By Alice B. Van Doren
"THE Long Trail A-Winding."
Who that has read "Kim" will ever forget Kipling's picture of the Grand Trunk Road, with its endless panorama of beggars, Brahmans, Lamas, and talkative old women on pilgrimage? Such roads cover India's plains with a network of interlacing lines, for one of Britain's achievements on India's behalf has been her system of metalled roads, defying alike the dust of the dry season and the floods of the monsoon.
One such road I have in mind, a road leading from the old fortress town of Vellore through twenty-three miles of fertile plain, to Gudiyattam, at the foot of the Eastern Ghats. It is just a South Indian "up country" road, skirting miles of irrigated rice fields, gold-green in their beginnings, gold-brown in the days of ripening and reaping. It winds past patches of sugar cane and cocoanut palm; then half arid uplands, where goats and lean cattle search for grass blades that their predecessors have overlooked; then the _bizarre_ shapes of the ghats, wide spaces open to the play of sun and wind and rain, of passing shadow and sunset glory. They are among the breathing spaces of earth, which no man hath tamed or can tame.
An Indian "Fliwer."
An ordinary road it is, and passing over it the ordinary procession--heavy-wheeled carts drawn by humped, white bullocks; crowded jutkas whose tough, little ponies disappear in a rattle of wheels and a cloud of dust; weddings, funerals, and festivals with processions gay or mournful as the case may be. One feature alone distinguishes this road from others of its kind; once a week its dusty length is traversed by a visitant from the West, a "Tin Lizzie," whose unoccupied spaces are piled high with medicine chests and instrument cases. Once a week the Doctor passes by, and the countryside turns out to meet her.
When the Doctor Passes by.
Where do they come from, the pathetic groups that continually bring the little Ford to a halt? For long stretches the road passes through apparently uninhabited country, yet here they are, the lame, the halt, and the blind, as though an unseen city were pouring out the dregs of its slums. Back a mile from the road, among the tamarind trees, stands one village; at the edge of the rice fields huddles another. The roofs of thatch or earth-brown tiles seem an indistinguishable part of the landscape, but they are there, each with its quota of child-birth pain, its fever-burnings, its germ-borne epidemics where sanitation is unknown, its final pangs of dissolution. But once a week the Doctor passes by.
What do she and her attendants treat? Sore eyes and scabies and all the dirt-carried minor ailments that infect the village; malaria from the mosquitoes that swarm among the rice fields; aching teeth to be pulled; dreaded epidemics of cholera or typhoid, small pox or plague. Now and then the back seat is cleared of its _impedimenta_ and turned into the fraction of an ambulance to convey a groaning patient to a clean bed in the hospital ward. Once at least a makeshift operating table has been set up under the shade of a roadside banyan tree, and the Scriptural injunction, "If thy foot offend thee, cut it off," carried out then and there to the saving of a life.
At dark the plucky little Ford plods gallantly back to the home base, its occupants with faded garlands, whose make-up varies with the seasons--yellow chrysanthemums with purple everlasting tassels at Christmas time; in the dry, hot days of spring pink and white oleanders from the water channels among the hills; during the rains the heavy fragrance of jasmine. All the flowers do their brave best for the day when the Doctor passes by.
Where no Doctor Passes by.
But what of the roads on which the Doctor never passes? From Vellore's fortress-crowned hills they stretch north and south, east and west, and toward all the intermediate points of the compass. Every city of India forms such a nucleus for the country around. Amid the wheat fields of the Punjab, under the tamarinds of the Ganges plain, among the lotus pools and bamboo clusters of the Bengal deltas, and on the black cotton fields of the Deccan are the roads and the villages, the villages and the roads. Some mathematically minded writer once computed that, if Christ in the days of His flesh had started on a tour among the villages of India, visiting one each day, to-day in the advancing years of the twentieth century many would yet be waiting, unenlightened and unvisited. Few have been visited by any modern follower of the Great Physician. Who can compute their sum total of human misery, of preventable disease, of undernourishment, of pain that might all too easily he alleviated?
