Monday, October 10, 2011

The God of Broken Things: Part One, by Ryan Phillips


Perhaps a film crew following us around for the last ten days has tempted me to lure you into reading this newsletter (my longest ever) with a flashy advertisement involving nothing less than

a close shave with a landslide, vehicle smash-ups, brake failure and near accidents, a massive earthquake, a terrifying nighttime encounter, a heroic team of doctors, leopards and monkeys, storms and floods, life and death sequences where many survive but some do not, a pregnant wife at home, battles with illness, evil conspiracy, and the triumph of good.

 The last three weeks have been indescribably full.  All of these things did happen, but we aren’t trying to make a Bruce Willis movie here.  It is in sharing these stories that I am able to process all that I’ve experienced and find the truth in the midst of it all.   I would like to share these stories with you.  I need to share them with you.  It is good to have friends that read, friends that listen, friends that care.  Here are the stories from the first of those three weeks.

Thursday, September15:

            The medical camp in Kolbong started off with sniffles and sore knees, but the patients seemed to grow more serious as the day wore on: the teacher’s wife who was suffering terribly from gallstones, the pregnant mother with the UTI and the older lady with hepatitis and hemoglobin count of three.  We arranged for them to be picked up by one of our ambulances (the Elephant) on Tuesday, packed up, and headed back home.  A light rain was falling which slicked the already treacherous road.  We spun our way up and out of the valley.  Immediately after saying, “Man, I don’t know what we’d do if we met another vehicle on this road,” we smoked around a corner (after four failed attempts) and met an overloaded jeep.   It backed up and wedged itself into the nook of a cliff.  The ambulance we were in (the Rhino) nearly lost its footing on the red clay of the embankment.  There were two inches between us and the jeep and little between us and the cliff.   The rear right tire of the Rhino was knocked out of alignment and was rubbing the body of the vehicle. The fat off-road tires we’d put on for our trip to Kolbong only accentuated the problem but without them we’d have been stuck.  Every bump and left hand turn, of which there were many, reminded me that something was broken. There was audible friction.

After a long day of travel it was time to let the Rhino rest in the parking area beside the government lodge.  Home was not far away but a storm had whipped up in the dark.  As lighting crashed out in the jungle, memories of the family in Dabling who had been recently struck by lightning came into my nervous mind.  While gathering up my things, something caught my eye and I glanced to the right.  A detached face was floating like a specter in the darkness, inches from the driver’s side window.  I lurched back and screamed.

 “Uncle!  I sleep down stairs?  I sleep?  I sleep?”

When I realized it was Sagar I broke out laughing uncontrollably.  The village idiot stood patiently in the deluge.  I grabbed my bags and realized that my flashlight was missing.  Sagar and I were still cackling as I exited the rear of the ambulance.  It was rainy.  It was dark.  There was no way to see the path.  He put his arm around me.  His pants were soaking wet but sweater was, oddly enough, mostly dry.  There was a flash of light, so we dashed forward as far as we could see and then waited for another bolt to illuminate the sky.  I half expected to be struck dead in the middle of the field and imagined the villagers finding our intertwined corpses.  But in this fashion we haltingly progressed towards the house, laughing all the way.  There was an empty plate sitting on the front door step.

  At the house the story came together.  The storm had knocked the electricity out and everyone had been getting ready for dinner.  Suddenly and silently Sagar had appeared in the dark hallway and scared everyone half to death. Sara made him plate of food and had him sit on the stoop to eat.  Just about the time he was handed his plate, the Rhino pulled in.  He devoured his food in about ten seconds and ran splashing across the flooded ground (hence his soaked pants).  He left his dry spot in the storm and ran out into the night because his friend had come.  He went to bring me home.  

Saran, one of our ambulance drivers, was covering the maternal ambulance in Git Dabling, so his room (where Sagar usually sleeps) was locked.  I broke the padlock off the door with a hammer, took Sagar inside, dressed him in a warm dry pair of fleece pajamas, and tucked him into bed.

_____

Friday, September 16:

            It was market day and, as usual, many patients came sauntering down to the clinic.  After hurriedly eating my belated lunch of momos I quickly headed out the door before another patient came.  I had been called about another mother in Dabling who had been heavily leaking amniotic fluid for three days without any labor pains.  The Rhino (with its tire incessantly rubbing against the body of the vehicle) took me as far as Dokan Dara and the rest of the trip was on foot.  A beautiful, healthy, glowing young mother emerged.  We gave her a good check up. She was doing just fine. 

