Bocas del Toro, Panama
As always, leaving Haiti was difficult. There is always a sense of leaving things unfinished, no matter how many patients you see or projects you complete. I always tell people, we are not going to go help Haiti. That is beyond our power…but we went to help HAITIANS, and helped many. Leaving is hard…but I comfort myself when I remember that our anchor will drop in Haiti again.
We had an amazingly calm and uneventful passage from Haiti to Jamaica (our 4th time crossing the Windward Passage…it was tolerable this time, I’ll give it that). We ghosted through mirror glass seas 200 miles off the coast on our way south to Panama, a full moon reflected among the stars on a sea so smooth that the horizon was not visible. We caught some fish, slept well, had a whale shark partially breach in our wake, saw pilot whales and dolphins…Jamaica to Bocas del Toro has been by far our easiest and most pleasant transit.
Our arrival in Bocas was marked by the immediate generosity of the expat and local community here. Dylan and Darien on S/V Jackaroo, the owners of the Calypso Cantina at Bocas Marina, helped arrange Bocas Marina hosting us while we are here, welcomed us with a fire dance at the cantina, and have just organized a big fashion show fundraiser to support our time here (blog with THAT story coming soon!). Chuck, Courtney and Rosemary and Dana from Bocas Marina have gone way out of their way to support our mission here, and everyone in the local community has reached out to help us here.
This place is almost purpose-designed for a team like ours: a large population spread out over a large area, mostly accessible only by boat, with little or no access to health care…nearest surgery is an hour and half by fast boat ride…a mammogram is 2 hours away…a very, very, very underserved population (lots of indigenous people who have had a long history of poor interactions with foreigners).
We immediately became involved in several initial activities:
Mobile Clinics:
By car (thank you Rosemary!) and by panga (thank you Alcaldia!) we have so far been running mobile clinics for the communities in San Cristobal, Drago, and Shark Hole and have returns for follow up and visits to other communities on the calendar for the next few weeks, with help from expats in the area, peace corps volunteers in the communities, and with the help of the local mayor (the Alcaldia).
- Sarah doing health checks in Drago (about 1 in 6 had something needing attention)
Dr. Joe, previously the town’s only doctor before entering politics, visits the outlying communities once a week with a government team (health inspector, education directors, building inspector, etc) and we go with to do a mobile clinic. We have some bigger multi-day mobile clinics coming up; on one we will be carrying five 750 gallon water tanks to a remote series of coastal communities for Operation Safe Water.
Nursing Home (The Asilo):
3 staff (cook, cleaner, nurse) on each day shift to cook for, feed, clean, wash, change, dress, and otherwise care for 25 long-term care residents who are wards of the state, most with few (usually none) family members and no means of support. The fact that the floors are clean and the patients are fed is a huge achievement, but otherwise it is heart-wrenching. There is a 3-inch concrete sill in each door…to go outside, I watched an old man with no legs roll himself up to the sill, climb down out of his wheelchair, lift the chair over the sill, lift himself over the sill, and then climb back into his chair.
Piles of rusting metal and trash and junk fill the backyard, and vultures walk amongst the patients in the fall-hazard garden. There are no handrails anywhere, including the bathrooms. A doctor has not come from the hospital to look at the patients for months, and they have no meds at all. And the patients have no charts at all. SO…we created charts, did full histories and physicals on everyone. Now we can write and document progress notes and exams and studies.
The mayor sent a municipal truck and we filled it three times with garbage and junk, CJ has gathered many cuttings and plants given by other members of the community and begun systematically landscaping the demilitarized zone that was the backyard, we’ve been doing wound care, skin care, walking and exercising the patients, repairing leaking water pipes, changing inappropriate shower heads, providing eyeglasses, and generally trying to improve conditions everywhere we turn. If you are in Bocas and reading this, come by and give us a hand!
Bocas Emergency Network:
We arrived here to find that the BEN (Bocas Emergency Network) was already in existence here—a network of about 50 expats scattered across the area who remain in radio contact to alert and assist each other in emergencies. The name seemed a fit made by fate, so our call sign in the BEN is ‘BEN911’. We have taken a couple of calls through the network, but fortunately none which were serious enough to necessitate an emergency callout. We are working on getting our own panga and programming known safe routes through this maze of mangroves to all the different BEN member homes (which are all located near local villages) into our GPS so with a searchlight we can make high-speed response to emergencies or do fast transit to Changinola (closest place with surgical facilities)
So far here we have had medical students from Israel and Saskatchewan, Canada, an RN and her cameraman fiancé from Australia, pre-medical and nursing students from Duke and Berkeley, an Optometrist living locally who is going to come do monthly prescription clinics (we have glasses), a nurse from Florida who just moved here with her husband, and we have a tropical medicine specialist coming from the UK, a nurse from California, and other volunteers coming throughout the summer, and some of our old volunteers returning too (awesome). It is amazing watching them go through the experience. It changes us daily, and it is fascinating and rewarding to watch people rise to challenges, encounter people and situations which push them past their boundaries, and seek out and develop opportunities to help.
I read about a playwright/director, terrified after an awful dress rehearsal before the debut of his one chance at success, who fell asleep and dreamed that he was scaling a immense mountain peak…vertical walls…no ropes…he, who had always been scared of heights, in the dream is climbing like a man born to the rock and the sky, and as he nears the summit, he loses his grip and slips, hanging just below the summit by his fingertips.
- Eve and Sarah changing decubitous ulcer dressings in Asilo
A man on the summit looks down and asks him if he is afraid of failing…and says ‘it is sometimes a mistake to climb; it is always a mistake never even to make the attempt. Sometimes, when you climb, you succeed, and sometimes, yes, you fall…but there is a third option…’ And then the playwright falls. And as he is falling, he realizes what the third option is: sometimes, when you fall, you find out you can fly.
This I believe.
And in this community there are already many hands under us. What do we have in the works? Of course we want to bring in a container from Direct Relief International with equipment and material for the hospital and dispensarias here; we will soon be doing training with the firemen (who do water rescue here also) in Bocas, working with Operation Safe Water to deliver more tanks and equipment for water projects, doing consults using the mayor’s old consulting room, putting a raised vegetable garden in at the asilo, getting some specialists down here, doing more multiday mobile clinics and continuing to return for follow-up…who knows what else? I feel like this is a community in which we can accomplish a lot…it’s an exciting feeling after 1 month; wondering what we will have done here in another few months…
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All pictures of patients used with patient’s or guardians’ consent.