A Problem In Multiplication.
Was it, one wonders, the memory of the Gudiyattam road, and those like it in nameless thousands, that burned deep into Dr. Ida Scudder's heart and brain the desire to found a Medical School, where the American Doctor might multiply herself and reproduce her life of skillful and devoted service in the lives of hundreds of Indian women physicians? It is the only way that the message of the Good Physician, His healing for soul and body, may penetrate those village fastnesses of dirt, disease, and ignorance. One hundred and sixty women doctors at present try to minister to India's one hundred and sixty millions of women, shut out by immemorial custom from men's hospitals and from physicians who are men. "What are these among so many?" What can they ever be except as they may multiply themselves in the persons of Indian messengers of healing?
And so, in July, 1918, the Vellore Medical School was opened, under the fostering care of four contributing Mission Boards, and with the approval and aid of the Government of Madras. "Go ahead if you can find six students who have completed the High School Course," said the interested Surgeon General. Instead of six, sixty-nine applied; seventeen were accepted; and fourteen not only survived the inevitable weeding out process, but brought to the school at the end of the first year the unheard of distinction of one hundred per cent, of passes in the Government examination. That famous first class is now in its Senior Year, and by the time this book comes from the press will be scattering itself among thirteen centres of help and health.
And so, in rented buildings, the Medical School started life. If ever an institution passed its first year in a hand-to-mouth existence, this one has. Short of funds save as mercifully provided by private means; short of doctors for the staff; short of buildings in which to house its increasing student body, for it has grown from fourteen to sixty-seven; short, in fine, of everything needed except faith and enthusiasm and hard work on the part of its founders, it has yet gone on; the girls have been housed, classes have been taught, examinations passed, and the first class is ready to go out into the world of work.
Just here perhaps one brief explanation should be made. These girls will not be _doctors_ in the narrowly technical sense, for the Government of India reserves the doctor's degree for such students as have first taken a college diploma and then on top of it a still more demanding medical course of five years. These students will receive the degree of Licensed Medical Practitioner (L.M.P.) which authorizes them to practise medicine and surgery and even to be in charge of a hospital. The full college may come, we hope, not many years hence, when funds become available. Meantime, this school will year by year be turning out its quota of medical workers whose usefulness cannot be over-estimated.
A Visit to Vellore.
Let us pay a visit to the School and see it as it is in its present state of makeshift. Since its beginning it has dwelt, like Paul the prisoner, "in its own hired house," but Paul's epistles tell of no such uncertainty in his tenure of his rented dwelling, as that which has afflicted this institution. The housing shortage which has distressed New York has reached even to Vellore. Two rented bungalows were lost, and, as an emergency measure, the future Nurses' Home was erected in great haste on the town site and at once utilized as a dormitory with some rooms set aside for lectures as well.
Let us first pay a visit to "Pentland," the one remaining "hired house," in which the Freshmen have their home with Dr. Mary Samuel, the Indian member of the staff, as their house mother. Just behind it is the thatched shed, carefully walled in, which serves as the dissecting room. To the uninitiated it is a place of gruesome smells and sights, for cadavers, whole or in fragments, litter the tables. The casual visitor sympathizes with the Hindu student who confides to you that during her first days of work in the dissecting room she could only sleep when firmly flanked by a friend on each side of her "to keep off the spirits that walk by night." After a few weeks of experience, however, the fascinating search for nerve and muscle, tendon, vein, and artery becomes the dominating state of consciousness, and the scientific spirit excludes all resentment at the disagreeable.
