Listen Here; Pat Penn: Valley In Vietnam

Well and good but I. Mean the last. Time. Was with a. Home Gym a really brutal No. This is a valley in Vietnam Rice Valley set among forested hills where the banana grows beside the pine. The rice is still young and in the rice fields and the pasta stand the charred stumps of many trees. There was forest here too before the hill people slashed and burned to clear the land for the crops. It is a wide valley of morning mist and sun. And now the monsoon has come of drenching off to new moves. Rain that turns the valley road to a soft red trail. South the road leads to the lot. The province capital and hill resort some 40 miles away in the mountains north it heads into the forest past many Hamlets. Down the valley length the dark Dome of the great river plunges through steep banks to Saigon in the sea. Two hundred miles to the south.

Sat on a rise between the river and the road. Caught in a tangle of barbed wire fences with sentries at the gate is down power hospital. A cluster of low buildings which was once an army post and flanking the hospital are the modern such villages of dam Pau and Dano. This little hospital in this valley in Vietnam was started by an American doctor Jim Turpin who came here from Hong Kong. And the project concern clinics that he set up there for poor people came to this valley here in the southwestern part of the province and first in October of 1963 this was just before premier Zim was overthrown. And I was not really prepared emotionally psychologically for seeing people who lived. As do some of these primitive tribal people the mountain yards and mountaineers of South Vietnam. And I was impressed frankly when I saw them in their line cause and. The women with their single piece of skirt. Children naked.

I saw them without schools without medical care and I decided then and there that this was really what I was after in. Project concerns work of bringing medical care to people particularly in Asia who right now don't have adequate modern medical facilities. Project concern Today's International and many of its staff and volunteers come from the British Commonwealth. Frank Cooper one of the first to come to the valley is a lab technician from Vancouver. Today we have. Two nurses here. One Australian one Canadian. We have. We have two Chinese doctors one trained in can one trained in Taiwan. We have we have an American medical student. We also have my staff of course. I come from Canada.

The hospital serves the hill tribes who inhabit the valleys and forests of Vietnam's mountainous spine. The French call them the mountain or mountain people and the name has stayed the Vietnamese despise the stocky dark skinned Aborigines and call in the Moise or savages. There are many tribes making an ethnic most sake of Indonesian Polynesian and come out of. This valley into a province is the home of the chill and the stray and the MA whose common language gives them the name call home. Their ways are primitive. Their village home is the common along houses of watermelon patch where they cook and sleep on the earth a wooden floor. Their coats are a man's brief and the woman's long black skirt woven on simple looms and little beside. Their crops of the rice they win from the forest. The mushrooms they find there and a little tobacco for the men and the women to put in their bamboo pipes. Their riches a water buffalo and their pleasure drinking rice wine that music is the moan of gongs and the shriek of bamboo

flutes. Their songs testaments to historic poverty. When you. Get to my village his with village and with the Vietnamese these people have names like cry and their weapons are the spear and the bow and arrow. Their own immense bangles and neck pits of brass and beat the bones which Pierce and lengthened the lobes of their yes and Rosary. Long before the hospital came to the valley. The priests were here. French-Canadian Redemptorist fathers who left communist North Vietnam two decades ago and as teachers accountants mechanics and farmers now live among and know the

people. Those people are leading us. And they have a natural natural leader emerge among themselves and everybody have to obey them. And this man will show it to everybody. The place. Where they have to make the rice and there is some trouble in the village. You have to go to him and a job. This started the work of the rice. January February Wendy's tired to cut the tree and they wait for two or three months into those three days are dry and before the first raining they burn all this. Feel the cut already. And after that they will wait for a two or three weeks to start to plant the rice and a call on the cabbage and after that they wait and keep the feel

good until the harvests harvest and. Andy may be are but how about i dno number in November. You know to make up the cut of a portion of the parse for each year and the next day make an order and so every year and all around their village they have a large country and the large man and so in a circle about 10 or 12 years they will be back to the first place the start. The priest must share the Highland parish with a host of spirits. Few Montagnier would risk offending the spirits of forest and mountain and rice. They must sprinkle the fields with chickens. The planting time I give thanks for the harvest. With a buffalo sacrifice it's gruesome it's cruel to the Buffalo is tied by the neck to a steak or to a purple one without overthrow.

