Last week we had an awesome experience—in the midst of our last weeks of preparation for our mission to Haiti, we are continuing to open our Oakridge clinic. Pretty hectic—clinic by day, boat work by afternoon and evening, and computer work late into the night…but totally worth opening the clinic not only because we had a full patient list right away, but also because we had some very welcome visitors to the Oakridge clinic on Wednesday.
Optometrists from Manteca Rotary Club in California’s Central Valley came to our clinic
and provided prescriptions and eyeglasses to 40 or more people in one morning’s work. They were cool—came in, knew exactly what to do, had obviously done it before and saw as many people as humanly possible in the time allowed. Exactly the kind of group I love to work with; the maximum effect with the minimum fuss.
One thing that made their work really efficient was the little device they had with them—it was a Welch-Allyn device for scanning and identifying patients’ eye prescriptions. When I heard optometrists were coming, we pulled out and dusted off the traditional optometrist machine sitting in the clinic building we use, but the device they had with them made it
look like a piece of obsolete medieval torture equipment. Fred, the optometrist scanned patients, gave them their prescriptions, and Renee (the former club president) gave them their glasses—both reading and distance.
If one of those were on station somewhere for a month, I think it could do about 2,000-3,000 patients. That is an INSTANT, huge increase in someone’s quality of life. Apparently the units are affordable, easy to learn to use, and of course small and portable. We have GOT to try and get one of those.
It was great being back in clinic—plus, we have Dr. Holly with us as well. We picked her
up at the airport in San Pedro Sula on our way back from Copan. She is an Accident and Emergency Room doctor and Tropical Medicine specialist from the UK, and will be working with us for 3 months before joining the Flying Doctors in Africa. It was wonderful to have so much help in clinic; Donna from Roatan Rotary was with us, Sky was running the front desk, Noah was doing his Thursday physio sessions. I love it when the clinic is humming; ultrasounds and minor ops, consults…love it.
Our container from Direct Relief comes soon…can’t wait to distribute it among the clinics (and pack the 350 cases of IV fluids onboard to take to Haiti for the cholera relief). So much to do in these last
weeks…just like the first time, we went, except this time we have already done it and have substantially continued to rebuild our ship ever since we set sail. We are better equipped and more experienced than our first trip, and that was a success.
I am confident, a little scared (if you aren’t scared of the ocean then you have no business going out on it), and excited to return to Haiti. It’ll be an 800-mile, uphill (upwind and up current) trip but with the right weather window we can do it. Still have a lot to do first, but it is getting done every day…and probably will be right up to the day we leave!
Medicine in developing nations is, most people would probably agree, substantially different from medicine in developed countries. Still, there are many aspects of the health care experience that seem to be universal, shared by ‘have’s and ‘have-nots’ alike. For example, the prospect of surgery under general anesthesia is daunting whether you are having it at the world’s most advanced hospital or in a temporary medical mission surgical tent.
And of course, men, women and children of all ages all hate getting injections (except for little old ladies, who—in every country I have ever worked in—take injections and other potentially uncomfortable procedures pretty much in stride). This week marks the end of our management of one particular patient whose experience made me think about the parallels in health care experience that are shared by patients worldwide.
One day a few weeks ago we had returned to the boat after a long day in clinic, and a 43 year-old
guy walked up to the boat asking if we were the medical doctors and could he consult with us. We invited him aboard, and I immediately noticed he was taking small, tentative, shuffling steps and was bent forward slightly from the waist, pressing his right hand over his bladder. He told us that 9 months ago, after several months of severe pain, blood in his urine, and repeated urinary tract infections, he had saved up for an ultrasound and they had found a great big 3 cm stone in his bladder.
At this stone’s size, open surgical removal is the indicated treatment, but he could not afford the 60,000 Limpira (about $3,300) charged by the private surgeon he saw, but the surgeon said he would make him a deal—he would do the surgery for 45,000 Lempira if the patient arranged for the surgeon to do it at the public hospital, thereby not using any of his own equipment and resources.
The patient DID arrange permission from the hospital to have the private surgeon operate there, but fortunately the patient came to see us (he had no choice, as 45,000 Lempira might as well have been 450,000; he had not worked for weeks and weeks because of his crippling pain).
