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HOW FAR TO THE NEAREST DOCTOR? 



HOW FAR TO THE 
NEAREST DOCTOR? 



STORIES OF MEDICAL MISSIONS 
AROUND THE WORLD 



BY EDWARD M. DODD, M.D. 

Medical Secretary 

of the Board of Foreign Missions of the 
Presbyterian Church in the U. S. A, 



New York 
FRIENDSHIP PRESS 



TO 
THE MEMORY OF MY FATHER 

WILLIAM SCHAUFFLER DODD, M.D., F.A.C.S. 

1860-1928 

BELOVED PIONEER IN MEDICAL MISSIONS 
IN THE NEAR EAST 



FOREWORD 

In this book the writer has tried to bring before 
American young people a living reality the medical 
work of the Christian church in many lands. It has 
been no easy matter to temper genuine enthusiasm 
with professional restraint, nor to achieve in the story 
a dramatic vividness alongside the everyday, hum- 
drum labors of doctors and nurses. Yet, in truth, all 
these elements make their contributions to a com- 
posite picture. 

I wish to acknowledge my debt to many books and 
collections of letters which I have drawn upon and 
especially to several books and pamphlets from which 
I have quoted. These are Dr. Paul Harrison's The 
Arab at Home (T. Y. Crowell Company) ; Mrs. Alice 
Pennell's life of her husband, Pennell of the Afghan 
Frontier (Fleming H. Revell Company) ; Dr. Albert 
Schweitzer's Forest Hospital at Lambarene (Henry 
Holt and Company) ; Mrs. Katharine Scherer Cronk's 
story Three Knocks in the Night (Women's Mis- 
sionary Society of the United Lutheran Church) ; and 
Dr. Walter H. Judd's pamphlet A Philosophy of Life 
That Works (Student Volunteer Movement) . 

Particularly do I wish to express my gratitude to 
my medical friends and other gracious hosts who 



viii FOREWORD 

shared with me their homes and their experience as I 
traveled around the world in 1930 and 1931 while 
making a study of this great phase of Christian mis- 
sions. Finally I would express my sincere thanks for 
the cooperation of the committee and editorial staff 
of the Missionary Education Movement in preparing 
the manuscript for publication. 

E. M. D, 
Montclair, N. /. 
March, 



CONTENTS 

I. WHY THEY COME I 

II. FRONTIER TRAILS *1 

III. WITCH DOCTORS vs. CHRISTIAN DOCTORS 41 

IV. MEDICAL SERVICE ON DESERT AND UPLAND 60 
V. ALL IN THE DAY'S WORK 82 

VI. PREVENTION IS BETTER THAN CURE 99 

VII. DOCTORS OF THE FUTURE 115 

VIII, TOMORROWS NURSES 127 

IX. TEST TUBES AND GERMS 138 

X. WORKING WITH THE GOOD PHYSICIAN 153 



HOW FAR TO THE NEAREST DOCTOR? 



CHAPTER ONE 



WHY THEY COME 

THE desert is the home of several millions of 
scattered people in western Asia and North 
Africa. The barren, inhospitable, boundless spaces 
are their world. Many desert dwellers, in Arabia, for 
example, never in their lifetime see a city, or any 
people but their own roving, fighting tribes. When 
they do leave the desert and visit a town, with its 
narrow streets closed in by high-walled houses and 
crowded with strangers, they are restless and uneasy 
until they can get back into the open. They are born, 
they live and they die in the picturesque black 
Bedouin tents, under the sun and the stars; and die 
little colts, which later become such splendid Arab 
horses, eat and sleep and play with the children in the 
tents. No wonder the Arab horse and the Arab rider 
are fast friends. And the camels those queer, gro- 
tesque brutes, grunting and chewing their cuds out- 
side the tents are the Ford cars and trucks of the 
desert. Without the horse and the camel these people 
of the desert could never survive. 

Life is hard for the nomads of the desert, even when 
things go well. When there is some misfortune, like 
sickness, it becomes doubly hard and often cruel and 



HOW FAR TO THE NEAREST DOCTOR? 



tragic. There are no doctors or hospitals within easy 
reach. The nearest doctor may be days of arduous 
caravan journey across the burning wastes. The near- 
est hospital is likely to be a mission hospital in charge 
of a Christian doctor, and that also tends to discourage 
the desert Arabs from seeking help in that quarter, 
for they are strict Moslems who are taught to de- 
spise all non-Moslems, including Christians, as in- 
fidels. Good Moslems are not supposed to have any- 
thing to do with them. So it is both a hard physical 
adventure and a great personal adventure to go from 
the desert to such a hospital. Suppose, however, that 
out of dire necessity some Arab family decides to take 
one of its members to this hospital. Let us start across 
the desert with this family. 

What a road that desert is! Blistering hot sand as 
far as the eye can see. A torrid sun in a steel-blue sky. 
Not a breath of air stirring. Nothing alive but the 
caravan. Nothing growing; no trees, no grass, to re- 
lieve the eye. Just that world of baking sand under 
foot stretching everywhere to the flat horizon, and 
furnace-like air overhead. 

The camels the godsend of the desert swing on, 
one behind the other in the caravan. The riders doze 
in the heat. The camel drivers, who walk the sand, 
seem almost in a daze. But those Arabs know what 
they are about, and just where they are going. They 
know exactly the distance from one water-hole to an- 
other, and the amount and quality of the water avail- 
able. If they didn't, it would be very easy to die. The 



WHY THEY COME 



desert is no place for a stupid person. It is a case of 
wits and endurance against death all the way. When 
you are caravanning in the desert you simply have to 
make it to the next water hole; if you don't, you stay 
there on the sands for the vultures. Only the fittest 
survive, developing endurance and stamina. 

Imagine a swarthy, desert-hardened, Wahabi father 
one of the Arab tribes bringing his sick little boy 
to a Christian hospital across the desert road and ar- 
riving at the gate of the hospital ground. The mother 
is brought along too. His language, as he addresses the 
gatekeeper, gives us the flowery idiom of the Arabs. 
And where there are no newspapers every traveler is 
expected to tell all the incidents of his journey. 

"Open the gate, O gateman! Let in the sick and the 
weary ones. Praise be to Allah, we have arrived! Open 
the gate, I say. We would see the doctor, for I have 
brought my little son, lo these ten days, across the 
desert. And he is in pain, and the camel has gone 
lame, so that we came slowly. What a world! What 
a world! Ten days across die desert with Bin Has- 
san's caravan and much trouble on the way. My 
son's mother is also with us, and she must have 
a suitable place to rest What a journey! What a 
journey! . . . Come, little son, mine heart! Mine 
eye! I will take thee down from the camel and lay 
thee down in the shade within the spate where he 
now opens the gate* Allah forfendl We will take 
thee to the doctor and he will make thee well, as he 
did Bin Bilahid. Lo, Bin Bilahid is now as a lion. 



4 HOW FAR TO THE NEAREST DOCTOR? 

And thou wilt be even as he, my heart. I will lay 
thee thus in the shade. . . . 

"What is it thou sayest, O gatekeeper, that the doc- 
tor is busy and cannot see us now? It matters not. We 
will rest in the shade. Bismillahi Rahmani Raheem! 
We are here. And, please Allah, the doctor will come 
before evening and will care for my son. . . What 
is it thou sayest, gateman? Thou canst get me to the 
doctor sooner if I give thee a rupee. Is it so? Then so 
be it. Here it is. We must see the doctor before to- 
morrow lest my little son have too much pain. 

"What a journey! What a world! The tribe of 
Azman would have caught and slain us. May Allah 
destroy them! But we used cunning and traveled 
through their parts by night and so escaped them. 
Lillah el hamdJ Thanks be to Allah! It was our ki$ 
met to escape them. Then we were without water at 
the last water hole but *>ne. I might have known that 
that hole would have been dry this year, with the 
failing rains. But I hoped in Allah that it would have 
water. And we came to it. And it was dry. Then we 
must needs push on to the last one, all day all day, 
and no waterl But Allah brought us out, though the 
boy became sicker and the camel went lame. Show 
me where I can stable the camel. It is a good beast 
and brought us with the caravan, though lame. . . . 

"We are Wahabis, as thou seest, and it is in our 
law that we should not come to the Christian infidel 
doctor. But Bin Bilahid, who is our great one, came 
to this doctor and was cured of much affliction* 



WHY THEY COME 



Therefore, now it is lawful for the Wahabis to come 
thus. But in our village there was much talk about 
and about. And some would have prevented us. But 
my son was grievously sick and in pain. And Bin 
Bilahid had made it lawful And my son's mother 
cried out that they would kill our son by detaining 
us with talk of the law, even though Bin Bilahid had 
come. So I borrowed the camel of my uncle, for I 
am a poor man, Allah be my witness, and we came. 
. . . What is it thou sayest about money for the 
hospital? Before Allah we have only three rupees. 
The rest went by the way for food. If we had not shot 
a gazelle and caught a lizard we would have starved 
by now. We have nothing. The doctor will have 
mercy. Let him look upon my little son who suffers 
with the stone. And he will assuredly have mercy." 
Many of the patients who come to Christian hos- 
pitals in Arabia or Iraq, Syria or Palestine or Egypt, 
travel across just such a desert as was traversed by this 
family. The desert is both their home and their high- 
way. Here is what Dr. Paul Harrison of Arabia writes 
about the desert type: 

The Arab is a splendid scout. His sight and hearing 
may be no better than ours, but his natural abilities to- 
gether with lifelong training make the sand o the desert 
an open book. As the caravan marches along, the desert 
newspaper is read. "Ah, three days ago a flock of gazelles 
passed here"; "Here is the track of a wolf that was fol- 
lowing them"; "This is the track of a dhabb" the large 
lizard of the desert which the Arabs regard as a great 
delicacy. 



6 HOW FAR TO THE NEAREST DOCTOR? 

However, their ability to read the language of the 
sand and plain goes far beyond such abc's as that. "Now 
what do you think of this?" announces one of the cara- 
van's outriders. "Ibn Khalid's caravan passed along here 
four days ago. He had twelve camels with him and five 
men." 

"Were they well loaded?" 

"No, only three of them were loaded at all, and the 
loads were light. Two were carrying dates and the third 
rice." 

"Yes, and his fine white camel, the one he bought a 
year ago from Ibn Ali for three hundred riyals, has gone 
lame." 

Expressions of appreciative sympathy are heard from 
all the caravan. To the stupid Westerner the thing seems 
uncanny, and the Arab's effort to show how simple it is 
to read the book of the desert only increases his feeling 
of amazement. If someone could devise an alphabet in 
which a resembled a gazelle track, b that of a wolf, c that 
of a lame camel, the Arab would learn to read in a few 
hours! 

It is from among such people as these, with their 
wild and rough life, but with their keen and sturdy 
qualities, that many patients come to mission hospi- 
tals in Asia. Having, as usual, put off the visit too 
long, they are more likely than not to arrive in an 
advanced stage of disease, and it is over such desert 
trails as this that Hassan, Mahmoud or Ali, who lives 
off somewhere across wide spaces, has to travel to get 
to the Christian hospital. He comes against his own 
beliefs, for a good Moslem should first try the con- 
coctions of his regular hakim (doctor) , or his priests 



THEY COME 



bind on his arm: or hang around his neck the charms 
that they sell him. If he is in severe pain, you can 
dimly imagine what every lurch of the camel means, 
hour after hour, day after day. If he is burning with 
a fever, what suffering there is on those glaring sands, 
where water is as precious as gold! Then, when the 
patient reaches the end of such a journey and finds a 
kindly and skilful doctor and a comfortable hospital, 
you can imagine something of what it means to him, 
and how his ideas about Christians change. The most 
important thing of all is the spirit of the hospital. 

Why does Hassan or Mahmoud or Ali come to the 
mission hospital? Why do any of the patients in India 
or China or Africa go to such hospitals? 

Well, for one thing, they are in great need of medi- 
cal attention, and often have no other doctors to 
whom to go. 

Suppose we take the case o Hassan, son of Akbar, 
as an illustration from one part of the world. Hassan 
lives in a village high up in the mountains of Afghan- 
istan. There are countless such villages in the East, 
huddled masses of little mud-walled, mud-roofed, 
mud-floored houses, each consisting of one room 
which opens into a stable for the cattle. Moreover, 
owing to the family feuds and the clan fights and 
raids, the Afghan house may have a little watch- 
tower with loopholes for rifles. In short, every home 
is a tiny fortress. Now Hassan falls sick with a fever. 
To him and to his family, fevers are just fevers 
whether they happen to be malaria or typhoid or 



HOW FAR TO THE NEAREST DOCTOR? 



whatnot. Anyway, here he is, hit by this fever which 
keeps coming back every other day. There is no doc- 
tor of any description in his village or in any of the 
surrounding villages; as far as Hassan or his family 
and their untraveled neighbors know, there are no 
doctors in that part of the world. 

Hassan has a family of four children. Life in that 
poor Afghan village is a struggle from harvest to 
harvest. Hassan manages to work in the fields parts 
of two or three days a week. But most of the time he 
feels too wretched and weak to work. What is the 
family going to do for food if Hassan cannot work? 

The family, squatting in a circle on the mud floor, 
goes into conference in the casual, lingering way they 
have, and ends up by sending to the next village for 
an old man who is something of a local herb doctor. 
When the hakim comes he concocts some sort of evil- 
tasting brew out of various plants, without any real 
knowledge of disease or medicine. He does the best 
he can for his patient. Hassan gets the concoction 
down and waits anxiously. So does the family. No re- 
sults. The fever is back as usual. Meanwhile an uncle 
has called in the village mullah, the Moslem religious 
leader, in order to make sure that all available means 
are used. The mullah writes a charm in Arabic and 
ties it on Hassan's arm. Again the family waits. Still 
no results. The fever keeps returning. Hassan is losing 
weight and strength and getting discouraged. 

Then one day a stray peddler, with his donkey pack 
o odds and ends, passes through, and in a chance con- 



WHY THEY COME 



versation with Hassan's brother, tells of a foreign doc- 
tor in Meshed, across the border in Persia, who cured 
so-and-so of a fever like Hassan's. Moreover, he him- 
self had had inflamed eyes which this doctor treated 
with ointment and cured. "You should see/' the ped- 
dler continues, "the hundreds of patients going to 
that Infidel hospital." 

The family conclave gathers again to discuss this 
new idea. Meshed is a long way; but still people do go 
there in pilgrimages to the famous shrine of Iman 
Riza. It is a hard, trying journey, donkey-back; more- 
over, a good Moslem, like Hassan, has a strong preju- 
dice against going to a Christian hospital. But he is 
obviously getting worse, and there is no help in 
sight. Finally Hassan takes things into his own hands. 

"If I die, I die," he says with that yielding to kis- 
met, or fate, that is common among Moslems. "If I 
stay here, assuredly I will die. If I go, it may be the 
mercy of Allah that I live. Let us go." 

After many days of painful riding over rough 
mountain paths on the back of the slow-moving little 
donkey, Hassan arrives at the Meshed hospital. The 
kindly doctor promptly diagnoses his trouble as ma- 
laria and prescribes quinine. Within a few days Has- 
san is better. Presently the fever stops. His strength 
and hope revive. The doctor has him stay for treat- 
ment until his health is fully restored. When he 
finally leaves, he is singing the praises of the hospital. 
Wherever he goes for the rest of his life he tells about 



10 HOW FAR TO THE NEAREST DOCTOR? 



his good friends at the Christian mission hospital and 
what they did for him. 

So it runs the chain of need, helplessness, then 
help; and the word-of-inouth spreading of the news 
about the place of help. People like Hassan comfc to 
mission hospitals because of dire need. Only there 
can they find the relief they require. This applies 
much more to certain parts of the world, Arabia and 
Afghanistan and most of Africa, for example, than it 
does to certain other parts where there are more doc- 
tors. Not by any means are all cases so simple or suc- 
cessful as Hassan's, Not everybody gets well. Nor is 
everybody who leaves a mission hospital a grateful 
patient. But, in the primitive and backward areas, 
there are so many experiences comparable to Hassan's 
that it is a fair sample. 

Suppose we look at India, a country in which an 
enlightened government has been trying to do the 
best it can for the people through a great many years. 
What is the need there? It differs from Arabia or 
Afghanistan in that there are a great many doctors. 
But India is an enormous country, with a population 
nearly three times that of the United States. About 
nine-tenths of the people live in villages. The average 
village consists of about four hundred persons. If 
there were one qualified doctor for every three vil- 
lages, there would have to be 250,000 doctors. But 
this is more than ten times as many qualified doctors 
as there are in the whole country. 



WHY THEY COME 11 



The villages are really worse off than these figures 
might lead one to believe, because nearly all the doc- 
tors, in order to make a living, have to practise in the 
cities. The villages are too poor to support them. 
So the vast majority o the 750,000 villages of India 
have no doctor in them or near them. In other words, 
there are people enough to make up at least two 
countries, each with a population equal to that of the 
United States, who have no adequate supply of 
trained doctors. 

A careful survey of health conditions made in India 
a few years ago shows what a terrible amount of sick- 
ness and death is caused by certain diseases. In the 
course of ten years there were over two million deaths 
from plague. In the same period there were over three 
million deaths from cholera. Fevers of all types caused 
in ten years over fifty million deaths. Malaria was the 
chief cause of these, and malaria is usually readily 
curable with quinine. In other words, while there is 
a huge total population of three hundred and fifty 
millions, yet there are millions of deaths from diseases 
that are not necessarily fatal and which medical sci- 
ence knows very well how to treat. 

Nowadays the infant mortality in a country or city 
that is, the death-rate of babies less than a year old 
is considered the important test of its healthfulness. 
The average death-rate for the two largest cities of 
India, Bombay and Calcutta, is about four times that 
of New York. For six of the next largest cities the 



12 HOW FAR TO THE NEAREST DOCTOR? 



record is even worse. All this is due to ignorance and 
poverty. 

When we go on to look at China we discover that 
there are even fewer doctors for that huge population. 
The great mass of the people have access to nothing 
better than the treatment of an old-fashioned Chinese 
doctor. These so-called doctors are not scientifically 
trained at all. Their theories and medicines are mostly 
hand-me-downs of ancient superstitions. Such things 
as toad-skins and tiger's claws ground up into various 
mixtures are most popular. It is only fair to say that 
the old-style Chinese medicine, by hit-or-miss methods 
over centuries, has stumbled on a certain number of 
effective remedies. Some of the old-style Chinese doc- 
tors' medicines have value, but these are prescribed 
without any accurate idea of their proper use. 

An acquaintance of mine tells of watching one of 
these Chinese doctors at work in his medicine stall 
on a market day, an occasion which, on a small scale, 
is something like a country fair. Out of the passing 
crowds that had come into this large village from sur- 
rounding hamlets, people suffering with various ail- 
ments would stop and enter the doctor's stall. First 
a farmer stepped up and asked for some medicine for 
a swelling on his chest. The doctor took out a rusty 
needle and stuck it into the swelling, "to let out the 
air." Then he clapped onto it a dirty black plaster. 
Next a man came along with a toothache. He thought 
there was a worm in his tooth the popular notion 



WHY THEY COME 13 



about the cause of toothaches. The doctor poked 
around with an old rusty piece of wire, and by some 
sleight-of-hand produced from somewhere a wriggling 
worm! This satisfied the man for the moment. But I 
wonder about the toothache. Another man pushed 
through the crowd and asked for some medicine for 
his baby son at home who "is hot and won't eat." Of 
course the doctor had never seen the child. "Sell me 
a good medicine/' said the man, "one of those which 
contains twice seven ingredients and costs sixty cop- 
pers." That was his idea of a good medicine as many 
ingredients as possible, and expensive! I pity the small 
baby at home. 

Well, that gives us a glimpse of what millions of 
Chinese get in the way of supposed medical treatment, 
if they get anything. Does not that indicate a need 
for competent doctors who are honest and who 
care? 

And that leads us to another reason why so many 
people in such countries as China and India and 
Arabia come to mission hospitals. It is because of the 
kindnesses they find there. Mission hospitals are usu- 
ally small and perhaps not very well equipped in com- 
parison with modern city hospitals in Western coun- 
tries. There are, of course, fine large hospitals in 
many parts of Asia and Africa, but these are found 
chiefly in the important towns and cities. The point 
we are making here is that regardless of its size or 
equipment the people know that they can expect hon- 



14 HOW FAR TO THE NEAREST DOCTOR? 

j -jT-juruiiir -*-'j-'-~ j-'Jff^ir jr ^v J~ wur -HT'j^^ir jf JiP'uim" jr.ir jy j*- .ur-^r.r ^ -*-* J* of "*" <&-*'<4r<*-'fi**'f-<4n 

est and equal treatment, friendliness and kindliness, 
at a Christian hospital. 

I often recall the many wards in the sixty-six mis- 
sion hospitals I visited when traveling around the 
world in 1930-31, wards which radiated good cheer 
and good will. Most of the poor, down-trodden vil- 
lage people, who are the patients to be found in them, 
have never before had such experience of care as is 
given them here. I picture to myself the children's 
ward at a hospital in Hwai Yuan, China. Skilful 
surgical and medical work is done there, but what 
impressed me even more was the atmosphere, the 
spirit, of that cheerful ward, where every bed was 
taken. Dr. Agnes Murdock and her sister Miss Mar- 
garet Murdock, the doctor and nurse respectively, 
told me how children respond to the happy feeling 
in the ward. Some children are at first unhappy or 
contrary or fearful, but within a day or two they in- 
variably swing right in with the cooperative friendly 
ways of the place. The doctor and nurse attributed 
this chiefly to the splendid Chinese nurse in charge 
of the ward. My guess is that they all helped to create 
that spirit. 

Some years ago I was in medical missionary work 
in Persia. One cold afternoon in autumn my gate- 
keeper came to my door to announce a patient. One 
of the crude, solid-wheeled, unlubricated Persian ox- 
carts had just shrilled and groaned its way to our hos- 
pital gate, carrying the patient. 



WHY THEY COME 15 



"Doctor Sa'ab," said the gatekeeper, using the 
familiar expression, "there is a sick one." 

I went over to the hospital. It was dusk, so I could 
not see clearly down to the other end of the long hall. 
All I could make out was a curious shapeless mass tot- 
tering toward me. As it came nearer I saw that it was 
an old man carrying a boy on his back. We guided 
them into the examining room, for the boy was evi- 
dently very sick. I soon found that he was a good deal 
sicker than one likes to see. He seemed almost in a 
dying condition. 

The old man who carried him was his father. They 
had come a long way on the ox-cart two or three 
days* journey I think because there was nowhere else 
to go to but our hospital. The father, who was a very 
poor and ignorant village man, began to tell me the 
story. 

"He and the other boys were out on the Mils with 
the flock from our village. It was very cold, an early 
snow fell, and the boys could not get back that night. 
Before we found him, his feet were frozen and he 
could not walk. We knew not what to do. One said 
this and one said that. And one said that we should 
bring him up to the Meriz Khana [House of the Sick] 
at Tabriz. They showed us the road and we came/* 

His eyes followed me with dumb questioning as I 
examined the poor boy. Then he went on, "Praise be 
to Allah! We are now here. Can you cure him?" The 
mother of the sick boy, who had come in behind 



16 HOW FAR TO 



now crept up to the table and murmured, "May Allah 
bless you. Save our boy!" 

There was not much examination necessary to show 
that he was in a serious condition. His feet were far 
gone with gangrene; in fact they were literally at the 
point of dropping off. It required almost no surgery 
and no anesthetic to remove the feet and bandage up 
the stumps. The main thing was to get him to bed and 
do all we could to keep up his strength. 

He was made comfortable in a clean bed, the first of 
the sort he had ever been in, and was soon warm and 
at rest after his hard trip. His old father and mother 
simple village folk of few words sat on the floor by 
his side. When I made my late evening rounds, there 
they were, bowed over the bed, comforting him in 
their own fashion and doing what little they could for 
him. He was very low. 

During the night he slipped silently away. The 
father and mother sat quietly weeping. I felt as if I 
could sit down and join them. It is a very grievous 
thing to lose a son in Persia. And I think he was all 
they had. But the touching part was to see how grate- 
ful they were to us. In their ignorance and grief they 
could say but little, but they felt more than they could 
say. Their boy had died. But his last hours had been 
spent in comfort and warmth and amidst kindness. 
With tears streaming down their faces they said over 
and over again their simple thanks, "May Allah re- 
ward you," "May Allah give you long lifel" 



WHY THEY COME 17 



Still another reason why people come to the Chris- 
tion hospitals is because they want to be honestly 
dealt with. How often have patients said to those o 
us who have been in mission medical work, "We came 
to you because we know you will tell us the truth. 
Our doctors promise us this and that. And we cannot 
trust them. But we know you people tell the truth." 

I often think that the clear telling of the truth day 
by day in the Christian hospitals is one of the strongest 
practical demonstrations of what we are trying to 
share with the people around us. There is often so 
much of lying and falsehood in their background, in 
contrast to Christ's life and teaching and all the best 
heritage that has come down to us. In the Moham- 
medan traditions, for example, Mohammed is quoted 
as saying: "Verily a lie is justifiable in three cases: in 
war, to women, and to reconcile friends." Not that all 
Americans are truthful and all Asiatic people are not! 
Far from it. But Christian teaching and influence is 
consistent in emphasizing honesty and truth telling, 
whereas the religions and traditions of some of the 
people the Christian doctor meets are not. It would 
be easy to give many examples of this from various 
countries, but here I can give just one out of my own 
experience in a Moslem country. 

During the World War many of us in the Near 
East did relief work for the refugees of all races and 
countries. It happened that I was in charge of one 
piece of relief work in the Persian town of Dilman, 



18 HOW FAR TO THE NEAREST DOCTOR? 

In which region we had ten or twelve thousand peo- 
ple of four different nationalities to care for in one 
way or another. One of these groups consisted of refu- 
gee Kurds from the hills, the very people who had 
been proud and cruel marauders a year or two before. 
They were a picturesque and independent people 
composed of various hill tribes. The war had finally 
devastated them, too. Ragged and sick and starving, 
they were flocking down onto the Persian plains 
where they heard that relief from America was to be 
had. 

One need we had to meet was that for warm cover- 
ing against the cold, and we tried to provide them 
with quilts. These, incidentally, had been made by 
other refugees as a means of earning money. It was 
a raw, bitterly cold day; our courtyard was filled with 
forlorn, half-clothed, shivering Kurdish women to 
whom we were giving quilts. But the people had been 
arriving too fast for our stock of quilts, and it soon 
gave out. It was then my unwelcome task to step out 
and announce to them most regretfully. that we had 
no more quilts at the time but would have some as 
soon as possible. 

They wouldn't believe me. They thought I was 
withholding something from them as their own 
great and powerful chiefs might do. I repeated and 
explained, but still they begged and implored me to 
give them the quilts that they thought I must have. 
In their dire need they tore their hair, tossed their 



WHY THEY COME 19 



arms, and In their Oriental manner threw themselves 
on the ground before me, crying out that they must 
have quilts. Didn't I see how forlorn they were? 
Allah was their witness that they needed coverings! 
Wouldn't I produce the quilts? A small pandemo- 
nium broke loose in that courtyard. 

