Friday, August 27, 2010

Whirlwind tour of a tiny part of Indonesia

As many of you know, we had no plans for August because D was waiting to hear if he had a job/visa and we couldn't plan anything until that was settled, which it finally was towards the end of July (he got both and will be moving here in a few weeks!!). We then very hurriedly planned a last minute trip to Indonesia - we literally bought the tickets four days before we left, got a guidebook and a hotel for the first night and then took off. For some countries that's fine, but for Indonesia it's not extremely recommended to do it this way... but it sure beats staying at home!

We based ourselves in Bali, which we found out is the center of honeymoon culture for a reason - it is packed with gorgeous boutique hotels organized into villas rather than giant rectangular buildings. Many of the villas have their own private swimming pool, jacuzzi bathtub, etc, and the option of having a candlelight dinner out next to the pool in your villa. It's a bit over the top, but very luxurious... and once you locate the online discounts, relatively affordable. Our favorite was the Gending Kedis in Jimbaran, closely followed by Dreamland Villas. Highly recommended for some quiet time relaxing with your loved one.

But of course we only relaxed for a few days before flying over to the neighboring island of Lombok on a tiny little Chinese plane. We spent the next three days climbing the Rinjani volcano, which is extra awesome because inside the crater is a lake, and in the middle of the lake is a mini-volcano that is actively smoking. It was, on the whole, a beautiful hike, but much more difficult than advertised. A lot of people intended to summit, but in the end probably less than half the people who made it to the crater rim even attempted to summit, and of those, several didn't make it all the way up. I let D go while I slept in, as I was nursing some serious blisters and couldn't quite face the thought of scrambling up volcanic scree on my wounded feet.

We recovered with a night in Senggigi, a seaside town on Lombok with more big villa resorts, where there was a gorgeous sunset over the beach... though I was fairly passed out the whole evening and barely able to walk because of the muscle soreness and blisters, so I can't say I took advantage. Seemed worth staying longer if you have the time, though - it's got all the beauty of Bali with less of the crazy party atmosphere.

The next day we got a fast boat back to Bali and spent the afternoon in Kuta, which is kind of like an Asian Cancun... lots of scantily-clad Western women, all-night booze fests, drinks with dirty names, etc. The attraction for me was mainly the shopping, though, and the proximity to the airport, which we visited again the following day when we took another tiny plane over to the island of Flores, where we landed in Labuanbajo looking for a boat to Komodo National Park.

Organizing a tour on arrival was relatively easy, though it meant that our day got cut a little short. After lunch we took off on a fairly small boat, just the two of us and two crew, with a table on the deck that was moved over and replaced by mats to sleep on at night, which was actually relatively comfortable, though it was pretty much camping. But of course it was totally worth it, and we arrived at Rinca Island, home of about a third of the world's wild Komodo dragons, and just as we got off the boat there was a dragon sitting there in the sun not 10 feet away from us. Over by the visitor center were several more (attracted by the smell from the cafeteria, apparently), and we went on a hike around the park and saw a few females guarding their nests. The nests are big holes in the ground, and they actually make several as decoys so they are harder to penetrate.

Komodo dragons, we learned, can reach up to 3 meters in length and around 100 kg. They are vicious predators, eating anything that moves, and can kill animals as large as buffalo (even lions can't kill adult buffaloes). They rarely attack humans, although it has been known to happen. The coolest thing about them, though, is that they aren't actually venomous - instead they have over 50 species of bacteria in their saliva, so when they bite their prey, they infect it. They then can trail the prey and wait patiently for up to two weeks (!) while the animal slowly dies of an overwhelming infection.

When you are on the islands, you are required to have a guide with you at all times, and that person carries a big wooden stick with a forked end. Supposedly this method of defending against angry dragons is time-tested, but it didn't look especially trustworthy to me. As we were on our way off the island, a big dragon lumbered down the path ahead of us and then got in a territorial fight with another dragon just in front of the pier. There was a lot of loud hissing and it definitely looked like you wouldn't want to mess with the dragons, but fortunately there was a platform we were able to get onto so we didn't have to try out the stick.

The next day we went to the actual island of Komodo, where we saw more dragons, a lot of deer, a snake, and a kind of bird that always goes around in pairs that you see digging dirt with their feet. We then went snorkeling in unbelievably crystal clear water near Pink Beach, where there were incredibly colorful (and big) fish, before heading back to the main island for our flight back to Bali.

The last few days we spent in Ubud, Bali's cultural capital, where we stayed in a hotel right on the edge of the Monkey Forest. It lived up to its reputation and not only did we have a whole troop of monkeys playing on our balcony in the morning (which we could watch from bed), but monkeys routinely came and stole food off the breakfast tables of people sitting at the edge of the dining room. Since a comment to this effect was one of the main reasons we booked the place, we were happily satisfied. We visited a few temples, ate really well (Three Monkeys is highly recommended!), did a fair amount of shopping, saw a pretty uninspiring performance of Balinese dance, and visited a coffee plantation where we tried the world's most expensive coffee.

This coffee is, I kid you not, made from beans that are collected from the poop of the civet, a lemur-like animal that trolls the forests of Bali looking for the choicest coffee beans. The beans are then processed by the enzymes in the digestive tract of the civet and collected by people who spend their days searching the Balinese hills for civet poop. They are cleaned and roasted and then sold at several hundred dollars per kilo of coffee... I'm not exactly a coffee connoisseur, but I would say the civet coffee tasted more "earthy" than regular coffee. I didn't think it was worth the price, but the experience was, of course, priceless.

We spent our last day in a gorgeous villa in Jimbaran, from which I had to be dragged kicking and screaming, such that we almost missed our plane home. It's really a shame Indonesia is so far away, because realistically I wont be back any time soon, much as I am dying to return. It's a huge country, extremely varied, with something for every taste and budget (though as far as I could tell, not a lot for the extreme low budget traveler). It's a bit of a hassle to get around because of the island chain factor, but it's worth every bit of energy and money you put into getting there, and once there, you can have a luxury vacation for the price of a low-end one at home. Plus, tourism is somewhat reduced after the bombings of 10 years ago, so it's less crowded and overpriced than it was, and outside of the main resorts of Bali, you have the place practically to yourself... for now.