I visited the public hospital to speak to the chief of surgery there, Dr. Indira Sanchez. She is a fabulous surgeon; the first night I dropped in to help in the hospital I assisted her doing an open abdominal surgery on a gunshot victim, closing perforations in the colon and removing and directly re-attaching a perforated piece of small intestine (total number of personnel involved in the entire surgery, including me? Only five people; patient did fine). She has great hands for surgery—sure, experienced, and capable. I presented the patient’s case to her, she consulted with him, and booked him for surgery only a few days later.
She gave him the orders for his pre-op blood work and chest x-ray (which he had to get at the private hospital because the public
hospital x-ray was not working), and he went straight out and got the tests all done, which we microfinanced. Then he came back to present his test results to one of Dr. Indira’s team, the doctor sent the patient back to Dr. Indira with his endorsement that he was ready for surgery (which we also financed), and two days later the patient had the stone removed in about 30 minutes under general anesthesia.
He recovered well, and is no longer in agonizing pain all day every day. In a few more days he can go back to work, after over 9 months of debilitating pain.
Pre-op blood tests and x-ray: $80
Open surgery for bladder stone removal: $20
Price for living without pain? Pretty hard to quantify, but it seemed pretty important to the patient!
The whole thing got me thinking about the complexity of health care, and how daunting it can be for a patient to try and navigate
their way through the system—DEFINITELY an experience shared by patients in the developing and developed world. Almost anyone who has ever had to use their health service, especially for something major, can appreciate the confusing nature of going from specialist to specialist, office to office, exam to exam, wondering when the whole process will finally be over.
This case was a classic example of one of the main roles now played by General Practice and Family Practice physicians—that of a guide to navigating the maze of specialists and tests and procedures available in an ever-increasingly complex health care system. As Medicine gets more and more specialized, it will become more bewildering for patients—especially for patients who do not have a wide base of health knowledge—to find their own way through it.
The patient gave us permission to document his whole experience; soon we will put out another short video focusing on his experience with a health care system. I think that people in any nation at any socioeconomic level will resonate some part of his experience with their own history of interactions with health care. Some aspects of being a patient appear to be universal…watch and decide.
In this case, the patient was unaware of how to try and arrange a public hospital surgery and our representation (based on the good working relationships we have developed with many clinicians here on Roatan) was key to the surgery being performed.. Although we assisted the surgery and post-op care, our main role here was simply to take a patient and help guide him through the whole process, making an overwhelming prospect (especially for someone acutely sick!) a smooth series of events resulting in the patient regaining his health.
The other primary role of the GP or Family doctor is to try and help keep their patients well enough that they never have to go to the hospital!
A real highlight of the whole experience for me is that it all happened when my mom and
Grandmother and cousin Ishan and his wife Maria were here visiting us in Roatan. These were the people who have been there from the very, very, very beginning, when Floating Doctors was a wild dream keeping me sane during months of freezing, dreary weather in Ireland, to the year of frantic planning and fund raising, to the year of rebuilding the boat, to Haiti and thence to the shores of Honduras.
Our families have been so supportive…without them this never would have been possible. I was very proud to finally be able to show them what all their encouragement and support made possible; it meant the world to me that they came all the way to Honduras to see us. Love to all of you–fair winds and a fast return.
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Man, sometimes a week brings a flood of minor upper respiratory tract infections, fungus, and the usual small town clinic maladies…and some weeks, the dam opens and all kinds of situations arrive on the doorstep. We did a lot of small surgeries, mostly taking off cysts and dealing with minor wounds, and did loads of ultrasounds (lots of ovarian cysts, some gallstones and bladder stones); but we also had a few more unusual cases come in.
First, there was Missty (yes, that is how it is spelled). She lives on a sailboat with her mom and dad, and climbs all over the place like a wild child. She is the cutest little girl ever—she came in a week after getting her knee stitched up at the hospital; she sliced it about 4 inches across the front on a piece of sharp metal and then tore ALL her stitches jumping down onto her boat/home and landing in a deep knee bend. Then it started to get infected, so it was a green mess when I took off the bandage.
Tough as nails, she let me take out the stitches and debride the wound, then I steri stripped it together and rebandaged it and sent her home with some antibiotics and dressing changes… “No more running around like crazy on the boat for one more week!”
Then a guy came in unable to swallow or drink, and unable to lower his chin because his tonsils were so badly inflamed they were like tennis balls, with another tennis ball sized abscess in his
cheek. He was really dehydrated, so we gave him IV fluids and pumped him full of antibiotics. The next day he was marginally better, so we kept him on the antibiotics and after a few days he could swallow and take liquids. Only his cheek abscess remains, and it is shrinking rapidly.