Pentland Compound possesses another feature in pleasing contrast to the dissecting shed. As you come away from a session there and close the door of the enclosing wall, from the opposite end of the compound comes the sound of children's voices in play. There in a comfortable Indian cottage lives the jolly family of the Children's Home. They are a merry, well-nourished collection of waifs and strays, of all ancestries, Hindu, Muhammadan, and Christian, mostly gathered in through the wards of the Mission Hospitals. Only an experienced social worker could estimate what such a home means in the prevention of future disease, beggary, and crime. It is good for the medical students to live in close neighborliness with this bit of actual service. One student in writing of her future plans mentions that, as an "avocation" in the chinks of her hospital work, she plans to raise private funds and found a little orphanage all her own!
Not far from Pentland are the new buildings of Voorhees College belonging to the Arcot Mission of the Dutch Reformed Church. For the resent, the Medical School has the loan of its lecture rooms and laboratories in the early morning hours before the boys' classes begin. That means seven o'clock classes, and previous to that for most of the students a mile walk from the town dormitory. Here is the Chemistry Laboratory. Freshmen toil over the puzzling behavior of atoms and electrons, while in lecture rooms the ear of the uninstructed visitor is puzzled by the technical vocabularies of the classes in anatomy and surgery, and one wonders how the Indian student ever achieves this vast amount of information through the difficult medium of a foreign tongue.
In Hospital Wards.
Next in our path of visitation comes Schell Hospital, where the theories learned in dissecting room, laboratory, and lecture are connected up with actual relief of sick women and children. Here the students are divided into small groups and many kinds of clinical demonstrations are going on at once. In the compounding room you will see a lesson in pill-making. That smiling young person working away on the floor in front of the table is a West Coast Brahman, sent on a stipend from the Hindu state of Travancore. It is her first experience away from home and the zest and adventure of the new life have already fired her spirit.
In this verandah another group are at work with bandaging. We watch them while brown arms and legs, heads and bodies disappear under complicated layers of white gauze.
In the large ward Seniors, equipped with head mirrors and stethoscopes, with chart and pen, are taking down patients' histories and suggesting diagnoses. Soon it will be their work to do this unaided, and every bit of supervised practice is laying up stores of experience for the future.
On the next verandah Doctor Findlay is giving a lecture and demonstration on the care and feeding of babies. Demonstration is not difficult, for the hospital always provides an abundance of ailing infants whose regulated diet and consequently improving health serve as laboratory tests.
The Ford in a New Capacity.
Now we follow the shady verandah around three sides of the attractive courtyard with its trees and flowering creepers. At the far end the class in obstetrics is going on. And behold, the irrepressible Ford has entered into a new province. This truly American product will probably be found to-day in every continent and nearly every country in the world, but one ventures to prophesy that Vellore is the only spot on the habitable globe where its cast-off tires have been metamorphosed into models of human organs! Every student not working over an actual mother or baby is busy performing on these home-made rubber models the operations she may some day be called to do upon a living patient.
In the midst of these Dr. Griscom is interrupted by next ward that didn't cry for a week? You know that this morning you slapped it and it cried for the first time, and its mother was very happy. Now she wants to hear it cry again, and says--"may she please beat it herself?" The Doctor leaves her Ford tires, and runs to the ward to explain to the overzealous mother the difference between _massage_ administered by a physician and the ordinary manner of "beating" a baby.
Our next place of pilgrimage is the "town site" where the new Nurses' Home affords temporary dormitory accommodation. Beside it is the Doctor's bungalow, and in the open space next is to be built the big dispensary. This is well called the "town site," for it is in the thick of Vellore's population. Children, dogs, and donkeys swarm across its precincts, and there is no fear of these students being separated from the actualities of Indian life. The two-story buildings, however, give abundant opportunity for the occupants to "lift up their eyes unto the hills"; and the open air sleeping-rooms promise breezes in the hottest nights.
"Mrs. Earth Thou-Art."