The buffer cannot move. The man who is chosen for the sacrifice sacrifice. Is an important man in the village he has a large sword and spear. First thing he takes the sword. And whacks the buffalo across the back leg and breaks the leg. About. The calf of the buffaloes down on his knees and then he takes the spear spear the buffalo in the side and then with a broad sword one slice in the head. There's a lot of blood. Many young leaning to Western ways bluejeans Bush hats and bicycles. The hospital interpreter is one but when he accepts a young girl's proposal of marriage Buffalo will be part of the diary she brings when they are younger and from the. Day one

from and from Boy Yes mainly from The Wrestler. And and and. Vietnam has seen 20 years of fighting the communist takeover in the north Corps tribal migration south in the 40s and the villages have been swollen with thousands of Hmong unknow and toe anti today Viet Cong activities causing local migrations from neighboring valleys and forests tribesmen and their families struggle the road with all they possess on their backs and baskets Mattocks on shoulders driving their livestock before them looking for places to build their homes. But even in this valley things are not as secure as they were some kilometers down the road from down power the American army officers who act as security advisors to the Vietnamese province. But in the last couple of months activity has increased coinciding

with the monsoon season of course. They've come in they've. Shot and the Chiefs. Ambushed along the roads which they've never done before in this this area. They've killed soldiers. They've kidnapped construction workers these are people who go out into the hammocks and work with the people to help build the school to build aid station maternity houses and I said and they'll come in and kidnap people. We've had more incidents of this kind. Just last month I never had before. The most recent incident one occurred less than a week ago where the Vic Kang forcibly entered a village took three young men from the village ostensibly as a recruiting program and then killed a fourth because he refused to go with the

children in his own village. The mountain would by both sides call the VC have played on the antipathy between the tribes people and even to promising them their own autonomous region. Many mountain ya's are known to be with the Vietcong but not always from choice. Very good you know. And our next speaker. Three nights ago it was reported to us that. You were ambushed on the road and killed just me just a few kilometers down the road a few weeks ago. The Vietcong went into the Chinese find the evergreen farm about three

kilometers just beyond us. Carried bags of rice and. Tires rubber tires and. Flower took money and then they gave. They called all the people together and gave them a lecture lecturing to the people. In isolated incidences one time they went into the fire. Damn power actually right. Right by us and took all the sugarcane from the farm they're never coming into our hospital compound that we know. But from time to down we get stories of them being in the vicinity. It's against this backdrop of jungle that the hospital works in Vietnam. No country road is safe after dark. And there are risks in the daytime. Most afternoons the white hospital sets out with a doctor and medical students along rutted forest tracks and sets up a clinic in some village and the people come in uniforms for the white man's

medicine. Ralph is a fourth year medical student from Oklahoma doing six months as a volunteer in Vietnam. This little boy in the village was one of 60 people he saw. He's probably got a belly full right. Look at the way that sticks out there like that. Yeah yeah we're missing anyway. Yeah. I'm a day supposed to get papers in. One week one week. OK Shorty. There you go. Who's got a hand on this you names on them and over you know he's had his. Hearings misson laying a

vision for how long. We don't go to any specific village on a specific day because there is the possibility that the VC might anticipate our actions and. Cause us trouble there or we. Do just enter the village. And set up shop so to speak in any convenient location and tree honest depths of a church or in the BMOC house if he happens to be in that village. The people will come. Pen lined up. To be examined by the doctor for the most part they are. Thin. And rather malnourished. They. Are very dirty no shoes. Their hair is usually long and rather and kept. The babies will be smaller than the Western babies. This is due

mainly to malnutrition and often there is a big potbelly appearance and this usually amounts to a belly hook worms. We find the main load of our cases is diarrhea. Now this is diarrhea caused by dysentery or hook worms or round worms thread worms. The common things you find in a tropical primitive society. There is also. Many cases of conjunct divide us in this area. And as it is. A infectious disease it travels. Within the family and I've seen cases of four or five members of the same family with the same disease. The reasons for these infectious diseases and parasitic diseases is. Mainly that in these villages there is very little or no no sanitation whatsoever. There is no toilet facilities. There is no

purification of the water. There are no clinics of the food. They have no concept of a sepsis whatsoever. We find that. In their sleeping habits and in their living habits they often crowd together very very often and they examined. Sick people in these real dark rooms where there is no ventilation and no light and on dirty skins and clothes on a bed it's on. All these things are from. Contribute to their health. The project concerned hospital itself has daily clinics and people coming from distant villages on foot by pass on a better taxi and impatiens bring their habits with them. Kay Hodges is a nurse from Esperance Western Australia. The first day I saw it I was quite horrified. It looked terribly dirty and

