Project Phongsali 2011: Sometimes challenges in Laos keep children from getting proper treatment.

February 14, 2011
By

Last year Pome's family traveled to distant Luang Prabang so he could be treated for clubfoot. When we showed his family a video of his treatment many villagers were eager to learn more about his adventure. During our visit we solved the mystery of why Pome had not continued his treatment.

Week Two

Day Eleven:

When we passed through Luang Prabang on our way north I stopped by the COPE clinic (Cooperative Orthotics and Prosthetics Enterprise) to check the treatment records for six villagers we delivered to the center last year.  They were a mixed group of villagers; some were amputees who had never been fitted with artificial limbs.  Others were adults born with foot or leg deformities who had lived their entire lives without treatment.

One patient was a small boy named Pome who was born with clubfoot.  We found him in his mountaintop village last year and recognized his need for prompt treatment.  (On this web site is a video of Pome beginning treatment.  See video posted on December 14, 2010:  “Few options for Lao children born with birth defects”).

The center’s director told us that Pome made excellent progress as the staff applied a series of casts to his misshapen foot, hoping to slowly, gently, redirect it into a normal position.  During the three months that Pome’s parents lived with him at the clinic they were happy with both his treatment and their living conditions.  While they no doubt grew homesick, the boy’s parents gave every indication that they valued the help and would return for necessary follow-up procedures.

The director checked written records to confirm her memory and regretfully informed me that Pome’s family had failed to return for their June appointment.  As a consequence, he had missed being fitted with a leg brace that is a temporary, but essential, step in his treatment.

Hearing this disappointing news, I promised the director that we would detour to Pome’s village, find his family, and attempt to set things right.

The worst-case scenario was that Pome had died.  In some parts of Laos, one child out five fails to survive to school age.  Perhaps illness had claimed the boy’s life or kept him from traveling to Luang Prabang.

Another possibility was that the weather conditions interfered.  A June appointment would fall during the rainy season, a time when Tintook village is typically isolated from the rest of the world.  I’m told that during the monsoon, the one trail leading to Tintook is often cut by swollen rivers or blocked by landslides.

Today, Yai and I decided to head up the mountain, find Pome’s family, and resolve our worries.

After a quick trip to the market to buy emergency provisions (a kilo of sticky rice, a hand of bananas and several tins of sardines) we picked up a friend, Mrs. Siveelai, at her home across from the district hospital; she’s the big-hearted, ethnic Khamu woman who led us to Pome last year.  In her role as a visiting nurse, Mrs. Siveelai makes occasional visits to remote settlements like Tintook to immunize children and to treat minor wounds and illnesses. We especially needed Mrs. Siveelai’s language skills since Pome’s family is Khamu-speaking.

The road to Tintook consists of one hairpin turn after another.  Getting there is all up and no down.  The road exists for foot and motorbike traffic; that a car or truck might attempt the climb must have been an afterthought to the builders, if it was a thought at all.   As we traveled the road, our right-hand mirror slapped at brush on that side, while the left mirror whipped foliage on the other.

As soon as we hit the road, the road hit us back.  As our truck lurched over rocks and ruts we occupants bounced like children frolicking on a mattress. Yai, lucky to be the driver, had the steering wheel to hang on to.  Mrs. Siveelai and I had only one another.  As we trampolined along, she and I locked ourselves in a bear hug hoping that if we stuck together neither of us would go airborne.  Several times Yai and I parked the truck and walked the road while we debated strategy for avoiding deep ruts, tall boulders, and cliff-side washouts.

We also stopped for thirty minutes to observe eleven elephants grazing on a distant hillside.  Although I’ve seen domesticated elephants working in the forests here, that was my first sighting of a wild herd.

When we arrived in Tintook most of the village turned out to greet us.  School was in session but that didn’t stop a gaggle of children from jogging over to see who had arrived by truck. They simply deserted their classroom to join in community-wide rubber necking.  Thankfully, we found Pome in robust health, at his home with his mother, grandmother and four-year old sister.  His father was away working in the family rice field.

Last year Pome was a toddler ready to take his first steps, albeit on a foot that looked to be attached to his leg sideways; his left ankle was heavily calloused from his standing on his anklebone.  This year, Pome is a walker, able to trot about.  He no longer walks on his ankle but he’s still incapable of a normal gait.  His problem foot toes-in severely.

Mrs. Siveelai got right to the point, and asked Pome’s mother why the family had failed to keep their appointment at the COPE center.  Was she unhappy with the treatment?  Had she suffered so from homesickness that she couldn’t bear to leave her village again?  Was she so satisfied with her son’s partial progress that she had decided to forego further treatment?

Pome’s mother was unhesitant, her answer simple and direct: when the time came to take Pome back to Luang Prabang, they simply didn’t have the money to finance the trip.

Although COPE would have reimbursed Pome’s family upon arrival, they would have needed up-front money for bus tickets, guesthouse rental, and food.  Even discounting the need for a modest stash of “emergency” money, the family would have needed at least forty dollars in hand before embarking on the three-day trip.  They simply couldn’t come up with that much cash.

When I told Pome’s mother that a friend of mine from Decorah, Iowa had donated money for just such a need, she asked if she and her son could leave later in the week.  I cheerfully agreed and the deal was closed.  (Later that afternoon, after conferring with her husband, Pome’s mother decided to leave the very next day).

Yai and I showed Pome’s family the video that I made last year while they were at the COPE clinic.  A sizable crowd of villagers, both old and young, invited themselves to the viewing and enjoyed seeing Pome on television, receiving treatment; he was a star and I felt briefly elevated from paparazzi to filmmaker.

As Yai and I rose to leave, Pome’s grandmother told us that she had just killed a chicken in our honor and wanted us to join the family for a mid-day meal.

While Pome’s grandmother prepared the meal I treated myself to a self-guided tour of the village.  Then, about ninety minutes after the sacrificial hen met her demise, we joined the family for a modest feast of stewed chicken, boiled mustard greens, sticky rice and chili paste.  There was one additional dish that I avoided since Yai couldn’t find the English words to identify it’s ingredients.  All Yai could tell me was that it was mostly “river chicken”.  Hours later it dawned on me that he had meant to say “chicken liver”.

Pome’s grandfather toasted us with shots of homemade rice whiskey.  Three shots of Lao white lightning for me; just one for Yai.  (Yai’s English improves as he drinks but his driving suffers, so I keep him on short rations).

By mid-afternoon we were back in Muang May.  Early the next morning Pome and his parents, as promised, came to town and caught the bus to Luang Prabang.

One Response to “ Project Phongsali 2011: Sometimes challenges in Laos keep children from getting proper treatment. ”

  1. Carole Daughton on March 28, 2011 at 4:19 pm

    Jim–what a story. Thank you for making that awful trip. I had a vision of you grasping the woman and hanging on for dear life. How wonderful to get an update on Pome and how sorry the treatment wasn’t finished. Very understandable though and happy they are continuing. I’m headed for Pay Pal right now so that I can reimberse the pot for his treatment. Was jiggling down any better than up? Carole

Leave a Reply