Upon receipt of a B.S. degree in biology, an acquaintance of mine -- let's call her Linda -- decided to spend the summer in Asia working at a small medical clinic that had a staffing shortage. The clinic was near a major river, on whose banks were crowded thousands of families living in small densely packed hovels.
The shacks, tents, and slapdash dwellings did not have access to electricity, indoor plumbing, nor cooking facilities. Consequently, hoards of people spent countless hours every day trekking to locate semi-private spots to undertake their toileting and to find materials that could be burned for outdoor pit cooking. They, also, spent an inordinate amount of time trekking to and from the river to collect water for food preparation, cleaning and baths, as well as for any livestock and small gardens that a minority of the households maintained.
In addition, many people would become unwell from drinking the river water, particularly because lots of fecal waste, garbage, and trash inevitably wound up in its currents. Especially young children whose immune systems were not fully functional and elders became stricken with intestinal infections, and would,doubled over with cramps,drag themselves to the clinic, a claustrophobic closet-like facility, for any sort of cure.
However, there was such a shortage of medicine that nothing of real value could be offered and, certainly, no one could suggest that avoiding the river in order to make the illness, whichever type it was, go away. As such, mostly sympathy could be offered.
These included antiseptic ointment and gauze for wounds, splints made from slender tree branches for broken limbs, several other items, and suggestions for bed rest, the latter of which was often an impossibility since one needed to move about to get the river water, fuel (primarily animal dung and small scraps of brush) and food from hawkers that included river fish and eels for meal preparation. Many people's health further deteriorated to the point that they prematurely died, and then, another problem arose.
This additional difficulty concerned a way to dispose of the bodies since the majority of the deceased persons' kinfolk did not have sufficient funds to carry out burials or cremations. As such, the waterway served another function, which was as a corpse recipient. Linda noted that, nearly every day, bloated water-logged remains could be seen quietly gliding downstream.
A compassionate person, she found the sight disturbing and, while she enjoyed aiding individuals as best as she could at the treatment center, she felt largely helpless during her experience there. She came to realize that, while she was grateful for the small remedies that she could provide in some instances, she really could not change much in the quality of life for the often desperate mobs, who patiently sorted themselves out so as to line up every day in a continual stream seeking help that, more often than not, couldn't be rendered.
Meanwhile, her realization of her limits was simultaneously sad, humbling and vexing. After all, it is demoralizing to have great hopes to help the world improve and then learn that certain troubles are so great that one will always feel insufficient, unless she focuses on the few small successes that she does occasionally manage to pull off. With such a conflicted understanding, she was relieved to return to the USA after her summer job abroad was over.
At the same time, she felt grateful for the medical care, reasonable homes, clean water, indoor plumbing and food stores available in America. In a flash, she came to realize the reason that so many legal and illegal migrants want to come to first world nations, even if those countries have job shortages.
It's really quite simple in the end. The alternatives seem dreadful.
Especially, she surmised, when their rivers and other water sources dry up after the glaciers that feed them disappear on account of climate change. She wondered about what they would do then.
Considering that the 18,000-year-old Bolivian Chacaltaya glacier, on which 77 million people rely for water, recently disappeared shocked her. She didn't wish to imagine that the many people who she'd met in Asia would, eventually, face the same plight.
Where would they all move? How would they eek out a living? Who would feed them and provide a new source of water? Where would they find homes and a sufficient number of healthcare clinics? She couldn't imagine any realistic answers to her questions.
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At the time that Linda was embarking for Asia, another woman, who we'll call Anne, had just received her undergraduate degree in philosophy from a different college than Linda's. She, too, entertained an idea to engage in social service volunteerism for the upcoming summer months. Yet instead of Asia, her plans inevitably took her to Africa, where it had been arranged that she would work with the one doctor available in a region that covered roughly a hundred square miles.
In the territory, various interconnected tribes lived in small communities. Therefore, the doctor's job was to make the rounds and visit one site after another each month, after which he would repeat his tour unless an emergency, like a major fire at one of the locations, were to immediately redirect him.
At the same time, each village had at least one paraprofessional health care worker, generally a woman, who delivered babies and provided a modicum of aid in the doctor's absence. So she would be the first person with whom he would consult upon arrival at each tribal compound, so as to get an overview about what he was to do next.
Meanwhile, the American lived with one of the health workers near the doctor's hut so that she could learn further about medical intervention from the assistant. As a result, she learned many details about therapeutic care.
Likewise, she learned about its limits. For example, there was in this region, as there was in the area that Linda visited, a dire shortage of medical supplies. Therefore, they had to be doled out very sparingly and only to the recipients who best qualified (i.e., the ones who had the best chances of showing improvement upon receipt of intervention).
This choice naturally precluded people who were either too sick to get well or who were otherwise rejected, as were very old and very injured people. Moreover, the villagers all had a policy that, if someone were somehow grossly defective, he would be left to his own devices and shunned, as there simply was not enough food and other supplies to give any to anyone who was severely impaired.
Emily Spence is a progressive living in MA. She has spent many years involved with assorted types of human rights, environmental and social service efforts.
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