July 2, 2009. Palm Coast, Florida.SHARKS IN THE CANAL!!
You know, the story here keeps changing…when we got here, Sky and I took one look at the green, zero-visibility canal teeming with life and thought immediately, ‘Wow, what a bullsharky-looking place! And wow—the only shade anywhere around the canal for a big alligator to rest on the bottom during the heat of the day is under our boat and under our dock!’ However, everyone around here told us that sharks don’t come in here, and they have only seen an alligator once every few years during big storms. So last week, we saw a big 7-foot alligator idling around in the canal before it disappeared in the twilight, and today we saw a 5-foot shark (a bull or a blacktip) swim casually past the boat. It makes me a lot less happy about going back under the boat to clean the propellers! If I didn’t know better I’d think the neighbors were trying to encourage my demise, except that they have all been so nice to us—one of our neighbors, David, sent me a photo of the Southern Wind graphically altered against a nebula shot from the Hubble space telescope called ‘The Cosmic Voyager.’ Hopefully we’ll never be that far off course! Zero cross-track error is our goal!
A supporter of ours named Jonathan, an ER Nurse in L.A. (who is also an experienced transit captain, having spent years sailing the breadth of the Pacific) gave me great ‘rule-of-thumb’ advice about swimming in unknown waters. You never know if the seemingly calm, placid water you are about to dive into to survive the blistering heat has had 10 huge tiger sharks show up every afternoon at 5 PM for the last thousand years, so always seek local knowledge—but if none is available, never go in the water if you can’t see the bottom clearly from the deck of your boat! The dark, tannic waters of this canal looked sharky from the moment we saw it!
But that is the consequence of having a canal teeming with life. Now that we are living in Dennis and Jeannette’s old house (they moved across town and are letting us stay in their house where the boat is docked), we have taken to fishing off the boat in the evenings—after 6 PM, we are DONE working on the boat and we often take a break before dinner to fish, since a lot of the crew are just learning and we will have to provide a lot of our protein this way during our journey! Tonight we caught a stingray, which we let go right away—she was gravid (pregnant); you can see the large bulge in the middle of her body from the base of the tail forward—and I caught my first ever tarpon; which we also let go. Fascinating and Beautiful, respectively, but so far we have caught a lot of fish but none that are much good as food! We SEE them in the water, big red drums, but so far they seem to be mocking us!
After dinner (thank you Sky!) we usually work on the various logistical tasks remaining; for example, Jamie, after working all day painting below decks and putting in corner moldings, spends hours in the evenings working on our global health care survey. With her Public Health focus, she is the perfect person to coordinate the development and administration of our survey. It was originally based on the World Health Organization’s 2000 World Health Survey, but my Godfather, Dr. Gene Caine, and Dr. Marianne Kirtland (both Public Health MDs) have consulted with us and advised many changes to answer the questions we want answered. We want to study issues in health care delivery, particularly perceptual questions of health care. We want to know not only what the problems are, but what do people believe are the biggest problems? What are the barriers to health care—how far do people live from care? How much does it cost? What care do they expect they should have, and where do they think it should come from? What kind of care is actually available to them? What do people KNOW about disease and health? In short, where do people go when they need medical help, what do they get, and WHY? These are questions that have not yet been deeply explored.
Back in L.A. a few months ago, I gave a ride to two guys from Honduras who were hitchhiking in Topanga Canyon. When they told me where they were from, I practiced my Spanish by telling them about the voyage we were making. I realized ‘Well, here is my chance to start my survey’ and asked them what they thought was the biggest health problem in Honduras. At the time I was unsure about what the major issues in Honduras were, but if asked I probably would have guessed something like poor childhood nutrition, or poor pre-natal care—something affecting A LOT of people and their futures. They both, without hesitation, answered ‘Dengue Fever;’ caused by a hemmorhagic mosquito-borne virus. It turns out that there have been major outbreaks of Dengue in Honduras over the last 20 years, though it seems more prevalent in other Central American countries at the moment. This disease can cause dangerously high fevers, vomiting, and spontaneous bleeding but is primarily lethal in children. Thus it remains a significant problem, made much more dangerous by poor childhood nutrition (which weakens the ability of the body to launch an effective immune response).
It is hard to get people to focus on preventable problems like poor childhood nutrition or poor pre-natal health—problems that don’t seem so acute at the time but cause SERIOUS consequences later—when dramatic outbreaks of Dengue keep occurring. And since Dengue is still a very real danger, a way to motivate people to try and provide better childhood nutrition may not be to only emphasize the long-term benefits, but to emphasize the increased ability a child would have to survive a Dengue infection if the child were in better health.
We have a lot to learn about how to make adequate health care available, and what people BELIEVE about health and health care is just as important—maybe even more so—than merely cataloguing the existing problems!