Pasang
and his cohorts lingered in front of the Git Dabling Primary Health Center
(PHC), just a stone’s throw away from the Donkey. They eyed the ambulance as
they began to rehash their complaints in harsh tones. Their greed and
opportunism was thinly veiled with a veneer of contrived injustice. Sensing the
nature of their group therapy session, another local driver named Bhomey
sauntered up.
“Can
you bring an ambulance like this to our village? If you could, could you run
it? There isn’t a vehicle like it in our district. It has been a huge blessing
to this village. How many people have benefited from it already? If any of you
try to get rid of it and put your own vehicle in the Government program, I’ll
come and beat you with an iron rod—or cut you with my machete if you’d prefer. If
any of you try to damage this vehicle . . . I live right down there and I’ll be
watching. Look, Sir up there in Kaffer has already worked it all out. It’s all
on paper. Don’t even try it.”
Disheartened,
the group disbanded, but Pasang’s intentions were the same, only his target had
changed.
______
Caller ID: Sanyasi Dara – Dawa’s Wife.
The
phone rang at 5:30 a.m. I’d gotten in late the night before and was afraid the
phone would wake the kids up. I was also afraid that the woman on the other end
was calling to ask for money again to pay for her husband’s hopeless dialysis
treatments. In the fog of sleep deprivation I picked up the phone and said, “Please
don’t call so early. I got in very late last night. Call around seven or so.” There
was silence on the other end and the call cut out. Several days later I found
out that her husband had died. I felt terrible. Had she called for the
ambulance? Had she called to tell me he’d died? Either way . . .
_____
The
leaves on one side of the fruitless fig tree were withered. A black path,
following the trajectory of its roots, was cut up to a boulder that then
glanced off at a ninety degree angle. It had ploughed its way through the earth
for eighty feet, throwing large stones out of its way. The super-heated burst
of electricity travelled straight up the wall of the traditional Lepcha house,
blowing off the adobe. It followed the centre support beam of the roof,
splintering it. A charge branched off and arced across the bed of a sleeping
mother, father, and two-year-old child. After burning the quilt above them and
blasting splinters from the boards below them, it shot out through a solid
stone wall. The main bolt proceeded to burst from the centre beam, incinerate a
swath of the grass roof, and leap to the main house. After peeling back a
section of the corrugated tin roofing, it vaporized the electric wiring along
the front of the structure. The grandfather of the house awoke at 3 a.m., his
body seized by countless volts surging through him and jumping onto those who
slept nearby.
_____
Caller ID: Suruk – Sister Miriam.
“Remember
those guys who were giving you trouble in Git Dabling? You’ll never believe
what they did!”
The
post in Samthar/Suruk for the Matri Yaan Ambulance had gone empty. A jeep owner
from Algarah heard the news and put his vehicle into the program. A jealous
vehicle owner from Samthar, finding out the details, launched an attack against
the “outsider” and ran his vehicle out of town. He started pulling strings and
tossing money to get the contract shifted into his name. Seeing what was
happening, Sister Miriam asked friends in Luxembourg to send some money, and used
it to order a brand-new ambulance. She couldn’t stand to see such a valuable
program get squandered in the hands of goons.
Seeing the vehicle she’d ordered, the Health Department
was very pleased and put the contract on hold for its arrival.
“I
came up here to Darjeeling to pick up the work order. It seems Pasang showed up
a day early and brought a bunch of rowdies and politicos with him. He stormed
into the office and demanded the contract. He threatened that if they gave it
to me that he and his gang would chop me and the ambulance driver down with a khukuri.”
“What?
His main complaint against our vehicle was that we’d brought an “outside”
vehicle and “outside” driver in. Now he’s gone all the way to Samthar,
threatening to cut down someone with a real ambulance that has lived there for
years, so he can put his Git Dabling jeep in? What kind of . . .”
“He
took it by force, just like that! Do you think such a person is going to give
free rides to pregnant mothers even if he gets the funding?!”
