Maia and Tomi

I would like for you to meet Pantskava Maia, who is 30 years old.
Maia had been married 4 years when she fell while cleaning a house for a wealthy Russian family. They wanted outside windows cleaned. There was no ladder. Maia fell 3 stories. She is now a paraplegic. A lovely girl. Lying in her bed with a sad sort of smile, a half-smile.
Her husband left her after the accident, and two years after that her only child, a son, died of leukemia. Her mother moved to Germany and her father is deaf and frail and is not able to care for her. Maia’s aunt lived in Sukhumi and offered her a place to stay.
We provide her food and dressings for a chronic fistula at the surgical site on her back, the unsuccessful surgery. Maia’s only wish is to go to the cemetery to visit her son. We got her a wheelchair this week, it is not what MSF typically does, but I have a small “undesignated/ miscellaneous” budget to work with, and I spent a portion of it on Maia‘s wheelchair. Many who contribute to MSF never know exactly how their money is spent. I wish they knew how they helped Maia. I am grateful to those persons who have given Maia a whole-smile to replace her half-smile. She is planning a trip to the cemetery to see her son tomorrow.

Tomasina Gaiyina lives alone, at least with no other humans. She actually isn’t alone at all, with her dogs and cats and chickens and polka dot pigs. Tomi is strong and her dog is mean. Today we go to visit. We call her name from outside the fence in a very loud voice. She slowly walks out the door, onto her porch, we see her turn around, get on her hands and knees. She then backs down, step by step, until she reaches the bottom. She picks up two tree branches made into walking sticks, with mean dog by her side, and she hobbles to the fence. Mean dog growls as she approaches the fence where we are standing, the cats and chickens of course don’t care. The polka dot pig is grunting and schloppily shlugking in the muck.

Inga is afraid of dogs and gets back into the MSF vehicle. I stand by the gate and Inga translates leaning her head out of the truck. Tomi says “After I open the gate the dog will come out and be nice“. Hummmm, do I trust this? My predecessor had 5 dog bites, my colleague had a dog bite near our house just yesterday. Tomi looks so kind, and she shakes her hand with a gesture of assurance, the tree branch also shaking, communicating non-verbally “really, the dog is OK, he is nice”. I wait, I spot a stick within reach, so stupidly I think I can grab the stick and fend off the dog, once he gets out of the gated yard, if he decides he does not like me after all. I remember I had the full rabies series while in Paris.
Gate opens, out comes the dog, he looks at me, growls, tail starts wagging, he looks back at his master and watches her. Nothing. She was right - Mean Dog is Nice Dog outside the gate.
Of course, I will be examining Tomi not in the comfort of her home, but in the wide-open……but she is so unsteady and how foolish of me to not bring an exam table or at least a chair. I go to the back of the truck, there is an emergency box, a metal box, about 2x2x3foot. Perfect ,a make-do chair. It is hard to find a flat space, so the “chair” sits on uneven ground and I help Tomi sit. Blood pressure very high, lungs clear, heart irregular. .No swelling in her feet, her knees arthritic and it is arthritis she is complaining of today. I change her medications to hopefully impact her BP and recognize there is nothing I can do in her front yard to improve the irregular heart rhythm, other than the selection of an antihypertensive that might also slow the heart rate a bit. She gets paracetamol (the equivalent of Tylenol) , and some ibuprofen with proper warnings. Inga and I carry the old-fashioned black bag with all sorts of medicines and goodies, never knowing what might be needed. We dispense the proper amount in little teeny zip-lock packets, with the Russian names written. We give verbal instructions. Mean dog has been sitting dutifully by his master the whole time, a perfect doggie-gentleman.
We finish our examination and visit, Tomi is happy. Mean dog is happy. She has chocolates in her raggedy pocket. She hands them to me. I say thank you in Russian. I watch her habbleto her home on the hill, place her two walking sticks next to the stairs, which this time she ascends one at a time on her knees.
Mean dog stays at the fence , on his side, and growls viciously.