Sri Lankan Highlights

Sri Lanka is a beautiful, green country, although most important things seem to be at the top of rocks, so lots of stairs/climbing is involved (some of it bare foot). Entry into these sites is expensive. In India most attractions cost 500 rupees (£7), with the Taj Mahal costing 1000 rupees (£14). Here the entry fees are US$25-30 (nearly 5000 rupees). Obviously in India £1 is 80 rupees, but in Sri Lanka £1 is 180 rupees, so do take that difference into account.

 

I took a pre organised 10 day tour of Sri Lanka, so these are my highlights.

Buddha at Mihintale

Anuradhapura: I visited Mihintale, which is were Buddhism started in Sri Lanka. It has 3 main parts - the statue of Buddha on one hill (above), a stupa (solid hemisphere containing relics) on another and a large rock that we climbed up. It was a really interesting place and we sat on a rock behind Buddha for the sunset which was lovely. Buddhist sites don't allow you to wear hats or shoes, so all this rock climbing/stairs was bare foot. It can get hot so don't forget to take (and drink) plenty of water.

Buddhist relic shrine

We also visited Dambulla Rock Temple - a complex of 5 temples built into caves at the top of yet another hill. These temples are decorated and filled with statues of Buddha and was incredibly pretty, especially as it came with a hill top view.

 



Sigiriya involved climbing up Lions Rock (entry $30 or nearly 5000 rupees). We did this at 7am before it got too busy and it involved a lot of stairs - some of which were attached to the side of the rock. The rock used to be home to a palace, so the archaeological ruins remain at the site. There is a lovely panoramic view from the top. It took us 1hr30mins to get to the top and back down, stopping to take photos and read the information boards along the way. If you look at the photo below you will see some of the stair attached to the side of the rock... It's not a time to look down as you climb up to the top.

Lions rock - staircase entrance

In Sigiriya we also did a village tour, which involved a bullock cart ride, a short boat ride on a reservoir (I use the term boat loosely), a cooking session and a tuk tuk ride back to the start. This cost 2000 rupees and was a lovely experience. The cooking session was interactive and we made coconut roti from fresh coconut and maize flour in a basic outdoor kitchen.

Orchid, Botanical Gardens

In Kandy we visited the Botanical Gardens - Peradeniya. This complex came with lots of bamboo collections and an Orchid House. It has a suspension bridge out over a river and large gardens. There is certainly a lot to see and it is very pretty. Entry was only 1500 rupees for a foreign ticket, but you could easily spend a whole/half day here.

We also visited the Temple of the tooth relic in Kandy. It was very pretty and as you can see in the shrine below, highly decorated. It is quite a popular place to go, although the tooth relic itself is in a closed room behind a pretty screen with its own pair of ivory tusks.

Shrine to Buddha at the Temple of the tooth relic

Next to the Temple is the Kandyan Culture Centre. At 5pm we watched an hour long show made up of 12 different dances and finishing with 2 men walking through fire. It was very interesting to see the different dances, to traditional music in full costume. It is definitely something that is worth going to see.

Cultural Dance

Nuwara Eliya: We stayed here in order to go to Horton Plains National Park, arriving at 6am when the park opened to walk the 9km circuit. We were finished by 9:30am, as it started to get hot. There are 2 view points - Mini World's End and World's End which are set on the top of the hill. It was pretty cloudy when we went but apparently the clouds get heavier as the day progresses. There is also a waterfall called Bakers Fall which is very impressive, even if we visited in the dry season.

World's End, Horton Plains

Yala: We had a half day safari around Yala National Park, but I would recommend going for a full day to get a better chance of seeing more animals. I was surprised by just how many peacocks there were. We didn't see any leopards, but we were lucky enough to see a couple of wild elephants, some crocodiles, deer, buffalo and even a rabbit. It was a lovely afternoon out, but 4x4's are a bit bouncy off road - you have been warned. You will also see quite a few lunchboxes full of humans (other tourists in 4x4's - leopards pre-packed lunch :) ).

