Doctors at My Home

Motion-impaired needy people in Zhuolan, northern Taiwan, long for the monthly visits of Tzu Chi medical volunteers.

TIMA volunteers sing for an elderly man before they conclude their monthly visit to his home.

When 74-year-old Xu, who lives in Zhuo-lan, Miaoli, northern Taiwan, heard vehicles pulling into his front yard, he shouted loudly to let the visitors know that he was inside. The last thing that he wanted was for the visitors to turn around and leave because they thought nobody was home. He had wanted to see them for some time, but he was unable to go out to meet them because he was bedridden. A stroke 18 years before had almost completely paralyzed his left side.

Before, when the visitors called on Xu on their monthly visit, his wife was always waiting for them in the family living room, but she was nowhere to be seen on this day. Followed by a group of Tzu Chi volunteers, Dr. Ji Bang-jie (紀邦杰), head of the Taichung chapter of the Tzu Chi International Medical Association (TIMA), walked through the open door of Xu’s house before entering a dark room in which Xu was lying in a bed. The doctor handed some homemade bread to the old man and asked him where his wife was.

Xu told Dr. Ji that his daughter had placed his wife in a nursing home a couple of weeks before. The news surprised the visitors even though they knew that Mrs. Xu had dementia, diabetes, and Parkinson’s disease. Xu explained that she had often fallen since their last visit. Concerned about her safety, their daughter decided to put her in a rest home.

“Who takes care of your meals now?” Ji asked. In spite of her illnesses, Mrs. Xu was able to cook for her husband before she was sent away.

“My friend A-kai does,” Xu replied. He added that A-kai also came by regularly to help him go to the bathroom and that a government care provider visited him three times a week to bathe him. Xu’s reply made Ji feel a little better.

Xu used his right arm and leg to wiggle himself toward the edge of his bed. Doctors Ji and Zhuo Xi-bin (卓錫彬) and other volunteers immediately stepped forward and helped him into a wheelchair.

Nurse Su Wei-ling (蘇瑋苓) checked Xu’s blood pressure and found the readings to be within the normal range. After recording the numbers, the nurse sat down by Xu and told him to use his right foot to pull his left foot toward himself and count to five. She then held his right leg, straightened it, put the foot flat on the floor, and counted to ten. She repeated the exercises a few times more. All along, Xu did as he was told and he counted with her.

Su was concerned that Xu’s left arm and leg would wither further from disuse and that his right arm and leg might be injured from overuse, so she showed him a few exercises that he could do himself without help.

It is important for stroke patients to avoid a sedentary lifestyle. The more sedentary they are, the worse their blood circulation and the faster their deterioration. Su hopes to help patients like Xu by sharing her expertise with them, and she always encourages them to exercise more. “Our encouragement helps keep them going,” said the nurse.

Before the volunteers concluded the visit, Su reminded Xu again to be sure to do the rehab exercises three times a day. Xu said he would do his best. He went on to say that he might no longer be here when the volunteers came back in a month. Now his daughter had found a good nursing home for his wife, she would put him into that same home. “It’s better to have people take care of you,” said Dr. Zhuo, who had come to this house to see Xu almost every month for two years now. 

Dr. Zhuo Xi-bin (right) leads other TIMA volunteers to their next destination in Zhuolan, where Zhuo has a private practice.

 Zhuolan, a land of fruit

Many residents in Zhuolan are fruit farmers. As the TIMA volunteers traveled by car to the homes of the other people they had come to see, they saw pear orchards all along the road. Many small bags were tied to branches of the pear trees; in each bag was a pear, formed, growing, but not yet harvest-ready. The bags kept the ripening fruit out of the reach of hungry birds or insects searching for their next meal.