Monday, August 02, 2010

Vipassana Meditation – Is it a cult?... aka Buddhism for Dummies

Last year as I was traveling through India, where I had an immediate feeling of spiritual homecoming, I had the good fortune to meet a fellow traveler who told me about a program of silent meditation called Vipassana. Now, I am the most skeptical person you will ever meet (except, perhaps, for my other half), but something about it appealed to me for whatever reason, and I got it in my head that I must find a way to attend this program. In the meanwhile I endured snide comments about joining a cult (mostly from you know who) and about how it sounds like the kind of brainwashing torture they do to POWs, and I was not able to find many very clear and concise explanations online in order to defend myself. So now that I have been through the program I feel the need not only to share this amazing experience with you but to clear the air about the important question – is it, in fact, a cult?

In a word – no. Here’s what it is: 2500 years ago a man by the name of Siddhartha Gautama, who was an Indian prince, renounced all his royal riches and went off to live the humble life of a poor man in search of enlightenment. At the time, and still, there were many methods of meditation available, most of which promised to give you inner peace and liberation, etc. Gautama tried a bunch of them and settled on the technique of Vipassana. Vipassana is not a religion – let’s be clear – it is a philosophy of life and a technique of meditation that allows you to try to achieve a physical sense of that philosophy. And the philosophy is simple; it espouses three things, and three things only: sila (morality), samadhi (focusing the mind/observing one’s self), and panna (wisdom). So the idea is that through meditation you get to the root of what is going on in your mind, particularly your cravings and aversions, by really paying attention to your body’s physical sensations, and you learn to view them with equanimity, thereby tempering your reactions in life so that instead of reacting with hatred, anger, and greed, you face the world with love and compassion. This leads to a sense of inner peace and profound happiness. Basically it is a very primitive form of cognitive behavioral therapy.

So when Gautama became enlightened, he became a buddha, which just means an enlightened person – he was thus one of many buddhas, although he is the one we now refer to as The Buddha. He then spent 45 years teaching this philosophy – which is referred to as the dhamma – to as many people as he could. Over the following 5 centuries it spread to many of the neighboring countries. Over time there was opposition from various people who were making money off of people’s greed and other vices, and the dhamma slowly disappeared, only preserved in a monastery in Burma, where it was faithfully practiced and taught in the way of the Buddha to a select group of Burmese people until early in the last century, when the technique started to grow and be spread, first back to India, the land of its origin, and then around the world.

What I find to be great about it, though, is that it is open to anyone and it doesn’t ask you to change your beliefs, renounce your god(s), or even accept any part of it that you don’t like. It doesn’t make you a Buddhist (for instance, I don’t believe in the cycle of reincarnation, and I don’t have to), it is a philosophy that applies to anyone of any background or religion, and it’s one that generates an attitude of compassion, humility and servitude, and really, who can argue with that?

Vipassana courses like the one I attended are now run in many countries all over the world. You are required to start with a ten-day course (which is completely free and funded solely by the donations of past students, because of the virtues of charity and renunciation fundamental to the technique), during which you observe complete silence. I thought this would be difficult, but in fact I found it refreshing, and when the ten days were up, I didn’t want to start talking again. The reasons for the silence are manifold, but perhaps most importantly, if you can talk, you start comparing your experiences, and you start judging and feeling like you aren’t making as much progress as you should be, and then the whole idea of equanimity is blown to pieces.

The other thing that appealed to me about the course was the teacher, SN Goenka, who teaches via DVDs and recorded audio. At first I found this a bit weird, but the fact is that he is a great speaker and to be honest he is the first person that I have heard speak in a reasonable way on the subject of Buddhism. For instance, one of my big pet peeves is that people think of Buddhism as one of the world’s major religions. It is not a religion. It is a philosophy of life. Buddhism doesn’t have any gods. The Buddha is a figure who represents the philosophy, and as such people pay their respects to him, but they don’t ask him for favors, as he has no special powers. However, because it is a philosophy rather than a religion, and people seem to need religion, it gets overlaid with the local beliefs, and thus in India and Sri Lanka, for example, the gods that “Buddhists” worship are actually Hindu gods. The funny thing is that most people who call themselves Buddhists don’t even realize this, and many don’t follow the basic tenets of Buddhism.

Buddhism has a set of guidelines, and these include not killing, not lying, not stealing, etc. However, these are quite often not followed or even entirely understood by people who call themselves Buddhists. When I was in Sri Lanka, a primarily Buddhist country, I tried to get to the root of this, and started with the obvious question: why do most of them eat meat (violating the no killing rule)? I got answers that varied from “well, technically the Muslims kill the animals” to “it’s not realistic to be a vegetarian” (um, hello, have you heard of India? It’s this big country right next door where hundreds of millions of people are vegetarian…).

My hosts, sensing my interest in learning more about Buddhism, actually arranged a meeting for me with a preeminent Buddhist scholar at the university in Colombo. Ah ha! I thought, now I will finally get an answer on this subject. Here is how this part of our conversation went:

Me: So, I see that in Buddhism you aren’t supposed to kill or harm any living being. I was wondering, then, how Buddhists reconcile that with the practice of eating meat.

Professor: You know, my ten year old son asked me that the other day… and I said, “shut up!”

Ok, not very impressive for someone who is purportedly an expert. But when I got to the Vipassana course, I found that Goenka-ji was the first person I had seen who actually acknowledges the Buddhist philosophy and lives by it (and to be clear, he is a Hindu, but since it’s a philosophy, he can practice both). One of the first things he pointed out was the hypocrisy that I have been trying to get to the bottom of on this vegetarian issue. And he went on to explain the rest of the philosophy in a very clear way and one that finally agreed with all that I had read of what Buddhism is theoretically supposed to be.

I liked this anecdote of his very much, and I paraphrase:

Jesus Christ was a very great man – when you look at how he died, tortured to death, and see that he had only love and compassion for those that killed him in their ignorance, there is no doubt that he was a very great man. A student came to me once and said “oh, Goenka-ji, I am a devotee of Jesus Christ.” “Oh, wonderful,” I said. “Yes, I am a devotee because I believe he was the son of God,” said the student. “What? You think he needs your testimonial? You think if enough people say he’s the son of God then he will get all puffed up and he really will become the son of God?? No!! He doesn’t need your testimonials. If you are truly a devotee of Jesus, then you follow his morality – you are humble and compassionate. Otherwise it’s a blind devotion, and what is that worth?”

Now, this is how I’ve always felt, and this blind devotion is one of the big reasons that organized religion always really turned me off. So I was personally really impressed by this man’s insight and willingness to say it like it is. And I also really like the fact that here is a philosophy of life that espouses all the things that I believe in without resorting to eternal punishment to scare people into being good. Shouldn’t we just be good people because it’s the right thing to do and we and everyone around us will be better off for it? I’ve always thought so, and here it turns out Vipassana has been saying that for two and a half millennia!

