It was barely six o'clock in the morning when bells rang out loud and clear from a local mosque, calling faithful Muslims to morning worship. They also roused me and other visiting Tzu Chi volunteers for another day of work. The thermometer hanging outside our tent read 9.5 degrees Celsius (49 Fahrenheit). It was another wet, cold morning in Muzaffarabad. Dew had condensed inside our tents. Since water was scarce, some of my fellow Tzu Chi members wiped off the condensation with towels and used the wet cloths to wipe their faces. "It should get warmer when the sun gets higher," remarked volunteer Yang Ming-da.

We experienced drastic temperature fluctuations in those mountains throughout the day. The temperature rose to as high as 30+ degrees Celsius (86+ Fahrenheit) during the day and dropped to less than 10 degrees Celsius (50 Fahrenheit) at night. The nighttime cold felt like thousands of bugs made of ice creeping over the skin of our heads and faces. Although we were equipped with cold-weather outfits that were supposed to keep out the cold and keep in the warmth, we still had to use scarves to cover our heads for extra warmth while sleeping.

Sadly, the locals had no professional-grade clothing to help keep them warm at night. It was not hard to imagine how cold and uncomfortable the local residents must have felt trying to survive through the long, cold nights.

We arrived at the UN campgrounds for earthquake relief in Muzaffarabad on October 22, 2005, and set up our tents. We soon discovered that obtaining water was a major challenge for all the relief organizations present there. We bought over ten barrels of drinking water for cooking and brushing our teeth and fetched water for all other purposes from the public water tank installed next to the damaged restrooms. Although the Red Cross and the Pakistani army frequently refilled the water tank, we often found it empty. It was common for us to go several days without taking a shower or washing our clothes. On more than one occasion, our team decided to sacrifice a bottle of drinking water so that we could use the water to wipe ourselves clean.

A highland stream

On October 29, we followed the Jhelum River south from Phagwan to Naushera to conduct a free medical clinic. Some portions of the road were lost to landslides, making the journey treacherous. At one point we had to get out of the cars and walk in single file over a makeshift bridge and down a rocky road. Eventually, we arrived at the village and were able to hold the free clinic.

We spent the night at Naushera. On the way back to Muzaffarabad the following day, we came to the rickety bridge again. Our group was preparing to cross in single file once more when, on second thought, we paused. The water supply to the entire city of Muzaffarabad, and thus to our camp, had been cut off for the last two days. Not having taken a bath in quite some time, we saw an opportunity to wash ourselves by the stream. The water, originating from the Himalayas, was clean and refreshingly cleansing, but it was freezing cold!

Late night visitors

The generators on the UN campground were started up as night fell so that members of the NGOs could continue working into the night. After a hard day's work, the Tzu Chi volunteers donned their down-filled jackets, brewed some hot tea, shared the day's experiences, and began to plan for the following day.

The UN compound was guarded by armed Pakistani guards at night. Some stood guard at the entrances while others patrolled the grounds. This was a difficult job for them: some of them unavoidably caught nasty colds after spending so much time in the freezing temperatures.

At about ten one evening, two tall, armed policemen came to our camp. A bit alarmed, we were wondering about the purpose of their visit when they asked if there were any physicians in our group. The visitors, still holding their rifles, complained about their sore throats. Dr. Qiu Zong-lang, still awake at that time, examined them.

After looking at them, Dr. Qiu prescribed some medicine for the policemen. "Take these twice a day after meals," he instructed them. However, after a bit of thought, Dr. Qiu told them to take the medicine once before sunrise and once after sunset. This allowed the policemen to comply with the observation of Ramadan, the Islamic month of fasting and prayer.

This unexpected encounter between the policemen and a physician and the juxtaposition between lethal rifles and life-saving medicine made for a memorable night in Pakistan.

Grocery shopping

Rice is a major crop in Pakistan. It is sown in March and harvested once a year, in September or October. When we reached Phagwan to hold a free clinic there, the golden rice grains in the terraced paddies were ripe for harvest. Farmers of all ages were working barefoot in the wet, muddy rice paddies. They bent down to cut the rice plants with sickles, and then they stacked the cut plants, including the grain, in big heaps. We found this very interesting; rice farmers in Taiwan usually remove the grain first before piling the empty stalks.

