Mongol Derby 2015 - Experiences from the Steppe
She was, I reckon, around 50 years old, but her weathered hands and face displayed a life well lived beyond those years. After hearing there was a doctor in the Ger, many locals had attended for a “check up”. This consisted of a blood pressure check, a listen to their heart and a resounding thumbs up, telling them they had the heart of a “Mori” (horse). But this matriarch had some symptoms.
She proceeded, through my interpreter, to explain that she had chest pain. Yes, when asked, indirectly, it was like a weight. Yes, again, it occurred when she was active and went away when she rested. Yes, she felt more fatigued than usual and occasionally got short of breath.
Sounded like angina, I thought. And this is suddenly where your isolation becomes acute. My links to the western world were actually pretty good so far. There was the 4 wheel drive, an interpreter, snacks from the local “soum” or village, and sat phone coverage for most of the time. But here…. now….. I became stuck. The nearest hospital was 900 km away and even then it was not free. Cardiac angiography is not exactly available to everyone. I guess I could give her an aspirin. I could spare 7 days’ worth from the riders’ kit but what would happen after that?
So in a desperate grab at some validation of my years of doctoring, I decided I should at least explain her condition to her. Involve the patient in their own care, yeah? So I asked my interpreter to translate the following.
“The arteries in your heart could be blocked. They take oxygen, or air, to the heart muscle so it can pump well. You know, like when your plumbing gets blocked…..”
And it hit me. The woman I was talking to, about a condition I could do nothing about, had never seen plumbing.
The Mongolian Steppe people move their ger at least once a year. It is a type of large nomadic tent, beautiful in its simplicity and so homely. But their water comes from a well or stream, and their toilet is wherever they dig it. So explaining angina through the analogy of plumbing is not really going to help this wonderful woman understand a thing. So I handed over a weeks’ worth of aspirin, told her to try to see a local doctor when she could and to try and take it easy. How the hell, I thought, could she take it easy? But anyway….
And just to really make me feel humble, she held my hand, thanked me profusely for seeing her and gave me a bag of cured yogurt curd, a delicacy that would often have pride of place in the family larder.
There is an easy joy to the Mongolian people and a humility born from a life with no guarantees. I thoroughly recommend you experience it for yourselves.