So anyway, if you’ve reached the end of this, you should be quite proud of yourself, because I’ve gone on for a long time, but I imagine that many of you are like I was just a couple of years ago, with only a vague idea of what Buddhism is or what the Buddha actually taught, and it’s such a wonderful message that I hope I can let you in on it without you having to read some boring book. And as for Vipassana, I would encourage you to try it out. After all, it doesn’t cost anything, so if you don’t like it, all you’ve lost is 10 days (and maybe a few pounds if you play your cards right). And I can almost guarantee that if you go in with an open mind and really try to practice the technique seriously, you will come out feeling happier and more peaceful and wont regret having given that time.

One final disclaimer – I don’t consider myself a Buddhist, nor do I claim to follow any religion. I am simply someone who believes in being a good person, serving others, not harming living beings (except maybe cockroaches – ick), and being as compassionate as I can. I have no interest in converting anyone to anything, but I’d be happy to discuss this further with anyone, or point you to additional resources and information. One good place to start learning about Buddhism is, and you can find information on Goenka’s Vipassana courses at For the literary-minded, there is always Hermann Hesse’s Siddhartha as well, along with a plethora of books such as What the Buddha Taught, which I haven’t read yet but have been told is a good introduction to the subject.

Be happy!

Friday, July 23, 2010

Layover in Doha

When I was on my way back from Colombo to London via Qatar, I had a lot of questions concerning the stopover there, most of which I was unable to find answers to online. So now that I've done it, I'm putting a bit of what I learned out there so hopefully others will be helped in the future.

I flew, not surprisingly, Qatar Airways, which was a reasonably nice airline. On the way over I had a very short connection, but they not only held the plane when we were late but managed to get my luggage transferred.

On the way back I had almost 6 hours on the layover, so I debated trying to go out and see some of Doha. The rule is that if your layover is 8 hours or more, Qatar Airways will sponsor a visa for you, otherwise you have to buy one. The good news is that it's extremely easy and fast to buy one (at least with a US passport) -- you can pay with your credit card, and it's only US$28. I had read online that the airport in Doha is awful and you shouldn't spend any time there - it's not THAT bad... I've definitely seen worse. The ground floor is a huge duty free store with everything you could imagine, and there is a pretty pathetic food court upstairs.

But then again, the airport is 10 minutes from the city center, so there's no real reason not to leave. My plan was to take a taxi to the Sheraton, which is at the far end of the Corniche (the walkway next to the ocean that everyone advises you to walk down as part of your tour) and to walk back. The taxi was easy to get and cost me 30 riyals. However, I feel compelled to say that the walk back was not the best use of my time, despite being the number one attraction all guidebooks and other tourists told me to see. The end near the Sheraton has some big and modern buildings (much like the other big Middle Eastern cities), and there are a few things to see here and there, mostly a reasonable - if smoggy - view of the skyline, but it's a long walk and Qatar is hot. I mean at 7 am on a July morning, it was probably above 100 degrees already... so it took me a long time to walk, there's not much water available, and I ended up exhausted.

I walked as far as the pearl monument and dhow harbor, which I suppose are nice for a photograph, but I think I would recommend that you start there and forget about the rest of the Corniche. From here it's a short walk to the Souk Waqif, a big winding market that has been restored so it's in really good condition but looks old (I mean it IS old, and they've been careful to retain the old style despite the renovations). It's a good place to see Qataris in traditional dress and lots of shops stuffed full of all kinds of miscellany.

It can be difficult to find a taxi back to the airport - I managed to find one on the street and I was told there is a taxi stand somewhere around the souk. I actually ended up going back to the airport early because I was dangerously close to heatstroke, and the airport is blissfully air conditioned. Getting back in through security and customs was quick, so there was definitely no problem with my plan of visiting the city even with such a relatively short layover.

For what it's worth, I am a woman and was traveling alone, and not only were there no touts or anyone to harass me as a tourist, but I didn't feel any more danger as a woman than I do in any developed country. People generally left me alone.

At the end of the day, I found the part of Doha I saw to be relatively characterless and not particularly attractive, though the souk was kind of nice, and I was interested by all the people dressed in traditional costume (and tried not to be upset by the women with nothing but their eyeballs showing), though in fairness you can see this at the airport too. Who can say if I'd have a different opinion if I had a longer layover or was there at a different time of day, but for now my recommendation is that you might as well go into town if you have a 5 or 6 hour layover (or longer) but I certainly wouldn't pick Qatar as my primary vacation destination.

Tuesday, July 20, 2010

Sri Lanka - A little bit of culture

If you haven’t given up on me by now, I’d like to take this opportunity to tell you a little about the fun side of my trip to Sri Lanka. First of all as a brief overview (I promise, no politics or health care), Sri Lanka is a truly tropical island, with lush greenery, extensive rice paddies, plants with humongous leaves, and giant insects all through the south and coastal areas. The north is more of a desert, with craggy rock formations, and then there is the “hill country,” where the famous Ceylon tea comes from. There are plenty of birds and monkeys, iguanas and geckos, multiple species of sea turtles and whales, plus a few cows wandering the streets. The Sri Lankan people are extremely friendly and welcoming, though it’s an interesting dynamic, as the country is significantly more developed than its large neighbor India, but yet in many ways still developing – this translates to some people still being quite friendly and open, but more people being a bit more cautious. However, when people do open up and decide to care about you, you are shown no end of generosity. Actually one of the things that most impressed me about Sri Lankans is the family structure and how they are so close and look out for each other. Almost never did I see a patient in the hospital without a family member by his side 24 hours a day, sleeping in a chair next to the bed, feeding him and changing his dressings. And of course in my own personal experience I was hosted by the parents of a friend, and although they had absolutely no obligation and had only met me once before, they treated me like their own daughter, and I felt incredibly welcome. In fact, many people I’ve met here – once they have had a chance to get to know me a little – have been overwhelmingly caring and warm.

But back to the sightseeing… the north of the country is still off limits to foreigners, but as far north as you can go you find the Cultural Triangle, a series of ancient cities that were former capitals of Sri Lanka and have more Buddha statues than you can shake a stick at. Probably the crown jewel is Sigiriya, a huge rock (which interestingly is actually the lava core of an ancient volcano, but the volcano part eroded away, leaving this giant rock in the middle of the plain) that you climb and climb to reach ancient cave paintings that are quite well preserved and an ancient meditation center with great views. Nearby Anuradhapura is a whole complex of temples and statues and palaces – this is where the annual Poson festival took place, when thousands of white-clad Buddhist pilgrims flocked from all over the country with lotus flowers in hand. Dambulla completes the part of the Triangle that I saw. This one is a bunch of caves with giant carved Buddha statues, much like some of the caves I saw in China, although these ones mostly have painted statues. All in all, they were pretty impressive sites and worth the steep entrance fees.

