Thus I Saw and Experienced

A plastic surgeon, a Chinese medicine doctor, and a pharmacist shared their experiences of volunteering at Tzu Chi free medical clinics in May 2019 in Mozambique.


Healing the Land That Nurtures Me

By Xie Ming-fang

Translated by Wu Hsiao-ting

Photo by Cai Kai-fan


When it comes to transforming lives, education is a very important step. Only with a successful education will people have the ability to prevent diseases and do other things to change their countries for the better.—Honda Hsu, M.D., Department of Plastic Surgery, Dalin Tzu Chi Hospital

The weather was a little cool when he woke up in the morning. A light breeze wafted the smell of burning wood to him and warmed his heart. “That smells so familiar,” said Dr. Honda Hsu (許宏達). “I’m home.”

Hsu immigrated to South Africa from Taiwan when he was eight. He went to school and later practiced medicine there too. He returned to Taiwan when he was nearly 30 years old, but because his formative years and early adulthood were spent in South Africa, he always thought of himself as a South African.

Now, 20 years after having moved back to Taiwan, he again stepped onto the soil of Africa, the land that had nurtured and nourished him. Back on the African continent, his childhood memories flooded back to him. It wasn’t South Africa to which he returned this time, but Mozambique. Even so, the familiar aroma of burning wood—a common smell in Africa—brought on a rush of homesickness.

Hsu was in Mozambique to participate in several free clinic events that Tzu Chi was holding for survivors of Cyclone Idai. “The land of Africa gave me so much, and yet I can only repay it a little,” he said. He thanked his colleagues at Dalin Tzu Chi Hospital, in southern Taiwan, for changing shifts with him so that he could take part in this medical mission.

His heart ached for the local people as he volunteered at the free clinic sites. It had been 20 years since he had left Africa, and yet residents there were still plagued by many of the same contagious diseases, such as AIDS. Hsu believed that inadequate basic education was the culprit. Without a proper understanding of the diseases and the hygienic conditions required to prevent their spread, such infectious diseases would always be present. He had noticed, for instance, that many African residents suffer from sexually transmitted diseases, while people in Taiwan rarely do. He reasoned that this was likely the result of inadequate education.

“About 40 percent of the population in Africa are children,” Hsu noted. “We need to start by educating these children to bring about a positive change; only with a successful education will they have the ability to prevent the spread of infectious diseases.”

It takes a long-term plan to transform Africa. “Master Cheng Yen has decided to build schools there—this is a very important first step,” Hsu commented. He sincerely hopes that every child in Africa can have access to education so that they can change their countries for the better.

Deciding not to become a pediatrician

Hsu couldn’t communicate directly with his patients at the free clinics due to the language barrier. Thankfully, local medical students served as interpreters and bridged the gap. There was such a huge turnout of patients every day that a doctor specializing in one area of medicine had to see patients seeking help in other areas too. Though Hsu is a plastic surgeon, he saw patients coming for services in internal medicine, surgery, OB/GYN, or pediatrics as well. Hsu was glad that he had the experience of practicing in South Africa and so he had no difficulty attending to the various needs of the patients that came to him.

On the first day of their free clinic service, a five-year-old girl showed up with a cut next to her brow. A friend had accidentally hit her with a stone when they were playing. Hsu and other medical professionals treated the girl and stitched up the cut. The girl barely registered a reaction when a shot of anesthesia was administered to anesthetize the area to be sewn up. “A shot of anesthesia is actually quite painful, but she didn’t even cry,” Hsu said, “and she was very cooperative when we sewed her up. She was really brave.” The physician declared that if it were his daughter going through the same procedure, she would have wailed and howled uncontrollably. He was impressed by the resilience of African children and their willingness to submit to what came their way.

Hsu’s heart grew heavy when he saw some children with large bellies. He said that all they had to eat was cornmeal, a local staple food. A diet like that over time leads to malnutrition and a deficiency of protein. As a result, fluid builds up in the abdomen, giving rise to an expanded belly.

The sight of these children brought to his mind an incident that had happened to him when he was an intern in South Africa. One time he went to the countryside to serve, and a child that was just skin and bones was delivered to them to treat. Early one morning, a nurse came to him in a panic and told him the child had stopped breathing. Everyone rushed to give the child first aid. The attending physician came too, but then he just said, “No need to save him.” “Why?” Hsu asked in puzzlement. “He died of starvation,” came the reply.

