Overwhelmed

We’d been here in Nakyot for about 2 minutes when asked the first time for medicine. We are about 26 kilometers from the “main road” (a washed out dirt track) and hours from a reasonable clinic that will have supplies and a doctor. Especially considering these folks travel on foot most of the time. So the nearest place is days away.  There are thousands of people who live in 8 villages, all within sight of where we’re staying. Parasites, malnutrition, malaria, and diarrheal diseases are all prevalent.   Some times of the year there is no clean drinking water. There are no sanitation facilities, no schools and certainly no clinics. Why am I surprised that I’m already being asked for help and meds? While unloading the truck a woman came up to us with an obviously displaced shoulder and asked for help. Judging by the atrophy of the bicep I’m guessing it’s been displaced for a while. Kids have painfully distended abdomens, festering wounds and a tremendous number of other issues.  The felt needs are so intense that to start to treat only causes riots.

This evening, as the sun set we sat down with 6 village health workers from the area and discussed what could be done. These VHW’s have been given medical boxes by the government and are stocked with a few doses of amoxicillin, a very little Artamether, several packages of Oral Rehydration Solution (ORS), and some zinc tablets. That’s it. And all for children 5 years old and younger. They have been taught that if the child has a cough give the amox. If a fever give the artamether (for malaria), if diarrhea give the ORS and zinc. Dr. Val and I had brought a few other meds so they were divided between the VHWs to give as people need. But it seems so discouraging. I brought quality malaria treatment but I expect most of it will be misused.  They don’t have a way to test, they just figure if a person is sick it must be malaria. There isn’t much critical thinking- like no fever and the pt has a cough so it is probably something else.  I would have liked to test people for malaria and evaluate to use the meds so that they have the best impact. But there are so many reasons we just can’t do it that way. The mindset of the people is the biggest issue. If we started to test and hand out meds 100’s (literally) would come and demand help also. They wouldn’t understand if we tried to tell them that they didn’t have malaria. They see their needs as just as great and how dare we help another but not them. They quickly tend toward violence, both with each other but also toward us. We didn’t hand out any meds and I was still grabbed and had people demand help as we walked through the village. I put a dressing on the foot of one of the men who helped unload materials from the truck and before I could even finish I had 6 others shoving their sores and wounds in my face. One mother snatched the tape, seized my arm and tried to drag me from the truck. Later she brought a child to me with a wound on his face. I’m sure she just wanted me to help her son but it is so hard not to just throw up your hands when they start yelling, grabbing and get so physical. I want to badly to have compassion on their situation but they can be hard to love.  

This trip was simply to lay some ground work. I’ll be teaching and supplying the VHWs so that they can begin to better meet the needs of the people a few days a month. But I feel like that is so meager. They really can’t assess, they have practically no education. How is this going to make a difference in the health needs of the community?! And then I begin to feel so overwhelmed….