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Painting a Hospital - 9/13/05

I hadn't thought of using patients to help paint a hospital, nor doctors, nurses or the cook, but they, along with several local arts students and other community volunteers, were pressed into service by Dr. Ardan Batorov, pediatric specialist for the Orlik Hospital's Children's Clinic.

Orlik is a small village in Russia of about 2,200 people approximately 400 kilometers south east of Lake Baikal high in the Sayanie Mountains not far from the Mongolian border. The village's hospital serves as the major trauma and health center for a vast, but sparsely populated region (approximately 40,000 people in an area about twice the size of Rhode Island) - and does so without the benefit of running water.

I first visited Orlik as part of a delegation of people from the Adirondack Park organized two years ago in September 2003 by Dan Plumley, director of the Totem People's Project, and first visited the hospital nine months later on a solo return visit arranged through the Adirondack North Country Association and backed by an anonymous donor. At that time I was impressed by the dedication and caliber of the doctors (who earn around 4-500 dollars a month) and the modest facilities and medical resources available. Knowing how long, dark and grim the winters can be, especially on patients living in a hospital with all white walls, I determined to return and help at least make the physical environment more warm and relaxing, first and foremost for the children patients.

When in Orlik in May 2004, I made a presentation to the hospital leadership (grand round in our terms) that showcased the use of the arts in hospitals. They were quite enthused and said if I would return they would start such a program. Several cartoon images on doors and walls in the Children's Clinic created by the hospital director many years ago demonstrated their understanding of the value of using the arts to uplift the spirits of patients. I also noticed that the hospital's lab was equipped with a microscope that used reflected sunlight as its light source - this to examine for blood infections and other medical conditions. With the help of Dr. Carl George of Union College, who successfully encouraged his college to donate an electrically powered microscope of far greater magnitude, and the delivery assistance of the High Gold Mining Company of Toronto, that immediate technical need was filled.

A Fulbright grant enabled me to return, although a prime objective was to teach at the East Siberian Academy of Culture 1,000 kilometers away in Ulan Ude. The time for Orlik was a brief window between arriving in Ulan Ude, capital of the Republic of Buryatia, and my first faculty meeting on August 28 - a mere 10 days to work on the hospital made less by average fourteen hour travel time to Orlik, made even tighter by a three day delay in catching a ride with a hospital van sent specially to bring me and art supplies purchased in Ulan Ude.

Starting Work.


Voting on colors

"We start tomorrow at 9:00 AM," said Yanzhima Vasilieva, director of the Institute of Pandito Khambo Lama Itigelov. "Dr. Ardan is working and it is too late. You sleep now?"

Our trip up from Ulan Ude was so late in departing, and so long on the road, that a planned 10:00 AM arrival had become 3:00 PM. Instead of sleeping, with Yanzhima as interpreter, I started asking the patients and staff for suggestions of uplifting colors and using their ideas to develop possible wall and trim options. By nine the following morning I had come up with four options. A challenge was that the only person in Orlik who spoke English well was in a hospital in Ulan Ude and the local school English teacher was out harvesting, as were most adults. Therefore I developed a rating scale one to four where a happy face equaled #1 and a frowning face stood for #4. I started gathering votes from the patients, doctors, nurses and service staff. Through sign language I explained the voting system. Once a couple caught on they explained to others and soon everyone understood the process and were eager to vote. The tally showed that the children and adults had the exact opposite for their favorite choices but everyone's second choice was the same, a combination pale yellow, light green and red-orange - colors often used in Buddhist temples and believed to have healing properties. The effect would be dazzling. The next challenge was to convert these ideas into painted walls.

"I have one volunteer coming in twenty minutes," said Dr. Ardan at 10:00 A.M.

"I have another volunteer coming in fifteen minutes," said Dr. Ardan. "This one speaks a little English." And so it went through the morning until thirteen people were at work painting walls, working on the trim, and had me constantly mixing paint. They included two patients, two doctors, two nurses, the cook, a member of the maintenance staff, hospital visitors and community volunteers.


Taumna, painting.

Most people spoke Buryat, a softer more rhythmic language with few of the harder sounds of Russian. All constantly asked me questions in both languages - none of which I understood directly, but developed a good sense based on body language and circumstance. In addition I had trouble remembering their names as few were in the more familiar Russian, but mostly Buryat with a certain sing song quality; all except Maxim, a three-year old boy of high energy who was bored and desired and gained attention by ramming into people, tipping over chairs, and getting into the paint. I had a desire to whack him a few times or tie him to a tree with duck tape, but fortunately (or unfortunately from the owner's point of view) Dr. Ardan left his car unlocked and Maxim spend untold hours ravaging its inside and pounding on the horn.

