July 22, 2010. Isla Roatan, Honduras.
Our passage from Jamaica to Roatan was without incident. We had a following wind and sea, so we made pretty good time, although the last few hours were literally a race against the sun. As we approached Roatan, we made contact with Barefoot Cay, and they said, if we got there in daylight, they would send a panga out to guide us through the narrow channel to their dock. If we couldn’t get there in daylight, they suggested we stand offshore, and they would bring us in the next morning. Needless to say, we pushed hard to arrive in daylight. We goosed the engines, and I tried to squeeze another knot or two out of the steering wheel. We arrived at twilight, picked up the panga ahead of us and followed it in to the dock, parking the boat as the full dark of the new moon began to descend. What a relief! Coming into an unknown dock in the dark in a 144,000-pound vessel is always a little tense. We tied off the lines and shut down the engines and unclenched after another successful crossing of just over 800 miles. It is beautiful here—we are incredibly fortunate that Barefoot Cay is hosting us at their dock. It is the perfect place for us to use as our base here in Roatan. Besides being a gorgeous facility, it is located about a third of the way from the island’s west end, so it is central to everywhere we are working. I had originally planned to give everyone a week or two off to rest and recover from everything we saw and did in Haiti and to get some maintenance done on the boat, but our destiny had other ideas.
On arrival, we rendezvoused with four incoming volunteers—two nurses, Annee and Sirin, who have just finished their Masters degrees in nursing, an EMT named Martin, who is in the middle of applying to medical school, and Ash Leigh, an Occupational Therapist. A few days later my old classmate Maddie, an educator in one of the toughest school districts in south central Los Angeles, also joined us. Our initial plan was to work with the Clinica Esperanza, but in the two weeks we have been here we have expanded our mandate. Within 5 days our new volunteers and Haiti team were working in Clinica Esperanza, the Centro de Salud in Los Fuertes and the V.O.M Clinic, a PT/OT clinic for children with cerebral palsey, movement and behavioral disorders, and people with injuries or post-stroke deficits.
We are also the new flight crew for the Aeromedical helicopter, the only civilian emergency medical helicopter service in Honduras, available not just for tourists, but also for members of the community here. Sirin—who is also a CPR/BLS/EMS educator—is working with Maddie and the local Fire Department to do life support training for the fire and ambulance crew, some of who started working as firemen when they were 14 years old and have little formal training.
We have arrived in the middle of a nationwide Dengue Fever outbreak, so we have plenty of work to do. I did learn a couple of great clinical diagnostic tricks for Dengue. It is a hemorrhagic fever that causes bleeding. Like many terrible diseases, it has very non-specific initial signs-fever, malaise, aching, tiredness, etc. You can put a blood pressure cuff on someone’s arm, pump it up and leave it for two minutes. If they develop petechiae (little bleeds) on their arm, it is probable for Dengue. Also, intraocular pressure seems to increase, so gentle pressure on the eyes, with eyelids closed, produces a lot of tenderness in Dengue patients. I’ve had a few confirmed cases already, so we give supportive care and help people try and ride it out safely, but Dengue is not called ‘Breakbone Fever’ for nothing—it HURTS!
What has struck me most poignantly here is that, although Honduras is a poor Central American country, EVERYONE we have met here and every business we have connected with seems to be involved in some way with ensuring there is some access to health care for themselves and their fellow islanders. Barefoot Cay supports Clinica Esperanza. The local gym (which we are allowed to use as guests of Barefoot Cay) is organizing an American Gladiators-style competition to raise money for Esperanza. There is an island marathon being planned for the V.O.M Clinic. The Rotary Club here supports the Los Fuertes Clinic. Many of the islanders pay about $10 a month to support the helicopter service. It is amazing. Honduras is a place which has little. It has been very hard-hit by the economy in the US. It received terrible press when their military arrested the previous president and essentially evicted him to avoid him seizing power. But the people here are an surprising example of what we are trying to promote—taking personal responsibility for health and access to health.
It just goes to illustrate what I have always observed—people who know true need also understand the value of helping each other in a way that people living in more prosperous countries can never know. And especially here, on a 30 mile long island, it is like being on a boat with 60,000 people—everyone is in the same boat, and only by pulling together, can they survive the storms and squalls of fortune.
It is inspiring to see, and I am proud and humbled that we get to be a part of it.[flickr-gallery mode=”photoset” photoset=”72157624523709627″]
July 8, 2010. Port Antonio, Jamaica.
