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Arlene Samen: Encountering Open Doors on the Path of Service



Jul 16, 2016

Audrey: Good, morning, good afternoon everybody. My name is Audrey and I will be your host for our weekly Global Awakin Call. Welcome and thank you all for joining. To share a little bit of context for those of you who have not joined these calls before; the purpose of these calls is to share stories and to tell stories. They are simply stories that help plant seeds for a more compassionate society, while fostering our own inner transformation along the way. We do this by holding collective conversations with guest speakers from all walks of life who inspire us through their actions, to live in a more service oriented way. And also behind these calls is an entire team of ServiceSpace volunteers, who's invisible work allows us to hold this space. Today's guest speaker is Arlene Samen, someone who really embodies today's theme of "Encountering Open Doors On the Path of Service". Thank you for joining today's call. We're really excited to hear some stories from her, but we'll start with a minute of silence ground ourselves in this space.

[Minute of silence]

Audrey: Welcome again to our weekly Awakin Call, today in conversation with Arlene Samen. Here is how the call works: in a few minutes our Moderator Ameeta Martin will engage in deep dialogue with our speaker Arlene. At the top of the hour we will have a Q & A session and circle of sharing where we invite all of your reflections and questions. And at any point now, you can hit *6 on your phone and you will be prompted when it is time to speak. You may also email us at ask@ServiceSpace.org with your questions.

This week’s theme as I shared earlier is "Encountering Open Doors on the Path of Service". We have all read a little bit about Arlene in the bio, but one meeting with the Dalai Lama changed her life, and he told her: “On the path of service all doors will open to you." So [a question for our audience today is] what has inspired you to serve? And as your heart has opened further how you have experienced the opening of unexpected pathways? Those a are a couple of the themes we will explore in today's call and since we have the pleasure of our remarkable moderator Ameeta today. I thought we could start by kicking of our circle.

To give you some context, Ameeta lives in Nebraska. In the time that I have got to know her, I feel like she carries a quiet humility about her and later you find out the she is a dedicated mother for two grown children and a pediatric cardiologist with some remarkable stories of her own, who's been practicing for several decades. And then she spends her free time volunteering on these Awakin Calls and Acts of Kindness online portal; KindSpring. So service seems to be the water that she swims in. I don't even know if she knows, but it is such a gift to spend time with her and to have her moderate our call today. Ameeta thanks for joining us! Do you have any thoughts on our call today?

Ameeta: Oh I'm just so thrilled to be moderating today's call and am so inspired by Arlene's story. She has been a nurse practitioner in maternal-fetal health for over thirty years now and her work in saving women and newborns is mind blowing. It is truly inspiring. Thank you very much for inviting me to moderate this call with this very inspirational woman.

Although we stated earlier that Arleen's call to serve in this area in Tibet started with her meeting the Dalai Lama in 1997, actually Arleen has been in service and service to others for quite a bit longer than that. Her history in service actually started in the 1980's. Arleen, can you take us to the beginning and how you began your journey into service and how that led to your meeting with the Dalai Lama?

Arlene: I feel like I'm a conduit and not so much a leader on this path, I guess I just keep saying yes. My journey really began in the early 80's when I lived in West Virginia and my ex-husband was studying to become an anesthesiologist and we were invited by a group called Interplast who is now called Research. And they were one of the first medical groups who went to different countries to do cleft like and cleft palate surgery. I was very fortunate, my very first trip I got to with Dr. Donald Laub, who was the chief of plastic surgery from Stanford. Some very amazing and famous plastic surgeons of their time, in reconstructive surgery and I remember we went to Hondurans and we arrived and there were a sea of children and families who had walked for days to get there to have an opportunity to have their clef palate/lips, burns of whatever they came with fixed. I remember thinking "Oh my gosh I don’t know if we will have enough time to all these cases.”

I was so impressed that every person on the team, we worked from six in the morning until ten/eleven o'clock at night and with the goal that we would get through the hundreds of people waiting. By the end of it I think every single one of us felt so deeply touched and inspired by the people themselves and that we left after two weeks that we had received far more than that we could have ever given back to them. Just their confidence in us, their compassion towards us and own stories of courage and survival and their deep love and devotion to their children that they would walk days to get this surgery.

It gave a gift to me I would say in knowing that that is what I wanted to do with my life. Because it was far bigger than (I'm not going to say just being a nurse because I had had an incredible nursing career) But that I wanted to serve in a bigger arena than my job at the university. Rather I was also working on a Navajo Indian reservation, but I just felt that the World was beyond that and that my neighborhood was global I suppose.

I worked with Interplast for over twelve years and it was really my journey with Interplast that led me to meet his Holiness the Dalai Lama in India, because there were several Tibetan refugee children from Tibet who had cleft lip and palates. There was a letter that came from the administrative health in India to Interplast and they had asked me to go over  [to Tibet] and asked me to take some surgeons with me and take care of the children there.

Ameeta: So how did this lead to you visit with his Holiness?

Arlene: Well there were four of us that arrived but prior to my departure of going to India, someone I had met when I was living in Salt Lake City told me the Dalai Lama's niece, his eldest sister’s daughter was living in Salt Lake City. I then contacted her and then her husband’s cousin was actually the doctor that ran the hospital in Dharmala, in India. So not only were we invited by the ministry of health but I was also able to reach out directly to the hospital director who arranged our visit. Who, upon our arrival he asked us if we would like to have a private audience with his Holiness. And of course none of us said “No”', we were so excited.

