Wednesday, March 28, 2012

Long time, no write...


Many thoughts have flitted through my head in the last month (that I think I should write about) but I just haven’t focused on doing it.  Now, I am having a week’s break from hospital work and it seems like a good time to write.
There is this woman who cleans in the hospital who has the most beautiful smile.  I frequently greet her as I am walking in the hospital corridors, but I haven’t really gotten to know her.  The other day, I met her on the path and we talked for a bit.  She is the first wife of a man in town, but since she didn’t produce children for him, he took another wife.  He is still married to both women, who have both come to live in his familial town, as is the custom in Nepal, but now that she has proved fruitless, she lives alone while he stays mostly with the wife who has given him children.  She experiences grief, but she accepts her lot in life.  She has found work at the hospital which helps her afford to care for herself.  And more importantly, she has found peace and solace in Jesus Christ.  Yes, she suffers here, but this life is brief and she knows that one day the wedding feast with her Husband, who is the King of kings, will come.  And then her joy will be complete.
I wonder how many of you have read The Hunger Games  We hear it’s the rage in America these days.  Because of Nick’s and Nate’s interest in the books, I bought them before we came to Tansen this year.  Now, all of us, except for Josh, have read the series.  I have been thinking about how these fictional books apply to my life, here and now, in the twenty first century, in Tansen, Nepal.  I have been thinking about this because my mind keeps trying to conceive of a way to fix the systems in Nepal that oppress so many people.  I look at the medical system and desire to make changes.
There are so many people whom we cannot help.  They have come to the hospital years too late, having ignored symptoms of illness until the illness has progressed to destruction of vital organs.  Then they come and plead for a cure.  Most of them are beyond cure.  Then there are those like the young woman who had abdominal pain, so she went to the local shaman.  He told her that her birth control was causing her pain, so she abandoned that.  She didn’t improve, so he tattooed her wrist, wrapped a tourniquet around her arm, placed a fetish around her neck and prescribed a diet of ashes to cure her illness.  Now, she is in the hospital seeking our help: she has a baby in her womb that she wants us to get rid of, she still has abdominal pain, she has elevated liver enzymes, she is anemic, her mental status is slightly altered and none of our tests really point to a specific diagnosis.  What would you do?
The other day, I was asked to read an ECG and look at a chest X-ray of a patient who came to the female outpatient department.  I reviewed these and found evidence of an enlarged heart in a potentially dangerous rhythm (SVT).  I quickly called the patient to come to my room.  However, she didn’t show up for several hours.  The common procedure for patients is that they get some tests, they go for lunch, they wait several hours and they hope to see the doctor before the day is finished.  This patient’s shortness of breath and chest pain did not qualify her for more urgent attention, so her family thought.  I guess they were out for lunch when I was calling for the patient.
Speaking of enduring pain, I cannot tell you how many older women I see who have limb deformities.  When asked, they tell me about some time when they fell and broke a bone, but they did not receive any treatment.  And speaking of broken bones, last Saturday was another typical day at Tansen Mission Hospital.  On Saturdays, we only take emergency cases; nine kids were admitted for broken bones after falling out of trees.
An elderly woman in our neighborhood, as well as some local kids, has taken to using our yard as a bathroom.  Is there any need to wonder why worms and giardia are endemic here?  So, I think to myself, if we could just convince Nepal’s populace of the importance of the use of latrines and avoidance of defecation in the open, we could significantly improve the health status of the citizens in this country.  But, I know that many have tried to change this system over the years, but still the problem persists.  This reminds me of a recent letter I read about an area of Nepal more remote than where we are.  Somebody from the west decided that it would be good for kids in this area of Nepal to learn to use computers.  So, they generously donated computers to the local school.  In this particular area, fewer than 30% of inhabitants use a latrine.  Most defecate in or near the river that is also the village’s water source.  So, they are learning to use computers and dying of diarrhea.  Does something seem wrong with this picture to you too?
On the topic of changing systems…I keep racking my brain to come up with ways to change the systems here (medical, sanitation, government, educational, etc.)…and I keep realizing that I do not have the power to make real, lasting, effective change.  Changing human behavior is a very complex enterprise, even when it is for the good of the humans you are trying to influence.  So, I abandon my ideas again, and I ask the God of the Universe what I should do today.  What it really seems to boil down to is this: I can give wise advice, I can prescribe medicines that may or may not cure illness, and most importantly, I can make connections with humans who so often need a loving and caring touch.  So, do I practice medicine or does my knowledge of medicine simply offer me the opportunity to come into contact with many hurting people to whom I can show love?  I am not entirely sure.
On our journey into Kathmandu Josh asked me to listen to an Adventure in Odyssey episode with him.  I am always amazed at how God can speak wisdom to me in so many different ways; here is the quote that inspired me recently: “Love is never for nothing; it always does good, even when we don’t see it.”  So, I press on to love those around me.  There is no greater endeavor.
Sometimes the opposite of love is trying to control people.  Returning to my thoughts about The Hunger Games: one small group of people is controlling the vast majority of people in a fictional country, and as always happens: power corrupts men and women.  So, if I had the power to change systems here in Nepal, for the people’s good of course, would I also corrupt in time and end up oppressing those people for my own pleasure/comfort/gain?  Now my mind goes to the infinite wisdom of God.   His plan turns out to trump all other ideas.  Man needs free will to truly thrive.  True, he is free to choose life and free to choose death, but without freedom, there is certain pain, suffering and oppression.  And Christ came to set us free, from the chains of sin and death.  And we now can set others free also. 
In conclusion, I think I will not make any significant changes to the systems that hurt people here in Nepal.  But I can love my neighbors, I can seek to understand and reach the hearts of those I have the privilege to relate to, I can check my own tendencies toward controlling others, and I can point out the way to Christ, the only one who can truly grant us the freedom that we were made to enjoy.  Until I see Him face to face, that will be my goal.
“If I gave everything I have to the poor and even sacrificed my body, I could boast about it; but if I didn’t love others, I would have gained nothing.” (I Cor. 13:3)
Thanks for listening to my rambling!
Kimberly

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