Sunday, August 31, 2008


Sunday, August 8

Once again, we rise early and meet the rest of the group for a good breakfast and some words of inspiration from Omar. He's a gifted speaker, and every morning he sends us on our way with a great devotional to think about as we go. I love to hear him pray. It's like eavesdropping on a conversation between him and God. His prayers are simple, direct and personal. He sounds completely comfortable, no
flowery language, he's just talking to a friend. It's beautiful.


One morning, he told us about the "under-rowers" on the tall trireme ships, used in ancient times primarily as battleships. There were three tiers of rowers, and those on the bottom tier, deep in the hold of the ship, had the hardest and least glorified job of all. Their oars dipped more deeply into the water than did those of the upper tiers, yet they had to maintain the rhythm of the rowing for the rest of the ship. They rowed to the beat of a drummer, faster or slower according to the tempo he set. No one could slack off or lay back at all, because then the oars would become crossed, the rhythm would be disturbed and the whole ship would be put at risk. He encouraged us each to see ourselves as an under-rower, probably not a recipient of any glory or recognition, and often with a difficult job to do, but nevertheless a vital part of the group effort. We left that morning, eager to do our part, and there was never a word of complaint from anyone that day.

Today, we're going out to a different site. During the night, the Mustangs have dismantled our two tents and five gers, and moved them to the new site. In our clattering vans, we drive further over paved road, then turn off onto a rough and rutted track, rougher than the road to our original site, if that's possible. When we arrive, there are our two tents, and our five gers, and a sixth ger, about a hundred yards away from the others. This, we learn, is the food tent. Our original five gers now house the pharmacy, three doctors, and a dentist from town, who has joined us today.

By now, Toom Chris and I know the drill very well, and set up our table and benches quickly. We each have our own stethoscope and blood pressure cuff, and there is a pedi-size cuff that we keep on the table between us and share it. We each sit astride a bench, and our clients come in and sit on the bench in front of us, with our interpreters hovering nearby. What on earth would we do without them? They are unfailingly cheerful, and carry their little English-Mongolian dictionaries to help them over rough spots. BatBubba is a bit more proficient, having spent some time in the US, but the girls are pretty good, too, and eager to learn. My sweet Biamba has been replaced at this site by equally sweet Moogi, (or Moogii, I'm not sure) and she's a joy. Here's a picture of all three:


We begin seeing clients, and for the most part, it's pretty much the same as the last three days. Terrible blood pressures, pain in kidneys, stomach and joints, gallbladder pain, headaches. Toom Chris and I have decided that this is all attributable to their diet and the fact that they beat themselves to death on those awful saddles all the time. My kidneys would hurt, too! Heredity may influence the blood pressure, and the blood pressure isn't doing their kidneys any good, and certainly will give them headaches. The stomach pain may be from that wretched erek, the mare's milk concoction. Anyway, we have it all figured out. We should be doctors!

The people look much the same as the ones we saw at the original site, though if anything, they're a bit more "rural", if such a thing is possible. At any given moment, there are about thirty horses tied to the trees surrounding the clearing - a Mongolian parking lot.

We see a steady stream of people, and then it's time for lunch. We close up shop and walk the hundred yards or so to the food tent, wondering what lunch will be today. I could go for some more of those little meat pies. However, today we have something different. Under the lid of one five-gallon bucket, we find a mixture of diced potatoes, MUO (that's meat of unknown origin, you'll remember), a little onion and a mild seasoning. Mongolian hash, and it smells good! In a second bucket, we discover shredded potatoes, MUO, a little onion and a mild seasoning. Hmmm. The choice seems to be between diced or shredded potatoes. No problem. I get a little of each! A little slaw (there's always slaw), a hunk of bread and some Mongolian catsup rounds the meal out. Mongolian catsup is good. It's a bit thin, and tastes like a cross between catsup and Tabasco, so naturally I love it, and it's great on the potato dishes.

With a handful of the ever-present dried peaches to chew on, we return to the tent and go back to work. We finish up, and the day ends uneventfully. We make the bone-jarring ride back to town easily. We're used to it by now, and manage to make congenial conversation the whole way. The landscape is so vast and beautiful, the cloud formations are breathtaking with the setting sun reflecting on them, and the peace that descends at this time of day is almost palpable. I could learn to love this country.

Back at the hotel, we have dinner and again share the experiences of our day with the other teams. The construction team reports on the progress they're making as they work on building bathrooms onto each Mustang dormitory, and try to get the plumbing finished. They had a problem when they ran out of materials at one point, but they were undaunted. A couple of the men simply boarded a train for Ulaanbaatar and went after what they needed! That trip took us four hours by bus, and that was a direct run. The trains make every little whistle stop and winding detour, so it took them much, much longer, but they went anyway. They got what they needed, which took quite a bit of shopping and looking - remember, there are no Home Depots in Ulaanbaatar. After a while, if I remember correctly, they were met by a truck from CTW, and returned with the goods. The work goes on.

You'll recall I told you earlier about the group that works at the infant feeding station. This is a daily endeavor, and takes a lot of time and devotion. A few mothers are fed there, too - the ones who appear particularly undernourished and sickly. Not only is the ministry concerned for the mothers themselves, but if they're lost, then the child becomes an orphan, along with any siblings, and will add to the numbers of children who are under the care of CTW.

The humanitarian aid team has been visiting in the apartments, passing out bags of food, and has uncovered some real horror stories. They are seeing the absolute poorest of the poor, and the things they have seen are almost unbelievable. I know we have poverty and want in the US, but I'm not sure we have anything like this. They tell of finding whole families living in the space under a staircase. That would have to be about 5x10 feet, not much more. Many of us have closets larger than that. They have no power, no heat, certainly no a/c, no water, no toilet. One woman heads a family of eleven living in such a space, all dependent upon her for support. She ekes out a living by sweeping the doorsteps of nearby apartments, for which she is paid a few cents a month.