Maxim's mother, Sveta, was a woman of 23 who Dr. Ardan introduced as having artistic ability. I immediately put her on the thankless, but critical edging work where I also painted as much as I could. Our task was to fine-tune the enthusiastic energy that totally transformed the hallway into a space where sunglasses seemed needed. No muted colors for the children of Orlik. At noon Dr. Ardan said, "What about flowers, animals, birds and fish?"

"Ardan," I said, feeling a bit overwhelmed by directing and supervising thirteen people of wide ranging skills, none of whom I could speak with in their native tongue; using a mix of phrase books, Russian-English dictionaries, and a severely taxed Yanzhima. "First we have to create the overall atmosphere by painting the walls and trim and then determine what we want to do where."

"Can I paint them white?" said Sveta of the cartoon-like images on some of the walls.

"No," they have been here many years," I said. "People may be very attached to them. We can improve their appearance by painting the trim around them dark blue so they are better presented."


The entry--before

"What about animals and flowers," said Dr. Ardan around five during our tea break. "What will we do for the kitchen-dining room? What will we do for the entry?"

"I haven't given it a thought," I said. "We have been so busy working on the hall. But let's discuss some ideas." And so we did coming up a mural for the dining area and a sky motif with perhaps flowers for the entry. I suggested we write something on the entry wall to the effect of Welcome to the Orlik Children's Hospital with each letter a different color, but that idea was immediately shot down. I was told that no one ever says welcome to a hospital in Russia. The closest statements the group came up with were either Hello or We Love You, both considered appropriate, but didn't generate any real enthusiasm.


The kitchen, before.

Day Two

"Sveta and her friend Simjet would like to paint the wall of the kitchen," said Dr. Ardan the next morning. "Do we have enough paint? Can they start?"

"Yes we have enough paint," I said, "But first I'd like to see them draw out their ideas on paper. Let's see what they have in mind."

The two young women were fine with that suggestion and shortly came up with very accomplished rendering of an old man sitting at a table reading to an owl, a dog, birds and other wildlife. I was impressed with the sketch as was everyone else. We agreed on a size and they went at it working side by side as of one mind and hand, the only distraction being Sveta's son Maxim. It took the full force of his personality and lungs to make a dent in her concentration - clearly her threshold of pain was at a much higher level than the rest of us were accustomed. But after a while we heard the repeated sounds of Dr. Ardan's car horn, and we all knew he was at least temporarily distracted.


Volunteers painting.

With Sveta and Simjet busy in the kitchen and others finishing the hall, two young girls, Katia Angazhacba, a patient, and her friend Tuana Gomboeva, and I set to work on the entry. We decided on painting a simple blue sky with clouds and a sun on the upper third of all four walls and a huge flower on the side of the clothes closet facing the door. Yanzhima and Dr Ardan were put to work decorating the kitchen tables. The previous day we painted their legs yellow and sides dark orange. They worked on a heart motif. These tasks occupied us all throughout the day.


New kitchen with mural.

Around four a young man came to the hospital and handed me a plastic bag containing six tomatoes and a quarter of a watermelon. "Yanshima," I called passing them a long. "Someone is dropping off food for the kitchen."

Yanzhima spoke briefly with the young boy and said, "These are gifts for you."

"Gifts?" I said.

"Yes, in payment for the hospital. His sister is a patient and their mother sent these to you in appreciation because they have made her stay in the hospital so happy." I was a bit floored and humbled. It was a gift from the heart. It's hard to think when I was better paid.


The entry, after.

Days Three and Four

The next morning Dr. Ardan, Yanzhima and I surveyed the progress.

"I have to work in surgery today," said Dr Ardan. "And I may have a delivery in the afternoon. So I cannot help with the painting."

"No problem," I said. "We have made amazing progress. We will start work in the patient rooms."

"The color shouldn't be so busy," he said.


New patient room.

"I was thinking of just painting the upper half of the wall a light yellow and perhaps painting a border of icons just below the ceiling - some images repeated in a row."

"I like the idea for the color and the modest treatment," he said. "What images?"

"What are symbols of healing in Orlik?" I said. "Are there any particular animals, plants or shapes that represent healing to the people of the region?"

After looking up the meaning of symbols in the Russian-English dictionary and conferring with Yanzhima, he said, "Fish and swans. They are both powerful images of peace and healing."