I remember the night before: my friend Bill is part Chinese and part Irish and he was wondering "What am I going to ask His Holiness?' and Paolo, an Italian plastic surgeon said; "I want to ask His Holiness, why there is these acid burns? How can anyone throw acid on a young bride in Bangladesh? Because when that happens it destroys their life!" Paolo was seeking an answer and then they asked me, what are You going ask His Holiness?" And I told them I'm going to ask him "How can I help?" The next day we waited in the waiting room and we were brought in to meet with His Holiness and we had about two hours and it was very informal, sitting in a living room chatting. We showed him the pictures of the before and after of the children and he talked to Paolo about karma and that could be something playing out with these burs and then he [His Holiness] said to me: "I know your background is in maternal-child health, I want you to go to Tibet and help the women and children. My mother had sixteen children and half of them died under the age of five. I thought "oh okay" and then we all left, we operated on a few children and then left and they all had the commitment to go back to Dharmsala and Paolo and I decided we would do our best to go to Tibet.

At that time Tibet was closed. It seemed daunting to figure out how are we going to get invited to go there but I looked around and found a doctor that was from the [San Francisco] Bay area actually, who was doing a project there, contacted her and she then gave me the number of a doctor who spoke English in Lhasa and contacted Dr. Palden and then he made arrangements for us to get permission as an outside medical team to come to Lhasa, to come to operate on children with cleft lips and palates.

Everyone said that number one, we were not going to get permission and number two, and there are no children with cleft lips and palates there. We did get permission and we arrived there and it seemed like everywhere we went there was a child, who had a cleft lip or palate, or we would go for a walk and we met a monk with a cleft lip and it seemed like people came out of the woodwork. We got one monk who was in his twenties to agree to come for surgery and it was much easier because he was an adult than to put a child under anesthesia, and so that was the first opportunity we had to in Lhasa.

Then while I was there I heard so many stories of women dying of child birth and it is a fascinating phenomenon, especially in places like Tibet. Because news got out very quickly even thought I didn't say a word, that I have a background in high risk obstetrics. And people would then literally just come to my hotel room.

Ameeta: Wow, one of the things that we discussed and of the things that I had no idea about was the cultural view around child birth in Tibet. Women there would basically go out and have babies on their own, without any assistance from a midwife or anyone else to help them in their birthing process. Can you talk more to us about the child birth process in Tibet?

Arlene: I find it quite fascinating because us westerners an assumption that there is what we call traditional birth attendants in many cultures. And now I work in many places around the world and actually that myth is not true, there is many cultures, Tibet being one of them. In Tibetan Buddhism there is a concept around pollution around the blood of childbirth and menses, but more around child birth. And so women around child birth, during child birth always gave birth outside of the home. Usually in the animal shed where there was hay and it was dirty. For them it made sense if you were going to 'pollute' something that you would go and 'pollute' something that was already dirty.

The women would go out alone, like an animal, because that is just how historically it was and they didn't ever think about delivering in the hearth of the home where the fire was because this 'pollution' would offend the 'spirits of the home'. And then these spirits could cause harm to the family and then these spirits could has seizures to the baby, or cause the mother to have post-partum hemorrhage, or cause the cord to wrap around the neck.

There were lots of superstitions around that and so when we first went we took cultural anthropologist that were specialists in Tibetan medicine and Tibetan Buddhism. And we did cultural surveys to understand the cultural and spiritual beliefs. And then understanding those beliefs, we came up with an idea with the community to if we were to design a clean birth kit, that had a clean plastic sheet, a clean razor blade, a clean string, gloves and all of these things, what if we could deliver in the home where it was warm and people were around then we could contain the pollution and then and go and bury it or burn it. We also took the birth kits and had blessed by the local lamas. And people thought "That would completely work".

That is how we first started with birth kits and getting people to deliver in the home. Then the local government was starting to have birthing centers. They were pretty rough looking when we started working there so we also worked to upgrade these birthing centers. And women wouldn’t go there because women would not want to birth with strangers. There was this belief that these strangers could bring with them hungry ghosts on their back and the hungry ghost could jump into the baby and make the baby sick. So then we said, 'OK, if we trained a health worker in the community, that people knew, and we train them and they get the training and they have all the equipment to be birthing attendant, they will no longer be a stranger and then if the women also go to them early in the pregnancy, they will know them, they will take care of the woman/women, and all the pollution could be left behind in the birthing center and the women will have someone who can really take care of you.

That is how we got over the next hurdle.
We looked at every challenge or every superstition as an opportunity. We adapted to their culture, instead of asking them to adapt to ours. And it was the same thing around pollution, that is why they used a dirty knife to cut the cord. And so we thought that if you use this clean razor blade, it doesn't have any pollution on it and we can also burn it. Because if you are using this dirty knife you are also getting pollution on your baby and you are also getting it on your knife. And they understood and thought it was perfect. So it had been my favorite part of the project is navigating those opportunities and adapting to their culture instead of them adapting to ours.

Ameeta: That is an amazing story. I can't even conceive how any woman could do that {give birth on their own] haven gone through medical school myself, I can't even imagine trying to do the birthing process on my own and then cutting the cord and then delivering the placenta. How did these women who didn't know anything about the birthing process, how could they even go out into their own shed and deliver a baby on their own and know what to do?