This story was told at one table at dinner, and we had just learned that a ger sells for about $600. Well! We have the answer to this woman's problems! There are about thirty of us present, and if each kicked in $20, we could buy this woman a ger, and move her out of that staircase hole. We're about to pass the hat, confident that we can do a humanitarian deed here in a few minutes.

Then Jerry Smith appears, and with great tact and kindness, he helps us to see that our effort won't work. Yes, we can buy her a ger, but where would we put it? She has no land. True, we can put it out on the plains, where she could live for four months without paying anything for the land, but then she would have to either move or pay up, and she would have no water and no way to go get any. She has no help or vehicle with which to relocate the ger, and no money to pay up. Also, her livelihood is tied to these apartment buildings, and if we move her to the country, she has no income at all. T
he herding families have their livestock from which to obtain milk, meat and a little money from selling the offspring, but she has no livestock, and probably doesn't have any experience with animals, either.

Jerry also tells us that in many cases, these families have been offered job after job, but they refuse them. Many of them prefer to eke out a living by picking up cans and other recyclables and selling them, sweeping doorsteps, whatever, because they can do these things or not, whenever it's convenient. They don't want to be obligated to show up for work somewhere. Often what money they do manage to get is spent on alcohol. Hmmm. This all has a rather familiar ring to it. Not much different from the welfare rolls at home..

Jerry says he'd much prefer that we just continue to support CTW as we have been doing, and trust them to administer the funds responsibly, applying aid where and how it's most needed. He thanks us for our generous spirit, but then gently points out that we're here for only a week or so, and his staff is here all the time, and know the people and their needs better than we do. He needn't worry about trust as far as I'm concerned. I really can't imagine questioning him on anything he does. After all, he's willing to live in Mongolia, and I'm not.

In one apartment, the team saw a child who was said to be four years old, but was extremely small and thin, weighing about twenty pounds. He appeared to have some brain damage, doesn't walk or talk, and his eyes don't track. He was just lying on the floor, seemingly unaware of his surroundings, crying a little now and then. The team left a bag of food with the family, but still felt that something more needed to be done. As they shared the story with us at dinner, their concern and distress showed on their faces, and we were all touched by the story.

After dinner, Eloise and I returned to our room, neither of us talking very much. We looked again at the makeshift faucet arrangement and the wet tiles in our bathroom, at the stained pillows and ripped pillowcases. We sat down on our hard, low beds and looked across at each other, and then simultaneously we said, "At least we're not living under a staircase!" It is to become our watchword.

Saturday, August 30, 2008

Saturday, August 7.

We are up bright and early, have a quick breakfast and by 8am, we are in the vans headed back for another day at the remote site. When we arrive, there are a lot of people already there, waiting for us. Word has spread, apparently. They smile and nod at us, not at all out of patience at having to wait. I have never met kinder or more gracious people.

We set up shop, Toom Chris and I, and after a few minutes, the intake team starts sending us clients. One old granny lady hobbles in, carrying a bowl of the ever-present dried milk curd pieces. These are a bit different, as a white substance has been spooned over them. It looks like cottage cheese, but it doesn't taste like it, unfortunately. She presents the bowl to us using both hands, Mongol style, and we accept it with both hands. She stands expectantly, so we each take a piece of it and nibble away. She is very pleased, her weather-beaten face crinkling as she smiles. The large gaps in her stained teeth somehow do not detract from the joy that shines in her eyes as we partake of her gift.

She sits down on the bench in front of me, and I take her vital signs. Naturally, her blood pressure is terrible. Through sweet Biamba, my interpreter, she begins to recite her litany of aches and pains. She describes them in detail, and places a gnarled hand over each location as she speaks. Pain of kidney, pain of bile (gallbladder), pain of heart, pain of stomach, pain of head, pain of knees. She rubs her knees with wrinkled, knobby hands. Arthritis, of course. I glance at the old woman's card. She is 62. Dear Lord. I'm 65.

Lunch is more of the little meat pies and the cabbage, this time accompanied by chopped tomatoes, no doubt from the greenhouses back at the CTW compound. They're delicious. There is also more of the hard dry bread, and I find that I've changed my opinion since yesterday. I eat a slice. We eat and enjoy the food, exchange war stories with other team members who are present, laugh a lot, and return to work, chewing on some of the leathery dried peaches along the way. I'm having the time of my life.

We continue to see people all afternoon, and again, I'm amazed at the toughness and resiliency of these people. Their blood pressures are horrible. Americans with blood pressures like these would be on six different medications, and would probably still stroke before they reach 40. Yet these small, tough people keep going. How do they do it?

One family comes in, a man and wife and small baby. The baby is adorable, wearing a little knitted cap with mousy ears on it, just as an American baby might wear. The mother is wearing jeans and a sweater, and leather riding boots, while the father is in traditional Mongol dress. It crosses my mind that there is no stroller, no diaper bag, none of the elaborate accoutrements that American parents think they must have when traveling more than a hundred yards with their baby. Guess what, there isn't even a car seat! They don't need one. This becomes evident as the family leaves, because the father goes into the bushes and comes out leading two horses. He mounts one, the mother hands him the baby and then mounts her own horse. The father jams the infant down into the saddle in front of him, and with a slap of the reins, they gallop away, with the baby's little head bobbing to the rhythm of the horse's hooves.


Back at the hotel, I find Eloise and we go to dinner. She has been working with another team, preparing food at one of the feeding stations, helping to feed babies that are brought in for what is probably the only meal they'll get that day. I think that her job is much more difficult than mine, because she's seeing people in real, dire need, especially the little children. The people I'm seeing may be poor by most standards, but they do have their livestock, and they're not underfed. Their life is rugged, and they work very hard, but they don't go hungry.

