An amusing arrival

As we drew up to Janak Nagar village in our buffalo carts, we saw more and more locals. Passing under a large archway that announced the entrance of the village school, the buffalos halted and we slowly began to extricate ourselves from the various contortions that had kept us aboard.

Having had my legs tightly crossed and squeezed under the bar opposite they were a little deadened. As I jumped down from the cart I tripped sideways, startling one of the buffalo. It bellowed at me, making me jump and yelp in mild shock. A roar of happy laughter made me look up and realise that we had been surrounded by neatly uniformed school children ranging from six-year-olds to young teens, both male and female. They were all finding my predicament, and the buffalo’s loud distaste of me, highly amusing.

I blushed and laughed with them. What an entrance! I smile when thinking about it now. I’m not a naturally funny person in general, but I find I have no issues coping with accidental situations that make me appear even sillier than the average visitor. It meant that the children were less nervous of me from the outset and, when I produced my video camera – complete with overhead microphone covered in a ‘dead cat’ wind sock – I was an immediate curiosity.

Janak Nagar school

The school had been visited by previous expeditions. They knew who JBS was and knew we would have gifts with us. There was therefore a great deal of anticipation and inquisitive posturing going on from the outset.

These kids had clearly been instructed by their teachers to be on their best behaviour. They were dressed in their best and were always polite. It transpired later in the day that it wasn’t even a school day. Everyone had turned up, in full uniform, on what should have been a holiday, just to see us.

The entire village was there. Children and adults alike. The adults, men in shirts and trousers, women in more traditional clothing in gorgeous bright colours, had formed a tight group around one of the buildings at the side of the campus. This was where our medical party had set up shop.

The children milled around us in small groups, slowly gathering in the middle of the grounds where there were benches and shade. Most waited for us to approach them. But, just like children everywhere, they would be egged on by peers, allowing their curiosity and excitement to get the better of them. Just occasionally, I found myself with a grinning imp dancing in front of me in the hope of being filmed, or a slightly shy individual sloping across shot trying to look inconsequential while staring back to make sure the camera was pointing at them as they did a little spin, or drew some precious object from their pocket, displaying it with great pride.

Girls gathered in groups, turning into one another, covering their mouths with a hand as they whispered into their friend’s ear. I would catch them giggling together and shifting their gaze tellingly. A ten-year-old boy on a bicycle found a spot to casually carry out a few tricks. He was being very cool about the whole situation, until his foot slipped and he crashed down painfully onto the seat. His immediate response was to look up at the camera and blush deeply, giving himself away completely. It was wonderful to see them all being so like every other group of children I have met. We could, in fact, have been almost anywhere in the world at that point.

Girls will be girls

I noticed Siv take a photograph of a group of girls, then turn the camera screen to them to show the image she had just taken. Their delight and fascination to see the resulting image and comment on its acceptability was clearly a gift in itself. I began to do the same, reverting from video to camera to be able to do this more easily.

As soon as I was spotted doing this for one group of teens, I was surrounded by females of all ages. I would lift the camera and they would all jostle one another to get in shot. Then I would show them and there would always be at least one grown woman who would point at herself in the photo, wave a finger and make it clear that this one must be deleted. Her teeth made her look ugly. Her scarf was in the wrong position. Her hair was blown out of place by the wind. Her friend had stood in front of her. She just didn’t like it…

I guess people really are just people in the end. Perhaps we need to stop blaming fashion magazines for our vanity. Females clearly need no incentive other than themselves and one another to feel they don’t quite meet the grade for one reason or another.

I gave up trying to satisfy the crowd and went to see if I might film the dentists in action.

Not exactly dream dental conditions

Just left of the school entrance, away from the main teaching buildings, was a long low structure made from simple breeze blocks and concrete with a corrugated tin roof. It had bars across its windows with green wooden shutters and a green wooden door. It was high off the ground and had concrete steps rising, into almost theatre-style seating, with a wide concrete landing all along its front. I have no idea what the school would usually use this for, but today it was a clinic.