Just then a Persian of the town who knew our 
Christian medical work by reputation, though a 
stranger to me, came along and saw what was going 
on. He stepped into the hubbub and cried to the 
women to be still a moment. Then he said, "Why do 
you keep troubling the Doctor Sahib? He says he has 
no more quilts now. Therefore, he has none. It is the 
truth. When these people speak, they speak the truth. 
They are not like us!" 

There he was, a Moslem speaking to fellow-Mos- 
lems, and in one breath making a striking admission 
and paying a notable tribute. They accepted what 
he said and became quiet. The incident was very valu- 
able to me in what it taught me of the way the people 
recognized our standard of truthfulness. Such a popu- 
lar reputation places a constant responsibility on all 
who work in the name of Christ. 

We have been thinking here of the reasons why 
people in various parts of the world seek out the 
Christian hospitals, and we have had some glimpses of 
these sufferers on their long journeys to the nearest 
doctor. Suppose we turn now to look more closely 
at the life and work of some of these hospitals and 
their staffs of doctors and nurses. Let us see how they 



20 HOW FAR TO THE NEAREST DOCTOR? 

take care of the people who come to them in such 
need. We may well begin by acquainting ourselves 
with a few of the men and women who have pushed 
out into some of the frontier areas of the world to do 
pioneer work under pioneer conditions. How do such 
doctors tackle their job? What has been their in- 
fluence? 



CHAPTER Two 



FRONTIER TRAILS 

HOW many of us know Walt Whitman's stirring 
poem of the days when our "resistless, restless 
race" was developing the West? 

Down the edges, thro* the passes, up the mountains 

steep, 
Conquering, holding, daring, venturing as we go the 

unknown ways, 
Pioneers! O Pioneers! 

This spirit of daring and discovery has been char- 
acteristic o many medical missionaries. Livingstone, 
the famous explorer of Africa, was a medical mission- 
ary. But the spirit of Livingstone and other pioneer 
Christian doctors in Asia and Africa was that of ex- 
ploration and pioneering for the sake of people 
not just to open new country, valuable though that 
may be. 

This spirit has taken them across deserts, through 
the perils of forests, and over forbidding mountain 
ranges. It has brought them into contact with all sorts 
of people beyond the frontiers semi-civilized or sav- 
age whom they could serve. 

One of these forbidding mountain regions, which 
is a constant challenge to the pioneer spirit, is on the 



22 HOW FAR TO THE NEAREST DOCTOR? 

northwest frontier o India. As one passes out of India 
in the direction of Afghanistan, there is a rough 
border country, which is a sort of "No Man's Land/* 
It is neither under Afghanistan nor under the British 
government of India. The inhabitants are wild, un- 
tamed, Moslem tribesmen, called Pathans. Nature is 
unkind to the Pathans. In winter, up in their rocky 
hills, they suffer from snow and intense cold; in sum- 
mer they are scorched with heat. They have to be a 
hardy, tough race to survive. In the short spring they 
manage to raise a little grain; and they pasture 
meager flocks on the scanty pasturage of those hills. 
But their envious eyes are ever on the fertile plains of 
India, stretching away southward from the hills to 
the countless villages and towns, where the daring and 
skillful may loot or kidnap for ransom. So they do a 
good deal of marauding from their mountain fast- 
nesses. And the nearby plains people, who are not 
such fighters, live in constant dread of them. 

You can sense something of all this when you see 
Pathans going about on business in India. Many of 
them, contrary to Moslem teaching, are professional 
money lenders. Always going two and two, they ply 
their trade of lending money and collecting. They 
are rather strong and effective on the latter. When 
you see two burly Pathans, with their big turbans, full 
belts, loose trousers and brass-bound sticks in the 
streets of an Indian village, you notice how they swag- 
ger along and how the rest of the people give them 
plenty of elbow room. 



FRONTIER TRAILS 23 

It was on this frontier of India that Dr. Theodore 
Pennell of England went to work. And it was from his 
border hospital at Bannu that he rode on many er- 
rands of help into the Pathan country. One day there 
came a call to see one of the outlaw chiefs Chikki by 
name. His friends told Dr. Pennell it was too danger- 
ous. They said that Chikki the old reprobate was 
just appealing to him with a fake illness so as to rob 
or kidnap or kill him. Everyone knew Chikki. His 
name was all too familiar in every bazaar and every 
caravanserai of the frontier. He was one of the worst 
bandit chiefs of the whole border, and to him treach- 
erous raids and kidnapping and assorted murder were 
all in the day's run. If one had the ill luck to meet up 
with his rampageous outfit, it was just one's kismet; 
but to go and deliberately put your head in his hand 
by venturing into his village stronghold was unthink- 
able foolishness. Here he was, asking the foreign doc- 
tor to believe his fine tale of sickness and to come to 
see him. Allah forbid! By the beard of the Prophet, 
what a ruse! Surely the Doctor Sahib would not go! 

But Dr. Pennell insisted that he would go. Yes, he 
was going to take Chikki at his word, as a man in 
need. After all, this was just the sort of thing for 
which Dr. Pennell had come out from England to the 
northwest frontier of India. If you tried to help these 
Pathans and Afghans, risks were part of the game. 
It was not armchair country, round about Bannu 
where his hospital was located, but rugged, mountain- 
ous waste where wild, lawless people lived by their 



24 HOW FAR TO THE NEAREST DOCTOR? 



rifles or knives and their wits. You had to take it or 
leave it. 

So off they started on horseback, Dr. Pennell and 
Chikki's fierce Pathan men. The first stage had to be 
covered swiftly because the spring floods were due 
down a river which they had to cross. If they didn't 
get to the ford first, they would be delayed for days. 
So in the last lap they had to spur their horses into 
full gallop and make a dash for it. They made it. 
But, just after they had splashed and clattered 
through, the foaming waters came down, making the 
river impassable. The last stage led through a steep 
gorge flanked by great cliffs. As they turned a sharp 
corner, the leading Pathan grunted and pointed up- 
ward: 

"Chimarak." 

High up and ahead bristled a rough fortification 
Chikki's stronghold. The approach to it had to be 
made in single file. Half a dozen men could defend 
it against hundreds. Higher and higher the party 
climbed. Then they were at the big gate. The turbans' 
of Chikki's men showed over the walls. The gate was 
thrown open and promptly closed behind them. In- 
side they were at the complete mercy of a murderous 
outlaw. Dr. Pennell was all eyes, with curiosity and 
interest. 

Chikki, the famous outlaw, short and black-bearded 
and swaggering in manner, armed with revolver, long 
knife and rifle, was before him. They looked at each 



FRONTIER TRAILS 25 

other with keen interest, and the outlaw chief gave 
the conventional Moslem greeting, 

"Allah be with thee." 

"And with you, my friend," replied Dr. Pennell. 

"Didst thou not fear to come?" asked Chikki, with 
a grim smile. 

"Am I not thy guest?" was Dr. Pennell's cool and 
skillful reply. The law of safety in hospitality is rec- 
ognized even among such people. 

His host promptly did the honors. Seats were 
brought out and covered with rugs. A sheep roasted 
whole, savory dishes and tea were brought on. And 
the party, hungry from the long ride, fell to. 

When they had finished, Pennell asked how he 
could serve Chikki. 

"One of my men is wounded. It was an accident 
in the hills a shooting affair/' said the chief. Pennell 
could readily guess the nature of the "accident" but 
he showed 110 sign of questioning. 

"Let me see him," he said. 

Chikki led the way through the huts of the village 
to where the injured man lay. The doctor dressed the 
wound and gave the man a cooling drink. He had 
fever; and it is quite likely that the Pathans had the 
idea, which is so common among Oriental people, 
that you shouldn't give water to a person with fever. 

When Chikki led the way back to his own court- 
yard, he made a curious remark, 

"I have heard, Sahib>" he said, "that you are a 



26 HOW FAR TO THE NEAREST DOCTOR? 

preacher of the Injil (gospel) , and I wish to hear 
thee, that I may judge of the merits of our religions." 

This is one of the surprising characteristics of many 
people that the missionary meets they are so often 
ready to talk about religion, even when, according to 
our notions, they would hardly be called religious peo- 
ple. But Chikki's request gave the Christian doctor a 
great chance to tell these strong, lawless men what he 
considered the most vital and precious part of life. 
Few missionaries have had such an audience. Most of 
them were presumably outlaws who would kill a man 
on the least impulse. 

Chikki may have thought that Dr. Pennell had 
some doubt about his own safety, for he said: 

"Do not be alarmed about these fellows. They may 
all be rascals, but I have my rifle here, and if anyone 
molests you, I will send a bullet through him." 

The next day, after seeing the wounded man and 
other patients, and assuring Chikki that the man 
would recover, Dr. Pennell prepared to leave. Chikki 
hated to see him go, and kept him in a long and seri- 
ous conversation on religious matters. According to 
his lights, Chikki was- a good Moslem. He observed 
the regular forms of prayer five times daily. When he 
killed someone, he made an extra prayer. He had a 
special prayer for his aim when he was sighting his 
rifle on a victim. "The prayer is always accepted by 
Allah!" he explained to the missionary. 

Dr. Pennell left with him some copies of the New 
Testament and rode away. He never saw Chikki 



FRONTIER TRAILS 27 

again. But interestingly enough, Chikki gave up some 
of his lawless habits, perhaps as a result of Dr. Pen- 
nelFs influence or of reading the Testament. Later, 
when a Moslem holy war was declared by the Afghans 
against the British, Chikki would not let his tribe 
join in. 

The physician's right hand man, Jahan Khan, was 
won in a similar friendly way. Although Jahan. Khan 
had been very much opposed at first, he gradually re- 
sponded and finally became a splendid Christian and 
an immense help in mission medical work, 

Dr. Pennell took every opportunity for serious, 
friendly talks with the people for whom he worked. 
He had not left his English home only to help people 
physically. That was, of course, very much worth 
while in itself. But the purpose for which he gave up 
home and England and went out to such a dangerous 
and unpromising border country was larger and 
deeper. He had a dream of bringing a new life to 
people, a life which meant catching something from 
the deeds and words of Christ. Here he was doing 
some of the deeds of Christ; and he also constantly 
longed to share the words of Christ. He wanted the 
people to know why he had come to live among them. 
Many a time on his village calls he and the local 
mullahs would get into warm discussions. The mullahs 
were, of course, opposed to him because he did not 
believe in Islam, the Moslems 1 religion, and because 
they did not believe in the Christian religion. They 



28 HOW FAR TO THE NEAREST DOCTOR* 



were, moreover, undoubtedly jealous of his power to 
help the sick and of his influence. 

The Pathans, as we have said, are freebooters and 
marauders of the frontier, fighting each other in fam- 
ily or clan feuds. Yet they are upstanding, virile, in- 
teresting people. Dr. Pennell loved them with all 
their faults, and devoted himself to them. His .frontier 
hospital at Bannu came to be known all up and down 
the turbulent border. Many were the strange, tragic 
and pathetic cases that found their way there. 

One day a wounded Pathan, who had been shot in 
a family feud while going home from evening prayer 
at the mosque, was brought to the hospital in a seri- 
ous condition. For days it was uncertain whether he 
would pull through or not. Two brothers took constant 
care of him. They were all sure that he had been shot 
by an uncle with whom they had had a quarrel over 
some family property. Gradually the man got better. 
One day he showed more vigor and said to Dr. Pen- 
nell that he had a request to make. Dr. Pennell, al- 
ways eager to help, bent over him. 

"Sahib, I want you to get me some cartridges; here 
is the money." 

"What for?" asked the doctof. 

Then the man, who had barely escaped death, ex- 
plained that he wanted cartridges so that he could 
go home and get his revenge. Dr. Pennell refused, 
and tried to reason him into a better attitude of 
mind, but with no success. The violent eye-for-an-eye 
code of border life was too strongly in the blood. 



TRAILS 29 



Half humorously, Dr. Pennell finally remarked: 

"Well, I suppose we shall have your uncle here as a 
wounded patient in a few days, and shall have to take 
the same trouble over him." 

"Don't be afraid of that, Sahib," was the comfort- 
ing reply; "I am a better shot than he is!" 

Dr. Pennell traveled about the country a great deal, 
for he felt that in camp and village life one comes 
into closest touch with the people. When he reached 
a village, the news of the arrival of the famous doctor 
sahib would be spread around quickly. And the cara- 
vanserai or guest-house would presently be crowded 
with patients. Often there would be an opportunity 
to correct some mistaken idea. For example, he dis- 
covered that the reason a large number of the people 
were strenuously objecting to the British govern- 
ment's free vaccination against smallpox was a wide- 
spread belief that the foreigners were looking for a 
girl to sacrifice in England, and that they would rec- 
ognize the right girl when milk instead of blood 
flowed from the arm scratched for vaccination. 

The Pathans and Afghans of the border are difficult 
people to deal with, not only because of their violent 
and lawless ways, but because of their trickery and 
thieving. On one occasion some tribesmen brought 
in a patient and went away with profuse thanks. They 
took careful note, however, of the hospital grounds 
and of the hospital tent which did duty as part of 
the equipment. During the night they came back and 
cut away and carried off half of the tent, 



30 HOW FAR TO THE NEAREST DOCTOR? 

The next night, expecting a return visitation for 
the rest of the tent, guards were posted. In the night 
a disturbance was raised in a distant part of the 
grounds, and the guards were fooled into running off 
to see what it was. At that moment the thieves quietly 
slipped in behind them and carried off the rest of 
the tent. When Dr. Pennell heard of It, instead of 
'being furious he roared with laughter over the clever- 
ness of the thieves. It was a mean bit of thievery, when 
the doctor had taken the friend of the thieves into the 
hospital for treatment, but his sense of humor came 
out on top. 

Dr. Pennell was under no illusions about the dan- 
gers he ran. In addition to a host of friends and grate- 
ful well-wishers there were plenty of utterly un- 
scrupulous outlaws around, who did not know him 
or who were too casual in their murders to care about 
whom they killed. He wisely made a point of going 
unarmed. Not only would he prefer to be shot than 
to shoot anyone else, but he also knew that any arms 
he carried would be a tremendous temptation to 
border freebooters. Killing a man for a good revolver 
or rifle was quite in order and considered good 
business. 

His frequent danger was once illustrated when he 
was off on a trip alone. At a turn in the road he came 
upon a mullah, who knew him, and two other men 
talking earnestly together in low tones. He stopped to 
speak with them. Presently the two men demanded 
a favor of him on the ground that they had saved his 



FRONTIER TRAILS SI 

life. They explained that as he came along they had 
been debating whether to kill him or not, and had 
finally decided not to do so; therefore they claimed a 
reward! The mullah had argued that since Dr. Pen- 
nell was an infidel, it would be a sure way to attain 
Paradise if they killed him. The counter argument 
had -been that he was working for the good of their 
people, so that it was not lawful for them to take his 
life. 

Such incidents did not intimidate Dr. Pennell in 
the least. He came and went fearlessly, wherever and 
whenever needed. 

The faith in his power to cure was often pathetic 
and was particularly true of the blind, since eye trou- 
bles are most frequent in these barren mountains and 
deserts. Many hopeless cases were brought to him. 
They went to his heart because nothing could be done 
for them. But it would often be hard to convince these 
blind people that this was the truth. "O Sahib, just a 
little light! Only a little sight/' they would implore. 
"We have come all these days* journey because they 
said you could cure everything!" 

Then, in the midst of his great service, Dr. Pennell 
was cut off. An infection, caught from, a patient on 
whom he had performed an operation, laid him low. 
When word went out that he was critically ill, the 
whole community was moved as it had never been 
moved before. From the whole border region, where 
human life is cheaply held, people flocked to the hos- 
pital where their beloved friend lay sick. They 



32 HOW FAR TO THE NEAREST DOCTOR? 



crowded about, asking for word of him and hanging 
upon every report that came out from the sick room. 
Normal life in the town of Bannu came to a stand- 
still. These Moslem people prayed for his recovery. 

Meanwhile, Dr. Pennell was cheerfully courageous. 
His friend and faithful helper, Jahan Khan, with 
other friends, came in the evening and prayed with 
him. But, little by little, his strength ebbed and then 
failed. When the w r ord of his death came out to the 
huge, waiting throngs a great sob seemed to go 
through them; and they abandoned themselves to 
grief. It seemed as though everyone in Bannu was 
stricken; as though he or she had lost a dear, per- 
sonal friend. 

They asked to see him once more as he lay serenely 
still. So they were allowed to file past him for several 
hours. It was an impressive sight fierce, rugged war- 
riors from across the frontier, beggars in rags, officers 
and soldiers of the British government, women with 
children, shopkeepers, villagers, the high and the low, 
Hindus, Mohammedans, Christian converts, ex-pa- 
tients and their friends hour after hour they filed si- 
lently by, with streaming eyes taking their one last 
glimpse of the beloved doctor sahib. 

They could not believe that he was dead. "Our 
beloved Sahib could not die/' they said; "he lives." 
In a different sense they spoke the truth. Their doctor 
sahib lives in their memories and hearts, and his story 
will be handed down from one generation to an- 
other. 



FRONTIER TRAILS 33 

Such was the impression made by one great pioneer 
doctor. 

With different people and a different setting there 
have been many other courageous and pioneering 
spirits. I should like to give you a glimpse of one 
more, from the country of Siam. Siam has been known 
as the land of the white elephants (which are not 
really white, but grey) , and for the Siamese twins 
(which really were not Siamese but Chinese) . So ap- 
parently what little we know about Siam is likely to 
be wrong! The country is largely composed of jungle 
or forest, and in general presents a green and rich- 
looking landscape as one travels through it. The peo- 
ple are easygoing and friendly, and seem to have 
enough to eat. 

The Siamese still use elephants for lumber han- 
dling and other kinds of heavy work, though not to 
the same extent as formerly. Readers who have seen 
the famous movie of jungle life called "Chang," 
which was filmed in Siam and partly in a medical 
mission station, strange to say will remember the 
wonderful elephant scenes, and how much the people 
seem to depend upon elephants. It is interesting to 
observe, by the way, that the animals used in that 
motion picture were work elephants, hired from a 
lumber company and made to act like wild ones. The 
story goes that when those elephants got through 
doing their rampaging movie "stuff" and were put 
back on the job, they wouldn't work at first. They had 



34 HOW FAR TO THE NEAREST DOCTOR? 



had too thrilling a time crashing houses and running 
wild generally "too much Hollywood" to be will- 
ing to go back to the humdrum hauling and piling o 
logs. It took a little time and firmness to discipline 
them once more. 

Though elephants are "going out" and automobiles 
are gradually "coming in/* the vast majority of the 
people still live in very simple fashion in small, primi- 
tive villages. There is only one sizeable city, the capi- 
tal, Bangkok. This is a large, beautiful and partly 
modern city, with some fine buildings the impres- 
sive palace of the king and two or three quite modern 
hospitals. But most of the country has nothing at all 
equal to this. In general, outside Bangkok, the Sia- 
mese have no better medical facilities than are to 
be found among the rural population of China or 
Persia. 

In 1931, when the king of Siam came to America 
for an operation on his eyes, we read a good deal 
about Siam. Being a quiet little tropical country, 
tucked away between Burma and Indo-China, it does 
not often appear in the headlines of our newspapers. 
Today Siam is making great progress from a sort of 
primitive jungle village toward modern conditions. 
Its principal railroad is one of the most comfortable 
I ever traveled on. The people and the government 
have been unusually friendly toward those who have 
gone there in Christian work. Christian hospitals have 
been given substantial help by the government. 



FRONTIER TRAILS 35 

But when Dr. James McKean went to Slam about 
forty years ago it took longer to go from Bangkok, the 
capital, up to his station of Chiengmai, In the north 
of Siam, than it did to go from San Francisco all the 
way across the Pacific Ocean to Bangkok. He was 
telling me about it the other day in my office, when I 
asked him about his early experiences. The voyage 
from San Francisco to Bangkok took thirty-seven days, 
and the journey from Bangkok to Chiengmai took 
fifty-seven days. When I went up from Bangkok to 
Chiengmai in 1931 it was a very comfortable train 
ride of about thirty-six hours. 

In those days travelers had to go up country by 
river boat. And they had to wait for the special kind 
of Chiengmai river boats to come down stream, as 
other boats couldn't make it. There were some forty 
rapids to navigate on the way up. Four or five men 
poled each boat. Sometimes, in particularly bad 
places, the boats had to be unloaded to get through, 
and the loads were carried laboriously along the 
bank. 

Though Dr. McKean was not the first medical man 
to go to Chiengmai, the conditions were about as 
primitive as if he had been. There was a small native- 
style building of bamboo for a dispensary, with two 
small so-called wards. Operations were done on the 
veranda, in the sight of the passers-by in the street. 
There was no dearth of patients; the difficulty was to 
handle all who came. 



$6 HOW FAR TO THE NEAREST DOCTOR? 

On his medical trips Dr. McKean sometimes used 
elephants. There was a good deal of rough going, up 
hill and down dale. The elephants were good at this. 
There was one such elephant-back journey of forty 
days. One of the missionaries, Dr. "McGilvary, had an 
elephant of his own which was very useful and very 
intelligent* Dr. McKean tells of how they used to 
have breakfast in camp, and how the elephant would 
come and stand at Dr. McGilvary's shoulder while 
they were eating and be fed with pancakes out of Dr. 
McGilvary's hand. 

Once an elephant got a bad abscess on his back, 
caused by the rubbing of the howdah in which the 
passenger rides. It wasn't exactly the sort of case that 
his medical professors had taught the young Dr. Mc- 
Kean to treat. But there he was with a new job for a 
medical missionary! They made the elephant lie 
down. Then Dr. McKean opened the abscess, and the 
pus drained away well. After that he would give it a 
daily washing with an antiseptic solution, using a 
garden hose for the purpose! The elephant squealed 
and made a fuss the first time, but was so relieved that 
thereafter it obeyed and submitted in the most docile 
fashion, evidently realizing that the treatment helped. 

Dr. McKean was so highly esteemed in Siam that, 
after a time, he was made private physician of In- 
tanon, king of the northern part of Siam. There is 
just one king for all of Siam now, but less than forty 
years ago there was a king in the south and a lesser 
king in the north. 



FRONTIER TRAILS 37 



In Siam lepers were once neglected. They used to 
be outcastes until Christian doctors came. Nobody 
wanted them around. If they came near other people, 
they would be asked in no mistakable fashion to move 
on. Their own people would not lift a finger for them. 
This was not because the Siamese people are hard- 
hearted. Quite the contrary. They are naturally kind 
as kind as any people in the world. But their reli- 
gion, Buddhism, teaches them that suffering is a sort 
of paying up for evil done in some previous existence. 
It teaches that each soul is reborn into life many 
times. Thus if a person sins in one of these lives, he is 
punished for it in another. So the lepers, according 
to this view, were people who were being punished 
for what they had done in some earlier existence. 
Therefore they must go through with the punish- 
ment; it would be interfering with divine law to help 
them out. They should be allowed to suffer and do 
penance for the past. Compare this with what Christ 
teaches about suffering people, and with what he did 
for lepers. 

Dr. McKean, like many another medical mission- 
ary, was deeply stirred by the suffering and hopeless- 
ness of the lepers. H'e asked the government for some 
land on which to build a place of refuge for them. 
He was granted a large island in the river at Chieng- 
mai. The island had been the domicile of a crabbed 
old royal elephant. When the elephant died, the 
island was turned over to Dr. McKean without any- 



58 HOW FAR TO THE NEAREST DOCTOR? 

body's thinking very much about it. Nobody wanted 
the island particularly, and certainly no one wanted 
lepers near by. And if Dr. McKean wanted to put 
some lepers out there and care for them, all right. 
But nobody imagined what was going to be created 
on that beautiful jungle island. 

Those were the days before medical science had dis- 
covered a real treatment for leprosy. Leper asylums 
were just places of refuge human scrap heaps 
where the human wrecks could be kindly taken care 
of until they died. It was a work of love, but it was a 
work without hope of cure. Nowadays the doctors 
know how to deal with leprosy in its early stages, and 
patients can be virtually cured and sent back to their 
homes and friends to live normal, useful lives. Even 
cases in later stages can be helped more or less. The 
treatment consists of injections of chaulmoogra oil, 
which is obtained from the fruit of a tree found in 
parts of India, Burma and Siam, and which has now 
been introduced to Hawaii and South America. It 
takes many months, or even years, of steady treatment 
to effect a cure. But it is worth it. 

So Dr. McKean's asylum was started as just a place 
where these wretched people could go and live in 
peace and have food and shelter. Two or three tiny 
huts were built just large enough for a person to 
crawl into and secure shelter from the rain and cold. 
People with leprosy suffer badly from the cold. So 
even a tiny hut and a blanket meant wonderful com- 



FRONTIER TRAILS 39 



fort for them, after the knocking around from pillar 
to post to which they had been accustomed. 

From these first crude little huts there has grown, 
year by year, a beautiful, well-planned village, which 
I visited not long ago. It is one of the most wonder- 
ful places I have ever seen. Instead of two or three 
cramped huts, there are rows of neat little cottages, 
a beautiful chapel building, a clinic, a hospital, an 
office building, and a handsome, though simple, rec- 
reation building. They dedicated this last building 
while we were there. This village for leper people 
now has four hundred inhabitants. They have their 
own organization & mayor, village elders forming a 
sort of town council, a school, a police force, and a 
sanitary squad. They have a carpenter, a blacksmith, 
a tailor, and a painter and other artisans. The boys 
have a lively band, which played at the dedication ex- 
ercises of the recreation building. 

There are probably as many as twenty thousand 
lepers in Siam, which has a population of about thir- 
teen millions. About fourteen hundred o these 
twenty thousand have passed through the leper village 
at Chiengmai. In many parts of the world there are 
leper hospitals carrying on similar work. The agency 
through which much of this great service of mercy is 
directed is the Mission to Lepers to which thousands 
of Christian people of all churches in the United 
States and the British Empire contribute. 

The spirit in that Chiengmai village is remarkable. 
These lepers have caught the ideal of Christian broth- 



40 HOW FAR TO THE NEAREST DOCTOR? 



erhood, and out of their small allowance of goods and 
money, are constantly praying for and making gifts 
to others who are worse off than they are, not only in 
Siam but also in distant parts of the world. 

The key to Dr. McKean's inspiration lies in some- 
thing he is fond of quoting: "God had one son. And 
this son was a physician/* 



CHAPTER THREE 

WITCH DOCTORS vs. CHRISTIAN DOCTORS 

DAVID LIVINGSTONE, who was a great mis- 
sionary doctor as well as a great explorer, was 
the forerunner of the brave men and women who 
have, at the risk of health and life, slowly extended 
our knowledge of Africa. Penetrating her forests, 
crossing her deserts, they have sent back information 
about her great natural wonders, her animal life, and 
especially about her peoples, their beliefs, manners 
and customs, until Africa has come to be a never- 
ending source of interest to the rest of the world. 

