New address

I've had to move the blog so that I could put a password to entries that have not been cleared by MSF. The new address is www.raquelnurse.blogspot.com . If you have not received the password you can e-mail me at quiabo@yahoo.com.

Cheers
R.

What else can go wrong?

What else can go wrong?

If our MSF project, here in Uraba, was a reality TV show, it wouldn’t lack in drama. Aside from the obvious drama involved in the work we do, what goes on backstage is sometimes just as intense. This last mobile clinic was a good example of that.

Juin Puubur is an indigenous community close to the boarder with Panama in the middle of thick jungle. The only way to get there is by a small river that is shallow and difficult to ride. We had been trying to get in there for several months, but always something would happen that made us cancel our plans. The latest was that two dead bodies showed up in the river a cpl of days before we planned on going, and the rumors were that they were left there for days. So obviously, for security reasons we waited for things to cool down. Last week we decided to try again. One of our nurses got sick and couldn’t go but we thought we could do it with one less.

We wake up early the day of our departure, everybody excited to go and our community boat arrives. Great, right? Exept that the boat is too small... Scramble, scramble, rent another boat, load up the boxes, ready, right? That’s when Pilar, one of our nurses walks in holding one eye, looks like she scratched her cornea with some sort of brush. All right… deep breath, two nurses down, but we can still fix this. Replace her with one of the nurses from our team in Riosucio, wait for her to pack her stuff, tic tac, tic tac, it is getting late, ready, right? Now the psychologist is down… not feeling well either. Ok, no psychology this time, let’s go, get on the boat start the engine, go, I want to feel the wind fast on my face… where is the wind? Look around…why are we going at a snails pace? One of the boats has a 15HP motor, someone informed me… all right, maybe we will make it there next week… Let’s just keep going, ok? Why are we stopping? The engine of our boat is making a weird noise. “We have to go back” Paco announces. “You’ve got to be kidding me” I am thinking. We turn around. The good news is that there was a spare motor at the office, the bad news is that it was a piece of crap. Thanks to some brilliant business man up higher on the chain of command, we’ve got this thing that costs like 2 thousand dollars less and that you have to stop every 15 minutes to change some nail or something (Pasador, as they call it). It was like going on a Dacar rali with a motor home. Forget about making it there next week, we’ll be lucky if we get there next month!

At least it was not raining and the thick forest protected us from the hot sun. Getting out of the boat to push the canoe up the shallow parts of the river was refreshing (although freaking dangerous). This was by far the hardest river I have had to get through.  My feet would just sink on the mud, almost up to my knees, which would put the water at my waist level while I am trying to push the boat. One, two, three, puuush… careful so I don’t get squished or squish somebody between the boat and the tree trunks. Careful walking with the hidden logs under the water. Watching for snakes, especially on top of trees that can jump into the boat (it has happened before).  “ Communities geographically isolated and with difficult access” they had told me about the work here before I came. “F’ing right!” I thought to myself, now keep pushing.

Despite all odds we made it there by 5:30 in the afternoon, wet, tired but happy, and all the little kids surrounded our boats to see what they could help carry, which helped me renew my spirits. The place was very nice, with the exception of the largest number of cockroaches I have seen in my life and with the fact that there was no bathroom. We set up our hammocks on this large tent while the bats flew by.

The next day, as we weighted and measured the children, I was happy to find out that there actually is at least one indigenous community in Columbia with children well nourished. They were also very organized. We vaccinated and offered consults for two days and things went very well despite all predictions that something terrible would happen. The way back was not any easier, but after a lot of chain sawing and pushing, and despite our motor home, I mean, boat engine, we made it back in one piece, looking forward to our next adventures.

The MSF cooks

Oct 24 – Rio Sucio – Colombia

As my wise friend Maricela said today, MSF is not a job, it is a lifestyle. Living the MSF style of life is definitely not for everyone. After a while privacy and private life are vague concepts of the past. We do just about everything together: eat, sleep, work, and I have had to even to go the bathroom together for security reasons in areas where we cannot walk around alone.  As a friend said, you know more about each other than you know about your own family sometimes. If somebody has a diarrhea or something, everybody knows it. There are no secrets. I guess in a sense we are a big family, looking after each other and with our own dysfunctions.

