Zokawthar, Day 1

Finally, a little action. Within 15 minutes of opening the clinic the building echoed with the sound of a young woman's obscenely laboured breathing. What made her do that was a mystery, but it didn't matter because it stopped, abruptly. Immediately after that the curtain around the doctor's office blew aside and the unconscious girl was carried upstairs.

“Put her in Doctor David's bed upstairs so she's not in the way.”

“What was wrong with her?” we asked the Calgarian doctor who decided to conclude the check-up when his patient passed out. For the sake of accuracy, I have to admit we asked him that night.

“She's having panic attacks and hyperventilating. When I tried to get her to breathe in a paper bag she got scared and stopped breathing altogether. So I thought, 'uh oh.'”

“Why is she having panic attacks?”

“I don't know. She lives in Burma, so, stress.”

This was the first day in the Zakawthar clinic; the closest you can get to Burma without leaving India. Most of the patients had walked for hours from inside Burma to be seen by visiting Western doctors on the India side of the river. This group of Canadian doctors ran health checks in half a dozen villages in the area over the past week, but most of those villagers had left Burma years ago and live permanently in India now, so they're sick, but not Burmese sick. Zakawthar is the Indian side of a town centred precisely on the border, where Burmese (Chin, to be accurate) cross back and forth all day to sell cheap Burmese goods on the other side.

The two halves of the town are connected by a dirty iron bridge painted red in the middle to mark the borderline. On the Indian side is a thatch hut with two guards paralysed with boredom, since Burma wouldn't dare. Across the bridge is a more elaborate check-point manned by Burmese guards, identifiable by their buzz cuts and leather US Air Force jackets.

The ground around the clinic was splattered red with betelnut spit. Betelnut is a stimulant, chewing wads of it is so popular in this part of the world that enclosed spaces generally reek of it and even teenager's teeth are stained red.

It was a good day in the clinic for voyeurs of medical curio. After Panic Attack came Bear Guy, a man who had been mauled by a bear years ago but who couldn't afford reconstructive face surgery in Rangoon. Since then much of that side of his face has healed into a purple misshapen lump. Once a week he changes the gauze that protects the skin that refuses to heal.

There were a few goitre ladies, a little girl pale with malaria, starvation-soft hair and pierced ears, 80-lb old ladies and productive coughs. Unfortunately, for the voyeurs anyway, we missed the guy whose butt cheeks were melded together by untreated syphilis scars. He was in last week. Gross.

Very gross. But the majority of patients were just tired and hungry. They needed vitamins and aspirin and TUMS. In the morning volunteers and interpreters fought off fatigue by exchanging courtesy questions about family, in the afternoon by genuinely cracking jokes.

Around two o'clock, three of us, Dr. Lopita from Toronto, Zoey the Geisha-faced interpreter, and I, were called to the house on the hill to see a woman in labour. Woman, or teenaged girl, not important. She was well, the midwives were skilled, and we were only taking up space in the little plywood house. “Call us again when the baby comes.”

Around five o'clock the crowd was thinning and the sky was dimming. I slipped around the curtain and into Lopita's office. Her and Zoey were chatting softly, really just waiting for it to become too dark to work. Zoey's tiny Betty Boop lips were stretched over a piece of chaw lodged in front of her bottom teeth.

“Zoey, what are you eating?” She giggled and threw a pack of powdered betelnut on the table. “You should know better!” She giggled again and crossed her legs.

“You want to try?” Of course. Of course I want to try. She split the pack between Lopita, whose Indian heritage accustomed her to betelnut long ago, and the one who doesn't even like to drink. That's me.

One new to betelnut, especially in its potent powdered form, will suffer from an urgent desire to hork it as far and fast as possible out of their mouth. Then to go drink from a hose. Bitter, nasty dry stuff that sticks all over the mouth. My face blushes and contorts wildly even with mild discomfort, so my reaction now sent Lopita and Zoey into hysterics.

“Spit out! Spit out!” laughed Zoey. No, never. I'm tough, I can't take it. I squeezed my face to keep

myself from gagging and shook my head. When I stood up to go back to the waiting room I was introduced to the true power of betelnut.

“Oh god I'm dizzy. Zoey, I think I'm high!” They were laughing so hard by the time my knees gave out that the doctor in the office banged on the wall for us to shut up or share. I staggered back to the waiting room and collapsed into the chair. While I tried to scrape all traces of betelnut out of my mouth into the garbage can at my feet, Chester, who is from the '60s, counselled me. “Chester I'm high.” He agreed. “It's a stimulant Suzy, like mild cocaine.”

“I don't think this counts if I did it by accident...Oh jeez Chester, these Chins are all high.”

“Yeah,” he grinned. “Didn't you know?” Until that day I was proud to have never experienced a chemical high. Now I have to find something else to feel superior about.

The midwife raced back in, the baby was born.

“Wait for me, I need you two to help me to walk.” Every time either of them looked at my situation they began to laugh again, which made our hike to the house on the hill a giggling stumble. We stomped through the door, laughing and wiping away tears and holding me up until the world stopped spinning.

But there was a bad air in the room. The mother was resting, wrapped up on the floor. The midwife sat on the bed. a silent bundle of blankets in her arms. She unwrapped the blankets to show us. I thought it was already dead. It was least two months premature, like a skinny little guinea pig. It's skin was grey, its eyes were sealed shut and it's mouth dry and open. The midwife leaned this tiny body toward my lens so it would be easier for me to take a picture, which made me feel guilt-sick.

Outside the room Dr. Lopita said she couldn't tell if it was alive or dead, but the midwife said it was still breathing a little. Dr. David agreed to bring an injection of steroids to force the lungs open. When they stuck the needle in the little baby's thigh, it flinched, and gave us hope that it might survive until tomorrow. But Lopita said there was no hope it would last longer than that. It did indeed die overnight.