After dinner, we return to our room and try to wash off the day's accumulation of dirt. I say "try", because there's always that ridiculous faucet arrangement to contend with, and after all the leaks are supplied, the flow from the actual shower head itself isn't much to brag about. Still, it's water, it's wet, and eventually we get clean. Clean enough, anyway.
We get into our beds, and I lie awake for a few minutes, wondering what tomorrow will bring. The medical team will be going to another site, even farther out into the countryside than we've been for the last three days. I think I'm going to miss our old camp, I've gotten used to it.

Saturday, August 23, 2008


After bouncing and churning over miles of unbelievably rough terrain, we come to a stop near a group of three gers. There is a small corral, some cattle and assorted goats, a wolfish dog, and four saddled Mongol ponies. We climb out of the vans, and learn that we have been invited to the home of a Mongol family.

Our host is the man who was driving the jeep. He is handsome, his features a bit more finely-cut than most Mongols, and he sports an American-style crewcut. He's wearing a white shirt which is cut almost like our Western cowboy shirts, black pants and of course, riding boots. He is trim, muscular and very fit. A broad smile seems to be a permanent fixture on his face, and his whole demeanor conveys a genial welcome.

We are led, almost pulled, into the main ger and urged to be seated. The ger is surprisingly roomy, and easily accommodates about twelve of us, plus the man and his family.

Our hostess has prepared a spread of traditional Mongol food, and has obviously gone to a great deal of effort, and probably significant expense. There is a wide array of little tidbit foods, and a platter of roasted mutton, with some boiled potatoes alongside. We are encouraged to serve ourselves, and since there are no serving utensils to be seen, we find that fingers work very well. The mutton is tough and stringy, but tasty, and I enjoy a few bites. The potatoes are, well, boiled potatoes!

There are some small things which look like cookies, but which prove to be very hard and have almost no taste. The hostess indicates that we are to dip them into a creamy-looking concoction, which to our surprise is delicious. It tastes like sweetened, buttery cream, and the combination with the hard little cookies is really very good. There is a large platter of the slices of dried milk curd, which seems to be a staple of the diet around here. We have been given several plates of it as gifts, brought in by the locals and presented to us with pride. We have tried to eat it, but it's not easy. One could easily break a tooth, and the stuff is truly not worth the loss! Still, out of respect for our hostess, we each take a piece and gnaw on it a bit. I slip mine into my pocket when no one's looking.

There is a plate of sliced cheese, which looks delicious, but which proves to be hard, dry and leathery, with no taste and is almost inedible. It seems that almost everything they make from milk is hard and dry, and I think I know why. With little or no refrigeration available, at least in the summer, anything that wasn't completely dessicated would mold or otherwise spoil. In the winter, they just sit things outside and have instant refrigeration, but in the summer that doesn't work. So, they have developed a process for drying everything, which keeps it very well. I'm not sure how they do it, but I suspect it's a method that has existed for centuries. These people keep traditions!

Then comes the moment we have all heard about, and have been dreading. The hostess brings out a lovely blue and white china tureen, beautifully painted, and a ladle. She begins to fill bowls with a frothy white liquid. I can smell it from where I sit, several feet away. The bowls hold about a pint, and she fills them to the brim. To serve anything less would be considered very rude on her part. The liquid, we know, is "erek" (phonetically spelled). It is made from mare's milk (yes, they milk their horses), which has been fermented for a long, long time. There are small lumps floating in it, and occasionally a vein of clear liquid will appear. She stirs each bowl and begins passing them around. I try to disappear, but can't quite manage it. I receive my bowl and thank her.

The smell is awful, rather like spoiled buttermilk. Now, I like buttermilk very much, but I never drank it if it was spoiled. I can't imagine how hard this would be on someone who doesn't even like buttermilk. Our handsome host is smiling at me, nodding eagerly, obviously anticipating my pleasure in his most cherished offering. I'm trapped. I have no choice. I take a small sip and somehow manage a smile, as the "kick" coursed through my insides.

The taste, surprisingly, wasn't quite as bad as I expected once I got past the smell, but it is definitely not something I'll ever forget, or ever acquire a taste for. It's sour, of course, and has a gamey taste, and of course, that kick. Yep, my very first taste of an alcoholic beverage! I had to come all the way to Mongolia to do it.

The host and hostess continue to urge us on, and I take several more sips, as much as I can muster. Finally, knowing my limit, I put the bowl down on a ledge beside me and try to ignore it. The awful taste is still in my mouth, as another bowl comes my way, passed from one to another. This is a communal bowl, and everyone seems to accept that fact. It contains a clear fluid, like water, but it definitely isn't water. It's Vodka. I know it's Vodka. I have heard that Vodka has no taste, and hoping that it might wash out the taste of the erek, I figure, well, why not? I've come this far. So I take a swallow of the Vodka, and can truthfully say that it tastes worse than the erek! I have thinned paint with something that smelled like the Vodka tastes. I believe you could blow stumps with it. So much for that. Right now, I'd just really love to have a big glass of iced tea.

My host has noticed that I'm not drinking my erek, and points to it and makes drinking motions. I have no choice. A couple more swallows, and mercifully he seems satisfied. I put the bowl down again, and sit quietly, waiting for Genghis Khan's revenge to overtake me.

Soon, our host stands and invites us outside. He indicates that they have saddled the horses, and he would be pleased if some of us would care to ride. Well, of course, I'm there. My friend Karen and I mount up and ride a few hundred yards. The horses seem to have two speeds. Walk, and stop. We can't get them to move any faster than a walk, no matter what we do. Heels drummed on ribs were ignored. I don't know if they were waiting for a Mongolian giddyap, or what, but whatever the magic word was, we didn't know it. Perhaps they knew we crazy Americans would fall off of those weird saddles. That was a possibility, indeed. They leave you feeling very insecure, those saddles. Still, I actually rode a Mongol pony.

We ride back to the ger, dismount and others of our group take our places. Toom Chris is persuaded to try, and quickly finds out that his frame just simply doesn't fit in a Mongol saddle. He notified us that he would be singing with the sopranos in the choir from now on.

