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.
THE TWO FACES OF MONGOLIA - GRANNY IN TRADITIONAL DEL AND BOOTS, HER DAUGHTER IN WESTERNIZED CLOTHING.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.
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