ONE HUNDRED MILLION IN THE AUDIENCE

ONE HUNDRED MILLION IN THE AUDIENCE 2,380 wds

In 1979, Communist Viet Nam invaded Communist Cambodia, where Pol Pot had set up his Khmer Rouge government. The Khmer Rouge are said to have executed between one and two million of their own citizens during Pol Pot’s doctrinaire rule. During rainy season, the mud kept the two armies apart. But in late October, the Vietnamese tanks could move across the land again, pinning the Khmer Rouge army against the Thai border.

Each army had tried to deny food to the other, and so each side had destroyed crops wherever they found them. Hundreds of thousands of Cambodian refugees, mixed with fleeing Khmer Rouge soldiers, were caught in the hill forests of southwestern Cambodia. They had no food except leaves on the trees, and no protection from malaria and other forest diseases. As the Vietnamese army drew closer, a half-million or more sick and starving human beings fled across the border into Thailand.

There was nowhere to put them. The daily newspapers carried pictures of dying children and mass burials. Thirty-thousand refugees flooded across the border in a single day, near the border town of Aranya Prathet, and were vulnerable to the mortar shells of the pursuing Vietnamese. The Thai army assembled dozens of buses to move the refugees away from the border, and set up the first of many camps by clearing a field near the town of Sa Kaew.

Up in Mae Sariang. 500 miles to the northwest, I wrote to our former neighbors Bob and Pat Coats who now worked at mission headquarters in Bangkok:

"We understand that some 91,000 have come across the border from

Cambodia this month, that a great many need medical help, and medical workers are swamped. We try to look at this realistically and not let our emotions run away with us. But the thought persists that here we are, in our slack season, [in rice harvest time]

seeing patients for only 3 to 5 hours a day, when there is this shortage of

medical help down on the border. We could spare a doctor for a month

or so if you can use us. We don’t know if this is God’s will or not, but thought

we would make the offer and see what he does with it."

A telegram asked us to come as soon as possible. Lois and I were in the first group to go, along with Rosa Crespo-Harris, Mala (a Karen nurse) and Weena, a Karen nurse-aide. We drove to Chiangmai next day and took the overnight train to Bangkok, where Bob and Pat Coats met us. They explained that we would be on loan to CAMA Services, the relief arm of the Christian and Missionary Alliance Church. We would work at the Sa Kaew camp, three hours drive east of Bangkok, where Red Cross was setting up a tent hospital. CAMA had a permanent medical team coming from Holland, but they wouldn’t arrive for two weeks. Rescue workers said thousands more refugees were scattered about the border area, many of them too weak to walk. The camp had existed for four days when we arrived, and of the 30,000 refugees, 1,200 of them were in the make-shift camp hospital. Some ill Communist soldiers were among them, but those strong enough to fight were still across the border in Cambodia. Sa Kaew was far enough back from the border to make hot pursuit by the Vietnamese unlikely.

Our driver turned off the highway and stopped at a Thai Army checkpoint, where a Red Cross worker gave us ID cards. My first impressions were of a sea of mud, surrounded by barbed wire. Thousands of make-shift lean-tos― blue plastic sheets supported by a few sticks― crowded the fields. Our first problem was to navigate the deep mud. We picked our way from rock to tree root; at one point, Lois had to reach elbow-deep into the mud to retrieve a shoe. The hospital area was on slightly higher, more solid ground.

The refugees were deathly afraid of the Khmer Rouge among them, and we had no way of telling who was who. We just treated them all as the severely ill humans they were. We didn’t even have a translator for the first two or three days.

That first day was chaos. We were put to work immediately on arrival, I with another new doctor, Lois over in a large tent full of orphan children, and we lost track of the other team members. None of us knew where things were, or even what was available. Each of us scrounged through the supply tents to find whatever might be useful. At dusk, another convoy of army trucks arrived, bearing yet more starved, feverish, even unconscious people, with meager bundles of cook pots or other small possessions. Some made no move to get down from the truck, and workers clambered up to pass them down to those of us waiting on the ground. Another worker and I struggled to carry a comatose man on a piece of box-cardboard over to the perimeter fence and pass him through the barbwire to others inside.

Severe starvation resembles being isolated in a blizzard. First you burn the firewood to keep warm. When the firewood is gone, you break up the furniture, and finally the walls of the house itself, to ward off death. Many of these people had lived off nothing but their own body tissues for weeks, and had arms and legs scarcely bigger around than their skin-covered bones. They had lost all fat and most of their muscle, to fuel the remaining small spark of life. Even the proteins to make digestive juices were gone.

We had to be very careful not to overload their digestive tracts those first few days. We started with clear broth, with a little rice and vegetables added. Some couldn’t even handle that, and quietly died after reaching the camp. After a day or two, we added protein gruel, “Kaset food” made by Kasetsart University in Bangkok. Weena carried a pail of it back and forth, ladling out a cup twice a day to each of our ward’s hundred and fifty patients. Later still, rice and curry came from a central kitchen for all 30,000 in the camp. Different volunteer groups managed each of the dozen or so tent-wards; we cooperated with each other, but we were too fatigued to socialize much.

We treated malaria, diarrhea, pneumonia, parasitic worms, anemia, and nutritional deficiencies. The chief deficiencies were iron (malaria destroys red blood cells) and beri-beri (lack of thiamine, one of the B vitamins, causing nerve weakness and heart disease.) That first day, we had nothing to clean patients with, nor any change of clothing for those who had soiled themselves. Each morning when we came to work, those who had died in the night had been left outside the tent, rolled up in their bamboo mats. We took the dead to the penetrating stench of the morgue tent at the far edge of the hospital area, to await burial in mass graves by Buddhist monks who volunteered their service.