Arlene: They didn't know what to do, and that was a big part of the problem, they just had the concept that animals do that, and they either survive or not. Sometime a mother-in-law or a mother-in-law would come and give them tea and help with cutting the cord, but then again with a dirty knife. It was a matter of "this is what your mother did and that is what they did for generations and that is the way we are going to do it".

And this is not different than the women in Ecuador where I worked. It was the same process of with the Ashwards in the Amazon Jungle. Many places in Nepal where we are working it is the same story.
And this recent trip, asking women now 'How did they feel? Why do they go to a clean birthing center?" And they all had the same answer: "Because the nurses are kind. And I feel safe." They did go into child birth a lot of trepidation; they knew they would be facing death, or their child’s. But [culturally] it is accepted that if a woman dies it is part of their karma, or if the child would die. So, teaching them things like: if their baby is not breathing and not to just set the baby aside but to try to resuscitate it and give a breath to the baby was such a new concept. They thought it was magic that when we had a baby who did not breathe initially, and we could just do some basic things to get the baby to breathe. It was unheard of to these mothers, like that's 'magic'. And then it took on like wild fire because everyone wants to save the baby or the mother.

It has been really about driving systemic behavior change that saves lives now and future generations because they won't go back [to the old way of doing things.] That is one thing I remembered was so profound me. It was  when I was out one night, when I was staying out on the Tibetan plateau where we worked in places that were 15 thousand feet, just wide expansive plateau with these magic mountains and then these clouds that looked like you could touch them and then wild horses and yaks and fires burning and realizing that this is never going to be the same. This ripple effect will now take hold; they [the women] will never go back to delivering babies that way again.

That really hit me in that realization that, how one person, one thought has that ripple effect and can touch hundreds of thousands of lives, and future generations. It was really something extraordinary for me to witness, within myself. That is not ever going to be the same. Ever.

Ameeta: How did the men in the villages in the families how did they react to all of this?

Arlene: It's been really beautiful, the grandfather's and the husbands, in Tibet, where so curious and wanting to learn everything as well. Although they usually did not at that time attend birth, but they became very engaged in the process in making sure the woman did go to a place where there was a birth attendant. Some of the birth attendants in Tibet were actually men. Men were very much a driving force behind the change, because they didn't want their wife to die and they certainly did not want their child to die. Although no one really understood the birthing process physiologically and anatomically, but getting them engaged was very simple because they had such a curiosity around it. Subsequently they became the helpers. Making sure that the woman got the care that she needed.

And then in Nepal, we are actually seeing the men in the community are the driving force has birthing centers in their communities. They are donating their owl land, collecting donations and building the birthing centers and have made commitments that all women in the communities will be taken and deliver in the birthing centers. And the men now are accompanying the wives and witnessing the births as well. It has been phenomenal change.

Ameeta: It really is, there are so many places where you could think that men would be an obstruction to this process that is amazing to see how you changed the entire culture of these communities.

Arlene: Well in fact, I started working more in Nepal because of the husbands were more engaged actually than in Tibet. In Nepal when i first started and we were meeting with about 70 of the health post administrative team, which were mostly men, about 80% men. I posed a question, actually I felt it was channeled to me, I had not planned this at all but it was one of those organic moments where I trusted my intuition, and I asked: "How many of you have a mother?" And they looked at me like, "what is she saying?  What a crazy question."

So I raised my hand and I said: "I want you all to imagine for a moment, close your eyes and imagine what your life would be like today if your mother had died at child birth." There was a moment of silence, and tears. I continued: "Even if your father re-married, that woman would not be YOUR mother, and probably wouldn't treat you like her only child. And if your mother died, then you would probably be raised by other family members, you wouldn't have the same type of nurturing and that kind of love, your whole life would be different."

The men came up to me later on and they said. "we want to take a stand, and we want to be a part of solution, and not part of the problem." And they said: "Because we realize we have been part of the problem, not always helping our wives to get to a birthing center or putting money aside to make that a priority, or even giving her the loving supportive care that she needs."
I said: “If your wife dies, she is the mother of your child. If you beat your wife, you are beating mother of your child that is like having your mother being beat in front of you."

You could hear a pin drop [it was that quiet.] And that was enough to change their attitude.

Ameeta: That is a really powerful image. I can almost see the room and you talking to these men and like you said it being pin silent, as they are realizing the impact of your words.

Arlene: Yes. And then we broke out into focus groups and then it was all about what are the obstacles for women getting access to care and how to solve those problems. And every single group independently came up with the things that men needed to do. To make this shift happen. And literally, these men in the communities have been that donated their land, build the birthing centers and taken a stand that all women within the community will give birth within a birthing center with a midwife.

Ameeta: One of the parts that was so interesting about reading your story was how you actually changed outcomes. We all love the idea about being able to do good things, but you truly have made such a huge difference. Can you give us statistics of what the maternal-child or infant mortality was like before versus now after the initiation of your program and how things have changed?

Arlene: We know that since we started working in two of the districts of where we work which is Baglan and Aldopa which are rural districts in Nepal, and very mountainous and same happened in Tibet. What we saw when we started in Tibet, that 1 woman out of 100 would die in child birth and 1 our 10 newborn babies. When we started our program in the counties we worked in, five years later down the line we had zero maternal mortality and newborn mortality dropped from 10% to 3 %. It has pretty much stayed that way, as I'm in touch with my staff in Tibet that took over the project after we had to leave. Then Baglan in Nepal the number of neonatal deaths from 2010 dropped from 300 to 0 deaths last year in 2015. And the number of maternal deaths went from 30 a year to 0 deaths, the last two years.

