Tag Archives: Northwest Medical Teams

He Ain’t Heavy, He’s My Brother

Before I saw the wound my staph-sniffing nose was aware of it. The dust-encrusted, fraying bandages wrapped around the teenager’s left foot were no match for the scent of gangrenous flesh. Seated on a lacquered black chair in the neatly tiled, well-scrubbed room serving as my operatory, he was unfazed by his injured foot or the wounds around his swollen left knee. Or by his missing right leg.

My interpreter, a junior doctor from Da Nang, introduced him as Thanh. Born a decade after the end of the war, Thanh did not have the benefit of immunizations. No one in Viet Nam did for the first dozen years after peace broke out. As a result, polio became the scourge of Quàng Nam Province’s humid river valleys extending from the mountains of Laos to Da Nang Bay and the East China Sea. War’s desolation had wrecked all semblance of sanitation, allowing polio to spread savagely from village to village, hut to hut.

P0001382Thanh became ill with the crippling form of spinal polio before his fifth birthday. For the first few years he hobbled on a disease-withered right leg no longer able to move, and a weakened, poorly controlled left leg. With no braces to support his atrophied limbs and no shoes to protect his feet, skin breakdowns and infections took their toll, especially on his feet. By his tenth birthday, the unavailability of antibiotics caused a bout of life-threatening gangrene. In desperation his right leg was amputated by doctors at the regional hospital in Tam Kỳ. But it was not the end of his problems.

Undaunted, Thanh propelled himself along on one barefooted leg. But that leg’s spasticity caused his foot to drag on its instep. Frequent falls, leg abscesses, fluid in the knee, and now a two inch raw infection exposing his first metatarsal bone had cratered his remaining leg like a war-torn hillside. Wearing a white baseball cap jauntily placed on his head with a few strands of dark hair peeking out, he continued to smile. His younger brother, a head shorter than Thanh, looked worried however.

NWMTI013Carefully soaking off the blood-stained dirty bandages and then layers of pus and skin debris, we faced oozing tissue and exposed bone. Marie Davis, a veteran of many mission trips, cringed; Rachael, her daughter, a young nurse herself, had to turn away. Realizing the wound’s full potential for osteomyelitis and fatal sepsis, I gave an injection of Rocephin antibiotic in the only area of his buttock with enough tissue to absorb it. Generous amounts of Silvadene on the raw lesion, covered with non-stick Telfa, followed by multiple layers of Kerlix gauze wrapped around his foot and ankle covered the ugly wound. Concealed, it looked better; meanwhile, Thanh’s smile never left.

Before we could wonder how he would keep his freshly bandaged foot clean or get around with no shoe or other leg to steady him, his younger brother slid onto the chair in front of him. In a seemingly well-rehearsed routine, the younger boy stood up carrying Thanh piggy-back style. 015_12Incredulous, expecting the smaller boy to collapse any moment, we offered to help him. Smiling, he shook his head and replied; our interpreter’s eyes welled up as he translated:

“He’s not heavy, he’s my brother.”

By this time Rachael’s tear ducts were working overtime, Marie’s eyes were filled and the dams were about to burst, and my eye allergies were acting up as well.

More than thirty years earlier an American soldier, walking with his troops in this same region of Quàng Nam Province headed to a village which had just been bombed. They passed a heart-wrenching scene – a boy carrying his dead brother away from the burning village. One of the soldiers who spoke Vietnamese stopped to speak with the boy and comfort him. When he asked, “Isn’t the body heavy?” The boy responded,

“He’s not heavy, he’s my brother.”

But Thanh and his brother would not have heard that story. The few remaining older men never speak of the pain of those years – years relegated to dusty history books and repressed memories. An American songwriter named Bob Russell, inspired by the sad tale, penned a song, colloquially naming it “He ain’t heavy, he’s my brother.”

Children_frameIt has been a quarter century since hostilities ended and pronouncements of peace were issued. But for Viet Nam peace unleashed the horrors of a war won badly. The American War they called it. Its legacy featured ruined villages, dioxin poisoned vegetation courtesy of Agent Orange, a generation of polio and birth-defected children, and a missing generation of men.

In this summer of 2001, while a new generation of industrious Vietnamese were rebuilding their country, America, ignorant of what laid ahead, was enjoying its last pretense of re-acquired innocence, before the terror and the realities of the next war were rung in.