Elephant

Galle: We first visited a turtle sanctuary. Here they care for turtles injured by fishing nets and give a home to the ones that are unable to be released back into the wild after receiving medical care. It is also egg season and they buy eggs from fishermen and keep them safe from the predators until they hatch. We were lucky enough to be able to release one each back into the sea. They head towards the sea and then get carried out with the tide once they reach the water. Week old turtles are tiny black little things. It was definitely worth a visit.

Turtle

From here we headed to Galle Fort to take photos of the Dutch clock tower and the English lighthouse. The fort itself was built by the Dutch and then taken over by the British when they colonised. We only came here as a photo stop, but it did seem quite a popular tourist attraction.

Galle Fort

Colombo: We have visited 2 temples in Colombo, one of which is a museum. It is crazy and filled with everything from old cameras to jewellery to Buddha statues - we even spotted Pikachu. It is definitely an experience in there. We also visited Colombo National Museum which, despite the lack of air conditioning, was a really good place to visit. It covers everything from early man up to more recent history with coins, fabrics and art to name a few of its many galleries. It wasn't too expensive to get in either, which is always a bonus. We have also been exploring our local area which has lots of higher end shops scattered about, so it is a great place for those who like to shop. There are also markets and beaches to hand if you don't mind a short ride in a tuk tuk.

 

I have enjoyed seeing the amazing scenery that Sri Lanka has had to offer over my 10 day tour and have taken so many photos (I think in 10 days I took more photos than I did over 6 weeks in India - woops). There is still more in store for my time in Sri Lanka, but that's another blog post in the making...



Top Tips for Travelling in India

Crossing the road
There is no rhyme or reason to Indian traffic, apparently there are rules but what they are eludes me. I have found that the best way to cross a road (especially if you are alone) is to find and follow a local person who is crossing. They are much braver and seem to know when and how to dodge the multitudes of oncoming vehicles.

Eating Out
Food in India is pretty cheap, however all prices exclude tax. Eating in a restaurant there can be up to 30% charges added to the bill, so it is something to be aware of if paying in cash. Make sure if they give you water it is filtered or bottles and the same with ice cubes. Where possible get takeaway and eat out, then you save on some of the tax.

Rickshaws
Rickshaw drivers seem to make up their own prices. What normally costs 50 rupees can suddenly become 100 rupees. Ask someone what the cost should be before you go out and then stick to that as your guide. Sometimes the drivers refuse and other times they agree after some debate. You can ask for metered fares but you have to be careful they don't take you the long way. If you have any trouble get out and ring the police.

Shopping
Markets are amazing places, full of clothing (by the way the colour runs like crazy from Indian clothes). Most of the prices vary on the vendor, so again you need to haggle to get the price down. Just going to walk away also helps in the frantic price reduction. Something that they asked 400 rupees for suddenly drops to 350 then to 300. Have an idea of what you are prepared to pay and only get into debate if you actually want something. If you want high end products then there are shopping malls that have all the high street brands.

Make sure you get your change
A lot of people don't like to give you change, even if they have the ability to do so. Twice I didn't get any change and once I didn't get all my change. Learn from this - make sure you know how much change you should get and make sure you get it all.

Trains
Trains are a pretty cheap way to travel (compared to in the UK), but train tickets either need to be purchased well in advance, online or from the foreign ticket office at New Delhi railway station. In the air conditioned chair class you get food. Think of this food as lower quality plane food and take snacks in case you don't want to eat it. I did get a free 1L water bottle each way though which was brilliant. There are still printed lists on the edge of each coach, so you can check you are in the right place. Sometimes they stop randomly and whereas you started out on time, you may still arrive rather late to your destination.

India is an amazing place and the people are so friendly and helpful. You certainly won't get bored, especially in the cities. Overall I have had an amazing experience in India and would recommend it as a place to visit to anyone.