The other place that absolutely everyone hypes up is Kandy, Sri Lanka’s “second city.” Well, I must say that for me it didn’t live up to the hype. To my eye it was a rather congested, smoggy city with a fair number of tourists (relatively speaking) and a fair amount of hassle. There is a nice lake, and the claim to fame is the Temple of the Tooth – which supposedly houses, inside a very large series of golden boxes, the canine of the Buddha himself, salvaged from the funeral pyre. You can’t see it, but you take it on faith that it’s there. Plus Kandy is famous for its dancers, whose costumes are lovely but the dancing itself either isn’t very special or they don’t make much of an effort for tourists.

Around Kandy there is a “Temple Loop” of three temples built in the surrounding hills. The temples themselves aren’t much to write home about, but it’s a pleasant enough walk, and I had the pleasure of meeting a lovely local family who took me back to their nearby home for tea. Their house was a plywood shack with a tin roof, no electricity and the kind of kitchen that we were warned is a major worldwide cause of COPD (due to the smoke it fills the house with). As I sat there in their only chair I noticed a big bunch of red bananas on a tree nearby, and I mentioned that we don’t have those in America – only yellow bananas. To which my host said “you want banana?” which I took to mean she would take one off the bunch and give it to me to eat, so I said ok. Next thing I know, her brother has come with a machete and chopped the whole tree down, and they start piling this bunch of bananas – there must have been 50 of them – into a bag, and she says to me “you take banana to America” with a big smile. I can’t tell you how touched I was by this gesture, and it almost broke my heart to have to tell her that first of all, I can’t bring bananas into America, and second, I can’t carry 50 bananas around for the next week in my backpack. I don’t think she quite understood, but I took about 10 of them, and I’m sure they made good use of the rest.

From Kandy I made my way to Ella via a very long and significantly delayed train ride that had stunning views of the miles and miles of tea plantations in the hills. The train reaches 2000 meters in altitude, which is pretty high, especially when you consider you are essentially starting from sea level. Ella is a super-relaxed, backpacker hangout, but due to my short vacation time and the delay of my train, I wasn’t able to do any of the walks in the surrounding hills that I had wanted to do. Instead I treated myself to a full Ayurvedic treatment in the spa there, of which the most surprisingly wonderful part was a steam bath in which you lie down completely naked in what looks like a medieval torture device/casket, with only your head sticking out the end. When they closed the lid on me, I just about had a panic attack, and I am not a claustrophobic person. They then proceed to steam you like a brussels sprout for half an hour until you beg for mercy. In fairness, the first 15 minutes or so were pure bliss – it felt like my body disappeared and just my head was left, and I thought I could stay there forever. And then I started to really sweat, and I started thinking about how I was becoming hypovolemic and vasodilated and was going to pass out when I got up (ah, the joys of studying medicine), and eventually I got overheated and asked to be let out, at which point I got dizzy and was offered a glass of tap water, which I luckily asked about the source of before drinking. The evening concluded with shiro dhara, the pouring of hot oil on your forehead, which also sounds like a method of torture and is also amazingly blissful and highly recommended. It sounds weird, and you smell like a coconut for about three days afterwards, but is well worth it.

So much for Ella, as the next morning I set off for the southern coast, where I stopped at the beach town of Mirissa for a few days. Mirissa is quite underdeveloped, with a few guesthouses and about two little restaurants on the beach, and it is so quiet and peaceful and gorgeous and wonderful… not a single tout wandering the beach trying to sell you anything or bother you. So you sit on the sand, swim in the ocean, and generally enjoy the atmosphere of relaxation. I would recommend it if you are looking for something a little less commercial than a standard package beach holiday.

From there I went to Unawatuna, just to see what all the fuss is about, and what I found was exactly what Mirissa is not – a totally built up beach with so many guesthouses and restaurants and touts and taxi drivers that there is not a moment of peace. But it’s great if you want to just hang out in a resort with tons of other tourists. Unawatuna is right next to Galle, where the claim to fame is an old Portuguese fort with the walls still intact and winding little alleyways inside the fort. I found it to be much less charming than expected, and ended up spending most of the afternoon chatting with a British medical student I happened to meet there. Not that Galle isn’t worth a visit, but I wouldn’t have spent a lot of time there.

Lastly I stopped by Kosgoda to visit the turtle hatcheries. Six different species of sea turtles live in the waters off Sri Lanka’s coast, and they have largely become endangered due to both animal and human predators, who take the eggs off the beach to eat them. Due to joint efforts of foreign and Sri Lankan volunteers, several hatcheries have sprung up where they collect the eggs off the beach, very carefully incubate them in sand piles, and then keep the babies for three days (until their shells close up entirely – turtles have a fontanelle!!) and then release them into the ocean. This vastly increases their chances of survival, and any that are blind or have deformities are kept at the center so they wont die in the wild. They let you hold the little babies, and oh my, are the ever CUTE! And very strong – I was amazed by how strong their little fins were, pushing against my hands.

And thus ended my time in Sri Lanka. I wouldn’t call it my favorite country I’ve ever visited, as one well-traveled backpacker called it when I met her years ago, but it was well worth a visit and has some beautiful and unique places to visit, great food and wonderful people. If you have been to India, you absolutely cannot consider it is just more of the same, and now that the war is over and the country is generally peaceful, it’s a great time to go before the masses arrive once again.

Some practicalities:

Language: Sri Lanka’s primary language is Sinhala, with a decent-sized Tamil minority. They all learn English in school, but I found that in general most people don’t speak it much if at all. Try the well-dressed ones who look like professionals if you are really in need of an English-speaker. Sinhala is hell to pronounce, and I can’t say I made a lot of inroads into the language during my stay there. I was ok with English, but it definitely added an extra layer of challenge since a lot of signs are not written in English, particularly destinations on buses, though I think this is slowly changing.

Costs: Traveling in Sri Lanka is quite expensive by regional standards. I found in general – in the off season – that I couldn’t find a room for less than $5/night, and in Colombo it was as much as $15. Colombo is well worth giving a pass, though. A meal generally costs around $2-3 for a fair amount of food, and train and bus travel is pretty decent value, though again more expensive than, say, India. Where they really get you is the entrance fees for the must-see sights, where they totally take advantage of foreigners who’ve come so far they aren’t going to turn away now. The big ones like Sigiriya and Anuradhapura are a whopping US$25 each (a veritable fortune in Sri Lanka – the entrance is free for locals), and many others are $5 or $10. This can hit the backpacker budget quite hard.