We are preparing to leave, and our genial host makes the rounds, giving each person a very firm, gentle handshake. I'm struck by his good looks. He has beautiful white teeth, with a gap between the two front ones, that does not detract at all from his appearance. His face is brown and a bit weathered, but less so than many I've seen. His eyes are bright and direct, and convey a friendly openness that is disarming. His clothes are Mongol, but there's a hint of Western in them as well. And of course, there's that American crewcut! These people are a strange combination of cultures, but the more I'm with them, the more I like them.

We boarded our vans, and bumped and bounced over the open plain, eventually reaching the highway, and headed back to the hotel. It was almost 10pm when we arrived, though just barely getting dark, but dinner was waiting. We had a good meal, and a time of sharing with the teams who are doing humanitarian aid visits in the town. Later, we returned to our rooms, and after a quick shower, I fell into my bed and was asleep almost at once.

Friday, August 22, 2008


Toom Chris and I arrived at the supply ger, and found two or three of our colleagues there ahead of us - one doctor, one nurse and our pharmacist, along with a couple of the Mustangs. There was also a significant number of flies. Yep, there are flies in Mongolia, and they look just like ours. Those of you who know me well can imagine how thrilled I was to see flies in the food tent, but I reminded myself that I was not at home, and no one else seemed particularly bothered, so I just tried to ignore them and didn't run about madly with a rolled paper or a swatter. Besides, I couldn't find either one. Apparently, no one swats flies in Mongolia.

The food was presented in five-gallon plastic buckets, which I recognized as having held the dried peaches we measured out into the bags of food for the needy families. They looked reasonably clean, so no problem. Inside the buckets, we found a pile of little folded-over pies, like a fried pie at home, but smaller, and I'm not sure they had been fried. They were steamed, I think. Another bucket held a lot of the very thinly shredded cabbage and carrots that we have seen before at dinner back at our hotel. It's hard to describe. There is a dressing but it's clear, not mayonnaise-y like our slaw at home, and the taste is very mild, but pretty good. We saw a stack of little pink cereal-type bowls sitting on the floor, and gathered that they were our "plates." Forks stood in a cup next to them.

I got a bowl, and by using another small bowl as a scoop, I scraped the top layer of the slaw off to one side (in deference to the flies) and scooped up a serving for myself, putting it in my bowl. Then reaching underneath the top layer of little pies, I chose one pie and went off to a corner (hard to do in a round ger) with my lunch. There was a slice of bread also, and after taking a bite of it, I decided I probably wouldn't eat the bread again. Hard, dry, coarse, and not a lot of taste to it. I ate my slaw, and nibbled at the little pie. Hmmm. Not bad. Not bad at all. It was filled with meat, which we were told was classified as MUO. That's Meat of Unknown Origin. Not very reassuring, but it was tasty, and I forced myself to forget that it could have come from any one of a number of different animals, including yaks and horses. I ate my little pie, and decided that perhaps I had room for another one. Ate that, too. I was hungry, for pete's sake! We stayed only a few moments after finishing our food, then walked back to our tent, gnawing on a handful of dried peaches, and carrying a bottle of water. Bottled water has been abundantly available to us so far.

We have seen another 30 or 40 people each so far in the afternoon, and they're still coming in. A huge dump truck comes grinding in, and people spill out over the sides. Someone assists a feeble old man with badly bowed legs, and hands him his crutch when he's safely on the ground. He's proudly wearing his del, and a little round derby hat. Hats, as I've said, are all the rage, and they range from Aussie-style canvas hats with rolled-up sides, to baseball caps, to Panama Jack styles, to Bing Crosby straw hats, to one tall silk top hat.

It is mid-afternoon, and suddenly there is the thudding of hooves, and in rides Genghis Khan himself. He is taller than most Mongols, dressed in blousy, purple satin trousers, a turquoise satin shirt that is made like the top half of a del, and one of the colorful, pointed Mongolian hats. He ties his horse to a nearby tree, strides into the camp, and someone directs him to the intake tent.

In a half hour or so, I look up to greet my next client, and realize it is Genghis Khan. He sits down on the bench in front of me, and I look into a ruggedly handsome Mongol face, and see that while his eyes are basically brown, they have lights of those peculiar green/gold colors in them as well. Very unusual eyes. I see also that the whites of his eyes are very red, and his eyes are watering. He doesn't smile, but rather maintains a rather severe posture. I get his blood pressure, which to my surprise is normal, and then my experienced little interpreter, Biamba, asks him what his problems are. He speaks for the first time, looking directly at me. His voice is very soft and gentle, and he speaks in a respectful and earnest manner, pleading for help. It's his eyes, he says. They are very red (he's right!) and they itch and burn and make tears all the time. It bothers him very much, and he hopes there is something we can do to help him. I'm very happy, because we probably can. We have allergy pills and eyedrops in our pharmaceutical supply. I tell him this, and he smiles broadly. A Mustang escorts him to a doctor's ger, and he's on his way to comfort.

A bit later, as we're about finished with everyone, he reappears, all smiles, and asks if Biamba and I would like to sit on his horse and maybe take pictures. Well, I suppose so!! Biamba was as thrilled as I was, and we each got on the horse and someone used my camera to take pictures. Genghis Khan held the horse, I think he didn't trust us, or maybe he didn't trust the horse, but he never let go. No problem. A Mongolian saddle is not the most comfortable thing I ever encountered, and though I'm usually quite comfortable on horseback, I felt very insecure and off-balance. The saddle is placed quite far up toward the horse's neck, and is made so that you don't settle into it, but rather perch against the high cantle. The stirrups are short, and the whole effect is to keep you almost standing, leaning over the horse's neck, and feeling very much like you could just pitch right over his ears at any moment. Later we learn that this saddle design came from the days of the true Genghis Khan, and was intended to make his warriors, who were probably of rather small stature, appear much larger and more imposing, as they rode into battle standing up and leaning over the horse's head.


