Thursday, July 19, 2007

Seeing a Mobile Clinic Made the Bumpy Roads Well Worth It!

When I signed onto the internet Thursday morning, I was pretty shocked to see "steam pipe explosion near Chrysler Building" as the top story on yahoo news in Mongolia! There is a 12 hour time difference between NYC and UB. For those of you that don't know, Americans for UNFPA's office in NYC is located just across the street from there. Thankfully, no one from our office as hurt- Deni and Marcela were the only employees in the office and they were quickly evacuated from the building (So quickly that Deni's cell phone, wallet, and the video footage from her visit to 2007 Honoree Mdme Traore in Niger are still sitting on her desk..oy!) I've since heard that the external damage to the building is quite bad and they are waiting for reports about the inside. Our office and the entire building are closed until mid next week at the earliest.

About 20 minutes later, that same day, I learned that there was an Anthrax scare in Kar Khorem—the ancient city—where we were planning on spending the night in the Ger. Who knew that there was more to Anthrax than being a chemical weapon? Apparently it is actually first transmitted through cattle. According to Dr. Munkhuu's son, (the dean of public health), there is no evidence of cattle to human transmission, yet. None the less, there is NO WAY we are going to Kar Khorem today. Anthrax in Mongolia and a natural disaster explosion in NYC—definitely not a lucky morning for Americans for UNFPA.

As planned, we carried on with the first half of our day—a visit to a UNFPA funded mobile clinic. Once my photos are posted you won't have to rely on my descriptive visuals—but in the mean time—picture two tents pitched in the middle of countryside fields with an emergency mini-van beside them. The only things in any proximity were two gers about 300 meters away, A couple of cows and horses close to the gers and our two cars pulled up in front of the tents.

Right there, in the tents, they had two pretty impressive things going on. In the first tent, they were conducting an ultrasound on a pregnancy woman and in the second tent, about 8 doctors were seated on the floor for a "train the trainer section." I kid you not when I say a laptop was loaded up, and a powerpoint presentation was reflected on a screen at the front on the tent. Technology.. it is everywhere.

The mobile clinic serves about 500 patients a year and spends a week or so at a time at each of its regular locations. I've seen many pictures of mobile clinics, but I never realized conceptualized how remote they actually are. We traveled bumpy, unpaved roads for several hours to get to the clinic. Even when the roads were paved, we often drove next to them because some how the grass/dirt was smoother. We saw zero street signs and a couple dirt forks in the road. A doctor from the clinic greeted us about 20 minutes away from the mobile clinic and directed us the rest of the way. If our car took off, I'd still be standing there and would probably become best friends with a stray cow. Moo.

But, the clients that need the services seem to know exactly how to find them. A great deal of public awareness and advocacy exists locally to ensure that remote rural communities receive quality care. They receive a lot of support from the governor, which I guess helps a lot.

Mobile Clinics operate in 7 provinces in Mongolia . (They call provinces/states—Amags..pronounced Imags.) In the province of Tuv , where this particular mobile clinic was located, the clinic visits 4 distinct locations (they call theses soems…which I guess are the US equivalent of a county).

Through the train the trainer program, annually UNFPA helps train 3000 doctors, nurses, counselors and other social services providers. The project operates in 9 sites, seven of which are rural and 2 that are urban.

It's pretty incredible work.

We arrived back in Ulan Bator at about 6:30pm and spent a bit more time at the UNFPA office. (I received my third lesson on Amags versus Soums, etc…and finally grasped the concept)

In retrospect, timing wise, it probably worked out for the best that we were unable to go to the ancient city. The bumpy roads without four-wheel drive made the trip pretty long and tiring.

Anika and I went to a Lonely Planet recommended restaurant for dinner that night called Silk Road. The hostess told us the wait would be two hours, but I spotted a daughter/dad pair that were clearly about to finish their dessert. About 20 minutes later we were seated. The ambiance was great—although there was a tour guide seating across from us that felt the need to speak at the top of his lungs non stop for the entire meal. We are convinced he didn't stop for questions or even air. I can still hear his voice in my head. All I can say is I'm glad I didn't pay to have him as my tour guide.

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