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Roatan, Honduras
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!
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“Superinfermera”
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.
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On Wings Of Angels
A few days ago we did a house call from the RBC Center to a lady who was 6 weeks post stroke. The family’s house was at the top of a 35-foot steep slope, and she had pretty complete right sided paralysis. Her speech and cognition were affected badly; she seemed unable to understand questions and had no speech. She had a permanent indwelling catheter, and could eat and drink when fed but her swallow was affected and she seemed to be aspirating a little bit (saliva or fluid entering the lungs). Like most elderly or infirm family members in the developing world, she was being cared for at home.
There was not much I could do to help her improve, although her stroke was so recent that it was impossible to say how much spontaneous improvement she might experience over the coming weeks. We told the family to interact with her as much as possible and Annee demonstrated passive motion exercises the family could do with her to help prevent contractures and blood pooling, and discussed turning and bedsores. We talked about signs of urinary tract infection (always a danger with permanent indwelling catheters). And the folks from the RBC center are going to try and help out. Overall, the prognosis was not good, but there is one thing this lady had going for her that many elderly patients in the US and Europe never enjoy.
In the US and Europe, the general tendency is to stick elderly family members in nursing homes and visit them occasionally, usually out of some kind of guilt or obligation. I worked in Care of the Elderly in Ireland and I saw it everyday. The first time I did a house call on an elderly woman in Africa, who coincidentally had also had a stroke, I was ashamed of how we treat our elders in the developed world. Here in Honduras, as in Africa and Haiti and everywhere I have been, older people live with and are cared for by family members in their homes. They do this for two reasons—first, because they have no choice; there are few nursing homes to deposit and forget elderly family members. The second reason is because the culture in most developing countries has much more respect for the older generation, and elderly people get home care and attention from their families simply because that’s the way it is.
The granddaughter of the elderly stroke victim hovered over her grandmother, stroking her hair and talking to her. The family washed her and cleaned her, emptied her catheter bag, fed her and talked to her and interacted with her. Lying there paralyzed, she received the most tender care and inclusion in the life of the family. There may have been no advanced tech available but this lady was being wonderfully cared for. And a week later, she got some of her comprehension and speech back, and some control over her right side mobility. With love and more care, hopefully she will recover enough to regain some measure of independence, but if not I have confidence in the care I know her family will provide if she remains permanently disabled.
The RBC Center, para los ninos con incapacitados, is staffed and run by people who have extended the kind of care they would provide a family member to the kids and people in the community who have cerebral palsy, have had a stroke. Ashleigh has been there nearly every day she was with us, providing Occupational Therapy and Physical Therapy and helping the clinic workers learn new techniques of therapy.
I am amazed, and very proud of what Ashleigh has accomplished at the RBC Center. She and Annee started a Yoga class for the mothers of the handicapped children, many of whom have bad backs and joint pain from carrying their immobile grown children everywhere. The women who come to the center love the class; one 57 year old woman said it was the first time she had ever exercised, and she was so proud of herself. Peggy from Clinica Esperanza gave us a couple of children’s walkers, and a few days ago a 7-year old boy walked for the first time, and a 9 year-old boy wrote his name for the first time.
Ashleigh does movement therapy, sensory therapy, passive massage; pretty much everything—Supertherapist! Fridays are my favorite day…on Fridays I always go to the RBC Center and see patients, young and old. I treat a lot of gastritis and arthritis there; the moms of these kids have lots of stress and physically challenging lives. But on Fridays, when I am there seeing patients, I get to see what Ashleigh and everyone is doing—giving attention to the children, giving the mothers a desperately needed rest from the constant care they have to provide, helping people get their mobility and independence back. Annee, Sky, Noah, Sirin, Rachel, and Nick have spent many days working with the people at the RBC., and I love when we get to all work in the same place.