Finally, the day ends. No more people arrive, and we finish the last one and send him to the doctor's tent. We pack up our equipment and leave the tent for a very welcome potty break. Our potty is a tiny gray tent with a zippered door and a small chemical container. It serves the purpose.

We have time to stand and enjoy the beauty around us. The sky is incredibly blue, the mountains to the west of us are awesome, the air is clean and fresh. We're camped on the bend of a swift river, and it looks inviting, but I'm sure it would be icy cold. The whole effect is one of beauty, peace and serenity. I mentally compare it to my own home, and remember the smog, the traffic, and the neighbor boy's booming car radio, and I wonder why anyone would want to live there. I know, of course, that it's home, it's what I know, and it's where my family is, but for just a moment, I have to wonder.

Finally, we are ready to leave, and we climb aboard the vans and start down the rutted road. A mile or so out, a jeep which has been following us since we left the camp suddenly passes us, bumping over the open plain. It contains a group of Mongols who are dressed like herdsmen, and I recognize the driver as a particularly charismatic man whose vital signs I had checked earlier.

The jeep passes our whole caravan, and takes the lead. Someone remarks that he was just getting out of our dust, and that seems reasonable. Not so, however. At some point, we realize that our vans are no longer on the same road we came in on, but rather are following the jeep over a barely discernible track over the plain. No one has a clue where we're going, but we don't really care. One road is just as rough as another, and besides, we're surrounded by breathtaking beauty everywhere we look. So, we just settle back into our seats, try to hang on and keep from being bounced through the roof, and wait to see where this mysterious man in the jeep is leading us.

Wednesday, August 13, 2008


About mid-morning, an elderly gentleman enters our tent. He is dressed in traditional Mongol attire, which consists of the ubiquitous leather boots, loose-fitting trousers, and a del. Since the Mongolian alphabet looks like ours only for a few letters, I may be wrong about the spelling, but it's pronounced like "the farmer in the dell." Anyway, a del is a kind of coat worn by men and women alike, and may be worn over just about any kind of clothing. The effect is charming. The person looks so "Mongolian" in their del, and underneath may be Levi's and a Hard Rock cafe T-shirt!

Back to the elderly gentleman. He wore his boots, trousers and del, and a hat that looked like a cross between a derby and a panama, if you can imagine. He entered the tent, and approached us, nodding his head deferentially, and smiling a huge smile that cracked across his weathered face like a sudden sunrise. His hands were worn and callused from hard work, and gnarled and knobby from arthritis. He was holding a curious little jar, with a loose lid. There were a few people ahead of him, and he sat down to wait, all the while grinning in anticipation of what he knew was to come.

When his turn came, he approached our table, said something in Mongolian, and our interpreters immediately told us that he wanted to share something with us. We nodded and smiled, and with great ceremony, he took the little jar, lifted the lid carefully, held the jar near his nose and inhaled sharply! A fragrance, perhaps? The interpreters quickly told us to accept the jar, and duplicate his actions, but to inhale very, very gently. It was presented to me first, so I did as I was told. I could see that the lid was attached to a little rod inside the jar, which obviously lifted the contents when the lid was lifted. I inhaled very gently, I'm happy to say, because the jar contained snuff!

I smiled and nodded at the man, and made a happy face, and he was delighted. When I returned the jar to the man, he presented it to Toom Chris, and was obviously very happy when Chris inhaled not once, but twice, and feigned great enjoyment. The old man was so pleased that we had enjoyed his gift, and just cackled with delight when the interpreters gave him our thanks and appreciation. He had shared with us one of his most precious commodities, and we had been pleased, so he was pleased as well. Incidents like this were repeated many times over the next few days, as people who have so little shared with the visiting Americans, who have so much.

Let me tell you a little about the "del." As I said, they're worn by both sexes, and even by the children. The main distinction between men's or women's attire is the fabric and fancy-work. For women, the fabric is usually silky, or like satin, and always very colorful, colors you see on butterflies and hummingbirds, jewel colors. Probably many of the garments actually are silk, but in today's world they may very well be polyester as well, though they still feel like silk. There is usually embroidery work, and the closures are elaborate ball-and-braided loop arrangements. For men, the fabric may be heavier, like suit-coat material, or it may be satiny and colorful, but with less embellishment than the women's coats. They close at the top of one shoulder, slant downward and fasten again under the arm on that side, and again at the waist. The sleeves are long, and the garment flares slightly below the waist. A long strip of colorful cloth is wrapped snugly around the waist several times and tucked into itself. This has the effect of making the whole top of the garment into a big pocket, and they carry everything you can imagine tucked into those dels.


Underneath these beautiful coats, a woman may be wearing jeans or cheap polyester pants and a worn T-shirt, and her footwear may be anything from riding boots to platform shoes over striped socks, but her coat is so beautiful that you just don't notice anything else.

The faces we see are fascinating. Most are dark, weathered and wrinkled. I see one face that looks at least 80 years old, but her card says she is only 52. Their lives are so very hard, and it shows on their faces. Most Mongols have black hair, dark skin and dark brown eyes, but now and then, peering out of a brown face, there will be a pair of sky-blue eyes, and sometimes the eyes are a strange green-blue-gold combination that I have never seen before. These folks usually have a lighter hair color as well, though not always. We're told that this coloration comes from the Russian occupation, and that most Mongolians do not find it particularly attractive. Still, I find these people to be strangely beautiful. Perhaps it's just the contrast.

We continue to see clients, and quickly learn to anticipate high blood pressures. Anyone with a normal pressure earns a comment from Toom Chris or me. I would estimate that at least 85% are significantly hypertensive. A systolic pressure (the top number) of 180 or above is common, and the diastolics (the bottom number) are usually over 100. Even those with fairly normal systolics will have high diastolics. We saw one 13-yr old whose pressure was 130/96. We saw many adults with pressures as high as 200/130. This is stroke territory, yet these people just keep on going.