A farmer picked a grain of rice and shelled it open with his fingernail to show us the rice. It was the same kind of rice that had sustained us for the last few days.

This area of Kashmir is very fertile, and crops of all sorts grow in abundance. Gentle breezes wafted the sweet smell of green grass across the fields. We kept a record of the crops that we saw along the way. I could recognize some of them: string beans, tomatoes, radishes, corn, and sorghum. Other vegetables were foreign to me. Trekking on the narrow ridges between rice paddies, we scared grasshoppers out of their hiding places. As we stepped over puddles, a large group of frogs jumped out and hopped away in various directions. Lin Yan-huang, the photographer on our team, grew up on a farm; he commented, "A large number of frogs indicate that there are no harmful chemical fertilizers used in the paddies. The rice grown here is truly organic."

As we walked, we saw a young man sitting under a tree with a lot of vegetables displayed for sale. Because none of us could speak Urdu, we communicated in universal sign language. In the end, we bought three kinds of vegetables, weighing a total of about 2.5 kilograms (5.5 pounds). The vegetables we purchased were very inexpensive, only 30 rupees (about US$0.50).

On the way back to our tents, we came across a physician from the Pakistani medical station. "Grocery shopping?" she asked us.

"Yes, only 30 rupees for all this," we replied, pleased and excited with our purchase.

She looked over our all-male bunch. Smiling, she asked us, "But do you know how to cook?" Her companions could not hide their grins.

In fact, we did not even know the names of the greens that we had just bought, much less how to cook them. We did not even know what they would taste like. We only knew that we would have to cook them to find out.

"We have a chef," we replied with confidence.

Eid Al-fitr

November 4, 2005, was the second day we offered a free medical clinic at Khanda Ballia. It was also Eid Al-fitr, the holiday that marks the end of Ramadan in the Muslim world.

We could feel a festive ambiance in the air as dawn broke. Everyone was dressed up to mark the end of the month of fasting. Children played with firecrackers, just as people in Taiwan do to celebrate Chinese New Year.

Our volunteer interpreter, Ali Shan, told me that people usually celebrate Eid Al-fitr with a huge meal, singing, dancing, and visiting friends and relatives. After the earthquakes, however, people were not in the mood for dancing and singing. This year's celebration was mainly limited to calling on friends and relatives to wish them well.

Even so, people tried to uphold the festive customs of the day as well as they could, given the recent tragedy. A young girl, all smiles, showed everyone a good luck charm which she had drawn on her hand. In a distant field, a group of boys were happily playing cricket, a legacy of the colonial British.

During Ramadan, the month of fasting, people are allowed to eat only after sundown. Because we first arrived at the Muzaffarabad camp during this month, we honored the local custom and skipped lunch. Occasionally, we went into our tents to have a cracker or two to suppress our hunger. Oftentimes, however, we just kept ourselves busy and fasted as our hosts did.

Rice is a staple in the Kashmiri diet, as it is in Taiwan. However, Pakistani rice is different from that in Taiwan in at least one respect: it absorbs more water. One time, Huang intended to cook rice porridge by adding more water to the rice. However, due to the unique characteristics of the local rice, he ended up with regular steamed rice. It didn't matter to us. We were so hungry, we ate and enjoyed it all the same.

After Eid Al-fitr, people are again allowed three meals a day. Liao Ming-quan, a member of the Tzu Chi delegation who doubled as our chef, was now able to openly cook lunch for the group. Dr. Lai Yu-ming also demonstrated his culinary skills during breaks between patients.

While the first lunch after Ramadan featured quite a modest menu--tomatoes, instant noodles, and soybeans with fried brown rice--it was nonetheless the first decent hot lunch for us since our arrival at the camp. The team apparently enjoyed the food so much that Huang continued providing the same menu for several days.