            “Don’t worry," I said. "The baby’s heart is strong, the placenta is in a good spot, and you still have sufficient waters.  Labor should be soon.  Call us when the pains begin.  Amanda Miss should be back by then and if not I’ll do my best.”

            They paid me for my trouble with two kilos of squash, several tomarillos, and a pouch of homemade cheese.  I left an emergency birth kit on their table and headed home.  By the time I reached the lodge the tire was really digging into the body.  On Wednesday, Sandeep had backed our original ambulance, the Donkey, into a van. This was only days after a breakdown in which the Donkey had cut off traffic.  Fortunately, the owner of the vehicle was a friend from HIMSERVE and there wasn't the normal barrage of accusations and demands.  It seems that there is no end to the upkeep of an Indian-made vehicle on Indian-made roads.  At least the Elephant was doing fine.  After dinner a call came in from some patients at the Kalimpong Government Hospital.

            “Our buhari here needs some help.  The doctors here are saying that she is too weak and anemic and won’t let her deliver here.  They referred her to the Medical College but we’re terrified to go there.  We were hoping to take her to Gayaganga tomorrow morning instead.”

            “Okay…. I have to go down to pick up Amanda tomorrow anyways.  The vehicle will be empty on the way down.  I’ll take you.”

_____

Saturday, September 17:

            I awoke at midnight and couldn’t go back to sleep.  So many events were swirling in my head and I realized that it was less than a week until the Gayaganga doctors and a documentary film crew would come to Kaffer.   There were still so many preparations: the road map I'd made of the region needed to be downloaded for the printers, flyers needed to be made and distributed, food, and the welcome committee!   Around three thirty in the morning another call came for the Maternal Ambulance. 

            Yohan and Sumila live in Katarey which is a few hours walk from Dokan Dara in Dabling.  At ten o’clock the previous evening, just as I was going to sleep, the mother’s labor began.  They had been told by the Government ANM (Auxiliary Nurse Midwife) to go to Kalimpong a month early to rest and eat, because she was severely anemic.  But in the village it is rarely so simple.  There was the farm to run.  Who would tend the goats? Where would they stay for so long in Kalimong?  They were entitled to stay in the maternity ward but few can tolerate the overcrowded conditions for such a long period.  How would they pay for it all?  On Thursday Augustina and Somit two HIMSERVE TBAs (Trained Birth Attendants), came to visit.  They recognized latent labor and advised her to head to the hospital, or at least to our place in Kaffer.
            The mother responded, “No, I’m not in labor yet.  I’m fine.  Plus I’d rather die than go to that hospital.”

The following evening, at ten o’clock, true labor began and Yohan, being an attentive husband, began to carry his wife.  He carried her up out of the deep valley, through the dark in yet another torrential downpour.  By one in the morning they’d reached lower Dabling and went to the house of Phulmit (a Hayden Hall paramedic).
When Phulmit saw the mother she said, “No, this mother should have gone to the hospital.She shouldn't deliver in the village.”

          “What can we do?  We started to carry as soon as it began.  The baby is coming soon.”

By one thirty the child was born but the placenta was not delivered.  A few thin mealy pieces emerged but the bulk was retained.  Phulmit called the ambulance to Dokan Dara to pick them up.  But the mother protested.
“NO! I won’t go.  I’d rather die than go to that hospital!”
Due to the rain and dark they were unable to continue carrying her until sunrise.  They lied to the mother, telling her that they were taking her home.  The stretcher didn’t emerge at the road head until seven thirty.  When I saw the mother, I turned almost as blue and cold and she was. 

Blood Pressure: 0/0

Respirations: Agonal gasping with throat spasms.

Pulse:  Faintly palpable at the carotid artery.

            My heart dropped into my stomach for I knew what I was about to witness. Hoping against hope, oxygen and saline were employed in my endeavor.  Yohan had a contented smile on his face because Sumila was in the ambulance.  She was with the big “foreign daktar.”  She was on her way to the hospital.  Everything was going to be alright.

