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.

 

Where are the heroes?

Sep 17/2010 – Balsita – Colombia

I have finally understood what is the problem in Colombia. Why do people fight so much here? What fuels and motivates people to fight? It is because the place is just too beautiful, too rich.

We went up the mountains today to a community called Balsita, where people also had to run away due to conflict. The drive was absolutely gorgeous, although a bit scary, through a narrow one lane gravel road, with lots of sharp curves going up the mountain with a big cliff on one side. The view was just spectacular, mountains, rivers and the forest… beautiful.

So, back to my original question, why is it that people fight so much here? Simple: greed. Greed for the rich and beautiful land, Colombia’s greatest asset and also its biggest problem As a friend of mine here wisely pointed out, also greed for power and control.

Sometimes, thinking about all this greed , I get these waves of disappointment and loss of hope for humanity. Everything we do seems like a waste of time, because men are just evil and will destroy whatever good we do. But then I think about all the good people around the world that support good causes. I look at the amount of resources that MSF has, the cars, the boats that take us to the communities, the medications, professionals and all the network of support. It takes A LOT of money to keep this organization running and it ALL comes from good people that donate it, because they just want to help.  Then I think of the number of projects that MSF has around the world and then I am really blown away just trying to figure out the amount of money necessary to keep it all going… I have a friend working with MSF in Zimbabwe, where they see from 800 to 1000 people per day, all with HIV. Huge projects all over the world. There must be A LOT of good people out there providing the money. There must be more good people than bad ones in this world. That is how I recover my hope for humanity and the joy to work.

Thank you so much, so very much, to all the good people out there that donate their money and make it possible for us to do the work we do. You are all the real heroes. 

The MSF "super concert"

Union Chogorodo Sep 15 - 2010

Almost 200 consults in 2 days of mobile clinic. I am not sure if I should be happy or sad. If all these people were lining up to see a concert, it would be one thing. But no, they are lining up for hours, waiting on the sun with their children held close to their breasts for health care. And for BASIC health care. It’s not like they are waiting to see a specialist, or to have an expensive exam done. They are waiting for basic health treatment and a simple malaria test.

Managing that kind of crowd was a real test on us. Triage was transformed basically into crowd control and mechanical work: get the baby, measure, weight, name, fever?, next.  I felt like we were offering the bare bones quality of care compared to what we can actually offer, but there was just not enough time. Better have some care then none at all I thought. I think we did manage to at least recognize the sickest of the sickest and to see the children first.

We took 3 children out to a center for nutritional recovery that exists in Rio Sucio (an 8 hour boat ride on a good day). They were all so sick and small… One of them was a year and a half old and only weighted 5 kg (a bit more than 10lbs). She could not walk or talk yet. On the boat, I watched her hold a piece of toast and fall asleep with it. Afraid that she would drop it, one of the girls tried to take it, but she was holding on to it with such determination that she would not let it go. She held on to it the whole way and nibbled at it here and there.  She was the one too sick to smile or play with me.

The last day we had to send some people home without being seen, and we were finally done at 8pm after packing up everything with flashlights, I thought we would have people coming in the middle of the night, like the night before, but we only got one couple.

We plan on going back there soon, and spend more days and hopefully bring a dentist in November, we’ll see how it goes. 

Strange desires

Sep 12/ 2010 – Union Chogorodo

Tonight the sky is absolutely beautiful. For once the clouds have gone away and I can see the stars high up there somewhere in space. The moon is not full, but the light so powerful that it illuminates the sky enough for me to distinguish the silhouette of the tall coconut trees against it. I am sitting outside, contemplating it, with the frogs and night crickets as my soundtrack. What is on my mind, you ask me. Well, actually, all I can think about right now is… coconut water. I know, it is the silliest thing to think about now, but there’s nothing I can do! I have been thinking about it all day… ice cold coconut water as they sell it on the beaches in Brazil… humm.

So, one of our logisticians today, learning about my unexplained sudden desire for coconut water, kindly asked the locals for 4 coconuts and indeed they sent somebody up the tree and he successfully retrieved 4 coconuts. Then they proceeded to drink it, all 4 coconuts by themselves :( I am not sure where the communication line got lost there. All I know is that now, more than ever, I want coconut water. Oh well, I will survive. I am so tired anyways that I will fall asleep in no time and dream about coconuts and Brazilian beaches all night. It will be wonderful.

