A Lesson in Cultural Sensitivity: Assumptions

Last week, my team and I learned a valuable lesson in cultural sensitivity. Having traveled as much as I have and having been in many situations where I have been privy to privileged information, I considered myself to be well versed in culturally sensitivity. However, as I have learned countless times in essentially every aspect of life, there is always space for improvement and a seemingly endless stream of lessons to be learned.

Focus Group

 As I am currently in India studying a highly sensitive topic, in planning my research, I attempted to make every effort to ensure that my data collection was appropriate and inoffensive. I have spent years rearching this facinating culture but despite my research on these topics, I still had a lot to learn being on the ground interacting with women. Before leaving, I felt like I was constantly debriefing my team members on what to expect with Indian culture. We set up focus groups with Community Health Workers (CHWs) to refine our questions, piloted the final result, and asked our questions with well-educated Telugu translators. I knew that the women in villages would be too embarrassed to discuss their menstruation habits with men, so I arranged to conduct interviews with the only female translator that was available. The other members of my team, both male, interviewed CHWs and, unfortunately, had to take a male translator.

 

Hut in a Village

 This is where we made our first mistake–the assumption that because the CHWs interact with both male doctors and men about sensitive health information, that they would feel comfortable talking about the menstrual health habits of women in their villages with a male American medical student. However, the questions asked were still too sensitive and the situations in which they were asked brought embarrassment to the CHWs. On our first day, at the suggestion of our male translator, the male portion of our team interviewed the CHWs outside their home. The translator had a very loud and projecting voice and he spoke so loudly that I had to send my translator out from where I was interviewing to ask him to speak quietly. The next day, we realized that these questions needed to be asked in a private environment and, with the intense heat (110 F +), again at the suggestion of the male translator, this team decided to interview the CHWs in a private, air conditioned car. In making this decision, no one considered how this would appear to the villagers, and we neglected to think of having a female chaperone.    

In both of these situations, our team attracted attention to our project. As we are discussing such a sensitive and taboo topic, much of the attention that we drew was negative. In a society that is unfortunately dominated by males, the husbands of our interviewees interrogated their wives and became angry at us for asking their wives such sensitive questions. In retrospect, I see how someone might be offended if a group of men took another man’s wife into a private vehicle and asked whether she or the women in her village wore underwear… Sometimes it takes this sort incident to shift the lens and change perspective.

Some of the questions themselves that we asked were offensive. For example, we were interested in finding out about the villager’s and CHW’s general knowledge of menstruation. We quickly found that no one knew anything about the physiological process of menstruation and that this lack of knowledge made them feel uncomfortable. One question in particular, asking about the origin of menstrual blood, was extremely offensive. Even a seemly innocuous question—a question about which religion our interviewee followed–was met with extreme discomfort. Unfortunately, this question was misunderstood by the villagers, who thought that we were asking about their caste.

Unfortunately, we did not know that any of this was going on for our first two days of interviewing–we were at the mercy of our translators. We had made yet another assumption that our translators would translate the full responses, including the discomfort and the scolding that apparently went on in some of the interviews. We only learned of the trouble we caused when it was large enough to inhibit the study’s progress. One evening at dinner, we were told that the CHWs were calling each other and saying that we should not be allowed into their villages, as we were asking “bad questions”. We also were told that the husbands were particularly angry that we were asking their wives such sensitive information, and that if we proceeded with the study as is, we could be met with violence in some villages. I think that this lack of communication was due to the fact that our translators, who were also our hosts, felt obligated to proceed with our faulty and insensitive study, as they did not want to offend us. Having worked closely with people in this part of India for the last two and a half years, including one of our translators, I regretfully should have anticipated this issue and should have spoke with our translators more about giving us “bad news”.
 

Esther and BeBe (CHW)

 After learning this unfortunate and surprising news, we were all understandably upset. After all, we came to India in attempts to help alleviate some suffering, not to cause further discomfort and suffering. I felt (and am) responsible for the discomfort caused and couldn’t help but think that I could be responsible for episodes of domestic abuse, which is horrifyingly all too common in the villages. I retreated to my room, where, between several episodes of crying out of frustration and guilt, I began to brainstorm ways to salvage the study. After several Skype calls with friends and mentors, I was able to organize my thoughts and come up with a plan. In the period of about 16 hours (including about four and a half hours of sleep), I shifted the focus of the study, pulled the males (and with them, an important aspect of the study, as I do not have time to do in-depth interviews with all 25 CHWs on my own), and built in the mentorship and knowledge of key persons into the study, getting every question approved by multiple wise and influential women. 