            Ten minutes down the road I knew that things were not all right.  My flashlight revealed fixed pupils and I glanced back at the father’s eyes which were alive and hopeful.  Lacking the heart to do the needful I prayed, “God, I know it is your will that all be well and whole.  You created us for health.  I want death to be crushed today and life to triumph.  Lord, you raised Lazarus and the girl that had died from the fever!  Why not this one?  It would be easy!  I don’t want bragging rights that I prayed and someone resurrected!  Please do not let this baby be deprived of its mother’s milk.  Please don’t let this husband’s efforts be in vain.  Please, Lord. Please!” and hoping that my persuasive concoction of words and obstinate prayer would pay off, I sat for fifteen more minutes, not looking at the body, as the Donkey carried her towards the city.

Sandeep pulled over in Lolay and I checked.  Yohan was just starting to nod off from his sleepless night when I said, “Bhai, she’s passed.”

            In a fog of exhaustion and disbelief he asked, “What did you say?”

            “She’s passed.”

            “What?  I didn’t understand.”

            “Her life has left her.”

            It was as if a landslide had dislodged above us, the full force of which hit him broadside.  He wept, writhed in anguish, and pounded his fist against the wall of the ambulance as I removed the impotent oxygen mask and limp saline line. Sandeep turned off the engine.  The oxygen meter rested on the zero pin.  We waited for him to emerge from the rubble of his emotions. 

            “Can we.. (guttural sounds) …take the body home now?”

            My mind began to race.  If we were to take her directly home we would be giving those who are against us an opportunity to lay false blame.  But I barely dared to imagine the firestorm I may have to walk into at the hospital.  This was uncharted territory.  Having just finished reading a report published by Human Rights Watch entitled, “No Tally of the Anguish,” I remembered the systemic resistance to and non-cooperation in reporting maternal.  Nobody wants that blood on their hands, so it is better to cover it up.  Though we had done everything possible and there was nothing we could’ve done to save her my gloves were bloody.  It was a terrifying decision but her story had to be known.

“We have to take her to Kalimpong and file for an official report.”

The rear leaf spring of ambulance began to rattle, as I launched a volley of calls to all the Medical Officers throughout the area and told the officials the story. The ACMOH (Additional Chief Medical Officer of Health) told me to take the body to Emergency/OPD and register it with the MOIC.  So I did.  As soon as I walked into the room, I saw both the doctor’s faces cringe.

“I need to speak to the MOIC, who is on duty today?”

Under furrowed brows and through clenched teeth she responded, “What do you want?”

Assuming that I’d found the right person, I recounted the tale from the onset of labor to the present moment.  When we reached the point where I administered oxygen and saline, she expounded, “Oh that was completely unnecessary and wouldn’t help at that stage.  What you should have done was CPR." She slowed down her voice for my ignorant ears. “That is c-a-r-d-i-o  p-u-l-m-o-n-a-r-y  r-e-s-u-s-c-i-t-a-t-i-o-n.”

“Yes. I am familiar with CPR.  But if someone has bled to death and there is no volume in their system… there is nothing left to pump.”

“Yes… anyways you won’t be allowed to bring the body in here.”

“Oh… then where should I take the body?”

“You take it back there somewhere and have some local doctor make a death certificate.”

“I already told you that she lives a couple hours walk from the nearest road… there are no doctors there.”

“Well if you bring the body in here it will be a long process.”

“I want to do things officially.”

“You see it is not our responsibility the death happened elsewhere.”

“You are the closest hospital.  We want to register this.”

“These villagers are careless and come to the hospital too late.  Then there is a long process involved for us.”

“Her husband began carrying her as soon as she went into labor.  He carried her all night in the dark and rain up a mountain.  Do not call him careless.  He did everything he could.”

Obviously frustrated she consented to something, “Fine.  We will contact the Ward Master and there will be a postmortem at the Dead House.  The baby had already been born, so we will treat this as a "brought dead."  Take him to the Ward Master.  You give him this.”

  Any maternal death within six weeks of delivery for ANY reason is supposed to be reported as a maternal death.  But being obviously too ignorant to communicate for myself, the doctor proceeded to write down everything I’d reported smattered with Indian Medical English jargon.
“You show him this paper and say these words, okay?”

Waiting outside the Ward Master’s office, I watched two men doing puja for the ambulance.  There was bronze plate full fruit, peanuts, and smoking sticks of incense.  They waved it around engine and intoned prayers.  A man who obviously worked there straddled up beside me.
I asked him, “What is this a new vehicle or something?”

“This is Viswakarma Puja.”