Today we saw 67 patients, which is a lot of people for one day of mobile clinic. I was between triage, lab and pharmacy. It was crazy the amount of work we have done to be able to cope with the amount of patients. We again saw many of the children malnourished, more malaria and other diseases.

At lunchtime I went to the river again. This time 2 little kids, I would guess about 5 years old, were playing with a machete about as tall as them. They were using it like a bat to pass a small object (that I could not distinguish) back and forward. I was looking around to see if some adult would intervene but the natives didn’t seem disturbed at all. I waited for a chopped finger or something, but the little guy really knew how to use his toy. No chopped fingers or toes, just me, once again, impressed with the skills of these children and their adaptability.

Anyways, I am so tired, enough talking for now… I’ll go dream about my coconuts

MSF fitness plan: canoe pushing

Sep 11 – 2010 – Union Chogorodo

Well, yesterday was “interesting”. We set up for consults in Chicao, where usually a lot of people show up, and only 7 people came. We found out that it was some sort of protest by the displaced community that used to live there because MSF is not going to their new community.

Usually we set up camp there and the sick from the community are brought by boat. Getting up there ourselves is a real logistic problem since only very small canoes can get in and the walking path is very difficult, up and down the mountain. Well, I guess we will have to figure out what to do next.

Meanwhile we enjoyed the day in a beautiful community and I had a wonderful bath in the river with the butterflies, followed by an afternoon nap on my hammock, diner and more sleeping. I new I would pay for all that tranquility later. As my boss said “Raquel, when we are running like mad women, trying to keep up with the work, please remind me of today”.

The next morning we left early to our next stop. This time our destination was an indigenous community up the river called Union Chogorodo. Our travel time, well, anywhere from 2 to 8 hours depending on the river conditions.

The river was quite shallow, which meant we had to get off the boat and physically push it up the river. I am not too sure if my help pushing the boat actually made any difference, since I have no strength and most of the time I felt like I was just hanging on to the boat to avoid being taken away by the fast water.  Somehow we managed to push it up the river and through the current.

We arrived early, at 1030, thoroughly soaked and tired. We set up the clinic, had a meeting with the community and started consults in the afternoon.

Union Chogorodo is a beautiful place and the people very nice and helpful. It was cute to see all the little kids looking for the smaller items that they could help carry out of the boat, and the line up of people helping unload everything. We definitely felt welcomed.

Like other indigenous communities here the houses are also built elevated from the ground and there is a big tent-like large and open house with a tall straw roof that serves as a community hall where several men and children gather to watch a TV playing Colombian music videos with the generator as background noise. Most of the women don’t bother wearing tops and a lot of the children just run around naked.

I sat there too while waiting for lunch, but chose to watch the river instead of the TV and marvel once again at the adaptability of children. There were several of them, running naked on the rain and mud. A little one found a small wood board and invented mud surfing. I had to smile at that. Another little girl came in carrying a huge thing of plantain, so big that I wouldn’t be able to carry it. When some of them fell on the floor I thought her little brother would go and help her, but he just helped put the plantain back on her shoulders.

Anyways, we were very, very, very busy all afternoon and have already found several malnourished children and 2 cases of malaria. Tomorrow the promise is of even more people, as there are people also coming from nearby communities. So I better turn off my flashlight and go to bed, I mean, hammock. 

Butterfly Land

After a week of office work in Apartado, enjoying the good life with air conditioner and even a swimming pool, it was time to leave and get to work again.

First we had to go back to Rio Sucio, the flooded town. The bad news is that the road had deteriorated further in a few crucial places, a bridge almost collapsed completely, the river had gone up even more, and our MSF clinic was flooded too. The good news is that we were able to make it into town despite de road (God bless whoever invented land cruisers), there were more “bridges” made for walking around town, and the electricity was on, which meant I had a fan (life is always better when you have a fan). 

Even though the soccer field had flooded, the children where still playing. Something like a water soccer game. I guess there is never bad weather for children, is there?

Part of our team stayed in Rio Sucio. I left early the next day to another mobile clinic, this time by boat. Our destination: two isolated communities along the river Domingodo.