The majority of the team are women, and we share a lot of similar characteristics: young, beautiful, smart and educated women (yes, of course I am including myself on the list ;) ). But this gypsy lifestyle also has its disadvantages: mostly of us are single and either smoking or trying to quit (no, I do not smoke yet, but give me a few years on this job and I might just get started). But the most interesting characteristic we share is our lack of cooking skills: the women in MSF can’t cook, that is a fact. Well, most of us can pull off something to survive if necessary, but as a general rule, the men are the ones doing the cooking.

Last night I walked in the kitchen of our common house in Riosucio, at 10pm to grab a glass of water before going to sleep. Rosmira had finally decided to cook something to eat and was attempting to cook a fine and delicate meal: white rice. The pot she was using was too big and the lid too small. While waiting for the rice, her and Isabel were making plans about finding a suitable man and having children one day. Rosmira then decided to check on the rice and found out that the lid was stuck to the pot. I came to the rescue, could not open it either. Isabel tried, nothing. We stood there looking at the sealed pot: “Decio!”, we yell. The only man in the house comes to the rescue: “you have to let it cool down”. We are all laughing by this time at the complicated task that making rice has become. Rosmira than has the brilliant idea of putting the rice pot under cold water to cool it down. The pot starts to steam up and make noises, they run from it: “It is going to explode!”. Oh goodness… and then they wonder why they are still single… By the way, after Decio finally opened the pot with a hammer, the rice was uncooked. Anybody up for a sandwich?

If I were an animal...

Oct 19 – Apartado – Colombia

If I could be an animal I would be a dolphin. People that know me already know that. I love their freedom, their agility, beauty and they’re super smart on top of it all. I also love the water, and the ocean even more. It is a good thing I grew up inland or I would have never studied as much as I did. I would just spend my days on the beach, with a surf board or other similar sport.

This weekend I went to a scuba diving course and I found out that I can fly in the water. What a wonderful sensation! To be suspended in the water, “flying” effortlessly over beautiful corals, among beautiful fish, turtles, rays; traveling in between huge beautiful big walls; just gorgeous. The sensation is amazing and I experimented as much as possible: going fast, slow, upside down, rolling around. It is just so much freedom! More than that was the peace you feel down there. Everything is so calm and silent, no noisy cars or people, just the sound of the bubbles my regulator makes every time I breathe while the fish swim calmly by. Even when I saw the shark it was peaceful (although I was a bit scared of it). He really didn’t have the slightest interest in us and swam away.

Capurgana is a little village on the boarder with Panama, only accessible by boat or plane, with lovely beaches and absolutely no cars. You can feel the energy change as soon as you walk out of the boat, into the village. People are just so much more relaxed and friendly. No cars zooming by, just the traffic of people walking around calmly on the cobble stone streets and the sounds of the waves gently crashing on the shore. That was before the party started, of course…

I got a room, dirt cheap, with an ocean view and a balcony with a hammock. There was a festival going on during the weekend, “El festival de la sigua” like a mini mini Carnaval I would say, or just an excuse to party all day and all night long and drink a lot. So, at 5:30am of the first day of festivities, the band (2 drummers, one flute and one sax., or something like one) was going around the streets and the people following it. They were quite good! I went to the balcony with my wrinkled face and my mop-style hair (typical “I just got out of the bed” face) to watch them go by. My friend Johanna also came out in a less jolly mood: “if they do this every day I’ll kill them”. Isabel just rolled over in bed, and with the wisdom of the locals informed: “they will do this every day”. Turns out that they didn’t need to do it everyday because the party never stopped (except for the wonderful moments when the electricity was off, but of course somebody made sure everybody stayed awake with those fireworks that make a huge noise, which I hate, and that dogs tend to hate even more). There was loud music just about all day and all night long.

