel the 1 1/2 hrs to Ketapang for our 9:20 flight to Jakarta.  We have about three hours at the airport and then on to Bali.  We have learned that while we are in Bali there is a major Hindu festival called the Day of Silence.  This day lives up to its name with everything closed including the airport, everyone stays home, and is not supposed to use  electricity etc.  BUT at the hotels it is different and we can eat in the restaurant, swim, and have electricity.  This day is preceded by an event which sounds somewhat like Mardi Gras with huge parades with lots of constructed figures of some sort which are grotesque so that the evil spiirts are scared away. It should be really fun!

Rakus, the cat, is doing well and can jump amazing heights with her three legs.  She didn't appear this AM so perhaps that means she is straying further from the house.  Kinari arrives on the 17th and will take over care while Julia, next door will help in the meantime.  Cats here have learned to eat spicy food at least to some degree...and my Norwegian ancestors would be surprised at what I can handle now.  I think there have only been two meals when neither of us could manage the "heat".

We will miss the monkeys on the roof although not the resulting dust/debris from that thatch, the sound of our friendly gecko - even during the night- the early morning ride to the clinic with a clear view of the national forest - the cheery voices of the kids and the adults greeting us as we ride by and the great people we have met. We are over ready to not be dripping sweat most of the day, to have sit toilets and real showers, and for a change in food (especially Jim),and, of course, no ants (at least until summer).  Snow is sounding very good to us!

I have also been somewhat of an English tutor and am helping two of the staff with their essays for applications for Fulbright scholarships.  One of them asked me as I was preparing for the earlier English class if I was teaching the current progressive tense.  The what??  I've had to think about conjugating verbs etc.  Who would have thought.... 

Thanks for taking this part of our trip with us. Next stop, Bali

More pictures from Tanjung Puting

Pitcher Plant - carnivorous - thankfully too small to cause trouble

Tiana, our klotok.  We lived ala Downtown Abbey

Not the dominant male, but looks like it

Fwd:

Our Klotok with bednets...our home on the river for the weekend.

Our Klotok with bednets...our home on the river for the weekend.

Fwd:

What a great visit!

What a great visit!

This mother orangutan really posed for us!

This mother orangutan really posed for us!

Continued

 Just remembered that I forgot to explain why these animals are semi-wild.  All of the original orangutans were in rehabilitation for one reason or another (injury, orphans, etc) and then were released back into the wild.  There is ongoing controversy regarding the success of these efforts going back 40 years -- since many continue to return to the feeding stations are are less afraid of humans, has it really worked??  Some of the females have bred with wild males and more than 200 have been released back into the wild over time, so it appears to me that there is at least some success.

Upstairs/downstairs

It's Monday and the clinic is busy, as usual.  Our first case of malaria in a 13yo boy today -- from one of the islands.  Story is one of fever daily for a month, some malaise.  Exam reveals an enlarged spleen and pale conjunctiva.  Hemoglobin is 9+ and platelets down to 88k.  His thick smear shows lots of gametocytes (banana-shaped with the parasite inside --falciparum).  Will, nurse and lab tech both, had not had a positive smear for three years!!.  

The weekend was great, as we were picked-up by taxi at 5AM on Friday, taken to the airport in Ketapung for a 7:45 flight to south of there, near Kumai, where we again were  met by our guide for the weekend at the airport and escorted to the harbor in Kumai.  There, we boarded a klotok (long wooden boat with a crew of our guide, a captain, assistant captain, and cook -- all for the three of us from ASRI.  (Ilana, the new resident from Stanford was third).  The port of Kumai is actually fairly large and busy with ships carrying cars and people to Java and lots of commercial shipping as well.  The crew is mostly not seen and in the lower deck, while we occupy the upper deck, which is outfitted with a table, three chairs, some padded mats on the floor and a few pillows as well.  There is then a canopy over that upper space (which also serves as our bedroom at night).  At night, the push the table to one side, collapse the chairs, and put-up mosquito nets, inside of which are our mats/beds.  The stern of the boat has a "bathroom" with a sit toilet in one cubicle and a "shower" in the other -- actually, there was a shower head powered with a generator that we used once when the river water was relatively clean.(in the black river)

We then journeyed a short distance up the Kumai River and turned into the jungle with Tanjung Puting National Park on one side and private land on the other.  Initially, the jungle was mostly palms of one or another sort and we did see one orangutan in that section, but soon, the arboreal forest began and the river narrowed.  Shortly after noon, and our first great lunch, we reached the first feeding station and waited for the 3PM feeding time.  Fortunately, Dr. Birute Galdikas, the president of Orangutan Foundation International and researcher for the last 40 years, was leading a group from US AID on a tour for the weekend and we intersected with them several times over the next couple of days.  We have a picture of Lauri and her chatting at Camp Leaky.  The orangutans at the various stations, especially Camp Leaky, think of her as their "mother" and will walk directed towards her before moving slightly away -- neat to watch.  Apparently one of the females (she refers to her as demented), sat on Birute for an hour on one occasion.  That same animal was at the station during this trip with her 4yo infant. I almost forgot to mention that our guide had family tree for each of the females and all the subsequent progeny are given names that start with the same letter, so keeping track of various families is easier. We were able to observe these beautiful animals at all three stations:  they are considered semi-wild, but often do not visit the feeding areas for weeks at a time and there is actually an attendance book at each site where the rangers record which orangutans have visited each day.  At times they would come within a few feet of us -- a bit unsettling -- and we were told not to carry food or even water bottles that they might be attracted to.  Sometime soon, we will send a few photos.  