Here, too, the Seniors have their lectures in obstetrics, and with the beginning of that course a new difficulty arose. Equipment here, as in practically every Mission institution, is pitifully limited by lack of funds. For the proper teaching of obstetrics there is need of a pelvic manikin, lifesize. There were no funds to spare for so expensive a piece of apparatus, and, if there had been, there would have been a delay of months in getting it out from England or America. But meantime obstetrics must be taught, and a manikin must be had. "Necessity is the mother of invention." Necessity got to work, and "Mrs. Earth-Thou-Art" is the result. Dr. Griscom sent for the potter, who left his wheel in the bazaar and came to this market for new wares. After long and detailed instructions, he returned to his wheel, and set it to the making of a shape never seen in the potter's vision of Jeremiah or Robert Browning. The first attempt was a failure; the second and third were equally useless; at last something was produced that approximated the human size and form. The tires of the Ford were again requisitioned and, by the miraculous aid of the blacksmith, nailed to the pottery figure without wrecking the latter. "Mrs. Earth-Thou-Art" at last reposed complete, one example of the triumph of the missionary teacher over the handicaps of the situation. We hope that her brittle clay will survive until such time as some friend from across the sea is moved to provide for her a "store-made" successor.
"That which shall be."
One more spot must be visited before our pilgrimage ends. No guest of the Medical School is ever allowed to depart without a visit to "the site," that pride of Dr. Ida Scudder and her staff.
Three miles out from the dust and noise of the bazaars lies this tract of fertile land, the near hills rising even within its boundaries, the heights of Kylasa forming a mountain wall against the sunset. Here in the midst of natural beauty, open to every wind of heaven, the dormitories, lecture room, chapel, and new hospital will rise. It will mean a healthful home, with the freedom of country life and endless opportunity for games and walks. The motor ambulances will form the daily connecting link with the practical work of dispensary and emergency hospital.
We have spoken much of buildings and courses of study, but little of the girls themselves. Who are they? Where do they come from? Why are they here? What are their future plans?
They are girls of many shades of belief, from many classes of society. The great majority are, of course, Protestant Christians, representing the work of almost every Mission Board to be found in South India. There are a few Roman Catholics, and about an equal number of members of the indigenous Syrian Christian community. Nine are Hindus, including one Brahman. They come from the remotest corners of the Madras Presidency, and some from even beyond its borders.
Why did they come? There are some who frankly admit that their entrance into Medical School was due solely to the influence of parents and relatives, and that their present vital interest in what they are doing dates back not to any childhood desire for the doctor's profession, but only to the stimulating experiences of the school itself. Others tell of a life-long wish for what the school has made possible; still others of "sudden conversion" to medicine, brought about by a realization of need, or in one case to the chance advice of a school friend. Two speak of the appalling need of their own home villages, where no medical help for women has ever been known. Some of the students have expressed their reasons in their own words:--
"Once I had a severe attack of influenza and was taken to the General Hospital, Madras. I have heard people say that nurses and doctors are not good to the patients. But, contrary to my idea, the English and Eurasian nurses there were very good and kind to me, more than I expected. I used to see the students of the Medical College of Madras paying visits to all the patients, some of whom were waiting for mornings when they should meet their medical friends. I saw all the work that they did. The nurses were very busy helping patients and, whatever trouble the patients gave, they never got cross with them. They used to sing to some of them at night, give toys to little ones and thus coax every one to make them take medicine. I admired the kindness and goodness that all the medical workers with whom I came in contact possessed. As medical work began to interest me, I used to read magazines about medical work. Again, when I once went to Karimnagar, I saw ever so many children and women, uncared for and not being loved by high caste people. I wanted to help Indians very much. All these things made me join the Medical School.
"My father's desire was that one of his daughters should study medicine and work in the hospital where he worked for twenty years, and so in order to fulfill his desire I made up my mind to learn medicine.
"Now my father is dead and the hospital in which he had worked is closed, for there is no one to take his place. So all are very glad to see that I am learning medicine. There are many men doctors in Ceylon, but very few lady doctors and I think that God has given me a good opportunity to work for Him.
