Tamang woman and child at Tipling Clinic

We left Sertung in the early morning of April 7th to a gracious send off by the villagers. The villagers, as with the lone woman standing at the Tipling village exit several days prior, presented us with a necklace of woven white rhododendron flowers and the traditional hard-boiled egg. The villagers also place red and yellow paste mixed with rice on our foreheads for good luck. Our collective group, grown in size with the addition of several patients we were taking with us to Kathmandu for referrals, hiked up and out of the village with high spirits and a special fondness for the people of Sertung.

We would spend the next two days following the Ankha River south as it meandered towards the fertile plains of Nepal. With the magnificent Ganesh Mountains to our backs we walked alongside many terraced fields of grain and through numerous villages of stone huts and thatched roofs. All along the way we were escorted from village entrance to exit by smiling and inquisitive Nepalese children. We spent the night of April 7th on a grassy terrace in the village of Jharlang, pitching our tents next to a Buddhist Shrine. We had the good fortune to hike up to a seldom visited village in the mountains above our campsite. Our journey to this remote hamlet was for the purchase of the famous Gurka knives, known around the world for their craftsmanship and strength. The knives are worn decoratively on Army solder's belts; as well these knives are an indispensable tool for the villagers. We didn't find any knives, but had an enjoyable time meeting the villagers who looked at us with curiosity, perhaps their first glance at foreigners.

The four-day hike out of the mountains was a good time to get our legs back into shape as well as affording us many moments to reminisce about our two medical camps. Our thoughts were on the accomplishment of having seen more than nine hundred patients and having made a positive contribution to two desperately poor villages. My mind was also on our young Tamang woman whom we had evacuated by helicopter. I was looking forward to visiting her in the hospital, but also had the uneasy feeling of not knowing her condition or even if she survived.

The four-day hike out of the mountains was also a time of concern by our guides for our safety. The Maoist guerillas, who have significant support in the rural areas of Nepal, have in the last year escalated their terrorist attacks. Although they have mainly targeted police stations, foreign tourist's spots have also been targeted. The first HHC medical trek of the spring was cancelled due to an explosion in an area of Kathmandu frequented by tourists. Thankfully, no one was injured. However, upon our arrival in Kathmandu two weeks prior, we were greeted with the news that the Maoist guerillas had massacred twenty-one police officers in the western part of the country. Our trek, being of humanitarian nature, and sharing at least one of the demands of the Maoist ("Health care for all") was reason for us to believe, at least on one level, that we were not obvious targets for the Maoist. However, reality was that we were four Americans and four very obvious targets for the anti-capitalist Maoist rhetoric. Our leader, Anil, ever mindful of our safety, led us out of the mountains with a guide on each side of us and a keen eye on the trail behind and ahead of us.

Even with this vigilance we twice almost came into contact with the Maoist. The first was at our second planned campsite after we left Sertung, in the village of Khaniyabaas. The Maoist had planned a rally in this village the same night we had planned on camping here. (So much for advanced reservations!) With the typical "Sickle and Hammer" emblem prominently displayed around this village, we decided to move our camp that night an additional hour down the trail. This evening, our last before we would walk back into civilization, was fittingly spent on a terraced field overlooking a beautiful green valley. Adjacent to our campsite was a low pass that we would walk up and over the next day. This pass would take us out of the mountains and bring us to Trisule Bizarre, the village that we had driven through fourteen days prior on our way into the mountains.

Our only other close contact with the Maoists was along the trail. Several times during our last few days we heard their eerie whistles (their method of communicating), echoing down the valley as we hiked out. No job is completely without risks, and any job where you are delivering humanitarian need to people in politically volatile areas has its potential for injury or worse. Thankfully none of us were injured and the HHC staff did a masterful job of keeping all of us healthy and safe during the entire trek.

The four-day hike out was not easy by any means. Indeed we were dropping to lower elevations each day, but the walking was on "Nepali Flat" as one of the guides liked to joke. "Nepali Flat" is not flat at all, but consists of many ascents and descents throughout the day that ultimately does get you to a lower elevation. In addition, the heat and humidity at the lower elevation was high (90 degrees). The porters themselves preferred walking up into the cool thin air of the mountains as opposed to down into the muggy, hot valleys. Nevertheless, after two weeks of hiking our team emerged from the mountains and ended our trek in Trisula Bizarre. Some had sore feet, others had a little diarrhea, but we will all have great memories.