Ameeta: That is phenomenal. There are so many NGO's operating out there, that can't claim the success that you've been able to have in these remote areas and as you've stated saving the mother and saving these newborns. I'm so very inspired by your commitment.

Arlene: I think it goes to that saying, "you teach a man to fish and they learn to feed themselves", is that everything we do is to empower and to give he skill to the local people and they do it. I'm not there doing it they are, and are taking full responsibilities of these outcomes.

Ameeta: But you are able to incorporate their own cultural view and come to a way that they are able to empower themselves and as you said it wasn't imposing western tradition and doing more harm in these areas, that is what is so inspiring about it.

Arleen: And to be honest with you Ameeta, I think my experience with Interplast taught me a lot of things. One thing I knew for sure is that in global health in general, in the past, we've wanted to drop in and kind of been like "O.K. this is how were going to do, our way." We haven't always take the time and effort to build an infrastructure within the community, for the community, by the community and understand beliefs and practices that need to be adjusted. Instead of wiped out. We need to adjust to them. And I think that that is a different way of doing global health and it is a slower process, but I think it is more sustainable and replicable in the end. It's not like we are doing to drop in and do something and then leave. It really is a commitment to the behavior change happening and giving them the tools to change their behavior. And [giving them] the love and support and the respect. I think that is what is very unique about One Heart is that we have made that kind of a commitment where ever we work.

Ameeta: And that was amplified when you were asked to leave Tibet in 2008 during the Chinese uprising, and [despite this] they [the people] continued to follow these practices and continued to have success, like you said because you worked within the community to make itself sustaining.

Arlene: Yes.

Ameeta: Can you tell us a little bit about what happened. I know you've said that March 14th 2008 was such an important day for you. Can you tell us a bit about that and the uprising?

Arlene: Yes. I think I shared with you Ameeta yesterday that prior years before I was going to work in Tibet, that I took refuge with a very senior and very well respected Tibetan Rinpoche who had been a meditator for thirty years in a cave and it was his first time to come to the U.S. to teach and to give refuge to students. He came with one of his students who was a translator. During that process of taking your vows as a bodhisattva, taking refuge and the translator got up from his cushion, and came up to me only and made a gesture that even if a Chinese soldier holds a gun to your head will you take refuge in the Buddha, The Dharma and The Sangha? And of course I said "yes" and I thought, that is never going to happen.

Flash forward and almost twenty years later the day of the uprising it was made public that I was a 'CNN-Hero' and that was going to be live on the internet and we were going to celebrate. There were some minor incidences during that week, because on March 10th is when China invaded Tibet, so always around that time it was quite sensitive and this was the year of the Olympics and we were all worried that something was going to happen. And there were some little scuttles that happened at several monasteries earlier in the week.

Then that Friday the 14th, my staff was going to gather and my three daughters that I was taking care off were all going to get together and celebrate the 'CNN-Hero' award thing. And around noon I went out for a meeting. I usually didn't go off by myself when I was working. My driver dropped me off and I looked around and I just thought something was a bit off. I went into a restaurant and when I went to leave I could see that there were some demonstrations happening and I saw cars being turned over and set on fire and people running. I knew there were a lot of military tanks because when I arrived in February we saw thirty of forty tanks coming into the city. It was very clear that an uprising was in motion and I went back into the restaurant and I called the U.S. embassy and I was the first person to call in and asked: "what do I do?" I asked if someone could come and get me, because now I was surrounded by danger. They told me that no one could come and get me because they don't have an embassy there. They said they could call my family and they gave instructions" to stay away from the windows make sure you have water" and all these things. And after three of four hours of explosions and gun fire and there was smoke, I just decided I needed to get out of that restaurant because I felt I was in harm’s way there.

I don't know where I got the courage to walk out of that door but I did, and once I walked there was no way to go back. I walked until I found a hotel where I knew there would be other foreigners and banged on the door and they let me in. At least six hours before the Chinese government sent the tanks and the army to stop the riots they just let it escalate and all the shops that were Chinese were broken into and everything was thrown into the streets, there were fires everywhere and then that evening the tanks rolled in and I'm sure tear gas, but also shootings and things going on.

For the next 36 hours you were wondering what was happening because then it was martial law and trying to stay in touch with my staff and my daughters and people that you know. The phone was going down and the internet was sometimes off and then on again. Then the next day the police came and they wanted all the foreigners to leave the hotel and I asked to be taken back to my office. I was put in a police car and driven to my office where I was even more in harm’s way because we were surrounded by military and it had been an area that a lot of the riots earlier had taken over this Muslim area in Chinese. There were a lot of attacks on the Muslim shops as well. And there were a lot of gunshots in the area still.

One of my Tibetan staff that was there she said we should go to my apartment and get my stuff. And then I responded saying that "there are soldiers out there and it was martial law, I don't think they are going to let us." So she went out there and spoke to the Chinese soldiers and they said "O.K. You can go, but we are not going to protect you." So the two of us now went out on abandoned streets to get my passport and my stuff at my apartment. We caught off guard a Chinese soldier who was interrogating a Tibetan family and so they just turned and held us at gunpoint. I remember at that moment looking at this young Chinese soldier and having absolutely no fear. And I remember thinking to myself: "I take refuge in The Buddha, The Dharma and the Sangha." And he put his gun down and apologized and let me go get my things. We had to go back through the fire and everything thrown in the streets and chaos. Then we were held by a tank so that we could no leave and forced to witness Tibetan being arrested and being beaten in front of us. Until the police officer thought that we had seen enough basically, and put me in a car and said: "See what the Dalai Lama has done?" Eventually we were able to get outside of the city and stay close to the airport and leave.