The trouble that we faced happened because we made assumptions. We made the assumption that menstruation was less taboo of a subject, the assumption that the CHWs would be comfortable talking with men about menstruation, and the assumption that our translators would translate our interviewees discomfort and inform us if our study was not well received. As painful and frustrating as this experience was, myself and my team learned important lessons in global health and cultural sensitivity that we will take with us on future endeavors. 

  

Post Interview

  

 Currently, the newly designed study is going smoothly. The women leave the interviews smiling and many wait for all the interviews to complete to take pictures with me or walk me to my vehicle with their children. The CHWs are happy and comfortable, generously offering their home and electricity so that I can have both comfortable and private interviews. So far, my findings are interesting and my mind keeps rolling with new study ideas and possible interventions. In fact, one important finding is that many of the women in the villages suffer from painful menses and cite this as a primary reason for missing work or school. Today, I was able to present information on normal menstruation as well as an intervention for painful menstruation to 22 CHWs at the quarterly CHW training. 

In closing, I learned a valuable lesson in cultural sensitivity and in making assumptions. However difficult, this experience will undoubtedly shape my approach to future work abroad. Luckily, I was able to salvage and reshape the study and look forward to sharing the results in the coming months.

Chalagamari VIllage

India, India! (I return)

After over two years, I’m back in India. For whatever reason, this country has grabbed me more than most, and I have returned to the same place again in my travels, with plans to return for many many more visits… 

  

SNP Widows

 In the middle of an unrelenting heat-wave, I am back at the BIRDS campus in the village of Muthylapadu, in the Kurnool District of Andhra (no longer Andhra-Pradesh), India. The school children are on summer break and without them, the campus feels empty but at peace. Taking their place, are the widowed employees of Shelter International’s Sanitary Napkin Project. Visiting them in their workshop and my interactions with them have been a highlight of the last few years. Words do not begin to express my sentiments and I hope that I am able to process and share these feelings in the future.

While I am here for the widows, I am also here to research the beliefs and practices of feminine hygiene in this portion of village India. Two friends have joined me and together we are trying to create a concrete and evidence-based picture of the area’s current feminine hygiene practices. As tools, we are using focus groups and individual interviews with women and Community Health Workers (CHWs).

 

Transportation

 So far, only two days into the individual interviews, our results are quite interesting. It seems that the majority of women here already use sanitary napkins, most having adopted them recently because they wanted the “freedom” and “comfort” to move about. Previously, they used bits of cloths that restricted their movements, caused mortifying menstrual mishaps, unpleasant smells, rashes, and were embarrassing to wash, dry, and reuse. When I ask these impoverished women the maximum price that they would pay for napkins, they almost unanimously reply, “Napkins are now a necessity. Even if the cost was 100 rupees (current prices in the villages range from 26-45 rupees), we will pay it, because we will never go back to the old ways.” 

Despite this unexpected progress, many of the women still face restrictions on their behaviors and movements during menstruation. So far, none of them worship during their menses, as they feel “impure.” Several do not travel or leave the house, many restrict the foods that they eat, and some are forced to stay outside or in a corner for the duration of their period. Thus, while some women do have the freedom and comfort to go about their days normally, because of custom, many women are still restricted and stay home from work or school during menstruation.

Education is also lacking and, perhaps surprisingly, mothers do not tell their daughters about menstruation until after menarche (their first period). And, as one might expect, sex education is lacking in the Indian school system. Thus, when girls see their first drops of blood, they fear disease or death and run crying to their mothers, who then tell them that this is a normal process for girls– their entrance into womanhood. Several of the women revealed that they never had the opportunity to learn from their mothers, because they were married within a month of menarche and their mothers did not have time to explain how to manage menses. Furthermore, women have no knowledge of the physiological process of menstruation and very few women are able to identify the origin of menstrual blood.

Still early in this process, my mind rolls over future projects and mostly educational interventions. I am also dreaming up ways to expand Shelter to employ more widows, as widows frequently travel great distances hearing that we employ widows and treat them well (unfortunately, the stigma of widows is still strong). While I do have a slight bias, I have already seen the impact that Shelter has had on the lives of our employees and even on women in the villages. I feel so lucky and thankful to be able to do this work. It is what drives me and gives me the energy to succeed in my studies.