Food: Restaurants haven’t really caught on in Sri Lanka, so most people just eat in their guesthouses. You tell them in the afternoon if you want dinner, and they provide you with the standard dinner – a giant pile of rice with several bowls of curries. Sri Lankans eat with their hands, but they usually have forks on hand for tourists. Breakfast in guesthouses is generally white bread toast with butter and eggs, which I generally skipped because I don’t want to eat any of those things. A real Sri Lankan breakfast is either rice and curry or what they call “hoppers,” which are kind of like French crepes, also served with curry. The food is very spicy, though they will often make it bland as soon as they see your face. I found it quite difficult as a vegetarian. Guesthouses would accommodate me, but restaurants, such as they were, had few vegetarian options. I must say, though, if you can get yourself invited to someone’s house, eat there. Even in the guesthouses where they were just a family making food for me, I never in my entire stay had food as good as what I got at the home of my hosts, who ruined me for the rest of the country. And do take advantage of the amazing tropical fruits, which are mostly in season in the summer time, including super sweet-pineapples, about 18 varieties of bananas, piles of rambutans, and the infamous durian (I recommend you avoid this one).

Visas: US citizens get a free 30 day entry visa on arrival. Most flights leave Colombo somewhere around 3am, so I found many people wondering if leaving the country after midnight on the 31st day would get them in trouble – from my experience, no. I did it, and no one said a word.

Bus and Train travel: So… public transport is not Sri Lanka’s strong point. The train network is not very extensive, and the delays are measured in quarters and halves of days. However, you can sit down, and it is certainly more comfortable than the buses. On the other hand, the buses are often faster and cheaper, and if you can handle hanging on for dear life while pressed into a crowd of Sri Lankans, I’d opt for the bus every time. The major other problem with the buses is that most of them are not labeled in English letters, so you have to either rely on the generosity of a local to help you find the right one or stop every one that goes by and shout your destination at them until one of them doesn’t look at you like you are crazy.

Women: I heard a lot of mixed reports before I went, such that I was a little worried about traveling alone there. Sri Lankan women don’t generally go anywhere alone, and I was met with the usual “but can you manage?” However, while I didn’t have the same sense of safety being put with other women that I did in India, I found that if I dressed conservatively (covered upper arms and down to below the knees, no tight clothing), looked confident and rudely, if necessary, rejected any advances, I was fine. I did not have any incidents while I was there, but in fairness I must report that a woman I met was not so lucky, as she had a man do something very nasty to her on a bus and received no help on attempting to report the event to the police. But for the most part, using some common sense and being a bit on the defensive, and perhaps avoiding night-time travel, I would say it’s fine to travel around as a lone woman.

Monday, July 12, 2010

Health care disparities, part two: the private sector

And now, in the second and final part of my survey of health care in Sri Lanka, I'd like to give you a look at the private hospitals, and a little side note on an NGO working with displaced Tamil refugees in the north.

In order to show me that not all Sri Lankan hospitals are like Colombo South, my hosts took me to see Colombo's Central Hospital, a swanky private hospital that was built just a few months ago. The first thing I noticed when I walked out of the elevator onto one of the medical floors was a teenager playing games on his iPhone. This should give you an idea of the clientele. The place looked like a hotel, with nice private rooms at, I believe, about $100/night for room and board, and "super luxury" rooms on the top floor with kitchens and dining tables complete with a full setting of hospital branded plates going for about $220/night. They had all the latest equipment, including fancy computerized MRIs, and the place was mostly empty. I was told that last year of all the hospital admissions in Sri Lanka, approximately 8% of them were to private hospitals - this should solidify your idea of who has access to this kind of care.

Interestingly, despite the fact that the place was modeled on a hospital in Singapore and had all the latest technology, they didn't seem to be washing their hands there either. I was told that this wasn't feasible given the number of patients, and that alcohol hand sanitizer doesn't exist in Sri Lanka. Upstairs in the ICU, I saw a bottle of alcohol hand sanitizer at the foot of each bed and was told "of COURSE we clean our hands before we touch the patient"... so even between floors there was a huge disparity. In the lab I was told that people were supposed to wear gloves but often didn't because it is "hot here." Upon pressing further, I amazingly got the same reply as in the government hospital - "they know the risks, so it's up to them if they want to wear gloves."

Nonetheless, if I had to get care somewhere in this country, it would definitely be at this private hospital. To compare, I spent a week at the private clinic of my hosts in a smaller town near Colombo. It was also quite clean and people had their own private rooms for the most part, but the hygiene problems persisted. I didn't see any hand washing, and I watched them repeatedly take the temperature of feverish kids and adults with the same thermometer that was being stored in nothing more than normal saline in between. When I asked if they ever disinfected it, the response was "what? between each patient? that's not practical!" The same argument for everything - we see too many patients here, and we don't have time for hygiene.

So clearly there are some major obstacles to be overcome that are not a matter simply of money. You're always better off if you have money, but it obviously doesn't solve the problem. For my part, I'm feeling a lot more appreciation for the American system, as awful as it is, than I did before.

And now just briefly I'd like to tell you about two NGOs that are doing good work here:

Survivors Associated is an NGO run by the mother of a friend of a friend of mine. I must start by saying that there are two sides to every story, and as I am not allowed into the region in which they work, I cannot go see for myself what is going on. However, the stories that I heard from them are horrendous. During the war, the hardest-hit regions were the north and the east. Tamils were displaced from their homes, which were torched, and more than 300,000 of them crowded into refugee camps built for 75,000 people. After being fired upon by the LTTE, who were supposedly on their side but instead used them as a human shield, the injuries were severe, with many amputations. Foreign NGOs such as MSF were working in the camps until the government made it so unattractive that they left, and the government claims that the one hospital in the area can handle it just fine, but I am told that not only is the hospital not enough, but these amputees have no means of actually getting to the hospital. The Sri Lankan government is proud of how many Tamils they have relocated back to their homes, but apparently there is now no infrastructure there - no access to clean water, no buildings, no means of work or food - and people are actually worse off than they were in the camps.