It is wonderful what can be achieved when you are helping somewhere long enough to learn the lay of the land and what the real needs are, and make the friends and connections necessary to undertake more ambitious projects. Of course, you also need outstanding individuals like the volunteers that have come out to help us. Ashleigh was amazing in action; when she went home it was a sad day for us and also for the clinic staff and patients and families.
The clinic closes for an hour at lunch, and we usually walk down the road to our friend Sherman Arch’s Iguana Park. Sherman is caracol, meaning of white descent but an islander who speaks the patois of the island. He is second generation here, and on his property iguanas are not allowed to be killed, so over the decades they have congregated. He takes in rescue animals, including monkeys and coatimundis, and does turtle rescue. He often feeds us at lunch and sometimes gives us rides back to the boat in his truck or the 37-foot skiff he made himself. He has been enormously kind to us, esta un bueno hombre, another angel we have met.
High in the air during a night flight across the dark ocean a week or two ago, I suddenly remembered a story I read years ago that seemed appropriate for the moment. It happened on the way back from a patient transport in the helicopter to the mainland, and I was sitting in the back thinking about what Floating Doctors became after starting so long ago as a decision made on the plains of East Africa, when I decided to go back to the developing world with more help. I contemplated the path we followed to make Floating Doctors a reality; I thought of all the heartbreaking setbacks and the glorious triumphs that were achieved by the goodwill of people who seemed to come out of nowhere to help pick us up when we fell, and encourage us to keep going, and who worked side by side with us.
The story I remembered is about a man climbing a tall, steep mountain in his dream. After a desperate struggle, he makes it nearly to the top…then falls. The story says that when it comes to the dreams perched high atop the mountains of your mind, it is sometimes a mistake to climb to reach them—but it is ALWAYS a mistake never even to make the attempt. If you climb, you can either succeed or fall. And sitting there in the helicopter, thousands of feet above the dark, luminous, serpent-haunted sea, I understood in a very literal way the third option mentioned in the story: sometimes, when you fall during the climb to reach your dreams, you find out you can fly.
There have been many angels who caught us when we fell and who helped Floating Doctors continue forward. I know I talk about it a lot, but I don’t care. I wanted to thank you all again very much, and to know how much it means to me that you believed in us and helped us and worked with us to make Floating Doctors fly—both in spirit and, riding the clouds over the gulf of Honduras, in literal fact.
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Two years after I decided to hang up my stethoscope in Ireland, leave the hospital in Dublin behind and move back to the US to organize the Floating Doctors, here we are in Lake Worth Inlet on the Southeast Coast of Florida waiting for a weather window to make the crossing the Haiti.
So many generous hands and hearts have made FD a reality. I am thinking of our friend Don Capo, who helped us save thousands and thousands of dollars, guiding our work on the hydraulics and running gear, and hull repairs, and the refurbishment of many other systems. He finished the survey of our vessel the very morning we sailed from the dock at St. Augustine Marine Center and headed to the inlet to anchor. He stepped off the boat, and he grew smaller and smaller on the dock we left behind. His kindness and generosity are part of what we will carry with us and pay forward on our mission.
On the 200 mile transit to Lake Worth inlet on Florida’s southeast coast we broke up into three watches of three crew each, 4 hours on duty twice a day, 8 hours apart. My own was the 12-4 AM/PM watch. I am usually up till 3 or 4 AM anyway–when you are working on the boat all day and leading a crew, the quiet night hours are the best time to get paperwork and admin done. I have no difficulty sleeping till 9 or 10 AM after coming off watch at 4 AM, even with the morning noises accompanying the other two watches getting up to begin their day. Some of the crew are inherently early risers–you know, those folks who wake up around 5 or 6 AM every day and have no trouble falling asleep around 10 or 11 at night…lucky devils. Some have sleep patterns more like mine, so we were able to do a pretty good job spreading people around into watches that suited their natural sleep/wake cycles.
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Man, what a week…you know, I’ve always admired ants…when a group of them swarm together, they can make short work of tasks far greater than their individual size would suggest. With Southern Wind up on dry land, she looks like the project of some giant ant colony, with people crawling all over grinding, sanding, epoxying, building, wiring, and finally checking off all the thousand projects we have had aboard since we started this rebuild.
