Article: A Little Bit of Power, One Injection at a Time

We pile into a Toyota four by four, crank up the AC and the radio, and hit the road. The windy road makes me thankful that I popped a few Dramamine before embarking on this three hour trip. While accustomed to three hour drives with a car packed to maximum capacity on my way back to school, this trip was different- this was a road trip with a cause.
I had been invited to observe a Mobile Health Clinic that brings reproductive health services to the Hill Tribe people of Northern Thailand. These people are mostly refugees from neighboring Myanmar and their undocumented status and geographic location make it difficult for them to obtain medical attention through the formal system. The unit goes to them to do PAP tests, education on self-breast exams, and family planning. This particular trip was for contraception. Every three months the truck, staffed with three nurses (and today one observer) hits the road to bring injections of Depo-Provera and packs of oral contraceptives to women in remote areas.
The double-yellow lines on the road seem like more of a suggestion than a rule as we pass cars, trucks, motorcycles, and busses alike. I am briefly nostalgic for traffic police who at least curb some of the impulses of crazy drivers; though this ends when I mentally sum the fines I have paid for speeding tickets in the US and convert it into Thai Baht (I could easily live her for months on the sum). There is no seatbelt in the back seat of the truck so instead of worrying I just let the Dramamine put me to sleep.
Sleeping is no longer possible when we run out of highway and hit the dirt. I’m not even sure that what we drive through could be adequately described as potholes, perhaps ‘moguls’ is the more appropriate term. Now I understand why we needed four-wheel drive for this trip.
We start our ascent up a bumpy hill and pass through lychee groves and lose all our momentum as we stop and get out to grab some fresh lychees to eat. As our driver expertly shifts the two stick-shifts (why does he need two of them?) all I can think is “we certainly didn’t learn how to do this in my five-hour driving course.”
As we get closer to the top of the hill the driver honks the horn as we pass each cluster of huts to alert the women that we have arrived. We drive through a small village and stop in front of the convenience store that sells sausages, junk food, cold beverages, and plastic containers. The shop owner clears off a table for us and before we can set up 40 women dressed in red traditional clothing with sequins and colorful belts are lined up. They all produce ratty yellow cards with their names, ID numbers, and a stamp for each time they come. One by one we dig up their medical records, take a brief medical history and send them over to the nurse (who has set up as sterile a field as possible given the situation) for injections.
The highlight for the women is being weighed on the scale. It is neat that something as simple as a bathroom scale can be such a huge attraction. While I am pretty useless when it comes to taking medical histories and giving injections, numbers are universal so I am charged with recording weights. This task gives me a lot of practice with my numbers in Thai between about 40 and 90 (since we weigh them in kilos).
Our task is completed within an hour and we pack up while women clutch sore arms and the children play with the empty cardboard boxes left over from the supplies. It seems that each woman lingering around has a small child clinging to her skirt. The national goal is to have families with two well-spaced children. The logo on the side of our truck consists of the silhouettes of a happy family of four. In order for this goal to be achieved by those who are interested, services like the ones the Mobile Clinic offer are essential. While these women may not be in control of all of their circumstances— they cannot time when the rains will come to nurture their crops and they cannot dictate the market demands for the wares that bring them their only income— at least, with this help, they can choose when to have children.
As we drive away I feel like I am part of something so meaningful. I feel like we gave these women a little more power in their lives, one injection at a time.