Camp Leaky was the farthest away, up the "black river" which was much cleaner and along a narrow, jungle canal , really gave us a sense of jungle travel.  So in addition to the "main attraction", we saw lots of probiscus monkeys, long tail macacs, silver leaf monkeys, lots of birds (hornbills, broadbills, kingfishers), one small crocodile.  Probiscus monkeys actually swim, but will wait for a boat to pass (keeps the crocodiles away) before jumping into the water from great heights.  Our guide was great, the food the best we have had, and sleeping on the boat really nice -- no falls overboard during the requisite potty trips at night.  And....no ants in our beds or on our feet all weekend.  Sunday morning, we arose at 4:30 and walked to a tower, built some years back to watch for fire, climbed to the top and watched and listened for the jungle to awaken -- no interesting sightings, but lots of bird and gibbon sounds.

So now, we are only three days from departure for Bali -- early Thursday AM -- with arrival around 4PM.  After doing battle with ants again last night after returning and this morning, we are ready to be done with them.  The cat seems to be doing well with her broken leg -- and no splint-- so guess we will leave well-enough alone.

I am sure I have forgotten some important details, but Lauri will add them, to be sure.

Jim

3 pictures for you

Harvesting stone after being cut by hand out of the hill

Carrying thatch for someone's roof

  Sunday karate on the beach

3 pictures for you

Our home's water pump

Sunset at the hotel

Monkey outside our house

So here is one of the clinical dilemmas we face all too often here:

So here is one of the clinical dilemmas we face all too often here:

We have a 50+ year old man with a mass in the R upper lobe of his lung that was found in August and presumed to be cancer (long-term smoker).  He returned last week and really was not looking as sick as we thought for 6 months further along.  So...does he really have TB or another process going on?  Unfortunately, he lives on an island some 4 hrs away.  Still, he was able to afford a chest x-ray in Ketapung, so he returned with that this week and the mass is much larger -- still suspicious for cancer, but he is just not very sick and has no nodes we can palpate.  About the only thing we could actually treat would be TB; however, there is no DOTS (direct observed therapy for TB) worker in his village.  Add that to the substantial risk that if we treat him for one month, he likely will be lost to follow-up and increase the risk of developing MDR Tb (multidrug resistant).  Also, in-order-for the government clinics to prescribe the TB drugs for free, they require more proof of tb than what we have for him.  What to do??  Nur will call the govn doctor in his village and try to convince him to give a trial of TB meds for a month and provide follow-up.  We simply cannot risk treating him incompletely for TB.

Always, the care we provide is balanced with the ability of patients or families to afford what we suggest (sometimes x-rays or surgery).  Many decisions are made to forego the treatment we suggest because it's not affordable.  We do an amazing amount of care with just good clinical judgement.

We have just four more clinic days before departure and will see what new or old problems will confront us.

Jim

Sent from my iPad

Look at that lovely "cast" for Rakus.

Look at that lovely "cast" for Rakus.  BUT by the time we got back from the clinic tonight she had wriggled out of it.  So, I guess we will let her be.  She is becoming quite adept at hopping.  

Pictures Goat Exchange

The house where we purchased the goats

Weighing the goats

Miftah and Hen, two ASRI staff along

Broken leg, Goats, and Beach

It is Wednesday AM and  I am sitting in the dental office waiting for some dental patients while Hotlin scrubs the dental chair with a disinfectant concoction with a toothbrush.  Obviously there are no patients at the moment but that could change as soon as someone picks off one of the "tickets" from the nail outside the front door.  No rain for the last few days, so the sun is shining which will make for a very hot day under the tin roof. Thankfully, there is a fan behind me.

There is much effort being expended to complete reports/applications/gather local supporters etc. all targeted at hopefully obtaining financial support from USAID for the building of the much hoped for hospital.  The process is slow but it sounds like there are three contractors who will bid and the design is also being adjusted so that part of the hospital could be built and then expanded if funding requires.  So we hear "America" frequently in the morning discussion, but really do not know what is happening.  There is an architect here who is the point person.

Patrick continues fixing things and will put in a sink in one of the patient rooms...this makes washing hands MUCH easier.  Most of the other patient exam rooms have sinks as does the dental office.  Talk about things to be thankful for!  We will work with him regarding the bikes and will hopefully be able to establish some kind of maintenance program.  BUT at least people are putting the bikes that still have some life under the shelter in front of the clinic. Slow progress...but progress

Now for the broken leg...it isn't one of ours or any of the staff's.  BUT we inherited a small, very pretty cat named Rakus who came along with the house.  Monday night she appeared holding up a paw and let Jim examine her, revealing a broken leg at the joint between the upper and lower leg. Now what do we do...soon there were four of us hovering over her attempting to fashion some way to stabilize the break.  We had to call one of the nurses for some supplies and used tongue blades.  Well, it didn't work and within an hour we took it off.  She was/is eating and was getting around with her three good legs.  BUT we have now devised another split which will stabilize better had have rigged up a way to keep it in place using the stocking net I had packed my (now moldy) shoes.  She has been unbelievably patient with all of this and has never tried to bite or kick after that first exam.  