_____
Sitting
in the office of the Assistant Chief Medical Officer of Health for the
Kalimpong Sub Division, I began to outline what seemed to be a looming crisis. “The
first month we had ten maternal transports, the second twelve, and for this
month, I’ve heard that there are already thirty-five mothers with vouchers set
for transport. Look, even last month your maternity ward was double its
capacity. We haven’t even gotten the vouchers out to the Nimbong region yet, which
is a huge area in the greatest need of Matri Yaan. The problem is that your
hospital is going to be inundated with a number of cases that your
infrastructure just can’t handle. It is already too much, and the more word
gets around about this . . . ”
“What
we need is for you to build a hospital in Kaffer.”
“No
. . . we need a subcenter. Let’s do first things first. I know that in areas where
there is a land problem, subcenters are being run out of rented buildings and can
be authorized to do deliveries in remote locations.”
“We
aren’t going to be able to solve this problem until we can get all of the
normal deliveries taken care of at the PHC level.”
“Honestly
speaking, your PHCs aren’t functioning properly and people don’t trust them.”
“I
know, I know. Your little clinic is better equipped than our PHCs.”
_____
On
the way back from visiting the lightning strike victims, the phone rang and the
Caller ID showed up “Darjeeling – Khagen Subbha.”
“Hello,
Khagen?”
“We
are almost to Git Dabling.”
“What?
I’m supposed to pick you up in Kalimpong tomorrow.”
“Father
Kennedy and I decided to come today and set up things for the refresher
training there.”
“There?
You told me just a couple of days ago we were still having it in Kaffer.”
“You
need to come tonight. We have to leave early tomorrow morning to head back to
Darjeeling.”
“It’s
4 p.m. I’m riding my bike back from seeing some patients! You’ve got to give me
this kind of information ahead of time. What if I wouldn’t have been here?”
As
I was pedaling up the switchbacks which led back to Kaffer, the phone rang
again: Caller ID: Rateygaon – Ram Kumar.
“My
wife started taking the medicines for the kidney infection, but now she is
bleeding and having strong cramps in her lower abdomen. What should we do? Miss
said that if this happened we should go to the hospital. Can you send an
ambulance?”
They
didn’t have a voucher to ride in the Donkey, the Rhino was full of loose
components and ready to go for modification, and I needed to drive the Elephant
to Git Dabling to plan the refresher course and medical camp.
“Let
me think and talk to Amanda. Call me back in a bit. I won’t be able to reach
you since there’s no network at your house.”
Sweat
mixed with liquid frustration ran down my body as I raced home on my bike.
____
As
Father Kennedy, Father Felix, Sister Johanna, Khagen, and I hashed out the
details of the paramedic refresher course, the Gayaganga Medical Camp in
Kaffer, the open training on the medicinal use of indigenous plants, and the
big regionwide Unity in Health Services meeting, my phone rang again. Fortunately
the Caller ID said simply “Amanda.”
“Hey,
Ryan . . . ”
“Hey
did Ram Kumar call back yet?”
“No,
he hasn’t, but there’s another problem. Sara just got a call . . . her dad
suddenly died today.”
“What?
She just lost her mom not too long ago. Oh no . . . is she okay?
“No,
not really.”
“Does
she need to go tonight?”
“I
don’t know, we’ll talk about it once she’s stopped crying. It seems the
stepmother wouldn’t let the family take him to the hospital in time.”
____
David
Sir sat in our kitchen as I made him a cup of coffee. “Ryan Sir, my brother is
in a lot of pain again. The lymphoma is coming back.”
Richard
was twenty-five when they got the diagnosis last year. He was a smart kid
working at a call center in Bangalore. I handed him the steaming cup and asked,
“What needs to be done now?”
“He
has to go for another round of chemo . . . this time stronger. He’s had two
rounds of chemo already and one round of radiation therapy.”
“How
much are they asking?”
“One
hundred thousand rupees . . . with at least with fifty-two thousand up front. We’ve
exhausted all our resources. We tried to raise money through the church, but
didn’t get nearly enough. We were in the process of taking out a loan against
our land to pay for the treatment . . . but then my foolish father lost the
paperwork.”
