Prior to the exploration of outer space our euphemistic reference for the most distant place on earth was considered to be outer Mongolia. With that in mind, I became intrigued with the notion of making that journey as soon as I saw a project to Mongolia appear on the schedule. With barely a thought, since these projects had become as common as taking the drive to the Yankee Stadium, I signed up for the project in 2001. Shortly after I registered I was diagnosed with prostrate cancer and the doctor called to gave me the diagnosis and the treatment options. I asked if the treatment could be delayed by two months so that I could complete what I thought would be my last project in Mongolia during the first week of September. I was advised that the delay would be a no great consequence so in early September I flew out to London, spent half day seeing the sites and attending a concert and took the night flight to Moscow. After a day in Moscow, in which sadly, the Bolshoi was closed and I left for Ulaanbaatar l, Mongolia the next morning. It was a balmy September day with temperatures in the 70s and so I filled my camping shower with water and placed it in the sun to heat up during the day to provide me with a warm shower at night.
The architecture in Ulaanbaatar was rather bleak, in that the Mongols left no temples or castles that would speak to its history and most of the buildings were Soviet style utilitarian complexes that lacked any aesthetic appeal. Within 12 hours, the weather changed dramatically and the following day we had snow which not only rendered my Solar shower bag useless but we realized there was no heat in the building where we were billeted. Shivering to the bone we were advised that there was a break in the main heating pipe that served our section of town. This was incredulous to me since I assumed the heater furnace in the building somehow was in disrepair, but I soon found out that in the Soviet social system individual buildings did not have their own heating system, but all the heat came from a central location in the city and was driven out to different sections of town through large pipes under the road. At night we had no electricity so I had to make my way around my room using the luminescent glow for my wristwatch. We had a coffee pot in the room to boil hot water to drink which I used to fill my solar shower mixing it with cold water from the tap, providing myself with a warm shower.
The next morning, we all piled into SUVs and drove over the plains to remote villages and tried treating patients in freezing cold cells. We had no chairs, so we laid boards from the windowsill to the ground for patients to lie on while receiving treatment. One young woman who was in severe pain pointed out a tooth she wanted extracted, but when I examined her, I saw that there were several that were badly infected, but she insisted I only do the one. Complying with her request I gave her local anesthesia, asked her to wait 10 or 15 minutes while I saw other patients. When she returned and reclined on the cot which served with my dental chair I probe the tissue around the infected toothto be sure that the anesthesia was profound and using modern well designed dental instruments I elevated the tooth from the socket without using a forceps, packed the area with the gauze, and told her she was done. I noticed that she had another area where tooth was missing, and I asked my translator to ask herwho had taken that tooth out. She told my him that she had done it herself by drinking vodka and prying it out with a screwdriver. She said It had taken her all day. When she got up from my chair, she walked in the door, turned around and looked at me somewhat daze
but before leaving, she turned and meekly asked if I would extract the rest of her disease teeth. I realize that the reason she didn’t want me to remove any others initially was because she was unfamiliar with the miracle of anesthesia and delicate instrumentation assuming I would be prying the remaining infected teeth out as she had over several hours using a screwdriver.
Each day we adventure out in our Range Rover’s over the rolling terrain, which was marked by the occasional skeletons of livestock that had not made it through past winters. We traversed.massive expenses of grazing pasture land which played a major role in their culture. Throughout our long drive over rugged terrain we would see young men on horseback shepherding their flock from one grazing field to another. Occasionally, you would see a small cluster of “gers” (circular distinctive /homes) which were round mobile homes insulated with felt featuring a charcoal stove in the center of the tent structure. Each little home could easily be
deconstructed and put on horse drawn cart and moved to another location within a few hours then reconstructed in a totally new location many miles away on the open plains. Such with the nomadic life of the Mongols.
Sadly, Mongolia is one of the poorest countries in the world where many people live along the fringes of the dump, finding shelter under a convoluted arrangement of corrugated cardboard and feeding off the scraps in the pit. . One of our saddest and most tragic experiences I experienced was when we identified a family told them to prepare to leave the dump for a new dwelling because we were in the process of building a “ger” for them. Tragically,
on the day before the ger was completed, the mother was caught up in a fire in the cardboard boxes at the dump and died. This was not a rare event. Homelessness was rampant and street urchins would crawl under the manhole covers in the streets and wrapped themselves around the heated pipes at night which ran from the central boiler station out to various sections of town.
Our contact intermediary who prepared the way for our work was a missionary from Texas who move to Mongolia to give these streets urchins a warm home, food, clothing, and education. Having saved hundreds of kids, in time he was deemed a threat for the political hierarchy in the community and he was ultimately banished from Mongolia..
I left Mongolia a few days before the rest of the team because I had pending surgery for my prostrate removal so I returned on September 10, 2001. My return home was uneventful but on the following day, September 11, 2001 the terrorist attack in New York, which destroyed the World Trade Center and 3000 Americans turned the world upside down. The rest of the team who were still in Mongolia was due to leave two days hence, but ended up being detainedin various airports throughout Asia unable to get back to the US because flights had been canceled. It took our project Director 10 extra days to get home.
Once I got home, I began to wonder whether or not I had picked Mongolia because it was an exotic place to go or if I truly felt a commitment to these people and in order to resolve that doubt in my mind, on the one year anniversary of the 9/11 terrorist attack, I signed up to go again the following year. This time, my daughter, Kelly, came with me who came with me on projects in Honduras in Cambodia.
The connecting flight from Beijing, China to Ulaanbaatar, Mongolia was uneventful except that there were Mongolian newspapers written in English available on the aircraft. Upon reading the headline, I was informed that Mongolia was marking September 11 as a day of reflection in Mongolia on behalf of the American people. The article went on to say that government workers had donated a portion of the salary to the families of the World Trade Center victims. It struck me as most ironic that here in one of the poorest countries in the world where kids sleep underground around hot water pipes, and where families huddle near the dump to survive they had room for empathy for Americans, many thousands of miles away. I shared the contents of that article with our local newspaper that we all should be humbled by their display of humanity.
On our last day our whole medical mission group divided up into two construction teams to determine who could build a “ get”the fastest. After they were completed we moved two new families into them.
At this point, I was probably on my 30th project and as usual I was the only dentist on the team with three young physicians, each of whom were making their first mission trip. The unique nature of dental services and oral surgery is that one could make a definitive diagnosis, provide anesthesia, perform a
surgical extraction leaving the patient pain free and their dental disease completely resolved. Unfortunately, for the physicians it was nearly impossible, working in the bush, for them to pinpoint a diagnosis when a patient presents complaining that they hurt all over. As I told my physician friend Bill, who had a similar lament in the mountains in Nepal… it is apparent by the patient’s reactions that you don’t always have to provide definitive treatment since most of these patients are at the very least comforted by the awareness that you cared enough to be here.
Upon the completion of this project, I thought my mission days were over and I would return from the outer reaches of the planet earth …but then again there was one more stop to be considered… and that would be Rwanda the following year.