Yesterday was a day filled with a great experience.  About midway through the morning Satiawati, the woman who is in charge of the Goats for Widows program came and with some translation help asked if I wanted to go with her to see the goats.  She rides a motorcycle and I REALLY like motorcycles at this point.  One is cool riding on a motorcycle!  Two of the staff who work with conservation and   the organic gardening program were along.  Realize that at this point I didn't know if any of the others spoke English.  Off we went to a house about 20 minutes away.  We were invited in, left our shoes at the door, sat on the wooden floor and waited until three goats arrived.  Their legs were tied, they were hung upside down and weighed on a make shift scale hung between two trees.  

Then we returned to the house, sat on the floor, and after some discussion, money changed hands (counted multiple times including by the man's wife!) .  We were buying the three goats for the program.  By this time Mifta had revealed that he could speak more English than I knew so I was getting some help.  Back on the motorcycle and off we went down more narrow roads, past homes, rice fields, a school here and there to another home which had some furniture and was obviously lived in by a family with more wealth.  After a bit of waiting, here comes the motor bike with the huge double baskets on the back and inside the baskets....all three goats being brought by the man who sold them!  Shortly three widows who were to be the recipients arrived and there was a small celebration on the "porch" of the house.  The man who lives there is a Forest Guardian - one who works for ASRI as a monitor against illegal logging in the village.  We were served coffee, crackers, and water and there was much laughter, many photos etc.  In short it was a real celebration and I was thrilled to see this great gift to the women.

Off we went, heading to lunch I thought, but first there was one more stop.  After another 10 minutes or so, we arrived at another area where people were gathered under a large tree.  The children  were running about and a few tried out their English which is always fun.  They know as much English as I do Indonesian, but we both try.  This event was a passing on of a goat, one of the requirements of the widows who receive goats through the program.  Soon up walked an elderly woman leading a goat and under tree there was another elderly woman who could have been her twin.  The rope was passed from one hand to the other, pictures were taken, there was lots of laughter.  How special for a very poor woman who now can keep any future baby goats as her own, to pass on the gift.  My heart was truly full.

So, we did make it back to lunch and the egg plus small white egg plant dish was quite good.  I rather wish they wouldn't fry their chips in the same oil as they fry the fish, however!  

We rode to the bank in the heat of the day because bankers hours are a real thing here and were able to withdraw the cash we will need for our weekend trip.  Talk about a wad of cash!  In all we withdrew 5,000,000 Rupia which will cover our plane tickets and the cost for the three days in the national park.  We had to put it in our backpack as it simply won't fit in our wallets.  

Evening was spent at the beach covertly drinking a can of beer with three of the other volunteers.  Two of them had plastic mugs to more easily camouflage their beverage.  The sunset wasn't spectacular, but the breeze was welcome and the company good.

Time here is beginning to feel short.  There is so much more to share, but it will have to wait.  I want to rewrite my ASRI kids report, who by the way, went hiking in the local national forest yesterday.  They are the ones who will work to protect the rain forest in the future.

Monday miscelaneous

The clinic day is over but the internet is still working so a few thoughts.

It is going to take a while before we automatically don't think "monkeys" when we hear noises on the roof or in the trees outside our house.  After a  week or so of absence a group were in full force this morning.  The branches were waving  and I managed to get a photo of at least one of them.  We are looking forward to our trip to Tanjung Puting National Park. The new resident who arrived yesterday will go with us for the three day trip.  We will be staying/sleeping on a boat called a klotok and are counting on seeing orangutans, many kinds of monkeys, birds and flowers.  I have heard no reports of trouble with leeches which was my original fear about visiting the rain forest.

We will also miss the nightly sounds of our resident Tokay gecko and have fun keeping track of how many times he makes his characteristic call.  Supposedly it is always between 3 and 5.  It is unique and I really don't mind even during the night.

Let's talk meals:  Jim has become the king of soft poached eggs on toast every other morning and we use the frying pan to make toast.  That also works for toasted peanut butter sandwiches.  Yami makes and leaves us a meal everyday including Saturday.  They always include rice, some vegetable mix which is often the better part of the meal, tempe or fried tofu and the some kind of main dish which is put over the rice.  Sometimes it is small pieces of chicken with some sauce.  I think they often use cloves, and occassionally it is too spicy to eat.  We avoid the fish which is served at  lunch at the new  yellow house which is the entire small fish and not that good.  We occasionally eat at the cafe next door and have soto  which is a kind of soup:  broth, pieces of  rice cake, peanut sauce, hard boiled egg, noodles, a few piecesof shredded chicken all for 50 cents.  We doctor it with some hot sauce, sweet soy sauce and line.  And we really like it.  The other choice is chicken sate which is quite similar minus the broth and with pieces of chicken on skewers.  That costs $1.00.  