Our doctors tell us that there is probably a genetic influence on their blood pressures, but certainly their diet plays a large role. They eat very little fruit and vegetables. Their diet consists almost exclusively of meat and dairy products, with a few potatoes now and then. I cannot imagine what their cholesterol levels must be. Hmmm. So much for the Atkins diet!

Many tell us that they are on blood pressure medication, but only take it "when I need it." Their determination of "need" is when they have a headache they just can't stand. Toom Chris and I, through our interpreters, try to educate them about the need to take their medication ALL OF THE TIME, whether they have a headache or not, but I don't think many of them really get it. It is such a common problem, and the interpreters have relayed it so many times, that I finally resort to just telling Biamba to "tell them the medicine story." She knows it as well as I do by now, and tells them, while I'm taking vital signs on the next patient.

We see about 150 people, and have finally stopped telling each other about the high blood pressures we find, because it's no longer news. The weather is hot and humid, we're tired and getting hungry, our ears are getting sore from the stethoscopes, and the lines are still very long. Where on earth are all these people coming from? We have worked all morning, it's nearly 1pm, and people are still walking in out of the bushes. For a land that looks so deserted, it's pretty darned well populated! We both have snack food in our packs, but we have learned that it would be extremely rude to try to eat any of it, since we don't have enough to share with everyone. In America, if you have a candy bar or some snack crackers, you can eat them and no one really expects you to share. After all, they probably have some of their own, or certainly have the money to buy it if they wish. Here, when you have a treat, it's really a treat, and it would be inexcusable not to share. So, with growling stomachs, we work and wait. Finally, the word is relayed to us - shut down and go to the supply ger for lunch. Hooray!

One problem. Our tent is filled with people waiting to be seen. They have not had lunch either, and they're just as hot and tired as we are. Our interpreters assure us that there is no problem, and they quickly inform the people that the American doctors (?) are going to be gone for a short time. Indeed, there is no problem. These people know full well where we are going, but they all smile and nod, and with a broad palms-up gesture they motion toward the open tent flap, clearly encouraging us to go ahead and leave. We see them re-settling children and themselves, fully prepared to wait patiently until we return. I continue to be impressed by these remarkably kind and gracious people.

We exit the tent and head toward the supply ger, looking forward to lunch. I'm not sure what we expected to find there, (a cheeseburger, perhaps?) but what we found probably wasn't on our imaginary menu.

Thursday, August 7, 2008


Friday, August 6

We are up early, good breakfast at 7, and into vans for the trip to the remote site where the clinic for the "ger" families will be held.

A ger is a round structure that the herdsmen and their families live in, and the landscape is dotted with them. The same type of structure is used by nomadic people in parts of Russia, and there they are known as "yurts". They're also used in town, as living quarters and very often as storage sheds or supplemental buildings for businesses.

The Mustangs are living in gers at present at the CTW compound, until their dormitories are finished. Gers come in different sizes, depending upon how many wall sections you use. The floor is wooden and comes in sections. The walls are made of a criss-cross lattice, that collapses like a folding child gate. In the center, two stout poles support a circular wooden frame. Lighter poles are inserted into the outer rim of this circle like spokes from a wagon hub, and extend out to the walls. There, they are simply tied in place.


Large sheets of very heavy felt are then wrapped around the whole structure. The felt is made by the herdsmen from the hair of the animals they raise - sheep, goats, yaks, horses and cattle. After a time, the felt takes on the shape of the structure itself. In these "modern" times, a sheet of plastic is thrown over the felt, especially over the top, to make it more rainproof, and a canvas cover that has been sewn to fit the structure is put in place over the whole thing. There is a vent hole in the top, like in a tepee, and this can be opened or closed with the help of long straps attached to the coverings.


The side walls can be rolled up like a Roman shade on the outside, and a chimney effect then provides circulation, as air is drawn in from the sides and carried out through the vent in the top. It's quite effective. Five men working together can put a ger up in two hours, and can take one down in thirty minutes. This makes them very portable, and a family can relocate in a day.


Inside a home, pretty fabrics are hung around the walls, and furniture is arranged around the perimeter, against the walls. The ger is surprisingly roomy, attractive and functional. Mongol people have lived in them for centuries, so the concept is tried and true.

One might wonder whether they smell, with the felt being made of animal hair. They do. When it's raining, they really do. However, it smells a lot like a stable, which has never bothered me anyway. It's just a warm, earthy scent, not at all unpleasant, very reminiscent of my growing-up years, when my horse was my beloved companion. It didn't bother me at all.

Back to the clinic! First of all, there was the trip out there. We rode in the Russian vans, made in the early 70's and still hanging in there. There are a couple of newer vans, that belong to CTW, but the Russian vans and drivers are hired to transport us. I'm not sure the newer vans would make the trip. The Russian vans are a sight to behold. Gray, of course. I don't think the Russians know there are any other colors. Everything they make is gray. The vans have seen better days, to put it mildly. The door stops are gone, so to keep the doors from swinging completely around when they're opened, and breaking the hinges, they're tethered with pieces of wire, rope, whatever the driver could find. One is fastened with an old seatbelt strap. Not sure where that came from, since there are no seat belts.

We travel over paved road for a few miles, then the driver turns down a track - it would be an exaggeration to call it a road - and continue on.
The vans wheeze and chug and groan, and the drivers herd them over the unbelievably rutted track without mercy. I half expected them to take out whips and start beating them! The vans protest, but the drivers are relentless. Our engine dies, and the driver raises a lid over a console next to him, tinkers a bit, then pours some clear liquid into something under the lid. I think it must have been Vodka, because the engine coughed, choked and clattered into life, and on we went. The vans rear and pitch and buck, but the drivers keep urging them on. We're bounced around the vans unmercifully, as the vans plow over ruts and holes and mudslides, like crazed animals in search of water. I will definitely be sore tomorrow.