In recent years daring aviators have criss-crossed 
the Dark Continent in long-distance non-stop flights, 
and today only small portions remain to be explored. 
But that is only a preliminary survey. The great work 
of reaching the people has only begun. In this chapter 
we shall follow a section of that small, devoted army, 
the missionary doctors, who are carrying on the Liv- 
ingstone tradition of Christian helpfulness on behalf 
of the vast, scattered populations of Africa's forests 
and grasslands. 

If you were a doctor and suddenly found yourself 
put down in Africa to help her primitive, supersti- 
tious people, how would you begin? How would you 



42 HOW FAR TO THE NEAREST DOCTOR? 

take hold of things and go to work? One way would 
be to find what the special needs o the people are, 
and then, in a spirit o sincere friendliness, try to 
meet them. One of the greatest needs of the African 
is to be freed from the awful power of the witch doc- 
tors who terrify him and impose on him cruelly. To 
give the African people the truth about the causes of 
disease and death, to free their simple minds of super- 
stitious fears, is to bring them help where they need 
it most 

The witch doctor is the African's medicine man. 
He is supposed to know all there is to know about 
disease, its cause, prevention, and cure. His idea of 
cause is chiefly that of evil spirits which have been 
coaxed by some enemy to enter the sick person. The 
way, therefore, to help the sick person is to punish 
the guilty enemy. The witch doctor has his impressive 
way of discovering this enemy by a ceremonial process 
of "smelling him out." This really means that the 
witch doctor picks out and accuses anyone he pleases. 
And, usually, everyone believes him. They are afraid 
to question his authority, since he was elevated to this 
position by the chief of their tribe. When "smelled 
out" the accused person is cruelly punished prob- 
ably tortured perhaps killed. 

Now just imagine yourself, if you can, as an African 
in one of the villages far off in the forest. A man in 
your village has just died. He was no special friend 
or connection of yours; neither was he an enemy. You 
and he were on perfectly good terms. Just a few days 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 43 



ago you were out together hunting monkeys for din- 
ner. Then he fell sick with a fever, and yesterday he 
died. Now the whole village is in a furor. Why did 
he die? He had been perfectly well. Why should he 
die like this, so suddenly? It must have been one of 
the many evil spirits that haunt the forest. Someone 
must have bewitched him. They all say this, because 
they cannot imagine, in their ignorance, that disease 
can come from any other source. At the same time 
they feel worried and afraid, because no one knows 
who will be charged with the crime. For, in order to 
lift the evil spell, the person who cast it on the victim 
must be "smelled out" and forced to recall it. You 
feel particularly uneasy, because you and the witch 
doctor had a little argument the other day about a 
rooster which strayed off. This was a trifling matter, 
and, to be sure, the witch doctor got the rooster. Still, 
you can't tell; perhaps he secretly holds a grudge 
against you. 

The people are standing around talking excitedly 
and waiting for the village palaver to decide the trag- 
edy. The sharp penetrating sound of the village drum 
suddenly rings out. It sends a shiver down your spine. 
These African drums are wonderful broadcasters, 
with their own code and language they can be .heard 
at great distances; they are the telegraph and radio 
of the African savage. The drum says that the villagers 
must gather for the witch doctor's palaver. You and 
the others scores of people with shaky knees form 
a huge circle and squat down on the ground. You can 



44 HOW FAR TO THE NEAREST DOCTOR? 

see how everyone Is getting more and more excited 
and nervous. So are you. What if it should be you or 
one of your family? 

Now the witch doctor is approaching. He is decked 
out in the most gorgeous and fearsome fashion, with 
paint and feathers and a big spear in his hand. He 
comes stalking into the great circle, and then, with a 
great air of mystery, begins to go around "smelling 
out" each person. Who is to be the victim? It prob- 
ably means torture to obtain a confession, perhaps 
death for someone. Here he comes nearer and nearer, 
leering at people, crying out weird sounds, and 
brandishing his spear, a terrifying sight. He hasn't 
picked out anyone yet. And he is getting nearer and 
nearer to you! 

Well, suppose we leave you right there! Think of 
living with this kind of fear always hanging over you! 
Every time something goes wrong you are in danger 
no matter how innocent you are. It is a cruel form 
of slavery. 

How would you go about helping people to get out 
from under this horror? Would you simply talk 
against the witch doctor? Would these simple minded 
people, brought up to believe in his magical powers, 
accept you if you did? Would they dare? The witch 
doctor has always been a powerful menace in their 
lives; they can't believe that you are more powerful 
than this one of their own tribe whom all fear. Or 
would you try to show the people something different 
and better? If you could really prove something to 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 45 



them which they could see for themselves, wouldn't 
that convince them better than talking to them about 
their foolish beliefs and fears? 

This is how the Christian doctors who have gone 
to Africa work it out. They believe that if they show 
how kindness, reinforced by scientific knowledge, is 
used to treat the sick, and explain the causes of dis- 
ease, the people will gradually understand, and finally 
free their minds of the fear of evil spirits and witch 
doctors. As the people see the truth of what is demon- 
strated in treating diseases, they become open minded 
towards the Christian teaching of one great loving 
spirit, God, who cares for them. Thus slowly they 
lose their superstitious terror of a swarm of malign 
spirits that, with the witch doctor's aid, are always 
trying to do them harm. 

Dr. Albert Schweitzer, the Alsatian scholar, chose 
to leave a great career in Europe to take up this kind 
of work in Africa because he believed that the people 
out there were the most needy; that as a Christian 
doctor he could render them the greatest service. He 
not only chose the hard field of Africa, but he chose 
a hard place in Africa. It was not a place where he 
could step into a ready-made job, but a place where 
he would have to be a pioneer. 

Dr. Schweitzer was already a man with a great repu- 
tation as a professor of theology, as a writer and as a 
musician. His organ recitals and lectures on the great 
composer Bach were famous throughout Europe. His 



46 HOW FAR TO THE NEAREST DOCTOR? 

books were widely read. He could have gone right on 
with a distinguished career. But a new purpose grow- 
ing up in him led him to do an extraordinary thing. 
In the spirit of Christ he felt a tremendous urge to 
work for the most needy people. He gave up his posi- 
tion and career as professor, and started in all over 
again. He took the strenuous medical course in order 
to be of practical use in some needy part of the world. 
When he had finished eight years of this preparation 
he was then nearly forty years old he sailed for 
Africa in 1913, the year before the World War broke 
out. His field was to be one of the loneliest and hardest 
parts of the continent. 

So here we have this versatile philosopher, musi- 
cian, doctor, arriving in the wilds of Africa to start 
medical work from nothing. The place he chose is 
called Lambar6n, in French Equatorial Africa, and 
it is about two hundred miles up the Ogowe River 
from the sea. There was nothing there but a primitive 
house and a corrugated iron hut. Lambarn was 
chosen, he says, because it was a center of river water- 
ways to which patients could come in dugout canoes 
from various directions and from considerable dis- 
tances. 

Dr. Schweitzer didn't have to sit and look at a doc- 
tor's sign, waiting for his patients. Africa is a sick 
country. Since the treacherous witch doctor is usually 
all that the people have, a trusted missionary doctor 
is a godsend. And a good dugout canoe on a big river 
will land you at the door of the hospital. In fact the 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 47 

river is the only good road in this dense jungle region. 
People build their huts along its banks and travel 
on it. 

Perhaps your next question is, Did the people come 
to him? Were they brave enough to break away from 
the witch doctor and trust themselves to a foreigner? 
The Lambaren witch doctors naturally didn't like 
to see their patients and their trade going elsewhere. 
Nor did they like to see their authority dwindling. 
They presumably did all they could to persuade the 
people to keep on with the old ways and not experi- 
ment with something new and dangerous. O course, 
things didn't happen all at once. In any country some 
people move faster than others. There are always those 
who hang back. So it was in the region around Lam- 
bar^ne. Some people would risk it and come to Dr. 
Schweitzer. When they found how kind he was, how 
so many people who had fevers got well, and when 
they saw that a man mauled by a leopard was so care- 
fully and successfully treated, then more and more 
would come. In writing about his work recently Dr. 
Schweitzer said that there were from one hundred 
and twenty to one hundred and sixty patients at the 
hospital all the time. And there were only two doc- 
tors, at most, to take care of them. Sometimes he 
would be alone, as he was when he started. The fact 
that his hospital has so many patients answers the 
question whether the people come to him and trust 
him. It also answers a lot more. It means that they are 



48 HOW FAR TO THE NEAREST DOCTOR? 

learning a new view of life, that some of them are 
gaining a new faith. 

Of course it is not all plain sailing when one tries 
to give medical treatment to people who are hardly 
more than savages. They are confirmed in their ideas, 
just as we are in ours. The fact that their ideas are 
rooted in superstition and fear makes the problem 
worse. The evil spirits of the forest and the power of 
the witch doctor still haunt their minds. Just as we 
think that our American way is the only way, so they 
think the old African ways are the best. 

But the new ways of the white doctor at first seem 
even more fearsome than the familiar ways of the 
witch doctor. For example, the missionary doctors 
have great difficulty in persuading people to take ether 
or chloroform anesthesia for an operation. These 
simple people are afraid of being poisoned and never 
waking up. A good deal of poisoning goes on among 
them, so it isn't altogether surprising that they are 
afraid of being put to sleep in such a magical way by 
a strange doctor. It seems to them a new kind of witch- 
craft. One evening Dr. Schweitzer heard a patient* 
who had just waked up from an anesthetic, say to a 
neighbor: 

''Yes, the doctor wanted to kill me. He put some 
poison in my nose, and I was actually dead. But he 
hadn't given me enough, and I carne to life!" 

But when hundreds of people are put to sleep in 
this way and undergo serious operations without suf- 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 49 

fering pain, and then recover, It cannot fail to impress 
the whole region. 

One o the great scourges that the missionary doc- 
tors have had to fight is the African sleeping-sickness, 
which was formerly regarded as always fatal. Its vic- 
tims slowly waste away, getting weaker and weaker, 
drowsier and drowsier, and more and more miserable 
until they die. There was no treatment for it. Now 
there is a remarkable drug, tryparasamid, developed 
by one of the Rockefeller Institute doctors (and 
similar drugs have been developed in Germany and 
France) w r hich can actually cure the disease if used 
early enough in the trouble. 

One of these sufferers, N'Tsama by name, when 
brought to the hospital was almost a skeleton, and was 
going crazy with the disease. Dr. Schweitzer treated 
him with tryparasamid, and he began slowly to im- 
prove. He got over his mental symptoms and regained 
Strength. Then he developed a great urge for fishing 
and would stand for hours on the river bank, though 
without catching much. Dr. Schweitzer finishes the 
story: 

One day, when there were planks to be unloaded and 
taken up to the hospital, I laughingly called to N'Tsama 
to leave his fishing and help us, whereupon he lifted up a 
plank and carried it away on his head. There is much 
jubilation over this in the hospital, because it is thus evi- 
dent to all that even sleeping-sickness sufferers in the last 
stage of the disease, who have hitherto been doomed to 
death, can now be restored to healthy life. At the 1 begin- 
ning of the summer N'Tsama asks to be allowed to help 



50 HOW FAR TO THE NEAREST DOCTOR? 

with the forest clearing, and he stays with us as a laborer. 
"The doctor is my father (he says) and the hospital is 
my village." The only relic of the sleeping-sickness is a 
proneness to fatigue and irritation. On account of this 
he is only allowed to work when one of us is present, so 
that too much exertion may not be expected from him, 
and the others may not excite him by making fun of him. 
Since then we have had many excellent results from the 
use of this drug. 

It is a wonderful victory that scientific medical re- 
search achieves when it finds remedies for diseases 
that once seemed to be hopelessly incurable. 

The patients are usually very grateful for the care 
they have had. Most of them make payment in fruit 
or some other food bananas or smoked fish or seed- 
lings of breadfruit trees, for example. There isn't 
much real money to be had; so the friends of the pa- 
tient are told to bring whatever they are going to 
bring while the patient is still in the hospital. If they 
don't pay then, they may never be heard from. The 
forest isn't much of a place for a bill collector. 

Suppose, again, that you were in Africa as a doctor, 
and that you wanted to build a hospital in order to 
help the people. Can you imagine how you would 
have to go about it? It is pretty hard to imagine. You 
can't expect to build a hospital like ours in America. 
There are no materials ready, no factories or stores, 
nor are there architects, builders or workmen. The 
doctor has to be architect and builder and foreman; 
his materials are what we call raw lumber obtained 
from the virgin forest, other necessities supplied by 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 51 



nature and fashioned to use by primitive methods. 
And he certainly has his problems. 

There are no skilled workmen, except as you train 
them yourself. Neither are there any labor unions. 
Whitewashing, for example, is a real problem. 

We "believed at first [writes Dr. Schweitzer] that we 
could train natives to do the whitewashing, but their 
chief contribution to the work was to ruin most skilfully 
the few brushes that we possessed. If a primitive gets a 
brush into his hand the brush has in two days not a hair 
left. I do not know how they manage this, but so it is, 
and as the whitewash must also be laid on very carefully, 
there is nothing for us to do but to do the work ourselves. 
Doctors and nurses vie with each other in the practice of 
this unfamiliar art. 

With all these exasperations you might think a doc- 
tor would get tired and disgusted with such people. 
To a certain extent he does. But here is what Dr. 
Schweitzer writes, as he leaves his work to come home 
on leave: 

It seems to me incomprehensible that I am leaving the 
natives for months. How fond of them one becomes, in 
spite of all the trouble they give onel How many beauti- 
ful traits of character we can discover in them, if we re- 
fuse to let the many and varied follies of the child of 
nature prevent us from looking for the man in him! How 
they disclose to us their real selves, if we have love and 
patience enough to understand theml 

How would you raise money for your hospital, if 
you were working as Dr. Schweitzer is? That is a real 
problem. The African people of course can't pay 



52 HOW FAR TO THE NEAREST DOCTOR? 

much, though they pay what they can In supplies of 
food, material, or labor. 

Fortunately Dr. Schweitzer has a great asset which 
he can turn to account for the problem whenever he 
goes home to Europe on leave. His reputation as an 
organist, especially with the music of Bach, is such 
that he can draw large paying audiences for recitals. 
And from the proceeds of these recitals he is able to 
do a good deal toward covering his hospital expenses. 
His musical tours of Europe have been very success- 
ful; and he receives much applause and praise. Then, 
when his leave is over, he turns his face from the com- 
forts and friends and success of civilization to the dis- 
comforts and ignorance and struggle of Africa. Could 
anything but an inspiring faith and love make a man 
do that? 

Another man who feels keenly the needs of Africa, 
and especially the desperate problem of the witch doc- 
tor, is Dr. James McCord of South Africa whose work 
is carried on under one of the American mission 
boards. The people call him Big Doctor Jim. I think 
this applies to his spirit as well as to his physical big- 
ness. I remember his talking about the witch doctors 
when he was home some years ago. He considers them 
to be the great obstacle in the lives of the people with 
which a Christian doctor has to deal. The witch doctor 
is the bane of Africa, he says. 

When the witch doctor tries surgery he is particu- 
larly pernicious. This is how he operates to cure head- 



WITCH DOCTORS w. CHRISTIAN DOCTORS 5$ 

ache. He cuts through the scalp until he gets down 
to the bare bone of the skull. Then he scrapes the 
skull-bone with some sharp instruments. You can 
Imagine how much headache that will cure, especially 
as it is all done without an anesthetic and later gets 
infected! 

Dr. McCord was once asked whether the witch doc- 
tor ever does any good to his patients. His reply was, 
"Possibly so, although I have never seen a case in 
which he did." Something very important that Dr. 
McCord emphasized is the need for training African 
doctors. The foreign doctors who go to Africa are 
never going to be sufficient in number to take care 
of the people adequately. For all this part of Africa 
there is about one doctor to every million people. 
What are one hundred and forty doctors among that 
many millions? And there is no particular prospect 
that this number will be greately increased in the next 
generation. There are plenty of witch doctors avail- 
able, but it is a long way to the nearest Western doc- 
tor. So Dr. McGord and his associates have gone to 
work to train young men in medicine. He also has a 
nurses* training school, from which competent and 
useful nurses are being graduated. 

Dr. McCord feels that the only way to get rid of the 
terrible bane of the witch doctor is to offer the 
Africans something better, which means providing 
enough practical doctors and nurses to go around. It 
is an ambitious program. No one man and no one 
school can come anywhere near carrying it out. But 



54 HOW FAR TO THE NEAREST DOCTOR? 

the beginning has been made. And there is a great 
challenge in it for young Christian doctors and nurses 
to continue it. 

Suppose we take in a sample of Big Doctor Jim's 
outside medical calls, and let him tell the story. A 
man had come in post-haste from a distant village to 
ask him to come and treat his sick wife. 

I went into the mission nursing home about eight 
o'clock that evening to see if there was any excitement. 
Dr. Morledge was out for the evening, but the afore- 
mentioned father was there impatiently waiting to see the 
doctor. I listened to his tale of woe, grumbled a little at 
my luck, and climbed into my motor car with a pretty 
full kit of instruments and dressings. The father came 
along to show the way. We stepped on the gas and sailed 
off. As we were about to leave town, I heard a pistol shot 
beside the road. No, it wasn't a bandit. No such luck. It 
was a blow-out in a front tire. I had a spare, but my other 
front tire had worn thin and was likely to explode any 
minute; so I slowly drove downtown and found a tire 
shop that was open all night and luckily found a new tire 
to fit my wheel. 

We finally left town at 10:15 P.M. There was a bright 
moon and my headlight and spotlight were in commun- 
ion, so we felt quite happy but somewhat in a hurry. The 
trip to Verulam was uneventful except for the bumps. 
The road was nice and hard. Beyond Verulam the road 
was not bumpy and it was not hard. Decidedly muddy in 
fact. It was a strange road and I didn't know what was 
coming next. Several times I thought we were going to 
get stuck in the mud, or on the steep hills of which there 
seemed an endless succession. But by backing up and 
taking another run at the bad places we managed to get 
through. 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 55 

I comforted myself with the thought that we were not 
many miles from our destination, and if we were stuck 
we could walk the rest of the way, and the devoted 
father would have to carry the box of instruments and 
dressings. We got higher and higher in the world until 
my guide finally told me that we could now walk the rest 
of the way. We did so for a mile or two further, until 
the dark hovel hove in sight. 

The father knocked and a streak of light appeared 
under the door. I thought someone had turned on the 
electric light, but when the door opened I saw that the 
brilliance was caused by someone throwing a stick on the 
fire. By the blaze from the stick I saw about a dozen foims 
lying on the earth floor, some in heathen dress, some in 
semi-civilized dress, but most of them wrapped in their 
blankets. (The mother, who was the patient, was among 
those on the floor.) 

It was midnight. Surgical procedure was necessary if 
the mother's life was to be saved. My operating table was 
the dirt floor. My electric light consisted of two small 
stone bottles of kerosene with rags stuck in to act as 
wicks. The operator was myself. My first assistant was 
myself. My second assistant was myself, My anesthetist 
was myself. It was a one man show. From the shadows 
of the hut a dozen pairs of eyes watched the clinic more 
than a dozen, for others kept dropping in. 

It was somewhat strenuous to give the chloroform and 
then operate while the patient was coming out from the 
anesthetic. However, everything went smoothly, and at 
two A.M. I was able to start on my homeward way. The 
mother's life was saved, and that was the main point. 

I had thought that I would curl up on the back seat of 
the motor car and sleep until morning, then drive home 
in the light of day, but the father carried rny small trunk 
to the motor car for me and expressed a desire to go to 



56 HOW FAR TO THE NEAREST DOCTOR? 

Durban with me, to get medicines for his wife, so I de- 
cided to drive straight through. I got to bed at 5:30 A.M., 
about the time I usually get up, and got an hour and a 
half of sleep before beginning my day's work. 

It was a hard night's work, but very satisfactory. It 
always is if you can save a life or relieve suffering. 

That is the only reward that the missionary doctor 
expects, and he treasures it. Nothing less would keep 
Dr. McCord in Africa any more than it would Dr. 
Schweitzer. 

If you were set down in Africa, as we have imag- 
ined, and had laboriously built your hospital, you 
would realize, after all, what a drop in the bucket one 
hospital is, or what a hundred hospitals would be, in 
huge Africa. You would probably come to the con- 
clusion, as Dr. McCord has, that the people must learn 
to do for themselves. They must develop doctors and 
nurses of their own race, with the help of the foreign 
doctors and nurses. Moreover, the teaching process 
must begin right in the homes. The mothers must 
become intelligent and ambitious to learn sanitary 
ways of living through Christian ways of thought and 
faith. 

I don't know of any story that has appealed to me 
in this connection more than that of Dr. Agnes Fraser, 
of Scotland, who has been one of the inspiring women 
doctors of Africa. 

She was among those who were deeply impressed 
with this need of teaching. What good was it to cure 
babies when the mothers were actually killing them 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 57 

by the terrible methods of care that they followed? 
Dr. Fraser found that over seventy per cent of the 
babies In her region were dying. They were dying of 
perfectly preventable diseases or of mishandling. 
Babies just born would be left to lie for a while un- 
covered and naked on the cold, damp, mud floors. 
Food that should not be given to babies before they 
are nearly a year old would be forced down their 
throats. No wonder over seventy per cent died. 

The people, she found, were at first afraid of every- 
thing strange and different. Even a very simple hut- 
like hospital was too big and queer for them. They 
were terrified to stay inside of it. But gradually they 
got used to it. 

Of course, new ideas of any kind were even harder 
for these simple savages to understand and accept than 
this primitive hospital in which they must stay. Dr. 
Fraser began simple lessons with them. She had ob- 
jects with which to illustrate the ideas. One of these 
was Tobias. 

Tobias was a celluloid doll which Dr. Fraser used 
as a model for all sorts of teaching. Tobias was a won- 
der. He survived everything from being bathed and 
bandaged to being poulticed and put to bed. He even 
had a pot of boiling water dumped over him. This 
was in order to show how burns should be treated. 
Tobias was fixed up after this imaginary accident with 
applications and dressings until he convinced the real 
sufferer. When Dr. Fraser was teaching the women 
how important rest is in a critical illness (instead of 



58 HOW FAR TO THE NEAREST DOCTOR? 



having a room full of talking, shuffling, friends and 
relatives) Tobias did duty again and slept profoundly. 
The women actually tip-toed around so that Tobias, 
In his fevered sleep, should not be disturbed. They 
became very fond of him. I should think he would 
have gone on strike when it was decided he had the 
itch and must be covered all over with sulphur oint- 
ment! 

When Dr. Fraser wanted to teach the women about 
germs, and that boiling was the way to kill germs in 
water or food, she illustrated with an egg. A boiled 
egg couldn't, of course, produce a chicken. No setting 
hen could hatch a hard-boiled egg! They knew that. 
And she pointed out the comparison. Boiling killed 
the life in the germ just as it did in an egg. 

Dr. Eraser's mothercraft classes grew and flourished. 
Women came in for courses of a few days of systematic 
teaching, and they loved it. The chief quality she 
aimed to develop was confidence in themselves to go 
ahead and do the things they had learned. One of 
the women made Dr. Fraser proud of her work. Off 
in her village, this woman's child came down with 
dysentery. Most African children would have died of 
it. This mother, however, being too far away to get 
a doctor, followed instructions for three days of 
severe illness and pulled her child through. It gave 
her a great feeling of satisfaction to know that she 
could put into use what Dr. Fraser had taught her. 

An old man, once a redoubtable warrior, brought 
a new-born baby forty miles to Dr. Fraser. It wasn't 



WITCH DOCTORS vs. CHRISTIAN DOCTORS 59 

Ms baby, but no one else in the village would do any- 
thing about it, so he got busy and carried the baby all 
that distance. On the way he just gave the baby clean 
water, following the doctor's advice. And the baby 
was saved. 

After a few days of one of these mothercraft classes 
in which the women were keenly interested, one of 
them exclaimed, "To think of the things we used to 
believer ' "When?*' asked Dr. Fraser. "Last Mon- 
day!" was the reply. 

Experiences like these of Dr. Fraser's or, for that 
matter, of Dr. Schweitzer's or Dr. McCord's show 
something of the possibilities that there are in primi- 
tive peoples. If you think the African people are 
stupid, just try to learn more about them. Stupid? 
Not a bit of it. The doctors I know in Africa tell me 
that the young fellows whom they bring into the hos- 
pital to train as assistants observe keenly and learn 
rapidly. And eventually they become very skilful One 
of the doctors I know said that he no longer cares to 
give the special injections for sleeping sickness, or for 
some other diseases, in front of his African assistants, 
because they now do it so much better than he does. 
He trained them originally, and they have done so 
much of it that they have become experts. 

So the missionary doctor, although inadequate in 
number for Africa's gigantic need, strives to overcome 
this handicap by developing the wonderful human 
and spiritual possibilities of the Dark Continent and 
training them for its own service and betterment. 



CHAPTER FOUR 

MEDICAL SERVICE ON DESERT AND UPLAND 

YOU dirty dog of an infidel! You scum under my 
foot! May Allah condemn your parents to 
Jehannum (hell) for bringing you into the worldl 
I have a pain in my stomach. Give me some medi- 
cine!" 

Sitting in his clinic Dr. Paul Harrison, of Bahrein 
on the east coast of Arabia, looked up at the tall 
Bedouin, a real son of the desert. From under the 
burnous of wool that protects the Arab's head from 
the extreme heat, black eyes glared down at him with 
hate as these guttural Arabic words were uttered with 
all the venom that a fanatical Moslem uses toward 
an infidel a Christian or a Jew. 

To us it sounds incredible. Here was a man suffer- 
ing, yet he was asking for medicine in insulting lan- 
guage, and, what is more, expecting to get it! Our 
immediate come-back to any such peremptory and in- 
sulting demand would probably have been a sharp 
one. 

Not so Dr. Harrison. He knew the proud, fanatical 
Mohammedan of the desert, and his hatred for the 
infidel. Lacking the polished ways of more civilized 
regions, where polite words just as often cloak hatred, 



ON DESERT AND UPLAND 



this rude, rough son of the desert was unable to hide 
his disgust at having to admit that a Christian doctor 
was more effective than his own wise men. Unaccus- 
tomed in his desert life to ask or give favors, least of 
all with Christians, this Arab was furious at being 
forced to ask a favor of Dr. Harrison, In the desert 
he fought and killed for what he wanted, and he had 
been raised to loathe all infidels. The real Arab of 
the desert will not eat with any of us, because he con- 
siders us unclean. 

But it didn't bother Dr. Harrison in the least. He 
knew that it was just as right and natural for the Arab 
to talk that way as for us to say the Lord's prayer or 
salute our flag. This was just the sort of man a medi- 
cal missionary goes out to win to friendship and Chris- 
tian understanding. 

Well, the rest of the story is just as interesting. This 
fanatical, scornful, Bedouin stayed in the hospital for 
a couple of weeks and got well. Besides, he learned 
that the foreign doctor from Johns Hopkins who took 
such skilful care of him was no ogre or infidel or con- 
taminated substance, but a real man like himself, with 
the heart of a friend. Little by little the desert preju- 
dice thawed and melted. Before he came to leave he 
was a real friend. I claim that when you have made 
anything like that happen you have done something. 