Life in the dental clinic continues.  Last week we had the major rain that Jim mentioned right in the middle of a difficult root canal.  What with the electricity going out at least twice, waiting for the generator to kick in, then the roof leaking between Monica and myself as I held instruments and passed various items, it was quite exciting.  She just keeps on working.  I should also mention that we are both barefoot and today I practiced  turning the suction machine off and on with my big toe.  That is what happens when it is on the floor and we both have gloves on which we are keeping as sterile as possible.  Still hurts my heart to see the children come in for tooth extractions.

WE are seeing watching lots of old movies and reading lots of books  It is DARK here beginning about 6:30 and there is really nothing else to do.  It is VERY important to have the computer battery charged basically all the time in case the electricity fails.  It is very irritating to reach the last 15 minutes of a movie and have the battery start pinging!  

That is all for now....56 patients today for the MD's.  Monday is the busiest day.

Love to all, Lauri

Fwd: 2 pictures for you

Check out the fingernails in the photo taken by Diane, a previous MD volunteer here.  I'm still looking for the man....  Rather wonder how long it took to grow these!

---------- Forwarded message ----------
From: Diane Dakin <diane.e.dakin@gmail.com>
Date: Wed, Feb 20, 2013 at 11:05 PM
Subject: 2 pictures for you
To: Lauri Young <lyoung@cfu.net>


 So have you done karioke night at the  hotel yet??!!  And seeing your
email about the  finger nails- how about thisone fromthe hardware
store in town!!
 I sure wish you were stopping in Seattle on your way home. I am so
enjoying living vicariously and I am sharing the notes with a friend
who is going in June with his son who is starting med school in the
fall.
 Ciao or rather slamat malam! Diane

You have been sent 2 pictures.


IMG_1476.JPG
IMG_1448.JPG

These pictures were sent with Picasa, from Google.
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It's Monday morning

It's Monday morning and I am sitting here waiting for clinic to get started.  We have one doc who is screening for the cataract clinic today and another home sick with an insect bite, so the remaining two will be busy.  Ilana, a third year Stanford resident arrived yesterday and will be a great addition.  

Last week, US AID made a site visit here.  This team consisted of the head person for Indonesia, based in Jakarta along with a couple of his folks, and the overseeing organization (makes sure that our tax dollars are being spent as planned) that is based in Manilla.  ASRI is hoping to get a major contribution from AID for building the hospital, but their funds are for conservation (which is clearly the purpose of this clinic and hospital). So, it will be a hard sell, but still a good possibility. Fortunately, AID really loves ASRI and has been supportive of the conservation efforts and the excellent record-keeping and care being delivered.  So...we had some good conversations with these really personable folks and are hoping for the best.

This whole concept of regulation and policing of expenditures is in direct contrast to what we have seen locally.  Truckloads of illegally logged lumber will drive down the street and they do not get arrested.  Suddenly, the chainsaws in the national park go silent when the park officials show up.  Enforcement is, at best, spotty.  All of which makes us even more grateful that we have laws and responsible agencies to protect our national treasures.  

A word about smoking here:  So many people smoke (mostly men) and we have learned that cigarettes are a government monopoly, thus, very little effort is made to curb the habit.  And, they are really cheap. In fact, the television ads for cigarettes have a tiny safety statement that lasts all of a couple of seconds and has print that needs bifocals to be read -- wonder why???  We are now seeing COPD (emphysema), lots of stroke and hypertension -- all the ravages of smoking.

Our weekend was hot, damn hot.  Saturday, we took a 1.5hr walk, then did some biking around town trying out different bikes, and finally a 10 mile ride (one-way) to see large fruit bats as they emerged at twilight (only, the bats were mostly no-shows -- didn't get the message that we were there to observe).  The ride home in the dark was ok but not as pretty as the ride out.  For some reason (we blame the heat), we were really wiped by the time we got home --about 7:30.  So, I spent the whole of Sunday, except for an hour at the beach, reading my fourth book (The Help).  I cannot remember when I last spent an entire day reading for pleasure.  Thankfully, I still have two books on the IPAD.

We have also been thinking alot about infrastructure or the lack thereof.  There is no central water system or sewer system and, as we have noted, no system of garbage control.  Our water (at the house) comes from a well in-front-of the house and is pumped to a large tank up the hill from the house, thus gravity feed to fill our barrels in the bathroom and to operate the shower.  So much is dependent on the people who must provide their own services.  As we were riding to the bat place, I watched a man bathing in the ditch water -- a frequent and likely usual place for those who have no water in the house (the majority, I would say).  We have so much for which to be grateful.

We have heard about the snow in Iowa.  Hope you are all well.

Jim

Re: 3 pictures for you

Friday morning -- a few thoughts and observations:

Last night, no power from probably 3PM until after midnight -- ate by headlamp again.  Really heavy rain with wind during the afternoon and our house has all kinds of dust from the thatched rood.  No ants last night -- another bonus-- and I avoided my usual cappuccino during the afternoon, so slept much better -- this instant stuff must be loaded with caffeine.

Cappuccino -- 30 cents;  soto (soup) -- 50 cents:  a pineapple -- 50 cents.  Fried noodles -- one dollar,

Lauri is busy preparing for her English class this afternoon.  After that, we will bike to the juice place and buy some more fruit and coffee.  This weekend, we are planning to bike, at sunset, to a place that has huge bats, we are told -- need to find some better bikes for that ride of 30 minutes or so.