primitive just no sheets. It was quite a change from any other hospital I had seen. When a patient comes here the whole family moves in with a patient. At night when you do around you look under the mosquito net and you can see as many as five sometimes six patients in bed. Sometimes the grandparents come in so the son and daughter come with their children to look after grandmother while she's in the hospital. Never. Let them. Talk to cries now. Reading the rules hospital patients the first patients dogs patients are not allowed to keep their dogs and other animals in the ward. Patients patients families and their friends

are not to spare your nature Defra Kate in the ward there to use the toilet provided. This is proved a problem in the past because they come in and squat on the floor and they still do the mothers will hold their babies and let them die for k to urinate in the corner. The adults doing it too. We have to stress again and again the importance of it. Tell them. Just basic things that we always know. It's so strange to them. As for the animals. Many times we've come in and there's been a dog under the bed. Some of these dogs I mean they won't let you go near their family. I don't know if you get them from the lake or something. And one day one of my nurses went into the maternity ward and there on the head of the bed was a rooster. Crowing and the mother had just given birth to her baby. What Stana Terri. Positions.

Anything. In her propped up. I've even had a gun under the pillow. I cannot understand why the dog to shoot outside. We knew from the very first that we couldn't have a sophisticated medical program we don't have the financial ability for that we don't have the staff or we don't have the logistical support for it. But we felt we could have a basic kind of a hospital or dispensary. We felt also that perhaps the most significant contribution we could make would be in terms of a practical and appropriate medical training program. This is why from the very beginning we instituted what we call the village medical assistance training program. This is our only significant contribution to a province we've graduated 35. We have an additional 15 in classes now.

Thank you. Frank. The first month of this training course. Now this is basic BASIC is we can put it because these people had very little or no education no

nutrition types of food some food type of food. Hygiene sanitation. Communicable Diseases preventative medicine. And throughout this we stress venit of medicine. This is important because we want our BMI. And they go back to the village to work. We want them to teach the village people what they have learned. And this way we can try to do away with. The communicable diseases. So for the last four months consists of instruction and use of the drugs the medicines the drugs. And the diseases they treat. We have practical in the hospital where they work in the ward. Of course then followed by the practical work in the villages. Also the construction of toilets and showers etc. and then they will have with maternity. Anthropologists agree that many virtues do not include industry or

intelligence. Vancouver has the graduates working with us. I have seen hospital medical assistants. Who have done with project since its inception here a couple of years ago. Spit into the sink and spat on the floor and then rubbed his heel in. They are just as prone if no one is watching to grab any piece of us whether it be stare or on the floor. Watch the moon and apply this dressing. They are quite capable of leaving any instruments to boil all day or until the pan runs dry and then of course you have nothing but a mess and to ask them to clean up part that is covered with soot is. Something one has to fight over because they think it's very demeaning to take apart outside and rub it with sand and rinse and then bring it back and fill it with water

so that it can be used again. On the other hand we have several female hospital medical assistance. They are much better and far more capable and show more initiative than the male. Unfortunately the woman. Doesn't particularly wish to leave her. Therefore the applicant's are chiefly male at the time. While we're having our lectures they seem to understand but later on maybe two or three days later I will ask them a question pertaining to this to the same subject and sometimes they don't get me that they haven't a clue a blank face. You have to remember that these young people particularly the mountain yards have come out of tribal existences where a large part of the day many days out of the year is spent almost literally doing nothing except the fellows drinking rice wine and the women perhaps pounding the the pay or the the rice. And

so there are male medical officers especially have had their fathers and grandfathers grow up in a culture if you can call it that where the men do almost nothing mental or emotional jungle grows back very quickly so that we find it necessary to go over and over and over. We find one of the big problems is the translation problem. Our hospital medical assistance and village medical assistance only have basic rudimentary knowledge of English and we as doctors only have a basic knowledge of the whole. This makes translation very difficult and some diseases that when we need to know precisely how much and how much diarrhea was their blood or mucus in the diarrhea. So a lot. Of reaction got out Gow a lot.

