Medicine & Healthcare in Mongolia by Tenaya Storm
I was 17 years old and about to start my final year of secondary school, which meant applying to colleges and preparing for my first ‘real’ adult decisions outside the protective enclave of boarding school and my parents. College is, of course, a time for preparing for a future career, and I felt that I couldn’t make an informed decision about what and where I wanted to study without confirming my interest in medicine as a profession.
I have had a passion for volunteering for as long as I can remember, and knew both then and now that I want to incorporate that passion into a future career. Volunteering in a hospital abroad was the perfect opportunity to do both!
Arriving in Mongolia
At the Chinggis Khaan International Airport I was greeted by about fifteen taxi drivers, all wanting to give me a ride into town. Thankfully, I soon found my in-country support liaison, smiling and holding her Projects Abroad sign, and was guided to a small car which took us along the gravelly road into Ulaanbaatar--Mongolia’s capital, and the place where I would be spending my placement.
For the next month I was to be living in an apartment building with a “middle-class” family who had five children, three of whom were grown and living on their own. Despite their “middle-class” status with two full-time working parents and employed adult children, the apartment’s electricity was intermittent and there was only one bedroom.
I felt very privileged to have the bedroom to myself while the family slept together in the living room, and always felt welcome in the household. Upon my arrival, my host mother greeted me with a bowl of beef stew, and was shocked and confused when I told her I was vegetarian. In a country whose main diet consists of meat and alcohol, all she could say was “why?” However, I actually found it very easy to get by, especially with the numerous vegetarian restaurants in the city.
My Medicine placement
The next day I was given a tour of my placement in Shastin Central Hospital. Shastin was a fairway away from my apartment, so every morning gave me the opportunity to ride the bus through the city. The hospital was always very busy, with patients filing in and out of the outpatient wards throughout the day, and anxious family members waiting outside in the courtyard or in the lobby.
The inpatient wards were large, usually containing six beds with patients recovering generally from the same surgeries. Something I found very interesting was that being a Mongolian doctor does not come with the massive pay check and god-like status that is usually granted to doctors in the US. Doctors live on average wages, and are required to spend several years working in clinics for nomads before they are allowed to work in hospitals in the cities.
Hospitals maintain themselves on innovation rather than large checks from the private or government sectors, as evidenced by the empty juice bottles serving as blood and bile collectors at the foot of outpatients’ beds.
Throughout my placement at Shastin, though I was assigned to shadow a specific physician, I ended up shadowing whichever surgeon was busy at the time and willing to take me along. They were all very excited to show me around, and were frequently showing me the up-close aspects of different operations. Though I didn’t actually get to assist in any surgeries, I had great opportunities to observe surgeries, and inpatient and outpatient procedures.
The most meaningful thing I learnt from my placement was this: surgery is definitely not my calling. I was completely overwhelmed with the refusal of my brain and body to like what I thought might be a lifelong pursuit. I spoke to my supervisor about this, and after two weeks at Shastin I was transferred to a different hospital where I volunteered in the emergency room.
While most people associate emergency rooms with blood and guts, it actually mostly consisted of taking blood pressure measurements, performing examinations, and taking blood samples and patient histories, which helped me to remember that healthcare is not primarily about surgeries and trauma, but is in fact very much about maintaining health and preventing the major issues which result in surgery and trauma care.
Travelling around Mongolia
In the whirl of emotions, thoughts, and experiences, it took me about three weeks to realize how deeply affected I was by culture shock. I had never been in such a foreign place for such a long period of time, and I suddenly acquired a deep understanding and empathy for what it was like for my school friends back home who were international students from very different cultures compared to the United States.
Mongolia is probably one of the most foreign nations to the western world--and understandably too as Mongolia does not trade any major resources with the international community, mostly because their high-value production and international trade centres on a relatively small supply of minerals. Therefore, most people don’t know of the shocking beauty of the Mongolian wilderness.
I had the good fortune to take two incredible backpacking trips with other volunteers over the weekends that ended up being some of the most powerful moments of my life. Outside of the city, Mongolian culture is imbued into the landscape, with stupas (in the wilderness, these are huge piles of rocks with a tall branch in the middle pointing towards the sky, meant to be signs of respect and celebration of nature) covered in blue cloth, and many families still living in accordance with the land and animals.
On one of those trips I floated down a river in an inflatable raft with another volunteer, and we passed several Gers (Mongolian houses, which we think of as ‘Yurts’ in the United States) with herds of horses and cows gathered around the riverbanks.
My final thoughts
Mongolia is an incredible country, with an immensely resilient people and a fascinating and extraordinarily rich and ancient history. Ulaanbaatar is a striking example of modernity confronting an old way of life, with its huge downtown buildings surrounded by the conforming and bleak-looking apartment buildings of the soviet era, and the apartments subsequently bounded by the sprawling of traditional Gers.
With roughly a third of its population trying to break into the fast-paced modern world, the other two-thirds continue in the traditional nomadic lifestyle. Anyone with the opportunity to witness Mongolia and experience its culture should consider themselves very lucky!