The first part of the trip was a real treat. Going fast along the Atrato (a large river that works like a highway here), wind on my face, i-pod blasting in my ears, life was good.

For the second part of the trip we had to switch to a smaller boat in order to ride through the smaller river. The natives from one of the communities met us with a long old and leaky canoe. I had my doubts that it would stay afloat with all the gear we had to load it up with, and with the water that constantly leaked in (one had to be constantly throwing water out with a little bucket), but somehow it did.

I went on the “bigger” MSF canoe, quite comfortable sitting on a plastic chair (thank you MSF logisticians). The ride was absolutely beautiful. The forest closing in on us, as a big hug from nature, the rich green leaves filtering the sun beams, producing amazing colors. But the most beautiful thing were the butterflies. So many of them! Orange, yellow, blue, they were just everywhere! I thought to myself “This is the best ride to work I have ever had”.

Well, there were obstacles, of course: branches zooming by your head just as you duck from them, floating logs and fallen trees. Thankfully somebody thought of bringing a chain saw (thanks logistics again). Just as one of our guides was cutting a big tree branch out of the way, and I was thinking “what a wonderful invention this machine is” one of my friends tapped me on the shoulder and said “ You know, there was a time when in this area they used to kill people with that, member by member”. A shiver went through my spine. It amazes me the capability of men to transform just about anything into some sort of weapon or something bad.

We have arrived in Chicao early in the evening.  It is pretty much a ghost village in a very beautiful area. The population fled from here in 2002, when the chainsaw massacre was going on and only a handful of families came back. It is a good location for MSF to set up the clinic because people can come in from several communities nearby and where access is more difficult.

We set up camp for the night, had our river bath and relaxed the rest of the evening, listening to the rain drops on the tin roofs and telling jokes.    

Until next time, Urada.

Written I can't remember when anymore, posted today.

I woke up early with the birds making noise. Actually, it was one specific
bird that literally screamed us awake. No need for alarm clocks here, more
useful are earplugs. This morning, knowing that the chances of bathing in
the river later were very slim, I quickly grabbed my stuff and went off to
the river. Cold water in the morning is actually quite nice. The river was
wonderful and I felt I could be there all day, but today we needed to do
things better, start earlier and see more people. We were expecting the
pregnant women from another tribe near by to come today, so even more
patients.

I assumed my post at triage again and got to work, holding children down to
take their temperatures, giving out pills, listening patiently and trying to
make sense of histories half told in Spanish and half told in Embera,
calculating weight/height tables to assess for malnutrition, etc, etc.

We made more progress this morning and I even had some time to go help with
the lab, testing people for malaria. In total we found 5 people with
malaria, all children. MSF gave them medication and mosquito nets. One of
the little ones (2 years old) was too sick and malnourished to stay and we
decided we needed to take him out with us. The whole family was very poor
and his 2 brothers were also showing sings of malnutrition. A process of
coordinating and transport with the local hospital was started using the
satellite phone (which is a tricky thing to do). It was decided that they
would leave with us the next day.

We saw a total of 62 people that day, 20 more than the first day. Finished
late again and still had to pack everything for the next day.

That night again the mules came to make us company all night. This time when
I needed again to go to the washroom in the middle of the night, one of them
was actually inside the washroom. Luckily I didn't have much trouble sending
it away with my flashlight.

We woke up at 5am with the punctual gentleman that brought more mules from
Pavarando to carry our gear. Also several men from the community came to
carry our backpacks for us. We left the two high quality water filters we
had brought with us as a donation for the school, in hopes that they will
use it to drink clean water.

This time I used a walking stick to help me walk in the mud and only fell
once :) Also, without the weight on our backs we made it back in only 2
hours!
The family we took out with us was taken to the local hospital and MSF
provided them with an allowance to survive the hospital stay. Later, the
whole family was sent to Medellin, for higher level of care, and our social
workers helped organize with other NGOs for accommodations. The last news I
had was that they were doing well.

Careful with what you wish

We got up early the next day to set up the clinic the best we could with the supplies we had. The men of the village got up even earlier to go get the rest of our boxes and I was pleasantly surprised when I saw the mules crossing the soccer field with our boxes covered in mud. Time to get to work.