Viswakarma is the patron god of blacksmiths, mechanics, vehicle owners, tool vendors, petrol pumps, etc.  He is bribed once a year with offerings and petitioned to keep everything mechanical working, gears meshing, and systems functioning.  I thought about the concerning rattle in the Donkey, the rubbing tire on the Rhino and the Elephant en route from Kaffer whose spring bushing we’d been trying to get changed for weeks.  I thought about Sumila’s systems failing and my desperate prayer and said to myself, “I wish I could blow some smoke and throw a handful of peanuts at God and he’d keep everything running smoothly.  I wish he’d make things work.”

My companion said, “You brought that Lama who fell off the cliff last year didn’t you?  I did that postmortem. Whoa, what a mess.  Ok… well now we have to go to the police station.  Come with me.”

  We hopped in another rattletrap van/ambulance and as I shut door, it fell off.  Good job, Viswakarma.  As they were struggling to reattach it, the Lyang Mary’s guardian  emerged from OPD.
“Sir, will you take us?  Will you take us to Gayaganga?”

“Yeah, I’ve just got to go to the police station first… you work on the discharge and we’ll get you out of here as soon as possible.  Hey… your patient is from the same village as the mother who died this morning are they related.  Yes, her husband is our girl’s cousin.”

Two in the same family, I shook my head.  Two from the same village, I shook my head.  Ambulances whose doors fall off, I shook my head.  Headed to the police station, I shook my head.  I recounted the tale again to the officer on duty. He was surprisingly more attentive and concerned than the doctor on duty at the Hospital.  He kept shaking his head as well and saying, “Oh, dear.  Oh, dear.”

After the tale was told I requested him, “Can you please come quickly for the investigation.  I have to take another weak mother to Siliguri and they are waiting. They are from the same village and I don’t want this to happen to another mother.”

“Yes… surely.”

After expressing my thanks, I turned to rush back to the hospital when the officer spoke up.  “Come sit and have tea.  It has just come.”

Despite the stress and urgency something signaled me to stay.  As we sipped together the officer began, “You said that one of the Hayden Hall workers helped with the delivery.  Did you know Father Burns?”

            “Yes, briefly.”

            “My mother was in a terrible state and about to die when she was a little girl.  Father himself picked up my mother took her back to Hayden Hall and had her nursed back to health.  Later, our entire village was wiped out during the slide of '68.  Father bought a big piece of land, resettled us all, and helped us build houses.  I’m glad to know that there are people like you in Kaffer as well.  We’ll get your investigation done promptly.”

            Back at the hospital Saran had arrived and Sandeep came running up to me. “Sir, I’m going to talk to a patient up in Maternity.  I just got another call.  We have to transport another mother home today.  I’m going to tell them they have to wait a bit.  We can’t take them at the same time we take the body back!”

            “Okay, Okay… Saran will go with you to help.  Plus I’m worried about that spring and don’t want you to be alone.”

            Down in the Dead House the mother lay silent and cold.   The officers circled her and made a perfunctory report about this "brought dead" case.  And while there were lengthy descriptions of her appearance, and "reason" for death, I wondered if anyone would ever inquire into reasons for her death.  She had gone for her check-ups, taken her vitamins, and had her shots. She interacted with HIMSERVE and Hayden Hall health workers, her husband had done everything humanly possible (more than most humans are capable of), and in the end she ended up in the best maternal ambulance in the District with the best trained attendant in the region. Yet she died.  Things didn’t work.  The systems failed.  Who failed?  Who is guilty?

The Chief Medical Officer had already reassured me that there was no human guilt in this case.  So was God to blame?  It would’ve been easy for him, the creator of life to prevent or correct it.  Did all the parties involved neglect to appease him with incense and bribe him for good favor with fruit on a bronze platter?          

_____

            As I transported Lyang Mary to Gayaganga I noticed that all of the vehicles were decorated with ribbons and balloons.  Wisps of fragrant smoke trailed from every window save ours.  Yet, the road seemed little more than a slalom course through broken down semis marked with withered branches.  Each of the thousand ruts and potholes caused a disquieting clang under my right foot.  I made another of the what would eventually be 104 phone calls that day.
            “Saran, was the spring clanging on the way from Kaffer?”

            “Yeah it started on the way.  We lost the rest of the bushing.”

            “Did you check it… is everything tight?”