I have time to think about some of the patients we saw in Haiti. I told my mom about a burn victim—a guy who had, 32 days before he saw me, fallen and been knocked unconscious for 7 hours, left lying on the metal deck of the boat he was working on alone in a Santo Domingo boatyard.
The HOT metal deck…cooked him. In Ireland, I used to see cases of elder neglect. Elderly people, especially over-medicated or with dementia, would fall asleep with their leg or body against a radiator. Overnight, they’d get terrible burns. This guy had burns on his right buttock, on both calves, his ankle and on the back of his head. Continue reading The Last Patient of the Day is Always the Hardest
July 5, 2010. Port Antonio, Jamaica
Well, our passage from Haiti to Honduras was briefly interrupted. Our first day sailing from Haiti brought fine cruising downwind and down current, but as we began to cross the Windward Passage between Haiti and Jamaica we hit heavy weather. A beam sea of 8-10 foot waves made for a miserable roll. After 48 hours of fighting the helm, driving through lightning and winds reaching 55 mph, we found ourselves passing north of Port Antonio on Jamaica’s NE coast.
With our generator overheating and crew exhausted, we turned south and arrived in Port Antonio just after daybreak. Errol Flynn Marina in Port Antonio has been giving free dockage to boats coming to or from work in Haiti. Only a mile from land, the seas subsided, and we got shelter. We cruised into the protected harbor and pulled gently up to the dock. I was at the helm, and I will never forget the enormous feeling of relief that washed over me as I heard ‘All lines secure’ called out from the deck. I shut down both engines and relaxed fully for the first time in over 2 months.
We lived at anchor, enduring squalls and gales and constant maintenance, for well over 8 weeks in Haiti with nowhere to tie up or deep water to try and anchor in. Once or twice in Haiti our anchor dragged on a windy night and we had to pull and reset. An hour after we tied up at Port Antonio, a squall came through with 40 mile an hour winds, and I paid zero attention to it; a luxury we never had the whole time in Haiti.
June 28, 2010. Petit-Goave, Haiti.
“Another turning point, a fork stuck in the road,
Time grabs you by the wrist,
Directs you where to go,
So make the best of this test,
And don’t ask why,
It’s not a question,
But a lesson learned in time.”
–Green Day, “Time of Your Life”
Ah, calm seas and a gentle night breeze. Tropical Storm ‘Alex’ made things interesting for us over the last few days.
At the western edge of the bay of Petit-Goave, we were exposed to a 5-6 foot swell rolling straight into the bay, with 35 mile-an-hour winds holding us beam-on to the seas. Misery! Imagine that your house is the head of one of those bobble-head dashboard ornaments. During a break in the weather, we moved the boat under the mountains at the eastern edge of the bay, giving us much needed protection and a good night’s sleep. We are getting ready for the 800-mile transit to our destination in Honduras…fueling, taking on supplies, clearing the decks, lashing down gear, ballasting the boat, and the thousand small things that have to be done to clear Southern Wind for a crossing.
Most importantly, though, we are waiting for a weather window. Tropical waves are continuing to pass over this area. The water between here and Colombia is pretty rough and pushing north across our course to Honduras. Alex is messing up the whole western Caribbean—not a good time to push your luck on the water. Besides readying our boat for sea, we have also used the time to say farewell to our friends here and to catch up on some last minute patients. The farewells are very, very difficult for me—to see people and places that have become important to me grow smaller and smaller until they disappear below the horizon.
Captains Blog June 27th 2010
“Man is the measure of all things.” –Protagoras, ca 450 BC
Last night I watched Frank Capra’s great 1936 masterpiece ‘Lost Horizon.’ Set in a mystical land called Shangri-La, it is the story of a man who worked for peace in a world constantly at war. It is about a man, a diplomat, who dreams of a world run on compassion and dignity.
After his plane crashes en route from China, he finds himself far up in the Himalayas in the hidden valley known as Shangri-La. The valley is a community based on kindness and simple courtesy to one another. It is a paradise.
This is a beautiful story about what everyone wishes were true, but no one believes is possible.
When Frank Capra premiered the film, many snide comments were made about how silly it was. The movie that proclaimed the secret of a happy life is to “Be Kind” to one another was considered “Capracorn.”
That selfish cynicism nearly destroyed Frank Capra.