Bagging young fruit is but one of the backbreaking tasks that fruit farmers have to carry out. Another task is grafting—inserting one scion onto one stock in the hope of producing one marketable fruit. Performing these and many other needed tasks are hard enough when the farmer can stand on a level surface, but some fruit trees in Zhuolan, a mountainous area, are planted on steep slopes. This greatly increases the difficulty of the farmers’ work and forces them to distort their bodies into odd shapes in order to hold their footing enough to tend to the trees.

Prolonged hard labor often takes its toll, leaving indelible markings or irreversible consequences on the laborer. Huang, an elderly local woman, had some such markings. After years of farming in an ergonomically unfriendly environment, she suffered from severe varicose veins in her legs, and her ten toes were bent so out of shape that she couldn’t even wear flip-flops without making her toes chafed and bleeding.

Su Wei-ling knelt down beside Huang and carefully examined her feet, which were covered in lesions. The nurse told the old woman to soak her feet in warm water up to her calves every night and dry them with a towel. Because Huang spoke only the Hakka dialect and very limited Mandarin, Su talked to her through an interpreter, volunteer Cai Qin-sheng (蔡欽盛).

Su asked Huang’s son, who lived in Kaohsiung, southern Taiwan, but who happened to be home on vacation, to fetch a pail of warm water. Then she asked Huang to put her feet in the pail and expand and contract her toes, counting to ten each time as they went. After Huang had repeated the exercises several times, Su took her feet out of the pail, put them on a stool, and dried them off with a towel. She even held Huang’s toes apart so that she could reach and dry the space in between. “If the space between toes isn’t properly dried,” Su explained, “it becomes wet and warm, a hospitable breeding ground for germs. In a serious scenario it could lead to cellulitis.”

Huang’s children all lived elsewhere, so they could not help care for their mother. Fortunately, Huang was still quite mobile, so, before leaving, Su urged her to do what she had just taught her every day to help with her blood circulation and ease her symptoms of varicose veins.

Nurse Su Wei-ling (center) uses a towel to dry Huang’s feet, even between the toes, after showing her how to soak her legs in warm water.

Refusing to give up

The volunteers moved on to another home to see Li, who was hard of hearing. Dr. Ji had called her son ahead of time to make sure that she would be home for their visit.

Upon arriving, volunteer Cai Qin-sheng called out loudly in Hakka, but no one answered the door. Cai walked around the house, yelling into every window that he saw.

Li was a farmer for most of her life. Cai first met her three years before. At around that time, she had had a dispute with the county government over her farmland. Consequently, she shunned all contacts with the outside world, including Tzu Chi volunteers, but the volunteers continued to come to her home all the same. One year later, she still would not talk to them, but she was at least willing to let them into her home.

As he circled the house, Cai knew that Li was inside, so he kept calling out for her. Finally, the door opened.

The volunteers went inside and found that Li had had a bad cold. They could hear the mucus in her throat as she breathed. Cai sat down next to her and talked into her ear: “Have you taken cold medicine?” She answered in one word: “Yes.” Considering her usual reticence, that terse answer went a long way toward making Cai very happy.

“I just know that the passion of our volunteers absolutely can melt down the wall that anyone may have built to keep others out and herself in,” Cai said, looking at the old woman. Amid the conversation the volunteers were carrying on, Li finally broke into a broad smile, the hard lines on her face softening. Cai was overjoyed.

A free clinic at the community center

Besides visiting people with limited mobility at their homes, volunteers also conducted a free clinic at a local community center where treatments in internal medicine, dentistry, and traditional Chinese medicine were offered. Volunteer Huang Yi-qing (黃億青) provided complimentary haircuts for the underserved there. The event went on for the whole morning and attracted many townsfolk. It was a big change from the usual quietness in this mountain community.

Getting medical care is a big challenge for mobility-restricted people who have no family to take them around, especially in a mountain area like Zhuolan. The TIMA volunteers who visit the town every month must be a sight for sore eyes for many local residents. 

Dr. Li Yong-pan (李永磐) examines a patient at a free clinic at a community center in Zhuolan. Liu Sheng-jue


July 2018