Our job was providing technical assistance in setting up the dental and midwifery clinics, to assist in the training of village health care workers and to volunteer our services as health practitioners. Since medical care is out of reach to the poor of this region, the opening of a free clinic is a lifesaving effort with far-reaching effects.

Early morning at the clinic compound we wake to find villagers waiting at the front gate who walk many miles in the cool dawn hours to reach us and who are willing to wait all day to be seen. We begin our day in the classroom with 25 students learning basic health care, such as cleanliness and sanitation, recognizing common illnesses in their area, vital signs, nutrition, healing without medications, the value of water in health care, basic care of the pregnant woman, emergency childbirth, care of the skin, and prevention of malnutrition and dehydration. The students are bright and eager to learn.

Malaria is the big killer here, especially of the very young and the very old. The incidence of malaria is on the rise due to an increasing resistance to the drugs which are used to treat it. It is a disease which returns again and again to weaken the host. The parasite destroys red blood cells, leaving the recovering person anemic. Vomiting and diarrhea further add to the picture of dehydration, malnutrition and vitamin and mineral depletion. To top it off, the local diet is very poor in iron, vitamins and minerals, making recovery difficult. The climate is so hot and dry, with such a short growing season, that there are few fruits, vegetables and grains grown here. Imported food is expensive. We saw very few home gardens here. Seventy percent of the population are subsistence farmers scratching out a meager living from the sandy soil. Many of the people we saw had lived for years with their afflictions because of their inability to pay for medical care.

One of the important things I learned on this trip is how much health care can be taught through simple things like nutrition, hygiene, sanitation, rehydration, gardening, herbs and safe sex. All these practices keep folks out of the medical system and can be taught by one lay person to another-no college degree needed here. I was amazed when I realized that some of the Africans I saw in sub-Sahara were unaware of their need for lots of water, one example of a small teaching that is very health enhancing and really important information. Studying and working with David Werner's classic village heath care book, Where There is No Doctor, was a great education in basic medical care and a guide for tuning in to the level of work we need to do in developing countries.

Life is more precarious here and requires some tenaciousness, a clinging to the edge of the desert with sand and wind, hot sun and salty water. It breeds a kind of intelligence that is beautiful to behold. You can see it in the eyes of the children and you just want to feed it any way you can. And the payoff is big. One man said to me "Your husband, he pulled my tooth. I love him too much. I will make dur for him." (a way of saying "I will take care of him always" - "dur" is like dowry.)

We were treated with the greatest respect. We were immersed in the culture, sharing meals with Dr. Askari and her family. We were housed in the best of quarters. This clinic will be relying mostly on volunteer medical staff and welcomes short stays. We found our stay to be a very enriching experience.