It was hot Sunday at the Chungtung Tea Garden, and in the primary school, which has neither electricity nor desks, only wooden benches, the tin roof that made the four small rooms into a furnace. Still, the eight doctors labored to provide basic health check-ups to the 621 souls who registered. That is an average of 77 patients in five hours, in blistering hot conditions, no lights, no machines. The only doctor who had an examination area was the gynecologist, who had a corner with a plain bed around which she could pull a curtain.
They call it a Health Camp. I could only imagine that it would be illegal in the States, though there are people as poor as these where I come from, with as little opportunity and as little money for basic health care.
Various international organizations sponsor health camps in and around Darjeeling...indeed, all over Asia. Some of these folks have never seen a doctor in their lives. For others, it has been years. They live in on a tea estate that has been closed down for a couple of years. Normally, when a tea estate is functioning, the company provides some basic medical care to its workers; it only makes economic sense. But the tea gardens, as they call them here, are failing. And when they close, the pittance the workers were getting for their hours of backbreaking labor simply disappears altogether.
Sometimes the locals organize themselves into a kind of collective and continue to pick the tea leaves. Then, if there is a functioning garden nearby, they can sell their pickings to survive.
We ran out of de-worming medicine. Child after child was diagnosed with worms. We ran out of vitamin C and folic acid tablets and calcium pills. Malnutrition was rampant...but a bunch of eight doctors, four intrepid teenagers from the Rotary youth club called Interactors, and ten or so Rotary Club members could do nothing about that. The docs found at least three cases of tuberculosis, two of them in small children. They found liver problems. The eye doctor prescribed 15 cataract operations, which we'll organize to take place at the Lions Club hospital in Siliguri, a four-hour drive over harrowing small miserable roads.
A lot of the folks were suffering from headaches due to carbon monoxide poisoning from their cook stoves. Many people, said the orthopedic surgeon, had old broken bones that had been treated with herbal wraps and had healed improperly and are causing complications. One woman had an impacted wisdom tooth that has become infected.
The locals put up signs all over the area announcing the camp and started taking names and giving people numbers by about 9 a.m. We arrived about 10:30 a.m. on a typical rutted, pitted and pot-holed road that was muddy from the four or five landslides that had covered the road earlier in the monsoon season. Whole sections of mountainside simply give way and huge boulders come tumbling down to block the roads at this time of year. Immediately, people are out with shovels to clear the debris. For the biggest slides, bulldozers are called in.
As soon as we arrived, chairs were set out for the traditional welcoming ceremony, which invariably includes the bestowing of silk scarves on all the dignitaries present. Since Worlds Touch was sponsoring this camp, the master of ceremonies gave me the first scarf. Then we unloaded the boxes of medicines and set up a distribution center in a shed. Because the Rotary president, Deepak Sharma, is a doctor, he's been able to get the meds at about cost from the pharmacy in the same building as his office.
The women dressed in their finest clothes, but they came because they were suffering. As we drove up to the site, I was sure there wouldn't be anybody there. We left what looked like a village and drove for another 20 minutes out of town. Then we turned onto a road paved with stones. (How these local vehicles, without four-wheel drive, manage to keep going year after year is one of the mysteries of this place I'll never figure out.) There was not a soul on the road. I kept asking, "Are you sure we haven't passed the place? Nobody is going to be there. This is the middle of nowhere." But we came around a bend and there was the tiny hamlet, and there were already over a hundred people waiting for help.
The Rotarians and the Interactors went into action, once the welcome ceremony was finished. Prolad and Gopal took the first shift. The locals had already registered according to their complaints, and somebody stood at the door calling out the names in the order they'd registered. Proland and Gopal took names and ages, while another volunteer took blood blood pressures, and then they were assigned to the doctor according to their complaint.
There were volunteers who made sure the patients sat on benches so the docs could at least HEAR what their patients were saying. They wrote an initial diagnosis on one side of their pads and prescribed meds on the other side. Then the people went to the medicine shed where a skilled paramedic read the orders and put together the medicines. My job was to take the names of the people who are in need of follow-up care.