            “I checked it.  It sounds bad but you’ll make it.”

            Further down the road the disc brake for the same wheel began to fail as well, which, of course, added another layer of stress to the day.  I imagined complete brake failure and the Elephant ramping off a cliff hundreds of feet above the Teesta River.  Even if Viswakarma didn’t pull through on the mechanics, I thought that the addition of multi-colored fluttering ribbons, balloons breaking free in the sudden acceleration, and a vapor trail of incense would’ve really added to the effect.   Three ambulances and three malfunctions.  I was half tempted to buy packets of peanuts and a bunch of bananas from the roadside stalls along the way. A small lump on my inner thigh was rubbing against the edge of the driver’s seat. What I’d mistaken the day before as a pimple was turning into something. Considering the chainsaw, torch, poison-tipped dagger, and bowling ball I was already juggling in my mind… I ignored the pain.



Sunday, September 18:

Amanda and I woke early at the hotel in Siliguri.  She’d come in the evening before from the community health worker training in Buxa with HIMSERVE.  We couldn’t return home do to a lame Elephant and a driver bordering on delirium from sleep deprivation.  As we sat on our clean double bed with the fan spinning overhead we talked about everything: the events of the previous day, our work, our family, our parenting, our coming child, and the motherless baby in Katarey.  The family can’t afford formula for the long term.  Powdered milk and cow’s milk are insufficient.  Bottle feeding often leads to death in underdeveloped settings.

            “Whose going to feed the baby?”

            Without a thought nor look of feigned effort or false piety Amanda simply said, “I will… after my milk comes in.  We’ll have to work out what to do for now. We’ll raise the child if need be.  Pastor Simon in Suntalabari has seven kids of his own and three adopted children.  He feeds and educates them all on 1,400 rupees a month.  I think we can manage if we need to adopt this baby.

            Amanda was willing to endure suffering to bring life from her ripening womb.  She was willing to sustain that life, and that of another’s child, with her breast (which is already beginning to produce colostrum in preparation for our coming child).  To be willing is the ultimate courage and I was humbled by my wife again.  So, after a nice cup of coffee, we decided to go shopping for our baby and for Yohan’s .  The only problem was that I’d locked the keys in the Elephant in the midst of my delirium the previous evening.  Fortunately, Saran was on the way in the Rhino and had the extra key.  We headed back into the silent and lifeless restaurant attached to the Sachitra Hotel and waited for a waiter to materialize.

As the plates were being cleared and the tea arrived my phone rang, yet again, with a North American number.  A friend had been emailing for a couple weeks saying he would call and I recognized his voice immediately.  He needed someone to talk to because he’d been out of work and a place to stay for very long time.  He’s been living out of his car and was frustrated and depressed.  He’d become tangled in a web of doubt and theology which he’d woven in the midst of his crisis.  His pain had reached such a level that I became seriously concerned for him as he elaborated his plight over the phone.

“…and I just don’t know what to do.  I’ve done everything.  Everything!  I’ve tried to be patient and to trust in God but it seems like every time I get an opportunity he just throws a roadblock in the way.  I need a job, Ryan.  I need a place to stay.  I just don’t know what to do to make everything work out.”

Everything that Amanda and I’d been discussing for the last several hours seemed so pertinent.  I shared with him my experience with Sagar, the events of the previous day, and the thoughts I’d had about Viswakarma Puja as I drove down National Highway 31a.

“I’m sorry but I don’t have much to offer you.  I don’t have any advice that will make things work.  I can’t even make my own life work.  Sometimes I wish our God was more like Viswakarma.  That we could bribe him with our offerings and get an assurance that everything was going to run smoothly.  But he’s not like that.  All of your religious offerings are just like the fruit on that bronze plate and he doesn’t want that… it’s not going to work.  But Jesus is a lot like Sagar.  When he sees his friend coming home in the night he will run to him… even in the midst of a lightning storm.  He comes in a broken form into broken situations and throws his arms around us.  He’s content to get soaked with us and be scared with us in the dark. He’ll walk with us arm in arm until we finally make it home.”

“I don’t know, Ryan… there’s so much double talk and everyone gives me different advice.”

“That is what I believe about God.  He is the God of compassion.  We cannot do and do not need to do ANYTHING to earn his love.  It is always available to us.  It is always free.  But as long as we try to make everything work, as long as we try to fix ourselves, we’re blind to him.  If we can’t come to peace with the fact that we are broken, how will we ever accept God in a broken form on a cross?  Or as a Sagar? We’ll hate him because we hate ourselves.” 