Then, if you remember that hundreds and thou- 
sands of more or less similar experiences are taking 
place in mission hospitals in Arabia to say nothing 



62 HOW FAR TO THE NEAREST DOCTOR* 

of other countries it means that people are really 
being changed. The Christlike spirit is being felt. 

At one time Dr. Harrison was traveling up the 
Euphrates River in a small boat. He was the only 
foreigner with the Arab boatmen. River travel in such 
boats is slow going, especially upstream. But it gives 
time to get acquainted and make friends. It is hard 
work for the men. And every so often they tie up to 
the bank for a rest. One day, while their boat was 
tied up in this way, another Arab came along the river 
bank and saw these fellow-Arabs with this infidel for- 
eigner. He was one of the orthodox desert Moham- 
medans like our fierce friend of the clinic. It shocked 
him to see good Mohammedans on familiar and 
friendly terms with a lowdown, infidel Christian. So 
he cried out to them: 

"Why do you do this? Why do you defile yourselves 
with this dirty dog of a Christian?" 

Now those boatmen had become good pals of Dr. 
Harrison, and they weren't going to have this fellow 
calling him names. So they charged up the bank, 
brandishing their sticks and made for him. He fought 
back as they pursued him for some distance while 
they engaged him in a running fight. 

When they finally returned, rather warm but ap- 
parently pleased with the fray, Dr. Harrison asked 
them: 

"Why did you go after that man and try to beat 
him up?" 



ON DESERT AND UPLAND 63 

"Why," they said, ''didn't you hear what he called 
you? He called you a Christian!" 

"Well/* said the doctor, "that's perfectly correct. 
You know that that is what I am." 

"Oh," they said, "we know that. It's all right with 
us. But we weren't going to let him call you that!" 

Then there was another o his Arab patients for 
whom Dr. Harrison did a very unusual thing. A child 
who was brought to him had what is called a hydro- 
cephalus or water on the brain. It was born so. It 
meant that the child would live a few years without 
developing properly, and then would die. The parents 
brought him to Dr. Harrison, having heard of his 
great reputation. 

At that time a new operation was being tried by a 
few surgeons to relieve this hopeless condition. It 
consisted in cutting a vein out of someone's arm and 
transplanting it at the bottom of the patient's brain. 
There was some reason to hope that this would help. 

Dr. Harrison decided to try this operation as a last 
hope to save the child. It was a daring thing to do in 
a small, mud-walled hospital in Arabia, with no com- 
petent person to help him. Of course he told the 
parents honestly that he couldn't promise them any- 
thing, but that it was the only glimmer of hope there 
was. They talked it over and consented. 

Then came the next question. What member of 
the family would volunteer to offer a vein? Dr. Har- 
rison explained that the removal of a vein was per- 
fectly harmless as the body soon made up for it. But 



64 HOW FAR TO THE NEAREST DOCTOR? 



they were too much afraid. No one would sacrifice 
that much or take a chance. Thereupon Dr. Harrison 
decided to take a vein from his own arm. He sterilized 
the spot, cut through his skin, dissected as much vein 
as he wanted, and then, having prepared the place 
in the child's head, he planted the vein in and sewed 
it up. Can you imagine how the family and friends 
looked on! Whoever heard of such a thing! It was the 
talk of the town. 

Well, the child was no worse for the operation; the 
place healed up all right. The operation, however, 
did not help the water on the brain. But think of the 
Impression made on those people! 

I had lunch with Dr. Harrison in New York, not 
long before he and Mrs. Harrison went back to 
Arabia, and heard him tell some of these experiences 
over again. Then I told him some of my experiences 
in Persia. We swapped funny tales of our medical 
adventures and had some good laughs. It helps a medi- 
cal missionary to have a sense of humor just as much 
as it does anyone else, or more so. It would be pretty 
hard to stand the strain if you couldn't ever see the 
funny side. 

Arabia is practically next door to Turkey, where 
my father was a medical missionary for many years. 
In fact, until the World War, Turkey ruled part of 
Arabia. The Arabs and the Turks have been strong 
Mohammedans, though, since establishing a republic, 
the Turks have taken up many new ideas in recent 



ON DESERT AND UPLAND 65 



years, and are no longer such fanatical Moslems. 
When we were children up in the central part o Asia 
Minor, which is the heart of Turkey, in the days when 
the cruel sultan Abdul Hamid ruled the country, we 
used to see a great deal of my father's medical work, 
as the hospital yard was just over the stone wall from 
our yard. We used to see the patients all sorts of pa- 
tients coming to the dispensary. They came from 
near and far; and they were the rich and the poor, 
peasants and even a pasha or two, and from every 
race and religion of Turkey. 

Many of the people came on donkey-back, jogging 
hours or days through the heat and dust. Others came 
stretched on an ox-cart. Such carts as these are crude 
affairs that squeak and jolt and labor along the rough 
roads. Not exactly de luxe ambulances 1 Horseback 
was the way for many others. Some patients came 
perched upon camels. The well-to-do would come in 
carriages. Then a great many from near by would 
come on foot. 

The patients* horses and the donkeys used to be 
stabled in a certain shed in the hospital yard. Every 
now and then there would be a row among these 
horses, since nearly all were stallions, and much 
squealing and kicking and commotion ensued. The 
owners would rush in and separate the fighters. We 
children used to think these fights were a great show 
staged for our benefit. Whenever we heard the sounds 
of battle we used to rush out and clamber onto the 



66 HOW FAR TO THE NEAREST DOCTOR? 

shed, which had many convenient knotholes and 
cracks through which we could peer down at the fun 
below. Sometimes we would lie stretched out on that 
shed for a long time hoping for a free show in the 
way of a fight! 

Of course we talked in Turkish with the people 
who came there, as children would, and used to hear 
how much they thought of the American doctor, my 
father, the late Dr. William Schauffler Dodd. In 
those days there were almost no other doctors worthy 
of the name in all that great part of Turkey. The 
nearest medical missionary was Dr. Fred Douglas 
Shepard, of Aintab, a place several days* journey 
away, on the other side of the Taurus mountains. He 
also was a much-beloved doctor with a wide reputa- 
tion. 

Thus there grew up a saying among the people: 
"South of the mountains Shipard, Shipard, Shipard. 
North of the mountains, Tot, Tot, Tot,'* which was 
their way of pronouncing Shepard and Dodd. 

In those days of the evil Sultan Hamid Turkey 
went through some bad times, for the country was 
very different from what it is now. Once there was one 
of those fanatical outbursts on the part of the Turks 
against the Armenians, who were a subject race and 
Christian in religion. On one occasion the wild ele- 
ment among the Turks was about to attack our town 
of Talas. The rumor leaped ahead of them, and there 
was panic in Talas. The terrified Armenians came 



ON DESERT AND UPLAND 67 

fleeing into our grounds, hoping for protection. I 
remember how panic-stricken and helpless they were. 

Among the patients at the hospital just then was 
a Turk who was getting well from an operation. He 
had his gun with him, as it happened. When he heard 
that these other Turks were about to attack the doctor 
who had made him well and befriended him, he 
acted promptly. Calling for his gun, he stationed him- 
self in an upper window which commanded the ap- 
proach to the hospital, and vowed by the beard of the 
Prophet that he would give an account of himself 
before they touched a hair of the foreign doctor's 
head. The attack did not come off. But if it had, I 
don't doubt that he would have defended us vigor- 
ously. 

Like Dr. Shepard, my father did a great deal of 
traveling about to see sick people in the outlying 
villages, usually going on horseback. These villages 
were poor, cheerless affairs built almost entirely of 
mud bricks. The houses often had only one room, in 
which the donkeys and the sheep lived along with the 
family. The flat roofs were made of mud, the walls of 
mud, and the floor just packed mud. Many times an 
emergency operation would have to be done on the 
floor. On one occasion, when my father was operating 
on a poor woman on the mud floor o a village house, 
the family donkey strayed over from his corner and 
suddenly started to bray deaf eningly right at the doc- 
tor's ear. It always pleased my father that his hand 
kept steady in spite of the startling outburst. 



HOW FAR TO THE NEAREST DOCTOR? 



Much of Father's traveling was done on the back oi 
Prince, a splendid chestnut horse supposedly part 
Arab. He was one of the fastest and most tireless horses 
around, and very intelligent. For a time I had the 
job of currying and feeding Prince. On one of his 
winter trips Father was caught in a heavy snowstorm, 
Pretty soon he found he was going around in circles, 
as people so often do out in blizzards. So he concluded 
to trust to Prince. He dropped the bridle on his neck 
and spoke to him encouragingly. Prince seemed to 
sense the situation, pricked up his ears, and made a 
new start. Before very long he had worked it out right 
and brought up at the next village. 

Donkeys are a very important part of the life of the 
Near East. A lot of the short-haul work is done by 
them, such as taking produce into town, or vending 
food and merchandise around the streets. The donkey 
often becomes a kind of five-and-ten-cent store on legs. 
One time a boy, whose eye trouble Father had cured, 
brought his blind donkey to the hospital. The donkey 
was his means of earning a living. His faith in the 
Hakim Bashi (Chief Doctor) was unlimited. 
Wouldn't lie cure the donkey? Unfortunately the 
donkey had an incurable trouble. And the boy was 
much disappointed, 

As my father's work grew he felt that a hospital was 
a necessity. You can, of course, do some emergency 
operations and give out medicines under bad condi- 
tions. But for good medical and surgical work which 



ON DESERT AND UPLAND 69 



will really help people the most, it is necessary to have 
a clean place, reasonably up-to-date equipment, 
trained nurses and a laboratory for diagnosis. Little 
by little the money for such a hospital was raised 
among friends in America. And a very serviceable, 
though simple, hospital was built, which did duty 
for many years, during which thousands o patients 
came to its clinic and wards. 

Both Dr. Shepard and Dr. Dodd were pioneer sur- 
geons of the Near East at a time when there were 
hardly any surgeons in that part of the world. Their 
inspiration was always Christ. They loved their work, 
and they loved the people. And the people loved them. 
Not that they had no opposition; there was plenty of 
it. There was jealousy among the native doctors. 
There was always suspicion from government officials 
of the Sultan. And, of course, strong Moslems had no 
love for them as earnest Christians. But they left a 
wonderful memory which still lives. In both cases 
their sons followed in their footsteps. Some of the 
more ignorant people bring in curious legends that 
are circulating around the countryside to the effect 
that "Tot" had come to life again as a young man, 
and was back among the people in the person of my 
brother, Dr. Wilson Dodd. One version of the story 
was that my father became very tired from the work, 
so he had been put away in a huge earthenware jug, as 
in the story of Ali Baba and the forty thieves, and 
that during these nearly twenty years he had rested 



70 HOW FAR TO THE NEAREST DOCTOR? 

and grown young again, and had come out as a young 
doctor once more! 

Arabia, Turkey and Persia are neighbors in the 
Near East. Certain o my experiences in Persia during 
the war were like some of those that my father and 
Dr. Shepard had gone through years before in 
Turkey. Here is a tale about a good friend of mine 
who was my senior associate when I began work in 
northwest Persia. 

It begins with a big, husky, football, baseball and 
track star from Colorado College, Harry Packard, 
who became a doctor, practised successfully a few 
years in Colorado, and then went out into medical 
mission work in Persia- A man six feet, four inches 
in height, and weighing over two hundred pounds, 
makes even more of an impression in the Near East 
than he does here, for the people there are on the 
average shorter than Americans. 

Dr. Packard's station was Urumia, in northwest 
Persia on the border of Turkey. The mountains and 
the wild, marauding Kurds who liyed there, made up 
a picture something like that of the Afghan border 
where Dr. Pennell worked. The Kurds were in those 
days the fear and dread of the Persian border region. 
Every so often, in small bands, or occasionally in 
great hordes, they swept down on the Persian plains, 
raiding the villages right and left, killing freely, kid- 
napping a few women maybe, and departing for their 
mountain homes and strongholds. They had their 



ON DESERT AND UPLAND 71 

good qualities too. They could be friendly and hos- 
pitable and loyal. Several of us who worked in that 
region came to recognize these traits and had friends 
among them. I spent a very interesting and enjoyable 
day in the village of one of these chiefs, Amar Khan, 
who was a good deal of a bandit but a very genial hosL 

Dr. Packard, in particular, came to know them well 
and was well known by them. He traveled frequently 
up into their country, and they came down as patients 
to his hospital. Some of them were staunch friends 
of his and great admirers of his surgical skill. Year by 
year his work and his reputation among them grew. 
Then came the crash of the World War. Persia wasn't 
officially in the war; but the Turks and Russians be- 
gan fighting each other across the corner of Persia 
where Urumia is located. Every time tihe Turks 
started to invade the country an avalanche of lawless 
Kurdish irregulars swept along ahead of them, for 
it was a wonderful chance to loot and kill. On the 
first of these occasions, in 1915, the Christian people 
of the plains were quite unprepared. The cavalcades 
of hard-riding Kurdish horsemen were upon them be- 
fore they could flee. 

Hearing that a great swarm of the Kurds was com- 
ing up toward Urumia from the south, raiding as 
they went, Dr. Packard, who knew several of the lead- 
ing chiefs, decided to ride out to meet them and see 
if he could intercede in behalf of the people of those 
villages. Carrying an American flag he rode out from 
the walled city of Urumia on his daring errand with 



72 HOW FAR TO THE NEAREST DOCTORf 



a few Persian companions and servants. Who knew 
what the fighting Kurds would do to anyone they 
met? 

As they rode on a few miles from the city, they 
heard sharp firing off to one side. They swung off 
that way and soon found that the firing was from the 
Christian village of Geogtapa, which could be trans- 
lated Sky top. The situation was this: On a low hill 
in that village is an old Russian church within a 
high-walled enclosure. As the Kurds swept upon them, 
the people had rushed to this enclosure, and, with the 
few arms they had, were defending themselves from 
behind these walls. The Kurds were posted all over 
the village, firing at them from various directions and 
waiting to rush them when their ammunition gave 
out, as it was bound to do presently. 

There was no time to be lost. The situation looked 
desperate. Most men would have turned back while 
they could. Here were these age-old enemies in the 
thick of a small battle, the brutal Kurds without 
and the Christian village people within. The Kurds 
had tasted blood and some of their fighters had been 
killed or wounded, and they were bent on revenge. 
It was a matter of time a few hours or perhaps a day 
before the hundreds of people within would be 
overpowered and massacred. They could be sure of 
that. There would be no mercy. 

Dr. Packard found the Kurdish chiefs directing the 
attack in a neighboring village. He rode in and dis- 
mounted at the house which served as temporary 



ON DESERT AND UPLAND 73 



Kurdish headquarters. He was greeted variously by 
the assembled chiefs. Some were rather friendly; some 
were decidedly not. In general, they didn't welcome 
any interference. 

Then followed a strange and dramatic scene. Here 
sat the large circle of Kurdish chiefs, armed to the 
teeth, bent on carrying through their fight. In and 
out the door men came and went, bringing word of 
the fighting and taking out orders. And in the midst 
sat this big American doctor who was putting up a 
plea for the lives of the Christian people. He appealed 
to his friends among the chiefs as a personal favor to 
him to let the people go. A few among them showed 
some friendliness, but the others were bitter. It was 
no business of his what they did to those infidels! 

"They have taken the blood of our young men. 
And will we let them go? No, by the beard of the 
Prophet and Allah be our witness they must all be 
cut down!" 

So the debate went on hour after hour Dr. 
Packard pleading, advancing every argument he could 
think of, hanging on, though there seemed almost 
no hope. 

At the height of the debate one old grizzled chief 
came toward Dr. Packard and waved his vicious 
curved sword in his face, threatening and cursing- 
Away with him! The infidels must die! Out of our 
way and on with the killing! 

Perhaps his football toughness helped. But, any- 
way, Dr. Packard couldn't be scared away or tired out. 



74 HOW FAR TO THE NEAREST DOCTOR? 



He kept at them. And little by little his friends pre- 
vailed and the opposition wore down. Finally negotia- 
tions began for taking the people away from the Rus- 
sian church. Dr. Packard planned to take them to his 
mission compound in Urumia. 

It was a ticklish business at best. Even if the chiefs 
agreed to let Dr. Packard lead the people away, could 
the Kurds be trusted? Could their leaders restrain 
their hot-headed young men two miles away in "Sky- 
top" from firing on such easy victims? Dr. Packard's 
experience with the Kurds was that if they gave their 
solemn word it could be relied on. There was no 
question about the risk. But it was the only hope. The 
agreement was made. They would let him take the 
people away. But he had to ride into "Skytop" right 
under the rifle fire of both sides without any definite 
assurance of control there. 

Now came the other half of the program to per- 
suade the Christians inside the walls to accept the 
terms carried by Dr. Packard, and come out where 
they would be exposed to attack. Dr. Packard went 
up to the great gate of the enclosure and the Kurds 
stopped firing. One of the Christians who was guard- 
ing the gate told me several years later what then 
took place. 

"We couldn't believe that the Doctor Sahib had 
come," he said; "and when we heard the voice shout- 
ing to us from outside the gate, we didn't know who 
it was. Then I recognized his voice. And we saw that 



ON DESERT AND UPLAND 75 

we could open the gate and let him in," How his face 
shone as he told about it! 

To lead the people out from that temporary safety 
to the hazard of the exposure outside was an awful 
responsibility. For a while they were of two minds. 
Could they risk it? Dr. Packard assured them of the 
agreement with the Kurds. And finally they took the 
chance. 

Men, women and children filed out, laid down 
what arms they had, and, forming a great column 
seventeen hundred of them started out through the 
village toward Urumia. Not a shot was fired. The 
Kurds kept their pledge. Dr. Packard followed at the 
rear of the column, and they arrived safely in the 
mission grounds at Urumia. 

Over the main gate of these premises floated an 
American flag, which when the Kurds occupied the 
city, for months thereafter was the one visible protec- 
tion for these people and hundreds of other refugees. 

Some time after this rescue Dr. Packard came down 
with typhus. In the midst of his delirium he was con- 
stantly going over the tense experience with the Kurd- 
ish chiefs at Geogtapa, arguing, pleading, harangu- 
ing, for the lives of the Christian refugees. 

Of course, incidents like this are rather exceptional 
in medical missionary life and work. If I were to give 
the impression that similar experiences are the usual 
order of the day it would be a mistake. The usual 
routine in a mission hospital may seem quite hum- 



76 HOW FAR TO THE NEAREST DOCTOR? 

drum. Adventures form a perfectly true part of the 
picture, but they are not its everyday life. 

Since those stirring war days Persia has made steady 
progress in the organization of a public health pro- 
gram with which the missionary doctors are cooperat- 
ing. Strategic centers for mission work are already 
occupied and are being developed. For example, Dr, 
Packard and his associates have recently completed a 
fine new hospital in Kermanshah, to which his work 
has been transferred from Urumia. 

A Princeton man, Dr. Joseph Cook, went out to 
Persia about twenty years ago. Persia was at that time 
a very backward country. Things were done and life 
went on in practically the same way it had gone on 
for centuries. If a person from ancient times could 
suddenly have been dropped in on a Persian village 
twenty years ago I think he would have felt pretty 
much at home there. He might have seen some guns 
which were modern. He might have seen some old, 
tattered newspaper pictures on the walls which would 
be strange. But the houses and the clothes, the plough- 
ing and the reaping, the donkeys, camels and oxen, 
would have been familiar. 

Even in Teheran, the capital, there was not very 
much of modern progress then; there is now. There 
were then very few Persian doctors of any modern 
training or dependability. And there was no real hos- 
pital in that big city of perhaps three hundred thou- 
sand population, except the mission hospital. 



ON DESERT AND UPLAND 77 

Dr. Cook, with his magnetic personality, had been 
one of the most popular and respected men in his 
class at Princeton, and in Persia he soon made a large 
place for himself. Recognizing his fine medical skill, 
numbers of people began to flock to him. An early 
letter from him shows his enthusiastic spirit: 

I've never had such satisfaction in my life. This giving 
sight to blind people is wonderful. A blind girl came 
twelve days* journey we operated on both eyesboth 
turned out well. Where's the sacrifice to have this privi- 
lege? * . I've seen more interesting and more curious 
and rare and hard cases here than I've ever seen at home 
cases which I can find no reference to in textbooks of 
medicine. . . . Mother cabled me that Princeton and 
Yale tied. I am sorry we did not win but am glad we did 
not lose. Princeton has certainly had a boom year Wil- 
scm President-to-be, and athletic victories galore. 

After a while Dr. Cook's eager pioneer spirit, al- 
ways longing to reach the poorest and most neglected 
people, grew restless with the comparative comfort 
of Teheran. He wanted to push out into something 
harder where there was more need. 

Off to the east, near the border of Afghanistan 
the opposite side of Afghanistan from where Dr. Pen- 
nell worked there is the sacred shrine-city of 
Meshed. It is nearly six hundred miles from Teheran, 
In those days the journey between the two cities 
meant two weeks of hard travel by carriage, day and 
night, with frequent change of horses. It greatly ap- 
pealed to him to go there and open a new work. It 
would be hard and perhaps dangerous, for the people 



78 HOW FAR TO THE NEAREST DOCTOR? 

were fanatical and hated all who were not Moslems. 
But to Dr. Cook they were all human beings, and hu- 
man beings In need. Dr. Cook went there, with an 
older man, the late Mr. L. Esselstyn, a minister. 

In spite of the prejudice and hostility In Meshed, 
there was a surprising response to his work. In less 
than seven months he had seen over sixteen thousand 
patients in the city, beside many more outside the 
city, and had performed three hundred and fourteen 
operations. On one record-breaking day he saw two 
hundred and fifty-five patients. He had no trained 
assistant with him. Mr. Esselstyn frequently helped 
him, and Mrs. Cook acted as nurse. All this went on 
in a city where Christians were anything but welcome, 
and where they probably could not have remained if 
it had not been for the need of the people and the 
popularity of the American doctor. 

Dr. Cook kept pointing out the opportunity of such 
a place. "All roads lead to Meshed." Pilgrims came 
from all directions, hundreds of miles, to the famous 
shrine, which made Meshed one of the three most 
important religious centers of the Moslem world. 
People came from Afghanistan and Arabia and India 
and Russian Turkestan as well as from all over Persia. 
This meant a great chance for medical service, for 
many pilgrims would arrive sick. The Christian Influ- 
ence of the hospital, its teachings and its spirit, would 
be carried to all sorts of distant places where there 
might never be any other Christian contact. 

When Dr. Cook and his family went home on fur- 



ON DESERT AND UPLAND 79 



lough they left behind them a host of friends in 
Teheran and Meshed. He was eager to get back to 
Persia. In the meanwhile the World War made con- 
ditions very complicated. So, instead of bringing his 
family back to Persia with him, Dr. Cook started 
alone. On the way, however, he showed signs of 
tuberculosis and had to give up Persia. He rested for 
a time at Dr. William J. Wanless' hospital in Miraj, 
India. But after a while it was evident that he was 
not gaining as he should, and he was sent back to 
America. 

As his health returned, he went into practice in 
Banning, California. He developed a large practice, 
with tuberculosis as his specialty. But, no matter how 
successful he was, his thoughts always turned back to 
Persia. For a long time it seemed that there would be 
some risk if he were to return, but finally, after he 
had spent ten years in America, the doctors and all his 
advisers felt that he could safely return. He was de- 
lighted. He went right to work, handing over his 
practice and disposing of his medical equipment. He 
was giving up an income of twenty thousand dollars 
or more a year in order to go back to taking care of 
poor people in Persia on a small missionary salary. 

So in the fall of 1929 the happy family of six in- 
cluding two boys and two girls sailed for Persia, 
They were assigned to Hamadan, where Dr. Cook 
would work with his good friend Dr. J. Arthur Funk, 
who has a fine hospital there. Dr. Cook, who was al- 
ways eager to reach the poorest people, presently 



SO flOW FAR TO THE NEAREST DOCTOR? 

branched out into some clinic work in addition to 
that at the hospital. When I was there a year later, in 
the fall of 1930, he told me how he took a carriage 
and drove all around the city looking for the worst 
section. He finally settled in what seemed to him the 
poorest quarter of Hamadan. Here are extracts from 
his clinical journal: 

We have had our dispensary practically every week-day 
morning from eight to twelve. The m'ajority, possibly 
seventy per cent, of our patients are women. Many of our 
patients have been more or less regular attendants and 
have learned to come with their babies whenever in need 
of care. When one realizes that in Persia it is practically 
necessary to have three or four children in order to keep 
one, one can realize the splendid opportunity we have to 
educate these simple, ignorant, natural, good women. 
"I've had twelve children, this is the only one left/* "My 
boy is very sick, I only wish it were my daughter instead.*' 
I challenged this remark and learned that her daughter 
was deaf and dumb from scarlet fever. . . . 

So often when women are sick for a long time they are 
turned out divorced. Scores of such deserted sick women 
come to us for treatment. . . 

Little girl mothers with their sweet, sad faces; older 
women with Madonna type faces, the majority wistful 
and evidently yearning for something better. Essentially 
good, although in rags, loving their babies as we do, 
smiling when we are kind to their babies or themselves, 
always modest and always trustful, it has been the great- 
est privilege of my medical life to minister to the needs 
of these poor people. . . . 

Since July j, 1930, to June 30, 1931, we have treated in 
our dispensary 21,378 patients. . . . 



ON DESERT AND UPLAND 81 



One's heart goes out to these poor Ignorant people 
when they bring dying patients expecting miracles, and 
oh! how a doctor wishes he could say with Christ, "I say 
unto you, arise, and be healed." 

Dr. Cook was in this tide o glorious, happy work 
when he suddenly became ill. Presently It was found 
that he had typhus fever, one of the deadly sicknesses 
of the Orient. The doctors and nurses labored over 
him. But the dread infection was overpowering; and 
he slipped away. The shock and sorrow in the city of 
Hamadan and to his friends in America can hardly 
be described. 

Even those who knew what an impression his work 
was making were surprised to see how the city of 
Hamadan was moved by his death. A striking evidence 
of this was the delegation of Moslems which came 
with the request that he should be buried in their 
cemetery. This was an extraordinary request, when 
one recalls the feelings that Moslems have usually 
held toward non-Moslems. But it shows something of 
their love and admiration almost veneration for 
his example of self-sacrifice in their behalf. 



CHAPTER FIFE 



ALL IN THE DAY'S WORK 

WOULD you like to have a close-up of a mission 
hospital? The one In which I worked at Tabriz, 
Persia to describe the one I know best was a sub- 
stantial, ship-shape, brick building within a large 
walled enclosure or compound. All through the 
Orient such compounds, nearly every one with a gate- 
keeper, are to be found. Our Persian gatekeeper, 
Gambar by name, was a rather meek and kindly man, 
whose headquarters were in the little gatehouse by the 
large gate which opened onto the main street of our 
quarter of the city. It was his job to let in patients, 
bring messages to the doctor, and, incidentally, keep 
out people who had no business within. He also 
helped with numerous jobs about the place. 