Ameeta: Wow.

Audrey: That is pretty remarkable.

Arlene: I know. It's like watching a movie. It's like you are an observer to something going on. But then there was also this voice that kept saying to me: "Everything is in Divine order and you don't need to know what it is right now. Just trust” And the voice was like: "You can't make sense of this. How could you?"

Ameeta: I guess the last thing that I'm going to say before we open it up to Q & A. One of the most moving things that you said to me was that you don't believe anything happens by accident. And as you told me your story there was so much perfect convergence of things and how it happened and how we relate back to our theme of "On the path to service all doors will open" and it just seems this was your path from the 80's on and probably your entire life because it all just came together for you. Do you feel like this was your path? That this is what you were meant to do?

Arleen: Oh absolutely. It really is unstoppable because you know Ameeta, after the uprising we were not allowed to continue to work in Tibet, and I had to leave behind my staff my [adopted] daughters, my apartment. I left everything. I literally left there with nothing. And most of all left behind my heart and soul. And I thought "There is no way I could put myself through this again, I'm done."

But I did meet with His Holiness, and with my staff in Tibet and they said: "Never give up, please we beg of you to take what you have learned from us here and pay it forward" And at that time I thought: " No way, I'm not going to start this all over, it is just too painful." And you know, I did start it all over and it is growing by leaps and bounds and has this beautiful life force in Nepal, far beyond what I could have done at the time over in Tibet.

The Tibetans took over the project and just recently won the Charity of the Year- Award. So they are thriving. So if you can just get out of your own way sometimes. It's all about trust. And really trusting the Higher Force that it Is all in Divine Order, and I don't need to know what it is, but to be willing to serve. And at times if you Need to, to be willing Not to. But I did start it [the project] over and I did surrender which what learned is actually a position of great strength and not a weakness.
And then last year I was in the earthquake in Nepal, (chuckles) and went back to China and witnessed the 8.4 earthquake in Chinghai. And so for some reason I'm supposed to really learn or witness impermanence.

Audrey: Mmm. That's so powerful Arlene, thank you so much these amazing stories. And I just want to remind all the callers that if you have a question for Arlene, we've opened up our Q & A queue and to dial * 6 on your phone to get in the queue or you can email your questions at ask@servicespace.org, or if you are live streaming you can submit it through the live stream form.

Lots of ways to ask questions and I have so many questions from all that you shared! I'm curious as I listened to you speak, I get the sense that you are not the actor, that you are kind of at the right place, at the right time, with the right intentions and doing whatever is in the Divine Order like you spoke of, and I was reading in the bio about you on the [Awakin Calls] website, that the first boy you meet who had a cleft lip, Nicolas, in Chile, and how you helped him and several other children as they went through surgery. I'm curious if you could share more about Nicolas and how you never accepted 'No' as an answer o that path of service.

Arlene: Wow. That is a long time ago but thank you for reminding me of him. He was a boy that I met in Chile that cleft face. So the cleft went through his mouth and all the way through his face. When you are developing as an embryo your face comes together as two halves that meet in the middle, it doesn't happen the other way where it all happens at once, it forms as two halves that come together. And so, something happens and it can be genetic or environmental or we don't know, if some medications that interfere at some point in time when that is occurring. And if it is the lip or the palate, or it can be a cleft thought the whole face and instead of the two halves coming together, there is a slip, where the two halves are not complete.

Nicolas had had some surgery in Chile, but needed to have more cranial-facial surgery because they needed to move the orbits of his eyes closer together and the other parts of the cleft in his face that was still wide apart. They didn't have that type of surgery available or the equipment in Chile at that time. So when I met him I came back and I was working for a pediatric cranial-facial surgeon and I told him about the case. And he said he could operate on him for free, and if could get the hospital to take care of him for free and we'll find someone to take care of the family to bring him here. And so I did.

I went to the hospital directors and told them the story and asked if we could please bring him to the hospital. I then raised the money to get the family there, and I found a family that would take him in. The family would need to take him for a while because the surgery is done many times in stages. I just remember Nicolas who was just five or six years of age at the time, asking me if he looked like a monster, and just being able to say "No, you're so handsome." Then seeing his face after going through these surgeries and knowing that he would never be able look completely 'normal' but just the love that his parents had and watching him go through all of that and seeing the confidence [he had afterwards]. Watching the transitions through love and care and expert medical care. And as far as I know, he is thriving and doing well and has grown up to be a very kind and very compassionate young man.

Audrey: That's beautiful. And you ended up doing this with several children during your time in Chile all those years ago. Was it really that long ago?

Arlene: Yeah. I actually met a little girl with a similar story from Ecuador. And actually Nicolas ended up living with me at the time and this other girl Katrina who was older, who needed to have hand and foot surgery AND the cranial-facial surgery. She stayed with a family that I am still very close to and it changed the children's [in that family] lives, because they were about the same age as Katrina and everyone had to take care of her. I still know the daughters [of that family] and recently was talking to one of them and asking her what that was like for her, to have Katrina living with them. So, it can be challenging but you get so much more than you can ever give.

Audrey: I can only imagine. You've probably seen so many instances like that. Are there any that come to mind? Any memorable patients that you've had or experiences where you've been able to witness a shift in yourself? Or in them? [the patients.]

