Surgery and Healing in the Developing World - Dartmouth-Hitchcock

46
464 Surgery and Healing in the Developing World
without electricity, let alone flow photometers; makes this “laboratory” an ideal
medical school classroom!
Our Public Health Presentations which Draw Out Large
Swarms of Children, as Well as Political Health Officials
As we were working diligently on the large numbers of patients still waiting in
the hallways, a bus drove up and delivered us half a hundred school age kids. Then
another, then another, and suddenly we were looking at a couple of hundred Ladakhi
kids pushing and milling about, none of whom had any problem to be diagnosed,
but each had heard that there was free stuff and expertise to be had for the claiming.
Now, we can “Put Prevention into Practice!” We counted up the number of bottles
of vitamins we had and held out fifteen to be saved for the clinic. We then counted
up how many toothbrushes we had and held out a few for the clinic. Then we
organized all the kids who came out to the courtyard with the Thicksay Monastery
rising on its hillside directly behind the clinic and had them squat in the afternoon
sun, which mercifully went behind a cloud cover.
It was time for the Hadley and Amy Show, complete with blowing bubbles and
stick on cartoon “tatoos.” I was introduced by Bill Norton who mainly said how
happy it made us all to be here. I then said that while we were in the clinic we had
seen the good facilities and personnel and what they could do to help if one was sick,
but that we had seen several areas that might be more easily prevented than treated.
I listed eye problems, skin problems such as scabies, which could be corrected with
good hygiene, and dental caries, which could be helped by good oral hygiene. I
urged them to good diets and vitamins, and their completion of the EPI (Expanded
Program in Immunization). I then introduced Amy and Hadley and they had a
series of games and interactions with the kids who responded as kids would
anywhere-even if they were squatting in formation in regimented rows, the boys in
two columns of white-shirted uniforms on the right, and on the left the girls in three
columns of purple headcovers and sweaters—the school uniform.
Before the public health message was over, the kids were blowing bubbles, pasting
on tatoos, with the happy faces of kids anywhere with some small disposable
toys. Along with this they got a toothbrush and toothpaste with instructions in
dental hygiene. They got vitamins and a lecture about good diet. They were told
how to wash their hands and faces and how often. They were shown where the clinic
was to get their immunizations up to date. This process was repeated at a later arrival
of another large contingent. At a lower level over a broader scale, it may have accomplished
more good for health than our diagnostic screening and treatment.
The large numbers of kids seemed to draw a number of officials who were involved
in getting them here or in giving permission for our medical mission in the
first place. I met the district medical officer, the “block officer” for the 32 health care
centers in the Leh/Ladakh block, and a number of other people who were eager to
be seen and associated with the group but were reluctant when I said I would introduce
them and they could explain to the children in Ladakh just what it was that
they do to help them. But, at least they all got recognition.
After taking a number of pictures of Hadley and Amy in action with the scenic
backdrop of a large audience of kids (which will never hurt their medical school
applications) I scurried back inside to cover the last rush of patients in to see Sonia
and Elizabeth, and then took care of a half dozen stragglers myself who had got in
just before the cutoff to allow us to be packed up at 2:00 PM and gone by 3:00 PM.