By 9:30 am the first two patients to register reached the interview room set up by genetics team’s Marie Tolarova and Tripti Pawar. Moving along like an auto assembly line, the screening worked in this order: creation of a patient chart, taking vital signs, examination by the surgeons, once-over from the pediatricians, photo session with Jason Wilheim to attach a Polaroid to the chart, dental exam. Blood sampling and interviews by interns to compile data for genetic research completed the process.

Interns were drawing a blood sample from Pakinsamy and his daughter by 10:00 am. Within two hours the Pakinsamys were finished and told to come back at five to hear if they’d been scheduled for surgery. They exited into the hallway merging into the orderly throng streaming in various directions indicated by Rotaplast doctors and volunteers and the attentive Vinayaka interns, many only four months away from being doctors themselves.

Team volunteer Karyn Sinunu worked the line-up on the benches outside, getting the kids to smack her a high-five. One of them is the four-year-old boy who Wayne and I visited yesterday at his home with his dad, the genial roadside snackman and his wife. The kid needs a hole in his palate repaired. Looking optimistic, they hold number 39.

Agalya Sivarkumar, age 4 months, is also here in the arms of her dad, the textile worker whose house we dropped by the other day. They gave us a bagful of guavas from the tree in the backyard where they’d posed for Wayne with the family cow.

Back inside, nine-year-old Vijaylakshmi in her prettiest pink chiffon dress all the way from Jayapal, 250 kilometers distant, informs pediatrician David Rosenberg that she wants to have the operation on her cleft lip. “I want to be the prettiest girl in my class,” she says. Unlike some countries where kids are robbed of an education by teasing friends and impatient teachers, she’s still in school. “That says something about India society,” Rosenberg says.

Through the entire day, few of the kids in the clinic were yammering or running around like some of the spoiled little snotnoses we know back home. That also says something about Indian society, says Ursula Blasej, a Rotaplast mainstay devoted to working with kids in the recovery room.

By 11:30, they’d completed about twenty cases, with fifty-two at various stages of the screening process and another twenty-five waiting outside. About eighty-five adults were due to show up in the afternoon, including Shy Girl from the other day, the one who never ever left her house. Would she take that chance today?

At 1:00 pm, more than 100 cases had been filed, but rejection for one reason or another was in store for some. Rosenberg had the toughest job, telling a young couple with a red “reject” sticker on their file, “Doctors aren’t God. There’s some things we just can’t do.” The interns translated. Tragedy swept first into the mom’s face like a tropical cyclone, then the father, and tears overtook them and the bawling baby in the mother’s arms.

Even harder cases abounded, like the tiny infant squirming in her very young mother’s arms as Tolarova instructed interns to observe the characteristics of a congenitally-caused brain defect. The risks of operating needed to be considered, she said; this baby's chances of survival were slim as it was. The mother muttered that she wished the child had died at birth, rather than suffer all this time and cause such a burden. Ursula picked up the doomed kid and held her. Then he handed her to Wayne. Wayne is more accustomed to holding to cameras than babies. But this one he held for a long moment before handing her back to the mother, who wandered off looking as miserable as everyone else felt.

Close to 3:00 pm, long after we’d figured she’d chosen the shadow life of home and house cleaning for her parents, Shy Girl shows up with her dad. Wayne and I are glad to see her and we tell them so. Dad says, as if it explains everything, “We live nearby.” Of course. In any case, she looks hopeful.

At the end of the day, hopeful is what it’s all about for close to 200 kids here – even for the boy with the horrendous burns whose patient status is still under discussion as the doctors convoy over dirt roads back to K-town and some chow at the Paris. Tomorrow morning they’ll return, pull on scrubs and get down to action in the operating rooms.

Rex Weiner
Wayne Schoenfeld

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