Arlene: Well, I have three girls that have been in my life from Tibet. I met the oldest one who I think was 9 years old at the time and begging at the time. And with her she had a little baby that the family later learned had found in the garbage, she was in rags, the baby was in rags, the baby was in a box and she was feeding it coke in this dirty bottle and she herself was eating noodles out of the garbage. I saw her, and stopped to talk to her and gave her money. And then I thought: "That is not enough. This has to end right now." I went to my office and got one of my staff so that I could have a further conversation in Tibetan. When I got back there were two other little girls that were her sisters, and her mom. I took put them all in my car, took them back to my office, which was in a really nice hotel. And here I come in with these little ones in rags and I'm sure the hotel staff were thinking "What in the world is she going to do now?"

I brought them out to the back courtyard and got them whatever they wanted to eat. I got the story that they were very poor farmers from another area and this was their only means to make money, to put their girls on the street to beg and they had found the baby in the trash.
And so I said; "This ends today. These girls are going to go to school and make something of their lives and this begging is stopping right now." We got the girls in the bath, and the water was completely black, and the got out, and it was probably the first time the girls had ever had a bath and washed their hair and all. One of my staff then went out and got them all matching dresses and shoes. The girls then all twirled around in my room and I remember one of them asking: "Do we still look like beggars?" And I said: "No, you're my three little princesses."

And that has been another life lesson and still a struggle and filled with courage and tears and love and joy. The two [eldest] girls have just graduated from high school and are headed for college and the older of the three is married and has two children. These are my three girls. And I remember when I met them there was a tour bus with some people and one of the people on the bus was a minister from a church. And she asked the girls to tell a little bit about their lives and tell her who I [Arlene] was. And the girls responded; "Oh she's our Angel." And then I had watched them and if other beggars tried to get money from me, they would fight with them; they would push them away and start arguing. And I said:" You don't have to defend anything. Everything you need you'll have no matter what. Now each one of you is going to give money to beggars." And so I gave them money each day that they had to give away. So that they would know that they had more than enough. I remember one day after lunch there was extra food, they each got three packages of food, which I thought they would have taken back to their parents, but they said: "No we want to give this away to other beggars."

Ameeta: What a powerful way to teach them about abundance. Three kids that were born in to scarcity and you took this lesson and you taught them abundance.

Arlene: Mm-hm. Yes, and they learned it.

Ameeta: Are the girls still in Tibet?

Arlene: They are all in Tibet. And the two that graduated high school will soon be applying to go to University. One of the girls may end up going to the University of Lhasa, or right outside of Lhasa. And I'm not sure if the other will end up in mainland China. Once they apply to school over there and go to school over there, I'm going to see if I can get them to go to school over here. But it is very difficult for them to get a visa to leave Tibet.

Ameeta: So you're not able to see them while they are in Tibet?

Arlene: The only way I can see them is to meet them in mainland China. I can meet them there which I've done.

Audrey: They must miss you.

Arlene: We miss each other. I Skype with them. I've known them now twelve years. And they remember every little song that we've sang, all the little things that we said to each other. I'd put my fingers together and I would say; " I miss you THIS MUCH" With my fingers together it would go out to infinity (chuckles) and they still say that back to me and I've learned to say it in Tibetan, and it is very cute.

Audrey: I'm just curious because I live in a city and there are homeless people and people asking for money and things in a lot of corners that I turn, and I've noticed, sometimes my heart tightens or constricts around that. And I might think "I don't have the time, or I don't have what you want. Or whatever it is, and I'm curious listening to you share this story; in a way it is like you have no fear of what could come down the road and no sense of scarcity in a way. I'm curious what gives you that expansiveness to take the time to engage in that way? Because I'm sure you had no shortages of things to do, when you met those three girls.

Arlene: It's very quiet simple. I absolutely know that we are all one, and that God loves through me and that there is no lack of love. And so maybe I don't have money to give a beggar, but often I would often stop, look them in the eye and acknowledge them and vow to them. And sometimes I have the money to give to them. Some of them I know, I've gotten to know. And I'll start to talk to them. Or sometimes they are strangers and I'll ask and how they ended up in this situation. And I want them to know that I see them. Because they are me. They are all of us. They are a part of us. I grew up in poverty and yet my mother always made us believe that we had everything. Even thought we had nothing. I thought I had everything. And I did. Because what do we all ultimately need?

We need to be a part of a community and loved. There is no lack of that. We can tap into that always.

Audrey: Can you describe your childhood a bit? I mean I loved how you said you" grew up in Buckingham palace as one of three children, raised by a twenty-one year old mother in a Buckingham palace apartment” (Laughs).

Arlene: I know! I just thought I lived in Buckingham palace! (Laughs.) We lived in a two bedroom apartment with all three kids in one room, which we loved and all the animals that were there, the cardinal birds and the robins. I just thought they were all part of the grounds that I had to care for. I would take food out to the animals and I would just meet with anybody and everybody! (Laughs).

I remember there was a man that was alone and he would feed the squirrels and all the children were afraid of him, but me. I would just go and sit on the bench and learn how to feed the squirrels. He in my mind was the care taker of the animals. So I just had this whole thing I had made up. And I lived in Buckingham Palace! And it was all a part of the grounds, all of the apartments and stream and the trees. And it was expansive. (Laughs) I know! My mom was that person if you ever saw the movie Life is Beautiful and they were in a concentration camp, and then make believed they were in a play in away? That's how my mother was.