My day's schedule, which is a fair sample of that 
followed in many other mission hospitals, runs some- 
thing like this: 

6:30 Language lesson. This was put early to be 
sure of it. My teacher, a quaint, one-eyed, old 
Persian gentleman, would shuffle in with his 
loose slippers and his polite salaams, to drill 
a rather sleepy doctor on reading and writ- 
ing a language whose curlycue characters run 
from right to left. 



ALL IN THE DATS WORK 



83 



7:30 



8:00 



8:i 5 



9:00 



Breakfast. This was a good deal of an Ameri- 
can meal, though the typical Persian break- 
fast is tea and bread and goat cheese. 
Short worship service with the hospital staff 
and those patients who could go about. This 
makes a helpful start for the day. 
Making rounds among the patients giving 
not only directions for their care but also 
hearing what they have to say and trying to 
encourage them. 

Three days a week the morning was given 
to the downtown dispensary, which hap- 
pened to be about twenty minutes' walk 
away. This would mean seeing some thirty 
or forty old and new patients afflicted with a 
variety of diseases. 

Afternoon. Following lunch, calls on special private pa- 
tients in their homes; consultations with Per- 
sian doctors; surgical dressings in the hos- 
pitals; miscellaneous matters of hospital 
management. Perhaps a little tennis before 
dinner. 

Evening. Make rounds again. Perhaps work on hos- 
pital accounts, attend a meeting, write let- 
ters or read. 
Night On call for maternity cases and emergencies. 

Into this schedule the most unexpected things often 
intrude, which may seem trifling but which in less 
civilized countries can be very annoying and incon- 
venient. Perhaps the first announcement made to the 
doctor after breakfast, or before, is that the stovepipe 
in the operating room has fallen down. It happens to 
be a cold morning; and it Is only one hour or so be- 



84 HOW FAR TO THE NEAREST DOCTOR? 



fore operating time. The stovepipe has to be fixed, 
the fire made and the room warmed before he can 
begin to operate. Many mission hospitals, to be sure, 
are in tropical regions where stoves do not exist, but 
the tropics produce their own peculiar emergencies 
In the most unexpected manner. In such countries 
the doctor may be greeted in the morning with the 
news that a band of monkeys from the nearby jungle 
have raided the storeroom and scattered supplies all 
over the place. 

An ever-present cause of annoyance is the matter of 
baksheesh, a Persian word which means a gift of 
money and is used commonly throughout the Near 
and Middle East. Where people have been accustomed 
to paying or receiving baksheesh for any favor done, 
it is very hard to get an honest gatekeeper or attend- 
ant who will not yield to the temptation to ask for a 
"tip" really a bribe in return for certain favors, 
such as allowing patients to see the doctor out of turn. 
Often the doctor hears nothing about this sort of 
thing. The patients are so used to it among them- 
selves, that they think they will get along better if 
they make no complaint against the hospital servants. 
But, of course, anything like that around a Christian 
hospital is against its spirit, and the doctors and nurses 
stop it whenever they can. 

One of the regular jobs for the doctor or nurse in 
the mission hospital is to go over the daily accounts 
with the cook or the buyer. This means much de- 
tailed figuring in which there is plenty of chance for 



ALL IN THE DAY'S WORK 85 

honest mistakes and plenty of chance for cheating. 
The shopkeepers are likely to think that the foreign- 
ers have plenty of money (because they do handle 
more of it than most of the townspeople do) and so 
charge extra, I can remember many a weary evening 
session, of trying to make my accounts balance. 

In most mission hospitals in the Orient the water 
supply is a great problem. Very likely it has to be 
pumped or drawn by hand from a well or cistern, or, 
worse still, it may have to be carried on a coolie's back, 
or donkey's back, or by cart, from a distance. For 
many years one of the greatest hospitals in India, that 
founded by Dr. William J. Wanless at Miraj, had to 
employ coolies who spent their whole time bringing 
in water on a cart all day long, back and forth. Then, 
when you remember that the source of water supply 
In many places is likely to be contaminated, you will 
see how very difficult it becomes to have plenty of 
clean water for the hospital. Drinking water through- 
out the Orient must, of course, be boiled, and the 
servants, who don't understand the reason for boiling 
water, have to be constantly watched lest they become 
careless. 

If they are careless, serious consequences may fol- 
low. To give one example, an invaluable missionary, 
who held most responsible positions, died suddenly 
of cholera. On investigation it was found that the 
cook had been washing the dish-rags in a filthy ditch 
beyond the kitchen. It was plain where the infection 



HOW FAR TO THE NEAREST DOCTOR? 



came from. The careless servant had really killed a 
man whom he wouldn't have harmed for the world. 

In the tropics flies are even more of a pest than in 
this country and Europe. Flies, as we know, are dan- 
gerous carriers of filth. In mission hospitals it is often 
difficult to arrange effective screening. To train peo- 
ple to keep doors and window screens shut, especially 
doors, takes the combined efforts of the whole staff. 
Servants or friends of patients leave them open, and 
soon the place is swarming with flies. And it is part 
of the job to explain the menace of flies. Education 
in health measures is a slow and discouraging process, 
because it must displace years of ignorant custom and 
habit 

Many small or large annoyances appear in the day's 
work of a mission hospital. The equipment is often 
not of the best and creates difficulties. Suppose, after 
a tiring day, you are called in the middle of a cold 
night, and hurry to the hospital to handle an emer- 
gency case. You want some instruments sterilized 
right away. The nurse finds that the alcohol heater 
or oil heater won't work. You both fuss and tinker, in 
a frigid room in winter or a sweltering room in sum- 
mer, and then maybe decide to make a fire of charcoal 
or wood the universal fuel of the Orient a process 
which calls for time and patience. 

I mention all these difficulties and problems to 
show that medical missionary work carried on in the 
spirit of, and for the sake of, Christ, is not all excite- 
ment and romance and glory. It is hard, steady, often 



ALL IN THE DATS WORK S7 

worrying work, especially if the doctor lacks trained 
assistants and nurses and a properly equipped hos- 
pital. 

Moreover, if we give the impression that patients 
flock to the mission hospitals, and that it is all smooth 
sailing and popular acclaim, that would be wrong. 
There are two sides to the picture. First, a new doctor 
in the Orient must make his or her place, in much 
the same way as if starting practice at home through 
character, skill, and patient hard work. Recognition 
and results may be very slow. Many of the people do 
not want the modern system of medicine, they prefer 
their old systems; or they hesitate about a new foreign 
doctor he is so queer and different; or they say the 
hospital is too far away. Some of the younger medical 
missionaries starting in a new place have become dis- 
couraged during these early months or years. 

Again, since people are much the same the world 
around, they are likely to become critical when things 
go wrong. This is especially true of ignorant people 
in their relations with foreigners whose ways are 
strange. Often they think, no matter how hopeless a 
patient may be when brought to the hospital, that it 
is the hospital's fault if he dies there. Then, too, there 
are likely to be unfriendly or suspicious or unscrupu- 
lous people about, as in any community, who are 
ready to make accusations against a foreign hospital, 
or against a native hospital for that matter. Sometimes 
these criticisms and accusations are very hard to deal 
with; they may mean fewer patients, because the peo- 



88 nOW FAR TO THE NEAREST DOCTOR? 

pie are doubtful or have fears about the doctor and 
the hospital. 

In this chapter I am Intentionally showing some- 
thing of the everyday, unexciting side. Let me take a 
rather typical page from the diary of Dr. John D. Big- 
ger of Korea: 

There goes the community telephone. It is after six and 
nearly time to get up, so I jump into my clothes and has- 
ten down to answer. It is only R. wanting me to stop in 
on my way to the hospital to see his cow which has the 
colic. She is an American animal and very precious, as she 
supplies all the missionary children with good, rich milk. 
The early call gives time before breakfast to audit some 
accounts for the missionaries, a part of the doctor's sta- 
tion work. 

After breakfast and prayers the dormitory of the school 
for foreign children must be visited to see if Johnnie Y. 
is able to be up after a siege of bronchitis. Two of the 
other children must be inoculated with typhoid vaccine 
as there are many cases of the disease in the town. There 
are no other sick missionaries to visit, so I go over and see 
how bossie is getting along. (It is the doctor's job to look 
after all the pets and other animals of the missionary, as 
well as the missionary himself.) 

It is nearly nine when the hospital is reached. Dr. An- 
derson has already held the hospital prayers, so while the 
operating room is being made ready for the first case, the 
wards are visited and directions left for the nurses. 

The first case in the operating room is a farmer who 
has a needle in his abdomen. The native doctor, in 
poking around in the old fellow's stomach to make an 
exit for the spirit that causes pain, lost his needle, and the 
farmer wants it removed. The needle is found in the 



ALL IN THE DATS WORK 89 

deep muscles, the abdomen is opened and an ulcer of the 
stomach excised. 

The second case is an old lung abscess that has been 
draining a long time, and the patient's body and clothes 
were in an awful state. The natives do not know modern 
surgical methods, so we get many cases of this sort. Next 
is a little boy with tuberculosis of the spine. The par- 
ents claim that an evil spirit in revenge blew his breath 
on the little boy's back when he was asleep, because his 
father, while drunk, offended the spirit in his sacrifice. 

It is eleven and the operating room is yielded to Dr. 
Anderson, There are now some special cases in the dis- 
pensary. The first is a little eighteen-months-old girl, who 
while running naked around the house, backed against 
and sat down in a fire-pan. The wound has gone for four 
days and is very dirty and angry looking. Some skin graft- 
ing must be done later. There are very few .Korean chil- 
dren who do not have burn scars. A case of incipient 
smallpox is sent in a hurry to the Government Isolation 
Hospital as we have no room, for one. How we protest 
against going! There are a number of abscesses, cuts, sore 
eyes and coughs to be treated, a mastoid and several mid- 
dle ear infections are referred to the afternoon clinic, and 
it is time to go home for lunch. 

On reaching home, a walk of nearly a mile, my wife 
says that Dr. S. called up and said that he couldn't run 
his. F.ord, which his home church has just sent out, and 
wants me to come over and see if I can find the trouble. 
(The doctor is community chauffeur. He has a license 
but no car!) 

At the afternoon clinic we fixed up the ear, removed a 
tonsil, and cleaned out the mastoid. Then home 
again. . . . 

After supper we have a good romp with the children, 
and then see what is new in the medical journal. 



90 HOW FAR TO THE NEAREST DOCTOR? 



Here is another glimpse of daily work from Dr. 
Marian Moore o North India, during the cold season 
when she and her husband go into cainp and tour 
among the villages. 

North India is cold of nights during these three 
months. The early comer may find our patients huddled 
in the sunny patches between the mango trees of the 
grove where our tents are pitched. 

Mothers are here, with children all unwashed and un- 
fed, ready for drops in eyes, or quinine for malaria. A 
series of infections gone bad awaits assorted turns with a 
bowlful of hot disinfectant, and fresh dressings. (Thanks 
to a boxful from home!) Crushed fingers, thorn-infected 
feet, skinned toes, and at this season a procession of burn 
cases. A fire in a mud brazier, a shivering, huddling child 
in an old cotton cloth and we have days of anxious and 
painful dressings, to prevent searing and deformity. How 
we bless you at home for supplies of cloth soft wrappings 
for these agonizing surfaces. 

The malnutrition series seems more numerous than 
ever this cold season. The mango crop failed last sum- 
mer. Nothing else supplies the vitamine thus lost. Bricks 
without straw, bones without calcium, tissues without 
strength soil for the quick growth of the germs which 
the tubercular grandmother expectorates about the mud 
house. 

Old men sit in a gleaming group, rubbing oil lini- 
ment into their aching limbs, in the sunshine, grunting 
with appreciation. The castor oil spoon is scoured with 
a handful of earth, and washed, and then the com- 
pounder (druggist assistant) holds the arms and legs and 
nose of the next recipient. It is the one fluid which, with- 
out exception, fails of appreciation. And, alas, cod liver 



ALL IN THE DAY'S WORK 



oil is another, and would be so helpful if only it would 
stay down! 

One baby wears a necklace of burrs to save its eyes! 
The mother explained that she was too busy to bring the 
child every day for treatment half a mile to our Dis- 
pensary tent. Besides, his eyes had been swollen shut for 
a month, so she felt she must do somethingl 

One never knows what a day will bring forth, but only 
that as one's day is, so one's strength will be. 

A gallant medical work is being carried on under 
far more primitive conditions among the Igorot tribes 
who live high up among the mountains of northern 
Luzon in the Philippine Islands. Before the Ameri- 
cans came to the Philippines no one paid any special 
attention to these uncivilized little people. Now, with 
the town of Sagada as a center, a great variety of Chris- 
tian work is being carried on among them, including 
a small hospital in charge of Dr. Hawkins K. Jenkins. 

This hospital has to battle with all sorts of diffi- 
culties. The people are scattered and are very poor. 
It is as hard for them to bring in their sick over the 
steep trails as it is for them to pay the doctors anything 
for treatment. One patient, on leaving the hospital, 
presented Dr. Jenkins with an egg. The man's three 
words on departure, were "Sir! Egg! Good-bye!" To 
him an egg meant a fairly good payment. 

The work of this hospital Is constantly hampered 
by lack of space and shortage of money. Dr. Jenkins 
gives a picture of the patients in their cramped quar- 
ters. In the one small ward was a woman with a baby 
boy, seven months old, with a temperature of 105 



92 HOW FAR TO THE NEAREST DOCTOR? 



degrees who had been suffering from acidosls and 
abscesses in both ears. In the same room was another 
mother and her new-born baby. She had been carried 
in on a bamboo stretcher by four men, over a moun- 
tain trail, a four-hour trip. Still another occupant of 
that room was a woman critically sick with malaria, 
who was almost too weak to move. A fourth patient 
had bronchitis. The doctor would have liked to 
separate some of these patients, but there was no 
space. Even the hallway and attic each contained a 
patient. 

The operating room is a rough affair, in a building 
which was never intended as a hospital. There is no 
electricity and lamps have to be used for night opera- 
tions. 

So here again you have pioneer conditions, though 
not so very far from Manila, with its fine modern 
hospitals. Yet, for all its inadequate size and equip- 
ment, this center at Sagada, through its clinic and 
hospital and the visits of its staff over a wide sur- 
rounding area, reaches some twenty thousand people 
each year. 

There is no magic in being a medical missionary. 
There are the same problems and difficulties in treat- 
ing the sick in distant lands as anywhere, and these 
are peculiar to the place and people. We know that 
doctors don't make every one well here; nor do they 
over there. They get just as puzzled out there over 
some of their cases as they would if practising in 
America or Europe, perhaps more so, because so 



ALL IN THE DATS WORK 93 

often they work alone and do not have our specialists, 
laboratories, and hospitals. 

Sometimes their trials are due to the superstitious 
beliefs of the people. Patients may have had very 
harmful treatment at the hands of ignorant persons 
before being brought to the hospital. For example, 
mud may have been rubbed into a wound. Sometimes 
the trouble comes because the doctor's instructions 
are ignored. A good example of this last difficulty 
comes from a doctor in Abyssinia, that ancient, semi- 
Christian kingdom tucked away on the high plateaus 
of northeastern Africa. 

Dr. Stuart Bergsma, whose hospital is located at 
Adis Ababa, the capital, tells of an old man with a 
broken leg which the doctor had set and put in a 
plaster cast. Two days later, and long before the pa- 
tient should have left the hospital, his family came 
and insisted that he should go home. Dr. Bergsma 
strongly advised them to let him remain until the leg 
had healed. When they kept on insisting and finally 
took the man away, Dr. Bergsma carefully warned 
them to bring the man back to the hospital to have 
the cast removed. 

Three months later the patient returned in a most 
disappointing condition. His leg had knit together, 
but was wretchedly crooked. When Dr. Bergsma asked 
what had been done, the old man's relatives replied, 
"Yes, we removed the cast on the same day that we 
took him home. We broke it off with an axe. We 
wanted to see how the leg was getting along. And 



94 HOW FAR TO THE NEAREST DOCTOR? 

would you believe it, the minute he walked on it he 
had a great deal of pain, and his leg became crooked 
as you see it now." 

I might add that the king of Abyssinia has de- 
pended greatly on the Christian doctors of this hos- 
pital and he appreciates the work they are doing for 
his people. He has made gifts of land to the mission 
and shown his confidence and favor in many ways. 

Most mission hospitals are small, as compared with 
the average hospital in the United States. From twenty 
to sixty or seventy beds would be the size of the large 
majority of them. Only a few have over one hundred 
beds. But, of course, the usual Western practice of 
estimating the size of a hospital by the number of its 
beds does not apply in the Orient and Africa. In mis- 
sion hospitals the number of beds is very elastic. If 
crowded by patients, there may be makeshifts. In 
many Oriental countries people prefer to sleep on 
the floor, and the patients follow this custom. Some 
of our patients in Persia used to complain that our 
spring bedsteads and mattresses were too soft; they 
wanted to lie on something harder. Once or twice I 
actually placed boards between the mattresses and the 
springs, so as to make the beds harder and the patients 
more comfortable! One of my friends from Africa, 
Dr. J. C. King, whose work is in the Belgian Congo, 
told us at a medical conference that his hospital had 
an upper and a lower ward. The upper ward was on 
top of the beds; the lower was under them. 



ALL IN THE DAY'S WORK 95 

Many mission hospitals now have substantial build- 
ings of good brick or stone occasionally of concrete, 
but many are still simple and primitive, of wood or 
sun-dried brick, or even bark as in Africa. Few mis- 
sion hospitals have X-ray equipment, but a great 
many more have it now than did ten years ago, and 
they are getting better equipped all the time. 

In general, the mission hospitals do not have the 
conveniences of Western hospitals. Some have run- 
ning water and others don't. Some have electric lights, 
but many still use kerosene lamps. Some have modern 
sanitary facilities, while others do not, and where they 
are lacking difficult problems arise. Comparatively 
few mission hospitals, taking the world as a whole, 
have telephones, though they are increasing right 
along. I know of only a few with that luxury an 
ambulance. 

All this means that the towns and cities in which 
the hospitals are located are also lacking in such neces- 
sary conveniences as plumbing and sewer systems, 
electric power and telephones. But such improve- 
ments are being steadily introduced. In many places 
what is true today will not be true five or ten years 
from now. When it comes to operating rooms and 
instruments, even though these are not elaborate, I 
think they come somewhat nearer to what we would 
consider an adequate standard. The mission doctors 
can and do perform a great variety of surgery with 
success. 

The fine thing is that in spite of limitations and 



96 HOW FAR TO THE NEAREST DOCTOR? 

difficulties there is such a lot o thoroughly good work 
being done. Dr. Mary James of China, after describ- 
ing some of the handicaps and shortcomings of the 
hospital which she has successfully conducted for 
many years, goes on to say: 

To run now from our needs to what we really have, 
let me tell you about the sunny children that crowd three 
rooms of our primitive hospital. Many of them are little 
cripples with tubercular bone diseases who must spend 
long, long months, or sometimes years, lying flat on their 
backs, with weights attached to their legs. We have had 
Bradford frames (a sort of canvas stretcher with iron 
rims) made for them here in China, and every good day 
we carry them out into the little courtyard in the center 
of the hospital. The nurses have learned to give them 
such care as one might be proud of even in America. 

I have never seen a happier set of children than our 
little cripples. They are fond of the nurses, always ready 
to respond to our advances or to those o visitors, and 
eager to learn anything and everything. The Bible woman 
gives them regular instruction in reading their own lan- 
guage, and also teaches them Bible stories and the simpler 
doctrines of the church. Anyone who will teaches them 
hymns. In these they fairly exult. Should you visit our 
children's wards you would probably find yourself com- 
pelled to stand and listen to all the verses of "There's a 
Friend for Little Children," "Oh, Come, All Ye Faith- 
ful," or some other of their favorite hymns. But not all 
our children are cripples. Many come in with acute dis- 
eases, and these, too, soon respond to the spirit of cheer 
in the wards. 

It is heartening to see how some of the helpers and 
associates in a mission hospital catch the spirit of de- 



ALL IN THE DATS WORK 97 



votion, self sacrifice and courage which is part of the 
Christian ideal. Let this story I heard in China of the 
faithfulness of a servant close this chapter on the life 
of a Christian hospital. 

The splendid Yale-in-China hospital, far up the 
Yangtse River in the troubled province of Hunan, 
was one of the few that escaped destruction in the 
communist drive of 1927. But it narrowly escaped 
being looted, for the communists were out for every- 
thing they could get. The fat loot of a hospital had its 
lure; but they needed this one at Changsha for an 
army base hospital. So, for a time at least, it was to 
their interest to use it well. 

When the forces of the national Chinese govern- 
ment from Nanking pressed up the river, the com- 
munists were beaten back. The day came for them to 
evacuate Changsha. "At least," they thought, "we will 
carry ofi the equipment of the fine operating room/' 
They detailed a coolie to gather up the operating 
room instruments into hampers to be carted off. This 
job required his going back and forth from instru- 
ment room to operating room while he packed the 
instruments. 

Now It so happened that the regular operating 
room coolie was a faithful old soul who couldn't allow 
all those hundreds of dollars' worth of instruments to 
be stolen before his eyes. So he took his courage, and 
very likely his life, in his two hands, and started a 
little counter move. As fast as the communist packed 
instruments into the hampers and went out for more, 



98 HOW FAR TO THE NEAREST DOCTOR? 



he deftly shifted them elsewhere and piled in some 
junk or other in their place. So it went on, back and 
forth, the communist steadily stripping the instru- 
ment cases, and the hospital coolie quietly doing his 
double shift act. Finally the loaded hampers were 
carted out as the communists departed hurriedly 
ahead of the victorious Nanking troops. Not till too 
late, however, did they open up their hampers and 
discover their choice assortment of junk. All those in- 
struments are doing duty today in the great Yale-in- 
China hospital. That operating room orderly, I claim, 
was a real man. 

Here we have seen the hospitals and doctors at 
work, the problems they face in their daily service, 
and the response of the people to these efforts. But 
perhaps the question comes up as to whether some- 
thing could not be done to prevent all this suffering 
and misery, as well as care for those who are already 
in trouble. This is a fair question. Let us take it up, 
and see what is being done. 



CHAPTER Six 



PREVENTION IS BETTER THAN CURE 

ARJE the rats falling?" inquired Dr. Robert 
Goheen, when he returned to India from fur- 
lough in America. The question was asked of the 
mayor of Vengurla, a town on the west coast, south 
of Bombay, where Dr. Goheen is in charge of a Chris- 
tian hospital. "No," said the mayor, "they are not 
falling this year." Much relieved at the news the doc- 
tor plunged into his regular hospital work. 

Maybe the question of whether the rats are falling 
or not does not mean very much to you. But it is a 
tremendously important question in India and some 
other countries. Rats are the carriers of plague, one 
of the most terrible epidemic diseases of the world, 
that means almost sure death. But the plague is really 
transferred by fleas which live on the rats. When the 
rats are falling and dying from the plague, the fleas 
leave the dead rodents to infect humans and cause an 
epidemic of the disease. The rats are the barometers 
of plague, as well as its spreaders. 

Dr. Goheen had not been back at this work very 
long, however, before he began to hear from patients 
and neighbors that dead rats were being found. The 
people were getting worried. An epidemic was evi- 



100 HOW FAR TO THE NEAREST DOCTOR? 

dently starting, and there was no time to lose. If it 
could be checked at once, hundreds, if not thousands, 
of lives could be saved. What was he to do? 

Fortunately the method of fighting plague has been 
simplified by modern medical science. Aside from iso- 
lating individual cases, there are two main things to 
do: give preventive serum injections, and exterminate 
the rats. 

The first calls for an intelligent community which 
will come for injections, as well as a trained staff to 
give them and money to pay its salary. Vengurla was 
short on all these requirements. Therefore it was of 
the utmost importance to kill the rats, and quickly! 
The municipality of Vengurla, as soon as it was 
made to realize the situation, asked Dr. Goheen to 
take charge of the campaign. He sent immediately 
to the government health department at Calcutta for 
rat poison which is put up in convenient and delec- 
table morsels for just this purpose. This much was 
fairly simple, but the distribution of the poison in a 
superstitious community, without any local health 
force or other adequate staff of workers, was a prob- 
lem. For the Hindus and other religious sects, ex- 
cluding the Moslems, are taught that they must not 
take the life of any living thing, not even a dangerous 
animal or reptile. There was no volunteer response 
to be expected from the town at large. And the small 
mission hospital staff could not possibly handle it 
alone. 



PREVENTION IS BETTER THAN CURE 101 

Dr. Goheen now hit on the Idea o getting the 
young schoolboys interested. They were less super- 
stitious. He went to one of the local schools, next to 
a rival school, and then to still another rival school, 
explaining and appealing to each o them. It was rats 
or people. Kill the rats or be killed by the plague. 
Here was the poison, and with it a fighting chance a 
race for life. It was a matter of placing the poison in 
houses widely and thoroughly. Would the boys help? 
Would they! They responded with enthusiasm! 

The rival schools were organized into teams to 
work on a competitive basis. And they went to work 
with a will. 

Result? In a very few weeks the incipient epidemic 
was cut short. The rats were killed before they could 
carry the plague. Vengurla had won. Not a new case 
developed after the job was done. And all because 
there was on the spot a Christian doctor with the 
necessary knowledge, imagination, and ability to get 
a job done, and because those young students broke 
through their traditions and responded to a chal- 
lenge. 

Now think for a minute what this experience will 
mean to those boys! They have had an exciting part 
in stopping a frightful danger to their town and 
their homes by the use of scientific measures. They 
won't forget the lesson. My guess is that for many of 
them it will be a life event, a landmark in their edu- 
cation. Let your imagination follow through. What is 



102 HOW FAR TO THE NEAREST DOCTOR? 

going to happen the next time there is a plague or 
cholera or smallpox epidemic? Will they all fall back 
on the old superstitions again? When grandfather 
says, "Son, the evil spirits are sending us the black 
scourge, hasten down to Krishna Gokhale's shop in 
the bazaar and buy a chicken to sacrifice to the god 
that we may be saved," do you suppose the grandson, 
whose school had a notable part in the great plague 
battle of 1930, is meekly going to trot down to 
Krishna Gokhale's shop to buy a chicken for sacri- 
fice? Or do you suppose he is going to question the 
idea, and perhaps even have spunk enough to say 
politely and respectfully, "That used to be the thing 
we did. But it is old stuff. Besides, it never worked. 
We in school are learning better now. We must go 
to the health department and the doctors." It takes 
time to change people's thinking; but one demon- 
stration like that at Vengurla speeds up the process. 
Prevention of disease and a positive health program 
are vitally important. We shall always have sick peo- 
ple, and we shall always need hospitals. But we 
should try to lead the way in keeping people from 
crashing over the cliff, as Dr. W. W. Peter of China 
puts it, instead of merely waiting to pick up the 
mangled pieces at the bottom. There is so much that 
can be done by simple preventive measures. Clean 
food, clean water, clean houses, clean surroundings, 
and serum for such diseases as can be inoculated 
against, will go a long way to increase the happiness 



PREVENTION IS BETTER THAN CURE 103 

and usefulness of India and China and Africa and 
many another country. 

