This week saw the first heavy, 3 day long pouring rain for several weeks (of course, while we are trying to load the boat and finish our preparations for departure) and the tying off of many threads we have been following for months…we closed up our clinic in Oakridge, packing everything up and saying hasta luego a mi pacientes. Un momento muy difficile. Thank goodness we plan to return to open the clinic permanently as a satellite clinic, open every day with a doctor and staff on site even when Southern Wind is working elsewhere. Knowing we are coming back after this voyage, and knowing that with what we learned and the relationships we forged on Roatan, we can and will open that clinic, makes it much easier to say farewell. Instead, we say (we are going to Haiti, after all) aur revoir.
We finished off a lot of rainy day projects inside the boat (there are always, always more
projects), and got down to the business of prepping to load—that means taking every item out of its storage onboard, condensing everything, repacking all our medical go-bags (thank you Dr. Holly!), and most important: we took delivery of our 5 pallets of material left over in Miami from our last mission to Haiti (thank you Gary, Donna, and everyone at Roatan Rotary!), and our 40-foot container from Direct Relief International, packed with medicine and equipment for the clinics in the island and distributed the material to 5 clinics and the public hospital on the island.
This is a crowning moment for Sky. To get this container in, it required over 1,000 emails between Sky, the shipping company, Direct Relief International, Joseph Natale from Fundacion Heart Ventures, the customs office, the customs broker, Roatan Rotary, a cross-country trucking company and a local trucking company in Miami and another in Roatan, the warehouse in Miami with our 5 leftover pallets, the Ministry of Health in Honduras, 6 different clinics on Roatan, and Cepudo (a Honduran NGO on the mainland).
The difficulty is not in sending down material—anyone can order a container and have it
shipped down here…but not without enormous import fees. It is sending down material and getting it cleared through customs as donated material without $30,000 worth of customs duties applied that is difficult, not to mention that we wanted to create a conduit so that we could send containers on a regular basis. One time is easy…to set it up to be sustainable is way, way more difficult. It took more than anyone else will ever know to get it set up by Sky, but I will always know and always be impressed how much the people you already love and admire can still amaze you.
In a few months I will begin contacting the clinics again, finding out their needs and getting another request for DRI and container number 2…
In the midst of all this, we still see patients, provided the medical service for the Bay Islands Triathalon (including the kayaks monitoring the swimmers during the first leg), and Dr. Holly—whose training
includes major scene accident management—provided 2 days of training for the Fire Department, following up the training provided by our volunteer Sirin last year.
Dr. Holly showed the firemen a particular extrication trick—when you have a patient with suspected spinal injury from a car accident, you can extract the patient through the back window by lowering the front seat, sliding the board in through the back window and taking the patient straight out. Since we have the use of Gary and Donna’s open jeep, we could simulate the extraction without having to smash a car’s back window. We are nothing if not adaptable.
The weather is looking good for this weekend (pouring rain now)…high pressure pushing down, maybe keeping the low centers at bay over our projected route. Loading the IV fluids tomorrow and the next day…Finish securing the boat for sea…provisioning….and a last good night’s sleep.
Then give me that horizon.
Photos of patients used with patients’ express permission.
Photos of unloading and interior boat construction (pretty much most of the nice-looking photos) courtesy of Dan Chomistek
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″]
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