The attending physician’s reply induced in Hsu a profound sadness. Having always loved children, he decided right then not to become a pediatrician. “Because there wasn’t really much we could do for them.” Thinking back on this episode, Hsu’s eyes grew red with tears.

After he returned to Taiwan from Africa, Hsu worked at Hualien Tzu Chi Hospital, in eastern Taiwan, before transferring to Dalin Tzu Chi Hospital, where he still works. Besides working at those hospitals, he often volunteered at free clinics and conducted home visits to the needy too. About serving the underprivileged, he humbly states: “I’m just doing what I should do.”

Hsu had taken part in Tzu Chi free clinics in Indonesia, China, and other places, but that trip to Mozambique felt very different to him. “I felt I was going home to serve people in the land that had nurtured me.” When he heard Master Cheng Yen’s pledge to transform the lives of Africans, he decided he would always do what he could to support this meaningful undertaking.


Providing Stimuli, Enhancing Healing

By Zhang Li-yun

Abridged and translated by Wu Hsiao-ting

Photos by Cai Kai-fan

Acupuncture, cupping therapy, and gua sha (scraping the skin to cause tissue damage) work by enhancing the body’s ability to repair itself by causing slight disturbances to the body. It’s just like delivering aid to Mozambique after it was hit by Cyclone Idai. The most important thing is to awaken the land’s ability to heal itself by providing stimuli to it.—Dr. Cheng I-che, Department of Traditional Chinese Medicine, Taichung Tzu Chi Hospital

Dr. Cheng I-che gives acupuncture treatment to a patient under a mango tree at the Tzu Chi Home in Maputo. Zhang Mei-ling

This was the first time that most members of the Tzu Chi medical team who went to Mozambique to provide free clinics for victims of Cyclone Idai had practiced medicine in Africa. Cyclone Idai not only caused heavy losses of human lives and property, but also a surge of infectious diseases in Mozambique. The prevalence of AIDS and tuberculosis further added to the challenges faced by the medical volunteers. Everyone was therefore extra careful and on their toes.

Many specialties were covered in the free clinics, and there was an abundant supply of medicine and nutritional supplements too. However, the medical conditions the doctors encountered at the venues spanned such a weird and wild range that the western medicine available was unable to cope with them all. Fortunately, traditional Chinese medicine (TCM) treatments filled in where western medicine fell short.

Many Mozambicans had never seen a doctor in their entire lives, not to mention a TCM doctor. How would they react when they saw a long acupuncture needle being pushed into them? Dr. Cheng I-che (鄭宜哲), from the Department of Traditional Chinese Medicine, Taichung Tzu Chi Hospital, in central Taiwan, had his way of handling patients’ fear of the treatment. He had participated in Tzu Chi free clinic services in Sri Lanka before, and his experiences there helped him treat reluctant patients in Mozambique.

Actually, at first the most frightened and nervous people weren’t the patients, but the college students who were interpreting for Cheng. They kept asking him, “Shouldn’t we explain to the patient first what you’re going to do to him/her?” Doing so had occurred to Cheng, but then he had second thoughts. After all, fear of acupuncture is not limited to people unfamiliar with this kind of treatment; even those who know acupuncture can be unnerved by it too.

In Taiwan, when medical workers are giving patients a shot, they often tell them to take a deep breath. Faced with African patients who didn’t speak the same language as he did, Cheng resorted to saying, “One—two—three” to mentally prepare them before applying a needle as fast as he could.

To reduce the patient’s anxiety, Cheng would first apply needles to places out of their line of vision. He would also go first for the acupuncture points that usually hurt less when a needle is applied. Doing so would gently ease the patient into the experience. When the patient was more comfortable with the treatment, he then moved on to the areas that were more likely to unnerve them or hurt more. If a patient had an insurmountable fear of needles, he tried to cut down on the number that he used.

Although some people are so afraid of needles that acupuncture triggers reactions like nausea, dizziness, or panic, Cheng’s patients responded well to the treatment. “I administered acupuncture to nearly 200 people during the four free clinics, and no one felt unwell due to fear of the treatment,” he said.