So Survivors Associated is working to do rehabilitation programs for women and especially children who have been displaced by the war, as well as trying to get aid workers in to help with other kinds of health and social issues. The government has now clamped down on them as well, as they are apparently making too much noise and the government is afraid that outsiders will find out what is really going on here. In any case, I realize that this is one person's account and that I can't verify it through my own experience, but I would encourage you to read through their website and talk to people about the situation here. They are fairly well funded by foreign governments, and when I asked what would be the most helpful for them, I was told that the best way to help is to spread the word about the situation so that foreign governments exert pressure.

Women in Need, just briefly, is an organization of social workers, counselors and lawyers devoted to helping battered women in Sri Lanka, who by some estimates make up more than 60% of Sri Lankan households. I found out about this organization when a local woman reached out to me for help escaping from her own private nightmare - a husband who beats her, two children who depend on her, and no resources to get out. Spousal abuse is a very real problem not just here but in our own backyard. So I'm sharing this resource because I think they are a worthy cause if you are looking for one, and also because it's a good opportunity to think about this problem that truly affects us all.

Anyway, I'm done with my serious stuff now - next time I'll send you the fun stuff from Sri Lanka, I promise!

Sunday, July 11, 2010

Healthcare disparities around the world

Now that I've given you a little picture of the overall situation in Sri Lanka, let me tell you a little about the places that I've been working. These include a free government hospital, a private clinic, and a volunteer first-aid camp at the Poson festival, each of which has shown me a different side of medicine here. (Please gloss over any medical jargon as necessary.)

The general gist of health care here, as far as I can tell, is that there are free government hospitals in most of the big cities (there are at least two in Colombo), but that the government provides the absolute minimum of care. Then there are private hospitals that people can visit if they have insurance or if they pay out of pocket, which is obviously only available to people who are fairly well-off -- not even the doctors I worked with at the government hospital can afford to go to the private hospitals.

Almost everyone has extremely poor dentition (most have only a few remaining teeth, all of which are rotted) and most have various fungal infections on much of their bodies, especially their feet and nails. The conditions are so common that nobody even bothers to mention them, let alone treat them. The most common infectious conditions seen here are dengue fever, which is currently epidemic here, with over 15k cases and almost 200 deaths since January, leptospirosis, typhoid and other diarrheal illnesses, and other nonspecific viral fevers, including rheumatic fever. Surprisingly, diabetes, hypertension, kidney and heart failure, are also extremely common, despite the almost complete absence of obesity. So in the end, a large part of what is seen here is also seen at home, although usually we see it at much earlier stages, rather than at the end stages that almost everyone reaches here. Blood sugars, blood pressures, and everything else - the numbers I'm seeing here are so high I had previously thought they were incompatible with life.

My first two weeks were spent at Colombo South hospital, the second biggest teaching hospital in Colombo. Everyone tells me that the main Colombo hospital is so nice and has tons of facilities, but I haven't seen it for myself. Colombo South, on the other hand, is... shall we say... often better than nothing. When I pictured a government hospital, I suppose I imagined some kind of run down version of our own hospitals. I was assigned to work on a general medicine ward for men, and it was pretty representative of the rest of the hospital. Patients are admitted on a rotating schedule, with "casualty day" rotating between three wards. On casualty day, everyone who comes in who isn't a trauma or surgical case goes to your ward, no matter how full it gets. On post-casualty day you are desperately trying to deal with the giant crowd that showed up on casualty day, and on pre-casualty day you are desperately trying to empty as many beds as you can before the next casualty day - and so it goes in a never-ending three-day cycle.

Our ward consisted of 40 beds that were about the size of the dorm beds we get in college, all lined up with about 2-3 feet in between them in a big open room with no close-able doors or windows. As such, the place was full of flies, and there were stray dogs and cats running through occasionally. With an average of over 90 patients in the ward, most times the patients were two (or even three) to a bed, and only the sickest got their own beds. Usually the men would lie head-to-feet in order to have more room for themselves, and at night many would bed down on mats on the floor because they had to sit in chairs during the day. I was told initially that suspected TB patients were isolated outside, but I later saw two TB patients inside with everyone else, including one sharing a bed with a heart failure patient (who was about to also be a TB patient).

I never saw the sheets on the beds changed, nor hands washed, except sometimes when doctors were leaving for the day. I rarely saw gloves used, and on multiple occasions I watched doctors and medical students get blood all over their hands when they performed a procedure without gloves on. When I asked about it, I was told that HIV isn't very common here. When pressed further, they told me that people knew the risks, and if they didn't use gloves it was their own fault. Doctors coughed freely without turning away or covering their mouths. Almost everyone on the ward was on antibiotics, not surprisingly given that infection was likely carried from one patient to the next.

Patients with end stage kidney failure were dialysed only when on the verge of death, after which they were sent home until their symptoms overwhelmed them once again and they returned for another emergent dialysis, and this only if the doctor in charge was feeling sympathetic. Diabetics consistently came in completely uncontrolled despite having been given medication, and even after a day or two in the hospital, their glucose was still sky high. Doctors would give orders and these would only occasionally be carried out. Patients would be wheeled three at a time sitting on a metal stretcher if they needed to go for tests, as there weren't enough wheelchairs for them to each have their own. One time I was in the ward when a patient died, and the body was wrapped up in the bedsheet and then left in the ward for about 3 hours before being wheeled out. Incidentally, this is the only time I ever saw a bedsheet removed from a bed.

In the maternity ward I was shocked to learn that new mothers are allocated 4 hours alone in a bed after they give birth, after which they must share with another woman. Because two women and two babies can't comfortably fit in a bed, almost all the beds had two babies lying on them, with their poor mothers sitting in plastic chairs next to the bed. I had the good fortune to walk into the delivery room just as a woman was giving birth, and I was then appalled to watch a young doctor take the baby over to a table to listen to its chest, answer her cell phone and take a call in the middle of the exam, and then leave the baby wriggling on the table and walk away.

In Peds I was told that they separate the viral fevers from the diarrhea in different parts of the ward, and when I asked how they prevented infection, I was told "in pediatrics, even the medical students wash their hands," as though this was something to be proud of.

What was interesting was the air of defeatism that pervaded the place. Every time I would ask about something, I'd get the same answer that there is no money, and we are a poor country, and people get their care for free so they are happy with what they get. But I was amazed by the things that I saw that could easily be prevented by simple things like hand washing and cough covering. Little things that wouldn't cost much at all could save tons of money in the long run by shortening hospital stays and reducing the need for antibiotics, which are horribly over-prescribed as it is. Yet no one would listen, always telling me that this is just the way it is in a poor country.

