The Philippines
Most of the projects outside of the western hemisphere took at least two or three flights to get to the mission location. Since all arrangements and expenses were the responsibility of the volunteer, it became a little daunting passing through three or four airports or countries before getting into your destination. The Philippines was one of those “four stop” journeys, including the flight from New York to Seattle(which was delayed by a snowstorm and caused me to miss my next flight). Then on to Hong Kong where I had to scramble all day for a new connecting flight to Manila in the Philippines where I spent another night and finally caught my final flight from the island of Luzon down to the terrorist plagued island of Mindanao where I joined our team in General Santos City prior to the several hour drive up the East Coast to the foothills where the Tiboli tribe had established the jungle community in the mountains.
Our advanced team determined that this population lived in an area where there was no access to iodine in the food, which caused them to suffer from markedly enlarged thyroids, which in time would compress on their airway and suffocate them. Because of the nature of this project, our team was composed of two general surgeons and an anesthesiologist that were focused on partial thyroid removal while as the only dentist I began performing extractions and removing small tumors.
The surgeons treated their patients on elevated cots while I was relegated to using a low back chair behind which I placed a box to rest my foot on so the thigh of my left leg was high enough to act as a headrest for the patient.
Our clinical area was a small medical outpost with two or three buildings set in a clearing, surrounded by jungle and brush. The Tiboli tribe lived up in the mountains many miles away from our clinic and I was advised that a runner had been sent up into the forest to advise them of our arrival and then guide them out to the trailhead where a truck picked them up and brought them down to our camp. They came with their families intact and created their own little campsites in the brush and woods that surrounded the clinic grounds. Knowing they would be at the clinic for a couple of days, they brought bedding and food supplies to sustain themselves in the bush. At night multiple small fires could be seen surrounding our camp with the smell of wood burningsmoke wafting its way through the pitch of night.
As patient gathered in the field on chairs set up to create what was otherwise an outdoor waiting room it was astounding casting my gaze from patient to patient observing that almost every patient had a large projection growing out of their neck. The greatest population, however, were patients who were seeking relief from abscessed teeth and other oral pathology. Although I worked alone in my own cubicle, I was occasionally summoned into the operating room to remove posterior teeth on patients while hey were under general anesthesia for the partial thyroidectomy.
Two or three of us on the team stayed in a small dwelling that was a home to an elderly missionary couple who lived several miles from the camp. As usual, we slept in tightly netted bunks, protecting us from malaria bearing mosquito and from a cobra, who had molted his skin on the first floor of our dwelling.
Interestingly, this couple both approaching 90 years of age had only been married a fewyears. Apparently the woman , Margaret, in her twenties, had embarked on the life of missionary service with her best friend Sophia both being committed to remain unmarried. After several years in the mission on one of their projects in South America, they served with a male missionary , Peter. In time Peter and Sophia fell in love and eventually got married. The best friend, Margaret, who was my host, was happy for them but heartbroken that she lost her missionary soulmate. After that Margaret continued her life as a single woman for 50 years and then received a notice-that her old friend Sophia, had contracted a terminal illness and she and her husband Peter were forced to resign from their mission duties in a distant country and return to the United States. Margaret, now working in the Philippines, decided to take a leave of absence and go back and tend to her old friend in her dying days. Within a year after Sophia’s death, Margaret and Peter found comfort in each other‘s company and become very endeared to each other and so now nearly 50years later, the two of them married and acted as our hosts. To her great satisfaction this scholarly woman had just completed translating the whole Bible from English into the Taboli language.
It was not unusual following mission projects to leave behind much of your own clothing, and I distinctly recall Peter trudging around the bungalow in a pair of tattered slippers held together with tape so ….amongst other things, my recently purchased slippers found a new home with Peter in the mountains of the Philippines.
Toward the end of our project I asked my translator if there was a way I could get up into the mountains to see where the people had come from. He said it was impossible. They lived in the jungle and it was so remote on the mountain – side that we could never get there, but he did indicate that by way of his motor scooter we could get partway up the mountain trail and get a bit of an idea of what the terrain was like. So the following day after a clinic was over, I jumped on the back of his motor scooter, and we charged our way up the dirt trail and began making our way along a narrow rocky mountain path. After an hour or so of being jostled on the back of the scooter we stopped for a rest near a little bamboo hut which was considered a commune storehouse where non degradable food was stored for emergencies. While catching our breath,I noticed a very slight woman who I remembered,as having been at our clinic, emerge from the forest holding a newborn baby. She recognized me from the clinic and made a point of thanking me and our team profusely for the care she and her child had received. After that brief encounter my translator, and I continued up the mountain for another hour or so. The view from the top of the trailhead was breathtaking as animal drawn carts (with no wheels) carrying firewood,passed by. On our return trip we paused again at the little storage hut and was startled to see that same woman emerge again from the forest, this time holding her baby in one arm and a very small chicken in the other. She approached me timidly and said that although the chicken was very small and skinny, it was the best chicken she had and she wanted to gift it to me and our team for the care she had received. I was so taken by this act of gratitude that tears weld up in my eyes. I knew I was obliged to take this chicken as a courtesy to her even though I would be depriving her of important sustenance. After thanking her profusely I mounted the back of the scooter and headed down the mountain informing my translator that I had already named the chicken. I would call him “Willie“ because all you could do was to “Free Willy.” I was so touched by your act of kindness that I thought it deserved a reciprocal act of thanksgiving. I asked my translator if there were farms down in the valley where chickens were being raised, and he acknowledged in the affirmative. I asked him if we might not get a message to one of these chicken farms and buy 100 chickens and six months of food and returned them along with Willie to this lady up in the mountain. He said it would take a little scrambling to pull this off, but it could be done. I left the money to proceed with the project and a week after my arrival back in the United States. I received a notice that 100 chickens and Willy had been delivered up to this lady.