            By the end of the conversation and small spark of hope had rekindled in my heart for my friend.  I thought about the keys locked in the Elephant.  If everything had worked and we’d gone shopping as planned, I wouldn’t have been there to receive his call.  While the phone was still warm from having been pressed to my ear for over an hour, it rang again.

            “Sir, it’s Saran.  You know that big slide above the Teesta?  Well as I was driving across it I heard this noise.  I looked up and tons and tons of rock and mud were coming down at me so I gunned it.  The slide came down right behind me. Then I was going so fast that couldn’t avoid an Army convoy.”

            “Is everyone ok?  Is everything alright?”

            “Yeah it didn’t do anything to the army truck but I damaged the new ambulance.  Everyone saw what happened, so it’s not a problem.”

            “It’s fine.  Don’t worry.  Come on down to Siliguri.”

____

            The damage was minimal but I noticed that the entire interior was soaked.

            “Sir… all the windows leak from around the seals.  It has been raining so hard.”

            The roads were all flooded but still I protested, “This is a brand new vehicle! It rains half the year here!  What are we supposed to do with leaking windows!  I’ve had it with these vehicles!”

Finally, charged with a cup of coffee, we headed home.  Saran stayed back to tend the Elephant at the workshop.  At the petrol pump, the smiling owner greeted us with steaming plates of kichardi on broad leaf plates and invited to pay homage at the shrine he’d erected.  Between the celebrants, I could just make out the deity frozen in clay and gilded in bold colors.  Having just eaten a big lunch, we folded up the prasad and saved it for the monkeys near Coronation Bridge.  The rains had brought down a host of small slides along the way and we worried about the trip home.

We passed Lava around sunset and headed off on the rough road towards Goempa Dara in the dark.  As we turned a corner in the dense forest, an adolescent clouded leopard sprung out of the jungle and ran down the road ahead of us.  It was odd behavior for that species and it caught us off guard.  Amanda grimaced and held her belly against the vehicle which was violently rocking back and forth on the rough road.  Every major bump and depression of the clutch pinched the growing abscess on my thigh.  Just as I was telling myself that the pain was getting unbearable for the both of us, the towering cedars started shaking which sent down a shower of branches and dead clusters of pine needles.

“Boy it must be windy huh?”

“Yeah,” we both said. 
Despite the fact that the windows were open and the night seemed calm.  The phenomena lasted for little more than thirty seconds.  Near Deorali a the wide-eyed driver of an overloaded pickup stopped us and asked, “Is the road OK?  Can vehicles get through?”

“Yeah, no problem.”

Figuring that the rains had caused a major slide on the Lolay route (which we’d been expecting to travel on all season) and had diverted him, the Rhino rumbled down the homestretch.  Upon reaching the bazaar, everyone including a large group of tourists was wandering around in the dark with bewildered looks on their faces.   A thirty five second long, 6.9 magnitude earthquake, the epicenter of which was not far away in Sikkim, had rattled the village.  The ever-rising Himalayas are prone to earthquakes but it had been the largest in our region for decades.  It was felt as far away as Delhi, Dhaka, Lhasa, Kathmandu, and Thimphu.  Our home was undamaged but the walls, which had seemingly turned to jelly during the quake, sent Mom and the boys running out the door.
That evening Mom told us, “When we got outside it sounded like a freight train.  Even after the shaking stopped we could still hear it as it moved away.  It was as if the Earth was growling at us.”

Amanda and I have experienced three significant quakes here.  The first was in early 2006.  It was just before sunrise and my wife was having a dream.  She was walking through an enormous house with more beds than she could count.  In each bed there was a mother who’d died in childbirth.  A voice was telling her that this would remain the reality in India unless she decided to act.  It was the vision which convinced her to become a midwife.  We awoke to a 5.1 and ran from our little cabin in Daragaon.  The second took place on Christmas morning 2008.  We’d just decided to resign from IDEAS and start what would eventually become ECTA, so that we could begin a maternal health service in this region we now call home.  The third and strongest quake wasn’t even a surprise after the caliber of the recent events, which seemed to be happening non-stop.  Everyone else slept outside in fear of aftershocks.  We ate dinner and went straight to the comfort of our own beds.