We had a baby come in with a mysterious rash (see the photos below for the case details)…we did two surgical house calls for minor procedures at a shop run by two ladies in French Harbor. One of the ladies, from whom I removed a ganglion cyst, was in a hurry to get home so she could make dinner for her husband. I told her he should do it for her while her wrist has just had surgery, and she and her friend agreed…and both laughed at what a delightful fantasy it was, and how impossible. Still tough to have two X chromosomes around these parts.
Still, our clinic is seeing lots of patients. It was great to have Megan with us. She set up two of the clinic rooms for acupuncture and treated patients two at a time every day our clinic was open, and was always running all over the island after hours giving treatments in the community. Being able to combine acupuncture with western medicine was great—in the community we serve, there is a lot of stress and post-traumatic stress from abuse or violence, and mental health issues are somewhat of a taboo. These issues are often compounded with some form of chronic pain, usually in the knees or back or feet after years of hard living.
When patients I had treated medically and then referred to Megan came back for follow up, they raved about how much they felt the treatments helped, and I have seen acupuncture be effective way too many times for me to doubt that is has efficacy in a number of situations. I’m not sure I understand why it actually works, but although I would really like to know for my own interest, ultimately I don’t care—I really only care that it works! My dad always says that despite their frequent disagreements, there is one way doctors and lawyers are always in agreement: ‘Ultimately, both are only interested in results!’ Especially doing this kind of remote medicine, a doctor has to be ready to use any tool in the toolbox that can help, and I felt that of lot of patients got a good result from their treatments. A lot of them burst out crying after or during their treatments and shared all kinds of horrific personal tragedies with Megan…it turned out that often they were crying about it for the first time, even horrible experiences years ago.
I also think the patients were really, really receptive to the concept, too. Certainly, against the blend of bush medicine, Obia, and traditional home remedies in common use,
acupuncture probably didn’t seem too out of place, and there was also an element of the ‘well, the doctor has suggested this, it must be a good idea’ kind of thinking I often saw among older patients in Ireland and most patients in the developing world. Although in this case that attitude it made it easier to get patients to accept acupuncture treatment, that same outlook can sometimes put patients at risk of medical error. One way to bring people into more active participation in their health knowledge (i.e., questioning the doctor), is by empowering them with knowledge about their own health, and we spend a lot of time in consults drawing diagrams and explaining people’s physiology to them.
Sometimes, however, one of us becomes a patient…last night, walking barefoot on the deck, the side of my foot kicked the slivered edge of a cut pine board, and a giant splinter wedged itself into the bottom of my foot. It was wedged in deep and barbed like an arrow, but after I anesthetized it Noah and Sky got a scalpal and some forceps and pulled it out. Man, it sure is sore today…going to go soak it in salt water before showering tonight.
That’s when you know you have an awesome sister…an awesome sister is one who will hold the light for you when you have to inject yourself on the bottom of your foot, which is pretty much exactly like you imagine. So much is happening all at once—we just found out there is a possibility we will be going back to Haiti to help with the cholera outbreak, we are investigating ways to keep the Oakridge clinic operating on a permanent basis, we are coordinating containers of medical supplies and gear from California and Florida to Honduras, and in our spare time continuing to improve and strengthen Southern Wind.
With this much on our plates, I sleep a lot better knowing Sky and our crew are facing this with me.
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As we were closing up shop after a busy clinic day in Oakridge, we got a call from the Roatan Zoo—one of the new keepers had been badly mauled by one of the monkeys while cleaning the enclosure. Oh man…after a late night working on the computer and a CRAZY day in clinic I was looking forward to lying down for a while, but when the call comes for help, you have to help–so we grabbed our minor surgery bag and some antibiotics and headed over.
Apparently, the victim had been employed there about two months, and was working (as usual) with the main keeper, who had been with the zoo
for 5 years. They had been in the cages together many times before, and had no problems, but this time the head keeper stepped out to grab some additional cleaning supplies and one of the monkeys decided to challenge the new guy.
While with the head keeper, he had been safe—the head keeper’s place in the monkey society was well established (as boss), so the new keeper got a free pass. But when he was left on his own, one of the males just went for him. He was knocked to the ground and savaged, bitten and clawed all over his legs and his arms and hands; the monkey actually went for his face—all the wounds on his arms and hands are classic defensive wounds. Fortunately the head keeper heard the commotion, ran back and pulled the monkey off (the monkey immediately submitted to the head keeper).