But there were loose ends from that distant American War. Five of us were dispatched by Northwest Medical Teams to help World Concern address the rehabilitation of teenagers and young adults crippled by the after-effects of the war. Refugees in their own country from a war which ended before they were born, their deformities and infirmities sentenced them to a life in the shadows of a society eager to not be reminded of that distant war. Polio, endemic for decades after the war, and the birth defects of exposure to Agent Orange had left hundreds of attractive, kind-hearted Vietnamese young adults grappling with terrible handicaps. For liability reasons we were not allowed to mention chemical exposure, particularly Agent Orange, as a cause. However, in a mea culpa of sorts, the evaluations, the recommended treatments, and the rehabilitations were indirectly funded by the US government through USAID, before lawyers’ briefs and depositions, and world courts mandated it.

P0001383Hosting us for this work were Bob  and Kathleen Huff, World Concern missionaries in Da Nang, living and working among the visually shunned young victims of that still devastating war. Culturally astute yet uncompromisingly Christian, they did a masterful job of delicately dodging the various elephants in the room. Beside the mention of Agent Orange as a culpable cause for the birth defects, the faith-based nature of World Concern and Northwest Medical Teams represented the other elephant. Not only could USAID funding be withdrawn by overt evangelistic activity, jettisoning the project, but our Communist minders would have been thrown into convulsions of fingers-in-the-ears, head shaking denouncements.

But the world had not yet achieved full paranoid political correctness yet. All of us knew the rules of engagement, but mutual respect permitted the necessary freedom to act in our calling. We could not have had it any other way. In the Huffs’ daily demonstration of the love of Christ among Viet Nam’s outcasts, hiding their shame from their own people, the hope of the Gospel was never far from quiet conversations. Responding to their love, many of the young men and women embraced a forbidden faith.


I watch Thanh leave on his brother’s back, his bandaged foot dangling, as the next patient is ushered in, a twenty year-old girl with one eye missing and a horrendous cleft palate. I suspect she is a victim of her parents’ exposure to Agent Orange sprayed by American planes to kill vegetation, including crops. The dioxin in the defoliant chemical has become a poison in perpetuity. The soil in this province will be contaminated for a generation or more. Grieved by the barbarism of war and man’s misuse of his ingenuity in its pursuit, I am pleased, nonetheless, to be allowed to participate in bringing hope to these lovely young men and women, many pitifully deformed.

I reflect on the years since Bob Russell’s song was popularized by the Hollies. Its lyrics still rattle in my head. I wonder if we have learned anything about love, about bearing one another’s burdens. Or is it just a waste of breath, a vaporous Christian concept for people like Bob  and Kathleen Huff?

So on we go,

His welfare is of my concern,

No burden is he to bear.

For I know, he would not encumber me.

He ain’t heavy, he’s my brother.

If I’m laden at all, I’m laden with sadness,

That everyone’s heart isn’t filled with the gladness

Of love for one another.



Whose Idea Was This?

“Trust in the Lord with all your heart and lean not on your own understanding; in all your ways acknowledge him,

Proverbs 3:5-6 (NIV)

A Crisis of Belief

Continental breakfast on the Hotel Rozafa’s sun drenched patio is  where each day’s adventure for Northwest Medical Team members starts.  The dominating nine-story hotel in the center of Shkoder grabs the attention of visitors. Locals have learned to avert their eyes. With stained concrete slabs and an antenna farm on the roof, some pointing north to Russia with rumored linkages to the KGB,  it is a tribute to Communist era bleakness, a visual affront. Refugees from Kosovo are crowded into the unfinished upper five floors now. The tired but furnished lower floors are spoken for by more affluent refugees, some NGO’s like my roommate and myself, and a collection of pick-pockets and other unsavories who frequent the cavernous lobby, hiding in the smoke of their cigarettes. The refugee crisis has transformed this lowest-tier hotel to its highest use. During breakfast the senior team leader gives out the daily assignments. On my first day of work in Albania I am assigned to the clinic at the Tobacco Factory.

