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Dr. Dan It’s Saturday and the door is closed. He’s inside. Outside: babies cry, mothers pace, children sniffle and fathers sit still with arms folded in laps. There’s a line above a row of seats, along the yellow wall, paint chipped from years of wear, thousands of backs sweating and waiting, waiting and sweating, leaning against that yellow wall. One small blue sign hangs above the door, with crisp white letters. It simply says: DR. DAN. His patients come by the hundreds, every day, on the backs of dusty pick-up trucks, in taxis whose fares cost a week’s pay. They wear their Sunday best. They make it a family event. They wait and wait, outside that door, clinging to the strings of a delicate hope: perhaps the American doctor will cure them. Dr. Daniel Murphy has worked in East Timor since 1998, when it was still part of Indonesia. He worked with Indonesian tanks razing the streets, helicopters swooping over his roof, gunshots shattering bone. He worked while houses burned and bodies were dumped in the sea. The Indonesians deported him, they blacklisted him, but he made his way back. “Security is not even an issue,” he says. “You can’t think about it. You just gotta do what you gotta do.” What Dr. Dan says he’s gotta do is help people until there is no more need. My husband, Jerry, and I are journalists who have come to follow the story of Dr. Dan. We have heard of this passionate medicine man; he is legend in this country, newly born. On May 20, 2002, East Timor took its own reins. It became the world’s newest nation, and for the first time in recorded history, it faced a future alone. For 450 years, Portugal colonized the eastern half of Timor Island, remotely cast between Indonesia and Australia. That ended with a coup in Lisbon in 1974. Indonesian soldiers invaded the year after and stayed 24 more. Since then, documents, transcripts and witnesses have surfaced to substantiate this brutal indictment: the day before it happened, U.S. President Ford’s administration told Indonesia it was okay to invade. One can list dates and numbers about that occupation, but truth is much more brutal than that. Truth lies in the people we meet, the stories they suffered, the wrinkles of their grief. The Indonesians went in with a mission of “encirclement and annihilation.” They maimed, tortured, mutilated, burned. One-fourth of the Timorese population was killed in the Indonesian occupation. The people voted for independence in a 1999 referendum and they won, after a heinous fight. The United Nations intervened, and now — finally — a new nation is rising in the ashes of 200,000 dead. Dr. Dan was there through the country’s worst times, and he has every intention to stay. His Bairo Pité Clinic prescribes free hope to a people conditioned to dismay. He comes from Iowa. He has worked with migrant farmers and the impoverished population of Mozambique. He wears a perpetual salt-and-pepper beard and running shoes on active feet. He sees patients six days a week. On Sundays and lunch breaks, he monitors a tuberculosis clinic. On vacations abroad, he raises money and speaks about East Timor’s plight. He never rests — except once, with a bout of falciparum malaria, the deadliest kind. He took one afternoon off, in the solitude of East Timor’s inland mountains. Dr. Dan has no time for rest; his ideals don’t allow it. With its brand-new statehood, East Timor also jumped to the top of another list: it is now Asia’s poorest country. It has no medical school, no specialists, few native doctors and few diagnostic tools. Tuberculosis, malaria, gastroenteritis and pneumonia run rampant. Women die in childbirth and children die young. “Our health-care system is overwhelmed with things that wouldn’t have to be here,” Murphy says. The year that eclipsed all others was 1999. Fighting after the August referendum led to a “total collapse of the East Timor health system,” according to the United Nations. Seventy-five percent of the people left their homes, and more than 80 percent of those homes were burned to the ground. Health centers perished. Only 25 doctors remained in the country; others fled to Indonesia. Since then, a health crisis remains. The UN reports per capita income at $210 annually; the unemployment rate is 70 percent. Malaria is highly endemic in all districts, 80 percent of children have intestinal parasites and one in five kids is chronically malnourished. The maternal mortality rate, at 850 per 100,000 live births, is the highest in Asia — so high that the U.N. donated 