More to come as time, internet, and power allow…

 

I interviewed this widow over 2.5 years ago. She is still alive, wearing the same blouse, and is now in her 90s.

  

Raw Material and almost finsihed product

    

The BIRDS farm

 

In Closing: No End In Site

It’s been almost a year since my first day of medical school, and this first year, “MS1”, is finally coming to a close. Writing as a form of procrastination, I’m staring in the face of my last final and will fly to India the following day, where I will spend three weeks working with the widows and women of rural Andhra Pradesh on feminine hygiene. I promise, dear readers, that you will hear more about this project later, as time allows.

It’s been a wild year, so wild in fact that I can hardly differentiate or recall many of its details, as days tend to blend together while staring at my computer screen… That said, this year has had many highlights, many memorable moments, and more than a few “learning opportunities”…

All in a day's (24 hrs) work

All in a day’s (24 hrs) work

Going into medical school, I was convinced that I would take care of myself, maintain friendships both in and out of medical school, continue to write, and somehow get enough sleep. However, with an all too often empty refrigerator, free pizza several times a week, and an ever crushing workload, it’s been difficult to take the time to luxuriate in past enjoyments or even finish conversations (much less the copious amounts of “me time” to which I had grown accustomed). Instead, I languish away in medical school, watching others live their twenties through the lens of facebook, while I torture my brain and preserve my skin, enjoying the great indoors of lecture halls, libraries, and my cluttered office. This past year and for the foreseeable future, time off is not really time off (it is a time to sleep, or, better yet, watch the several weeks of classes that I have yet to stream…).

Almost one year in. How do I feel? Tired. I don’t have the same energy or enthusiasm for my studies that I had during my first semester. However, for the most part, I still enjoy what I am doing and am happy with my decision to go to medical school. As my reader can tell from my tone, I’ve had my fair share of frustrations, but mostly I’m just tired. (And a little bit stressed.) I also wish that I had more time to devote to intellectual and personal pursuits outside of medicine, as demonstrated by the forty or so tabs currently open on my browser (to “read later” of course…). But for now, I am learning. More than ever, I know what I am working towards and I know that the sacrifices I am making will be justified.

One thing that this past year has reminded me of is that the active pursuit of knowledge must be part of my life (these past few weeks, distracted from my course work, I’ve missed the stimulating environment and intellectual freedom of Reed College). Whichever specialty I choose, I feel that I will fit best into an academic setting, one where I can have side pursuits (public health, global health) and where others share similar ideals and desires to expand knowledge.

Until then, I will work.

More on India soon.

A&D

On Purpose

Instead of learning about this week’s viruses and the bacteria that I should have mastered two or three weeks ago (but who’s counting when I am this behind?), I offer my dear reader a glimpse of my happily overflowing life as a first year medical student. In these past few months, my identity has been both lost and strengthened, as I am stretched beyond capacity in nearly every direction, almost daily. It’s rather wonderful. Having so little time only enhances each moment, and I drink in knowledge, friendship, purpose.

"A still life"

“A still life”

Bad days are like today: I set no alarm to let myself sleep, and wake up unintentionally at 3:30 am. After a half hour of tossing and turning, I give up on sleep and drag myself out of bed for an impromptu 4 am yoga session (the last few months of near-inactivity have me lying awake in stiffness and pain, as I prematurely empathize with my future geriatric patients…), and begin my work in peaceful, dark, silence. Perhaps sipping a cup of single-origin coffee, the sun rises and the day begins, as I rush off to somewhere to furiously absorb or regurgitate newly procured knowledge.

Good days are also like today, except I may have acquired more sleep, eaten a less mushy banana, spent more time with friends, finished the day’s lectures, and pushed myself into a deeper backbend…

Frustrations, yes. Questions, sometimes (like the differential diagnoses that float to my mind when I question: what toxins will I likely ingest from this soup of questionable age?). Sacrifice, so much (but I am constantly reminded of how much this struggle is worth. What else would I be doing with my mid-to-late twenties?). Passion, always. Passion moves me. Yes, this word is overused and I am known to indulge in its use, but passion bubbles up so unexpectedly (and with such frequency!), that I can’t help but be overwhelmed with intrigue and delight. And these little bouts of passion, if you will, reaffirm my purpose and drive me forward.

