This morning is another beautiful day. I went straight back to the Buddhist cafe to try to get some work done. However, some lady with three kids running around recognised me from the day before and thought it was perfectly ok to interrupt my work and start up a conversation about holistic medicine. She was one of those somewhat "out there" ladies, but also very conservative and "spiritual" in her demeanor. Her attire wasn't bizarre, as you might expect with mania, but quite proper as well. She always spoke in a soft voice but she wouldn't stop talking. So my battery on my laptop ran out and I used that as an excuse to quickly find another cafe. I quickly stopped in at another souvenir shop (without a drunk guy) and found a few cool things for Michelle. I also found a cool think for mom and dad but I have to check on US quarantine issues first. I was headed back home to get my power cord when I passed Mael, the French guy at the guest house. He was headed to a nearby French cafe and bakery, so I went with him and had some great coffee, great bread, and of course wireless internet! I actually now got some more work done and I'm starting to put together a brochure that might be distributable to educate people about hypertension.

When I got back to the guest house, I was shocked to see that the quiet guest house with only 3 people in it now had three more groups, with 20 more people!! Aaargh! Now my room is completely full and its going to be a madhouse. I won't be able to call Michelle from my room anymore. Hopefully it will only be for a few days.

Anyway, I'm off to my clinic now!

I arrived at the Christina Noble Foundation office to find that it's up on the second floor of a dingy, run-down building. You'd NEVER find it unless you know exactly where you're going. In the office, it's actually quite spacious and reminds me of NYC lofts with big windows and a generally open plan. The equipment was modern(ish) and at the front counter sat one of the nice Mongolian men I had recently met at English club. It was his first week at this job and he was busily translating a document from English into Mongolian, but I think in the 15 minutes I was waiting there, he got maybe three words done. He seemed more concerned (or interested) that I had arrive 6 minutes early to meet the doctor, and I should have to wait until 5:00 before he would let her know I was here - he stated that he couldn't interrupt her to let her know I was here because she was busy with her "day job" until then. She came out a few minutes later and was wondering why I was just waiting there. She and the Mongolian man had a few words educating him about the fact that if a visitor comes to meet someone at a pre-arranged time for an appointment, he should let them know even if it is working hours! This seemed strange to him.

Anyway, we headed out to the truck, which is a massive Mercedes 4-wheel vehicle that you have to climb a ladder to get in. Inside the back part of the truck are two long benches and a linoleum floor and nothing else except some loose plastic crates holding the day's food and supplies. The driver, the nurse, and another man jumped in the front while Sara and I jumped in the back to head to our first location. After about a 10 minute drive (a very bumpy one!) we arrived in a parking lot and the kids immediately swarmed the truck and started climbing the ladder to get in. We had to move them off the ladder so we could open the door and they all piled in. There were about 25 of them here but only about 8 could reasonably fit in at a time. They quickly took their spots on the benches and obediently waited to get a quick check by the doctor, after which they'd get a yogurt, a juice, some vitamins, and a KitKat. A few of the kids tried to steal food from one another (right in the open, not secretly), and for the most part this was accepted by everyone as part of the street pecking order. The ones who had food stolen did not argue or resist, but just accepted it. They all had their mouths, hands, and feet checked for hand, foot, and mouth. They had their wrists, hands, ankles, and beltline checked for scabies. They had their teeth quickly checked for major cavities or other dental problems. And the few with specific complaints got their lungs listened too or their stomachs prodded. Those with problems were told to come to the drop-in clinic that runs every morning at the women's and children's hospital. This is all entirely free for the kids. They each had their names written down in a log and some of them who were new had their photos taken. The kids ranged in age from about 4 to about 16. Most of them had hands so dirty that even several good showers wouldn't get the dirt off. Their clothes were torn and obviously not washed in a long time, but those with insignia clothes like NY Yankees caps or NBA sweatshirts were very proud of these and were a bit more cared for. About a quarter of the kids had scabies, about 15% had serious dental problems, and a few others had fungal skin infections. For the fungal infections, nothing was done at the time but they were told to come to the clinic. For the scabies, the same. Later at one of the other stops, there were four sisters all with scabies and they were given some ointment to apply, though not nearly enough to properly treat them. Furthermore, without proper clothes and linen washing, they would become immediately reinfected anyway so I'm not quite sure what the point was, nor how they could really get rid of them. It just seems an impossible task given their living conditions.

Another young woman, who happened to be 20, turned up at the clinic too. She was at a different location and was apparently deaf and mute. She couldn't express what was wrong other than by pointing to her stomach. On palpation, she had a few very tender areas and it's quite likely she had either appendicitis, an ectopic pregnancy, gastric ulcer, or any combination of the above. In any case, she was told to come in to the clinic in the morning as well for a more complete examination. Her little sister, about 8 years old, did the sign language interpretation for her, and was happy to get the free KitKat and other treats.

On the one hand, I don't like giving money out to begging kids because it really does just encourage more reliance on this behaviour. However, on the other hand these kids are so desperately needy and often all they really want is food. Of course, kids being kids, they like junk food. I figure the best thing I can do is keep on doing what I'm doing, make them laugh and smile, and find more productive and positive ways to help them.

At one point, I listened to the chest of a young girl with some breathing problems. It sounded like she had a lower airway infection but once the kids saw me use the stethoscope, they all wanted a turn to listen. Of course, I cleaned the stethoscope after each use but they absolutely LOVED being able to listen to their own hearts and those of others. They seemed more interested in this than in the food at times. Hopefully this will inspire one or two of these kid to develop some further interest in medicine, if they ever find they have the means to do so. These kids are smart and resourceful, but they're really on their own with almost no help from anyone.

In all, we ended up visiting about 5 locations this evening and each was similar. Kids would swarm the truck, clamber in, and be very happy for that short amount of time. This truck goes out 2-3 times/week and the kids all know the schedule. I really don't know what these kids would do without this service.

Anyway, after a full evening, I headed home to take a very hot shower and wash all my clothes. Scabies is very contagious and you have to try very hard not to get infected when around so many kids who have it. After a good clean-up, I headed over to Dave's pub for the weekly English Club. I was a bit late but that was ok, as they hadn't really gotten into the singing yet. Lee, from Oregon, got out his guitar and we proceeded to sing Puff the Magic Dragon, Hey Jude, Yellow Submarine, Take Me Home West Virginia, and a few other classics. It was ok but I was quite tired. I had a quick cheese sandwich then went home to get some sleep. I gave Michelle a quick call to say goodnight and that was the end of another day.

G'night!