"For a long time I did not know much about the sufferings of my country women without proper aid of medical women. One day I happened to attend a meeting held by some Indian ladies and one European. They spoke about the great need of women doctors in India and all about the sufferings of my sisters. One fact struck me more than anything else. It was about an untrained mid-wife who treated a woman very cruelly, but ignorantly. From that time I made up my mind to study medicine with the aim of becoming a loving doctor. My wish is now that all the women doctors should be real Christian doctors with real love and sympathizing hearts for the patients.
"When I told my parents that I wanted to study medicine, they and my relatives objected and scolded me, for they were afraid that I would not marry if I would study medicine. In India they think meanly of a person, especially a girl, who is not married at the proper age. I want now to show my people that it is not mean to remain unmarried. This is my second aim which came from the first."
The following is written by a Hindu student:--
"Before entering into the subject, I should like to write a few words about myself. I am the first member of our community to attain English education. Almost all my relatives (I talk only about the female members of our community) have learnt only to write and read our mother language Telugu.
"When I entered the high school course I had a poor ambition to study medicine. I do not know whether it was due to the influence of my brother-in-law who is a doctor, or whether it was due to our environments. Near our house was a small hospital. It was doing excellent work for the last five years. Now unfortunately the hospital has been closed for want of stock and good doctors. From that hospital I learnt many things. I was very intimate with the doctors. I admired the work they were doing.
"My father had a faithful friend. He was a Brahman. He realized from his own experience the want of lady doctors. He had a daughter, his only child, and she died for want of proper medical aid. Whenever my father's friend used to see me he used to ask my father to send me to the Medical College, for he was quite interested in me, like my own father. After all, as soon as I passed the School Final Examination, it was decided that I should take up medicine, but at that time my mother raised many an objection, saying the caste rules forbid it. I left the idea with no hope of renewing it and joined the Arts College. I studied one year in the College. Then luckily for me my father and his friend tried for a scholarship.
"Luckily again, it was granted by the Travancore Government.
"I am not going to close before I tell a few words of my short experience in the College. As soon as I came here I thought I wouldn't be able to learn all the things I saw here. I looked upon everything with strange eyes and everything seemed strange to me, too. But, as the days passed, I liked all that was going on in the College. The study--I now long to hear more of it and study it. Now everything is going on well with me and I hope to realize my ambition with the grace of the Almighty, for the 'thoughts of wise men are Heaven-gleams.'"
You ask, what of the future? What will these young doctors bring to India's need? How much will they _do_? Might one dare to prophesy that in years to come they will at least in their own localities make stories like the following impossible?
A woman still young, though mother of seven living children, is carried into the maternity ward of the Woman's Hospital. At the hands of the ignorant mid-wife she has suffered maltreatment whose details cannot be put into print, followed by a journey in a springless cart over miles of rutted country road. She is laid upon the operating table with the blessed aid of anaesthetics at hand; there is still time to save the baby. But what of the mother? Only one more case of "too late." Pulseless, yet perfectly conscious, she hears the permission given to the relatives to take her home, and knows all too well what those words mean. The Hospital has saved her baby; her it cannot save. Clinging to the doctor's hand she cries:
"Oh, Amma, I am frightened. Why do you send me away? I must live. My little children,--this is the eighth. I don't care for myself, but I must live for them. Who will care for them if I am gone? Oh, let me live!"
And the doctor could only answer, "Too late."
On that road where the doctor passes by, one day she saw a beautiful boy of one year, "the only son of his mother." The eyelids were shut and swollen. "His history?" the doctor asks. Ordinary country sore eyes that someway refused to get well; a journey through dust and heat to a distant shrine of healing; numberless circlings of the temple according to orthodox Hindu rites; then a return home to order from the village jeweller two solid silver eyeballs as offerings to the deity of the shrine. Weeks are consumed by these doings, for in sickness as in health the East moves slowly. Meantime the eyes are growing more swollen, more painful. At last someone speaks of the weekly visit of the doctor on the Gudiyattam Road.