There was endless work to be done every day. Each trip out of our base camp, whether to assess damage and needs or to provide medical service, was a challenge--sometimes to find our way around the quake-damaged roads and sometimes merely to find the way to our destination. Each trip put our perseverance and stamina to the test.

One day our medical team prepared for a clinic at Phagwan as the rest of us got ready to assess needs in the severely damaged village of Balakot. Before setting out, we gathered to practice a Tzu Chi song, "We Are All in the Same Family." Chen Qiu-hua, a teammate rich in international relief experience, remembered that this song had brought smiles back to the faces of patients at many free clinics. Knowing that many people had neither laughed nor heard laughter since the quake, we felt a strong desire to sing for them, hoping to make them laugh again.

"The Pakistanis have a strong will for survival--if they find that their house has collapsed, they simply erect a tent beside the rubble," said Dr. Ye Tian-hao, my teammate and a member of the Tzu Chi International Medical Association. "To prevent the tent from being blown away, they anchor the tent with four pegs driven deeply into the soil." He treated patients in a similar tent. A small effort on his part, he said, produced significant results as he was able to help make people feel a lot better with some proper medical attention.

The innocence of the local children impressed Dr. Ye. "When you smile at them, they smile back, and when you wave to them, they wave back. Just like mirrors, only theirs are sweeter and more resplendent than mine."

Dr. Wu Wen-tian, a physician in the orthopedic department at Hualian Tzu Chi Medical Center, was more sentimental. "When we were getting ready to move the clinic to another site, a college student asked me when we would come back. I was reluctant to disappoint him, but I had no other choice but to honestly tell him that it would be a while before our return."

In a last-ditch attempt to keep the Tzu Chi volunteers there a while longer, the student took Dr. Wu on a tour around the village. "He took me to a tent crammed with 25 people, and then to several patients' homes and told them that I was leaving with the group," remembers Dr. Wu.

Hoping for another chance to return and serve again seems to have become a common hope for both teams of Tzu Chi volunteers who visited Pakistan's quake zone in 2005. They know that, deep in the mountains, there are still many earthquake survivors waiting for help that can only come from the outside.

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I Miss My Home in the Mountains

Narrated by Dr. Chien Sou-hsin
Vice superintendent of Dalin Tzu Chi General Hospital
Translated by Tang Yau-yang
Photographs by Lin Yan-huang

We returned to Taiwan late at night on November 15, 2005. Everyone in the delegation was unshaven and weary. Many Tzu Chi people came to welcome us home at the airport.

In Pakistan, I thought of my family in Taiwan whenever I looked up at the cloudless skies. Now that I am back in Taiwan, I miss the Pakistani "family members" that I have left behind. When they embraced me to say good-bye, they asked me to keep praying for them. I still pray for them frequently and think about them always.

I don't shed tears easily, but I cried quite frequently on this relief mission. The first time was in the Islamabad Airport, as I saw carton after carton of relief supplies roll off the luggage carousels. I knew I was looking at the support that people in Taiwan, Turkey, and many points elsewhere in the world were pouring out for the Pakistani survivors. I could not help but cry at the display of love this represented.

The second time I cried was on the day the Golden Bell Awards [the Taiwanese version of the American Emmy Awards] were announced. I had been nominated for "Best Host for a Cultural Information Program" for my role as host of "The Doctor with Great Love" on Tzu Chi TV. On the day the winners were announced, my son sent me a cell phone message: "To me, Daddy's nomination is just like winning the award." This was his gentle and tactful way of informing me that I had failed to win.

I cried not because I had failed to win. Rather, it was because I was so touched to see how mature my son was. Furthermore, the message reminded me of what a good environment children in Taiwan have in which to grow compared to their contemporaries in Pakistan. The children I was helping were living in makeshift tents set up along the roads, uncertain of their future. The contrast was heartrending. Again, I could not keep the tears from flowing.

Islam has strict rules on the physical separation of males and females. Females wear veils to shield themselves from public view. Males are extremely protective of their female family members. However, when we were holding free medical clinics in the mountains of Kashmir, the villagers there trusted the visiting Tzu Chi physicians so much that they even invited us into their homes to treat their female family members.