On the plateau country above Vengurla is a town 
called Miraj, with a famous mission hospital. The 
motor ride up from Vengurla, which is at sea level, 
to the railroad station at Belgaum presents some of 
the most magnificent panoramic views I have ever 
seen. You look out from the winding road which 
ripples around the precipices, over miles and miles 
of tumbled hills and valleys and green jungle to the 
sea the Indian Ocean, Those deep jungles are tiger 
country, and if one is sufficiently enthusiastic to sit 
in a tree and shiver and take a chance on malaria or 
pneumonia for part of a night, he may be rewarded 
by a shot at my lord the tiger. Occasionally at dusk a 
tiger is glimpsed crossing the motor road. 

The hospital at Miraj was founded by the great 
surgeon Dr. William Wanless, who on his retirement 
was knighted for his medical services by King George, 
and in the remaining years of his life was known as 
Sir William Wanless. When he died early in 1933 
newspapers all over the world noted his remarkable 
life work and cited the fact that in the Miraj hospital 
he had treated more than a million patients and had 
restored the eyesight of twelve thousand persons. Dr. 
Charles E. Vail, his able successor, carries on as head 
of this large institution. 

Dr. Vail, by the way, is a famous tiger hunter. He 
has spent some of his short holidays shooting tiger, 



104 HOW FAR TO THE NEAREST DOCTOR? 

leopard and panther. He has gained such a reputation 
as a sure shot that frequently a village which has a 
pet marauder a tiger, let us say, that is eating cattle 
and people sends an S.O.S. to Dr. Vail. Sometimes 
they don't have much of a tiger, but they want Dr. 
Vail to see some patients, and knowing how busy h. 
Is in the hospital they think that perhaps he is due for 
a day off, and that the promise of tiger will surely 
bring him to their section. Dr. Vail has had to learn 
to be a bit wary when he hears tempting stories of 
large man-eaters to be hunted at some village or 
other. 

What I really started to tell was that the people of 
Miraj also witnessed a great demonstration on plague 
prevention a year or two ago. An epidemic was upon 
them. The hospital offered anti-plague inoculations. 
But only the Christian part of the community re- 
sponded. The Hindus preferred to depend on their 
old charms and sacrifices. The result was a striking 
difference in the number of cases of plague between 
the two groups. The local saying was, "the Christians 
do not catch plague/* 

If you want to get an idea of why it is important to 
teach people of backward countries about hygiene 
and sanitation, just read this from Burma: 

There is a great deal of the amoebic dysentery. They 
say that the Chinese drink tea almost exclusively. That is 
probably the reason why there are so everlastingly many 
Chinese still alive. Our Burmese are not so particular. 
They drink anything that seems to be water, and it is 



PREVENTION IS BETTER THAN CURE 105 



often muddy and always unfit to drink. The little streams 
which they lead into their villages to supply them with 
water all have their source near some mountain village, 
so that they are practically the sewers o those higher 
villages. . . . 

In a section where there are no such streams, reservoirs 
are constructed. In order to waterproof them, cement 
not being available, the people wait until the first days 
of the rainy season when the ground is very soft and 
moist. Then they drive down a herd of water buffalo 
which are ridden round and round the reservoir until 
their feet have churned up the surface of the ground Into 
a thick, slimy, nasty, vile-smelling mud. The rain-water 
collects here for the four or five months of the rainy 
season and supplies them with water for the remainder 
of the year. They bathe beside this reservoir, wash their 
clothes in it, drive down their animals to drink, and then 
take buckets of it back home to use in cooking. 

But conditions are similar throughout the Orient 
and will remain so until education teaches the people 
better. For example, there is a prevention story be- 
hind this telegram which came to Dr. W. W. Peter in 
Shanghai: "Foochow was an island of safety in a sea 
of danger. Thanks/' It referred to a strenuous medical 
campaign to save the great city of Foochow from a 
devastating epidemic of cholera, and had been sent 
to him in behalf o half a million Chinese and scores 
of foreigners. 

Whenever an epidemic broke out in Foochow, the 
city was fairly panic-stricken. Cholera is a frightfully 
rapid and fatal disease. People who are walking 
around perfectly well in the morning may be dead 



106 HOW FAR TO THE NEAREST DOCTOR? 

by evening. They fall down stricken in the streets. 
For ignorant and superstitious people cholera is par- 
ticularly terrifying and overwhelming. They know of 
no way to deal with it no preventive, no cure. There 
is a good modern treatment for it, but in the great 
cities of Asia the doctors are far too few to take care 
of all the stricken thousands. And, anyway, the thing 
to do is to try to prevent the spread of the infection. 

During these epidemics people died so fast in Foo- 
chow that the supply of coffins gave out. Shops were 
closed because everybody in them had died. Ships 
stopped coming into port. The business of the city 
was fairly paralyzed. The people sought every sup- 
posed help they knew about. They consumed quan- 
tities of worthless old-style Chinese medicine. They 
flocked to the temple to burn incense and implore the 
gods. They had idol processions daily through the 
streets. But still the cholera would rage. 

In the midst of all this misery and tragedy there 
finally appeared one bright spot a cholera hospital 
was opened by medical missionaries aided by Western 
trained Chinese doctors. During the next visitation of 
cholera over nine thousand injection treatments were 
given here, and with such success that the influential 
men of the city took note of it. When the epidemic 
had run its course, having killed its thousands upon 
thousands, these leading men came for advice on 
prevention of its next visit. The result was that a 
group of medical missionaries and modern Chinese 
doctors was called together to draw up a plan. They 



PREVENTION IS SETTER THAN CURE 107 

sent a committee to Shanghai to consult with Dr. 
Peter's organization, the Council of Health Educa- 
tion. At this conference it was decided to conduct a 
great educational campaign a week or ten days ahead 
of the time that cholera might be expected to break 
out again the next summer, for it usually came at that 
season. In the absence at that time of any government 
health department, and in view of the prevailing pop- 
ular ignorance, it would be necessary to educate the 
people, and to teach them simply and definitely. 

The campaign was carefully prepared and then be- 
gun in June. In one week 247 meetings were held to 
advertise cholera prevention. By actual count 1 10,000 
people attended these meetings. A huge cholera pa- 
rade was held, visualizing the right and wrong ways 
of handling food and disposing of garbage and sewage. 
Three hundred thousand pieces of literature were 
distributed. To do all this, a small army of volunteer 
workers 2,480 persons mostly students, had been 
organized. The cost of the whole campaign was less 
than |s, ooo. 

Well, what happened? 

When the time for the usual epidemic came, there 
was cholera north of Foochow and south of Foochow. 
On the island of Formosa, just across the straits, there 
was cholera. Inland from Foochow there was more 
cholera. But Foochow was spared. A few cases came 
in from outside, but there was no epidemic. Scien- 
tific knowledge, cleverly spread by propaganda, had 
triumphed. No wonder the grateful people of Foo- 



108 HOW FAR TO THE NEAREST DOCTOR? 

chow sent that Interesting telegram, "Foochow was 
an island of safety in a sea of danger. Thanks." 

What a splendid illustration Foochow gave of 
timely prevention! 

Dealing with masses who could neither read nor 
write, Dr. Peter effectively used pictures, charts and 
lectures in his prevention campaign. One of these 
series of pictures showed the danger from flies as car- 
riers of typhoid, dysentery, and other diseases, as well 
as cholera. The first picture was that of a huge, mag- 
nified fly. A fly really looks quite terrible when shown 
in enlarged form. One Chinese woman who had lis- 
tened to the lecture was heard to say as she was leav- 
ing, "Well, of course, if they have tremendous flies 
like that in America, no wonder they are afraid of 
them!" This series of pictures continued with various 
scenes in which the fly was shown spreading disease. 
In the second picture the fly was contaminating a 
bowl of rice, which is the staple dish of China. In the 
third a man was doubled up with colic. After this 
came the doctor standing at his bedside. In the final 
picture the patient is being carried out dead. The 
moral was explained by the lecturer who interpreted 
the pictures. This sort of pictorial teaching slowly reg- 
isters on illiterate and simple people. One can't ex- 
pect too much at once, but little by little the points 
get across. 

There is no telling where and how such propaganda 
bears fruit. Dr, Peter said that, some years after he 
began employing pictures and charts, he was visited 



PREVENTION IS SETTER THAN CURE 109 



by a young Chinese doctor who was a stranger to him. 
This young man told the doctor that about fifteen 
years before he had seen one of his health exhibits in 
Shanghai. He had been deeply impressed with what 
it showed of the needs of China and of what modern 
medicine could do, and he thereupon decided to 
study medicine. And here he was, after all those years, 
a well-trained doctor, going back to serve his country. 

There is, of course, a great difference between dis- 
eases. For some there are definite methods of preven- 
tion; for example, vaccination for smallpox and 
injections for diphtheria. For others, tuberculosis for 
example, there is no absolute or definite method of 
prevention; it depends on a number of things good 
food, fresh air, sunlight, and general healthy living. 
There are many diseases of the first kind which cause 
an enormous number of preventable deaths in the 
countries of Asia and Africa. A few years ago the fig- 
ures for India showed that in the previous decade 
nearly two and a half million people had died from 
plague and over three million from cholera. Both 
these diseases fall within the class of those that are 
definitely preventable. And consider these figures also 
from India: from fevers of a number of kinds, espe- 
cially malaria, there were over fifty million deaths in 
the same ten years! It is as though two-fifths of the 
population of the United States had died from such 
causes in the last ten years! 

As we have already seen, one of the important 



110 HOW FAR TO THE NEAREST DOCTOR? 

places in which to get across the idea of community 
health is the mission school. Sometimes one partic- 
ular disease which is prevalent can be taken up by 
itself and emphasized. This letter tells how a con- 
tagious disease of the eyes was treated in a mission 
school in South America: 

Trachoma was present in an alarming percentage in 
the boarding school. An intensive campaign was begun, 
training the pupils to give the actual treatments. In two 
months the majority were free from the disease and by 
the end of the year, only one was under treatment. Over 
150 village patients came in for treatment. All were ad- 
vised to bring a relative to learn the intervals for in- 
spection. The idea worked well. Twenty school pupils, 
nine persons from villages and thirty from the open 
country were trained to give this treatment. Thus a mis- 
sion school became the home base for an effective public 
health measure in Brazil. 

What would most of us think of making regular 
payments to a doctor to keep us well? In one place in 
Syria this form of prevention was actually started 
some years ago and is succeeding. A group of villages 
are following a local health insurance plan. It came 
about through an enterprising young Syrian doctor, 
Dr. Ma'touk, a graduate of the American University 
Medical School in Beirut. He did some figuring on 
the amount of sickness in his village and on its cost to 
the people. Then he made a proposal to each family. 
"You pay me a certain sum each year," he said, "and 
I will take care of your family for that." There was to 



PREVENTION IS SETTER THAN CURE 111 



be no additional charge when illness came. And the 
amount to be paid for the year would depend on the 
income of the family. Quite a novel idea! 

It worked well both ways. The people paid an an- 
nual sum, just after harvest, when they had cash in 
hand. The rest of the year they had no worries about 
the doctor's bills, and could call him as often as they 
liked. It worked well for Dr. Ma'touk, too, because he 
had a definite income, and no worry about bills and 
payments the rest of the year. 

Perhaps you think he would be overrun with calls 
for all sorts of small ailments, and at first it began to 
look like that. But he was able to educate the people 
in two ways. One was in preventing those diseases for 
which inoculations could be given. And the other was 
in teaching people to care for small matters them- 
selves, such as giving first aid in accidents and taking 
quinine for mild cases of malaria. 

He carried on a thorough campaign against small- 
pox. So, although there was a big epidemic in the vi- 
cinity, none of his villagers died from smallpox. This 
health insurance plan has grown so fast that when I 
recently heard from it twelve villages and six hun- 
dred families were under Dr. Ha'touk's care. The net 
result is that the people are in better physical condi- 
tion. They pay less than they used to pay under the 
old system. Yet the doctor has a satisfactory income. 
And everybody is well and happy. 

Dr. Ma'touk had his training at the American Uni- 
versity in Beirut, Syria, from which hundreds of 



112 HOW FAR TO THE NEAREST DOCTOR? 

young doctors have gone out to Syria, Arabia, Meso- 
potamia, Palestine, Egypt, and other countries. Sev- 
eral of them are now in the hill country of Syria carry- 
ing on similar schemes. The plan works better where 
the people are educated enough to read and write and 
have some general knowledge than it does in the very 
ignorant or backward villages. 

In Siam Dr. James W. McKean of whose work for 
lepers we have already read, was a pioneer in public 
health service. Smallpox used to be a common epi- 
demic. Vaccination against it had already been started 
by others, but it fell to Dr. McKean to first develop it 
on a large scale. To begin with, there was no vaccine 
for him. He had to make his own from seed vaccine 
sent from London. The seed vaccine had to come in 
mail sacks on men's backs from Rangoon in Burma 
a two weeks' trip and it had already had a two 
months' trip to Rangoon from London. 

Vaccine has to be made from the lymph of an ani- 
mal, usually a calf. It was an exciting time when the 
first Siamese calf was made ready for implanting the 
seed vaccine. It was still more exciting when the first 
little blister-like eruptions appeared, indicating a 
successful take. The next chapter was a sad one. The 
precious calf somehow got tangled up in his halter and 
hung himself. Not so good! But fortunately enough 
lymph had been scraped off to keep the vaccine going. 
Another calf was used, and presently there was plenty 
of vaccine for a good start. 



PREVENTION IS BETTER THAN CURE 113 



Dr. McKean then went to work to develop a staff of 
men who could go out into the villages and give the 
vaccine. There were between a hundred and two hun- 
dred o these. They were given a very careful course 
of instruction and then sent out with a supply of vac- 
cine. They were allowed to charge a small amount 
for each vaccination, part of which was their pay and 
part of which was turned in to pay for the vaccine. In- 
tanon, the old king, gave Dr. McKean exclusive vac- 
cinating rights for the north. This would insure the 
use of safe vaccine and its proper administration by 
the vaccinators. Thousands of vaccinations were per- 
formed every year. After about ten years the Siamese 
government began to make its own vaccine and passed 
a law for compulsory vaccination. Dr. McKean's labo- 
ratory then became unnecessary; and he discontin- 
ued it. 

Dr. McKean tells me that the real beginning of 
vaccination in Siam was made by Dr. D. B. Bradley of 
the American Board of Commissioners for Foreign 
Missions, early in the last century. In those days 
scabs from vaccinations were often used by doctors as 
vaccine. Dr. Bradley wrote to a doctor friend in Amer- 
ica, who sent him a scab imbedded in a piece of wax. 
The sailing ship on which it was sent took months to 
reach Siam by way of Cape Horn. But the scab was 
still "alive" when it got to Siam. 

The Siamese people were quick to appreciate the 
value of vaccination, although it took sixty years for 
the government to take it up officially. Now the Sia- 



H4 HOW FAR TO THE NEAREST DOCTOR? 



mese are said to be the best protected against smallpox 
of all the peoples in Asia* Medical missionaries be- 
gan it. 

Whether it be in such work as Dr. Agnes Eraser's in 
Africa, or Dr. Robert Goheen's in India, or Dr. W. W. 
Peter's in China, the idea of prevention is taking hold. 
It took a long while for this idea to grow in America 
and Europe, as one can see from accounts of epi- 
demics of cholera in New York only a hundred years 
or so ago, and of the plague in England before that. 
Things were just about as bad as they are now in 
China or India, and in some ways worse. Later came 
the scientific discoveries in medicine that made pre- 
vention possible. Medical missions have done a large 
part of the pioneering necessary to carry the results 
of these discoveries into the Orient and Africa and 
Latin America. 

Whether it be in caring for the sick, or in prevent- 
ing sickness, the foreign physicians cannot hope to 
accomplish the whole task. Not only are there too few 
of them, but it is not a wise policy to make the peoples 
of these countries wholly dependent upon foreign 
doctors and nurses. It is much more practical and 
creative to help these underprivileged countries 
to learn to care for themselves and meet their own 
problems. In other words, they should be training 
their own doctors and nurses. What are medical mis- 
sions doing toward solving this important problem? 



CHAPTER SEVEN 



DOCTORS OF THE FUTURE 

AVISON/' said a prominent doctor of Toronto, 
Canada, * y u are a fl to g out there to 
Korea and bury yourself. What can you do with all 
those millions of people?'* 

Young Dr. Oliver R. Avison had graduated from 
medical school in Toronto six years before, and was 
an instructor on the faculty. There was every prospect 
that a man of his promise would forge right ahead to 
high standing among the doctors of Toronto. Yet 
he was giving it all up and going out to a queer, out- 
of-the-way, down-at-the-heels little country that you 
had to hunt for on the map to know just where it 
was. 

"Well," said Dr. Avison, "I can't take care of very 
many myself, of course, but suppose I train some of 
the Koreans to be good doctors and send them out to 
work for their own people. Wouldn't that be some- 
thing?" 

The Toronto doctor considered a moment and 
said, "Yes, that's different. If you multiplied yourself 
by turning out a lot of well-trained young Korean 
doctors, it might be worth while/* 



116 HOW FAR TO THE NEAREST DOCTOR? 

That conversation took place about forty years ago. 
Dr. Avison, who is still in Korea and very much alive, 
is head of one of the great medical schools of the Far 
East the Severance Union Medical College at Seoul, 
the capital of Korea. Hundreds of full-fledged, well- 
trained, Korean doctors have been graduated from 
that school. And they are at work all over Korea, as 
well as in more and more important positions in the 
Severance Medical College itself. In 1931 there were 
two hundred and fourteen applicants for the forty 
places that are open each year in the freshman class. 
That is all the college can handle with its present space 
and equipment, so it selects its students very critically 
and takes only the most promising young men. Such 
a policy promises far-reaching results in the future. 

Incidentally, there have been striking recognitions 
of Dr. Avison's influence and position in Korea. The 
alumni of the college have set up on the campus a 
fine statue of him. I was much interested to see it 
when I was there. Not many men have statues of 
themselves erected while they are still alive. It shows 
something of what this school and its founder have 
meant to Korea. Dr. Avison was decorated by the 
Emperor of Korea, In the days before the country 
became a part of the Japanese Empire. And after the 
Japanese assumed control there was another distin- 
guished decoration, this time from the Emperor of 
Japan. In both instances the reason for conferring the 
honor was stated as "recognition of the work done by 



DOCTORS OF THE FUTURE 117 

Dr. Avison along the lines of education and social 
service." 

One of the pioneers and leaders in medical educa- 
tion for women is Dr. Ida Scudder of India. She comes 
of a great missionary family. But, when a student in 
America, she had no idea of going back to India. 
When people asked, as they would, whether she was 
going to India she would say: "No, I'm going to live 
in America. There are enough Scudders in India*" 

Then it came about that she went out to India on 
a visit, because she was needed to take care of her sick 
mother. She fully intended to return to America after 
her mother recovered. Katharine Scherer Cronk has 
told the story of the change in Ida Scudder's life 
plans: 

One night she sat in her father's house in India. As the 
dusk of twilight was deepening into night a knock 
sounded at the door. The girl answered its summons. A 
man stood before her. He was a high-born Moslem, tall, 
slender, white-robed. He bowed low and spoke. 

"My young wife is ill, ill to the death. Our doctor can 
do nothing for her. Will the gracious lady come to at- 
tend her?*" 

Ida Scudder knew naught of medicine. 

"My father," she answered eagerly, "is a medical man. 
He will come to see your wife." 

The Moslem drew himself up proudly. 

"No man has ever looked upon the face of my wife. 
We are high-born. I should prefer a thousand times that 
she die than have a man look upon her face." 

Proudly he turned and went into the darkness. 



118 HOW FAR TO THE NEAREST DOCTOR? 

Ida Scudder sat down and thought. She was in India 
now. In India with this pitiful, unpitied child wife, who 
might be dying even as she sat and thought of her. How 
long she sat, she did not know. She was startled by a 
second knock. Possibly the man had been softened by the 
sight of the agony of his little wife and had come for her 
father. Eagerly she opened the door. It was not the same 
man who stood there. Possibly it was his messenger. 

"My wife," began this man, as had the other, "my wife 
is very sick. She is giving me much trouble. It is a pity 
that a wife should give her husband so much trouble. 
After all my pains she may die unless the Miss Sahiba 
comes and heals her." 

The girl looked at him hopefully. "I'm not a doctor," 
she explained, "but my father is a medical man. He 
will" The man interrupted her with a proud uplifting 
of his turbaned head. 

"I am a high-caste man," he said. "No man dare look 
upon the face of my wife." 

Even as he spoke he turned and disappeared in the 
darkness. 

Ida Scudder's thought went with him back to the girl. 
Perhaps she was only a little girl. So many of them were. 
Perhaps she was dying even now because no man would 
be allowed to help her, and there was no woman to help. 
Something clutched at the heart of the American girl 
and choked her as she sat helpless and unhelping. It was 
terrible that two calls should come in rapid succession 
on the same night. As she shuddered at the thought and 
the misery of it all, a third knock sounded. A third man 
came before her. His voice was almost eager. 

"My wife," he said. "She is ill, very ill. They told me I 
could find help for her herea wonderful foreign doctor 
who has done remarkable things." 

At last there was a call for her father. 



DOCTORS OF THE FUTURE 119 

"Oh, yes, I will send my father/' she answered gladly. 

The man involuntarily straightened himself. 

"Not a man! You must come." 

In vain did the girl plead to have her father attend 
the suffering woman. Sadly and alone the man departed 
as had the two other men before him. Ida Scudder sat 
down again. Were all the suffering child wives in India 
calling to her that night? 

The night passed on. The day dawned. Ida Scudder 
summoned a servant. 

"Go/' said she, "inquire after those who called last 
night." 

Soon the servant returned with his message. He bowed 
low before the American girl as he spoke. 

"Dead, Miss Sahibal" he said. "All three of them are 
deadl" 

Almost in touch of her hand they had died down in 
the village! Then, in the quiet, God's voice sounded a 
call to her. She understood now why her mother had been 
willing to go back to India, She sought her mother's 
room. 

"I am going to America, mother/' she said simply, "to 
study medicine. And then I'm coming back to India to 
help." 

On the register of the students entering the Women's 
Medical College of Philadelphia that fall Ida S. Scudder's 
name was entered. The call of India's need was on her 
heart as it had been on the hearts of her mother and 
father. 

The years passed. To the gate of a hospital at Vellore, 
India, a messenger came one night and a knock sounded. 
Again there was a call for a doctor. This time Dr. Ida 
Scudder answered it with joy. She went with the messen- 
ger and two lives were saved that night. Even as she re- 
turned, another call came. Eagerly she went the second 



120 HOW FAR TO THE NEAREST DOCTOR? 

time on her life-saving mission. Before she reached home 
the third call followed her, and she turned once more 
to help. 

"They live!" she said, tired but triumphant in the gray 
dawn. "All three of them livel I have answered the knocks 
in the night that have been sounding in my ears/' 

A peace that passed all understanding filled her soul. 

Year after year she answered similar calls: and a 
busy, useful hospital for women and children grew 
up. But the calls were limitless. And she was' just one 
person, tirelessly meeting all that anyone could; the 
need was certainly beyond the capacity of one person. 
She came to the same conclusion reached by other 
Christian doctors that there must be medical schools 
to multiply doctors from the people for service in their 
own country. So Dr. Ida Scudder dreamed of a medi- 
cal school for Indian women, and, what is more, 
worked at that dream. By and by, as more friends in 
America and England became interested, campaigns 
for money were put on, until a fine hospital was built 
and then, to crown it all, generous funds for a mod- 
ern, well-equipped medical school. 

In 1931 I was out there in Vellore and saw that 
splendid hospital and splendid medical school. I 
walked through the wards with Dr. Scudder and saw 
how those poor Indian women in the beds turned to 
her with the look in their eyes that I cannot de- 
scribe. Then we drove out to the new medical school 
buildings which were nearing completion, and 
climbed all over them. 



DOCTORS OF THE FUTURE 121 

Even before the school had acquired these beauti- 
ful new buildings it had been sending out a fine body 
of women doctors to do the sort of Christlike service 
which the women of India need so sorely. And now, 
with the efficient new plant, the usefulness of the 
school will grow more and more. 

Dr. Ida Scudder had a great vision. And it was 
thrilling to see that vision taking practical form. I 
wish I could help you to realize my impressions of 
that place. It is one of the finest things I have ever 
seen. 

Another leading spirit for the training of women 
doctors in India is Dr. Edith Brown of Ludhiana, in 
the Punjab. Nearly forty years ago she saw what was 
needed to be done for the women of India. In 1893 
she called a conference of women doctors in mission 
work. And the idea o a medical school was launched 
at that gathering. 

In these days, when millions of dollars are being 
put into medical centers, it is surprising to read that 
she started with a little less than two hundred and 
fifty dollars for capital, and the promise of the same 
amount each year for five yearsl The first faculty con- 
sisted of herself and two others, who gave an hour a 
day. In the first student class only four enrolled. 

Now there is in Ludhiana a flourishing medical 
school and hospital which I visited when in India. 
There are ninety-eight medical students instead of 
four, and about one hundred and fifty more who are 



122 HOW FAR TO THE NEAREST DOCTOR? 

nurses, pharmacy students and midwives. Over eight 
hundred students, a hundred and ninety-two of them 
doctors, have gone out from that school. The students 
are Christians, Hindus and Moslems, Fourteen differ- 
ent languages are spoken among them. The spirit that 
one feels throughout the place is well expressed in the 
words of Lagwanti, a woman of the highest caste, a 
Brahman, who went there with a friend of her own 
caste who was a patient in the hospital. Observing the 
care and kindness shown to her friend she said to her- 
self, "Great merit will accrue to these nurses for thus 
tending a Brahman." Then she began noticing that 
down the ward the nurses were giving just the same 
care to an outcaste. Weeks later, this Brahman woman 
wrote In, "I have come to join the Christian way. 
Your words about Jesus were good; they sat on my 
heart; but it was your deeds that made them sit." 

The medical school for men at Miraj, which was 
started by Dr. Wanless and is now being adminis- 
tered by Dr. Vail, is doing a service for Indian men 
similar to that which these other schools are doing for 
the women of India. I wish there were space in which 
to describe its splendid work- The graduates of this 
school go out to all parts of India, and even outside 
India. When I was traveling down through Persia on 
my way to India, I reached a town called Duzdap, 
which was the end of the railway that runs from India 
across Baluchistan to the eastern border of Persia. 
Here I found a small mission hospital, and one of 
the graduates of the Miraj Medical School was in 



DOCTORS OF THE FUTURE 12$ 



charge of it. It was a fine thing to see this young In- 
dian doctor, thousands of miles from home and the 
medical school that had trained him, carrying on 
Christian medical work. 

In China there are six mission medical schools, scat- 
tered over the vast territory from Canton in the south 
to Mukden, away to the north in Manchuria, and 
then out in a far western province toward Tibet, at 
Chengtu. 