My
mind started crunching the ethereal math. The secretary who is supposed to
dispatch the funds to the Matri Yaan scheme is “out of station.” This means the
last two-and-a-half months of operational costs have been out of pocket and not
a single rupee has been dispatched to our ambulance as of yet. Locals who are
legitimately running an ambulance in the program are borrowing money from loan
sharks to keep fuel in the tanks. The money wired from the States for the
purchase and modification of the Rhino ran out the previous day. We’d given
Sara several months’ salary in advance to help pay for the funeral. A good
chunk of change went into refinishing the
godown, or cellar, of the house for all our guests which are soon to arrive. The
wafer of manna in my pocket, often called an ATM card, started to look a little
thin.
“I’m
glad your father lost it. Don’t risk your land . . . it is the only thing your
family has left. Don’t do that. Like I said before, I raised money for this
girl named Jharna who we thought had a cancerous tumor. Since it wasn’t
malignant and the operation went really well, we have some left over. I’ve
already promised some of it to a boy in Lamey Thar who needs plastic surgery. But
we should have at least thirty-five thousand left over. We can get the money for the
advance out of our personal account and start writing to people, asking them to
donate the rest. If it was my brother—and he is my brother—I’d want to take him
tomorrow. Let’s take him tomorrow. Amanda needs to travel to Buxa for the
health worker training and we need to take the Elephant for some repairs . . .
it’ll work out nicely.”
_____
Caller
ID: Lolay – Sandeep
“Sir,
I just returned from taking a mother to the hospital and as I pulled into the
PHC the tire pin broke and the axle dropped out.”
The
vehicle was unmovable and cutting off traffic, including the vehicles of the
drivers in Git Dabling that were up in arms against our ambulance.
“Saran took a
patient down to Siliguri today and is repairing the Elephant. Call him and have
him pick up the parts. If you get a call for a maternal transport in the
meantime (I thought about the Rhino, which we had gutted again to paint all its
components) I’ll pick them up. ”
_____
This
morning Amanda was is Siliguri, preparing to teach the women of Buxa about safe
home deliveries. Our helper, Sara, was still in mourning. Saran, after driving
the entire previous day and repairing a broken axle half the night with Sandeep,
was in a coma in the godown. The boys were, yet again, practicing for a Cage
Fighting/Swiss Yodeling Tournament as Mom and I set out breakfast.
_____
Caller
ID: Dabling – Purni (HIMSERVE)
“Sir,
we have a neighbor here in labor. Sansamit and I are helping but the family
wants Miss to come for the delivery.”
“Laaa, Miss is out.”
“Could
you please come then? We’ll feel much better if you’re here.”
_____
What
is a family supposed think when a bolt of catastrophe drops from heaven? What
are those who seek to do good supposed to think when they are repaid with
threats of violence? What
are people supposed to think when the systems that their lives depend on are
failing? What are those who pour their
lives into their passions supposed to think when secondary parties arbitrarily
scramble the plans they’ve worked so hard on? What are those who have given
everything in hopes of a cure supposed to think when there’s still another
round left in the fight? What are we supposed to think when even the “richest
country on Earth” has gone poor and we’re not sure if there’s anyone left to
give to the needy? What are people supposed to think when they’re promised all
the resources they need but in the end that help is “out of station”? What am I
supposed to think when every time my phone rings a thunder clap emits from the
speaker? What am I supposed to say when the persistent widow comes seeking
justice again?
_____
The
examination of the entire family struck by lightning was almost as incredible
as the examination of their house. The two-year-old was reportedly unconscious
for two hours, but by the time I saw him he had no other signs or symptoms
apart from mild feather burns on his torso. The mother had some mild burns on
the side of her face and eye. Everyone else was completely unscathed apart from
a good scare. It was hard to believe considering the beds which had splintered
below them, the quilts which had burned atop them, and the rafters which split
above them.
“And
as for Grandpa here,” one of the family members laughed, “Even though he’s over
eighty a lightning bold can’t take him down.”
Trying
to keep the laughter rolling I said, “Well at eighty, his batteries were almost
run down. But now that he’s gotten a good charge, he’s gonna live to a hundred
and twenty!”
