Thursday, September 25, 2014

"But How Many Souls Did You Save, Doctor?"

Sometimes, I hear that question aggressively asked when I speak about medical missions to American audiences.
The answer is, “How many did I save? None. Jesus saves souls. But I hope I sometimes helped him.”
American Christians who have never been outside their homeland often assume that the missionary is the star performer on the foreign field. For the pioneer in an area never before touched by the Christian message, that may have been true. There are few more heroic tales than those of William Carey in India. Or of Adoniram and Ann Judson in Burma, who labored for seven years before even one person believed their message, but who lived to see thousands accept Christ.
But even then, the goal was to teach people of the country to tell the Gospel story in their own language and cultural view. That is even truer now, when in Burma, for example, there are over one million Christians—Baptist, Roman Catholic, and others.
There are still foreigners who become expert communicators. Among my close colleagues, Paul Clasper and Emily Ballard stand out, each completely fluent in conversational Burmese; Paul and Elaine Lewis in the Lahu and Akha languages, and Don and Janet Schlatter in Lawa. But they are far outnumbered by citizens of the land who have given their whole life and effort to telling their neighbors about Christ.
Sala Ai Pun, headmaster of the Lahu high school at Pangwai, felt called to resign his post and devote the rest of his life to the leprosy villages. (I had nothing to do with this decision; I was as dubious about the idea as anyone else.) The Lahus were aghast, protesting that he was needed at the school and, moreover, he was in his sixties, diabetic and almost blind. He replied that this was what God wanted him to do. He and Yakop (the young man who had visited the villages for years) made an unlikely pair, walking the mountain trails. The younger man limped with a deformed hip and had a defective heart; the elder was too blind to see the single-log bridges clearly that spanned rushing mountain streams. He had to crawl across them on his hands and knees, guided by his wife.
For the next several years Ai Pun visited leprosy villages, giving them the personal attention and spiritual guidance that no one had offered them in twenty years. At first I was concerned about his diabetes, because he never had any refrigeration for his insulin. But for him, the insulin always seemed to work. He and his wife are long gone now, but today most of their eight children are college-educated leaders in the Lahu community.
Sala Yawtha Chang was my next-door neighbor in Kengtung, and a leader of another group of Lahu Christians. I differed with several of his theological and medical beliefs, but I’ll never forget that, even though he believed blood once lost is gone forever, he still gave a pint of his own blood three times to help a man I was treating for recurrent internal bleeding.
The pastor of the Shan church at Kangna once came to me with a sore eye. I diagnosed dendritic keratitis, a viral infection that never responds to bacterial antibiotics, and that can destroy the eye. I painted his corneal ulcers with a special iodine compound repeatedly, with eventual success. The Kangna congregation, fifty or a hundred people in the l960s, now is reported to number around a thousand. The pastor must have continued to do good work. And the pastor in 2001 is a former hospital night watchman, on whom I performed an emergency appendectomy forty years ago. So even though I am not a prolific preacher, God has enabled me to be instrumental in other ways, as he can with each of us.
Some of God's servants are cultivators, some are harvesters. I perceived my work as preparing the ground. Or, if you prefer, I am the salesman with a foot in the door, offering a product (medical care) to which the householder could relate, until he saw that God had something even greater to offer.
Lois and I were sometimes parental surrogates to some of the nurses whose own families lived hundreds of miles away. Inevitably, these young ladies attracted suitors, and marriages took place. Fascinated by Western wedding customs, and seeking an exotic touch to the ceremony, they would ask me to give the bride away, or Lois to make a wedding cake, or blonde Susie to be one of the flower girls.
Lois was also able to assist others in bringing God’s word to those who had never heard it. For about a year, she went weekly with a Shan friend to Wan Mai, a village of new Christians, to teach reading and Bible. When a group of armed insurgents demanded a ride to a village farther on, her Shan friend told them, “We are women, we can’t do that.” This was apparently an acceptable answer. For a couple more weeks, I went with them, once passing a truckload of young men with rifles sticking out of the vehicle at all angles. Soon after, the Burma army shut down local travel outside the city. Lois often drove the hospital jeep truck to pick up market supplies or to drive a patient home. Even with no overt evangelism, small-town girls saw a woman actually driving a truck, and perhaps caught a vision of what might be possible for them some day.