Mumbai

View of Mumbai

Mumbai was my final stop in India. I discovered that the places I wanted to go where far away from my hotel by the airport. I stayed at the Mirador Hotel which was amazing! I was so well looked after there, so if you want to be close to the airport it is a brilliant hotel. I was collected and returned to the airport, they booked me Ola taxis to go out and made sure I went out with the duty managers phone number in case I had any problems. The service was incredible.

Gateway of India

My first stop was to the Gateway of India. This gateway was built to commemorate the arrival of King George V and Queen Mary to India. The British army left via the gateway once India had its independence and now it stands in front of the jetty where boats depart to Elephanta Island.

Faces of Lord Shiva

Elephanta island was a much longer boat ride away than I had anticipated. The caves are up a long flight of steps, which double up as a market. Rather than pay 1500  rupees for a guide from the jetty, I hired one inside for just 500 rupees. There are a collection of caves in the site, but only one of them has statues inside. The temple is carved into the rock and is for Lord Shiva, although it was greatly damaged by the Portuguese, so is no longer an active temple, but is still a world heritage site. Inside there are 9 depictions of Lord Shiva, all intricately carved so you can see other images through columns. The cave pillars have been restored, so are now part rock and part concrete. It was a very interesting place and I am glad I hired a guide to explain the different images to me.

 

I also visited Oberoi mall. Like every mall in India, you have to go through security and bag scanning to enter. It is a relatively big mall with high end shops, so is a great place if you want to go shopping. It was only 20mins away from my hotel and comes complete with a cinema.

 

I was only in Mumbai for 48 hours, but would definitely go back as there is so much still to see. It is much more humid than Delhi was, so make sure you carry and drink lots of water.

Private Healthcare in India - Imaging

CT Brain

So I spent part of the day with the Dr who reports the CT/MRI and x-rays. It was both interesting and boring all at the same time, so I am afraid this will be short, as I have defected back to the ED (again... Sssh don't tell HR).
The scan or x-ray itself is performed by a technician. The x-rays are printed out onto film and examined against a light box, whereas CT/MRI seems to stay on the computer to be reported. I have seen people with film prints of their CT/MRI scans, but I am focusing on how things are reported. The Dr then looks at the images. For X-rays the result was written on the envelope flap. MRI and CT reports were hand written into a book. These hand written reports are then given to a typist, who selects the report format and transcribes the report onto the system and prints it. The Dr then gets a pile of reports to sign. It all seems more complex than it needs to be - but such is healthcare.

I learnt a lot about looking at chest x-rays as there were a lot in the pile. Unfortunately I quickly forgot all the actual names for the anatomy and so am reduced to referring to the 'pointy angle at the bottom' to describe how to find out if there is pleural effusion. I also got to see one with a pneumothorax (pure black space - no white blood vessel shadows). I also got to see some MRI heads to look at sinuses and a CT brain, which was fascinating. Eyes in particular look amazing in scans, well to me anyway.

I warned you this would be short - I was only there for 4 hours.

I have had an amazing time at the hospital - I am absolutely gutted that I have to leave. I have learnt so much in such a short time and the whole ED team in particular feel like family. Indian people are so kind and genuine and it has been a pleasure to learn from and with them.

Amritsar

Golden Temple

I made the 7 hour train ride from Delhi to Amritsar. My first stop was to Jallianwala Bagh, the memorial garden to the Indians killed by the British on 13th April 1919. It is a maintained garden with a little museum with the history, which was very interesting.


Jallianwala Bagh Memorial

Next door is the Sikh Golden Temple where I went for sunset. The complex is white with the Golden Temple sat at the centre of water. I joined the que (well, more mad crush) for an hour to go inside the temple itself. I am not Sikh, so didn't really understand what was happening. If you are visiting you will not be missing out on too much if you just view the temple from the outside. The crush wasn't really worth it, but it is pretty inside. At 7pm they have prayers which was nice to see. You have to leave your shoes at the shoe house and make sure you cover your head to go inside.