Once again, our work is flying ahead because of all the support we have received out here from the community–the Rotary club here is providing funds for the extra fuel we will burn in a powered run to Haiti with a full load, and even up in St. Augustine everyone in the boatyard and the folks in the marine industry here have given us materials and hours of their time and experience to help us solve the various challenges we faced in our dry dock repairs.
Rick From Polaris Marine Continues To Share His Expertise With Ryan
For example, Rick, Tom and Cheryl at Polaris Marine continue to host Ryan in their workshop almost daily to let him crimp wires and help him decipher the complex wiring solutions necessary on Southern Wind, Sinclair from the Sailor’s Exchange is looking for red hull paint for us, and Bobby and Steve in the yard helped us get our old diesel generator out–after we removed all the bolt-ons (everything we could take off the generator in place), the core and block still weighed around 2,000 pounds–kind of hard to get out of a small space in the engine room!
Bobby and Steve Take A Strain On The Crane
After much discussion (thanks Don Capo and everyone who pondered this problem with us), we decided to bite the bullett and cut a hole in the hull, unbolt the generator from its mounting and lift it out with the yard’s crane. So we cut a hole (that now we have to patch, of course) and the next day, in a cold heavy rain, Bobby and Steve hauled the generator out the hole…it sounds so easy when I say it like that, but I guess all in all it was pretty easy (because we had their expert help and a crane). We literally pulled it out; there was not QUITE enough clearance in the hole we cut and the generator slid out of the hole tightly strapped to the crane above. I’ve been waiting 8 months for this moment–and now we can install the much more efficient and lighter generator Polaris Marine are donating and close up the hole. Continue reading Week #2 in St. Augustine
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June 21, 2009. Palm Coast, Florida
Waiting for the sun and wishing we had brought coffee!
Today marks the longest day of the year, and for us it surely was! We got up before dawn an piled into our rental jeep to head down to the beach and watch the sunrise over the water—a novelty for those us from the west coast, but we were thwarted by low clouds on the eastern horizon. Still, as we staggered out of the house in the pre-dawn (already in the high 70’s), the sky was a deep purple and shapes of houses and trees loomed out of it suddenly as we drove down the road to the Hammock Dunes beach nearby.
The sand is made of crushed clamshells and is multicolored; when we come here on Sunday afternoons to lie in the sun and recharge our solar batteries for another long week of work in on the boat, we never get fine sand stuck to us, which is nice, but we DO leave the beach with hundreds of little shell shards suction-cupped to us, and they are surprisingly hard to dislodge (since we discover them in our hair, on our backs, and other hard-to-reach places hours after we leave the beach).
Bathing our feet in the golden sun-water of the solstice dawn
We were all too tired to be chatty, and the pre-dawn is never a time for idle conversation—pre-dawn is when the world holds its breath like the audience at a concert, waiting for the first notes of the symphony while the conductor stands with hands raised, waiting to bring the whole orchestra into life. I think I understand why, at an intuitive level, so many religions originated with worship of the sun. The moments before it arrives above the horizon are filled with such expectation and faith (that it will, in fact, come up!) that every sunrise becomes a religious experience.
Today, a third member of my crew independently used the phrase “my previous life” to describe their life before they came here. So far away from the things that are familiar, working on something that is REAL and will leave a lasting mark in many lives around the world, many of the problems that seemed so important when we were immersed in them now seem more remote—and more than remote; they seem much less relevant to our lives and we wonder why we worried so deeply or hurt so badly or got so wrapped up in some drama or other. Our perspectives have changed. We are developing more perspective every day on the things that truly do matter—friends, service, honor, hope, determination, and family, which in the absence of our own relatives has been filled with each other. I still can’t get over how quickly we have all bonded, and it makes me think we just might survive long ocean passages as friends!