So Others May Live
A heavily pregnant woman arrived at our frontline mobile surgical clinic on a rainy day. She was too weak to walk, so her neighbors carried her for several hours to our makeshift facility. At the age of 40, with nine previous pregnancies, her body had spent more than half of its time on earth nurturing new life. But now, with swelling in her face, hands, and legs, pale and exhausted, the mother of so much vitality stared blankly with dull, hopeless eyes. Both of these patients were in trouble.
A quick physical exam confirmed the gravity of her condition. Her systolic blood pressure was almost 200 mmHg. Her kidneys were leaking large amounts of protein. The combination of high blood pressure, protein in the urine, and swelling of the face, hands, and legs all pointed to preeclampsia. In mild cases, medication, rest, and close monitoring can often carry the pregnancy to a point where the baby can be safely delivered. Severe cases are life-threatening to both mother and baby—and require immediate delivery. You just pray the baby is old enough to survive outside the womb.
At most hospitals in the world, this woman would have been admitted to a high-risk obstetrical ward, or if she started having seizures, to an ICU. Her story, however, was happening on the frontline of an active battle, in the jungles of Burma during the rainy season. Frontline hospitals need to be able to pack up and move quickly, so they only carry basic medicines and supplies. They are usually not equipped with the specialized medications and resources needed to manage serious obstetrical cases. Further restricting options in our case, the rainy season here turns jungle roads into impassable mudslides. It would be very difficult to get any new medicine in quickly or to move the patient to a better place. Our team’s ability to evaluate and treat this patient was extremely limited.
Our team had urged her to go to Thailand, where she would have access to world-class medical treatment and be safer from the fallout of the war, but she had refused. Someone managed to find an appropriate medicine (Nifedipine), which temporarily brought her high blood pressure under control. But preeclampsia would remain a threat until after she delivered.
Ultrasound estimated her to be around 32 weeks gestation, so the baby needed a few more weeks to mature. But mom could wait in a safer place if she promised to follow up every couple of days. Seeing 100 casualties pouring in after one particularly brutal battle, she became very afraid, and she quickly agreed to move to a nearby village.
About two weeks later, the patient went into labor and delivered on her own in that village. Within a few hours, two of our PAs went to check on the mother and baby. Unfortunately, they found a baby boy who was clearly premature, cyanotic, and struggling to breathe. Back at our frontline clinic, the baby responded quickly to oxygen. The team started IV antibiotics and crafted an infant warmer out of a cardboard box and a hot water bottle. They carefully managed the baby’s fluids and glucose. Sadly, after three days, the little one passed away.
“One more loss in an ocean of suffering”
Although I wasn’t on site for this particular case, I know every member of this team well, and I know their situation well. I have spent months with them on the frontline. I've been with them in the trenches, hiding from artillery and air strikes. Some of them have been within several feet of bomb explosions. Some have been shot at. One team member was injured by a piece of shrapnel.
I have seen them working long, long days and many nights—in humid temperatures of up to 108°F—with sweat dripping down their faces and soaking their clothes. Living in tents through the rainy season, they have endured several months of rain, mud, and hungry jungle insects. Some have had malaria or dengue fever. Mice have chewed holes in most of their clothes. You cannot chalk these guys off as just your typical adrenaline junkies.
Dealing with an uncomfortable dangerous environment is one thing. Dealing with the emotional trauma of constantly giving your all for so many severely injured people is another. They go about their daily routines as if a ward full of broken and torn young people was a normal occurrence. One more amputation of a shattered but otherwise healthy, well-muscled limb doesn’t seem to outwardly affect them much. And yet, at times, the pain seeps through. Especially when they tell stories like the young man who was hit in the neck with a small fragment. It was small but it had severed his cervical spinal cord. He can talk. That's it. He has no movement or sensation below the neck. For the rest of his life. He is only 20.
After the brutal battle mentioned above, when over 100 casualties presented to the triage area in short order, even our unflappable Dr Z was hurting that day. In fact, more than one team member admitted that for a few days after that battle, they didn’t think they could keep going.
So why do they do it? Considering the discomfort, the struggle, the emotional pain, the danger, the losses—why do these people keep going back to the frontline? They are all EM staff who volunteered. All are Karen, and most are Christian. One is Buddhist. Their Karen leaders do ask for our help. But no one makes them. There is no financial incentive.
Each person likely has a different mix of motives, but for many Karen, helping people and giving to their own country is a core value. One team member has defined this as his own dignity. He sees helping others as his dignity. Even when that “other” was a wounded enemy in need of medical intervention.
As well-trained healthcare professionals, they all know the best of modern medical standards and strive to deliver that, no matter the circumstances. Even in a jungle frontline during rainy season they find ways to creatively provide care. But if all else fails, they will still give what they have even if it means just holding someone's hand. Why? Because they see it as their own God-given dignity.
It is also clear that they get real joy from serving together as a team. One team member said, “If it wasn’t for this particular team, I couldn’t stay on the frontline.” Several of them have a tattoo on their shoulders now…
“So Others May Live”
All in the same style, same place. Truly, they are a giving band of brothers and sisters. I believe this kind of life paradigm, rooted in service and community, has the power to overcome even the most difficult situations because it reflects how God made us. When we peel back all our cultural layers, our faults, our brokenness, this way of life is in our DNA. It is exactly what Jesus did for us and what He calls all of us to do for others.
These things I have spoken to you, that My joy may remain in you, and that your joy may be full. This is My commandment, that you love one another as I have loved you. Greater love has no one than this than to lay down one's life for his friends. You are My friends if you do whatever I command you. No longer do I call you servants, for a servant does not know what his master is doing; but I have called you friends, for all things that I heard from My Father I have made known to you. You did not choose Me, but I chose you and appointed you that you should go and bear fruit and that your fruit should remain, that whatever you ask the Father in My name He may give you. These things I command you, that you love one another.
John 15:11-17
The following is a poem written in Burmese by one who holds a special love for one of our frontline team members.
For the Sake of Our Land
The question,
“When will you come back?”
I will never ask him.
As the country crumbles,
Words fail me,
Yet all I can offer to him is,
“Take care of everything”
In a land falling apart,
I wish I had more to give,
More to say,
But what strength I have, I send to him.
I long to have him by my side,
But compared to the sacrifice of those who gave their lives,
My feelings are small,
Insignificant, next to the burden carried by their families.
Like the strength of brick and mortar,
Together, we will rebuild our country.
He, ready to lay down his life,
And I, here to support,
For the sake of our land.
Every night, I pray,
For God’s mighty hand to shield them all,
Including him,
Awaiting the day he returns safely.
"The country struggle is my own..."
With this thought, I find strength,
Imagining the day he comes back,
From where is the work of God’s people,
With a heart full of grace.
Until then, whispering
“Be strong.”
From afar, I will watch,
And pray,
As I wait.
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