80 motorcycles to East Timorese midwives so they could attend more rural births. Jerry and I squeeze through Dr. Dan’s door as one patient leaves and another one enters. He welcomes us warmly but warns me he can only talk between exams, so I sit against the wall and Jerry stands on the side with cameras in hand. We watch just a smidgen of the life that defines Dr. Dan. It is the work of a dynamo. “One Monday we had 650,” he says. “I challenge anyone to sit down and see that many patients.” He’s seen hundreds of thousands in all, and the number swells every day. In and out, in and out, in a minute or two. No one knocks, they just enter. He sees them all, swiveling his chair, scrawling prescriptions, talking to me, living out his doctrine of grassroots healthcare. He talks about the election in 1999, when 98.6 percent of voters went to the polls and 78 percent chose freedom. That didn’t sit well with Indonesia or its militia supporters. “Everyone was thrown out of the country. Especially me.” He had worked at another clinic, but he returned to a city in flames. He found this vacant house and started anew. “This building was one of the few that wasn’t on fire.” He treated any and all, ignoring the guns and tanks and mayhem as best he could. There were others like Dr. Dan at the time — professionals who risked their lives to save the dying. A young nurse at the Bairo Pité Clinic who calls himself Jhony worked in the Dili hospital then. Women were raped, men shot and stabbed, children torn to pieces. “Lots of people died in front of me,” he says. Supplies were slim; they re-used needles because they had no choice. Jhony says he helped all patients — Timorese or Indonesian — because that’s what he was trained to do. But the Indonesians and their militiamen threatened him for helping their enemies. They told him, “Why do you want to help the Timorese? They’re nothing. They’re stupid.” East Timor garnered world attention then, with Dili burning and people dying. In those days, Dr. Dan did interviews all the time — like this, between the swing of patients through his door. He had to tell East Timor’s story, while he had an audience around the world, he says. It was a story unlike any other. “I’ve never seen a situation where a whole population did absolutely nothing to bring this down on themselves,” he says. “It just came.” The door opens. He turns to examine a little boy, diarrhea, four days running. “I just worry about giardia.” Then he tends to the mother, who delivered a child at home and has a sore that won’t heal. “Complications of pregnancy are very common here. Women die in childbirth all the time.” Dr. Dan works on a shoestring budget and a heavy tweed of love. He can’t cure more than the basics; he hasn’t time to investigate the mysterious. Cancer, heart disease, AIDS: there is little hope in this country. There is no chemotherapy, no bypass surgery, no complicated drug cocktails. First-world health is beyond his means. The door. A woman with epilepsy enters. She reacted badly to the first drug he prescribed, and Dr. Dan can’t find enough of an alternative. He combs the world in order to fill rare prescriptions. When foreigners tell Dr. Dan they’re coming to visit, he asks them to bring stashes of cures. “I always have a list ready,” he says. The door. Two men assist an older woman with scars across her left breast. It’s probably cancer. She went to a traditional healer who meant well but left her marred. She’s beyond surgery, though no one in East Timor could perform it, even so. “So this doesn’t look good,” Dr. Dan says. “Two months of lumps and now pain in the bones. But there’s hope.” He has a medicine that sometimes helps cancer patients. He doesn’t tell the woman she will probably die. He tells her he has some pills, he can’t guarantee they will work, but he will try. He says the woman knows her prognosis; her village neighbors told her it was cancer. She, like most Timorese in Dr. Dan’s experience, took the news in stride. After so much brutality, the Timorese have mentally reconciled their fate, he says. They accept death as a cycle of life. They must, to stay sane. “You have to come up with some pretty good mechanisms for that — and one of them would be not to think of the future at all.” Most of Dr. Dan’s patients are women and he has a simple explanation for that: “Men have almost all been killed. Half of the population is aged 15 and below. So this is basically a country of women and children.” He talks of an 18-year-old girl with a congenital heart defect. In Australia or Europe or