Healing the Montagnards

Years before full-scale U.S. involve ment in the war, and long before USAID-supported programs for civilian pacification got under way, some Americans were hard at work in South Viet Nam helping strife-ridden citizens. Few have worked harder against greater odds than Seattle-born Dr. Patricia Marie Smith, 40, who has been in the central highland province of Kontum since 1959, first helping in a leprosarium, then running her own makeshift clinic, now operating a 40-bed hospital.

What made Dr. Smith's work especially tough was the nature of the people she wanted to help. These were the mountaineers whom the French politely called Montagnards, a people apart from the lowland Vietnamese who sneer at them as moi (savages). In any language they are rebellious, superstitious, troublesome and riddled with diseases. Traveling by Land Rover, the big-boned, blue-eyed doctor sat around the fire in 200-odd Montagnard villages, becoming fluent in their principal dialect, sipping their raw rice wine and occasionally, as a good guest should, eating a native delicacy--rat.

Log Casket. Even these heroic efforts, over two years, failed to win the Montagnards' confidence. Then one evening Dr. Smith chugged into a village and saw, outside a long house built on stilts, a twelve-year-old girl in shock from diarrhea and vomiting. "Her father and brothers were so sure she was going to die," Dr. Smith recalls, "that they were hollowing out a log for her casket." Dr. Smith pulled out her infusion kit, hung a bottle from a bamboo overhead, and stayed up all night dripping fluids into the girl's veins.

The child's quick recovery so astonished the Montagnards that they began to pass the word that the white woman's magic might be even better than that of their own women sorcerers. The trickle of patients to Dr. Smith's five-bed dispensary in the provincial capital of Kontum grew to a steady flow and then an overflow. Dr. Smith thereupon began a long struggle to build a hospital outside Kontum, which many Montagnards regarded as a hostile city.

"Stop Firing!" The Minh Quy hospital, supported by several small Roman Catholic charities, is now a complex of six whitewashed buildings that are almost as overcrowded as the old dispensary. For its 40 beds there are 120 patients; fortunately, many of them actually prefer to lie on mats on the floor or on porches outside the buildings. There are no minor illnesses. "When a Montagnard comes in from his village," says Dr. Smith, "we take it for granted that he's malnourished, mostly from protein deficiency, that he has intestinal parasites and also malaria. After that, we ask what's wrong with him." Despite the confidence she has won through her skill and insight, Dr. Smith finds that many patients still will not go to the hospital until it is too late.

The war sometimes intrudes. In 1965, the hospital was caught in crossfire between Viet Cong and Americans. Dr. Smith herded all her patients into the wards and got all but one, a boy in traction, onto the floor to reduce the risk of casualties from machine-gun bullets. When Americans urged her by phone from Kontum to take refuge in the city, she snapped: "Don't be ridiculous! I can't leave my patients." Then a stray bullet hit a woman in the thigh, and Dr. Smith was on the phone again, this time barking at an American commander: "Stop firing on my patients!"

If anyone had told Patricia Smith when she entered the University of Washington that she would some day be pinned down by machine-gun fire, she would have hooted. Her first choice was journalism but, bored with that, she switched to premed. After internship, Dr. Smith became bored again, this time at the prospect of "tending to well babies and anxious mothers," so she worked for two years at a miners' hospital in depressed Appalachia. When that closed, Dr. Smith went to a Catholic women's organization, the Grail, and volunteered for overseas mission work. Now she has no time to be bored. In 3 1/2 years her Minh Quy hospital has admitted 12,000 different patients, and no one has counted the outpatients who show up for treatment during clinic hours. The Viet Cong give Dr. Smith no direct trouble, probably because the Montagnards have formed a living shield around the woman they now call Ya Pagang Tih--"Big Grandmother of All Medicine."

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