‘You must experience the winter here,’ is what a local partner of The Denan Project (TDP) told me during my visit to Mongolia in July 2017. So, I thought I was being clever by picking September instead: not the tourist-friendly months of July and August, but safe enough from the harsh weather of its long winter. Well, let’s just say…I was only half right 
Day 1: A Long Drive Across Frozen Mongolian Steppe
The long drive from the capital city Ulaanbaatar (UB as the locals call it) to Tariat started at 6AM, September 17. UB wasn’t fully awake yet — and neither was I. But I was looking forward to seeing the hospital staff in Tariat and Erdenemandal I met for the first time last year, and experience firsthand the progress they made past 14 months (and for the last 7 years since TDP’s arrival in Mongolia).
Just when I was about to reach my very limit and lean over to ask the driver about the cost of fixing the car’s suspension system, we entered Tariat. (Hooray!) Colorful roofs dotting the gray open field…gave me an instant relief — and made me smile.
Day 2: Promises Made, Promises Kept — and Renewed
Facing a compressed schedule for the day, we started early from our ger (yurt) camp and headed to the hospital to meet the staff and patients. Over a hot cup of kumquat tea (perfect for the cold morning!), the Head Doctor Dr. Gereltuya and her staff went over our regular metrics and new findings, such as how dental checkups revealed that 97% of the population have dental problems. They also shared their goals for the next 12 months. Among the topics we discussed, I was most impressed by how well the Tariat doctors are using the mobile examination tools we provided last year. They showed me medical reports generated from individual checkups. So far they provided baseline checkups for 900 people (measuring glucose, cholesterol, etc. for 18% of the total population), and are working to cover 60% of the total population (4,939) by the end of this year. This initiative will help them provide preventive cares, something that’s utterly lacking in many developing countries.
Another notable new initiative was their goal to become Brucellosis-free soum (district). Brucellosis is an infectious disease caused by a type of bacteria called Brucella that can spread from animals to humans, affecting many herder families. They’ve already examined 500 children ages 10–18, and treated 13 of them. Disseminating prevention information to herder families is a critical part of the initiative. As of now, there’s a vaccine for animals but not for humans. Every newborn animal will be vaccinated, and every animal will be tested but it’s up to the owner to put down the animals when they are infected.
Seeing how snow starts to fall in September, it was no surprise to Dick and I that the hospital is in need of a garage. But I was astonished to learn that they have to spend 40–60 mins just to de-ice the ambulance by burning firewood after receiving an emergency call. ‘Whaaat???’ was my response. That’s what they’ve been doing to cope with the winter temperatures that routinely dip below -40 ° (even -60 ° at some nights) without a garage. It was clear to Dick and I that we simply have to finance a heated garage for the hospital!
Walking around the ward, I saw what-felt-like a miracle. Yes, running water inside the hospital! The long-promised (and long-delayed) water was finally there, hot and cold, hooray! Now the government just needs to connect the hospital to the central sewage system so that they can have indoor toilets!
After the hospital visit, we went over to the Tariat school near the hospital. I had a keen interest in meeting some of the students in our Health Club, and possibly recruiting some more. The vibes inside the school and the dormitory were just what I was hoping to feel: bright, energetic and colorful. Maybe they were just being nice, but we did see all hands raised when we asked who would like to join the TDP Health Club 
Day 3 Big Changes. Small Details.
The next morning, we started even earlier to get to Erdenemandal Hospital. The district of Erdenemandal is a bit bigger than Tariat with a population of 5,644 (of which about 10% are under age 5). Although the hospital building is much bigger than that of Tariat, the outdated Soviet-era building was in much need of repair or rebuilding. I was excited to meet the hospital doctors and continue the conversation we started during my last visit.
To my delight, the Head Doctor (who is also the hospital surgeon), joined by his staff, greeted us with a full slide presentation, detailing the surgeries he performed and how each of the medical equipment and supplies we provided are being used (surgical gurney, monitoring screens, etc.). We were also happy to hear that the hospital dentist was finally able to treat her patients (a total of 877 cases during the past 12 months) with the dental supplies we provided.
After the staff meeting at Erdenemandal Hospital, we followed a local bagh doctor who’s making a house call to a herder family. Despite the apparent limitations (lack of medications, limited medical training, etc.), I was relieved to see how everyone, no matter where she lives, has access to free medical care.
Day 4 Progress in Sight — and Fast Approaching
On the way back to UB from Erdenemandal, we stopped at Aimag Center (the capital city of the Arhangai province overseeing Tariat and Erdenemandal) to meet Dr. Gandiimaa, Director of the Arhangai Department of Health. Over the years of our partnership in the region, she became an ardent supporter of TDP initiatives and a great adviser. We were particularly thrilled to hear that due to recent improvements we’re making in Tariat and Erdenemandal, the number of patients coming to Aimag Center from those districts has drastically decreased. Furthermore, the success we’re making at Tariat Hospital is becoming an envy of other hospitals in the Arhangai province.
Back in UB, spending hours trying to iron out the details of our next budget year with Dick, before flying back to Munich, I couldn’t help but think how many high school students raised their hands to join our Health Club and get trained by our doctors. Facing a serious challenge in recruiting medical specialists to work in remote places like Tariat and Erdenemandal, it’s clear to me that we need to start getting more active in nurturing the local students, helping them get advanced education — and serve the community. If we can succeed in that initiative here in Mongolia, we can certainly try to replicate it in our other facilities in Peru and Ethiopia. And THAT is a wonderful reason for me to come back next year, and measure our progress with the students who raised their hands.