So I think it's important to remember that it may seem like there is no way to fix the problems we are facing even in our own "first-world" situations, but sometimes if we look from another angle, the main thing that is really limiting us is our attitude. My big question now is how someone like me (and you) can change the attitude of such a monstrous machine as a health care system. In fact they do need money and they do need manpower, but most of all they need a paradigm shift. So I'm open to suggestions and would love to hear your thoughts.

Sunday, July 04, 2010

Sri Lanka: Please allow me a moment on my soapbox

It's a truly interesting time to visit Sri Lanka. I'm here by a happy coincidence and the generosity of my friend and his family, who have arranged for me to spend a month working in a few different hospitals here to get some experience in a different kind of medical setting. If you are desperately trying to think of where Sri Lanka is, it's a small island nation near the south-eastern coast of India. Despite popular belief, it is a sovereign nation, and is in fact very different from its larger neighbor, although its inhabitants are largely descended from Indian immigrants who came here hundreds to thousands of years ago. The clothing is similar but not the same (their saris have ruffles), the food is actually quite different (less spicy, more coconut, and more meat), and their roads are more often paved and less often clogged with cows. The major language is Sinhala, mixed with a smaller group of Tamil speakers. It's a tropical island with the associated vegetation, including 70% of the world's cinnamon supplies.

Having just in the past year emerged from thirty years of civil war colored by terrorist attacks from the LTTE (Tamil Tigers), the country is experiencing a surprisingly robust recovery. People tell me stories of taking separate buses from their spouses in case one of them didn't make it, and of relatively deserted festivals and once-bustling markets that people avoided because they never knew when to expect the next bombing. The strife started, as far as I can tell, with the British colonists (doesn't it always?). Apparently they initiated the tension between the two major ethnic groups here - the Sinhala and the Tamils - and then after they left, the new government made it infinitely worse by instituting Sinhala as the national language, thus effectively shutting down Tamil culture. Of course the Tamils responded by agitating for their own language and their own separate country, and thus began years of warfare, suicide bombings and civilian casualties. It's amazing how you can take the names of the groups away and this story just repeats and repeats around the world.

However, with the death of the LTTE leader last May, the war finally came to an end. The military has continued to expand and the streets of downtown Colombo remain somewhat deserted, with sandbagged military installations and groups of soldiers with machine guns on every corner. There are random document checks along the roads to make sure you are who you say you are, and apparently if you don't stop for them, they can shoot you without fear of repercussions.

At the same time, the bustling streets of the market area of Pettah have returned to their former liveliness. The hospital no longer receives large numbers of blast victims, and people's fear seems to have dissipated much more quickly than I would have expected. At this year's Poson festival in Anuradhapura, celebrating the bringing of Buddhism to Sri Lanka and one of the two biggest annual festivals here, there was a huge turnout of what I heard was almost 200,000 people. For the last 30 years people had largely been too scared to attend this festival, so now that it's finally safe, they turned out in droves. It was quite a sight to see, as thousands of pilgrims dressed in white flocked to ancient temples and a bodhi tree said to be over 2000 years old and grown from a cutting of the original one where the Buddha attained enlightenment.

So it would seem like a time of great opportunity for Sri Lanka, but there are some major challenges. There is a very wide gap between the rich and the poor, with the former seemingly unaware of the latter. I've been told by multiple people that no one goes hungry in Sri Lanka, but the UNDP points out that 23% of the population lives below the official national poverty level, and one out of three children is underweight and malnourished. These same people also tell me that most people have health insurance and can go to the fancy private hospitals, but they haven't seen the crowds at the government hospital, where patients are three to a bed and sleeping on the floor, and they would seem to be contradicted by the fact that Sri Lanka's infant mortality rate, a widely-used indicator of human development, is 18.6/1000 (compare this to 2.3 for the best, and 6.3 for the US). 18% of people don't have access to clean water.

Unfortunately the new leadership is proving to be corrupt, with the president favoring the rich with tax cuts on luxury vehicles and worsening the situation for the poor by increasing taxes on basic goods such as flour, rice and tea. He looks to be gearing up to try to revamp the law so that he can serve an additional term, and you know what that means. Additionally, the situation in the north, where the worst of the fighting happened, is dire, but the government is working hard to keep out any groups that might get word of the situation out to the rest of the world. I'll leave that subject for my next post, since I think it merits extra attention.

So why am I telling you this? If you are like I was two weeks ago, you have little or no idea what is going in Sri Lanka, except a vague idea of Tamil Tigers and terrorism. After spending a couple of weeks here, I think Sri Lanka is a lovely country, and the people I've met - rich and poor - are warm and friendly and extremely generous. The richer segment of the population is doing very well, but a lot of work remains to be done, particularly in the areas of health and human rights and fighting corruption. Sri Lanka, as a small, out-of-the-way country, often gets overlooked, so I'd like to encourage you to give it a moment's attention. Donate to an NGO that is providing essential services like food, clean water, health care, or medical supplies. Put pressure on your own government not to support the corrupt policies of a government trying to cover up human rights abuses. Volunteer a bit of your time to help improve the situation here by building houses, digging wells, or treating patients. Most of all, be aware of what's going on, and tell others.

By the way, I happen to be in Sri Lanka right now, but the situation here is far from unique. It's all too easy for us in the US to just sit back and remain blissfully unaware of what is happening all over the world, but it is irresponsible of us not to do something about it, even if the only thing within our means is to talk to other people so that we raise awareness. Once enough people take an interest, our government is more likely to do something about it.

Ok, I'm done with my soapbox speech for now. Next time I'll tell you a little bit about the hospital where I've been working and an organization that works with Tamil refugees in the north. I'll have a week to travel towards the end of my time here, so I'll save the sightseeing and more fun cultural details for then.

Wednesday, March 03, 2010

Taking it easy in Jamaica

For perhaps the first time in my life, I had only two goals for my very short excuse for a spring break: 1) get some sunshine, and 2) relax. With that in mind, we looked through the options for cheap destinations with some culture and some sunshine and landed on Jamaica. After some invaluable input from a couple of friends, we decided upon Treasure Beach, a surprisingly untouristed beach on the southwest coast of the island.

We rented a car in Kingston and decided to navigate the old fashioned way -after all, it's a small island with only a few main roads... how hard could it be? So with D. at the wheel on the left side of the road and me in the passenger seat armed with a map that could at best be called "approximate," we set off. Two things about driving in Jamaica - 1. although the roads are bad, once you get away from the populated areas, it's really not that hard, and 2. there are no road signs. And I mean none. Needless to say, we got hopelessly lost. After narrowly missing about three hundred pedestrians as we wildly tried to find our way out of the maze-like town of Mandeville, and a pit stop at Juici Patties, home of Jamaica's favorite snack, to build up our stamina again, we drove down tiny country roads, asking directions of confused Rastas along the way, until someone took pity on us as we were stopped on the side of the road studying the map, and we followed him to the beach.