"I suggest that we paint this one small room this morning," I said, "And that you stop by after surgery and let us know what you think." Pointing to the mural being painted in the kitchen by Sveta and Simjet I said, "These two women are very talented. They should be at the Academy of Culture in Ulan Ude or in Moscow. They could make a very good living as artists."

"There is a very good arts academy in Ikursk," said Ardan, "We have many very talented people here. The problem is there is no money to send them to the academy. Sveta is a single mother. It would be difficult for her to leave now."

The color scheme and fish images in the small room was later approved by for expansion to the other patient rooms by Dr. Ardan and, with the help of Tauna Gomboeva, a young girl of thirteen who had become an avid participant near glued to my hip, we finished two more. The next morning, beginning with the hospital director Dr. Zoua Samaeva, a parade of people came through widely enthusiastic about the results. Dr. Peter wanted to know when we would start painting the adult sections. Doing our best to work in the middle of many interruptions, Tauna, Yanzhima, a medical assistant named Sveta Ivenova, and I finished the remaining patient rooms while Simjet worked on the kitchen mural during her lunch break.

We discussed ideas for a hospital logo with Dr. Samaeva. Based on discussions with our participants, and observations made during my previous trip, I came up with two possible designs; a white goose (swan) against a blue sky, a sacred symbol I saw held on top of a high pole by a carved figure located where many tribes in the region annually gather, and three sacred mountains coupled with a pine forest and the river Orlik. Beneath both designs would be the words Orlik Hospital. Dr. Sameva immediately put her finger on the white goose and said, "This one, but the swan is the symbol of the Sayut people. They are a big part of our district, but most of our people are Buryats. Their symbol is an eagle. You must include both."

"Isn't the symbol of Russia the eagle?" I said.

"No, the symbol of Russia has two eagle heads. The Buryat has just one eagle," she said.

I made several sketches of a swan and an eagle together, but it was clear they made odd bedfellows. Later that evening on a fishing expedition that included Dr. Samaeva, Dr. Ardan, Dr. Peter and several others, a beautiful rainbow appeared over the whole valley.

"This is a sacred moment and a sacred symbol to all our people," said Dr. Samaeva.

"Maybe we should use the rainbow as the symbol for the hospital," I said.

"Yes. Perfect. It is a symbol from heaven. It is a symbol that everyone will understand and love. Let's do it," said Dr. Samaeva. The others gathered all agreed.

Before heading off on our fishing expedition, Ardan, Yanzhima Tauna and I toured the hospital to look at other possible sites to expand the arts activities. Knowing of Dr. Peter's keen interest, we started in his department of infections, a small space filled with narrow hallways and small rooms - everything, as always, painted white.

"They treat infections here," said Dr. Ardan, "Everything must be clean and white."

"Blue, yellow or pink paint can be just as clean as white paint," I said. "Paint's paint. The color doesn't matter. As long as it is enamel and can be easily cleaned, it makes no difference."

"Traditionally infection clinics are white," he said.

"Not any more," I said, "But let's continue looking at the hospital. We may wish to start someplace else first and we can discuss these ideas with Dr. Peter."

We all agreed and went over to surgery, clearly the most up to date space in the entire hospital. The walls and floors were covered with new blue, white and green tile, and a nice pattern had been put in the floor. The recovery rooms were a bit bleak, but we felt that overall the impression was quite good. We agreed that adding color to window and doorframes, some borders near the ceiling and hanging a few paintings on the walls would enhance the space, but clearly we could put work here off until later.

Next we visited the Therapy Wing; a section containing all manner of people, some having moved over from surgery, others recovering from various treatments, or undergoing either physical or mental therapy. This section was again all white - and a bit grim. As Dr. Ardan explained, and was clearly evident, we were in one of the older sections of the hospital. We immediately agreed that this would be the next place to work. Going from room to room we discussed many possibilities with Dr. Ardan who introduced us as the hospital's new arts committee. From there we went over to the Community Health Clinic, a dark space warmed by the use of natural wood, but with a slight terrifying aspect resulting from various grim posters graphically displaying the dangers of smoking, alcohol, premature sex, AIDS and other ailments. There were large V-shaped humps -a good 18 inches high- in two of the corridors, over which a crossbeam hung down about six inches - a potential lethal combination for myself at six foot. Throughout the corridors were short rows of dark brown wooden folding chairs that served as waiting areas for patients. It was clear to us that an easy and quick upgrade could be made through just painting the chairs - perhaps purple or green. I liked the warmth of the wood, but the posters needed work.

Final Morning

The next morning we shared our ideas for next steps with Dr. Samaeva. She said, "I like your ideas, but I think the women's section should be next."