I am blessed to be living with such fullness.

(No wonder I can’t help but smile)

An Introduction to Medical School (The Hanna Edition)

Underneath the Platysma

Underneath the fine lace (aka the nightmare inducing Platysma)…

My first five or six weeks of medical school have flown by in a haze of adrenaline, gratitude, information overload, and sleep deprivation. I wake up most days well before my alarm, work for a few hours, cook or blend breakfast (one day I decided to blend, only to find that I had no fruit–my breakfast consisted of unsweetened almond milk blended with a few cups of kale and a spoonful of plain full-fat yogurt…), and head to my 8 am classes. With eyes wide (as to prevent drooping lids, luckily for me in this case, not ptosis), I absorb and absorb beyond saturation, sometimes spending my afternoons and early evenings with my nameless cadaver, sometimes spending them tucked away in a sunny corner in the library or curled up in my home office until my computer, or the position of the sun, tells me it’s time to try for some sleep. Often still inspired, I stay awake writing bad poetry until my mind and body can take no more. If I’m lucky, my eyes close and my mind shuts off (or fills with images of peeling away the platysma), and five hours later, the cycle begins again.

Seriously. I thought we already had this conversation 40 years ago.

Seriously. I thought we already had this conversation 40 years ago.

Outside of classes, there are ten billion things in which I would love to be involved (and once again I wish that I had another few centuries of life in my twenties…). I have committed myself to Global Health, so I will be traveling abroad this year. And, being myself who is now located in Texas, my eyes (and mouth) are open wide for opportunities to advocate for improved women’s health and the de-politicization of the female body. Adrenaline is also running high for Wilderness Medicine and Emergency Medicine, and I am really looking forward to both gaining skills that I can use in the backcountry (and other resource-poor settings) and learning more about access to care for our nation’s poor (I see so many opportunities to put my MPH to good use in Emergency Medicine).

Outside of medicine, I am practicing my handstands daily and am trying to expand my yoga practice in the moments between classes. There is very little time in my life for the things I need to do, so I am trying my best to use the little free time that I do have to the best of my abilities.

So, my dear friends near and far, this is a little vignette of my life (and perhaps a call for forgiveness of the lag time in making and returning phone calls and emails).

Hanging out with some friends on a Friday night

Hanging out with some friends on a Friday night

 

On “Naming My Cadaver”

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De Humani Corporis Fabrica, Andreas Vesalius (1543)

The other day, I met my cadaver. I had seen cadavers before and had even held parts of the human body in my hands, but “meeting” mine, which involved turning the body over in a vat of formalin, as to prepare for the dissection of the back, brought the situation to life (no pun intended). Lying in front of me, naked and exposed, was the body of someone who had once been alive. And I was about to cut into this body, using it as a tool to expand my knowledge and understanding of medicine.

While in the anatomy lab, I heard the question, “What should we name our cadaver?” voiced several times by various “tank groups”. I guess naming cadavers is something that medical students do, as earlier in the day, I heard an excerpt from a book written by a doctor who looked back and remembered naming her cadaver “Cherry.” A quick google search on “naming cadavers” brings up discussions by medical students attaching names to cadavers to remind themselves that they are dissecting a human, someone who was once alive. I guess some might need this extra step to “person-ize” their cadaver. Or maybe some need to soften the strangeness of the situation by attaching a name, maybe even something slightly humorous or ironic. However, the idea of naming a cadaver immediately unsettled me and, before lab, I mulled over this idea and wondered whether I would name mine (as I had named the bodies of frogs I dissected in middle school), or whether I would even have a choice in the christening process amongst my tank mates.

But back to my cadaver. Judging by his body, I can tell that he lived a long life. I hope it was one filled with love, happiness, meaning, and minimal suffering. This man lying before me had a family, friends, an occupation, favorite places and things, various likes and dislikes, a life, a name. He was a person. He had created his own life and identity.

Who am I to give him a name?

One could get philosophical here and go into the deeper and perhaps existential questions about mind-body duality, the origins of personhood, what makes us human, the existence of the soul, its origin and location, where the soul goes when the body dies, and the body (is it just a shell?). I won’t go into these questions here, as that conversation would go on for days and I doubt that I would ever arrive at any meaningful conclusions. But, I will ask, is this body lying before me, naked and exposed, still a person? Yes, I believe so. But it is also an important learning tool and I will respect both aspects of this cadaver. I am deeply grateful for this incredible gift.