Once there, however, it was perfect. We got a little room in a villa right on the ocean, with a veranda overlooking the waves. The beach really was undiscovered - there were no big hotels, no gift shops, no buses or cruise ships, no hassle or vendors, and barely any tourists. Most of the time you could walk down the beach completely alone. The trade-off is that the beach itself is probably less conducive to swimming than some of the more famous ones, and it's not the stretch of white sand you see in the pictures. However, it was totally worth it not to have to fight the crowds for a spot, and the water was still warm and pleasant. Of course, there were very atmospheric restaurants and the requisite cocktails right on the beach (Jake's is a must-visit for dinner and drinks), but mainly you could wander around and swim in peace. I almost hate to write about Treasure Beach, because the reason it's such a gem is that nobody knows about it... but from the sounds of it, the developers are coming, so get there while you can.

We made a day trip over to the Lovers' Leap cliffs, so called because two slaves apparently jumped to their deaths there rather than be separated, and to the famed Little Ochie's restaurant at Alligator Pond, but mostly we just enjoyed the calm and quiet of Treasure Beach.

At the end of our stay we had one day in Kingston, but it turns out Kingston isn't much of a destination and it's almost impossible to get around without a car, so we restricted our visit to the former home and recording studio of Bob Marley, the tour of which consisted of "this is the tree where he liked to sit and smoke ganja, and this is the hammock where he liked to lie and smoke ganja..." and a lot of singing of reggae songs. Kingston is definitely not a recommended destination for tourists, unless you are a dedicated Bob Marley fan.

As for food, Jamaica was certainly not vegetarian friendly. Their specialties seem to be fresh seafood and "jerk," a spicy seasoning that can go on just about anything, but is mostly found on chicken and pork. The most unusual thing we tried was the typical breakfast of ackee and saltfish - ackee being a weird red fruit whose flesh looks and feels rather like scrambled eggs when cooked. It was actually kind of good. I was also a fan of "bammy," a sort of bread made out of cassava, and of course the Blue Mountain coffee and Appleton rum. On the whole, though, I didn't think food was Jamaica's strong point, though my opinion might be different if I were a meat-eater.

In sum, Jamaica was a lovely place to go for a relaxing holiday. With a bit of planning (get a GPS) you can avoid the crowds and have a paradise to yourself. There are some opportunities for hiking if you have more time, and of course there are the resorts on the northern part of the island if you are into that. We'll probably be back someday to see some other parts of the island, but it's admittedly not at the top of the list, mainly because I prefer to have a few more options than just hanging out at the beach, and while I'm sure there are some in Jamaica, they weren't immediately obvious. For now, though, it was 85 degrees and sunny, the pina coladas were flowing, and it was exactly what I wanted.

Monday, January 04, 2010

Lisbon, Porto and the Duoro

Over New Year's we had the opportunity to go to Portugal for a week. Lesson learned - the Algarve is beautiful at that time of year, the Duoro is in the height of rainy season. Choose wisely.

Lisbon is a fairly charming city, with winding back alleys and a lot going on. Unfortunately I was sick, so we didn't see much of the city. We did manage to make a stop by Belem, where there is a beautiful Manueline monastery housing the tomb of the explorer Vasco da Gama, and the nearby Antiga Confeitaria de Belem, producer of the heavenly custard tarts known as pasteis de belem, served warm and dusted with cinnamon. If you go to Lisbon, you MUST try these.

We stopped by the hilly town of Sintra, where there are pastel manors and a fairy-tale castle, plus a small monastery, the Convento dos Capuchos, featuring tiny cells lined with cork. The rain caused the area to be shrouded in mist, which actually added to the romance of it all.

We headed north then, up to the Duoro, the region known for its port wine. We visited several gorgeous little towns, each of which has its own specialty wine and pastry. Lamego features a dramatic staircase leading to a beautiful church, and a regional sparkling wine, raposeira, which is not unlike champagne. Amarante is an atmospheric little town that is the hometown of Portugal's Saint Valentine and very rich egg pastries - delicious but one or two is quite enough. Vila Real is known for the Palacio de Mateus, a baroque mansion that became known for a rose wine but now produces one called Alvarelhao, claimed to be one of Portugal's best. Because of its reputation we went out of our way to taste it - it was disgusting.

Our favorite stops in the area were Pinhao, the highlight of which is the nearby Quinta do Portal, producers of excellent port wine and moscatel. We wished we could have brought back a whole case. We also made a detour to the tiny town of Murca after noticing a footnote in the guidebook about granite pigs that were theorized to have been scattered about the remote countryside by Celtic people as some kind of fertility symbol. The best preserved one is in Murca, so we went to check it out. It turned out this was the middle of olive and grape country, so we picked up some excellent olive oil and wine and chatted with some of the locals. We also tried the local specialty - toucinho do ceu (frequently hilariously translated as "lard of heaven"), a very sweet cake.

Porto, the traditional hub of port wine exports, is an extremely charming city, worth a visit. The port wine lodges in Vila Nova de Gaia were closed because of the holidays but the old boats they used to use to transport the wine are still sitting picturesquely in the river and the city itself is colorful and full of history.

On our way back to Lisbon we stopped at Tomar, the historic headquarters of the Knights Templar. They have a huge monastery there, from which they used to run their operations. Because the Knights were rather more mercenary than religious, they have big, heated cells and plenty of space for entertaining and cooking, plus a church designed circularly so that the knights could attend mass on horseback. Tomar also houses the matchbox museum, a collection of over 60,000 matchboxes from just about every country in the world. Apparently there are matchbox collecting societies that people can join if they have this as their hobby... we learned many new things in Tomar.

Lastly we stopped in Fatima, a town where in 1917 there was an apparition of the Virgin, and now there are two giant churches and a courtyard twice the size of St. Peter's, where thousands of pilgrims come to worship every year. The place is not particularly beautiful, but the spectacle of the scale is something else. After we left Fatima, we headed back to Lisbon and had a last look around and a few more custard tarts before bringing our vacations reluctantly to an end.

Our conclusion - a visit to this region is highly recommended, especially for the port wine and delicious egg-based pastries, but is probably best reserved for the spring or summer.

Adventure map for 2009...