We would get a card board box and just think "Oh my gosh! Look at all the things we could do with this! We could make a house! We could make it into a train!" It was just never a lack. I never felt a lack of anything.

Ameeta: Well you certainly embody inter-connectedness, Arlene. I can just feel it.

Arlene: Mixed in with all of that I did have PTSD and there were times where I have had so much heart ache, and still at times I feel so sad that things have changed in Tibet, and that I can't go back. Also for the freedom that they have lost. And I cry. It's not every day that I wake up and think: "Oh my gosh I live such a blessed life!" Which I do. I also feel the suffering for those people in France, [after the mass shootings] and what is happening with Isis. I really try consciously to remember that that is all of us too. That pain, that suffering, that loss, that hatred it is just a thought away. And it is all up to us to embody love. Because that is the only thing that will transform our planet. We have to be fearless.

Audrey: What gives you that ability to be fearless?

Arlene: My faith. My connection with the God I am inside of me. Whether it is my Buddha nature or God, or that Life Force.

Ameeta: Are you a Meditator?

Arlene: I am. Or I do. I could meditate far more than I do. But yes, I do meditate. I was funny, a girl friend asked me yesterday; "How much time do you spend practicing? And I said "Every single moment of my life." Every breath I take.

Audrey: You can hear it in your stories too. How your grounding practices influence you in your work. We do have one question in the queue. But I'm just curious before we get to that, can you describe how you came to see the world from that perspective. From that kind of spiritual perspective? How does spirituality influence you in your work? You carry such a strong conviction. What is your spiritual practice?

Arlene: Well, I was raised Christian. And was raised by a mother who absolutely under all circumstances, no matter what, has believed that things were in Divine Order. And when I was really young I studied Eastern Philosophy and Buddhism. I didn't truly understand Buddha nature at that time as a teenager but it just seemed to be I think part of who I am. I can't remember a time when I wasn't connected to it. Even as a child.

I just remember always being connected to a higher force. I remember when I was quite young, when I was about 10 years old, that I had this sense that I had a conversation with Jesus. Knowing I had no fear of death. I never did. I've never had a fear of dying. I just have always felt very protected. And even more and more knowing that when I am anxious or fearful, that those are the moments that I feel separate from my spiritual practice. The God that I am, the Buddha that I am. When I forget that, that's when I lose who I am. It is very important to stay connected to that. I do that through acts for service. That keeps me connected.

Audrey: Thank you. We will go to our next question and caller in the queue.

Caller Nipun: Hi Arlene. Thank you for your incredible story and your life long work. I read in your bio that you've been working with this model called "Network of Safety Model” that you've used with 50,000 women, across the world in Nepal and in Mexico and other places as well. I was wondering if you could describe a bit of that "Network of Safety" model. It seems like, given your life's organizing principle, it seems like it would be a very different model than what someone in the 'think tank' might come up with.

Arlene: I'm happy that you've asked that question. And it was very much taught to us, I think by the work that we did culturally in Tibet. Realizing that to drive systemic behavior change that everything, like a spokes to a tire all have to be connected together and work in tandem with each other. So I being able to read a lot about public health a lot of times organizations go in an address one component, like making sure there is a birthing center and or trying to drive change at the Government level, like new policy.

What I realized was that first of all we put the mother at the center, and SHE needs to understand what happens in pregnancy and why it is important. Furthermore, what are the danger signs and why if those things happen needs to get care sooner rather than later. Then we teach that to the families. So that the family can support her and holding her in that she gets the care she needs . And if there is a problem they will be available to assist her. And then we teach the whole community, so like if you are my neighbor and you notice something is going on, you also know what to do.

And the ripple effect just goes out further to: "O.K. if we do that then we need to train all the community health workers so they know what to do and they have what they need to provide the care for her. Then there is a birthing center, and if there is a problem beyond that then we need to train people at the hospitals and make sure they have the equipment that they need and we also have to drive change at the Government level, When there is new advances in medicine that are easy to incorporate into the medical healthcare infrastructure that we are bringing those new technologies to the Government of the Nepal, to get approval and they decide it gets incorporated into the system.

We never create a parallel health care system but we work within the structure. So it is a very in depth holistic approach, where if, at any given time within the system that it breaks down and we hear for example there is a maternal death, then we go back out and do what we call a 'verbal autopsy'. We trace the steps backwards. For example what happened prior to this, ie she had these symptoms or this happened, or she didn't get care in time. So we can always adjust the system. And if there is new technology, we can ad it in to our already functioning live network, so to speak. This "Network of Safety" is really a web, around not only the pregnant woman, but her family, her children, her community. It just keeps going. Because all of it needs to work in tandem for lives to be save. We never though: "If you do an intervention at that[one] level, that's going to change lives" No, it all has to work together.

Nipun: And I would imagine after the birthing process the web would still be there because you've created it and it is reliant on so many social interactions that it would continue to sustain itself?

Arlene: Yes. Absolutely.

Nipun: Have you written about this depth or is it something that evolves organically in each of the places you work in?

Arlene: The model we have written about in depth, not to mention that it has been published in a few articles. In the sense that we talk about every life is important. So High Touch meets High Tech. Not the "Network of Safety" as an independent article. But we do have a lot of it written up. Our bigger belief is that it's the High Touch meeting High Tech saves lives. But not just technology saving lives. You have to have a foundation and then you can add to the foundation.

Nipun: That's beautiful. Thank you. I look forward to finding those articles online.

