Knockin' on Heaven's Door

As we edged rock by rock weaving our way through the clouds in India’s version of the Holden Barina, our suspension drifted from pothole to cliff drop towards Geyzing. The fog had descended and wrapped itself tightly, as though it wanted to squeeze the mountain faces together for a group hug and didn’t want to let go. Visibility was barely two meters in front and Vinod, our driver, impressed me with his technique of switching the lights from low to normal to high beam to try to gauge the distance in front of us. It wasn’t comforting. Axel Rose’s voice rung out through the cracks of the misted windows played through our guide Krishna’s late 90’s Nokia phone speakers... Knock, knock, knockin on heaven’s door, hey, heey….It could only be a bad sign.

In Sikkim, the closest hospital to Pelling is in Geyzing. It’s only ten kilometres away, but in a ten seater jeep, on partly sealed and unsealed hairpin bends snaking their way around mountains, the trip takes thirty minutes on a clear day. In our case, at night in a run down hatch back with fog and darkness blanketing the roads, the trip takes almost an hour. Geyzing is known among travellers as a transit hub to change jeeps to get to other small towns on ‘The Monastery Loop’. It’s also known to locals and whoever has had the unfortunate opportunity to experience it, as the only medical treatment facility within an hour of all the towns on this Loop.

On the journey, I learned that healthcare is free in Sikkim. ‘Hooray for Sikkim!’ I hear you say. The government is doing some good in the hood. But in this case, ‘free’ definitely does not equal ‘good’. It’s not even average. It’s woeful. At night especially, the hospital looks more like a condemned building being prepared for demolition - from the outside, as well as from the inside. The seemingly deserted building gives off a shady vibe and odour as you enter it. Disinfectant and sickness line your nose. The concrete floor and walls bounce every sound from the hollow rooms to the metal furniture rounding off the sense of worry and doubt that takes hold of a foreigner when you see the building for the first time. The night attendant informs us that there are no doctors or nurses on the premises and they need to be called in. The attendant makes the call. A family of eleven arrive in a jeep as we get out of our car, and silently carry in a sick child passed us. They aren’t surprised at the lack of noise or life inside. Business as usual at 10pm at Geyzing Clinic ED.

Three staff work the night shift. A doctor on call, a nurse and the night attendant who we’ve already met. My education about Indian Health Care continued when I came to learn that pain relief is maxed out with the administration of paracetamol. Codine is illegal in all of India and anything stronger is a laughable suggestion. Even though the doctor and nurse want to relieve your pain to help you, a proper medical inventory isn’t available to them. I think of home. If we were there, they would have the IV plugged in on the roadside, and you’d be on your third dose of morphine as you approached the hospital in a climate controlled, shock-absorbing five-star ambulance. There are no ambulances at night here. The pain from any injury is simply endured by patients. I think to myself, "This must be to remind them that they’re alive and should be grateful for that in itself."

The doctor attends to the child first. I caught a glimpse of his small blanket wrapped face. It was white, and his eyes were dim when he arrived. He lay on the bed looking into nothing. His feet dangled out of the blanket he came in, and they looked cold. His family gathered around him, and spoke quietly with the doctor. Maybe he got worse too quickly, maybe they couldn’t afford to get a car earlier, maybe they overlooked his symptoms and only realised too late the seriousness of his condition - pneumonia. Who knows. Only a green cotton screen is placed around the front of his bed to give them some privacy. The doctor checks his vital signs, and a rusted oxygen tank that looks like a WW2 relic is wheeled to his bedside. A mask is placed over the boy’s face. A few minutes later, the tank rolled aside and the doctor leaves the room.

We didn’t know what was going on. I asked Krishna… He says, “It’s over. The boy is gone.” 

Death was first met with silence. The child’s mother stepped behind the screen and released a muffled sigh and a painfully soft sob. After a few seconds, she left his side and the men returned, picked the child up and carried him out. We met the eyes of the younger men, and nodded our heads in acknowledgement and condolence. Krishna smiled at us and gave a small head wobble because we were so solemn. He vocalised his compassion to the family and spoke a little with the young men. As they chatted, they looked at us curiously, and I could only say “I’m sorry”. Krishna smiled and wobbled his head again at my reaction in a way that made me feel completely foreign. I took it to mean, ‘You don’t need to say sorry, death is a part of life, it’s not an uncomfortable subject here’. I looked at my companions in embarrassment, confusion and a little disbelief. I looked around the room I’m was in, with broken plastic chairs, a broken window, dirty sheets on the plastic mattress on a rusted iron bed inside an unrendered concrete block. 

Where were we?!??