Monday, September 15, 2014

Clinics Beyond the End of the Road

Dr. Gunter Kittel's account (PNG Attitude's blog, 'Bush Clinic at Nankina', 07/Sept/2014) is an excellent account of difficulties in bringing medical care to remote areas . His team went by air to the village of Nankina, Papua New Guinea, where the clinic had been closed for years, depriving 6,000 people of any medical care. The plane landed them all right, but when it came time to leave, heavy rain prevented air transport and the team had a three-day walk through deep mud to reach the coast. Frequent return visits are thus impossible.

This same problem was addressed for hill tribes along the Burma/Thai border in medical work with American Baptist Foreign Ministries in 1965:

The road had barely reached Maesariang district of Thailand's Maehongson province that year. Private air service and two-way radio were not permitted back then. Walking, or in a few cases riding an elephant, was the only way to contact most villages. Because hill villagers trusted their traditional medicine men, the Karen tribe members of our 10-bed hospital's board proposed reaching the villagers by offering to train their medicine men.

The board sent invitations to villages one or two days walk from Maesariang, suggesting that each choose two people to attend a three-day course. Each village would get a free box of medicines, with refills at cost. I chose the contents, mostly simple remedies for fever, diarrhea, pain, malaria, anemia, etc., including one or two simple type antibiotics.

Eleven villages responded. Each night after clinic hours, I taught how to use the medicines; other staff during the daytime taught sanitation, nutrition, maternal and child care.

Most students had only two three years schooling and knew nothing about bacteria. I introduced the topic by briefly mentioning familiar forest dangers like tigers and snakes. Then I scaled it down to mosquitoes, lice and other small critters they recognized as nuisances. Finally, I taught about still smaller "germs" that could enter the body and cause some of the diseases in their villages. I had our lab tech set up a microscope slide with a drop of swamp water, teeming with live organisms, for them to see.

The talks also covered a few simple rules for treating fevers, cough, etc., and when to send a patient to the hospital despite the distance. Some of them asked intelligent questions and taught me a lot about their traditional ways of treatment, especially childbirth. Others just sat there, and we had to hope that they would at least do little harm."
I learned to listen as well as speak. Not to tell them, "No, not that way", but 'Yes, and . . ," building on what they were already doing correctly. Karens traditionally encourage bleeding after the baby is delivered, placing a warmed stone on the mother's belly to get the "bad blood" out. I agreed that the womb should be emptied of clots, and showed them the way to massage the womb through the relaxed abdominal wall, to get it to contract. That way blood stays in the blood vessels, where it is "good blood".

We encouraged them to let diarrhea patients drink water, rather than to limit it. We explained the danger of applying cow dung to a burn. One Karen leader pointed out to the students that several green plants they regard as weeds are actually a good source of vitamin A, that would prevent one common type of childhood blindness. We encouraged proper prevention of measles, which killed so many children, despite the traditional Karen treatment of giving them pig urine.

By far the most popular session was two nurses teaching about family planning. The students stayed a full hour overtime to ask questions about ovulation, anatomy, and safe methods of preventing conception, all new topics to the Karens.

Altogether, everyone thought the conference a success. In following years, the hospital repeated it once or twice a year, with special conferences for village midwives, or for seminary students going out into hill villages.

In the 1990's the government in next-door Myanmar closed its civilian universities (for political reasons) and then realized that they had no new medical students to graduate. They invited my wife and me back to Myanmar as consultants to a medical group in the Kachin State. At the time we last went into Myitkyina and Putao in 1998, the group had trained 500 village health workers. each caring for about 30 households in their home village.

Villagers with a week's training are certainly not as good as university-trained nurses and doctors. But they are better than nothing, in the rainy season or beyond mountain airstrips.