We finally lurch into the camp, and the vans wheeze to a halt. We get out, a bit the worse for wear, and nursing a bruise or two, but we barely notice it. We're so excited to be here, and ready to get to work. There are two tents set up, one for the intake team to register the people as they arrive, and one for me and Toom Chris to do our job. We will take vital signs, and with our interpreters, get the history of each person - current complaint and what, if any, treatment they've had. By the way, "toom" is pronounced like "tome", and is the Mongolian word for "big". We have two guys named Chris. One is our pharmacist, and he is tall and slender. The other Chris is also tall, but no way is he slender, hence the distinction "Toom Chris". He's a shaven-headed, bearded biker, complete with leathers, studded belt, tattoos, the whole works. He's also an EMT, a Christian, and a marshmallow inside. He knows his stuff, and is fun to work with.

After Toom Chris and I have finished with a client, they are escorted by one of the Mustangs to a bench outside one of the gers where the doctors are working. The escorts try to keep the waiting lines at approximately the same length. We have two doctors today, each in their own ger, and our pharmacist is in a third one. There are a couple of empty gers as well, as we may be joined by a third doctor tomorrow, and possibly a Mongolian dentist.

There were only a few people waiting when we arrived, but shortly thereafter, people began to just materialize out of the brushy scrub that surrounds the camp. They came on foot, on horseback, in little horse-drawn carts, and a few on motorbikes or in ancient cars. They came from all directions, leading small children, carrying babies, assisting the elderly. They're dressed in an astonishing variety and combination of clothing. We see old pin-stripe suitcoats worn over baggy trousers of unknown fabric. The trousers are inevitably stuffed into the tops of leather riding boots, most of which appear to be of very good quality. Most of the men, and many of the women wear these boots, because horses are a part of their daily life. Everyone rides.

he clothing combinations are original, to say the least. One woman was wearing a pair of modern, pointy-toed high heels over a pair of argyle socks, with Levi's and a long-sleeved sweater, with a sheer pink nightie top over that. Amazing.

Many of the women also wear hats, and they seem to favor white or cream-colored straw hats, with wide brims. Another favorite style is straw, shaped like a baseball cap, with a huge, very exaggerated bill on it, about a foot long, and fanning out at least eight inches wide.

The people are gentle, friendly, and extremely patient and cooperative. Their speech is soft and rhythmic, and I enjoy hearing it, though I don't understand a word. The intake team is sending them to us faster than we can process them, so our waiting line is building, but the people sit quietly, and the children are well-behaved. This promises to be a long, tiring, and very enjoyable day.

NOTE: Friends, I must apologize for the strange shifts in print style. I'm not doing that. I've given this print engine every command the law allows. Some parts respond, some do not. I'm copying and pasting this text from my old journal, but once I highlight and override with new print commands, it should respond. Even if it doesn't respond as I tell it, it should at least misbehave equally everywhere, but it does not. So, I guess we'll just take whatever comes. Perhaps we can make a game of it - "Guess the Print Style" or some such. Oh well.

Sunday, August 3, 2008

Our first day on the job!

Thursday, August 5

We are up early, have a good breakfast, and load ourselves into the vans for the trip to the Change The World compound. It's located near a small town called Hongor, several miles from Darkhan. When we arrive there, I'm impressed beyond words by what I see. The property is beautiful. It's located alongside a river, on gently rolling hills, and much work has been done to establish a comfortable and secure place for the children. There are living quarters, a cooking facility, storage rooms, and perhaps most impressive of all, five roomy greenhouses.

Inside these greenhouses, Jerry and company are growing a wide variety of vegetables, including of all things - corn! I've never seen corn grown in a greenhouse before, but they're doing it. Tall, beautiful stalks that have reached the roof, and are tasseled out and producing large, healthy ears of corn. Outside of the greenhouses, in the sandy soil, there are cabbages with a leaf-spread of about three feet, and squash vines are rambling everywhere, bearing more squash than the compound can use. Jerry tells us that the excess of what they grow is shared with the poorer people in the town. What's that scripture about planting seeds and trusting God for the harvest?


After viewing the beautiful gardens, we move on down the hill to the baby rooms. There we meet about a dozen infants, who are being cared for by three or four women. The babies seem happy and well-fed, and are so very cute. We don't want to leave them, but it's time to move on.


After a short drive in the vans, we arrive at a point much deeper into the property, not far from the river. This area contains the dormitories for the "Mustangs." These are the teenage boys, most of whom were living in the sewers of Darkhan until Jerry found them and brought them to CTW. The dorms are semi-finished buildings at this point, which provide shelter for the boys, but still need work (and bathrooms). That's what our construction team will be doing while we're here. A sewer line will be placed and run to a septic tank, water lines will be put in, and a bathroom will be built on the end of each dormitory building.

The men on our construction team pick up tools and start to work. By lunchtime, Richard (our plumber) is almost unrecognizable. He is filthy!! He's been down in a narrow ditch all morning, and has connected an astonishing amount of pipe. He may be dirty from head to foot, but he's smiling through the dirt, and appears to be enjoying himself greatly. He cleans up as much as he can, and we all decide that it's good, honest, Godly dirt, and make room for him at the tables.

We eat in the semi-outdoors, in what would pass for a livestock stall at home - open, slatted sides with a roof overhead. It's large enough to accommodate four picnic-style tables and benches, We go down the hill to the kitchen, pick up our plates and return to gather around the tables. The food is good, and everyone eats well. There is one thing for certain, however. If you don't like cucumbers, you can't make it in Mongolia. We have them at every meal. They're sliced in very creative ways, but a cucumber is a cucumber, and it's pretty hard to pass them off as anything else. We are told that the ones we're eating today were grown here in the compound. Fortunately, I like cucumbers, so I'm in good shape.


