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.