Wednesday, September 10, 2014


Balloons fail to excite me. They are irritating, boring, trite. They are very politically correct nowadays, a popular way to urge joy and sensitivity on people, who may or may not be receptive at the moment.

Purveyors of new cars, party supplies, or political candidates are among those who dispense large numbers of balloons, and whole shops have sprung up in most cities, offering balloons as a substitute for saying it with flowers. Balloons rival T-shirts and coffee mugs as a way of expressing sentiment. Many of us may not fully agree with these sentiments, but we don't like to create a public scene by refusing the dam’ thing, so we allow ourselves to be bullied into accepting a balloon from some sad-eyed woman in a garish clown costume, or from an aggressive public relations agent blocking the aisle in an exhibit hall.

I have always been puzzled by ecology groups that celebrate the pristine purity of nature by getting the people at rallies to release a thousand balloons bearing, for example, the inscription Save the Ducks. The cloud of color soaring upward is very impressive. Up, up they go, carried eastward on the wind to disappear high over the horizon, invisible when they finally burst and send a thousand pieces of rubber-litter down on some forest glade or lake. Perhaps the ducks will think they are something to eat, and choke on them.

But returning closer to home, bouquets of balloons and other happiness icons are not so bad when delivered to the privacy of the home. Usually a van with some logo such as Giggles and Smiles, or Daisy's Bloomers and Balloons (one hopes that this is a florist shop) will stop at my door, and a bouncy delivery person will ring the doorbell and thrust a large artistic creation into my hands. The delivery person's smile is only semi-spontaneous; she does this all day long, and probably knows that I am thinking now what am I going to do with this? But she is just doing her job, so I thank her, close the door, put the creation on the table and search for a card of explanation. At least I can be grateful she didn't deliver a singing telegram along with it.

Here's the card: "Happy seventeenth anniversary from Bill and Barb!" or "Congratulations on whatever!" will mean sending a thank-you note (that's assuming that Bill and Barb have at some time past given me their last name and address). But at least I am in the privacy of my own home, and don't have to walk six blocks to where I parked the car, towing a balloon on a string.

In the latter instance, if I am lucky, I have a kid with me, and can pass the string to him/her, tying it to a wrist so it won't go sailing upwards accompanied by anguished wails. Or maybe you have already experienced the anguished wails when some grimacing clown has bent down with a latex bag of gas twisted into some ill-defined animal shape, to offer it directly in the little tot's face. Never mind; hide the creation in the crook of your arm. The kid can get used to it later. Try not to let it explode in his face. Unless, of course, he keeps rubbing his hand on it, making a sound like fingernails on a school blackboard.

Once the balloon is home, there are several things you can do with it. The first is, let it float up to the ceiling, safely out of the way. It can stay there for several days, requiring no further comment, and showing everyone that you are not such an old curmudgeon after all. In about a week, enough helium will have slowly leaked out to make it lose buoyancy and sink to lie restlessly on the floor. Now is the time to carefully clip off short sections of the string, or maybe trim the edges on those shiny metallic balloons, to where it is exactly light enough to float in mid-air. There will be enough imperceptible air currents in the house to waft it almost anywhere. Tonight it may silently drift up to hover over your mother-in-law's left shoulder, causing her to sense a presence there, turn, and shriek. (Maybe it's a balloon with a smiley face. So much the better in the semi-darkness).

When all the string and other non-essentials have been clipped, and the balloon has finally lost enough of its gas to sink to the floor, never to rise again, there is yet one more function it can serve. A lungful of helium does odd things to your voice; ordinary conversation sounds like a comment by Donald Duck. Choosing your moment carefully, you can inhale the remainder of the helium and make a conversational remark two octaves higher than your usual voice to some unsuspecting person. Perhaps the phone has just rung, or a solicitor for Save the Ducks is at the door.

Or, with suitable warnings about the dangers of more than one low-oxygen breath of helium, maybe you can amaze and amuse a medium-size grandson or niece with your new voice. The possibilities are endless.