On one such occasion, our host offered us tea with milk as we were preparing to leave the home. Knowing that they could hardly feed themselves, we respectfully declined. However, he insisted, reassuring us that the tea had been made with clean spring water and so was safe to drink. Because the full-bearded, wide-eyed man was so eager for us to stay and share tea with his family, we decided to accept his invitation. Despite the differences between our two cultures, he and his family had actually accepted us as their brothers and were willing to share with us whatever they could offer.

It was very chilly at night in Kashmir, and the same kind of blankets that were given to the quake survivors kept us warm in our beds. Using the same blankets as the survivors made me think of the same warmth that they might also be feeling. This was a source of comfort for me.

We held a simple presentation ceremony before we released the relief supplies. Hu Guang-zhong, a Muslim Tzu Chi volunteer from Turkey, respectfully recited a verse from the Koran and then read a letter from Master Cheng Yen to the survivors. While people may have different ethnicities and religions, there are no real differences in human hearts and minds. I finally understand why Master Cheng Yen established the Tzu Chi Foundation and built hospitals--to let all strangers become family members and let former adversaries live peacefully together.

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Bowing Low with Respect

Narrated by Dr. Li Jun-yi
Chief of Anesthesiology
Xindian Tzu Chi General Hospital

Our Tzu Chi mobile clinics had a unique feature: the doctors spent a lot of time educating patients on good hygiene and personal care. Many of our patients had been previously treated for injuries in other clinics. However, we found that many of the patients did not know how to properly care for their wounds after the initial treatment. The result was further infections or inflammation.

In contrast, we gave patients medicine and explained to them the proper way to change the dressings on their wounds. We urged them to return to our clinic if they could not change the dressings themselves.

I was responsible for maintaining order during one of the relief distribution events. A young man kept jostling forward for fear of not getting his relief supplies, so I had to ask him to stay back. He came to my clinic the following day. I apologized to him for my "rudeness." He apologized too, saying that his previous experience had taught him to "play tough" in order to get relief materials before they ran out. This was why, despite holding a claim ticket from Tzu Chi, he had tried to jockey for a better position.

He came to the clinic with two children by his side. I reminded him that his bullying others for a better position in line might set a bad example for his children. I was shocked by his unexpected response. "If I did not have children to support, I would not have played tough." Then he asked me, "If you had children to feed at home, hungry and cold, wouldn't you have done the same?"

Dumbfounded, I couldn't answer him. He lowered his head after asking that question. A moment later, he raised his head again, eyes reddened. Before he left with his children, I hugged him.

I am now back in Taiwan and cannot remember his face clearly. But I can recall his sad, teary eyes. Natural disasters destroy more than life and property. They also rob people of their dignity and self-esteem.

I finally understand the reason why Tzu Chi relief volunteers bow 90 degrees and use both hands to give relief goods to the recipients. These are traditional Chinese ways to show their respect to these mentally and physically tormented people.

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Village after Village

Narrated by Dr. Qiu Zhong-lang
Chief of Neuro-oncology
Dalin Tzu Chi General Hospital
Translated by Tang Yau-yang
Photographs by Lin Yan-huang

Using Muzaffarabad as our starting point, we trekked along the Jhelum River, offering free medical care wherever necessary. On our journey, we stopped and treated patients in front of dilapidated houses, on school playgrounds, or in tent compounds. We saw all sorts of ailments and suffering. The children we treated suffered with broken bones, pneumonxia, diarrhea, and many other heartbreaking illnesses. Adults bore the same illnesses and more--such as high blood pressure or diabetes--without medicine.

At one place, we treated a baby girl who had been buried in the rubble of a collapsed house for three days. She survived the ordeal, but was quite gravely wounded. By the time we examined her, the wounds on her head had been left untreated for more than 10 days. It hurt to see the white of her skull exposed through her still-open wounds.

For other children, simple colds turned into life-threatening pneumonia. Some had bloody stools, which if serious could lead to blood poisoning. The local government and the International Red Cross were aware of the potential problems and had obtained 120,000 doses of immunization shots for encephalitis, measles, and hepatitis. Unfortunately, the huge geographic area affected by the quake made it very difficult to effectively sign up patients and administer shots.

