Stories From Volunteers: Successes on the Border
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Planet Care
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The successes come in many forms, large and small, sometimes benefiting an entire village, sometimes improving the life of one.
In 2003, Dr. Tom Lee, Anusha Dahanayake, Grace Baek and Manny Martinez traveled to the border area to a village composed of people displaced by internal conflict, that was one of four pilot sites for GHAP’s malaria control program. More than half of the people had contracted malaria in the previous year, and about 10% were chronic carriers.
When the team arrived in the early morning, the village -- a cluster of bamboo huts perched on steep jungled hillsides -- was still shrouded by a thick chilly mist. Two hours later, the strong tropical sun had burned through, beating down on the thatched-leaf roofs.
The GHAP team, along with the village's two health workers, wandered the dirt paths between huts, and chose a handful of families for the initial practice protocol. Tom and Anusha, a nurse practitioner, guided the health workers, who interviewed family members about their malaria history, administered rapid diagnostic tests to determine the current level of malaria infection, treated those testing positive for the disease, and passed out insecticide treated nets. The GHAP team would be leaving village the next day, and the health workers would be on their own to administer the program and gather data.
The last family interviewed -- a 38-year-old farmer missing his right leg below the knee, his 22-year-old wife and their three young children -- lived on the edge of the village in a small, dilapidated hut: The roof had a large hole and the cramped sleeping area was covered with soot and ashes from the fire pit. After finishing the malaria survey, Tom asked the husband how he had lost his leg. He and his wife, speaking softly, told their story:
"A year ago I was foraging for vegetables in the jungle, about two hours away from my village, and I stepped on a landmine," said the husband. "I spent two days alone, stopping the bleeding by tying my longyi (sarong) around the wound."
"I was pregnant," his wife added, "and was worried when he did not return. I thought he was dead. My uncle, who is my husband's friend, and I went to look for him. My uncle stepped on a land mine and was killed."
"I heard the explosion, and thought my wife had been killed."
The wife described how she found her husband and carried him, by herself, back to their village. From there he was taken to Dr. Cynthia's clinic, then to the Thai Hospital. After surgery, he was sent back to the refugee village to recuperate. He had been there ever since, with only crutches to get around. He could not repair his hut, or forage in the jungle. Had he been in Thailand near Dr. Cynthia's, he could have gotten a prosthetic leg. But he had no papers to cross the border or money to pay for transportation.
"I want a leg, so I can help provide for my family," he said, simply.
At this, there was a brief pause as the GHAP team members looked at one another. "You could come back with us," said Tom.
He immediately nodded yes. He packed a small shoulder bag, said goodbye to his family, and used crutches to slowly make his way down the steep path to the truck. He sat in the back seat, with blanket over his lap to hide his leg, which would have identified him as a refugee to the Thai border guards.
At Dr. Cynthia's, he was immediately welcomed into the prosthetics clinic, where two workers -- both with prosthetic legs of their own -- started working with him, shaping a plaster cast to mold a leg. The GHAP team expected it to take up to several weeks to make the prosthesis and train the man how to use it. They checked back at the clinic two days later, and learned that he had been fitted with a leg, and was already on his way back to the village and his family.
In January, 2004, a GHAP team returned to the village to do follow-up interviews on the malaria program. They asked about the landmine victim they had met the year before, hoping to see him again. But his family's hut was no longer in the same place, and several villagers shook their heads when asked about him. Finally, someone pointed to the other side of the village -- across a creek, and up on a flat plateau above the school and church. At a large bamboo hut, with raised split-level floor, and separate cooking pit, there was the husband, standing next to a bonfire, charring bamboo shoots to strengthen his roof.
The man’s wife saw familiar foreign faces, and broke into a big smile, shaking everyone's hands. Through one of the health workers, the husband told the group that he built the hut himself. Earlier in the day he had been out in the jungle, setting traps. He smiled shyly and stoked the fire.
The next morning, the GHAP team surveyed a random sampling of families about malaria and mosquito nets. At one hut, a 20-year-old woman sat on her bamboo porch, with her two young children, chewing beetle nut and spitting a bright red stream into the dirt.
When asked whether she and her kids used the net, she said, yes, every night. And had she gotten malaria? At that, the woman's eyes got wide and she started laughing, covering her red teeth with her hand. She had just made the connection between malaria and mosquito nets.
"I thought I was going crazy! I used to have malaria very often, three and four times a year. But this year, no malaria, for me or my kids. I couldn't understand why. Thank you for the net!"
The young woman's experience was not unusual: The Malaria Program data for 2003 showed that the village’s infection rate had dropped to an astounding 8 percent. As Eh Kalu, one of the leaders of the Backpack Health Worker program, put it, "We're calling it the 'Malaria Free Zone.'"
-- Janet Wells, San Francisco Chronical Staff Writer
Copyright Planet Care