Patrick and I will do a little bike work this weekend, I think.  At least, perhaps, we can keep the newer bikes operating well.

Jim

Sent from my iPad

Fwd: 3 pictures for you

Leaving the restaurant at night. I'm the one in white in the back with a headlamp.

frying something with little fish...Jim likes the doughnuts also available.  I prefer chocolate

Preparing to make paper

An Unbelievable Rain

It's Thursday afternoon and we are having an unbelievable rain storm at present -- literally can't hear each other talk.  Just saw a man who's eye was burned with the sap from a tree he was cutting -- a couple of days ago -- has a cloudy cornea and nice, big corneal burn after staining.  Hopefully, the measures we are taking will save his cornea and, thus, his vision.

Just helped Patrick analyze the spin cycle of the washing machine -- had quit spinning -- and we found the problem.  Now, since we will never do the needed fix, we are looking at a work-around that might just work.

Can't believe with this rain that we still  have internet, but rest of the power if from the generator.

Jim

Major challenge!

This morning at the 8 AM meeting as the staff gathered to share information gathered over the past day(s) we received a call from Kinari (one of the founders of this entire effort) reporting that there has been either an initiation or an increase in illegal logging in a village  (Tanjung Gunung)  near the national park we are near.  The village is near the coast and through the village runs a road which leads to a research station in the park as well as the sought after trees.  It is one of the most pristine, not logged areas in the park and the challenge to the ASRI staff is to come up with a plan.  So, I look around the group and think what in the world can this really small group of people do?

When this information was given there was an audible moan/gasp from the group and this continued as more information was heard.  What was translated for me is that the national park staff is insufficient to adequately patrol the park and there is also a "mole" in the village who alerts the loggers when the park patrol will come to their area.  The villagers have said via a meeting with the ASRI staff previously that they wouldn't log if they were given cows because then they could farm more efficiently.  But there is another problem and that is flooding from the sea which would take an expensive dam to build to control.  And the area the dam would need to be built in is in the national park and thus prohibited.  Talk about a Catch 22.  So, as we start the clinic day, Hotlin (the second founder) and the man responsible for the reforestation/organic farming program (I think) are huddled in a back room around a cell phone talking and planning.  I am reminded that the effort being expended to protect the forest is being done for all of us...for the climate...for the wildlife diversity  and for the knowledge that is gained from the research i.e. new medications??  An update will come later...

NEWS FLASH!!  Two nights sleeping with out ant bed visitors.  On Monday after the clinic but before the shops close between 4 and 7 PM we high tailed by bike to the local "department store"  With the help of the dictionary we found a spray which we used in spite of the warning of the newest volunteer to arrive, Patrick, that we should be careful with such sprays in developing countries as they may contain substances banned in the US.  We sprayed, closed the doors to the room, and sat outside enjoying a cool drink waiting for the fumes to dissipate.  This isn't a problem as there is no direct contact between the walls and the roof except for some supporting frame .  It seems to have worked in the room we are in, but there is still evidence in the other bedroom.  But we are celebrating at the moment!

Life with ants is interesting...we basically keep everything free of food/crumbs sweet drink rings etc.  When Yani, the helper for our house, leaves us our evening meal, all the dishes are sitting on plates filled with water.  This creates a barrier as evidently ants can't swim.

Patrick arrived two days ago and is a grand addition to the crew.  He is a repeat volunteer i.e. 3-4 times, and comes with a wealth of skills in the construction/electrical/plumbing area.  The last time he was here, he built 4 wells operated with a treadle.  This time he arrived with the PVC pipe, Dewalt tools, plus whatever else he needs for various projects and says that he hopes to build 10 wells in the various villages..  This meant he paid for 400 lbs. of overweight luggage!  He brought a suction machine for dental use which was damaged in travel so he is on the search for replacement parts.  Our hope is that we will also be able to set up a bike maintenance program.  He brought the parts we requested.  Patrick has a big personality, has worked all over the world, and the standing joke is that he still doesn't speak much, if at all, Indonesian.  Oh yes, he also likes rubber chicken jokes!

Jason and Nadi left last Thursday and we will be receiving another Johnson and Johnson scholar (internal med. resident) from Stanford this weekend who will go to another national park where there are feeding stations for orangutans.  We also hope to see probiscus monkeys plus many others.  .  Jim and I gathered at the boat dock and saw then safely loaded into the narrow speed boat.  We also "met" what looked like a horse shoe crab but is called the turtle of the sea.  Huge, and very interesting.  It had been caught right by the dock.  I hope to send a picture.