Dr. Ardan then launched into his desire for indoor bathrooms for the children's clinic along with the need for a space for the sisters (medical staff), another exam-therapy room, and a room where the children can play, continue their school studies while in the hospital, and participate in physical therapy. I produced a floor plan on my computer that Dr. Ardan had emailed me, and suggested small wing projecting from the side of the building turning the small patient room next to the kitchen into the bathroom (enabling this room and the kitchen to have access to water by locating them back to back). This launched us into a long discussion that included financial and practical challenges. I suggested that the place where we could start is coming up with the plans. I said that I had architects in America willing to donate their design services. Once we had designs, we could take them to contractors for cost estimates, and then speak with government officials about funding possibilities. We agreed on this approach.

We then went over the Women's Clinic to consider Dr. Samaeva's suggestion that an expanded arts program start with the rooms for gynecological exams, birthing, and recovery for mothers and their new infants. A slightly startled Dr. Bier Dugozov, a well-groomed, very professional, well-organized and intelligent man who hadn't expected to receive a delegation that included the head of the hospital, met us. Dr. Samaeva explained that she wanted me to see his clinic, and we did going through all the rooms meeting a tiny two-day old baby, its mother, and several women resting in patient rooms. While in far better shape than the Therapy Clinic, Infections or the Community Wellness Center, it was again all white with anything but a warm and relaxing feel. Dr. Samaeva explained that she felt we should use warm, soft, relaxing colors and images - and to make the space feel more feminine. Following some intense discussion on the subject, I explained to Dr. Dugozov that our approach would involve himself, his staff and patients, along with Dr. Samaeva in the planning - that nothing would be forced on him - we'd come up with and agree on a plan together. I said the work would be done at a time mutually convenient for him, my teaching obligations at the East Siberian Academy of Culture, and for Dr. Sameva. I also said that enhancing the environment of the Women's Clinic was near and dear to Dr. Sameva's heart.

We all got a good laugh out of that as we all knew where the next steps would take place. As for creating a sign for the hospital and children's clinic, we could not find a piece of plywood or other large smooth board that could be used outside. We agreed that I would work on it back in Ulan Ude and send them up for installation.

The night before we had had a grand picnic near a glen where many farewell speeches were made and deep moving toasts given. Today we had a small farewell lunch and discussed our desires for the future. For Dr. Samaeva the project represented an important step forward of a vision she had planted with the mural she painted back in 1986. Dr. Ardan opened the door, recruited the volunteers and said yes to a vastly increased level of arts participation that has been warmly appreciated by the patients, staff and community. Yanzhima smoothed many obstacles and agreed to take leadership in helping to generate coverage by the Russian radio, newspaper and television media. Dr. Samaeva said she planned to write the Moscow Fulbright Committee to let them know how important this work has been to her hospital and community, that they have more work to be done, and that already other hospitals in the Inkinsky region have asked her if I would be available to work with them. My only disappointment was that the music school faculty was off harvesting as I wanted them to perform for the patients, but I knew we'd involve them on my return visit.

"What about the paint?" said Dr. Ardan. "Will you take it with you?"

"No, let's store it here. We'll need it for other parts of the hospital," I said. "Keeping it here is a strong reminder we have more work to accomplish."

"You were here only four and a half days," said Dr. Ardan. "Much work was done."

"We still have much to do, but I hope Orlik will help other hospitals take similar steps," I said.

"Slava will come at two o'clock," said Yanzhima. "We go home now."

And so we did.

WORK ACCOMPLISHED

Color theme and murals collectively determined
Hallway doors and trim painted
Sky and flower mural painted in entry
Five patient rooms painted
Mural created for kitchen-dining area
Tables painted in kitchen-dining area
Hospital campus toured, priorities set for next steps
Children's hospital measured for design to expand
Theme for hospital and clinic logos agreed on

VOLUNTEERS

Members of the Children's Clinic Staff (medical, service)
Dr. Ardan Barotov
Nina Balddaova
Vera Buhanaeva
Fenya Damshaeva
Sveta Ivenova
Victoria Munkonova
Simjet Teizenova

Patient
Katia Angazhacba

Community
Sveta Dabaeva
Gezelma Shagduzova
Yanzhima Vasilieva

Artist, Fulbright Scholar
Naj Wikoff

CONTRIBUTIONS

Travel and Meals - Orlik Community Hospital
Local housing - Dr. Ardan Batarov
Paint - Naj Wikoff from Fulbright housing/maintenance allowance

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