Our team had 3 nurses, one doctor, one psychologist, 3 logisticians, and 1 translator. I was appointed to be the triage nurse, which is something I quite enjoy doing. We started late, since besides the delay of our supplies, we also had a lengthy meeting, were everybody that was present from the tribe wanted to introduce themselves.

Urada has no access to treated water. They use the river, which is clean and nice, but not treated. Therefore I was not surprised to find out that just about all the children I triaged had symptoms of intestinal parasites. I was giving out Albendazol like candy when they came back holding their prescriptions. It surprised me their attitude when taking the meds. I was ready for the usual fit that I see in north American kids whenever they need a Tylenol, but most of them did not make a fuss at all about it. They just took the pill and chewed it after their parents told them to.

The children were so beautiful and sweet. They seemed quite happy and loved. They were not the starved for attention type of children that I had found many times in Brazil. I could tell that these ones lacked a lot of material things (including food), but they did not lack love. My favorite ones were the little babies, who got so upset when I had to get them naked and hang them to be weighted. I must have done that procedure a million times, but the women would always laugh and make jokes in their language whenever I did it. It was quite cute to see them hanging on this grocery-bag kinda device.   

Most people did not speak Spanish at all and understood very little, which made my work twice as hard. Simple questions such as “what is your name” were often met with a blank look. But the most difficult question of all was “how old are you”. Most people simply didn’t know and didn’t care either. Some of them would pull out their ID for me to figure it out for them (when they had one), but a lot of them simply pondered for a while and then gave me some estimated age. I thought how wonderful would it be to grow old and never realize it or really think about how old you actually are. Age is an invention of the modern world, of the busy men running around the rat race with their watches tightly wrapped around their wrist. Here, age didn’t seem to mean anything of importance. I learned something then.

Talking about age, the oldest person I saw was about 60 (looking more like 75). A little old lady that negotiated the narrows steps to climb up the house where we had triage set up. Most people were young, on their 20s or 30s. I thought what the life expectancy would be here. Probably around 50 I would estimate.

Another major problem we discovered, was the lack of registry. Most people did not have any record of birth or of existence. Without that paper, they can not get registered for health insurance either. So one problem leads to the next.

Vaccinations were also severely late and missing. Most children simply did not have a vaccination card, and the ones that did were behind on their schedules.

We saw about 40 people that day. We finished too late, when it was already dark, and therefore I could not go to the river, scared of meeting a snake and not seeing it. Fortunately it rained and a small shower was created from the water coming down the roof. So we bathed with that.

That night something funny happened. You know that saying “careful what you wish..” Well, in one of our meeting we had agreed that it would be nice if we had the mules available 24hrs, in case of an emergency situation or evacuation. Well, that night the 3 mules that live in the village paced around the room where we were sleeping all night long, clunking their feet on the concrete and pounding their tails against the walls. I woke up with the noise and desperately needed to go out to the bathroom. That’s when the paranoia kicked in. What if  there were men with the mules waiting outside for the first victim that gets out. I thought I heard steps. I laid with my eyes open paralyzed on my hammock, thinking what I should do. Should I wake somebody up to go with me to the bathroom? That seemed awfully stupid. I mustered enough courage to lift up my head and look outside. My gaze was met straight on with the mule’s and I jumped on the hammock. Phew… the mule was alone and it was quite happy to go somewhere else when it saw me. I made my way safely to the washroom with no further incidents.

The next day I found out that my colleagues experienced similar fears, so I didn’t feel too embarrassed. Our native translator was quite sure it was the guerrilla invading the village and started to pray. Anyways, moral of the story: careful with what you wish.  

Kiamombre (Good day in Embira)

Today we set off to Urada, an aboriginal village isolated from everywhere else (don’t get it mixed up with the afro Urada, I have been told). Despite weeks of planning, we are still not sure of what to expect. This is the first time MSF is going to set foot there. Contact with the community leaders has been difficult, but they are the ones that asked for our help; therefore at least we know that we are welcome. We know we are supposed to meet them at Pavarando, where there will be an x number of mules (despite insistent questioning we were still not sure how many mules would be available to carry all our gear).

The road to Pavarando was the usual gravel, muddy, holy and narrow road. At times I felt like we were driving through the bed of a dried stream, with the thick forest around us. Beautiful drive, and I would have enjoyed it even more if I were not dying with the heat.  “Doctors without air conditioning...” I thought to myself, oh well, I survived.