There are more than ten dialects in Mozambique. Over a hundred college students volunteered to interpret for the Tzu Chi doctors at the four free clinics. This afforded Dr. Cheng with a good opportunity to share ideas and talk about Tzu Chi with local young people.

The mysteries of the human body

Mozambique is not an English-speaking country, and so the Tzu Chi medical team, coming from Taiwan, the United States, and Australia, had to rely on local college or medical school students to interpret for them. Many of the students asked Cheng how acupuncture works, especially after they saw a fair number of patients who had come to the clinic looking very unwell leave with smiles on their faces.

Cheng answered by first asking the students, “Can a country be powerful if its rich people are very rich but poor people very poor?”

“No!” the students replied.

Cheng continued: “How then can we make this country more powerful? Is it by asking the rich people to reach out and help the underprivileged? This is how acupuncture works in the human body.”

The doctor explained that under normal circumstances it is difficult for acupuncture to produce extra energy for the body. Instead, acupuncture works by taking advantage of the body’s own resources; it induces the flow of qi (often translated as “energy”) to boost the body’s natural healing abilities. It reminds the body that some part of it is having issues, and it thus triggers the body’s ability to repair itself. Acupuncture can also move qi from one area of the body to another in order to help the healing.

Many other TCM treatment methods work the same way—for example, cupping therapy, gua sha (scraping the skin to cause tissue damage), and bloodletting. On the surface these treatment methods look like they cause damage to the body, but in reality they enhance the body’s ability to heal itself by causing slight disturbances to the body.

Cheng further explained that cupping therapy and gua sha might damage capillaries on the surface of the skin, but at the same time the body’s immune system and white blood vessels are quickly activated to repair the damage and help stiff muscles become softer. The oxygen contained in the blood that flows to the brain increases, which makes a person feel instantly refreshed and energized.

Cheng said that it was like Mozambique being hit by Cyclone Idai. Though the storm caused damage to the country, it also brought in help from Europe, the United States, or even Taiwan, which are thousands of miles away. This outside help worked like acupuncture, cupping therapy, or gua sha; it helped the land heal itself by providing stimuli. Tzu Chi’s aid to the country has, for example, brought forth an outpouring of native volunteers. These volunteers have allowed love to spread to more people. With local people helping themselves and each other, the land will recover much more quickly and grow even stronger.

“Outside help is just a temporary stimulus,” Cheng declared. “The most important thing is to awaken the land’s ability to heal itself.”

Elina Esmael Matavele (left), a Tzu Chi volunteer in Mozambique, passed out because of high blood pressure when she was volunteering at the free clinic held at the Tzu Chi Home. After Dr. Cheng treated her with bloodletting, she returned to consciousness with her blood pressure back to normal.

Bodhi tree forest

The last free clinic was held in Maputo at the Tzu Chi Home, which occupies an area of over three hectares. More than 90 mango trees grew there; there were also heavily laden lemon trees on the lot.

The Tzu Chi doctors treated patients under the mango trees. Working outdoors, Cheng felt energetic and cheerful. The scene brought to his mind the story of a famous ancient Chinese doctor—Dong Feng (董奉, 220-280). Although Dong was known for his superb medical skills, he never charged his patients for his services. Instead, he asked those that he had cured of serious illnesses to plant five apricot trees near his house and those cured of minor ailments to plant a single such tree. A few years later, the trees had grown into a large, lush forest. The doctor built a place to store the fruit that had been harvested from the trees. If people wanted any of the apricots, they could bring him rice in exchange for the fruit. Dong would then give the rice to people in need.

Cheng found a parallel between this story and that of Denise Tsai (蔡岱霖). Tsai, originally from Taiwan, moved to Mozambique after she married a Mozambican. She was the first Tzu Chi volunteer in the country. Spreading the Great Love spirit espoused by Master Cheng Yen to people in Mozambique, she has inspired many to join Tzu Chi and do charity work. Symbolically, it is like a single bodhi seed—Tsai—has led to the formation of a large forest of bodhi trees. [The bodhi tree is an important icon in Buddhism. The Buddha is believed to have attained enlightenment under a bodhi tree.]

