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Tucked far away deep in Central Asia, Mongolia is an exotic country to most of us here in the United States. Not many of us have Mongolian acquaintances. We are separated not only by distance, but also a different language and culture. Images of Genghis Kahn and warriors on horseback may come to mind when we think of Mongolia.

One morning Vanchensuren, a Mongolian wife and mother of two young children, came to our Clinic desperately ill. She had a relentless fever, shakes and chills for a week and was becoming more debilitated with each passing day. In a couple weeks, she would have great health care insurance, but she had none now.

Initially she was in California with her husband and two young children as tourists. Soon, she was to accept a coveted position of resident scholar at a prestigious university on the East Coast. They were staying with friends in the East Bay. Someone in the small Mongolian community here had previously been to the Clinic and encouraged her to get an appointment.

Upon arrival to the Clinic, she appeared so ill that a recommendation was made for her to go to the nearest emergency room. She adamantly refused saying she had no money and did not want to incur a large hospital bill and debt. During our assessment, she hardly had the strength to sit up. She was passing blood and pus in her urine and had intense pain on her right flank. After a discussion with our staff urologist, a diagnosis of ascending pyelonephritis was made. We negotiated with her family. An attempt would be made to treat her with an injection of a strong antibiotic plus an oral antibiotic. However, if she did not improve in several hours, she was to go to the emergency room. Everyone agreed.

Fortunately, she did well and came in later for a follow-up appointment. What a difference during this second visit and examination, smiles all around! Test results this time came out clear. Treatment in the Clinic was done at a fraction of the cost compared to what would have been incurred at an emergency room. Not only is money saved when comparing evaluation and management of a patient in a small clinic, but also congestion which impedes timely treatment of other patients in most emergency rooms. Because of generous support given to our Clinic, a favorable impact is made, not only for the individual, but to the greater local medical community, their resources and services.