The male in question had been horribly abused in its previous home; it had come to the zoo nearly dead…now it is in fine form; I guess it feels strong enough to challenge newcomers in its little kingdom. Everyone always looks at monkeys and goes ‘Awwww….how cute.” And it is true, with their little human faces and adorable antics, they are pretty fun—but they are also wild animals with motivations all their own, and with lots of strength, agility, speed and teeth and claws!
When we got there, the poor guy was a little shocky, covered in blood, dried monkey saliva, and dirt and debris from the bottom of the monkey enclosure. He was so filthy and crusted that we couldn’t even see where the wounds were. Pretty bad scenario from an infection point of view; monkeys have fangs that can bite pretty deep and inoculate your tissues with their raw sewage-like saliva (pretty similar to human saliva, probably).
I immediately gave him an injection of ceftriaxone and an injection for pain. We used a garden hose (the water at this resort/zoo is filtered and potable) to soak off the filth and dried blood as it would have taken more gauze than we had with us, and been more painful. The hose helped gently soak open the dirty scabs over the wounds, and let them bleed out a little to help clean them. Finally we could see the wounds—lots of them, probably around 40 bites and claw marks. If he hadn’t been wearing jeans, I think he would have lost half the skin on his legs, and if he hadn’t had his arms up in front of his face things would have been a whole lot worse.
After disinfecting and irrigating all the wounds, we salved them with antibiotic ointment, dressed them, and gave him oral antibiotics and painkillers, and fresh bandages for his family to change for him if he got wet. We also started him on acyclovir, an antiviral given as prophylaxis for monkey bites. The next day, all his wounds were clean and dry except for his right hand and left forearm, which were very swollen (and pus was expressed from the hand). We added a second, stronger antibiotic and got him to start bathing his wounds in hot soapy water a few times a day.
It worked—his swelling went down and his wounds are healing nicely. Never a dull moment practicing medicine in the tropics, but most of all I liked that we were able to bring care to his home. The house call is still my favorite consult.
When I was a kid I watched my dad do house calls in Los Angeles…practicing Alaskan small-town doctor medicine in a big city. In my folks’ house, as long as I can remember, there is an old print of a painting of a doctor, circa 1830ish, on horseback with a lantern and black medical bag in the dead of night, riding slowly through a driving rainstorm. There’s no adrenaline rush about the figure; the doctor is not flying down the road, coat trailing behind and sparks flashing from the horse’s shoes on the cobbles.
Instead, the doctor looks cold and wet—can barely see his face behind his upturned collar, peering head through the dimly lit night. He has the air of one doing a job that he is doing because he has no choice, because it is who he is. It would never occur to him that someone else should be the one to go out in the night and go help a sick patient. He goes, and gets cold and wet and more tired (he must be a critical care doctor), because to him, that is what a doctor does. It isn’t even a sacrifice, just a part of his core being. I always felt like that picture captured some of the essence of what being a doctor means to me.
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Wow, what a ride…a few days ago, Hurricane Richard passed almost directly over our position here on Roatan. For several days, we watched it approach, slowing down and gathering strength as it hesitated out in the Atlantic, almost as if it were undecided about whether to move northwest, as most hurricanes do, or to move directly west and sweep over the Isla de Bahia in Roatan. Naturally, we began to take elaborate pre-hurricane precautions, hoping that they would not be necessary.
We cleared all of our gear off the decks and lashed all the big stuff down tight, covered our bridge windows to protect them from flying debris, charged our batteries and filled our water, stocked up on food, added about a dozen dock lines and more fenders, and prepared to ride it out. These are the moments that are a true exercise in letting go; when you have taken all the precautions you can, and done everything you could–then whatever happens is beyond your control. The sea can be a very scary and intimidating place when you try to maintain the illusion of control on the water.
From the bridge, we waited, and tracked the storm on satellite imagery. As it came nearer to our position on the screen, the air felt heavier and heavier as the pressure dropped, and all of us–including Tweek and Giles, our ship’s dog and cat–started feeling restless and agitated…I guess it is true what they say, the waiting MAY not be the worst part, but it is surely no picnic!
First, the weather turned dead calm and still, the only change being the plummeting barometer…then came the rain, and then more rain, and then a LOT more rain…and then the wind. At first the wind wasn’t too bad, blowing at around 30-45 mph for the evening, but as 3:00 AM rolled around the wind began to pick up sharply, whipping the trees around us and surging the already full-moon high tide up over the concrete dock. Thank goodness we had had a chance to adjust and tune all our dock lines while the wind was still blowing only 30, since by the time the wind hit 79 mph it was difficult to move around safely outside.