Those first few days, silence reigned in the hospital tents except for coughing. Not even a baby crying. Everyone lay there on mats, too weak to move. I remember how, during the first week, they gradually began to talk and even smile and walk around as they grew stronger. In particular I remember two men, an amputee and a blind man, who often walked together, the cripple on his crutches, holding a guide-stick for his blind friend to grasp and follow.

Daily bus-loads of volunteers swarmed out from Bangkok to respond to the need. Leaders of Bangkok society mingled with students, digging ditches, feeding patients, acting as go-fers. Our daughter Nancy and some of her schoolmates from International High School used their "Senior Sneak" holiday to come help. One elderly European man, with whom I could only converse in Thai, adopted an old Cambodian who was too weak to lift a spoon by himself, and stayed with him night and day until the old man died.

Bob Jono, a CAMA supervisor about half my age, saw to the medical team’s needs. He found us a Khmer man who spoke Thai, and a Khmer girl who had returned from her home in New Zealand to help her fellow Cambodians, despite her terror that the Khmer Rouge would murder her. That made our job much easier. Through an interpreter, we could hear the patient's symptoms; we no longer had to practice "veterinary medicine."

Jono and his crew also made sure that a hot meal awaited us back at our house in town each night. The camp had a security curfew, not even medics were allowed to stay after dark, except for a single team to keep watch over the whole thousand-bed hospital from six pm until eight a m. Jono and I had to stay after the rest of the team left, for staff meeting at the Red Cross tent, where the day’s problems were worked out. I got back to town each night about 7:30 p.m. after a thirteen-hour day, ate supper, and fell into bed.

The second week was a little better. Fewer died, and many were obviously recovering. A lab technician appeared from somewhere, and set up a blood transfusion service. He split every pint in two; even a half pint is enough to help someone with a hematocrit of only two. By mutual consent, the medical teams refused interviews unless the reporter could show his receipt for donating blood.

An orphan girl in our tent, eight or ten years old, pointed excitedly one morning at the passing people. Her father and sister had just passed by; she had been separated from them a year ago! And a little girl who had been bed-ridden with beriberi heart disease squealed in mock alarm as her sister told her I was going to give her a shot. (I wasn't.)

Lois and I had even taken our turn on the all-night hospital crew. There isn't much you can do for a thousand patients, most of whom you've never seen before. The four of us (another nurse, Ruth Jones, and Tan, the translator) tried to visit every ward at least every three hours and be sure the IVs were running properly. We removed two patients who had died; checked one teenager with severe diarrhea, and a couple of women in labor.

About three o'clock in the morning, I took a few minutes on a break to gossip with the Israeli military doctor from the triage tent, the one other medic who was allowed to stay all night. We watched a team of workers adjust the new lighting on a scaffold outside, where a drilling crew was sinking a well. As we looked up at the scaffold, I said meditatively, "Haman built a gallows, fifty cubits high . . ."

Startled, the Israeli demanded, "How did you know what I was thinking! Where did you hear that story?"

"Hey, the book of Esther is in our scriptures too, just like yours."

News media were everywhere, every day. A man squatted beside me with a hand microphone as I treated a boy with pneumonia, and asked me to describe the case. I am told I was on Voice of America Radio the next night. A few days later, a television crew from NBC taped the hospital. I happened to be the only doctor available who had an American accent. Letters from back home later told me I had appeared in all the bars in Kellogg, to shouts of “Hey! There’s Doc Dahlberg on TV!” The broadcast was repeated several times all over USA and Europe, probably the only time in my life I will ever speak to over a hundred million people. At the time, I was more concerned with tucking my feet under me so the camera wouldn’t show how swollen my legs had become from long hours without rest.

Rosalynn Carter talked with Lois when the First Lady toured our tent. (I missed that because I was at a meeting back in town that day, orienting a group of newly arrived doctors.) Mrs. Carter asked her several questions, but Lois says her own finest moment was in response to all the newsmen, who nearly trampled our patients as they shouted at her, “Get down! Get down!” so they could get a clear photo of the President’s wife. Lois said, “If the reporters would move back a few feet, they wouldn’t be standing in the patients’ latrine ditch.” A lady in the group said, “Oh dear! I wish I’d known that a little sooner.” And one of Mrs. Carter’s Secret Service men grinned to Lois, “Say it louder. We’re being recorded.”

We were more tired every day than I can ever remember being. And I felt a dull anger as I watched some of my patients die, anonymous and alone, an anger at those who start wars and let others pay the consequences. But you suppress your emotions after the first day or two, because you have to choose between emoting about the tragedy, or doing something to fix it. I found I don't have enough personal resources to do both.

But the feeling I remember most, and am most grateful for, came to me one evening after the nightly staff meeting, as I drove back to town alone in the warm night air. Through the open car window I inhaled the pungent, vinegar smell of the tapioca crop drying in the farmyards I passed. I felt at peace, tired but no longer drooping with fatigue.

We had taken everything that Sa Kaew camp had thrown at us, and most of our patients were getting well. And I thought, I can do this! I can practice medicine under the worst conditions, and still look anyone in the eye and know without any doubting: I am a doctor! No one can ever take that away from me.

And I shall always remember the effect a single letter or action can have on one's life when mailed at the right moment, not only on other people's lives, but on my own as well.