I asked Umsani curiously which pregnancy she was in. Her reply astonished me: "I'm carrying my tenth child." She further added that only five of her children were still alive, the others having died from fever or dysentery. Living in this country, poverty allows sickness to creep up on one unhindered.

Thirty-year-old Suwaresihi caused quite a stir when she walked into the registration office: her back was badly hunched as though she were carrying something very heavy on it. While everyone at the free clinic was whispering about her, she pulled up the back of her shirt to reveal a large tumor that looked like a bag on her back. It must have weighed over ten kilograms.

"I have been carrying this tumor for twenty-two years, ever since I was eight years old," said Suwaresihi. She used to experience excruciating pain whenever she accidentally slept on the tumor, but over the years she actually grew numb to the pain. In addition to the huge tumor on her back, numerous smaller ones covered her body.

It was poverty that allowed these tumors to infest her body and to usurp her already meager nutrition intake. "I can finally have the tumors removed through this free clinic," Suwaresihi said excitedly. "I have waited so long for this day!"

"It costs one-sixth of a farmer's monthly income to treat a small cold. How can they afford to get treatment for a major illness?"

In Indonesia, even people with average incomes may not be able to afford a simple surgery, let alone the poor, who don't even know where their next meal will come from. Tzu Chi members in Indonesia held a large-scale free clinic in Serang on September 25 and 26, 1999, just before the Tzu Chi liaison office was promoted to Tzu Chi Indonesia branch office. Services were provided in internal medicine, dentistry, pediatrics, dermatology, ophthalmology and obstetrics, and for the first time even dentures were offered.

The local army and air force hospitals supported the free clinic with doctors and medical equipment. Furthermore, many volunteers from the Indonesian Chinkuang Group and the Paramita Buddhist Foundation were also actively involved. Tzu Chi Medical Association doctors from Singapore and the Philippines also participated.

Originally, some forty-odd Tzu Chi members from Taiwan were to take part in the clinic. However, because of the September 21 earthquake in Taiwan, most turned their efforts to post-quake relief work there and the number of people who went to Indonesia was reduced to eleven. That team was led by Dr. Lin Chin-lon, deputy superintendent of the Tzu Chi General Hospital, and Masters Te Yueh and Te Yu.

One hundred and twenty medical personnel and three hundred volunteers were involved in the two-day free clinic, making it a truly large-scale international event. Medical services were provided in two different places to avoid overcrowding: in an auditorium provided by the local government and in the army hospital.

Crowds had already formed outside the auditorium before the free clinic started. Entire families came to receive treatment.

Fifty-year-old Mintarsih pointed to her 80-year-old mother-in-law and her 26-year-old daughter. "My mother-in-law is almost blind from cataracts. My daughter for some reason has headaches all the time, and I have asthma. We are farmers and don't have the money to receive medical treatment. So if we are sick, there is nothing we can do."

Waiting outside the temporary surgery rooms were mostly women who had brought their children to receive surgery for harelip. At least twenty children in sight had this malformation. Large cracks caused their little lips to turn abnormally upwards. Some children even had double harelips and front teeth that protruded like those of rabbits.

Why did so many children have harelips? Surgeon Sumaqsudi from the army hospital said, "It is not that we have an unusually high number of people afflicted by tumors and harelips. It is simply that people here are too poor to seek treatment."

I noticed an apparently pregnant woman, Umsani, who was holding a one-year-old baby in her arms. I asked her curiously which pregnancy she was in. Her reply astonished me: "I'm carrying my tenth child." She further added that only five of her children were still alive, the others having died from fever or dysentery.

In rural areas, the sources of drinking water are rivers or unfiltered well water. Farmers wash their clothes and vegetables, bathe, and even discharge their wastes in the river. Once the river water is contaminated, contagious diseases spread uncontrollably.

"We have no money to see the doctor," Umsani said with moist eyes. "If our children get contagious diseases, there is nothing we can do but wait for the end to come."

Poverty alone can make life so fragile.

Just how poor these people are can be gauged by their income. The average daily wage of rural residents, mostly farmers, is between 6,000 to 8,000 Indonesian rupiah (US$0.82-1.09), and average laborers earn around 250,000 rupiah (US$34.23) a month.

The doctor's fee for a small cold is 10,000 rupiah (US$1.37) and medicine costs another 10,000 to 30,000 rupiah (US$1.37-4.37). Altogether a visit to the doctor would cost about one sixth of a farmer or a worker's monthly income--and this is just for a cold. They can hardly afford treatment for a minor sickness, much less a major one.

The Asian financial crisis in 1998 caused the shutdown of many factories in Indonesia and massive downsizing. Many laid-off laborers remain unemployed to this day. Farmers are also having a hard time getting by due to a recent drought. When feeding oneself becomes so difficult, other matters simply have to wait.

"Tumors grew on the back like rocks, choked the throat like eggs, or bulged from the eyes like ping-pong balls... There were so many such disfigurements, but locals have gotten used to the sight of them."

When I walked into a temporary operating room, the stomach-turning smell of antiseptics permeated my nostrils. Anesthetized children lay on operating tables while doctors, too busy even to wipe away the beads of sweat on their foreheads, adeptly and gently remodeled the features of these children.

In order not to disappoint patients who had come a long way, the doctors operated almost non-stop on one patient after another. They did not have lunch until four in the afternoon, and they continued working until all the operations had been completed at nine in the evening, when they finally had their supper. These doctors said that when they faced these patients, they forgot all about themselves and felt neither fatigue nor hunger.