Cheng said that the free clinics were opportunities to trigger more “energy” for this country. He hoped that the next time he visits, the ranks of people who have joined in to do good will have grown even larger.


Not Just Dispensing Medicine but Passing on Experience

By Hong Shu-zhen and Wu Xiu-ling

Translated by George Chen

Despite the challenges of working in temporary, makeshift pharmacies, we managed to dispense 5,000 prescriptions in four days. We were also able to pass on our knowledge and experience to local medical students. Thinking about the needy I’ve served at every free clinic always reminds me to seize every opportunity I can to give to the underserved.—Pharmacist Wang Zhi-min, Tainan

Several medical school students from the Catholic University of Mozambique learned and helped out at the pharmacy at the free clinic held at the school. Wang Zhi-min (fifth from left) generously shared his medicine-dispensing experience and expertise with the students. Zhang Mei-ling

The moon was bright and clear at night in Mozambique. At dawn, the sunrise was breathtaking. During the day, the blue sky and white clouds reflected in a lotus pond were so picturesque they stopped people in their tracks.

In contrast, the huts people lived in were simple and crude. School classrooms were shabby and makeshift, cooking utensils were primitive, and even the footballs the children played with were nothing more than plastic bags tied together.

Despite the difficult living conditions, the children were endearingly innocent and the villagers optimistic and cheerful. When they saw the Tzu Chi volunteers who had come to their area to provide free medical services, they surrounded the visitors with laughter and singing.

Pharmacist Wang Zhi-min (王智民), a Tzu Chi volunteer from Tainan, southern Taiwan, set out for Mozambique on May 12, 2019. He was a member of a reconnaissance team whose duty was to conduct on-site inspections and prepare for four free clinic events that Tzu Chi was holding in Mozambique. He arrived in the country a few days earlier than most of the other medical volunteers, who wouldn’t arrive until May 18, and so he got to see and experience some more of Mozambique than his teammates.

During those few days, Wang was able to witness and share the joy of a little girl who had just received new notebooks from Tzu Chi. He saw how a single pot of cornmeal was what an entire family had to share for their dinner. He watched while boys in Lamego village, Nhamatanda, played football—with a “football” made of layers of plastic bags tied together. From such direct interactions, Wang could empathize more with the villagers whose already difficult lives had been made harder by the onslaught of Cyclone Idai.

Pharmacy as classroom

The pharmacy was always very busy during the free clinics. At the clinic held at the Catholic University of Mozambique in Beira, six medical students who would graduate next year were sent by their professor to learn and help out. Wang explained to the students the prescriptions to be filled, imparting his knowledge to the future doctors. “Their professor hopes that they can learn what types of medicine doctors in Taiwan prescribe for their patients, and the role pharmacists in Taiwan play in the treatment process.”

The medical students made good use of this opportunity to learn. They said that they had learned a lot from the experience and that the knowledge they had acquired would be put to good use in the future. One of the students, Raposo, observed: “Many people have been plagued by infectious diseases as a result of the flooding. The antibiotics given by the Tzu Chi medical team are the best and can treat many diseases.” He thanked Tzu Chi volunteers for demonstrating their love to his country, and also for enabling him to gain more medical knowledge and clinical experience.

In preparation for the free clinics in Mozambique, pharmacists Wang and Chen Hong-yan (陳紅燕), as well as medical doctor Ye Tian-hao (葉添浩), designed a standardized prescription form so that doctors could prescribe medications more conveniently, and pharmacists could dispense medicine more quickly. As a result, almost 5,000 prescriptions were dispensed during the four large-scale free clinics, despite the limited manpower and immense time pressure.

These large operations were completed in challengingly simple environments. At the clinic conducted at a school in Lamego, the pharmacy was housed in a classroom whose roof had been blown off by the cyclone. A canvas was stretched over the room to serve as a makeshift roof. At the clinic at the Tzu Chi Home in Maputo, the pharmacy was made up of a few long tables under mango trees. Though the facilities were makeshift, the pharmacists prepared each prescription just as carefully as if they were working in a state-of-the-art pharmacy to relieve patients of their suffering.