Almost everyone secretly wishes there were some place they could lay down their stresses and burdens and pains and needs. That place, as fanciful, exotic and remote as Shangri-La, can be wherever people practice kindness to each other.
And kindness is always a choice.
Before coming here—my first trip to Haiti—we had done so much reconnaissance (and I have already been to many places in the developing world) that I had a pretty good idea what to expect, but I also knew that there would be many things that would come out of left field and surprise me. From experience, I knew that for the first couple of weeks everything would be new and exciting, and that after a few weeks there would be things about Haiti that were chronically frustrating and upsetting. In this case, corruption in the government, the behavior of many other non-profits that are here, and human greed top the list for things that upset me in Haiti. But this doesn’t discourage me at all—EVERYWHERE I have EVER been, including places I love and would live in or revisit in a second, has things that I don’t like: the traffic in L.A., the lack of mountains in Florida, the cold in Ireland, the rampant HIV in South Africa, government corruption in Mexico, the mosquitos in Botswana. After a few weeks here, yes, of course there are things about Haiti that I don’t like, but I don’t care. No place is perfect, but as much as the challenges to rebuild Haiti seem overwhelming, there are still people here who have not given up, and neither will we.
If I am miserable and unfulfilled in one place, I’ll be miserable and unfulfilled when I go somewhere else, but I am doing what I dreamed of doing, after having (as Sky puts it) “frankensteined together this project that came out of your own head and watched it accomplishing everything you hoped it would and more.” At age 34, I am watching my dream come to life despite naysayers and constant challenges, with many hands reaching out to us to help us along our way. From childhood my dream was to practice this kind of medicine—the kind of medicine I watched my dad practice when he took me on rounds at the hospital as a child, and saw him provide in the homes of his patients and on the side of the road at terrible car accidents in Topanga Canyon where we grew up.
When your life’s dream is being fulfilled before your eyes is very hard to be unhappy and negative. The most common comment we have gotten, hands down, from older people who have met us, is “It is so great that you are doing this now, while you are young. You will never have to look back and have regrets about things you wish you had done and the places you have seen.” And when I look back down the years, hopefully many years from now, I want my halls of time to be lined with the faces of people whose lives I have connected with, however briefly, and in whose lives I left some kind of positive impact.
June 7, 2010
Time for a quick status check, and to update everyone about our plans for the next phase of our mission in Central America. So far, in seven weeks in Haiti we have:
• Treated over 1200 patients and over 250 dental patients in the DesGranges clinic with our current skeleton crew.
• We have had three more volunteers (a medical student, osteopathic physician, and EMT) and my dad join us in working here in Haiti.
• We have finished one schoolhouse, roof and all, and are nearly done putting the roof on the second building.
• We have worked in the DesGranges clinic for more than 30 days, and put in more than 25 days’ labor on the school.
• Hand-unloaded and transported in UN trucks: 20,000 pounds of material.
• We have treated over 300 people in our own mobile clinics in the underserved communities near our anchorage.
• We have provided health and dental education to patients.
• We have moved the clinic from tents outside back into the inspected and cleared building, reorganized the pharmacy and pharmacy stockroom, set up an infirmary and triage room, and restocked the minor ops room.
• We have distributed several hundreds of pounds of clothes.
• We have conducted our activities here for one tank of diesel and a total of less than $250 a week for all food, gas for the skiff, laundry soap, transport, etc. for a crew ranging in size between 7 and 11 people onboard. That’s just over the cost of three night’s stay in the hotel here for one person (no food, transport, etc), where many other aid workers have no choice but to stay.
• We have made many friends in the community—we play pick-up basketball at 5:00AM some days, our Haitian friends visit us and often stay on board, we chat with the town baker, Madame Fievre, about methods of making Haitian bread, people bring us small gifts by way of thank you (a few mangos, some plaintains or coconuts), we go swimming, eat, and work with many folks here who ask us for nothing (some do, but many do not) but have no work and would rather work with us than sit around doing nothing.
June 4, 2010. Petit-Goave, Haiti.
At long last, my dad and I got to practice medicine together! Dr. George La Brot, was just with us for ten days working in the clinic alongside me. This was a big deal for me; ever since I was a child and I knew that I wanted to be a doctor, I dreamed of working with my dad. Over 25 years have passed and here, a continent and an ocean away from where we started, we saw patients side by side in the clinic and in our mobile clinics. It was a wonderful experience to consult with my dad, and to be consulted by him when we had troublesome cases to figure out. I really wanted to show him what all his and my mom’s support and encouragement on the path to medicine and then to Floating Doctors had wrought.