Another new experience...yesterday I went to school with Etty. She conducts classes for the children in the 23 villages surrounding the national park  This program is called ASRI Kids and is the program I am writing a report for to go to the donors.  Interestingly, this program was in response to daughters of a previous volunteer who asked why the children who lived near the park didn't get to see it and the wildlife in it.  In fact, when Etty did some pre-testing using a blowup globe and asked the kids to put stickers where orangutans lived.  The US, Australia plus many more countries received stickers.  Once they learned that ONLY Borneo and Sumatra have orangutans plus other wildlife and people come from all over the world to see their treasures, the kids were proud and in post testing have shown a much greater understanding of why and how the forest needs to be protected.  Etty's course which is continually evolving is a once a week course for 2 month followed by 1 and 2 month monitoring.  Each class is two hours and takes place at the school in the afternoon targeting 4 and 5th graders.  School is out for them at noon, so they have to return and they absolutely love it.  They learn about dental hygiene, the forest and the animals that live there, the importance of protecting this special place, trash and how to compost organic trash, the importance of and how to plant and care for trees (actually receive 4 seedlings to take home) and much more.  Yesterday we were making paper out of "trash" - used paper.  Picture a large wash tub filled with "blenderized" soggy paper and being mixed by lots of eager hands (only a little flicking of sticky paper at each other).  Then screens attached to a wood frame were lowered into the mix, lifted flat with the water draining ou and the pulp on topt, decorated with flowers and leaves and then put against a drying board and a "presser" used to press out the water while the frame is held in position.  Once the frame is removed the pulp sticks to the drying board and at the next visit, paper is removed.  Talk about eager kids!  They are also learning English too so we had fun with a few phrases.  One little girl dressed in pink told me that her name was Linda...that one I could remember.

Making paper is a way to teach children that what is trash can have other uses.  They will be the next forest guardians!

Now on to fashion....There are lovely ways to wear the head covering but I have yet to discover how it stays in place.  BUT I can not imagine how hot it is.  As for the men...long fingernails at least one per hand are considered a fashion statement.  I had thought there was a utilitarian purpose such as starting the pealing of various kinds of fruit.  WRONG

A man for whom we did some dental work yesterday had one little fingernail that was an inch long and two others including a thumb which approached that length.  I bet he doesn't do dishes!

As for the electricity forecast of yesterday.  It didn't go out until suppertime which was about 6:30 by which time it is totally dark.  So we ate some kind of soup and fresh bread and pineapple followed by rice pudding made with left over rice for Jim and a piece of chocolate for me.  The electricty appeared fairly soon afterward. It is interesting to note that all the blubs, house, shops, clinic etc are CFL's.  The only problem is that they are suspended too high which makes lighting after sunset challenging.  For a while last night I was reading by head light while Jim enjoyed his IPAD.  I'm saving a few books on my Kindle as down loading here would be a real trick.

New challenge.  Disposal of left over dental filling material which contains mercury.  At this point there isn't a procedure..we will need to persue. Also another young woman who prefers a tooth extraction to a root canal followed by dentures.  So hard for Monica and me to understand their lack of desire to preserve their teeth.

All for now!  another dental patient and the report to finish.  And in an hour we will see what is for lunch at the yellow house (which may actually become yellow thanks to Patrick's efforts) which we may enjoy  or else there is Amadi's next door.  More about the food later.

Love to all!

So, to finish my earlier note

So, to finish my earlier note.  My first case of leprosy this afternoon -- recurrence from previous treatment for one year.  It looks to be involving the nasal septum now, so we are trying to find the needed meds for this retreatment program.  The nasal smear was positive for bacilli as well as the erythema nodosum lesion on her leg.  I am told that she had multiple nodules on both arms that are now gone.  If you are interested, for recurrent leprosy, the treatment is rifampin, minocycline and ofloxacin all given only once a month for two years.

On we go -- just returned from the purchase of some ant stuff -- hope it's not too toxic for us.  

And, just  met Patrick who arrived for his third trip here of several months each time.  He will be digging wells, fixing things, doing wiring and likely a million other things.  He lives in Seattle and has built several  houses for himself.  Sounds like a renaissance man of sorts.  He will enliven the environment for our last couple of weeks.

Jim

Sent from my iPad

Ants!!!

It's Tuesday and we have finished the morning clinic and are about to start on the afternoon.  This morning, we said goodbye to Jason and Nadi and they are headed back to the US after a couple of nights in Kuching.  Jason's fellow resident, Ilana will arrive Sunday and also go with us to Tanging Putting the following weekend to see up-close the orangutans and other primates and birdlife.

Just when we thought we had the ant thing under control with switching beds, the ants, once again, out-foxed us.  Last night, I was having trouble getting to sleep -- thought I was feeling something, but then decided it was just paranoid thinking after all.  But, after getting up to the bathroom for about the third time around midnight, I had a look with my headlamp and ants were all over my pillow and sheet and mosquito net.  So...we spent the next 30 minutes killing as many as possible and checking-over each piece of bedding (several were summarily thrown out), then reversed our heads and managed to sleep the rest of the night fairly well.  Today, we are on the hunt for some potent insecticide.

Likely, the most helpful info I have imparted to this group of docs has been my experience with eye problems.  Fortunately, I received some good basic teaching early in my career and I have a fair level of confidence with several common eye disorders.  It seems that daily we see several folks with some eye problem and they really need to be able to manage many of these.  So far, we have seen glaucoma, iritis, episcleritis, punctate keratitis, conjunctival papilloma (we removed it), chalazion, corneal foreign body (for a month), acute hordeolum, allergic conjunctivitis, and likely others.

More later

Jim

Ants aren't the only thing that bites!!

Greetings everyone!  It is true that ants bite..but today at lunch sitting outside our former home, "the yellow house", on the bench I was reminded that there are multiple sources of bites here...this time it was the bench which is split and the parts separate and are more than eager to pinch your seat.  So far, no snakes, but ants, mosquitoes and benches are in this category.  We have learned that the malaria bearing mosquitoes bite in the early morning and evening and basically patients who are seen with malaria in the clinic aren't from here, but are from some of the off shore islands.  As for dengue fever...those are the ones that bite during the day and we have seen local cases of that fever.