But I was away from all that by going into the sea, down where I can hear the bubbles. I saw just about everything you can find on a warm Caribbean ocean (ok, that is exaggerating a bit, but I saw a lot of stuff): a shark (called nurse shark, how appropriate is that?), a turtle, rays, lots of colorful fish, a lobster, and on the last day, which was my birthday, they came… dolphins! 12 of them, soooo cute. It was the best birthday preset. We saw them from the boat, on the way to a dive site. I jumped in the water to try to get closer, but they were not interested in getting any closer. I did hear them under the water though. It was just great!

My birthday was great by the way. Johanna kept me awake the night before until midnight so I could hear Stevie wonder singing “happy birthday”, kindly provided by the bar below. I am so blessed to find nice people everywhere I go. The night of my birthday my new diving friends got me a cake, balloons and all that jazz. Too bad the electricity was gone and I couldn’t dance as much as I wanted, but well, nothing is perfect. I can’t complain: I rebalanced my mood, recharged my energy and found a new passion (diving). Life is great.

The world is going to end in paper

The world is going to end in paper… one day we will all be gone and the only things left will be paper and cockroaches, equally useful things.

This last week I was in Riosucio again. The river has gone down, but the mosquitos have gone up; oh well… At least it wasn’t as insanely hot as it usually is, which worked out perfect with the fact that the hospital had no electricity and therefore we didn’t have fans. The MSF clinic (which is inside the “hospital”) had a small generator only powerful enough to provide light to one of our consultation room, our two computers and a printer.

On Tuesday, 23 children from a indigenous tribe came down to the hospital looking for health care and were promptly denied it by the hospital, since none of them had any register of even being born, never mind health insurance.  So they came to ask for our help. The health system in Colombia is drowning in paper; I have never seen something like that. You haven’t seen bureaucracy until you try to understand how the health system is organized here, and the sick people are caught in it without proper care.

Take these children for example: they live in very poor conditions, up in the middle of nowhere because of decades of displacements, from colonial to modern times. Aside from what nature can provide them, they have very little resources. It is not easy or cheap for them to get down to the “city” and get registered, so  they often don’t register their newborns. It is not only that, papers don’t seem to have a whole lot of importance in the indigenous world, I don’t think it makes a lot of sense to them that they only exist if they have this paper, so they tend to neglect it.

Anyways, they went then to register all the children and the registration place didn’t have paper… yes, that is right. Now the children have to wait until the paper is back, so they can get registered, then apply for the government health insurance and then health care, in that order. So, they came to us.

In Riosucio the MSF strategy is a bit different. Instead of just offering medical attention to everybody we try to strengthen the local health system to work as independently and efficiently as possible by covering a few specific programs and offering support to others. Therefore, we usually don’t do consults for children, since this should be a responsibility of the hospital, but seeing these children stuck in the paperwork we went to help.

We negotiated with the hospital and saw 11 of the children, and the hospital was supposed to the see the remaining, which they never did. We then decided to see all of them ourselves, but then they didn’t come back. Hopefully they will come back this week, or maybe they all got miraculously better. I know that it only took 5 days for their papers to get ready.  Now I just have to hope that they don’t lose it. 

No Holiday

Sep 23/2010 – Llano Rico – Colombia

When I go back to my regular job in Canada, and when I have a really busy day and feel tempted to complain about workload, I will remember this day: Sep 21-2010, Llano Rico, Colombia. And then I will think: “Work? What work? This is a holyday!”

We got here on Monday, coming from Balsita, that is, down the mountain driving in a one-lane gravel road, after a whole night of heavy rainfall. I had my doubts we would make it through the road. There were several landslides partially blocking the road.