When I approached, every inch of step and landing was occupied. To get to the door it was necessary to step over and in between people. Once there I had to get Ram Din, who was helping to police the crowd outside, to ask the guide who was holding the door shut, to let me in.

Once inside I was accosted by a hot, dark room and a hive of activity. I found myself a corner where I hoped to stay out of the way and took a good look around.

Dr John was at the back of the room. He was carrying out initial checks on patients before they saw the dentists as well as those who simply wished to see a doctor. There were people squatting all around him.

There were two chairs in the main section of the room, each with a tiny table next to it. One was being used by Captain Sarah’s patients, the other by Angus’s patients. Carolina had her patients sitting on the edge of a table next to a window at the back so she didn’t have to bend over, sparing her back.

Each dentist had a small selection of spit bowls, tin cans for throwing sharps, gauzes and a big green bucket sat at the edge of the room. This was where the teeth, blood and used gauze was being gathered. There was also a large table in the centre of the room that had been covered in towels and had drugs, syringes and dental instruments laid out all over it.

Carolina, glasses perched on the end of her nose, looked in total control as she took a hypodermic syringe and injected its contents swiftly into a female patient’s gum before the young woman had a chance to change her mind. These people were turning up voluntarily for treatment they would otherwise have to travel far to get and pay for once there. However, the lucky few who did reach the front of the queue did occasionally back out when faced by the choice; pull it out or live with the pain? In these difficult conditions, there was rarely any other option the dentists could offer them other than a check up, referral to the clinic for serious conditions, or an extraction, there and then.

I watched Captain Sarah as she administered anaesthetic on one of the local men before bracing herself to pull a tooth from the back of his mouth. She called for assistance and Villa was there immediately. With her back against the concrete wall for support, Villa held the man’s head between gloved hands as Sarah, her stance wide, her shoulders at an angle as though she were about to carry out a karate move, pushed the tooth back into the man’s jaw before swiftly pulling it forward and out. The patient grunted a little but the whole thing was over quickly and the tooth was out. Sarah held it triumphantly up for the patient to inspect before presenting him with a wad of gauze to hold against the wound.

Seeing Captain Sarah carrying out dentistry is akin to watching a child playing with its favourite toy. She has clearly selected the right career. She thrives on it.

Angus, on the other hand, though equally brilliant when at work, looked tired, hot and flustered.

“It’s like working in a bloody abattoir,” he said in frustration. “I thought we were here to see the children but they don’t get a look in. The adults just push them aside.”

This was the outcome of what became a fairly clear cultural standard. Children were not afforded the same levels of favouritism that we display our offspring. The adults need to stay healthy to look after the children. It was every man, woman and child for themselves. The bigger you are, the harder you can push. It was that simple.

Mandy and Villa had the most difficult jobs of all. As well as jumping in to hold the heads of patients during extractions, they were also the ones trying to coordinate the patients and keep the dentists supplied with clean instruments. Mandy was having to keep a fire outside constantly lit under a large pot of boiling water and had to negotiate the crowds, lifting the instruments high above their heads to keep them sterile, each time she needed to add or take from the pot. WIth Hari’s help translating, Villa would have to get personal details from each patient as they sat down with one of the dentists so she could keep record of their age and the work carried out. If not required to hold a head, she would then liaise with Ram Din to let the next patient in. Once in the room, each patient would have to join a queue of people crouching against the back wall. This often required a great deal of persuasion from both Villa and Mandy.

Each time the door was opened those waiting would push and shove to be let through. Ram Din had to physically hold them back, shouting at them to be patient. This meant the door had to be kept firmly shut. The few windows at the front were were full of people, young and old, peering in, blocking any light and air that might otherwise be getting through. The sheer number of people in that room was extraordinary and, despite the ability of the Nepalese to pull themselves into a tight squat, the body heat that built up adding to the heat and humidity of the day itself was extreme. It was claustrophobic and chaotic. None of the medics had had anything to eat that day and even the drinking water was in short supply.

The fact that they managed to help so many people was somewhat miraculous in my opinion.

Lesson no. 22: All medics prepared to work in the field deserve medals