The Hackett Medical School in Canton is for 
women. Some of the others are coeducational. The 
Chinese young women are keen students, and they 
are willing to go long distances to get a medical edu- 
cation. But it is a far more serious matter for a girl 
in a country like India or China to leave her family 
and undertake the study of a profession than it is in 
the United States or Canada, because it has always 
been their custom for women to stay at home and 
limit their work to household tasks. Little by little 
this old attitude is changing, as we have seen, and 
large numbers of Oriental girls are going to college 
and into professions. 

One of the very interesting graduates of Hackett 
Medical School is Dr. Paang. When she was graduated, 
the faculty tried hard to persuade her to stay on as a 
teacher in the medical school. She was such a capable 
person that they felt they needed her right there. It 
would be a position with great possibilities of use- 
fulness and a comfortable living in a big, interesting 



124 HOW FAR TO THE NEAREST DOCTORf 



city. Dr. Paang, however, had made up her mind that 
she wanted to go out into the neglected village re- 
gions, away from the city, to render her Christian 
medical service. She started in one of the outlying dis- 
tricts not far from Canton. .From there she went to 
a mission hospital far in the interior, working there 
two years, until the hospital was closed because of 
political disturbances. Later, she and another gradu- 
ate went into another remote country region and 
worked until disturbances also broke out there and 
forced them to leave. 

We need to remember what courage and skill it 
requires for these young Chinese women doctors to 
go off into strange and sometimes dangerous places 
which are many days, or even weeks, of uncertain 
travel distant from their homes. It often means a big- 
ger adventure, and it requires stronger purpose than 
for most missionaries to go from America to China. 
We are more or less accustomed to the idea of travel 
and have convenient facilities for it. But Chinese 
women are not accustomed to the idea, and fre- 
quently they are obliged to travel by slow and irregu- 
lar river boats, or perhaps by sedan chairs carried on 
men's shoulders. In outlying regions these women 
doctors may be regarded as just about as foreign as 
we should be. So Dr. Paang's decision to do her medi- 
cal work in the rural districts meant that she was put- 
ting aside all thought of ease or convenience. 

Every now and then the papers mention something 
about the province of Shantung in China. It is one of 



DOCTORS OF THE FUTURE 125 

the most important provinces o China, and might 
be compared to New York State or Ohio or Califor- 
nia in our country. The capital city of this province, 
Tsinan-fu, is therefore a place of influence. In Tsi- 
nan-fu there is located one of the splendid mission 
medical schools of China. Its Chinese name is Chee- 
ICKX It was formed by the union of several small mis- 
sion medical schools, because the missions thought it 
better to have one strong school than three or four 
weak ones. It is now a thriving coeducational institu- 
tion with a flourishing hospital, a nurses' training 
school and various other activities. Its special aim is 
to prepare its graduates to go out in the spirit of Chris- 
tian service to the small towns and country districts. It 
encourages them to do this instead of settling down 
in large cities to take up practice that might bring 
larger financial returns. Many Cheeloo graduates are 
in mission hospitals in different parts of China. When 
I was at Cheeloo during my trip around the world 
I was tremendously impressed with the spirit and the 
work of this medical school. 

You might be interested to hear what different for- 
eign doctors in various mission hospitals have to say 
about a few of the graduates of Cheeloo both men 
and women. 

One doctor writes: "I am so happy to add that Dr. 
Teng is making good in every respect. Never have we 
had anyone more acceptable or more capable. She 
has the right material in her make-up for a mission 
hospital; she is a sincere Christian and all know it. 



126 HOW FAR TO THE NEAREST DOCTOR? 



1 am leaving her in full charge while I make a week's 
trip and visit. The hospital is full of patients and the 
clinics are very large. Cheeloo can well be proud of 
having turned out such a fine woman doctor." 

Another says: "Dr. Yu Tao Jung is doing fine work. 
The patients are increasing. He has one of the clean- 
est, tidiest, nicest places I ever saw. He is an earnest 
Christian. We are most fortunate to have him." 

From a lonely place up in the country comes an- 
other tribute to a graduate of the Cheeloo medical 
school: "Dr. Yang is outstanding in his profession and 
character. He has a strictly Christian standard of 
honesty and straightforward dealing that command 
the highest respect. . . . He is superintendent of the 
hospital. The hospital has twenty-five beds, with a 
daily clinic averaging forty, and an increasing num- 
ber of outcalls. There is abundant opportunity for 
developing an educational program of hygiene and 
general sanitation." 

Doctors are much respected among the peoples of 
Asia. And they often have great influence in their 
communities. Men and women of real character, who 
are well trained in modern scientific medicine, are 
more and more in demand. They are tremendous 
forces for health and for good. Though there are 
other medical schools in the more civilized parts of 
the Orient, it is especially in the mission medical 
schools that Christian character is developed. After 
all, this is what India and China and Africa and Ara- 
bia need most of all. 



CHAPTER EIGHT 



TOMORROW'S NURSES 

DAY after day in a little village a chair-bearers 
stood looking for the postman, uay alter day 
the postman did not come. She was awaiting the re- 
ceipt of her diploma, which would certify that she 
had passed the license examinations and could be 
considered a qualified and registered nurse. She had 
made a long, hard trip from her village to Foochow to 
take the examinations of the nurses 7 association. It 
was a three-days' journey, and it was through bandit 
country. But she was so determined to take the exam- 
inations, for which she had worked long and hard, 
that she decided to risk it. She had been carried by 
chair-bearers- one of the old modes of travel in China 
and had managed to get through to Foochow. 
There she met more obstacles because the practical 
examinations were in a dialect different from hers, 
and she had trouble making it out. But she struggled 
through the examinations, and was again successful 
in avoiding bandits on the way home. 

Now she was waiting for the report from Foochow, 
while not only days and weeks but even months were 
slipping by without a word. As a matter of fact, the 
mail was much delayed because of the upset conditions 



128 HOW FAR TO THE NEAREST DOCTOR? 

of the country, though she couldn't be sure of this 
reason for the delay The people o the village began 
to make fun of her. They, said that she had gone to all 
that trouble and paid out her money for nothing 
that all the nurses' association wanted was her regis- 
tration fee. She had been made a fool of, they said. It 
was pretty trying. She had nothing to show for all her 
work, and the anxious, empty months were going by. 

Finally, one day the postman delivered the long 
awaited package. He had been badly delayed. She 
tore the package open, and there, inside, was the 
coveted diploma properly seated and stamped. Not 
merely that, but she was told that she had passed with 
honors! 

What a day of days that must have been! The vil- 
lage people turned right around and began rejoicing 
with her and congratulating her. They had feasts and 
celebrations in her honor, somewhat as they used to 
do in the old imperial days when one of the old- 
fashioned examinations for government office was 
passed by a local young student. It brought honor to 
the village. From that time on they came to her when 
they were sick, and her advice was accepted on all 
matters of medicine and hygiene. She was able to do 
a great deal in all that region for the health of the 
people. 

You see, there is an official nurses* association in 
China, as also in India, very much like our nurses* 
associations in America and England. This associa- 
tion gives examinations, holds conferences and cir- 



TOMORROW'S NURSES 129 

culates literature. The mission hospitals around the 
country train their nurses and send them to take these 
examinations which decide whether the girls have 
qualified to be registered nurses. 

It is a great thing for girls in China, India, Korea 
and other Asiatic countries to be able to take up a 
fine profession like nursing. In the Orient there are 
not as yet very many careers open to women. But 
nursing is one of the best there is, for there are times, 
in a country where doctors are scarce or inaccessible, 
when nurses are almost as effective, especially in those 
Oriental countries where women are veiled or live 
strictly secluded lives. 

In all sorts of places in Africa and Latin America 
and Asia, girls are struggling to get a nurse's train- 
ing. They uave seen it as an ideal through which they 
can serve. In the Near East I reriember a girl, Abigail 
Shabas by name, who had been brought up in an out- 
of-the-way little mud-walled village where there 
wasn't even a school or anything remotely resembling 
a hospital. She had never heard of such a thing as the 
profession of nursing, but she had a natural love for 
looking after sick people. She would gladly go about 
in her village and take care of the sick, even though 
she had no training or equipment and had to depend 
simply on good sense and kindness. Later she went to a 
mission school, and about the time she was to graduate 
she heard that the mission hospital was going to open 
a nurse's training class. It seemed to be just what she 



130 HOW FAR TO THE NEAREST DOCTOR? 

had always been waiting for and working toward. She 
applied right away, was accepted, and presently began 
her course. There xvere two other girls in the class. 

Within the next year or so, the World War came 
down on that part o the Near East. Everything was 
torn up and knocked about. The regular classes were 
interrupted by emergencies and finally broken up 
altogether. But Abigail and the other two student 
nurses gained much practical experience. Wounded 
men were constantly being brought to the hospital, 
and there was a great deal of sickness. Finally, when 
the war was ended, the course for those three girls 
was resumed and at length they graduated. The 
graduation exercises were quite an occasion, with 
many notables in the audience, 

Miss Shabas, always ambitious for the best, later on 
managed somehow to get to England. There she 
studied in one of the great maternity hospitals so that 
she might fit herself to specialize in the nursing of 
women and children. Her training over, she went to 
Baghdad and began to work as the first nurse in her 
particular field that that historic old city had ever 
had, so far as I know. Her work was tremendously 
welcomed by the people there. And she had years of 
very useful service. Now she has gone back to Persia 
to the capital city of Teheran to continue her 
work. 

If you knew what it meant for a poor, uneducated, 
village girl in a backward Asiatic country to acquire 
these privileges, you would realize what a remarkable 



TOMORROW'S NURSES 131 

thing has happened. With these difficulties in mind 
you can understand why nursing work in pioneer 
regions has been slow and hard. It is naturally made 
up of plenty of amusing experiences and disappoint- 
ments as well as successes. 

Dr. Gordon S. Seagrave, of Burma, after speaking 
of difficulties presented in their nurses* training school 
by the fact that the girls came from different areas 
and spoke different languages, writes: * 

We finally decided to use the Burmese language, for 
all these girls understand a little Burmese just as you and 
I understand French you know how much that is. ... 
So away we went with Burmese. And we got along very 
well indeed. You can imagine how well we got along if 
you think what it would be like to ship an American doc- 
tor over to Germany to open a nurses' training school, 
allow him to take in only French and Italian girls, and 
make him teach them in the Russian language. But, at 
the end of four years, we graduated one girl. . . . When 
this first Kachin girl graduated with high honors (she 
became an unusually fine nurse) , the princes of the valley 
of Mong Paw, fifty miles away, heard about it and sent 
an embassy down to say that they would like her to come 
out to their valley to practise, as their people were en- 
tirely without medical assistance. It was arranged that she 
would go, on condition that they would build her a 
hospital. We supposed that if they built her a hospital it 
would be of bamboo. We were delighted, however, to see 
that they built her a hospital with wooden posts and a 
wooden floor. 

Nurse Hkang Nang has been out in that valley for 
about one year, entirely without medical assistance ex- 
cept when she was occasionally able to send to my asso- 



132 HOW FAR TO THE NEAREST DOCTOR? 



ciate such cases as she could not diagnose and treat But, 
during the first six months of that year, she cared for 
more sick people and cured them too than I did in my 
whole first year in Burma. We feel that this nursing 
school is ahout the biggest thing we do. Every one of these 
girls must be a Christian; she receives a good deal of Bible 
instruction in either the Kachin or Shan schools, and after 
graduation is able to do remarkable work in the care of 
the sick of her own people. . . . 

The nurses who graduate from mission hospital 
training schools have their difficulties, as they take up 
work among people who know nothing about modern 
nursing and doctoring. This means that the nurse 
really must do a great deal of educating. She becomes 
a teacher in the houses of the town or village where 
she lives. Here is a page or two from the diary of a 
Chinese nurse that gives an interesting glimpse into 
the kind of experiences that the girls meet: 

My chum and I have been called on another case. A 
wealthy Chinese family has just telephoned, asking for 
two nursesi to take care of a woman of the household. It 
was certainly fortunate that I happened to answer the 
telephone. Until the sedan chairs come for us there is 
time for a note in my diary. This is only my second case 
since graduating from Turner Training School at Hack- 
ett. I don't feel one bit nervous, but I suppose I shall 
when the family looks us over. If they are like most 
wealthy families there will be so many of them in their 
separate houses, connected by courtyards and passage- 
ways, that we may not be noticed. I hope the ancestral 
temple will not be near our apartment. Since I am a 
Christian, the smell of joss-sticks and the sight of food 
set before the ancestral tablets is depressing. It Is typical 



TOMORROW'S NURSES 133 



of the prevailing ignorance and superstition. The chairs 
have arrived. . . . 

Bedtime. Our patient is a very sick woman, with high 
fever and delirium at times. It is very plain, from the 
absence of images in her apartment, that she is a Chris- 
tian. That explains why a Hackett graduate was called 
to attend her when her baby was born a month ago. As 
soon as I had donned my uniform today I took the pa- 
tient's pulse, temperature and respiration; bathed her 
with soap and water, cleansed her mouth, gave her some 
water to drink, combed her hair and arranged her bed. I 
am sure I made her feel comfortable, for she went to sleep 
at once. Several of the many women of the family watched 
closely all that I did. Among them, of course, was the first 
wife or mother-in-law, who manages the affairs of the 
house as well as all the people living in it. 

When I was through, the mother-in-law said it was not 
necessary to bathe the patient with soap and water, as 
damp towels would be sufficient. She also said that I was 
not to give the patient any water to drink, as it would 
make her worse. I tried to explain to her how important 
water is. I told her that I had seen babies in the hospital 
that were almost dead come back to life in a few hours 
after being given water in large amounts. I explained to 
her how water alone saves the lives of patients with 
cholera. But it was no use. Then I asked when the doctor 
was corning, hoping that he would give the order and 
that she would believe him. But my heart fell when she 
said that they would send for two or three Chinese medi- 
cine men in the morning. 

Two days later. The patient is no better and it has 
taken me all day to recover from the events of yesterday. 
Very soon after the morning meal the Chinese doctor 
arrived. He felt the patient's pulse to test the condition 
of the heart, then tested the other side at various levels 



134 HOW FAR TO THE NEAREST DOCTOR? 

to discover the condition o other internal organs. Then 
he looked at the patient's tongue and eyes. After he had 
asked a few questions I saw he was ready to write his 
prescription, so I asked him quietly about giving water 
to the patient. 

"Oh, no, no," he said, "water is not needed, not at all." 
Just then there was a knock at the door and a bustle to 
get the doctor shuffled into another room. I looked 
around and another Chinese doctor came in. He made 
the same kind of examination and wrote his prescription, 
As soon as the prescription was received it was shown to 
the first doctor and his opinion asked. 

"It is of no use at all," he said, "it will not cure her." 
What could the poor family do but send for another 
doctor! True to Chinese style they did not stop at three, 
but, during that day, sent for nine different doctors. Each 
one of them made his examination and wrote his pre- 
scription, but there was no agreement among them. As 
there was no consultation their different pronouncements 
and medicine had little in common. None of them would 
attend to the kidneys or bowels or give fluids. Here I am 
helpless, and all I do is to make the patient as comfortable 
as possible and give her the concoctions which the mother- 
in-law brews by the hour over charcoal stoves in the 
kitchen. 

Just think what they must have spent for doctors yes- 
terday! Each visit would cost from four to ten dollars, 
depending on the reputation of the doctor. Then, too, 
they pay us nurses five dollars each a day. 

Six days later. The patient is worse. Yesterday my chum 
and I became desperate and managed to get the family 
and all the servants to leave the patient's roorfi long 
enough for us to give her some water and a real bath. 
She slept well afterwards, but her fever still continues 
high. Other Chinese doctors have come, but each new 



TOMORROW'S NURSES 135 

one means only a new mixture to be brewed and a new 
medicine to be given. The patient has been calling for a 
Dr. Lee, a foreign doctor from die foreign community of 
Shameen who had attended her some years ago. The 
mother-in-law says this doctor is no longer in Canton. 

Today, I told the family I would not stay longer; by 
staying on and giving only the medicine and treatment 
prescribed by the old-fashioned Chinese doctors I was 
betraying all that had been taught me. If they were not 
willing to let me do what I knew to be right to relieve 
my patient, or send for a doctor of Western medicine, I 
could not stay. To stay would mean that I was being a 
party to the gross negligence which I feel is being allowed 
here, for this poor woman will surely die. The family 
begged me to stay, and I agreed to stay a little longer. 
In the meantime the patient still calls for the foreign 
doctor. Poor folks they feel they are doing the best 
they can do. 

Two days later. How relieved I am! The family called 
in an American doctor today; also two Chinese doctors 
trained in Western medicine. Not only did these doctors 
agree as to diagnosis but they also had a consultation and 
prescribed the same medicine. At last I may bathe the 
patient, give her water and enemas. Now, we shall see if 
the temperature will not come down. I hope the family 
has not waited too long before taking this step, 

Six days later. At last my patient is better and her fever 
is lower. The family have been very much surprised at 
her rapid improvement and give the doctors much credit. 
There is every reason to believe that she will recover. 
They have had a real demonstration of the effectiveness 
of Western medicine in comparison with the old Chinese 
medical practice. The patient agrees with me in telling 
them it is Christian medicine that has cured her. She says 
she is the only Christian in the family. Perhaps more of 



136 HOW FAR TO THE NEAREST DOCTOR? 

them will be willing to listen to the Christian message 
because of this experience. I have promised to stay one 
more week until the patient is able to be up. If only all 
of my cases would end as happily as this one! 

Dr. Walter Judd of China, who went through dan- 
gerous times when he remained at an island station, 
the sole foreigner in a region that was overrun by 
bandits and communist forces, tells of the splendid 
way one of these young Chinese nurses took care of 
him when he was sick with a vicious form of malaria: 

I got sick in October with my forty-fourth attack of 
malignant malaria. It was the worst. I got to the place 
where I couldn't develop adequate resistance to it. I had 
taken quinine daily for years, but this time the quinine 
was like water and sort of weak water at thatl It didn't 
hit it. This attack came on when I was especially busy 
and tired. I ran out of the good quinine we had been 
using. There was another supply of quinine that I 
thought was all right, but it proved to be not all right, 
and the malaria got a head start on me. 

The second morning, after a night of delirium, I was 
dear mentally and gave some instructions to the Chinese 
nurse, a graduate of the Methodist Hospital in Peking, 
the finest nurse I have ever worked with. I know now how 
people feel when they think it is all over. I have read 
about men caught out in a snowstorm, freezing to death, 
when they want to lie down and die. It is just so hard to 
make yourself try to live. You are so miserable and lonely 
and far away, if you could just die and have the pain over 
with, what a relief I Yet something in your training won't 
let you give up. That little girl came to my bed, and the 
tears were pouring down her face. She knew what we 
were up against. She had seen plenty of people die of 
malignant malaria. Many times children come down in 



TOMORROW'S NURSES 137 

the afternoon at four o'clock, and the next afternoon at 
four o'clock, unless treated vigorously, they are dead. I 
had more resistance than that, however, because I had 
had many previous attacks. 

I told her that her uncle who runs a medicine shop 
had previously been given some of our good quinine. 
She was to go there and see if she could get enough, to 
last eight or nine days. If she could get enough, then she 
was to send a telegram, which I dictated and she wrote 
down, to the folks in Foochow, telling them that somehow 
or other they must persuade the postal commissioner 
there to allow some quinine to be sent up by the carriers 
of first-class mail (the parcel post service had been sus- 
pended for months) . If she couldn't get locally enough 
to last the eight or nine days till more could come, there 
was no use in sending the telegram. It would be too late. 
Then I tried to tell her what she should do for me, be- 
cause I knew that by noon my fever would be up and 
I would be delirious again. She went out to get the 
quinine. That is the last I remember for four days. But 
she got it and she kept her head. For eleven days I wasn't 
able to take a thing down by mouth, and she had to give 
me food and nourishment by other means. 

Along about the eighth of November, I came around 
and began to eat a little. On the twelfth, in was brought 
a Catholic priest, a Swiss, who lived in a neighboring dis- 
trict and who had been ill for three or four weeks. There 
we were, two sick foreigners, and twelve days' journey 
from the nearest doctor! I had to get up and do the best 
I could for him. . . . He was so far gone I was sure he 
couldn't get well. I was carried to his bedside that day 
and the next in a sedan chair, but the following morning 
I couldn't go any more. He went out the third day, and 
I came pretty near going with him. That little nurse 
never wavered. 



CHAPTER NINE 



TEST TUBES AND GERMS 

FINDING out more about disease is a very impor- 
tant part of scientific medicine. Doctors are all 
the time studying different diseases in their labora- 
tories and from their patients, and trying new meth- 
ods of preventing and treating them. Such work is 
called medical research. This is the way we have 
found out about vaccination against smallpox and 
about antitoxin for diphtheria. We hope some day 
that wq shall learn how to prevent infantile paralysis 
and influenza. There is still much to be discovered 
about many diseases. 

In the parts of the world where medical mission- 
aries are at work Africa, China and Arabia, for ex* 
ample there are still many diseases the doctors do 
not fully understand. The doctors know a great deal 
about some of the diseases like leprosy and hook* 
worm and dysentery. But they need to know much 
more, because there are still hundreds of thousands, 
and even millions of people who are suffering and 
dying every year from fevers, blood infections and 
other diseases caused by queer germs of different 
kinds. Any doctor or for that matter anybody who 



TEST TUBES AND GERMS 139 

jpi^nn^jii-uig-utf-ujl-^r^irvjiiir- Jf- jH^jr-jf- ^r jp-T^-&-i.^--ji-*-*-*rv^~*a*- J~ ^ar-O-ijiirr &-,jf- jr- ijr-ijr mf-ijirmr f if dT-idf ^n-ar* rf*i 

cares about fellow human beings should be inter- 
ested in these experiments and studies. 

An important point to remember about medical 
research is that it is teamwork o a splendid sort car- 
ried on throughout the world. Nobody works alone. 
Each man builds on what someone else has done. We 
say that So-and-so has made a great discovery. In real- 
ity what has happened is like what happens when a 
new country is discovered. One man goes so far and 
comes back and writes about it. Another man goes 
a little further, and perhaps, as a result of what he 
finds out, advises later explorers to spend no time in 
certain regions, as they seem likely to yield informa- 
tion of no value. Someone starts out intending to go 
further than any of the others has gone, but he is 
never heard from. Still another gets a fine view of the 
new country from a mountaintop, and he is therefore 
able to give a lot of help to the next ones. Then 
finally there comes one who pushes still farther ahead, 
using the information gathered by all, and it is he who 
actually makes the discovery. Our geographies are 
full of the names of these discoverers and explorers. 
The credit should really be shared with all the ex- 
plorers, which is what is usually done in medical 
discovery. And medicine, too, has its diseases and 
methods of treatment named after their discoverers- 
Doctors writing of their experiments in medical jour- 
nals and books are constantly quoting other doctors. 
And that is the way truth is gathered and built up. 

Medical missionaries are tremendously interested 



140 HOW FAR TO THE NEAREST DOCTOR? 

in research, but they are usually so busy with patients 
and have so little money and time for experiments, 
and so little in the way of laboratory equipment, that 
they are not able to achieve a great deal in the way 
of discovery. Still, I want to give you some examples 
of research they have carried out and discoveries they 
have made. * 

In Severance Union Medical College in Korea, of 
which Dr. Avison is the head, there is a regular re- 
search department, with a director and a committee in 
charge of it. During one year twenty articles along 
research lines were published by Severance men in 
scientific journals. This means that a lot of quiet in- 
vestigation is going on which is being built into the 
general knowledge of the medical world. These par- 
ticular articles and their authors may be forgotten, 
but from one of them there may come an idea which 
will help to bring about a great discovery. Some of 
the first successful investigations of the drug called 
ephedrine, which is so useful now for nose and throat 
and sinus trouble, were conducted at the Severance 
Medical School in Korea. 

You may never have heard of Dr. Hermann Barlow 
of China. But among people who are familiar with re- 
search in tropical diseases, he is well known. And he 
is well known because of what he did in research 
work on a disease with a name a yard long. It is caused 
by a parasite called the fluke, and which presents a 
very serious problem in China and some other parts 



TEST TUBES AND GERMS 141 



of Asia. It develops slowly and steadily. Persons who 
have it get steadily worse and worse and finally they 
die. 

For years the doctors had seen people with this 
disease thousands of people were dying of it all the 
time. Many of them came to the hospitals, but noth- 
ing much could be done for them because the doctors 
did not understand the cause or the treatment. Many 
thousands more never came to the hospitals at all. 
Meanwhile, research workers had been noticing cer- 
tain peculiar points about this disease of the long 
name. For one thing, it wasn't present in all parts of 
China, and there were certain areas in which it was 
especially bad. Why was that? They began to suspect 
a mean little worm called a fluke. They studied this 
worm in their laboratories, trailed it around and 
saw where it lived and what it did. 

Dr. Barlow was one of those who got much excited 
about this fluke. There was a great deal of the disease 
in his region, where Chinese all around him were 
wasting away and dying from it. He felt that he had 
to do something strenuous to find out more about it. 
So he conducted a most unusual experiment. It was 
on himself. He actually swallowed a number of the 
repulsive worms so that he could study at first hand 
just what happened that is, what happened in him- 
self. He was taking a big chance, of course, for he 
knew perfectly well that he might die with the dis- 
ease. But he believed the game was worth the candle. 
He didn't do this on a hit-or-miss principle. He had 



142 HOW FAR TO THE NEAREST DOCTOR? 

a carefully worked out plan to go to Johns Hopkins 
University in Baltimore, where there were the best 
of laboratories and where there were experts to study 
his case. He came as a patient, and they studied his 
case long and hard and learned a good deal. 

Then, when he went back to China, there was still 
more to be found out about this fluke which was 
such a bad actor. His board of missions gave him a 
year free from regular hospital duties so that he could 
do research work. The Rockefeller Foundation, 
through its China Medical Board, provided him with 
funds and equipment. 

It was a sort of Sherlock Holmes job, trailing the 
wriggling villain in the piece the fluke. Step by step 
the detective work went on, bringing clues and con- 
victions. One culprit, though he proved to be really 
an innocent one, was a certain small snail. The fluke, 
it turned out, got into this snail and lived there dur- 
ing one stage of growth. This particular kind of snail, 
incidentally, lives only in certain parts of China 
which you see, goes to show why the disease is not 
found everywhere. Next it was found that two kinds 
of nuts were guilty, as the fluke was in the habit of 
snuggling up inside of them. The Chinese are very 
fond of eating these nuts, which meant that they were 
unsuspectingly taking the flukes into their systems in 
this way. 

So it goes in research. When you have studied in 
your laboratory all the habits and habitations of a 



TEST TUBES AND GERMS 143 

germ or a parasite worm you are on the way to dis- 
posing of it and protecting people against it. Dr. Bar- 
low made important discoveries in the conquest of a 
fatal disease. His work was a mountain peak from 
which to take a first view into unexplored territory. 
Dr. Barlow once said, "This is my favorite passage of 
scripture: 'My Father worketh hitherto, and I work/ 
No heaven for me with a harp and a crown. I want a 
heaven with blue-prints in it something more to do." 