The doctor picked up the baby, pushed back the swollen eyelids, and washed away the masses of pus, only to find both eyeballs utterly destroyed. One more to be added to the army of India's blind! One more case of "too late"! One more atom in the mass of India's unnecessary, preventable suffering,--that suffering which moved to compassion the heart of the Christ. How many more weary generations must pass before we, His followers, make such incidents impossible? How many before Indian women with pitying eyes and tender hands shall have carried the gift of healing, the better gift of the health that outstrips disease, through the roads and villages of India?
The existence of the Medical School has been made possible by the gifts of American women. Its continued existence and future growth depend upon the same source. Gifts in this case mean not only money, but life. Where are those American students who are to provide the future doctors and nurses not only to "carry on" this school as it exists, but to build it up into a great future? It is to the girls now in high school and college that the challenge of the future comes. Among the conflicting cries of the street and market place, comes the clear call of Him whom we acknowledge as Master of life, re-iterating the simple words at the Lake of Galilee, "What is that to thee? Follow thou me."
Rupert Brooke has sung of the summons of the World War that cleansed the heart from many pettinesses. His words apply equally well to this service of human need which has been called "war's moral equivalent."
"Now, God be thanked, Who has matched us with His hour,
And caught our youth, and wakened us from sleeping,
With hand made sure, clear eye, and sharpened power,
To turn, as swimmers into cleanness leaping,
Glad from a world grown old and cold and weary."
AN EXAMPLE OF CHRISTIAN TREATMENT
Volumes might be written on the atrocities and absurdities of wizards, quack doctors, and the hideous usages of native midwifery. The ministry of Christian physicians comes as a revelation to the tortured victims.
The scene is a ward in a Christian Hospital for women in South India. The patients in adjacent beds, convalescents, converse together.
"What's the matter with you?" says Bed No. 1 contentedly. "My husband became angry with me, because the meal wasn't ready when he came home and he cut my face. The Doctor Miss Sahib has mended me, she has done what my own mother would not do." Said another in reply to the question, "The cow horned my arm, but until I got pneumonia I couldn't stop milking or making bread for the father of my children, even if it was broken. The hospital is my Mabap (mother-father)."
"What care would you get at home?" chimed in another who had been burning up with fever. "Oh! I would be out in the deserted part of the woman's quarters. It would be a wonderful thing if any one would pass me a cup of water," she replied. From another bed, a young wife of sixteen spoke of having been ill with abscesses. "One broiling day," she said, "I had fainted with thirst. The midwives had neglected me all through the night, and, thinking I was dying, they threw me from the cord-bed to the floor, and dragged me down the steep stone staircase to the lowest cellar where I was lying, next to the evil-smelling dust-bin, ready for removal by the carriers of the dead, when the Doctor Miss Sahib found me and brought me here. She is my mother and I am her child."
An old woman in Bed No. 4 exhorts the patients around her to trust the mission workers. "I was against them once," she tells them, "but now I know what love means. Caste? What is caste? I believe in the goodness they show. That is their caste."
Words profoundly wise!
On the slope of the desolate river among the tall grasses I asked her, "Maiden, where do you go shading your lamp with your mantle? My house is all dark and lonesome,--lend me your light!" She raised her dark eyes for a moment and looked at my face through the dusk. "I have come to the river," she said, "to float my lamp on the stream when the daylight wanes in the west." I stood alone among tall grasses and watched the timid flame of her lamp uselessly drifting in the tide.
In the silence of the gathering night I asked her, "Maiden, your lights are all lit--then where do you go with your lamp? My house is all dark and lonesome,--lend me your light." She raised her dark eyes on my face and stood for a moment doubtful. "I have come," she said at last, "to dedicate my lamp to the sky." I stood and watched her light uselessly burning in the void.
In the moonless gloom of midnight I asked her, "Maiden, what is your quest holding the lamp near your heart? My house is all dark and lonesome,--lend me your light." She stopped for a minute and thought and gazed at my face in the dark. "I have brought my light," she said, "to join the carnival of lamps." I stood and watched her little lamp uselessly lost among lights.
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