The language itself is a monotone to her grammar so it should be easy. I myself find it most difficult because I cannot make the sounds a lot of them are foreign to the Western ear. They're way down in the throat and the English. Martin who runs the office said they do have definite difficulty with some of these terms. In particular they want to say and they get mixed up. They think a temperature is a thermometer. Temperature. It costs us $5000 or 2000 pounds to run the hospital for a month plus free drugs given by

manufacturers. Most of this comes from the United States Australia New Zealand collected by committees but living on charity has its hazards and we are very short on such things and. Our supplies of antibiotics often run dangerously low. Such basic things as gauze and bandages and Band-Aids cotton and. Tape. Often run. Far too low for our safety. We find that people good hearted people all over the world will donate things they'll often donate clothing and and toys for the children. These things are fine but. They often are not the exact things we need all the time. We would much rather have the money to be able to. Buy the gasoline for our Jeep and pay the salaries of our employees and and buy these things that. Are essential in this part of the

world. Clearly the hospital is doing a very commendable job given a hard headed fundraising policy and a businesslike hospital administrator. It could probably do a better one. Meanwhile sterilizes incubators suction and X-ray equipment are lying idle for want of a subsidiary generator to run them. Even so the logistics problem that goes with this overcrowded docks no rail transport dangerous roads and a total reliance on air transport all mean makeshift will go on as long as the fighting you do under these unusual circumstances some unusual things we built tents. We have a tent but we've been in tents out of bits of plastic tubing and plastic sheets and blankets and anything we could get our hands on. For the most part they've been effective and we've saved some children with double pneumonia who would not have lived if we had not improvised. There certainly have been deaths due I think in large part to the fact we haven't had.

All of the equipment or all of the supplies or all of the medications we'd like to have. We've had a tremendous load in the last several weeks it's easing up now fortunately of dysentery. We've had bass Larry dysentery we've had amoebic dysentery We've had several cases of cholera. And we have at times just run out of intravenous fluids particularly the salt fluids the electrolytes. And I'm confident that two of our deaths a few weeks ago were attributed in part to the fact that we just didn't have the fluids to give them. And this I think. Of all the frustrations I have known including personnel problems personality conflicts financial deficiencies slowness of transport Haitian for supplies all the things MUCH TOGETHER don't. Nearly begin to equal the frustration that comes to a doctor who knows what to do. And who has diagnosed the case. But who just. Doesn't have the medication or the fluids to

administer and to stand by helplessly and see that patient die. When a child dies you know that is a whale and challenge. But I feel it's not such a major tragedy in their lives because they have seen so many children dying. I think I mean any footage that has at least one child. These children are very prone to have little or no resistance whatsoever and even a simple diarrhea child in this area blossoms out and hydration problem. Very hard to handle at times. Come here in a state of shock when they

arrive at the hospital. I've seen patients die because they are malnourished before they get there. And even though we can stop the dysentery the patient made. The veriest they do not trust us. We take one of their youngsters possibly into the treatment room. Or a mother into the delivery room. The relatives of course. And a relative must be present to see that the white. Is not harming the child in any way. They don't actively interfere with any treatment that we give. But they watch our every move and sometimes they do not agree with that perhaps not really. But you can see the expression in their eyes. Just last night we had a case of a man. Thought that we were harming his baby and causing his baby to have diarrhea by the simple and certain of a nasal gastric tube into the stomach. This man

left today. Because. He didn't think we were doing it right. Unfortunately some cases do the best to save the life of a young child and this fails. And I do not speak. I often wonder if they think perhaps. The treatment medication the child. May have hastened its departure that as I say not understanding the language. I am not sure we have a boy about 14 years. Of meningitis. We are able to keep him alive but he finally died worked around the clock with them on. We took shifts working night and day. I was with them when he died. When I went to help them pack up and leave. Mother had been at the boys constantly came up and threw her arms around my neck. He was crying and in many ways. We know that they do not understand that we are doing what we can to help them.

We find that there are cases that come in a rare case that. We. Get a lot of satisfaction out of helping because we know the patient would have been much worse had our hospital not been here or would have actually died. This brings to mind a boy of about 10 years old who came in. On an emergency basis last week with a. Very severe laceration of his forearm. A very deep wound he had just fallen off a truck and and hit some barbed wire on his way off. And the sepsis resulting sepsis. Could have taken this child is alive. In many cases of diarrhoea we find that a simple intravenous infusion will often bring these children around. Almost miraculously where if they were left in the villages. Many would not survive.