However, no matter the answers to these questions posed, giving my cadaver a name seems to somehow cheapen the experience.

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De Humani Corporis Fabrica, Andreas Vesalius (1543)

(An Introduction to) Life in Texas

On my drive to Texas...

On my drive to Texas…

New Starts. I love them. In my life, for better or worse, I have had many (more than I can even think of counting). I had seven high schools appear on my college application (I was only physically at five…) and attended three different colleges fulltime (not counting the other three or so where I have taken courses…). I have also traveled extensively, where every day essentially becomes a new beginning. And now I have started the next phase… Oh how I have loved the tabula rasa!

Cottage

(Hopefully) my little cottage!

I’ve been here, in San Antonio, for almost three and a half weeks. My time here has been busy, filled with my master’s courses, nearly completing my biochemistry prerequisite, working on SHELTER International’s Sanitary Napkin project, and an attempt to explore my new city. I also spent my first few weeks here scrambling to find housing, which I finally (hopefully) have. After visiting several over priced and mostly mediocre rental properties, I decided to buy an adorable little house in a historic district, mid-way between campus, Whole Foods, and my new hangouts. The house closes just a few days before classes start and I cannot wait to move in! I have been essentially living out of a suitcase since April and am anxious to settle. After a transitional few years (but isn’t all of life traditional?), I know I will have the motivation (of both relaxation and resale) to make the space beautifully my own. The decision to buy essentially happened overnight and I joke that I went from twenty-five (or whatever I am, some claim ninety…) to thirty in a period of just hours, as my free time suddenly became filled with thoughts of interior wall colors, countertops, how to tastefully match exterior paint with the new (green) roof which I will not replace, what to do with my front lawn, and my planting calendar…

A real first…

Other than buying a house and living around my homework schedule, I have had the chance to explore the city and meet a few people. The classmates that I have met so far are wonderful and I am excited to be around similarly motivated individuals. Also, actually very surprising to me, I actually really like San Antonio! Yes I have had “conversations” with conservatives who corner me with monologues of disbelief that I actually want to go into medicine in this day and age (can you believe it?!) and I will be driving past pro-lifers protesting Planned Parenthood (an organization to which I have proudly donated the last several years) on my daily commute. But I like it here. If anything, these oppositions will remind me why I have chosen the path that I have and will only serve to make life more interesting…

The road

The road

Other positives about San Antonio: I love the heat. I doubt that I will have to use my “happy lamp” often and will not need to make daily or even weekly trips to the sauna. I’ve found little corners of the city where I feel at home and have even found a few restaurants where I can eat!  More positives. I was asked out more times in my first two weeks here than I was in my six years in Oregon. Very few men here wear skinny jeans (they traded them in for cowboy hats and boots, a different story entirely…). It is a diverse city with a lot of culture to explore. Hill country is lovely. Most importantly, people are nice and I have encountered very little pretension. In short, Texas has welcomed me and I am doing my best to embrace a culture very different from my own. I am really looking forward to the next four years here and think that I am going to love it.

So, far away friends… come visit me once I partially reemerge from the stressful first semester of medical school!

A great fresh start!

A great fresh start!

(A Brief) On Sanitary Napkins in Rural India

Anyone that has talked to me in the last year and a half (or anyone who has read this blog) knows that I am deeply passionate about women’s health and the improvement of women’s lives worldwide. This past year and a half, I have spent my time working on various projects involving women. From my employment on the Native CARS Study, work with survivors of sex-trafficking through Save a Survivor’s Smile, my acceptance into an MD/MPH program where I plan to pursue women’s health, to the development of my non-profit organization SHELTER International, which aims to improve the lives of widows in rural Andhra Pradesh, India, it’s a wonder I ever made it outside (but I am so thankful that I did as there is just so much to hike…)!

Today, May 28th, is Menstrual Hygiene Day. As females in the developed world, menstruation is still a pain, but we simply have to make a trip to the drug store to cheaply purchase feminine hygiene products to manage our menses. In rural India (and many other parts of the world), menstruation is a whole different fiasco. Imagine having to travel a significant distance to a town large enough to have a market where they can sell feminine hygiene products. Now imagine spending half-a-week’s (or thereabouts) salary on expensive and imported sanitary napkins. Obviously, most women in this situation spend their hard-earned cash on food or school for their children and simply do without this “luxury.”