Our first stop was a very large tree that had fallen on the road. We all got out of the car and the drivers managed to get the cars through the bush on the side of the road (God bless Toyota Land cruisers). Then a man on a bike stopped our car to tell us that there was no way through. Great… We went to check it out and found a landslide and a river that had just about washed the whole road forming a little waterfall as it went down the other side of the road into the cliff.  Now what… We all got out of the car again. This obstacle was harder than the big tree, the water was fast and the rocks loose. We tried to even out the rocks, some using their feet others with the 2 shovels we had. The car tried to make it through, slid a bit towards the cliff, then got stuck on the rocks. Out with the shovels again, I started to pray. Second try… and we got through. Phew.

Arriving in Llano Rico the people started to follow our car as soon as they saw it. Before we had turned off the engine or gotten out of the car, there was already a lineup of people by the clinic. The clinic is an abandoned and partially destroyed health center recently renovated and recovered by MSF. Before renos there were only moldy walls with no roof. Now the roof is completed and this was the first time we saw it after the painting was done. There is still no running water or electricity, but things are coming along and we had a generator.

We started consults as soon as we organized ourselves and oh my god…  I thought we would never stop. We worked like crazy all day on our first day and on the second day, our poor doctor didn’t even stop to eat. Things started well with a very sick pregnant woman that vomited on our triage floor first thing in the morning and the rest of the people followed the rhythm and kept us insanely busy all day long. By 7pm when 3 victims of a motorbike accident arrived (one light chest trauma, a little girl with an injured knee that required stitches and an elderly woman visibly upset but thank goodness physically well) I lost hope of ever going to sleep that day. There comes a point when you just accept it that you will work till you drop and just keep on moving like a dead zombie.  You name it, we had it: burn victims, the motorbike accident, really sick pregnant women (besides the vomiting one), loads of sick children (with high temperatures) and lots of malaria. To give you an idea of the situation, we ran out of gauze, and we carry A LOT of gauze.  By 9pm when we finally saw the last patient out the door and organized our things for the next day, I was waiting for a woman in labor to come in, because really, that was all that was missing. Thankfully, God decided we deserved some rest and nobody decided to have a baby that night.

People started to arrive by 0530 the next morning. One angry father made his thoughts known saying something like “ How come this people sleep while the children are dying. They send you here to work and that’s what you should do.” Well, we were all too tired to argue with him that thank God, at the moment nobody was dying and that his baby had been seen by us the day before and already given treatment. That was the most frustrating thing… to work so hard and to feel like the people don’t recognize it and only expect more. Well, maybe I would be just the same if I were in their shoes without health care for long periods of time.

We couldn’t see all of the people that came to us, which always makes me worried, but I have to realize that we simply cannot take care of all the sick people in this world. We did our best and we saw the sickest of them. The rest I can only recommend to God and feel reassured that we will be going back there soon. 

I want rooster soup

Sep 19/10 – Balsita – Colombia

This morning the rooster came to visit early again, at 6am. At least he was not as early as the day before, when he came at 4am, but he was just as keen, and was not happy just singing loudly at my door but actually had to go around the whole room, several times, just to make sure that I would wake up.

I never thought that I would say that in Colombia, but it was quite cold. Balsita is a small community up in the mountains. The population here is what they call “paisas”, which is white people. The men wear some sort of scarf around their shoulders, a hat (cowboy style), a machete tied up at the hips, and boots. It is quite different. They also talk very fast and with an accent almost impossible for me to understand.

Tensions about the conflict are very high, with active groups present in the area and so the impact on mental health is the main cause why MSF comes up here. We had a slow day yesterday since there was a communication problem and the local radio station did not broadcast our arrival until the evening. Therefore, all the people came down from the nearby villages today.

Lots of horses parked on the street where the chickens, pigs and dogs also lived. Keeping the dogs out of our clinic was an almost impossible task. It looked like we were the veterinarians without boarders (hey, here’s and idea for the vets out there, those pets need you!).

Since it is Sunday, it was like a big event. The men played soccer all day. There was music, dancing, little shops selling treats, and a movie in the evening set up by the red cross: Shrek, a classic, followed up by a documentary on nature subjects.


Anyways, tomorrow we leave early to Llano Rico, so I better get some rest.