Normally, these camps just provide check-ups and free medicines. Follow-up care for the serious illnesses are just not in the budget and people either somehow make their way to the government hospital in Darjeeling (where it's a given they'll wait for hours). Because our Worlds Touch donors were so generous, so quickly, we will be able to provide for follow-up care, at least the first stage. We arranged with the local block development chairman for a car to bring the referral cases to the hospital where two of our doctors work next Tuesday. There, they'll get the tests they need and also further medications. The follow-up visits will not be free, but Worlds Touch has collected enough money to pay for the 14 who have been referred. Those suffering from cataracts will go for eye operations on a different day in a different car. The eye doc told me that cataract surgery, everything except the transportation to the hospital included, will cost just over $11 USD.
So Howard Hicks, my home Rotary counselor, who contributed $25, has paid for two eye operations. A little goes a very long way here. I've said it before, but it never fails to floor me. It's true that there is a whole lot to do here, but so much can be done with so little money, partly because these Rotarians and these young Interactors and the locals themselves are willing to put in their time and energy to make important and life-saving events happen.
I woke up this morning with the idea that I could contribute something techie to the event. I created a fast-and-dirty database in Access, not bad if I do say so myself. A client management system, is what we call it in the biz. Very simple, just four or five tables-- patient, doctor, diagnosis, meds prescribed, follow-up required...I got all excited making it, thinking that it might really work. Dr. Sharma, when he saw me with my laptop, gave me an extremely infuriating patronizing smile. But as usual, locals know best.
I tried confining my technological activities to just keeping track of the medicines, but there was no way. The people were lined up ten deep and the guy behind the table wasn't about to slow down filling prescriptions at top speed just to indulge my fancy for my laptop. He stood on his feet for hours and people went away from his table with precise instructions about how to take their medicines. There were two different sets of meds-- the Interactors make the rounds of the doctors' offices in the area and ask for the samples provided by the drug companies to be donated to the camp. They collect these in big sacks that are then sorted by type. Often, this is the sum total of the medicines available. But this time, there's another source for medication--the pharmacy in Dr. Deepak's building. The meds were ordered from the supplier and brought in five boxes to the camp. Whatever wasn't given out from this batch will be counted and returned to the pharmacy, and we'll pay only for the medicines we used.
Last night, I was talking about the camp to the government official who occasionally stops in at Joey's Pub. He told me that the going scam is to declare a huge quantity of medications "expired" and then these are resold in the pharmacy shops. The Rotarians don't operate that way at all. The donations of samples the Interactors collect are either still within the dates on the packages, or they are destroyed. But the bulk of the meds we gave away today were direct from the pharmacy supplier.
I took over recording the information of the referred patients, and managed to arrange for the whole group to come together in a car with a local guide to help them through the process of dealing with the big hospital. Worlds Touch will pay for the car and driver, as well as the tests the doctors have ordered.
It's impossible to describe the kind of intensity, the feeling of gratification, the swirl of activity where things manage to get done that you would never imagine possible--that comes with the day I have just spent. How did eight doctors manage to see 621 patients in six hours? How did we manage to organize, completely impromptu, for follow-up visits for fourteen of those patients?
Years ago, Ramesh Manandhar (who has "expired," as Miss Giri would put it) and I walked into the hills of Kathmandu with a French woman doctor who had a very large bag of loose pills. We conducted impromptu medical consultations at every stop. That experience is linked to this one over 27 years, but both of them touched my heart.
As we were leaving dinner tonight, Udaya Mani Pradhan reminded me to tell you wonderful people who hit the PayPal donate button either here at LiveJournal or on the Worlds Touch web site that you have done a beautiful thing today. The Rotary thanks you. I thank you on behalf of Worlds Touch, but more than anything, the people of Chungtung, who don't know your names or your faces, who only know that they've seen a real doctor and gotten real medicine to ease their suffering-- they thank you.