Monday, September 19:

The electricity was out and the communication networks were down.  As I sipped my morning tea I imagined people crushed and injured in the quake.  I imagined them trying to dial through the dysfunctional networks to call the ambulance in their time of need.  But my phone was silent.  The village was as still as it was the day after the Forest Department complex was burned down.  There was a silent fear of unseen and unexpected forces.  Drunken vandals who appear out of nowhere to burn down the heart of your village, regimented police who arrive without warning to indiscriminately arrest and torture, invisible waves that shake the foundations of your home and take the ground out from underneath your feet, all seem to have the same effect on most folks: Fear.  Everyone assumes that if you keep silent, if you stay hidden, if the village looks abandoned, then the forces won’t find you.  In people’s hearts the force of destruction always has a target: Life.  

Our friend and mentor Vicki Penwell was the first to put words to a trend we’d already observed, that evil has a specific agenda against mothers and children.  If God is the author of life and creation then Satan is the conspirator of death and destruction.  The Achilles tendon of humanity lies in the vulnerability of pregnancy and the delicacy of the first months and years of life.  Is it any surprise that the Devil decides to hit below the belt?  The main headline the morning following the 6.9 seemed little more than a novel sidenote to what was probably the hardest weekend of my life, but it still rattled something in my subconscious.  
It made me wonder, “Every time we make a major decision to protect mothers and children there’s an earthquake.  If it is anything more than a coincidence, what does that mean?  Is it evidence of divine source of our decision or is it a warning from the powers that be?  Is such primary application of the basic tenant, ‘Do to your neighbor as you would have done unto yourself’ enough to make the foundations of a broken world quake or are the ‘powers and principalities who have dominion over the Earth’ growling at us?”

Perhaps it is all a coincidence?  Perhaps I spend too much time sipping chai as an excuse to over-analyze/over-spiritualize everything?  Perhaps it is all plate tectonics?  Perhaps the prayers of the faithful do move mountains?  Perhaps it is the Devil shaking his fist at any that dare block his punches?  Perhaps.  Even if we can’t grasp the full reality of what’s happening in the depths, there is still something left in our hands, a choice.  If we choose fear then we will be as good as dead: silent and unseen in our tomb of protection.  If we choose life, we may be setting ourselves out there as a target, but at least we’ll live as long as we’re alive.

Tuesday, September 20:

The Elephant was traveling on cracked and destabilized roads to Gayaganga.  The patients from the Kolbong camp (the wife with the gallstones, the severe UTI in pregnancy, the old lady with the hemoglobin of three), and a possible case of breast cancer from Kaffer needed to go to the hospital even though many of the routes were blocked from the damage.  My abscess, now ruptured and weeping, meant I had to stay home.  Purna, our newest driver, went along to learn the ropes. Saran called from the jungle not far from where we’d unknowingly experienced the earthquake.  
“Sir, a rock shot out from the tire and shattered the water separator. Diesel was leaking out all over the place.  We’ve had had to tie plastic bags tightly around it to keep the fuel in.  I think we can make it to Gayaganga now.”

            Palm plastered to my forehead, finger and thumb rubbing my temples, I responded,  “Ok, Ok… get the patients to the hospital.  Fix it on your way back. Let me know if you need anything.”



Wednesday, September 21:

            The phone rang early, as usual.  
            “Sir this is Maria.  Lyang Mary needs blood. Do you know anyone with O Postive.”

            “We’ll look around and try to get someone for you. Let me call you back in a bit.”

            After hanging up, Sara informed me, “My sister in Siliguri is O Positive.  I’ll send her over to help out.”

With the amoxicillin in full swing and most of the pus drained, I covered my inner thigh with some DuoDERM and was finally up for a long walk.  I’d been meaning to go to Katarey for days to deliver the needed supplies to Yohan in hopes of preventing the common problems which arise in these cases.  Amanda and I discussed the option again and were unified.  I took off down the trail with a waterproof bag on my back not sure if I’d come back with a baby strapped to the front as well.  In the midst of all the mayhem of Saturday, I’d forgotten to even ask the gender of the baby and wondered what I’d find.