After lunch, the benches were removed, and we gathered around the tables to make up food bags for distribution to needy families. Boxes and barrels of donated food, mostly from the US, are carried to our area by some of the Mustangs, and we set to work. Three bags of dry soup mix, two cans of a dried meat product (we probably don't want to know), two bags of dried strawberries, one bag of shelled almonds, and a large bag of dried peaches, are all combined into one large yellow plastic bag. We tasted the dried fruit. Chewy, but good.


After the food was bagged up and carried to the vans and loaded into them, we returned to our "corral" to set up a clinic for the CTW staff. It was well-attended. My job is to take pulses and blood pressures, and with the help of an interpreter to also get a brief history of the individual's complaints. It immediately becomes apparent that most Mongolians have high blood pressure. Some relate that they have medicine for it, but most do not. Those who do have it tell us that they take it only when they need it. This is frustrating to the medical personnel, and we try to explain to the people that blood pressure medication must be taken every day, but they only smile and nod at us, and we know very well that they're not going to do that. We're dealing with a mindset here, and it will be difficult, if not impossible, to change it.

We finally see the last person, pack up our gear, pile into the vans, and return to Darkhan. After a good dinner, Eloise and I go to our room, get a shower of sorts, and fall into bed. Tomorrow we go to the first of the remote sites, to begin holding a clinic for the herdsmen and their families. That's going to be very interesting!

Friday, August 1, 2008

Arrival in Darkhan - our hotel

Wednesday, August 4, approximately 5:00 p.m., Mongolian time

We arrive in Darkhan, and are driven straight to our hotel. Originally, we had thought we would be staying in gers, but the plan has been modified, and we have rooms at a local hotel. Considered pretty nice by Mongolian standards, to our Western eyes, it is a stark, bleak, brick structure, half-hidden behind very overgrown trees and shrubbery. It looks deserted. It isn't. The lobby is bare except for a threadbare rug, a plastic plant, two small pictures and a bulletin board
, but a smiling, pretty young woman stands behind a desk, beneath a sign that declares her area to be "Reception."

We are told that we will all be on the second floor, and that we must use the stairs because the elevator doesn't work. Later we will find out that the elevator's cab is used for storage! We're glad we're not on a higher floor, because not only does the elevator not work, but there is no bellman or any help to be seen, just the dainty young woman behind the desk. The guys in our group bring our luggage up for us. Again, bless them!

Eloise and I are sharing a room, we're happy to learn. The room, indeed the entire hotel, is a strange blend of dignity and desperation. The bathroom defies description, but at least there is one. There is running water. Much of it runs onto the floor, but it does run. The toilet seat is not attached, but again, at least there is one. Several times I wished for a seatbelt, though. The faucet is fascinating. It's located between the tub and the sink, and swivels to whichever location you wish. There is even a hand-held shower head, hand-held because the wall bracket is broken. No problem, I prefer it that way. The bathroom tissue is very similar to the crepe paper streamers we used to decorate the gym with when we were kids, only it's a grim, gray color.

My pillow defies description, and the pillowcase is ripped in several places, and too small, so that the pillow bulges out through the rips. The furniture is tiny, and a bit rickety. The rug is threadbare, and even holey in places. Still, there are touches. The heavy drapes at the ends of the wall of windows are functional, that's all, but between them there are some absolutely lovely, gauzy white sheer curtains, with beautiful embroidery work on them. The windows are open, and the sheers are billowing in the breeze, and are just delightful. It's as though some unseen hand, at some time, has tried to bring a bit of beauty and quality into this government-issue place.

There is just enough time to freshen up and unpack before dinner. It's served in a large room on the same floor, on tables that are set very formally. Chargers under each plate, yet! The plate is a salad plate by Western standards. The food is served buffet style, and is very good. The salad plate is large enough.

Our interpreters are present, and are very pleasant young people. One holds a bachelor's degree in English. All seem to have a good grasp of the language. There are a few young men, but most of the staff are girls. They are all bright-faced and smile a lot. Except for one, they are all Christians, and it shows. The other Mongolians we have seen so far are not as apt to smile, though they are far more pleasant than the Chinese.

After dinner, we walked about three blocks to Jerry's office. It's located in a similarly stark and bleak structure, on the third floor, again no elevator. We were shown into a large, bare room, lined with boxes and suitcases. Our job was to empty the boxes and sort the contents into the suitcases. We sort out medical supplies and drugs according to purpose - antibiotics, anti-inflammatories, respiratory meds, whatever the class. We have a pharmacist in our group, who was able to guide the non-medical personnel.

Once this task was completed, we walked back to the hotel. Again, I am struck by the bleakness of the place. The city, almost entirely, was built by the Russians, and you can tell it. Row upon repetitive row of square, blocky, ugly apartment buildings, are lined up like cell blocks. Everything is square or rectangular, and everything looks alike. There is no architectural variety, no color, very few flowers, nothing to alter the look of dismal hopelessness.

Outside our hotel is what was once a fountain, but of course it doesn't function. It is two rectangular, above-ground pools, offset and connected at one corner. Some designer's attempt to be innovative, no doubt. The water source is a series of lead pipes, fully visible even if water was flowing. The whole effect screams "communism." Most of what we see was designed and built by the Soviet communist occupation, and their cold, unbending, hopeless, Godless mindset shows through everywhere.

The buildings, the landscape, the street scene - all taken together gives one the effect, the same feeling, that one experiences walking across a fairground after the fair is over and everyone has gone home.

Yet, I am amazed and pleased to learn, there is a flow of life, a pulse to it all. Inside one of those dismal buildings there is an Internet Cafe. Some of our group went there and sent emails home. There is the Mongolian version of a supermarket, which is just a cut above a mom-and-pop grocery at home. There is a bank, a post office, a restaurant, and a bar named, of all things, "The Texas Pub." It all looks deserted, but it isn't. There are never very many people on the street at any given time, but there is almost always someone.

We return to the hotel, I put a towel over some of the holes in my pillowcase, and have no trouble getting to sleep. Tomorrow is another day.