Golden Temple by night

The next day I visited 2 Hindu temples. The first was Durgiana which is a smaller scale version of the Golden Temple. It was a cute little complex and pretty quiet with a free shoe house too. I then went to Mata Lai Devi Mandir temple. This was amazing and words/photos don't really do it justice. It had cave entrances and tunnels and is something you should go and see if you are in Amritsar. You start off by going upstairs on the left and follow the one way system back round. It is full of beautiful decorations and was an experience in itself.

Inside Mata Lai Devi Mandir

I also spent a lot of time in the markets. I wanted to buy something similar to an Indian suit but a lot of places sell them unmade, so you need to spend extra on tailoring. I went to a shop that sold them ready made and bought a gorgeous dress (if I can call it that) with leggings for 850 rupees. There are 3 main market areas - the one around the temple, a fabric market and a shoe market. The latter is each a labyrinth of its own, but occasionally a rickshaw appears if you wish to escape. There are so many beautiful clothes on sale there.

 

The train was also interesting. Being in an air conditioned chair class, with a hot meal each way. The food was like poorer quality airplane food, but you do get a free 1L bottle of water. It is definitely a relatively cheap way to travel - just take an anti-bacterial wipe - the tray tables are super dirty.

 

I would definitely recommend an overnight trip to Amritsar if you are ever in North India. The temples are beautiful if nothing else.

Private Healthcare in India - Operating Theatres

I have moved from the emergency department to operating theatres in Delhi.
 

The first thing you notice in this hospital is that some of the theatres operate with their corridor doors open. In the UK each theatre has an anaesthetic room leading to theatre and you need to pass through 2 doors (which shouldn't both be open at once) to get into the theatre. There are also only 2 sinks in the corridor to scrub up in, whereas in the UK each theatre has a sink inside for you to do this.

 

Inside an Indian operating theatre

The most striking thing in India has been how much is reused. In theatres all the drapes and gowns are made of material and are kept, washed and reused. In the UK almost everything is disposable - gowns and drapes are all binned once the procedure is over. Clinically, however, the procedures are the same as they would be in the UK, if not slightly more advanced at times. There is also a pharmacy in the operating theatre department, so there are no cupboards in theatres with medication stock.

 

I am also in awe of the respect shown between the staff. Nurses are frequent called sister or brother, whilst Dr's are called sir or ma'am. I think this is amazing as in the UK we often call each other by first names, or you just hear the terms nurse or Dr. This respectful culture is definitely one that I think is great, especially as I am not a fan of being referred to as 'nurse' when I am at work. However, the hierarchy in theatres is clear - the Dr's have a spacious lounge, whilst the nurses have something near to a shoe box with curtains to change behind and a table in the middle. The nurses also have a different coloured uniform to the Drs, which I think is actually quite useful as in the UK often everyone in theatres is dressed the same, making it impossible to tell who is who.

 

I have been privileged to see several caesarean sections, including one for twins. I have also had some brilliant surgeons explain what they are doing along with others that work in complete silence. There is a separate little room in theatres with the incubator table and neonatal equipment.

The neonatal room

I have seen a lot of laparascopic procedures which has been interesting. Mesh for a hernia repair costs 43000 rupees.

There is also a pharmacy in theatres. I assume that alongside the cost of your procedure, any drug used is obtained from pharmacy and added to the bill. There are no real stock of drugs or dressings in the theatre itself, everything comes from pharmacy. Most wound dressings are just gauze and mepore rather than complex or waterproof as in the UK. Anything additional to your procedure is added up - each bottle of saline and each vial of antibiotics. Most people seem to be cash patients, rather than under any insurance.

You can also be operated on a lot quicker - one patient had only presented to outpatients an hour before she was having her procedure in theatres. Otherwise clinically things are relatively similar to practice in the UK, just in a very different environment. Next week I am headed to MRI/CT so I can look at pretty images