Friday was my first introduction as an English teacher and it really was fun!  There were about 12-15 students from the clinic...nurses, people from the pharmacy, the IT guy who is a real entertainer, etc.  Always beware when traveling.  People understand more English than you know!  They were eager learners and before long we were working on phrases such as "I am"  I have" I gave" in all the tenses and lots of nouns.  There was lots of laughter and unbelievable, they want to return next Friday and talk about time.  I learned that in the Indonesian language there is only one word for arm...and that includes everything from fingers to the shoulder!

Friday after work we joined a group sitting at the beach which was followed by a time at one of the food stands there selling fresh coconut milk/coconut direct from the nut.  Of course I forgot the camera....but the mental picture of the young man surrounded by a pile of coconuts hacking away with his machete will remain.  I'd recommend sugar and a straw.  Jim paid for part of the group which resulted in everyone singing happy birthday to him because on ones birthday here, you do the treating.

Saturday AM we were up early for a ride as it was cool.  We were loving it, and almost all the Indonesians had on sweat shirts or jackets.  No wonder they can take the heat better than we do!  The first round of the town was extremely frustrating as my bike was basically not ride-able.  A few carefully chosen words and some good tinkering has it better.  One of the impacts we may have is that the worthless bikes which were taking up space beneath the shelter at the clinic are gone and we have encouraged the staff to try to make sure their bikes are parked out of the rain.  A shelter is also being built near our house which will house the bikes for two clinic houses.  We still plan to put together a procedure for caring for the bikes along with an period of teaching for Eka who will be the one in charge when he isn't repairing our roof.

I can't remember whether I'd mentioned the hole in the thatch created by monkeys cavorting or not...but it it now patched as is a second one created in the same way.  Perhaps some morning we will awake to a monkey in the house.  That could be very interesting!

Saturday night we were introduced to a truly special road and place.  There is a new dock not too far from our house which is sued to dock boats during the dry season (which is NOT now), as the water is too low at the dock where we arrived.  The road/path to this dock takes us through a part of the rain forest which i VERY nice.  Lots of butterflies, a troupe of monkeys playing in the sun, huge trees, a real jungle.  The cement pier is very long and about 6" wide.  A challenge on our bikes but there was space at the end for a small picnic for one of the volunteers who was leaving the next day.  We tried two new kinds of tropical fruit, but our pineapple addition was the hit.  We had to head back home as by 6:15 it is dark and we needed the headlights we didn't bring.  Our night was capped by dinner next door at Hotlin's by headlamp and small kerosene lamp.  The electricity was off and stayed that way until after we were asleep.   

Sunday's event was waking to lots of ants in our bed....and they do bite.  Evidently the rain has brought them out, but they were all over..the bed, the netting, our clothes etc.  Thankfully there is a second bedroom in the house so we moved there, packed up all clothes we aren't wearing here i..e. sleeveless tops and picked the ants of the others that we do wear and hung them in a different spot.  BUT the new positive discoveries are that one of the banks uptown will accept our VISA card so we don't have to worry about getting cash AND we discovered that the shower head in our bathroom actually does work.  It is much easier to get the soap off when the water is coming down and not being rinsed off by throwing buckets of water at yourself.

We are continuing to love the people here...both the staff who are highly competent and the patients.  I am enjoying helping Monica and we have started on a root canal, done lots of extractions including one by me (!), some fillings and I'm really great at holding my little flashlight as her spot light.  Today we took pictures of some kind of connective tissue growth in a child which developed after a tooth extraction 8 months ago.  These pictures will be sent to a consulting dentist.   

Each morning starts with the morning meeting at 8 AM which is attended by the entire staff.  Everyone has the opportunity to contribute and there is good participation.  This is the opportunity, when translated, to learn about all work of ASRI.  It is a continual reminder that the purpose of ASRI is to protect the rain forest and that the clinic a  means to that end.  Once again, villages who do not log, have stopped, or are doing less receive graduated discounts at the clinic.  So there is lots of community pressure and support to not destroy the forest.  Patients are able to pay with hand craft, primarily weaving s and carvings, but this really isn't happening.  The prices at the clinic are too low for this to be as necessary as it once was.  There has been some talk about increasing some of the prices as the clinic needs to increase its ability to self support.

As a reminder.....check out the web site   healthinharmony.org which will give you some of the evaluation detail of their programs, annual report, news etc.  It is really quite impressive!  I believe I've mentioned that there are plans to build a hospital beginning this summer if funding is received.  This includes receiving a grant from USAID which Hotlin and Kinari both say is a stretch as they have to convince the grantors to see the connection between a grant which targets health care and preservation efforts for the forest.  Hotlin is training for a marathon the purpose of which is to raise money for a new dental suite in the anticipated hospital.  This means that she is running by herself at 2 AM sometimes,  4 AM others and I marvel at her determination.  There are efforts underway to obtain some support from a local credit union for more fuel efficient stoves.  They would still burn wood, but use much less which would help with asthma, and, of course the cutting down of trees.

