Saturday, February 7, 2009

OUR FIRST DAY AT THE HOSPITAL SITE

Friday morning - today we will be going to a different site. We have our usual good breakfast - tea, bread and jam, boiled eggs, scrambled eggs, fried wieners, and potatoes. Also the good catsup. It occurs to me that perhaps the hotel would sell me some. I mention this in Badmaa's presence, and her face lights up in a huge smile as she tells me I am not to worry, that she will fix it! I don't doubt it for a moment. If anyone can make it happen, she can.

Stuffing ourselves into our vans, we settle in for the ride. We're going to the village of Orkhan, and will actually set up on the grounds of the little hospital there! This seems very odd. I try to picture a situation where a bunch of doctors and nurses from France, for example, would come and set up a clinic on the parking lot of one of our hospitals. Somehow, I just can't imagine it. Still, that's where we're going. It should be interesting.

When we arrive in the little town, before we even see the hospital, the idea seems a bit more believable. The town looks like a Mexico City barrio. Deplorable living conditions. Squalid buildings, corrugated tin shacks, rutted roads. Livestock roaming freely everywhere. Not a blade of grass to be seen. I'm amazed to even think that there could be a hospital here.

We arrive at the hospital, following a narrow, rutted road behind some buildings to get there. Through a gate, and we're on the hospital grounds. So are a couple of cows, but no one seems to notice. No driving around looking for a parking space here. Our vehicles are the only ones in sight, and have all of the half-acre or so of space in which to park.

We climb out of the vans and walk toward our big tent which has been set up just about thirty yards from the entrance to the hospital. One of our gers has been set up on a concrete patio area nearby. The Mustangs have worked during the night to get everything ready for us. Bless their little hearts! The ger will be the pharmacist's domain, and also contains our supplies of water. Bottled water, as usual, will be available to us in abundance. All we have to do is look a bit dry, and a Mustang appears with a bottle in his hand. What would we do without them?

There is a long line of people waiting for us outside our tent. We quickly set up an intake table, and the Mustangs begin to escort people in to get their registration card filled out. The clients are then seated on benches inside the tent, to be seen by Barb and/or myself. We resume our routine from the preceding days, with Barb mostly doing vital signs and me mostly getting histories, but sometimes we switch off, or sometimes we each do both processes to keep the lines moving. As soon as these things are done, a Mustang appears to escort the client over to another line, just outside the hospital entrance.


THIS IS THE LINE THAT GREETED US WHEN WE ARRIVED

Our doctors are inside the building. Rooms have been made available to them, and their exams will be done there. No gers this time, except for the pharmacy. The rooms are reasonably clean, and they are large enough, but there doesn't seem to be any a/c, and open windows allow flies in. The hallway is full of people and flies, probably at least forty men, women and children (I didn't count the flies), all seated on the floor or on the few chairs that are provided. They are not our clients, but instead are waiting to be seen by the clinic staff of the hospital. Interestingly, we learn later that many of these same people will come through our clinic as well.



PEOPLE WAITING TO SEE OUR DOCTORS - OUTSIDE THE HOSPITAL ENTRANCE

We have no little gray tent this time, but instead are permitted to use the restrooms in the building. One visit there, and I'm wishing for our little tent. I cannot believe that the stinking, filthy little closet in which I found myself was actually a hospital restroom. The floor was wet - just water, I hope - and there was no commode seat. No matter, I can't imagine anyone using it anyway. The sink was equipped with a faucet, but the broken handle lay nearby and there was no way to turn the water on. No paper towels, either, so if I had washed my hands I would have had to dry them on my jeans. Thank heaven for our liquid hand sanitizer.

A few hours later, on another visit to a restroom, an officious, uniformed staffer led me to another bathroom, and used a key from a string around her neck to unlock it. Apparently it's reserved for staff only, and I understood that it was a gesture of professional courtesy that I was taken there and permitted to use the facility. Inside, conditions were perhaps a little better than in the other restroom. At least the floor was mostly dry, and the faucet worked, but there were no towels. No matter, jeans work well when they have to. The staffer waited outside for me, and locked it again when I exited. I thanked her, and she smiled and nodded in a friendly manner. Pretty remarkable, really, when you think about it. She could have resented our presence, could have considered our visit to be a criticism of her hospital's services. Instead, in her way, she made me feel welcome.

For the most part, the folks we see are much the same as the country folks we've seen in the past three days. Most of these people are residents of the town, though not all. Some country people arrive as well - we see a few horses tied to the fence now and then. The complaints are much the same, though there is more evidence of the influence of the Chinese herbalists with these townfolk. I suppose the herbalists find it more profitable to hit the towns, where they can see a lot of people at once, instead of traveling from ger to ger in the country.

The efficient Bulgan, who seems to be everywhere at once - assisting and translating in the pharmacist's ger, serving as liaison between the hospital staff and our group, organizing our lunch plans - has decided to give the waiting people a number, so that they can come and go with a bit of freedom, yet not risk losing their place in line. This wasn't necessary at the river site, but seems to be a good idea here in town. The Mustangs are very good at using the numbers to help keep the line flowing in proper order.

In the early afternoon, as we're seeing people and getting them processed through as quickly as possible, we hear a minor commotion outside, and a large elderly man comes striding into the tent, via the side flap, rather than the door. There is a Mustang in hot pursuit, and the old man brushes him away as he would a fly.
Our translators are quick to keep Barb and me informed of what's being said. The Mustang is pleading with him, explaining that he must have a number. The old man replies, "These are all the numbers I need!" and lifts the lapel of his frayed suit coat, displaying several shiny medals. One of the Mustangs examines the medals, and announces that they are medals of commendation from various military battles, that the old man is evidently a veteran of one of Mongolia's wars. He apparently considers himself a hero, though Goldie, my translator, tells me that some of the medals are of a kind that can be bought if one knows where to look for them.

At any rate, the old man seems to consider himself due a measure of extra respect, and since he's harmless, we decide to play along. The Mustang takes him to the registration table, and he is moved right on through. The folks outside the tent, who have been watching through the door, don't seem to mind. I would imagine the old man is well known to most of them, and in this country where age is held in great esteem, I'm convinced it would have been a mistake to try to make him conform to our procedures. We would have lost the respect and trust of the people waiting there.

When he removes his coat to have his blood pressure checked, I can see that he would have had a very good build in his youth. He has the remains of well-developed muscles, and the set of his shoulders is still square, his bearing proud. It was a pleasure to show this old fellow some extra respect, and he enjoyed it tremendously.

OLD MAN WITH MEDALS

This grows too long, so will be continued in another blog, another day.

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