So whatever the shortcomings of living on charity without all the quantified stuff that it needs the hospitals that. The only one in the province besides the hospital where they take sometimes on dangerous roads at night and before the hospital came. There were only the old tribal methods in the village of down May there's a sorcerer who is very well liked and accepted. And I was visiting there some few months ago and we had a man with what I suspect was a spinal cord lesion a tumor of his spinal cord and he was paralyzed from the waist down and the sorcerer was in the room in the little hut. When I went in to see the man they had told me he was desperately ill. And I've had several encounters with the sorcerers before and ordinarily the approach I use is to look for and let's treat this patient together you've got strong medicine in your bag I've got some strong medicine in my bag. You live here. I just call in here once a week so you'll get credit if we can

work together. Well my particular care for this patient involves primarily putting a catheter into the bladder because it was filling up to the point where it was nearly ruptured the sorceror had no concept of paralysis and what this did as far as the patient being able to empty the bladder is concerned. And this gave the patient considerable relief and. Raised my professional standing in the community certainly in that household and with that source for quite a little bit. So we worked together. The patient lived for quite a long while he did die several weeks later but not before we had made a much more comfortable and before I had made a friend with a sorcerer. No telephones and little traffic. The hospital's links with London and Sydney seem closer sometimes than those with the rest of the. Thing.

Who would be willing to move forward. We do get what's going on in Viet Nam and boys going to market in the lot. But I rely on getting news from BBC and also from the Australian Broadcasting Commission of the government. This group when there are demonstrations in this means at a moment's notice everything from coast down. And this did happen one Saturday when I was in the lot. We're trying to find me and the next moment she just closed up shop Thomas and we were lucky to get her before she chatted him with meat for the

weekend. The war is seldom in the front of us. There isn't the time they assume their patients include Viet Cong and they asked no questions and guard their neutrality jealously. Recently mortars and machine guns were moved into the hospital cum bond and this and other events they consider abuses that neutrality and invites attack. Just recently. We were reported in the area so. The troops the forces from subsector came down and organized an operation. From our house. We didn't like. But. The next day they went out on the strike an air strike we were able to watch the bombing from the back. Step of our house. About three or four bombers. You could see them drop the bombs then you could hear the explosion.

American military advisers just down the road and did ask to leave the hospital. The course of activity in the area. We didn't go we feel that we if we did just run away every time there was some activity in the area. One of the Americans. The feet located within a kilometer. Or. At least an easy day's march. From Tampa. Where military personnel have to look at it and the respect that. If. They did not have. Security for them a VC would come in and take their medical

supplies and if they were in dire need of medical qualified medical personnel they will take they'll take these doctors into the jungle. As they have done in the past. Project concern has been in this valley in Vietnam. These people go. It's part of the place of the valley on the forest and the river. The villages the rice and the people who would like them to stay. They have the ceremony of drinking rice wine and giving in these brass bracelets. Chicken was sacrificed. They set up a small altar. There's a big. Earthen pot of this rice wine in the bamboo straws in it and they. You take it with kind of a blunt knife and you slice the Chicken his throat

and make as much blood flow as possible and then you shake this blood all over the altar and over the rice wine. And then in turn you sip the wine. It's not too bad your sound is better than others but I did it. I wasn't at my fact I wasn't sick after. I think it shows that the people realize that we're here trying to help them and we are interested in them. I'm proud in a way of what I'm proud. Being a member of the Kohala tribe. They have given me the name of Bach she means Dr.. Haka. And Hawkeye in the Mountain your language means to remember and this is very flattering of course but they feel that I'm sensitive to their needs and will remember them. Wherever I am whatever I'm doing. I'll never forget. Brown one of our first hours after we graduated we equipped him with his medicines and supplies and offered to drive him to his village so that he could take his

gear with him but he had none of that. It was very proud moment for him. He wanted to go into the village by himself and discarded to show off what he's learned in what he had so he'd made a pack sack out of a cardboard box and painted on it his name in Project concern in great letters and took off halfway down the road with this on his back. Really he was just as proud as could be. I find it very heartbreaking to see these people. Working so hard with such primitive equipment. And yet they seem to be happy their family life is very close and very happy. I'm such a little that makes one feel very greedy at all the things. One does have. And yet we always want more. The people come. To this hospital with a great expectation. They come in. All modes of transportation on their

husbands back in their mother's arms on a Lambretta motor bus or in these massive. French. Buses that. Go from village to village with supplies. And I feel that they think a hospital belongs to them. Because it serves them it. Treats their ills they come when they need help and the hospital provides it. Though. I dare say but that. Well they pay more and only the blue moon they get them by law only get only the most. I I I.

And. Not your. Man and all. That. I get in the book.