I talked to my dad on Hughes’ phone as they were driving from the airport; my dad said that PAP looked like a lot of places he had been, but with more rubble—the wholesale destruction is much more striking in PAP because that’s where the biggest buildings were. He is right—anywhere I have been in the developing world, many things are exactly the same. As different and unique as each place is, there is always a strange sense of déjà vu that accompanies walking down a dirt road through an impoverished neighborhood watching children bathe in the gutter or a woman cooking something over a small wood fire. When he arrived at the clinic, we worked that first day, and in the afternoon all of us headed into town to run errands. We had to go to the bank, get bread from the bakery, get some produce from the market, get laundry detergent, get gas for the skiff, get some phone credit for our Haitian cell phone (indispensable for anyone planning to work in Haiti), exchange some glass soda bottles and collect our deposit, etc. For the afternoon, the clinic had arranged for us to have a driver with a beat-up old pickup truck. Continue reading Wherever You Go, There You Are
Well, at the end of our week here in Petit-Goave, it’s time to check how well we are meeting the goals for our project that I first envisioned over two years ago while working long nights in Irish hospitals.
I dreamed of a multi-skilled, highly adaptable relief team aboard a self-sufficient support platform that could use 21st Century medical technology, classical medical diagnostics and adaptability to different needs and resources to create long-term health benefits in developing world communities, making a difference one person at a time. Here we are, many months and many days of hard work later, and with many people who helped make this possible now a part of our story, anchored safely in Petit-Goave, Haiti.
For our first mission destination, I chose a tough location—Haiti: more than 800 miles from where we started, with huge challenges facing its people from every possible direction, a couple months after a huge disaster when people are still living in tents but many aid groups have pulled up stakes and moved on. If we could successfully conduct a mission here, I felt confident we could do it anywhere.
May 6 2010. Petit-Goave, Haiti
The sea has no memory.
It blew hard here last night, on the one week anniversary of our time here in Haiti. We spun twice around the anchor in the shifting gales as lightning split the skies and torrential rain washed all the salt and heat from our boat, and dawn showed the clear blue waters of Petit-Goave turned a deep murky green from the mountain and city runoff. Trash floated everywhere as streets poured their refuse into the sea, and I forbade the crew from swimming over the side until the water cleared. I didn’t know how long it would take, but the water off Petit-Goave drops off to over a thousand feet only a half mile from the port, and within two tides we watched the dirty green water sweep out to sea and be replaced with the normally deep blue open ocean water. On the second incoming tide, the water cleared and before the peak we could clearly see the coral and sponges of the reef below us. The sea showed no sign of the storms and rain of the night before, and it rolled on towards the shore as it has for thousands of years .
Thus the sea has no memory. It does not remember the earthquake, it does not remember Haitian independence, it does not remember the greed and corruption that spiraled Haiti down into depression and darkness, it does not remember all the failures and setbacks that have continually plagued Haiti. The tide rolls out, new water rolls in, and the face of the sea remains impassive to all the things that steal hope from a people.
It is amazing how much incident can be packed into each day. The week we have been here has flown by but also feels like a million years ago. Already we have seen so much, and things are not totally what I expected (in some ways things were EXACTLY what I expected). Devastation is everywhere; there is no work, no economy, everyone is hungry, there is nothing to rebuild with, everyone is living in tents…and yet somehow people still get up in the morning and go out to find work or food for their families. It is shocking to me that there are still people here who can have hope—the belief that things tomorrow might be better than today.I have seen Haitians who have literally lain down in the dirt and given up, and I cannot judge them that decision because from where they are standing there seems to be no hope at all. In the face of all we have seen, people still can have hope. From the rubble people try to build normal lives, and from high in the cracked remnants of buildings plants thrust out and reach towards the sun. Life, as Ian Malcolm says in Jurassic Park, cannot be contained. It is a powerful force, and when barriers and challenges are put in front of it, life finds a way. The human spirit is an extraordinary thing and I feel lucky to glimpse a small snapshot of its power, and to have the opportunity to do everything we can to help foster it and encourage its survival. New challenges get thrown up in front of us at every turn—how do you get 20,000 pounds of lumber, building materials and medical supplies through the complicated customs process, off the boat onto the broken,
half sunken pile of rocks that is the Petit-Goave dock?
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