            Somit and Augustina met me along the way to show me the right path. A piece of freshly turned earth encircled by white scarves met my eyes to show me the right house.  Inside, Yohan was coddling his baby.  He had been carrying the child over ridge and mountain twice a day so that his aunt could nurse it.  In between he’d been using formula but, as I suspected, had been making it much too thin.  After showing the proper concentration and teaching him how to clean the bottles, I crunched some numbers.
            “Yohan, if you do six feedings a day the formula is going to cost you 1,200 rupees a month.  As the baby gets older, so does the volume.  The cost will keep going up.  I don’t know how you’ll afford this.”

            The father looked concerned and the conversation volleyed for awhile.  But in the end Yohan came up with a solution.
           “Sir my aunt has a two-year-old son.  She is going to wean him and feed my baby.  I’ll go to live with her and help out on the farm as thanks.  That way I don’t have to buy the formula and the baby will be healthy.” 

            I watched the young widower gently playing with his daughter as the tea came.  He was enraptured with his firstborn.  In our hearts we’d already prepared for the chance that we may have had to raise this child as our daughter and as a result couldn’t help but feel some attachment and disappointment.  But these feelings were soon replaced by peace.  It was good that this little Lepcha girl would be raised by her family and her village.  As I left the house, the aunt arrived.  She had a heavy load.  There was a healthy boy slung on her back and her breasts (having been re-stimulated by the distinctive suckling of a newborn) hung heavy with milk.  Despite the beads of sweat on her forehead, she was smiling and went in to feed the baby.  I took off for home lighter than expected.

            When I got back home, Maria called, “The blood donor didn’t work out.  She was on her cycle.  We are going to have to buy some from the blood bank in Siliguri.”

            “I’ll be in Siliguri tomorrow to buy supplies and repair the vehicle.  I’ll try to give you a ride back out to Gayaganga.”



Thursday, November 22:

The following day, was full of repairs and preparations.  When Maria called again, saying that she’d picked up the blood, I wasn’t even half done with the tasks on the list.  She headed back in the hot and crowded local transport as I continued to buzz around the bazaar.  A documentary film crew was due to arrive the following day.  I would pick them up along with three doctors and several assistants from Gayaganga the following morning.  We needed food to feed them all, a spare tire for the Rhino, and a radio to endure the long drives, extra springs for the Elephant to endure the roads, and I had to meet the printers of the gigantic regional map we had prepared. 

By the time I reached Gayaganga in the evening, the ward seemed like a better option than the hostel considering my condition.  I peeled the bordered gauze from my inner thigh.  It was soaked after a long day of exertion but at least the abscess was almost healed.  Despite my exhaustion, my mind seemed to be spinning as fast as the fan overhead.  How many would come for the medical camp?  Were there enough doctors, enough cooks, enough helpers?  Would the maps be ready in time?  Did I have enough money to lubricate all the gears?  Would Purna and Saran make it back safely after leaving Siliguri so late?  Would the vehicles hold up on the new, expanded routes?  Would this film crew set off a torrent of jealousy and intrigue in the community?  Would this film generate a broader spectrum of interest and support for our work?  Would all of these projects and programs I’d been working so hard to set up work?  Would they fix the health situation in our region? 

A voice reminded me that I’d already walked this road; I already knew the answers.  No. I will not fix everything.  No.  Everything will work out.  No.  Things will not turn out like I envision.  No.  Suffering will not end.  So is it all a hopeless waste of time then?  No.  Father Burns did not eliminate the problem of landslides wiping out villages in our region.  He did not eliminate the problem of sick neglected children.  But even as a finite mortal man he decided to act.  He decided to live like his Lord by stepping as a broken man into a broken situation.  He clothed the naked, gave shelter to the homeless, nursed the sick, and fought for justice.  Although he did not fix the world there are still invisible ripples.  A compassionate and concerned Police Officer, a village health worker that wakes in the middle of the night to handle a high risk case, a host of paramedics preparing for more training despite having decades of experience: they are the aftershocks of Father Burns's life.  To choose to live and be willing, rather than survive obstinately, is the ultimate form of prayer.  There are so many no's but that doesn’t mean we cannot say yes.  The prayers of the faithful do move mountains.  I feel them shaking everyday.
"'The times are bad! The times are troublesome!' This is what humans say. But we are our times. Let us live well and our times will be good. Such as we are, such are our times!"---Augustine of Hippo (Thanks for the quote, Maren)

In Him and continuing the journey,
Ryan, Amanda, Asher, Shepherd, the one to come, Mom, Sara, Saran, Purna, and all the others who compose our family.

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