Wang Zhi-min and Chen Hong-yan, two pharmacists, work in a makeshift pharmacy at a Tzu Chi free clinic conducted in Lamego village, Nhamatanda. Cai Kai-Fan

Education is most important

Wang’s parents are also Tzu Chi volunteers. Engaged in wholesale traditional Chinese medicine, they educated their children through their own behavior. For example, they never charged the poor for their purchases. When Wang was in junior high, he started participating in Tzu Chi activities with his parents. He was influenced by what he saw and heard, and he came to appreciate his blessings more from witnessing others’ suffering.

While studying at the Chia Nan College of Pharmacy (now the Chia Nan University of Pharmacy and Science), Wang met Cai Hui-hua (蔡慧樺), who later became his spouse. Together they started a pharmacy. With other business partners, they also set up a biotechnology company specializing in health food research and production. When Wang was the president of the Parents Association at Tainan Tzu Chi Elementary School, he often volunteered at Tzu Chi events. In 2015, he became a certified Tzu Chi volunteer. His wife followed in his footsteps and received her certification in 2017.

Wang has participated in six free clinic missions since he was certified more than three years ago—in Jordan, the Philippines, Cambodia, and Mozambique. The experience of serving the needy in medically underserved areas made him realize how blessed he is to live in Taiwan. He often shares his volunteer work experience with his children and encourages them to participate in public service activities.

Wang says that owning his own pharmacy and biotechnology company gives him more flexibility with his time and schedule. When he travels overseas to volunteer, he has managers to help him manage the company and his wife to run the pharmacy. Therefore, he can volunteer without worries. “My motivation to serve is pretty simple,” he declared. “I don’t want to miss out on any opportunity to form good affinities with others.”

He discovered during his trip to Mozambique that the people there were philosophical and accepting in nature. Despite losing their homes and loved ones to Cyclone Idai, they remained optimistic and positive. When they saw Tzu Chi volunteers coming from other countries to provide medical services to them, they welcomed them with sheer enthusiasm.

Another scene left an indelible mark on Wang during his trip. He and other volunteers were in Maputo purchasing medicine. They were waiting at an intersection for the traffic light to change when they saw a little boy, carrying a brush and a bottle of water, run to vehicles stopped at the traffic light, respectfully bow to the people in each car, and clean the windows. He would clean several cars during the short duration of the red light in the hope that some drivers would give him a tip.

Wang was saddened that a boy of such a young age had to do whatever he could to make money, and he pondered what his future would hold for him. He remembered Master Cheng Yen once said that the only way to help the poorest of the poor was through education—it was only through education that their lives could be turned around. The encounter with the young boy helped Wang gain a deeper appreciation of the Master’s compassionate and noble commitment to helping the needy.

Wang’s earlier free clinic trip to Jordan, on the other hand, stirred in him very different feelings. The Syrian refugees in Jordan had all been forced to leave their country. In addition to coping with the loss of their material possessions, they also lived in constant fear—even though they slept in tents at a refugee camp, they feared that a bomb might suddenly drop on them. Uprooted from their homes and country, they were like duckweed, having no root to anchor them.

“Just like now, whenever I talk about or think of what I saw and experienced in Jordan, I feel like crying,” Wang said, choking with emotion. “I feel a sense of helplessness, a despondence at not being able to help.” He added that the experience in Jordan had motivated him to do whatever he could to help whomever he could.

Despite the sadness he had felt in Jordan, there were some positive memories associated with the trip. An eight-year-old refugee girl named Lugain had been very short for her age due to a severe deficiency of growth hormone. She was referred to Tzu Chi Jordan for help. After learning about this, Wang found a supplier of hormone injections that would sell the medicine for a lower price. He purchased a year and a half’s worth of the medication and had it delivered to Jordan. After three months, Lugain grew from 104 centimeters to 114 centimeters, and she continues to make progress with the treatment.

Wang met Lugain during his trip to Jordan, in July 2018. He was deeply moved by her sweet smile and her mother’s gratitude. The joy of being able to help them warms his heart to this day.

That he can volunteer in free clinics in underserved areas as a pharmacist means a lot to him, and he has high expectations of himself. “The underprivileged people I’ve met serve as reminders that I have to seize every opportunity to give, that I must work hard and contribute what I can.”

September 2019