After the operations, the children were moved to recovery rooms where volunteers bathed them with towels and fanned them to keep them cool. A child woke up and suddenly started crying, perhaps because the anesthetic had worn off and he was feeling the pain. He struggled hard, wiggling his arms and legs, and his shrill cries cut through the heart of every person there.

The child's father held his hands and said to him, "You are such a crybaby! That's not how a little hero should behave. Just now everyone was talking about how brave you are!" Volunteers also stayed by the little boy and tried to soothe him. After a while, he stopped crying and slowly drifted off to sleep.

Not far from the auditorium, doctors in the army hospital were also performing all sorts of surgery. There was a noticeable increase in the number of people who had come to receive operations for the removal of tumors. One woman told us that a friend of hers from the same village had received successful surgery at a previous Tzu Chi free clinic and had recommended to other villagers that they come to seek medical treatment.

There were all sorts of sicknesses and symptoms. Tumors especially took strange forms: they grew on the back like rocks, choked the throat like eggs, or bulged from the eyes like ping-pong balls... The disfigurements seemed incredible to the outsider, but locals had long gotten used to the sight of them.

When Dr. Lin Chin-lon was busy diagnosing patients, a man walked in with his wife. "Doctor, please save my wife! There are ulcers on her breasts!" According to the man, his wife was in the terminal stage of breast cancer. She had undergone an operation, but the wound had become badly infected. When his wife lifted her top, we saw that her breasts were covered with abscesses. It was a sight I could hardly bear to look at.

Dr. Lin examined the woman carefully and told the couple not to worry. Because the surgery would be a major one and the woman would need a large amount of blood, Dr. Lin scheduled the operation for two days later at the army hospital. He told the woman to eat more nutritious food because acute anemia would pose a serious problem for surgery.

Volunteers moved patients to recovery rooms after their operations. After witnessing the operations and being so close to the patients for the first time, one of the volunteers had many reflections and mixed feelings. "People are all alike when they lie on the operating table. Life is so fragile and so many things cannot be helped. Why bother fighting over anything in this world?"

"The villagers told me all about how Tzu Chi regularly distributed goods and held free clinics, and I was deeply touched," said Dr. H. Gunawan, first-time participant of a free clinic. "So I decided to look for them and become one of them."

During the two-day event, a total of 4,481 people were treated. In addition to the residents of Serang, patients came from as far as Sumatra, because they had heard that Tzu Chi free clinic services were so comprehensive.

Sister Liu Su-mei, head of the Tzu Chi Indonesia branch office, stated that after each free clinic, volunteers continue to follow up on patients. For surgery patients especially, return visits to local hospitals would be arranged until they had fully recovered.

The success of each free clinic involves much hard work. "We spent three months organizing this clinic," said Brother Chen Fu-cheng, free clinic organizer. "Communicating with doctors, borrowing equipment and facilities, and getting out pubic notices all take time. We had to take special care in screening for patients whose condition required surgery lest they make a special trip here for nothing."

Currently there are only twenty certified commissioners and nineteen trainee commissioners in Indonesia, so one person often has to take on many responsibilities. To this, Sister Wang Shu-hui said, "Although there are so many things to be done, we are all delighted to be able to give!"

The funds for the free clinic came from the continuous fund-raising efforts of local Tzu Chi members and donations made by many Taiwanese businesspeople and local Chinese in Indonesia who want to repay to local society what they received from it.

Since 1995, Tzu Chi members in Indonesia have been distributing medicine to tuberculosis patients and holding free clinics in Serang. Their actions have inspired a number of local doctors to become involved, and this time many doctors signed up for the free clinics on their own initiative.

One team of doctors was led by the director of surgery at the Indonesian air force hospital, Dr. Chandara, who had visited Tzu Chi headquarters in Hualien in August 1999. "I now have a wish, and that is to set up a free clinic center in Indonesia to take care of the medical needs of every poor person," he said.

Dr. H. Gunawan came to know about Tzu Chi during a free clinic in Cilincing village, where locals told him about how Tzu Chi regularly distributed goods and held free clinics. "I was deeply touched that there were such kind people in the world," he said. "So I decided to look for them and become one of them. I am so glad that this time I finally did!"

Doctors from the Tzu Chi Medical Association in Singapore took part in a free clinic in Indonesia for the first time. Despite the language barrier, they were still deeply impressed by the simplicity and sincerity of the locals. They also vowed to return for future clinics because they saw how difficult it was for the poor in Indonesia to receive proper medical treatment.

At the conclusion of the free clinic, these Singaporean doctors donated their electric coagulators to the Tzu Chi Indonesia branch for use in future free clinics. The leader of the Singaporean team, Feng Pao-hsing, also donated the antiseptic and anesthetic equipment he had bought in Germany.

"Although there are many setbacks and difficulties before each free clinic, everything pays off when we see the willingness of many locals to participate and help people," said Sister Liu Su-mei. "Especially when we see villagers freed from sickness through our clinics, all the hardships become a sweet burden that we are willing to shoulder."

Postscript

Suwaresihi, the woman with the large tumor on her back, was transferred to the R.S.S.M. Hospital for treatment for serious anemia and malnutrition. At the hospital, she received nutrition injections and blood transfusions, and local Tzu Chi members brought her nutritious food every two days. One month later, Suwaresihi was healthy and strong enough, and the hospital operated on her on November 9, 1999. She is now in good health.