Alas, like most projects in the Third World, one forward step of progress is usually followed by two steps backward. I received a notice within the next two months that bird flu and infected the chickens and they all died. I asked my contact to replace them all with ducks which he did, and they suffered the same indignity as the chickens. He added however, the goats are a prized hearty animal, and that they would survive well in the this jungle mountains. We resolved therefore to send up a small herd of goats to replace the chickens. As always, I measured the success of our trips, not so much in terms of the service I rendered while I was there because in my mind it was minimal, but rather what type of project I could leave behind providing lasting value after I had left. I continued to use this approach on many other projects.
Interestingly, that evening, I was reading my third Harry Potter book under a small canopy near the fringes of the forest. People began emerging from the darkness and surrounded me as I read under a kerosene lamp. They watched me flip through page after page for an hour and I came to realize that these people did not read, and therefore did not have books and found the flipping pages for an hour to be a startling and remarkable event. The
following day, I asked a Filipina physician who was working with our team that besides the chickens what else might I leave behind to increase their quality of life. Without a moments hesitation, she said “a literacy program“. Although I kept suggesting nutritional support, or medical treatment she kept insisting that it was the literacy. The following day she took me to a remote bamboo shack out in a field, which was set up as a classroom for 10 people. Each of them was learning for the first time how to write their name and to count. She pointed out that these people owned much of the fertile land many years ago but negotiated its sale to unscrupulous land barons
for less than what it was worth becausethey had very little awareness of its value or the value of money. They also could not read or understand contracts. She said they kept being forced to move further and further away from fertile land as they continue to be
swindled time and again finally ending up in this remote jungle settlement living in very primitive circumstances and suffering from iodine deficiency. She clearly stated, “we need schools!“ So upon her recommendation in addition to the chicken farm we supported the hiring of several teachers to advance their literacy and numeracy.
The following day, I was asked if I would leave the camp and go to a remote bamboo shelter in the middle of a barren field to treat patients. When I got there, I found one or two chairs in a small building with a roof but no walls and one small table and 20 or 30 perspective patients standing around in a circle. Interestingly, many of these patients walked long distances with little nutrition, and sometimes very dehydrated making them unprepared to endure the rigger’s of oral surgery plus they received treatment sitting up in a straight back chair, diverting blood from their head making them prone to pass out. As it’s so happened the third patient I was treating began to get very lightheaded, his eyes rolled back, he started sweating profusely and began sliding off the stool where I was trying to remove some infected teeth. I had to place the patient on the ground and elevate his feet while dousing his forehead and neck with cool water until he became more stable.. I allowed him to lay there for several minutes while I began treatment on another patient given the impression to the 20 people standing around, looking at me that everything was under complete control. I then returned to the patient on the floor completed his extraction and packed the surgical site with gauze and slowly got him back up into a chair, rehydrated him and gave him some food. I asked his friend to escort him home. These are unsettling moments, but what was most important was that I not betray any sense of anxiety to the 20 or 30 people standing around staring at the incident as it evolved.
That night when I returned to our camp, I noticed several military vehicles with 20 or so heavenly armed soldiers making their way through our camp. Apparently there had been a kidnapping and an assassination by terrorists in another nearby mission camp and the soldiers were there to protect us. The following day was to have been our last day on the project but rather than return to General Santos City by van, we crawled into these military vehicles and rode along with guys holding rifles, grenades and gas masks. They bought us to camp along the ocean which had a series of small shacks and old mattresses thrown out on the ground. We were told that we would be billeted here sleeping outside on the mattresses this night before they transferred us to the airport for departure from the Philippines the following day.
As a treat to myself instead of
flying home by way of Hong Kong I diverted my trip by 3000 miles and caught a flight to Bali, Indonesia where I spent two days on the beach decompressing. I went sailing with a local in an outrigger and let my feet hang over the edge and splash through the water. The thought then occurred to me that these may be shark infested waters so I asked my friend at the helm if that was indeed the case. He confirmed that it was, but then with tongue and cheek, tried to comfort me by saying the sharks really don’t hang out here near my boat, but over by those other rocks a few hundred yards away.I quickly took my feet out of the water and waited anxiously get back to shore.
Four flights later I was back in Connecticut shoveling snow.