Saving mothers
Dr. Chen is justly proud of the success of the first group of 25 midwives he trained. He reports that by June of last year, they had carried out 607 prenatal exams, delivered 404 babies and referred 14 cases to clinics. All expectant mothers and fetuses in their care were alive and well, a fact the medical community considers near miraculous.
Last year the medical mission began to help midwives set up delivery rooms in remote villages to prevent women from giving birth on the ground outdoors, as is the traditional practice. Says Dr. Chen, "By saving a mother, we save a family. By saving a family, we give hope to the whole nation."
As difficult as it may be to imagine, in Malawi people have no concept of giving blood. Hospitals don't have blood banks for emergency needs and many patients die because there is no blood for transfusions.
Dr. Chen recalls one particularly tough battle with death after a Taiwanese businessman contracted malaria. Tragically, the infection affected his brain, requiring an emergency blood transfusion that could not be performed because there were no blood banks in Malawi. Dr. Chen immediately mobilized colleagues and relatives to give blood, but despite their efforts the patient could not be saved.
To prevent a similar tragedy from ever happening again, Dr. Chen organized blood donation drives throughout the country, publicized the idea that giving blood saves lives, and imported blood screening equipment. Says Dr. Chen, "Achieving a safe blood supply is an enormous challenge in a country where one person in seven is infected with HIV."
Doing unto others...
Bit by bit, Dr. Chen's efforts have benefited people in Africa and indirectly strengthened Taiwan's ties of friendship with its allies.
In light of how successful the experience has been in Africa, the DOH is planning to promote a similar project in the South Pacific. Mackay Memorial Hospital, Wan-Fang Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, and Changhua Christian Hospital all plan to join the effort to pursue "medical diplomacy" among the South Pacific island nations that are diplomatic allies of Taiwan.
Dr. Chen's foreign aid mission has been remarkably successful, but his concern that he would be out of touch with his medical specialty for too long and that his children's Chinese language education would suffer made him decide to pass the baton once his three-year contract was over. He has been succeeded by Dr. Lu Tao-yang, of Pingtung Hospital, as the DOH's second representative to Africa.
For three years, more than a thousand days, Dr. Chen, his wife and children lived a life of isolation and great material deprivation in Malawi.
Dr. Chen has nothing but compassion and understanding for impoverished Malawi and harbors no resentment. When he speaks of the lack of public order, the ever-present thieves and the fact that so many people carry guns to protect themselves, his voice betrays deep sympathy for the local people.
"They live in great poverty," says Dr. Chen. To the locals, a roadside stall with a few simple items represents a wholesale store and a bicycle an ambulance. The day after the Chen family moved into their home, a thief broke into it. They were burglarized three times in all. Despite the fact that everyone urged Dr. Chen to buy a gun and told him that he could scare off potential thieves by firing it into the air, and that he was often unable to sleep at night because of incessant gunfire, he refused to buy a firearm. He had come all the way to Africa to "save people, not to kill them."
While he was traveling around Africa, Dr. Chen relied on security guards and five dogs (two of whom died of poisoning) to protect his wife, children and home. Other than that, he put his trust in God to bless and protect them.
Also a father
Neither material deprivation nor lack of security made Chen Chih-cheng seriously question his decision to take his family to Africa. But when his youngest son suffered two agonizing malaria attacks, he felt guilty as a father and was plagued by doubts. Had he brought his wife and children to this distant land to endure this? Was the sacrifice worth it?
In Africa, more than 3000 people die of malaria every day. In Malawi, the infection is as widespread as the common cold. Says Dr. Chen, "Although as a pediatrician I was capable of treating my children, I was worried about the potential sequelae of cerebral malaria."
Although Dr. Chen had his doubts before going to Africa, now that he looks back on the three years he spent there, he feels very positive about the experience. "In Africa I rediscovered much that we've lost in Taiwan," says Dr. Chen. As examples, he cites the relationship between doctor and patient and the respect accorded to doctors. In Taiwan, the status of doctors is declining by the day, but in Africa doctors are respected and rewarded beyond measure. Many patients curtsy when they speak or shake hands with doctors. Dr. Chen was deeply moved by such signs of respect.
Dr. Chen thinks that other than this, the three years they spent in Africa were a very valuable experience for his children. His five- and seven-year-old went to an international school run by an American church. In addition to schoolmates from Malawi, they came into contact with kids from all over the world and developed a genuine international perspective. In Africa, life is simpler and less cluttered with material enticements. The children got used to living without TV and electronic toys and learned not to want to accumulate stuff.
Sowing seeds in Africa
Since Dr. Chen completed his mission and returned to PCH he has continued to expand the hospital's overseas aid work. He thinks a great deal about all the unfinished work there is in Africa.
Says Dr. Chen, "The biggest difference between foreign medical aid and agricultural development aid is that the former helps people directly and is therefore the most deeply felt." According to him, that is why the work must continue. If diplomatic relations were cut and Taiwan stopped giving medical aid, it would be a huge blow to sick people in Africa.
Since returning to Taiwan, Dr. Chen seems to have left his heart back in Africa. He constantly thinks of Malawi's manifold needs and is making every effort to provide logistical support to the country. He hopes to raise funds to buy a bus with diagnostic, X-ray and surgical capabilities, which will be employed as a mobile hospital and TB prevention vehicle. He also plans to give midwives bicycles with attached flatbed carts to be used as ambulances to transport women in labor. And he hopes to raise the money to buy small gifts to be distributed to promote blood donation. "The Taipei Blood Center has already pledged a blood donor bus," says Dr. Chen, with obvious excitement.
PCH has plowed and sowed good seeds in Malawi, but it has yet to gather the harvest. Much work remains to be done. As the DOH's first representative to Africa, Dr. Chen believes that diplomacy aims to forge friendship and establish good relations between nations and to enable them to live and work together; but "medical diplomacy" enables us to save lives and show humanitarian concern for our friends. We must not give up this worthiest of missions, he says.
"Long ago, foreign missionaries came to contribute to Taiwan. It is now time for us to give back. We must go where there is need." Dr. Chen says that he may still go back to Africa at any time.