My Mongolia Memories
by Diann Wingert

Hikers and adventure seekers are increasingly drawn to Mongolia for its dramatic landscapes, a land with no fences where the nomadic lifestyle still occupies nearly half the population. Mongolia's remarkable geography - the deserts, mountains, lakes, steppes; the summer days in which the sun shines until at least ten in the evening; images of herds of sheep, goats, wild horses, camels and yaks present a romanticized version of this mysterious country. Foreign tourists can even stay in a "ger" in the countryside, the traditional Mongolian felt tent which remains the dwelling of the majority of residents to this day. But there is another side to this "Land of Blue Sky," one that reveals both heartbreaking circumstances and a compelling opportunity to help.

Mongolia is a large but sparsely populated and relatively undeveloped country in central Asia which broke free from more than 70 years of Russian domination with the collapse of the Soviet Union a decade ago. Not too long ago, foreigners were not even allowed in Mongolia. Along with the decline of the Communist economic structure went most of the country's social welfare programs and money for children and youth. Healthcare, the legal system and education have suffered enormous losses. With nearly 43% of the population under the age of 18, children have been hit the hardest.

Mongolia is now one of the poorest countries in the world, with one third of the population living below the poverty level. Mongolia has become proportionately one of the largest recipients of multinational aid in the world, accounting for approximately one third of the county's Gross Domestic Product (GDP.) Even though a number of NGOs (non government organizations) have been established in Mongolia to shoulder some of the responsibility for meeting the needs of disadvantaged people, most have inadequate resources and are typically working in isolation from each other. The vast territory, combined with the low population density makes delivering services very expensive, and is often complicated by the nomadic lifestyle of people in rural or isolated areas.

A recent UNICEF report on the social conditions in Mongolia links the depressed economy with increased alcohol abuse and increased violence against women and children. There are more than 4,000 "street children" in the capital city of Ulan Bator, hopping in and out of manholes, keeping warm during the long, cold winters by huddling together near the city's underground heating system. These youth have become runaways for the same reasons that kids end up on Hollywood Boulevard: alcoholic parents, domestic violence, child abuse, poverty. Life on the streets is no easier, as they must support themselves by shoplifting, pickpocketing, prostitution and competing with adults for the most menial of jobs.
These children are a testimony to the declining ability of many Mongolian families to meet the needs of children in a country that has traditionally valued them as their most precious resource.

In Ulan Bator, the remnants of Soviet socialization are numerous, from the Russian language signs to the drab cinderblock housing. Even the textbooks in the nursing college are written in Russian, although the nursing students only speak and read Mongolian. The Maternal and Child Health Research Institute is much in need of renovation; from the physical facility to the level of training, education and research.

Several NGOs, such as Save the Children UK, have been instrumental in helping to get social work publicly recognized as a profession in Mongolia, by working closely with the government and the State Pedagogical University, a training program was established, producing graduates who have been placed as school social workers in large urban schools. Their focus is on achieving more inclusive education for all children, to improve teachers awareness of psychosocial issues that may affect students and to reduce the number of children dropping out of school.

During my visit, I had the opportunity to introduce the physicians and nurses at the MCHRC to the role of the social worker on the medical team. Concepts so familiar at CHLA, such as "child-focused environment" and "family centered care", "developmentally appropriate interventions" and "interdiscipinary plan of care" are completely unknown to Mongolian medical providers.

There is no concept of the medical social worker, family centered care, child life, no exam tables, no colorful artwork, no videogames or t.v. sets, no volunteers, no stuffed animals, no quilts on the beds, no band aids, no gowns, no drapes, no medical records.