Another devastating disease found in China as well 
as in other parts of the East is kala-azar. It is fatal 
more times than not, if allowed to run its course. Not 
much research had been done on kala-azar when Dr. 
Samuel Cochran of Hwai Yuan, China, took up the 
study and made important discoveries about it. 

Back in 1908, while he was studying during a fur- 
lough at the School of Tropical Medicine in London, 
Dr. Cochran realized that in Hwai Yuan they were 
living in what is called an endemic area of kala-azar 
in other words, in an area where it is present all the 
time inftead of appearing just now and then in what we 
familiarly call epidemic form. After learning in Lon- 
don about the various methods employed in the search 
for the germs of the disease, he returned to China 
and began trying some different methods. His various 
attempts to find it in the blood came to nothing. Then 
he cut out a small lymph node from the body of a 
patient suffering from kala-azar and found it swarm- 



144 HOW FAR TO THE NEAREST DOCTOR? 

ing with the germs. When he reported this to the 
School of Tropical Medicine in London they were 
so much interested that they gave him money to carry 
on further investigations. He sent out a questionnaire 
to practically all the hospitals all over China for in- 
formation on kala-azar. From these replies he drew 
up a kala-azar map, showing the areas where the dis- 
ease was common. This was very important informa- 
tion. 

Dr. Cochran's work so interested many doctors in 
China that they studied the disease harder than ever. 
Prior to this time it had not been generally known 
just what germ carried the disease, though actually 
a few persons had found the germ before Dr. Cochran 
did. For some time no satisfactory treatment for kala- 
azar was discovered; then, fortunately, antimony was 
tried and proved successful. Now, if a case is not too 
far along before treatment is begun, it can usually 
be cured with antimony. 

When I was at Hwai Yuan, visiting Dr. Cochran's 
old hospital, I found that Dr. Theodore Yates, Dr. 
Cochran's successor, treats hundreds of sufferers from 
kala-azar every year. Sometimes more than half his 
hospital patients have this trouble. The people in 
that part of China have learned that this miserable 
disease can be cured at the hospital, and they have 
learned to go there when they think they have it. Dr. 
Cochran's work was one of the links in the chain of 
research that has conquered this disease. He did his 



TEST TUBES AND GERMS 145 



work not in an expensive, beautifully equipped in- 
stitution, but in a simple and small mission hospital. 

An unusual tribute was paid to another contribu- 
tion to research made at a missionary institution in 
China, when in 1932 a distinguished group o men 
from leading medical and social organizations gath- 
ered at dinner in a great New York hotel to honor 
Dr. Gordon Agnew of Canada, whose investigations 
on the causes of tooth decay had attracted the atten- 
tion of the scientific world. There were assembled 
representatives of the International Health Board, 
the International Dental Foundation for Children, 
the Columbia University College of Dentistry, the 
Metropolitan Life Insurance Company, the New 
York Academy of Medicine, the United States Public 
Health Service, the League of Nations Association 
and several other organizations interested in human 
welfare. 

Perhaps you have not thought of research work in 
the field of dental work as of particular consequence, 
It has never been fully recognized. There is a special 
need for it in a country like China, where anything 
like care of the teeth is almost unknown. But Dr. 
Agnew's studies had a far wider value than just for 
China. 

When he first went out there some years ago, to 
join the dental department of the medical school in 
West China Union University at Chengtu, he became 
especially interested in the problem of tooth decay 



146 HOW FAR TO THE NEAREST DOCTOR? 



and its prevention. With the able help of his wife, he 
set to work on scientific laboratory experiments in 
nutrition and on careful observations of large num- 
bers of Chinese. He noticed, for example, that such 
hard-working people as chair-carriers had a very re- 
stricted, simple diet but kept in good condition and 
had sound teeth. They worked through a large part 
of the year with light clothing and plenty of exposure 
to the sun. Dr. Agnew and his wife also noticed that 
certain aboriginal tribes, up toward Tibet, although 
living on a very limited diet had healthy teeth. The 
doctor and his wife analyzed that diet carefully. They 
also noticed that well-to-do Chinese, who wore more 
clothing and lived much indoors, had decidedly more 
trouble with their teeth than the poorer people who 
lived mostly outdoors. When the Agnews came home 
to Toronto on furlough they carried out an intricate 
and exhaustive study on about fifteen hundred rats. 
Rats are valuable animals for laboratory research. 
The Agnew study involved feeding different diets to 
different sets of rats, and then studying the effects on 
their teeth and bones. Finally observations on the diet 
of some three hundred and fifty school children were 
carried out in and around Toronto. 

Well, all these studies are not yet complete. But 
they have gone far enough to yield valuable new in- 
formation regarding particular elements in human 
diet as they affect the development and preservation 
of teeth. This field of dental studies is not, of course, 
a new one. Dr. Agnew pays tribute to the earlier work 



TEST TUBES AND GERMS 147 



of other investigators, but the testimony of the doctors 
at the dinner to Dr. Agnew was that his discoveries 
were remarkable. The future health of many of us 
here in the United States and Canada may owe some- 
thing to the skilful scientific research that Dr. and 
Mrs. Agnew carried on in a mission college In a re- 
mote part of China. 

These are just a few illustrations of the research 
achievements of medical missionaries. More could be 
cited. But there still remains a great challenge to 
young men and women doctors to take up this search 
for the hidden causes of disease. This indeed is Christ- 
like work. 

Even in an isolated and rough-and-ready sort of 
hospital like Dr. Albert Schweitzer's in Africa, there 
is some research going on. German doctors have al- 
ways been keen scientists and investigators. Dr. 
Trensz, one of Dr. Schweitzer's associates, is evidently 
such a doctor. He believes that he has found the germ 
that causes a kind of dysentery, which is one of the 
serious diseases of that region, and which many of 
Dr. Schweitzer's patients have. If this proves to be 
true, it may make a marked difference in the treat- 
ment of the disease. Things like this are likely to 
happen at any time. I mention it here as an illustra- 
tion of what is taking place right now, even before it 
is assured that a real discovery has been made. 

We have been looking at the contributions that 
have been made to medical research by mission hos- 



148 HOW FAR TO THE NEAREST DOCTOR? 

pitals and doctors In various parts of the world. Let 
us now look at the work of some of the allies that the 
Christian doctors have in their struggle for the health 
o the people they serve. Without the constant co- 
operation of such agencies as the great medical re- 
search foundations and the public health services of 
governments, the missions would not be able to 
achieve the results they have so far obtained. 

One such an ally in China is the hospital of the 
Rockefeller Foundation in Peiping. This hospital has 
carried on and is carrying on invaluable research 
work on many different diseases. Part of the impor- 
tant work on the drug ephedrine which is used so 
effectively now in America, was done there. The 
Rockefeller Foundation also carries on splendid re- 
search work in other parts of the world including 
Africa. 

In Calcutta there Is another great ally in the School 
of Tropical Medicine, where research is done on the 
diseases prevalent in India. One of the leading men 
at this Calcutta school, a world authority on leprosy, 
is Dr. Ernest Muir. Dr. Muir was a medical mission- 
ary In India when he began his studies on leprosy. 
With the excellent facilities of the Calcutta school, 
he is now able to carry forward these studies on lep- 
rosy which mean so much to hundreds of thousands of 
sufferers. 

More and more the governments of countries like 
China and Slam, which used to be called backward, 
are realizing the Importance of scientific medicine 



TEST TUBES AND GERMS 149 

and are carrying on research in many places, and the 
results are being put at the disposal o all doctors. 
Japan, whose progress in medicine has been sd rapid, 
has made many valuable research contributions. 

In Africa, under the governments of the various 
colonies and mandates, a great deal is being done to 
study disease and furnish medical aid for the people. 
For example, the French government in the Camer- 
oun has an active health department. Campaigns are 
carried on against certain of the worst diseases, one 
of which is sleeping sickness. This terrible disease, 
which is peculiar to Africa, is carried by the tse-tse fly. 
Until the new treatment was discovered by the Rocke- 
feller Foundation, the disease was considered fatal. 
The person who caught it became steadily more and 
more sleepy and weak until, paralyzed, he died. Now 
it can be cured if treated early enough. Mission doc- 
tors and government doctors have cooperated in this 
work. They have been so successful in one particular 
area, according to a medical missionary, that the num- 
ber of persons suffering from the disease has been 
reduced from fifty-six per cent of the population to 
less than ten per cent. The work will probably go on 
until the disease is entirely done away with until 
there are no more cases left to spread the infection. 

When I was in Nanking, China, I was one of a 
party that called on Dr. Lew, the head of the health 
department of the Chinese government. He is a gradu- 
ate o Harvard Medical School and a very able man. 
He discussed with us some of his plans for medical 



150 HOW FAR TO THE NEAREST DOCTOR? 

education in China, where there is such a tremendous 
need for scientifically trained doctors. Then we went 
out to the model government hospital of which Dr. 
Lew is the head. Though it was then in temporary 
quarters, while a fine new hospital was being built, it 
was a very attractive and efficient sort of place. It has 
excellent x-ray and other modern equipment, well- 
trained doctors and nurses and neat wards. Altogether 
it has an air of being an excellent hospital. 

Almost the first gathering I attended in Persia dur- 
ing my visit of 1931 was a lecture by an army officer. 
It was on the subject of exercise, and was one of a 
series of health lectures. The fairly large lecture room 
was filled mostly by young men. The lecturer was 
alert and vigorous, and he spoke fluently and enthusi- 
astically. The audience paid close attention. Ten 
years before, when I had been living in Persia, lec- 
tures of this kind were practically non-existent. Now 
the government encourages and carries out many pro- 
grams of this kind. 

When I was in Bangkok in Siam, Dr. Neils Neder- 
gaard, a medical missionary, took me to see two of 
the three splendid hospitals of that great city, the 
capital of the country. One of these was the Red Cross 
hospital, the other the university hospital, with which 
the government medical college is connected. Both 
are fine modern institutions. The medical college has 
been helped financially by the Rockefeller Founda- 
tion and has had Americans on its staff. But today 
nearly all the faculty are Siamese, and all have been 



TEST TUBES AND GERMS 151 



trained in modern methods. Research is, of course, 
a part of their program. 

The government of India has likewise done a great 
deal along medical lines. It provides vaccines and 
serums, as was shown in the account of Dr. Robert 
Goheen's fight with plague at Vengurla. It maintains 
a large number of free dispensaries. It pays a staff of 
doctors to take care of people in these dispensaries 
and in a certain number of hospitals. The government 
has established several medical colleges in the larger 
cities. It strives to improve the sanitation of the coun- 
try and to raise the standards of public health. 

The American government has done effective medi- 
cal work in the Philippines. When the islands were 
taken over after the Spanish-American War, health 
conditions there were very bad. Smallpox, for exam- 
ple, was rampant. Now, through vaccination and 
other means, smallpox has been almost stamped out. 
Leprosy was widespread; and nothing effective was 
being done about it. Now a leprosy hospital and 
colony with several thousand patients has been estab- 
lished at Culion. Culion is the most important project 
of the Leonard Wood Memorial fund for fighting 
leprosy in the Philippines. It is hoped that through re- 
search and treatment and isolation this terrible 
scourge of the Orient will be driven from the 
Philippines. Hygiene and sanitation are universally 
taught in government and mission schools in the 
Philippines. The results show. It seemed to me on 
my trip around the world that the Philippine stu- 



152 HOW FAR TO THE NEAREST DOCTOR? 

dents were a particularly alert, happy, healthy lot of 
boys and girls. 

In the Philippines, as in Siam, there is special effort 
to cooperate between the government and the mis- 
sions. The missions do not undertake medical work 
in places where the government medical work is ade- 
quate, and the government follows the same policy 
in places already served by missions. 

People sometimes ask whether many of the coun- 
tries served by Christian missions are not now doing 
so much for themselves that medical missionaries are 
no longer necessary. On this question there are at 
least two things to be said: 

For all their progress countries like China, India, 
Africa, Persia and Arabia are still a long way from 
having enough doctors or nurses or hospitals to take 
care of their people, especially their poor people. 
Moreover, we who have seen and known this work be- 
lieve that medical missions exert a unique influence 
for Christian character building. 



CHAPTER TEN 



WORKING WITH THE GOOD PHYSICIAN 

IF MEDICAL missions are relieving suffering, that 
is something. Indeed, it is a great deal, for they 
are keeping people from dying. But is that all they 
are trying to do? Is there not some greater purpose 
that they hope to accomplish? 

Suppose Dr. Harrison relieves an Arab of a long 
siege of suffering, and that man goes back to his desert 
life, having got rid of a bodily misery but not having 
been affected otherwise. Is the missionary satisfied? 
Suppose Dr. Agnes Fraser of Africa saves a little boy's 
life, and the boy's family go right on feeling and think- 
ing and acting just as they did before, without any- 
thing new having come into their lives. Has the mis- 
sionary accomplished all that is to be desired? 

We like to think about the friendship shown by 
those boatmen on the river for Dr. Harrison after 
they had been with him a while. We like to think of 
how that hard, gruff, Bedouin from the desert changed 
while he was in the hospital, even though he began 
by cursing Dr. Harrison. 

That picture of hundreds of fierce Pathan people 
filing past Dr. Pennell's body remains in our minds 



154 HOW FAR TO THE NEAREST DOCTOR? 



because we realize that something in his life and ex- 
ample had changed something in theirs. 

I remember reading a novel by H. G. Wells some 
time ago. One of the characters was a man who didn't 
have to work for a living and who spent all his time 
in healthy outdoor sports. He would play tennis and 
ride for a while, then go for a swim or go on a hike. 
After that he would box or play another game. He 
was always talking about how fine all this was for 
keeping himself fit. He spent all his time just keep- 
ing in perfect physical condition. One day somebody 
gave him a hard jolt by asking, "Keeping fit for 
what?" 

When we think of the work of Christian doctors 
and nurses such as has been described in this book, 
the question comes up: Does something happen in 
the lives of the persons whom they help? The great- 
est of physicians, Jesus, said that he came to give peo- 
ple life, abundant life. The doctors and nurses who 
go out in his name and serve in his spirit are trying 
to do something toward bringing this abundant life 
to all whom they can reach. 

Even during the terrible war conditions of China 
these quiet influences are at work. Sometimes it is the 
results of these very war conditions that change a life, 
as was the case with one young Chinese. He was a 
simple country lad who was pressed into the ranks, 
dressed in a strange uniform and hurried away to the 
front. The older soldiers tried to tell him about bat- 



WORKING WITH THE GOOD PHYSICIAN 155 

ties and campaigns. He hated It all, and longed to go 
home. Then he suddenly found himself in battle, fac- 
ing heavy rifle and machine gun fire, boys and men 
falling all around him, stumbling along toward what- 
ever they were supposed to be attacking. It was all 
very wild and horrible and deafening and blinding. 
And then everything went black and silent. He had 
fallen too. Hours passed. When at length he wearily 
opened his eyes he didn't recognize his surroundings 
at all. Where was he? In place of that bloody, reeking 
bedlam of the battlefield, he was in a clean white bed 
in a long quiet room with two rows of white beds. He 
didn't know yet that it was a hospital a foreign hos- 
pital at that run by the "foreign devils/' as the Chi- 
nese used to call all foreigners. Slowly and painfully 
he looked about him. Other boys and men were in the 
other beds some of them groaning some very still 
others apparently feeling better. And then, as the 
missionary who was present, says: 

A door opened and there stood a foreign devil! But 
could he be bad? He had such a happy smile. "Surely M& 
heart must be good," said our lad to himself. And fol- 
lowing the foreign devil was a young woman of his own 
people, and how kind were her eyes, tool Both came 
to his bedside. In his own tongue they questioned him 
gently and as gently dressed his wounds. The man went 
on to the other beds and the young woman told him that 
the foreigner was a great doctor and that she was a nurse 
and that they would try to make him well. "But I have 
no money/' said the boy, "I cannot pay you." "We want 
no money,** she said, "we do it for the love of Jesus/* 



156 HOW FAR TO THE NEAREST DOCTOR? 

Days passed, but our lad had much to think of as the 
pain grew less. He watched the great doctor go from bed 
to bed, so tender in his touch, giving courage with his 
ready smile. A second time he questioned his nurse 
"Tell me again, my head is so stupid, why is he so good 
to us poor chaps?" and again she answered, "It is for the 
love of Jesus." "But the doctor is a foreigner," said the 
boy, "There are no foreigners in the love of Jesus/ 1 said 
the nurse. "All the dressings on your wounds are made by 
foreigners across the sea, all for the love of Jesus." I 
never knew such love," he answered. 

Little by little, as she changed his dressings, day by 
day, she told him stories of the loving Jesus. She gave 
him a little book that held these stories. "There is a boy 
at home who can read," said our lad, "he will read them 
to me." And so when he went to his home in the sunny 
fields, he carried a new purpose "We will tell in our 
village these wonderful stories of a Friend who loves 
them all." 

One of the striking stories told me in my travel 
around the world was in India, at Fatehgarh, where 
there is a hospital for men and women, directed by a 
woman, Dr. Adelaide Woodard. The fact, by the way, 
that men come to her hospital is extraordinary in an 
Oriental country where women have always been so 
looked down upon. I can testify that die hospital is a 
busy place from morning till night. 

It seems that near Fatehgarh just across the river 
from it there is a certain village whose headman 
used to be very hostile to the hospital and to the rest 
of the CRristian activities. He seemed possessed with 
the idea of doing everything he could against the mis- 



WORKING WITH THE GOOD PHYSICIAN 157 

sionary workers talking against them, interfering, 
breaking up meetings, and in general making a lot of 
trouble. Then a strange thing happened. Or, Woodard 
was called to the hospital door one day, and to her 
utter surprise found this bitterly hostile man and his 
small boy who was evidently very sick. The father 
humbly laid the boy at her feet. 

"I have been to all our doctors and they can do 
nothing. And now I come to you to save his life." 

Dr. Woodard's examination showed a critical con- 
dition peritonitis probably from appendicitis. The 
only hope lay in an immediate operation, but there 
wasn't any great hope at that. She told the father 
frankly just how it stood. She was ready to operate 
and do her utmost if he wished. But he had come 
late, and she could not promise anything. Without 
an operation the boy would surely die. The father 
himself could see that. 

With tears in his eyes, he simply said, "He is yours." 

Dr. Woodard operated. It was a close call, but the 
boy pulled through. The father was overjoyed. His 
gratitude was overwhelming. Nothing was too good 
for Dr. Woodard and her associates after that. When 
they took, the boy away, the grateful family was sing- 
ing the praises of the hospital to which they had been 
antagonistic. The father now does everything to 
open doors where he used to close them; he praises 
where he used to curse. As a village head man, or sort 
of mayor, instead of obstructing, he now gives the 
influence he formerly withheld. Here we have the 



158 HOW FAR TO THE NEAREST DOVTOR? 

case of a man whose spirit was entirely changed by 
Christian love in action. 

In Dr, Goheen's leper hospital I saw among the pa- 
tients a quiet little man whose courageous spirit 
touched me so deeply that I shall always remember 
him. He had come to the hospital too late to be helped 
very much. His fingers are mostly gone and he often 
gets sick. A good many people in his condition would 
just give up, but not he. 

The Sunday I was there we had morning service on 
the open porch of the clinic building. The Indian 
people love music, and these leprosy patients had 
their simple little band, a drum and two or three other 
pieces. When it came time to begin, the drummer 
wasn't there. Then I saw this man slip quietly over to 
the drum, pick up the drumsticks somehow in his 
stumps of hands, and fall right in with the music. 
When the regular drummer came he quietly sur- 
rendered the drumsticks. Dr. Goheen whispered to 
me that that was the sort of helpful little thing he 
was always doing. It wasn't much, to be sure. But it 
was true to form. It showed his thoughtful, ready 
spirit. This man whose life seemed so forlorn and 
hopeless had found something that gave him a spirit 
strong enough to rise above his suffering. He was down 
but not out. When I think of him I don't remember 
his poor remnants of hands and feet and his sick- 
looking face, but I think of something fine and radiant 
about him, which has helped me. 

At that same hospital for lepers is a lovely, motherly 



WORKING WITH THE GOOD PHYSICIAN 159 

woman, who was a cured case some years ago. She 
could have gone away. After living with sad and 
tragic-looking people most of us would have liked to 
get away. But, because she had come to feel at home 
there, and to love the people, and had found how to 
be of service, she stayed on. She is mother and sister 
to all the women patients, and a beautiful influence 
in the whole place. To say that she had been cured of 
leprosy in that hospital would only be the beginning 
of the story of what had happened to her there. 

When I was in Hwai Yuen, China, some years ago, 
I went up on the mountain above the mission hos- 
pital. There is a magnificent view from there of the 
plains and of the two rivers that come together at the 
city. Up on this picturesque height is an old Chinese 
shrine, which used to be a very sacred place. As we 
looked out over the scene they told me a tale that had 
to do with another shrine and with Dr. Samuel 
Cochran, who had been the doctor at the hospital. 

Dr. Cochran began his work in Hwai Yuen over 
thirty years ago, when the Chinese there had not 
learned very much about foreigners and always called 
them "foreign devils/* But the friendliness of the 
hospital and Dr. Cochran's skill and spirit soon made 
a new impression. 

One day he fell desperately sick with typhus fever. 
Word went out in Hwai Yuen that the foreign doctor, 
their good friend, was critically ill. What do you sup- 
pose happened? A number of the substantial citizens 
of the town got together and went to the temple of 



160 HOW FAR TO THE NEAREST DOCTOR? 



the city god to make petitions for his life. Theirs were 
no ordinary prayers. Solemnly before their god they 
said, "Shorten each one of our lives by a year, and let 
Dr. Cochran's life be spared." That voluntary con- 
tribution of a year of life may sound fantastic to you 
and me, but to them it was a serious matter. They 
were prompted to sacrifice for their friend who had 
spent his life sacrificing for them and their people. 
Fortunately Dr. Cochran got well, and put in many 
more years of usefulness in China. 

Of course, there are great numbers of people 
thousands of them who come and go through mis- 
sion hospitals and seem not to be influenced in any 
way. They may not be changed at all. We have to, ex- 
pect that. But we never know what thoughts they may 
be thinking, and what different attitudes they may 
take in the future, and what they will say when 
Christianity and Christians are discussed by their kins- 
men and companions back in their villages. 

When something happens in a life at a Christian 
hospital, there is no telling how many more people 
will be influenced by that life. Here is an instance 
from Africa. Bekali Mendom was one of the first of 
his tribe to become a Christian. A missionary speaks 
of his "ugly, tender, beautiful, never-to-be-forgotten 
face." Someone else writes: "His zeal for the work and 
for winning men to Christ was like a flame. After an 
operation, he was placed in the midst of the most 
hardened characters in the hospital. While he was re- 



WORKING WITH THE GOOD PHYSICIAN 161 

covering, he led nearly every man about his bed to 
Christ." 

You wouldn't expect one of the fierce Boxers of 
China, who back in 1900 was killing foreigners, to be 
so touched by the way certain Christians met their 
death during the Boxer trouble, that years later he 
became a Christian himself. But this very thing hap- 
pened, A coarse, hateful, murderous man became a 
great Christian leader, because he had been impressed 
by the spirit in which those martyrs had died. 

Dr. Walter Judd, who had such critical experiences 
in China a few years ago, tells of one of these inci- 
dents, when the interior town in which his hospital 
was located fell into the hands of bandits. 

I was under surveillance in a sort of polite captivity 
for several months last year, in the hands of the most 
cruel, vicious man I ever saw. Every country has good 
men and women, and every country has bad men and 
women. This bandit chief, Lu Hsin Ming, was a terrible 
man. He was ignorant and uneducated, to be sure; but 
believe me, a man who can hold out as the head of a 
band of eight or nine hundred bandits has force of char- 
acter. The survival of the fittest is a real struggle. He 
captured our city in 1930 when the government troops 
were withdrawn to put down a major revolt in the North. 
As long as he was in the city and allowed to get the taxes 
legally, he would rather do it legally or with the pre- 
tense of legality and with orderliness. As long as I at- 
tended to my business and took care of his sick men and 
didn't make any effort to escape, they interfered very 
little with my usual routine. 

Fortunately, for me, he got a bad conjunctivitis and 



162 HOW FAR TO THE NEAREST DOCTOR* 

took Chinese medicine and got worse. He came to me, 
and I was able to clear it up quickly, so it put him to a 
certain degree under obligation to me. That went along 
through August and September and October. The fight- 
ing in the North finished in October, and the government 
started to send good troops back down to the South. We 
knew we were headed for trouble. 

In October I had my forty-fourth attack of malignant 
malaria. , . . I picked up strength and along about the 
first of December got around a little bit. . . . Then word 
came that Nanking troops, the 56th Nationalist Army, 
were being sent down to take over the district, and this 
bandit group would be driven out. The last of December 
was hard going. Everybody knew what would happen. 
They would take me and hold me for ransom, because 
they needed a doctor and needed money. . . . 

On the afternoon before New Year's Day at about one 
o'clock came a secretary from the bandit headquarters. 
He was a very good friend of mine but he had no influ- 
ence. He said, "Doctor, they are going to leave tonight. 
The new troops are twenty miles away, and we are going 
to move out. They are going to take you. I heard them 
talking about it. And they are going to take women, take 
people for ransom, and loot the city tonight." I knew 
what would happen to me in two days of exposure in 
the middle of the winter, in that weakened physical con- 
dition. But at seven o'clock that evening Lu Hsin Ming 
himself carne into my dispensary, sat down, and, without 
preliminaries,, said, "Dr. Judd, we are leaving tonight. I 
was going to take you along, as you know. I am not go- 
ing to do it now. You have been fair with us and have 
taken care of us in the hospital here, and I know you are 
not getting any money out of it. I don't see why you do it. 
You have been sick yourself. If you had to live the way 
we all have to live, up on the hills in the middle of win- 



WORKING WITH THE GOOD PHYSICIAN 163 

ter, you wouldn't live long. I know it. Hence I am not 
going to take you. How much do we owe the hospital?" 
He ps Id the hospital $170 and went out. In the middle 
of the night, at two o'clock when the shops were all 
closed, sc> that his men couldn't loot and he could control 
them betiter, he left. He took not a man or woman cap- 
tive. . . .; He could not do what he had planned. Some- 
thing had happened to Lu Hsin Ming. He could not do 
it. If Goo can change the heart of such a man, he can 
change anybody. The way of love works. 

After al ! that has been said about the healing work 
of Christia n doctors and missions; after we have fol- 
lowed the pioneer across deserts, through forests and 
over mountains; after we have watched the life-giving 
work of the hospitals; after we have seen the toiling 
search for the deadly germ, and then the application 
of this knowledge to prevent suffering and tragedy; 
after we have met the fine young men and women who 
are developing into responsible workers for their own 
lands; after all this, we can imagine no higher tribute 
to the work of Christian doctors and nurses than that 
of a simple Korean woman patient who said: 

"If the Jesus doctrine makes folks treat others as 
you have treated me, I want to follow the Jesus way." 



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