With each passing day, survivors must cope with more than the direct, physical wounds received during the quakes. They must also contend with contagious diseases and lingering psychological traumas wrought by the deadly tragedy. At another stopover on our trek, we saw some students sitting on piles of rubble, staring blankly at what was once their school. Families, or what was left of them, gathered and wondered what to do next. The psychological wounds are just as real as the physical wounds. Proper treatment and support of the former is just as important as the latter, but easily and frequently overlooked. I worry about how the survivors are going to carry on.

When we arrived in Pakistan on October 19, 2005, the official death toll was 25,000. Within twenty days, it had climbed to 73,000. Medecins Sans Frontieres predicted a second wave of casualties in the coming winter. The danger is particularly acute for the 200,000 people in the mountains around Muzaffarabad. The government has urged residents there to go to the lowlands to avoid the brunt of the severe winter. They can return to rebuild when it gets warmer. Unfortunately, some may be unwilling to leave their homes or may simply be prevented from doing so by damaged bridges and blocked roads.

The wide temperature swings between day and night made it seem like we experienced all four seasons in a single day. The scorching heat during the day was enough to dry and crack one's lips; winter arrived at night when the temperature dipped almost to freezing. Everyone on the relief team knew the importance of staying healthy and energized. Only by doing so would we be able to provide assistance to others. We could not afford to lose even just one member to injury or illness, because everyone had an important and unique role to play. We took medicine at the first sign of a cold.

In order to get in shape for international relief trips, I usually run 20 kilometers (12.4 miles) about twice a week. For this trip, I equipped myself with hiking shoes, gloves, cold-weather pants, etc. But I was unprepared for how hard this trip would be. On the fourth day, one of my shoes split in the front, and I had to tape it up. Ye Zi-hao, one of our teammates and a reporter for the Tzu Chi Monthly, suffered a similar fate with his shoes. As I continued to walk in my only pair of shoes, the opening in the shoe enlarged, forcing me to wrap it again with heavy-duty tape. I finally got a new pair when the second Tzu Chi team arrived to replace us.

We spent more than 20 days with local residents, police, and military personnel, and we found them to be very friendly. They would greet you first whether they knew you or not. Although resources were scarce after the earthquake, they warmly treated us to milk tea.

One day while we were there, an uncle of Mohammed, our volunteer translator, died of a sudden heart attack. We all went to the funeral to express our condolences. After the ceremony, Mohammed's family and friends came over to embrace us and said, "You are our brothers." I couldn't hold back my tears, feeling the power of love to unite everyone, even strangers.

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Love in Every Drop

By Ye Zi-hao
Translated by Tang Yau-yang
Photographs by Lin Yan-huang

Ali Shan was our volunteer interpreter while we conducted free medical clinics at Khanda Ballia. He asked the physicians on the Tzu Chi relief team if they would be willing to make a house call to his home, where his wife needed medical care. She, like all females in Pakistan, was not permitted to expose her body to the outside world, much less to some non-Muslim male strangers from Taiwan. We were surprised and also touched by his trust in us.

Drs. Chien Sou-hsin and Ye Tian-hao had the honor of representing the team. She was weakened by dehydration brought on by severe diarrhea. She needed an infusion of water and nutrients. Although we had brought the needed IV fluid from Taiwan, we did not have the tubing to administer it into her body. The doctors decided to use a general-purpose syringe for the job.

There were 300 cc of fluid in the IV pouch to be injected, but the syringe could hold just 10 cc at a time. Using two syringes, the two physicians worked together--one would fill a syringe with the IV fluid while the other worked with the other syringe on Ali's wife--all the while keeping the needle in place so that she only needed to be jabbed one time. Thirty repetitions and 45 minutes later, the job was done.

Three days later, we went to distribute relief supplies at the military camp in Hattian Balla. On the way, we saw that Ali's wife was up and about, well enough to be working in the rice field. We were glad that Tzu Chi's "IV of love" had worked so well.