Instead of using a hygienic product, women use bits of old cloth and sometimes even newspapers or sand to manage their menses. Due to embarrassment (as I am sure you can imagine), these cloths are rarely cleaned or sanitized and have been reported to increase the incidence of disease in the reproductive track. As these solutions can hardly be considered solutions, women and girls often have to stay home from school or work so that they can manage their menses. In turn, women have just one more reason to make less money and girls often fall behind their male peers in school.

IndiegogoSo, in an effort to help the area’s widows as well as pursue my passion for feminine hygiene (I realized feminine hygiene was a problem for many Indian women when I taught health and hygiene to girls in Tamil Nadu, India), my organization is trying to raise funds to purchase a machine to manufacture sanitary napkins. The machine will employ 10-20 widows and the low-cost product will be sold to women and girls in the area. I have wanted to get this project going for a year and a half and, after much research and planning, it is happening! We (SHELTER International) are also very fortunate to have several graduate students from Pacific University heading to the project site this summer to oversee and study the project’s implementation. I personally cannot wait to go back to India at my earliest availability to see the project in action!

Anyways, after spending so much time and energy working towards something, I am ecstatic to see a project that I am so passionate about finally coming through. Check out the Indiegogo campaign page, read about widows, learn more about the importance of menstrual hygiene, and women reading this post: be thankful that you are fortuitous enough to manage your menses in a way that doesn’t completely interrupt life!

 

Solo Adventures on the Kilalaua Trail

I have just returned from a visit to another world–Kilalaua Beach on the Nepali Coast of Kauai. I ventured alone–my first solo backpacking trip–and each step I took, my eyes opened impossibly wide as I questioned myself, “Can this place actually exist?”

It was that fantastic. Mind blowing. Beautiful.

I can see how easy it is too loose (or find) oneself in the mystic Kilalaua valley and beach. The valley is truly sacred.

As this post is rather long, I will break it up into several sections so that my dear reader can peruse only what he or she finds interesting and/or useful.

Topics include:

The Hike Itself
The Locals
Advice for Future Hikers

The Hike Itself

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Looking back at the Napali Coast

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I began the trip with myself, a 65 liter backpack loaded to an estimated 40 lbs with my tent, thermarest, silk sleeping sack, steripen, various other items, nutritious but heavy and calorie dense foods, and my old pair of trekking boots that at this point must have seen thousands of miles (and the tread, or lack thereof, shows). I had my injured right ankle (oh the pain it gave me only a week ago as I hiked through the streets of NYC!) wrapped in a brace. Because of my injury, I have been unable to do much in the way of my normal physical activity since March and so was hesitant to do the trek. With the possibilities of being out of shape and reinjuring my ankle, I set off cautiously a little after 8 am.

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At least I'm wearing sunscreen!

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A glorious portion of the trail

The eleven mile hike, with about 5000 ft of elevation gain up and down the valleys of the Nepali coast, took about 6.5 hours. I swore my pack became heavier with each step (surely my sweat had to go somewhere!). Despite my physical excursion, I smiled most of the way and, when I made it to the beach, I felt like running. How gorgeous it was!

My trek out, I felt so much lighter in every sense of the word and my pace reflected this lightness–I flew through the trail in just 5.5 hours. The hike out was fantastic. The weather was great and I could not help but smile and thank the world for providing me with such a wonderful life.

The Locals

I met very few locals and am far from an expert on the subject. I am just providing my most interesting experiences and I am sure that the majority of people living at Kilalaua are not mentally ill or addicted to hard drugs. I myself can see the allure of living so close to nature in such a beautiful place.

After arriving at Kilalaua, I decided to take a stroll on the beach. As I ventured from my campsite to the beach, I passed a strung out looking emaciated young man passed out on the beach a few yards from an occupied tent. I had heard that people lived on the beach and in the valley and correctly assumed that this man must be a resident. As I returned from my stroll, the man was sitting up and staring at me as I approached. From far away it looked as though he had somehow painted his face with red paint (oh, hippies…). As I moved closer, I saw that his face was actually swollen and bleeding. So, I ran up to him and asked him what he needed. Up close, his body was so thin and  the swollen lump under his eye provided the only bit of flesh on his face… He saw my water bottle and said he needed my water. I could barely make out his words as he tried to explain that he was beaten up. As I poured him some water, another man approached with some ice. The injured man cowered and mumbled something about not hitting him. The approaching man explained that he was just there to help and wouldn’t hurt him. I left him in the helpers hands and went on my way. A few hours later, a rescue helicopter arrived and the man was flown out on a stretcher. I asked around about why the man was beaten up and managed to learn a little about his background as well.