America, she’d be fine. In East Timor, she’ll die. So Dr. Dan goes to work online, soliciting donors, seeking visas, searching for connections. Money is always a problem. The government pays some staff salaries. The state pharmacy offers basic medicines. But that leaves a gap for him to cover, about $3,000 each month, to sustain a few dozen workers, a tuberculosis wing, a lab, a laundry, a kitchen, a maternity ward and trips to the mountains for outbound care. He scrimps and scrapes to pay the bills. The power fails, the patients must eat. “We used to get rice from a non-governmental organization. Now we don’t.” When the violence stopped, people quit donating — as though East Timor’s ills were cured by a quick dose of peace. “The work is really just beginning.” The door. A man enters. “He just had a little abscess on his head,” the doctor says. “He was beaten up by the militia in ‘99 and it flares up every so often.” Murphy struggles to stay focused through a day of so many patients. “I have to think about every second, every word, every motion.” But he feels personally compelled to talk about why he is here. He knows his country’s role in East Timor’s past. “So when I think I’m working, and my taxes are going to do this, I feel guilty.... How can we even dare raise our heads anywhere after doing this?” He thinks of the mountainfolk who came down from the hills to vote for freedom. He thinks of their fear of being killed. He thinks of how many times that fear proved right. “The world shouldn’t be like this. Something has to change.” He goes on and on. He does this from time to time, as patients silently wait. And I feel acutely conscious of moments slipping away, precious time pilfered from people in need. Then he gains control, he re-focuses and apologizes for the digression. “Sorry for getting emotional,” he says. The door. A woman enters and he pecks her on the cheek. “She had a baby during the worst crisis time.” No hospital. No doctors. The baby was born with no anus. The only surgeon available was in the Indonesian Army. Dr. Dan personally asked the man to operate on this Timorese woman’s child — his enemy by politics, his obligation by professional creed. The man did, and the child survived. The door. A patient from the previous week. “This woman was very sick last week. Near death.” Stricken with typhoid, burning up — but better now. “When I see people like her get better it makes me feel like at least we’re doing something.” He tells the story of a woman in labor, whom he helped a year earlier. She had trouble with delivery. The placenta wouldn’t come out. She lived just a few blocks from the clinic, but she didn’t go. Instead, Dr. Dan went to her. He found her on the dirt floor. She didn’t have clothes for the baby, she told him. She was too embarrassed to go to the clinic, she said. Pride, standing between life and death. The afternoon goes on, the patients in and out. “It’s just a constant stream. All day.” He says he’s used to it. It was worse when he first came to East Timor. “No air conditioning. I had that wooden chair,” he says, pointing to a patient’s chair, “and can you imagine trying to see 500-600 people? And that’s with tanks, helicopters....” his voice trails off. Now he has this adjustable swivel chair, a gift from an attentive Australian. It’s a small gift, but a cherished one that eases him through wearying days. The sun starts to fade through the windows, but Dr. Daniel Murphy is not finished, not even close, perhaps never. “My work is done when everybody’s healthy. So far that hasn’t happened.” The doctor stays until the last patient leaves, around dark. Then he heads to his computer, alone, in a quiet, secluded room. He connects to his network of friends and colleagues around the world, seeking donations and dispensing information on East Timor. The Bairo Pité patients stop coming around dark because they’re not used to going out at night. Darkness harbors fear and death, for those are the hours in which husbands, fathers and brothers disappeared; the hours when sisters were raped and wives disgraced. But the patients will return again, on Monday morning, rising with the sun. They’ll arrive before Dr. Dan does. They’ll fill every door, every bench, every seat, stoop and sidewalk. And they’ll wait as long as it takes. In the lab, technicians will probe for malaria and tuberculosis and parasites of the gut. They’ll peer through a microscope at tiny strips of glass. They’ll labor beneath a sign on the wall that says: “Near Enough is Not Good Enough.” And it never is with Dr. Dan. |