Unlike the charming ride into town the previous afternoon, past shops with outdoor merchandise displays and small restaurants overflowing onto sidewalks, we are now bouncing along the remnants of a road headed to the poor side of town. Yesterday’s nose tickling aromas of curried lamb sautéed with onions, fried meatballs seasoned with mysterious spices, and freshly baked Burek pastry, are replaced with the putrid smell of garbage. Today’s journey takes us past decaying buildings, over garbage ground into the dust of the road, piled next to it, and even scattered in front of broken down houses. Yesterday’s panorama of diners and shoppers spilling into the street, mingling seamlessly with honking cars, fuming buses, and swerving bicycles, is replaced by stray dogs, partially dressed dirty children, and young men in tight pants milling about. The sights and smells of poverty and neglect overwhelm me. Panic and doubt unleashes itself. For ten minutes I wonder if I was meant to come here, if I can handle this. I had not anticipated this crisis of belief.

“Was this God’s idea or Henry’s?” I ask myself.

Then we arrive at the Tobacco Factory. It was one of many factories closed and abandoned years ago during Enver Hoxha’s devastating forty-five year reign as supreme leader of Communist Albania. Fenced in by barbed wire stretched across eight foot high concrete posts, the top eighteen inches angling outward, security appears to be a priority. A uniformed guard opens a wide metal gate for us – and closes it behind us, locking it, I notice.

Black chemical stains run down the four-story buildings’ brick walls. Weeds grow out of cracks, along walls, and under pieces of dead industrial equipment rusting in peace. The evenly spaced windows of the three tall buildings flanking the courtyard are black holes set deep into the masonry. With no glass and no light in any of them, they possess the lifeless appearance of empty eye sockets. The buildings look devoid of soul.

I am reminded of an abandoned prison from a different time. I know I have seen this place before. Where? When? Then I remember. Auschwitz.

helping_oldOver four thousand refugees live in the Tobacco Factory, I hear someone tell me through my fog, as I attempt to come to grips with harsh realities. I catch myself referring to them as prisoners. A tour upstairs in the Tobacco Factory through the refugees’ accommodations does nothing to dispel the notion they are imprisoned. Curtains hanging in makeshift fashion separate families. The floor is covered in dust and grime. Dark corners and dingy light from naked bulbs on strings create a B movie atmosphere. A mother gave birth in one of these squalid family enclaves last night. Life is tough here – but it is also resilient.

In the courtyard, tacked on a tree, a sign announces Birberi.  Under the shade of the tree a barber plies his trade.  Nearby, with their wares set on a make-shift table, young boys try their hand at being merchants, selling the essentials of life – toothpaste, soap, gum, and cigarettes.

On the ground floor of one of the soul-less buildings, behind barred windows, life is returning from the ashes. A school has been organized. Albanian essays are tacked on the walls of one room. Another displays art work. The art gives glimpses into the souls of the children living here, and transfers their wounds to paper. The teacher tells me it has been therapeutic.

In the art room a child’s multi-colored map of Europe accurately renders the outline of most countries until it gets to the eastern portion. mapLarge red question marks cover Serbia, Kosovo, and the other Albanian-speaking countries. War motifs dominate a lot of the paintings. Serbice and NATO are inscribed on a number of them, often picturing tanks and burning houses. The painting gripping me the most is a Paradise Lost pastoral scene, a road through a series of rolling green hills headed in the direction of a rising sun. The teacher says this is what Kosovo, their home, looked like before the troubles started.

On one side of the courtyard is a row of outhouses with heavy canvas curtains acting as doors. On the other side are wash-up stations and water troughs. A tar-stained water truck stands near them. Women, dressed in colorful long skirts, carry buckets of water. Some are on the ground in the shade of the truck doing laundry by hand on large flat rocks. A precious plastic tub is shared between the women. Drying laundry is hung on trees, walls, benches, and on the one available clothesline. The essential tasks of life are going on, even as the almost complete absence of men is inescapable.

A smaller building, across a courtyard of children playing among building scraps, places me back in a familiar world. Inside, the smells of disinfectant, the sounds of blood pressure readings and medication doses being called out, and the sight of curtained off exam areas reconnect me to my comfort zone. As I am introduced to my work area, I pass scales to weigh adults and babies, neat metal shelves with basic medicines lining the wall, a dispensing table with the Northwest Medical Teams’ banner on the front of it, and a long line of waiting patients. The faces of the patients reassure me. They are the same weathered faces with high cheekbones and beaten down expressions I saw in the New York Times, which reminded me of my refugee relatives, and called me to this moment.  I am reassured,IV_lady

“This was God’s idea. You’re in the right place.”