The man had lived at Kilalaua off and on for several years and, after his first trip out after a bad break-up, has never been the same (some postulated that he took too much ecstasy on the first trip, others claimed that he was possessed). It turns out the man was schizophrenic and would come to Kilalaua when he was having episodes. The night before the attack, he had supposedly been wandering around tent sites asking for heroin.

This man was attacked by one of his old best friends (visiting the beach to see other friends/family living there) because he stole all the beer and food from his ice chest after having been told multiple times to stay away. The young man had gone so far into whatever world, that no longer recognized is friend (who eventually attacked him).

So, the second rescue helicopter of the day was called and the young man was flown out for treatment (a chief or something like it, who helps resolve conflicts, also has a mariners radio that he uses to contact passing boats, who then call in emergencies. The turn around time is pretty quick.).

The first rescue helicopter was called for an episode told to me by the “rescuee,” a rather portly and good humored Kauaian who came to the beach to visit friends. He had found an abandoned kayak on a beach and, after waiting weeks to see if someone claimed it, decided to pack it with beer and supplies and kayak to Kilalaua. Well, several miles in, the boat starting sinking. After swimming alongside the sinking boat, the passengers abandoned it and somehow managed to escape the ocean by climbing up a waterfall (had the boat sank anywhere else along the coast, they would not have had this escape route…). I actually saw the boat from the trail and just assumed that its occupants were snorkeling. A helicopter on tour reported the kayak and determined the situation to be an emergency, as they saw no one and just saw beer floating in the ocean along side the sinking kayak. Luckily, the passengers survived, managed to salvage some of their beer, and hiked the remaining miles into Kilalaua. I really enjoyed passing a rainy afternoon with the survivors and their friends.

Advice For Future Hikers

For those of you wanting to hike the Kilalaua trail, if you are an experienced hiker, it’s much easier than the guidebooks say. If you are fit and travel light, the trail can even be done as a day trip, although lingering on the beach is just so delicious and I would highly recommend staying. For less fit hikers, budget 7-10+ hours and consider breaking up the trip by staying one night at the 6 mile point, Hanakoa, where a man might jump out of the shelter with an “Aloha, wanna smoke some hashhh?”

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My site

If you do choose to stay at Kilalaua, try to stay for at least two nights and try to get one of the sites near the waterfall, as they are convenient for getting water and are just so much better than the first sites you reach in the forest. I actually stayed in the forest one night and then moved my tent early the next morning to a freshly cleared prime bit of beach front real estate. It was glorious.

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I bathed and drank in the falls...

So linger if you can, for I have traveled a little bit of the world and have seen my fair share of beautiful beaches, and this one might just top that list…

One fellow hiker described the beach as “kinda like a hostel where you camp”. Mingle with other hikers, the locals, hear their stories, and be moved and intrigued by the diversity of man (as well as the beautiful solitude that you should seek and bask in)!

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The end of the hike!

On the (few) Downsides of Traveling Alone

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So I’m on the road again, in another transitionary phase… I’ve moved out of my little abode in my beloved Portland, OR and am roaming around Arizona, NYC, and now Kauai, as I scramble to finish the biochemistry prerequisite for medical school and move to Texas in June to begin my MD/MPH. It’s been an interesting few months.

Now that we have caught up, I will point out the few disadvantages that I could come up with about traveling alone.

1. No one to share beautiful moments with (other than my glorious self, of course)

2. No one to watch my belongings while I use the restroom, swim, wander about…

3. Cost (my lodging and car rental is twice as expensive…)

4. No one to call for help when/if a rope breaks as I scramble up the side of a muddy, slippery cliff (don’t worry, I’m using my best judgment…)

5. (Most importantly at this moment in time) No one to assist in applying sunscreen, resulting in the sunburn from hell, but only on my backside…

6. Taking selfies while getting said sunburn from hell (or while doing any other various activity in a secluded location)

Other than these six considerations, traveling alone again has been fantastic and I have been getting a lot of much-needed “me time” to indulge in solo hikes and long walks on the beach. Bellisma.

(For more on traveling alone, read “The Solo Traveler“)

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