Healthcare at Their Doorstep

By Zhu Xiu-lian (朱秀蓮) and Lin Jing-jun (林靜君)
Translated by Siri Su (蘇錦琍)
Photos by Hsiao Yiu-hwa (蕭耀華)

Healthcare at Their Doorstep

By Zhu Xiu-lian (朱秀蓮) and Lin Jing-jun (林靜君)
Translated by Siri Su (蘇錦琍)
Photos by Hsiao Yiu-hwa (蕭耀華)

Volunteers conduct health checkups in Rahul Nagar, taking blood pressure, measuring height and weight, and offering urine tests.

During his quest for enlightenment, the Buddha is believed to have practiced asceticism in a cave on Pragbodhi Hill, near Bodh Gaya. At the foot of the hill are several villages, including Rahul Nagar, home to around 300 households.

Many families in Rahul Nagar raise cows and sheep. Most villagers follow the Hindu faith and consider cows sacred. Consequently, they do not raise cows for meat but primarily for milk production, assistance with farming tasks, and the creation of cow dung cakes. (Cow dung cakes are a type of biofuel, made by mixing dung with hay, then letting the mixture dry until it is hard.)

Moringa trees provide abundant shade outdoors in the village, and wheat stalks hang heavy and full before harvest. The sounds of chickens and dogs mingle, while cows and sheep roam freely. Residents, adults and children alike, bathe openly in the fresh air, lending a carefree ambiance to the village. It feels like a place disconnected from the modern world.

One day, several strangers entered the village, drawing curious villagers to gather and observe. Some children extended their hands to them, asking for things. These strangers were Tzu Chi volunteers.

For over a year, Tzu Chi has been conducting health checkups in villages in and near Bodh Gaya. Rahul Nagar is the ninth village to receive these services. Similar checkups have been done for monks from 12 temples and teachers from eight schools. The checkups include measuring villagers' height, weight, and blood pressure, as well as administering urine tests for protein, occult blood, and glucose. If abnormalities are found, medical referral forms are filled out for villagers to seek treatment at a community health center in Bodh Gaya. If a resident's body mass index falls below 16, they are provided with beans or milk to improve their nutrition.

Volunteers conduct door-to-door visits for these medical efforts and establish "Tzu Chi house numbers." Lim Kim Yan, a retired nurse from Singapore staying long-term in Bodh Gaya, created this house-number system after noticing the lack of doorplates and addresses in local villages. Recycled cardboard is used to make doorplates carrying Tzu Chi house numbers. The results of the checkups are entered into a computer and organized by house number. This allows health data to be easily accessed to monitor long-term health conditions.

India's summers are often unbearably hot, with temperatures soaring past 40°C (104°F). Some asked Lim why she didn't just choose a fixed location where villagers could go to receive checkups, instead of going door-to-door. She explained, "I prefer to go house-to-house because it allows me to get a better understanding of their living conditions and family situations. The information I gather can be shared with our charity team to offer further assistance if needed." Plus, Lim doesn't mind the added workload. Helping one more villager regain their health means they can better fulfill their responsibilities, preventing their family from falling into poverty. These thoughts keep her going.

Volunteer Lim Kim Yan creates hand-drawn maps of the households she visits and establishes "Tzu Chi house numbers" to facilitate further care in villages without doorplates.

Door-to-door dedication

Tan Siew Choo (陳秀珠), who worked with Lim Kim Yan at the Tzu Chi Day Rehabilitation Centre in Singapore for several years, commended Lim's decisiveness in handling matters and attributed this quality to her early experience as a nurse in the operating room. "She later worked as deputy director for Tzu Chi Singapore's Western medicine department, responsible for the family clinic and home care," Tan said of Lim. "She is applying her years of experience here [in India]." Tan added that Lim has strong willpower—when faced with problems, she always finds a way to overcome them instead of giving up easily. "This is something I need to learn from her," Tan asserted.