Arlene: Yes, If you do to our website under media, or if you google my name Arlene Samen.

Nipun: And just wanted to thank you for all that you are and represent it's a really inspiring journey.

Arlene: Aaw, Thank you so much. It's my honor.

Audrey: Yes, Thank you. We will be sure to find those articles and share them with the folks on this call. One thing I'm curious of when you were sharing the story of being held at gun point. I was curious, you had said there was this young soldier who was caught off guard and how he put the gun down and apologized. I feel like that left me hanging, (chuckles) what made him put down his gun and apologize? I don't know if there is anything in that moment? It must have been such a micro moment for you too but if there is anything more in there [to share]?

Arlene: I think that actually looking him in the eye and that human contact, like "I see you. And you see me and we are not different." I saw one time on you tube or something where an Israeli or Palestinian woman, where soldiers were shooting with and she actually went out and stood in front of the tanks and the soldiers and said "STOP!" and they did. I think that is what it will come down to. At some point in time this collective consciousness says "STOP!"

Audrey: That is powerful. In a way I'm reminded of this other woman on the Awakin call a month ago, her name is Ann Sieben, who is a lifelong pilgrim in a way. She's some really challenging areas, and there was one place where she was walking and these young soldiers. She was like “They were young enough to be my children." And it was basically a bunch of young soldiers aiming a gun at this white haired harmless woman walking on a pilgrimage and she said in a way she saw them as if they were her own sons. And by the end of the interaction they were sending her prayers to bring to the pilgrimage site that she was going to.

Arlene: Right. Right. Well, I think we all have that within us. Instead of seeing other's as our enemy that we see them as our self. Or our children. Our neighbors.

Ameeta: When you connect soul to soul.

Arlene: Yes. Soul to soul. I totally agree. You know our world is falling apart it seems with all these terrorist acts lately. I don't think the answer is to hate all Muslims that is not the way to go. They are suffering. It's not them. It is human nature making the choice, to do something out of fear instead of love.

Ameeta: And unfortunately the media all they do is amplifying the fear instead of love. And so people respond with fear and more violence.

Arlene: Yes. That's what I think. It's like, what conversation is out there. Let's have a conversation with Isis. I haven't heard that one. Right?

Audrey: I'm curious, given the reigns of experiences you've had, and worked that you've done is some many places. and the state of the world that it is. What is on the horizon for you? Where do you feel like you want to focus your time and energy now?

Arlene I'll continue to work with One Heart, but I'm also studying right now to work with patients with Post Traumatic Stress Disorder and end of life care. And people ask: "What are you going to do in your retirement?" (Chuckles) They say it doesn't sound like something you'd want to do in your retirement. But I'm very motivated to continue my path reducing suffering in our world and that is another one where I have a lot of compassion. Especially with our soldiers that come back [from war]. They've witnessed so much violence and committed violence.

Audrey: Right. Have you had a chance to work or interact with any of those soldiers?

Arlene: Not yet. I'm early in my course and right now we are watching a lot of videos of teaching working with PTSD soldiers.

Audrey: And I'm curious for you, how is it to come back to the U.S? I'm sure many times between your travels from being in a rioting area or war torn area and to come back to some safety or comforts that you might have here.

Arlene: I'm incredibly grateful and sometime very sad. In a way having to navigate my feelings of knowing that I've left, I've left behind people that are suffering. Like after the earthquake [in Nepal] I came home, but my staff and villages were there without anything. So sometimes I struggle with how best to deal with my own emotions around realize that what I am doing here will serve them greater than me being there. I feel sorry for them but it haunts me to think about that I can come to a place where I do feel safe. And that I have everything. A roof over my head and food and everything else and that I'm leaving behind people who don't have that. I struggle with that. I want everybody to have everything.

Audrey: Thank you so much. I know we are kind of rounding out to the last few minutes of our call. Ameeta do you have any last comments or thoughts and last questions?

Ameeta: No it's just amazing to hear live their passion and live through service the way you have done. You live from your heart, you live from love without fear and that is what we all try to achieve. It is inspiring to know that some people can actually do it. Gives the rest of us a model and how to move forward as well.

Arlene: The secret to all of it. The wind beneath my wings, which are my friends. It's the love and the community that hold me up. And they hold me through all the trials and tribulations with so much love that it just fills me back up. I have to say that it is really community and my faith. That's what holds me together. And feeds me and nourishes me. And some of my community is on the call right now. They know who they are!

Audrey: And now we are part of your community too! (Chuckles).

Arlene: You're all part of my community! (laughs too).

Audrey: And we'd love to know, how can our ecosystem be of service and support you, and your beautiful intentions and work in the world?

Arlene: Well just today, this phone call. I can feel all of your love and support. It comes back to me and it just goes back out to feed this beautiful Universe. What I ask now is that we hold all of those who are suffering in Turkey, in Syria, France, and all over that our prayers, our love reaches all of them today and every day.

Audrey: Beautiful. We'll close the call with a minute of gratitude. We're at the 90 minute mark. But I really want to thank you Arleen so much the gift of coming on this call and sharing your incredible experiences with us. Whether it's with a card box in 'Buckingham Palace' apartment, or in places of riots, or picking children up off of the streets and treating them as if they were your own daughters. It is so inspiring and it  definitely strengthens my resolve to be of service in whatever ways I can. So thank you so much for joining us today! We'll close after a minute of silence of gratitude.

[Minute of Silence]

[Group Thank You!!!]