The boat rocked and heaved amid the spiderweb of dock lines holding her out in the middle of the basin–one line snapped, but Captain Ed and Noah managed to get a replacement line around another cleat in time to keep us from being
pushed forward onto the seawall 8 feet dead ahead. As dawn brightened, the wind began to die down to gale force, and eventually petered out amidst a series of heavy showers into a preternatural stillness, and the first tiny patches of blue sky we had seen for days finally peeking out in the eastern sky.
Then all hands checked the lines one more time and turned in for some well-earned sleep–back at it in the clinics tomorrow! What did Graham Greene say about the sea.. “The ocean is an animal, passive and ominous in a cage, waiting to show what it can do.” The power of the Hurricane, this ‘little’ category one hurricane, gave us a brief glimpse at the forces that lie in wait under the deceptively calm waters and blue skies of the tropics.
The price of having even a chance of survival on the sea is eternal vigilance…when situations turn bad, they tend to do so quickly. Better to prepare thoroughly every single time than be caught out the ONE TIME you fail to take every possible precaution.
Live to sail another day!
Here in Honduras, as it was in Haiti, on any given day my crew are usually spread out at several locations, and when I find out later the details of what they have been doing, I am always astonished. Today we recognize the awesomeness of the work done by nurse and instructor Sirin Petch. By the time we had been here about a week, we learned that the single fire station on Roatan had not been given much formal training, and Sirin agreed to work with Maddie to provide training in emergency response. Nearly every day for almost two months, Sirin worked with the firecrews to provide training in airway management, scene assessment, lifting and immobilization, choking, and other techniques necessary for EMS response. Some of them had joined the department when they were 14, but few had been able to get formal training. The firemen are paid very little (they have to buy oxygen for the ambulance out of their own money), and they work hard.
Sirin first asked the Firemen what they would be most interested in learning, and looked at the resources that were available and would be the most useful instruction for work here in Roatan, and then provided training. Maddie was instrumental in helping communication, plus she is a naturally gifted teacher, and later they were joined by Zach, one of the pilots on the emergency helicopter, and Yolanda, a paramedic from Montana volunteering for a couple of months on the helicopter.
Sirin and her team trained the fire crews, went on night calls with them, and even after Yolanda and Maddie had gone home, Sirin continued with the firemen. Near the end of Sirin’s time with us (for now?), an incident occurred that says a lot about the relationship Sirin created with the Bomberos. I got a phone call to transport a patient on the helicopter to the mainland, so I made my way to the landing field, prepped the gear in the helicopter and waited for the Fire Department ambulance to bring a patient with suspected barbituate overdose. The ambulance arrived, the doors were kicked open, and out jumps Sirin and the firemen, who hand off the patient to me on the helicopter.
On the way back to the station, Sirin and the firemen got a call for a woman in full arrest. Sirens blazing, they arrived at a house surrounded by wailing family members. A larger woman in her 40s had a full arrest, in a house at the top of a 30-foot embankment. Using the techniques Sirin had taught, they put her on an immobilization board, inserted an airway, maneuvered her down the hill to the ambulance and raced to the hospital. They worked hard to resuscitate the woman, both in the ambulance and the hospital, but eventually had to call time of death. Sirin helped arrange the body and deal with the distraught family thronging the hospital corridor, then she and the Bomberos headed back to the Fire Station, only to be diverted to a brush fire. They gave Sirin a brush jacket and sped off to a banana plantation, arriving as it burned itself out. Scrambling up the smoking, scorched earth, they made sure the fire was completely extinguished, then returned to base.
Beyond the skills and training that she made available to the firemen, I believe that Sirin gave them something much more valuable. They looked at what Sirin knew, and her professionalism, and saw its value. She earned their respect (not always easy for female professionals in Latin America) and their friendship, and helped inspire them and motivate them to want more training and to seek it out. They have asked Sirin to send EMS instruction books and have increased their physical training (Noah has worked with them in the gym and done lifting and transferring instruction with them, and a few days ago I boxed with another).
I am very, very proud of the work at the Fire station, and very proud to have seen Sirin rise to such a challenge. Long after we are gone, I hope the knowledge and professional pride she left behind will continue to grow and help people.
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 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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