Lim is turning 72 this July. Since March 2023, she has spent most of her time in Bodh Gaya, dedicating herself to Tzu Chi's mission there. Inspired by her commitment to serving the local needy, Tan decided to follow her to India. Sometimes, when Lim visits villages to conduct health checkups, Tan accompanies patients to their appointments or follow-ups. The two of them make a great team, seamlessly working together and sharing the workload.

Going door-to-door to conduct health checkups has allowed Tan to better understand the local living conditions. She particularly empathizes with the local women. Coming from Singapore, she said that women in Singapore are very fortunate, almost like living in paradise. "Many go out to work," she said, "but there are people to take care of their children." In contrast, "some women here, if their husbands are present, do not even dare to speak up." Since they can afford only simple meals, many rural women weigh less than 40 kilograms (88 pounds). Due to constant toil, women in their 40s and 50s appear as aged as those in their 60s or 70s.

Tan continued to talk about the local conditions. The climate is either too cold or too hot and tends to be dry. The Niranjana River often runs dry, so water for daily use is drawn directly from underground and used without filtration. Villagers burn branches, leaves, cow dung, and even plastic waste for cooking or heating, causing severe air pollution. Because residents believe it is unclean to relieve themselves at home, they prefer to walk some distance to the riverbed instead. This likely contributes to many not drinking enough water and suffering from kidney stones. Alcohol consumption also poses a problem for some villagers. Volunteers have striven to raise residents' awareness of the harm of alcohol. Some villagers have health conditions, but they refuse to seek treatment in government hospitals. "If only we had the help of trustworthy local doctors and nurses," Tan said. "They would be able to communicate more effectively with the villagers and help ensure that they receive timely medical treatment."

Supporting younger patients

Tan has accompanied several patients through their surgeries, experiencing a mix of joy and sorrow. "I was especially gratified by Mithun's recovery from his burns," said Tan. "He can now squat deeply, and his hair has grown back. He happily returned to school and is getting along well with his classmates."

Five-year-old Raju is another burn patient. He suffered facial burns, and his left-hand fingers were severely twisted. Last July, Tan and Lim took him and Mithun to Patna, the capital of Bihar, for surgeries and escorted them home when they were discharged from the hospital. Both children showed rare smiles at the time.

Raju's family was supposed to provide massages and rehabilitation for him after his surgery, but they neglected to do so, leaving his fingers stiff. When Tan visited the village of Bakraur at the end of March to advise villagers to choose tea over alcohol, she coincidentally met Raju. When she held up his hand to check, she noticed that it was still deformed. Tears instantly welled up in her eyes.

Tetari Kumari, 20, is another patient Tan has helped. When Tzu Chi volunteers first met her in May 2023, her right leg had been amputated from the ankle down due to a congenital illness. Despite the surgery, her leg swelled to the size of an elephant's leg, a condition she endured for several years due to her impoverished family's inability to address it. Volunteers stepped in and arranged for her to undergo another amputation surgery. Following the procedure, they tended to her surgical wound, changing her dressings every other day for over three months. Finally, on January 22 of this year, she was fitted with a prosthetic leg.

It wasn't all smooth sailing after that, however. Tetari's eagerness to walk led to prolonged use of the prosthetic; that, coupled with a lack of sensation in her right leg, resulted in skin breakdown. Volunteers resumed wound care for her, provided a lightweight crutch, and offered exercises to strengthen her leg muscles while waiting for her skin to heal and thicken enough for her to wear the prosthesis again.

Tan first arrived in Bodh Gaya in May last year. After spending three months there, she returned to Singapore. When she woke up the morning after her return and saw her comfortable room, she thought about the villagers in India and broke into tears. "Observing the challenges faced by some patients in India, I wished I were a miracle-working doctor who could alleviate their suffering," she said. "Although I can't provide medical treatment, I can offer them comfort."

Persistence brings hope. Tan recognizes that immediately transforming the lives of the underprivileged people in Bodh Gaya may be impossible, but she remains optimistic, saying, "We hope everyone can see some improvement." She doesn't expect luxury for those living in the sacred place of the Buddha's enlightenment but hopes they can at least have enough to eat, better sanitation, and healthier, more dignified lives. If these goals are attained, it would undoubtedly bring solace to the Buddha.