Once
the cackling subsided, I added “I can’t believe no one died.”
The
grandfather responded, “We are alive because God blesses.”
_____
Arathi,
young mother in Rewan, only a ridge removed from the previous lightning strike,
was also struck at three in the morning. But it was the first pangs of labor
which roused her from her sleep. Purni and Sansamit arrived after sunrise. By
the time I arrived around eight thirty, her contractions were already two-and-a-half
minutes apart and she was unable to speak during them. Birth seemed too imminent
even for a transport up to our house clinic. Amanda had taken her birth bag to Buxa for the training, but at least I
had my EMT kit. Arathi’s vitals were all normal, she’d taken her vitamins, had
her tetanus shots, and everything looked good for a home delivery. But given
the general tone of recent events, my heart faltered for a minute. My God, what are you going to throw at me
today? Any lightning bolts from heaven on this one?
A
100-watt bulb and small charcoal fire were burning. It was hot and everyone was
as beaded with sweat as the mother. Purni sat at the mother’s feet. Sansamit
supported her from behind. I held her hands and helped her focus her pushing
during the contractions. It was amazing to watch this mother, struck again and
again with excruciating pain, focus all of her energy, not on herself, but on
giving life to another. Her face contorted in agony, her body trembled from
exhaustion, and yet she looked strong. It took three of us to contain her
strength as she pushed out her feet, pulled with her arms, and arched her back.
Soon enough, her firstborn son came into the world. We put him to his mother’s
breast so as to trigger the release of oxytocin.
The
hormone oxytocin causes the placenta, which a few seconds ago was the baby’s
only source of life, to break free from the uterine wall. As the baby is losing
the source of all the sustenance it has ever known, oxytocin simultaneously
causes him or her to trust. It gives the mother a feeling of euphoria and
creates an amnesia-like effect. The baby learns trust in the milk of blessing,
the mother rejoices at the gift of life, and both forget the pain they’ve just
been through.
_____
Once
the resonating thunder clap is gone and our skin stops burning and tingling, we
will one day find that somehow we’ve come through unscathed. Despite the
destruction around us, we’ll still have a home, a shelter, on that day. The
bolt of catastrophe, which seemed for a moment the death of us, will awaken us,
and we’ll finally realize that “we are alive because God blesses.” We will be
washed with trust in the daily bread we are given and the one who sends it
fresh each morning.
Dr.
Lingdo is advocating for Maternal Child Health Centre to be adopted as a
subcenter.
Those
seeking to profit in the name of pregnant mothers without having to serve them,
still haven’t received a rupee (along with the rest of us).
Richard
Lepcha is in the Cancer Center prepping for chemo. We are praying for people to
step forward to help a brother even in the midst of a recession. We’ve only
paid enough to get him in the door.
Sister
Miriam’s ambulance is soon to arrive in the remote village of Suruk.
Ram
Kumar and his wife made it to Gayaganga and received the treatment they needed
for the miscarriage.
The
Rhino is almost finished (for now) and should be rolling by tomorrow. The
Donkey is fixed and running non-stop. The Elephant is soon to run patients to
Siliguri/Gayaganga four times a week.
Amanda
is well into her third trimester but still braving the heat of the plains to
teach village health workers like Purni and Sansamit how to conduct safe home
deliveries.
Sara
was able to arrange the funeral and spend over a week with her family. She is
coming back to Kaffer tomorrow.
Everything
is coming together for the Refresher Course/Medical Camp/Unity in Health Services
meeting, even if in Indian style. Funds are dwindling but the invitations are
dispatched . . . no going back.
_____
At the end of the
long day, at the end of the long week, at the end of this long month, just as
we were sitting down to dinner, Sagar came bursting through the hallway in his
soiled garments.
“Uncle? Is
there bread? Is there any bread for me?
I thought for a moment. “Yes, Sagar, there’s bread for you.”
There’s more than enough.
May you live. May you be blessed. May you
bless.
Ryan, Amanda, Asher, Shepherd, the one
we’ll meet next month, and Grandma