We found the post office and mailed a note to  Nora, our 8 yr. old granddaughter whose class is collecting mail from around the world.  Can't find a postcard here...no tourists here...Was an interesting experience.  We waited for a handwritten receipt for the stamp!

Love to all... We going out for dinner tonight and the hotel to say goodbye to Jason and Nadia.  They will be missed.

More Pictures for you

Newest and latest

It is Friday morning and thus the clinic is closed although some immunizations are being given.  Jim and Joseph are searching for a replacement wheel for the bike he was riding back from the juice place last night when he and a motorcycle had a minor collision.  There is a problem with this "wrong/right" side of the road business.  He says that he turned in front of the motorcycle, but the guy could have stopped but didn't.  The result is a sore hip for him, no cuts etc. thank goodness, and a ruined front wheel on one of the better bikes.  OOPS.  But it looks like there is a replacement available although there has been some discussion re size and Jim was right!

I have interviewed the woman who does the environmental education in the schools surrounding the national forest and will write up a report for the donors supporting the ASRI kids program.  It was great fun to hear how this program developed and to learn that the children originally did not know that orangutans only live in Borneo and Sumatra.  They thought they lived in the US as well as lots of other countries.  Once they realize how special this place is, they are proud and want to take care of it.  More later on this if there is time and the internet holds.

Which is a problem.  We need more band width (perhaps) and a switch can't be flipped, any change requires a trip somewhere so we work hard  with the computers in the AM and always cross our fingers.

My latest fun adventure was traveling yesterday to Ketapang about 2 hours on a very bumpy road, but very intresting drive.  The two travelers in the back refer to their trip as being "popcorn" due to all the "popping" up they do as the driver manages the bottom scraping pot holes.  There were two goals of the trip.  First a trip to the park office to present a letter asking for support from whomever for a grant application to USAID.  There was lots of conversation and much laughter with people in the park office and perhaps a request in the form of a letter was passed but I didn't see it.  In the car as we left, Hotlin said that the person the letter was addressed to was in the building, but she couldn't just walk in and give him the paper work,  She needed to present a letter of request, he needs to think it over, and then at some future time there will be a meeting or something..  Sound vague???  Nothing is easy here by our standards.

After that visit we attended the grand opening of a newly built orangutan rescue and rehabilitation center.  And this was impressive and a very big event.  Multiple "tents" were put together on this open field facing a blue and white building which turned out to be the office for this center.  Under the primary tent there were about 200 plastic blue chairs with the first two rows of chairs covered in white with big blue bows.  As we checked in we were each given a box of "snacks" and a rolled up poster.  We were then shown to seats on the second row right behind a group of dignitaries representing different levels of government as well as the vet who started the entire project - a woman from Spain who is behind the entire center.  Speeches, speeches and more while I watched a winged creature of some kind crawl in and out of the hole by my feet and then we had a tour.  We did not see any orangutans but there were about 25 already at the center.  They are very susceptible to human diseases and any treatment is done with as little human contact as possible.  This really was an impressive, multiple building, site.  The hospital, complete with operating room, lab, Xray, medication cabinet etc. was the cleanest area I have seen arriving in Borneo.  Spotless.  There were multiple small buildings with small cages with climbing ropes for orphaned, hurt, or ill baby orangutans, and a very large enclosed forest area for the juveniles which does allow them to climb out the top, but they come back at this point.  Eventually they will house adults, but are not ready.  Adult orangutans are  8 - 10 times stronger than humans, and they aren't yet ready to house them.  25 or so are currently at this site and more will be moved from a transitional site shortly.

This event was also interesting in that we met a group of volunteers who are here participating in the constructiion....basically a Habitat international group although they are with the International Animal Rescue org.  They are here for a month, from Norway, Australia, Great Britian +.  They pay their way and for their housing and food and a certain amount greater than their expenses to support the project.  They are digging drainage ditches (this entire area is basically a swamp), footings for buildings, building a wood walk way etc. etc.  

I also had a very interesting talk with one of the managers of the construction who has lived in Borneo for 8 years and has along history with the Intentional Animal Rescue group.  He was one of the westerners running around with a big camera and recording all of the events.

Following the tour, everyone in attendance was fed and I am guessing that number between 200 and 300.  This is a BIG deal.  Again we had rice with beef - a sign of the importance of the event as beef is very expensive (and nothing like we are used to), rice, spices, water, langsat (a kind of fruit which is very good but lots of work to get out. Real plates were used and washed behind the office.  There is no HyVee to call for catering, so I can only imagine the effort it took to put this event together.  Oh yes, there are four vets and they rotate call.  I was told that about 3 years ago a baby orangutan was brought to the ASRI clinic with a bullet wound but did not survive.

It was very good to see this facility and to realize all the efforts that are underway to help the orangutan survive.  Some of the problems are that they get into farmers crops (because the farmers have encroached on the forest) and are captured to be kept as pets or actually harmed.  

We also have a second hole in the thatched roof which led me to a slip this morning returning from my "shower".  So, Jim ad I are fine but both nursing a somewhat sore hip.

All for now...lunch is calling...although we may visit Amadi's cafe next door instead.  And I have been preparing for my first English class.  This WILL be interesting!

Love to all,

Lauri