At Pavarando we made a stop at the local health clinic in which MSF worked for quite a while and helped set it up. All looked well and the only thing I had to complain about was the big rat I saw by the bathroom. Oh well again..

The aboriginal women were waiting for us - on their bright and colorful skirts and shirts -  ready with their baskets to help us carry our supplies. The men showed up shortly after, with ONE mule. Well, considering that we had at least 10 big boxes to take, 3 small coolers, food AND water… well, we had a problem. Not realizing the amount of gear we had, one of the men asked if all the mules we needed were for us to mount! I wish…  Oh well again.

Unable to find any mules to rent at this time of the day (it was now past noon), we decided to take whatever we can and leave the rest behind at the health clinic, and the men would come back for it first thing in the morning, rent some mules and bring it up. So we set off with our backpacks, heavy sun hitting our backs. I prayed for rain.

We had been told the walk was rough and swampy. But that’s describing it lightly. By swampy, they were referring to one foot deep, thick slimy mud. The kind of mud that when your foot sinks in you need help to be pulled out. And no other way around it. Just thick deep forest all around. My favorite part was crossing the rivers, were I could refresh my face and arms with the cold water.

As I walked though the narrow path, precariously trying to keep my balance hanging on to leaves and whatever I could find (I only fell 3 times), I remembered that in Canada, one time I saw this bridge that the government maintained despite only a handful of people using it. But those people lived on the other side of it therefore the bridge was needed. A whole community, left with a muddy walking road, would just not happen in Canada. Somebody would protest, a road would be opened and maintained.

I also looked back at our MSF training in Germany, when we had to walk for 5 hours in this park carrying jugs of water for a “team dynamics” exercise, and thought with humor how I had found that hard.  That was nothing! Now I was doing the real thing, with 30 plus heat and sun, on the mud and a heavy backpack to carry. Oh well again

Three hours later and water supplies exhausted (except for one jug) we arrived. I whish I could have taken a picture of our team, mud all the way up to the eyebrows, but all happy (MSF security policy does not allow pictures at the moment).

The village, was comprised of scattered houses, made of wood, with straw roofs, built elevated about 5 feet from the ground, with chickens and pigs walking around peacefully. In order to get up to the house one has to climb a little log, carved every 7 inches or so with a hole for your toes to fit. The village also had a soccer field and a school.

We were taken to the school, where we would work and live for the next cpl of days. I was impressed with it. By far the nicest building, organized, well built and planned. It had 3 large classrooms and even 2 bathrooms (real toilets, with a flush and everything). As everything else, it was made with large wood boards, except that these ones were stamped with “Bolivar lives, the fight continues” signs.

We set up camp, hang up our hammocks and the MSF banner, explaining who we are, what we do, etc. Then all the women in the group desperately set out for a bath in the river, and oh, what a nice surprise! What a beautiful river with clear crystalline water, so cool and refreshing. My spirits were renewed, and I stayed in there until the light went down; then put on my rubber boots again and set out for dinner and my hammock. Fell asleep, tired but happy, listening to the frogs sing, "reading" with my ipod and thinking about what we would find the next day. 

Raquel on the catwalk

Written Aug 20th


Rio sucio is a river community. Flooding is not something new here. The houses are built already elevated to, hopefully, accommodate the river water as it gets in. As our house cleaner said, it is just like Venice; except that instead of romantic gondolas, there are leaky old canoes with small motors attached (boat-taxi), and instead of beautiful arquitecture, there are very poor wood houses, infested with rats. I asked her why don’t people move to some place higher ground, and she replied that everything floods around here. But I think it is more than that. The people have a unique relationship with the river here, and their lives literally revolve around it.

On my boat ride to the clinic I can observe that lifestyle very clearly: the little kids running around naked and bathing on the river with their siblings playing in it, while the women scrub their clothes clean; somebody is peeling vegetables and washing it on the river, somebody else is getting water with a big basin, and so on.

Walking around town is a real skill. Some places have raised “catwalks” made of wood boards supported very precariously by more loose wood. I now understand where the name catwalk came from. One has to really be a cat to navigate them with any grace. I am no cat, and looked quite ridiculous trying to walk and not fall on the water. If I looked up to the distance ahead of me I would start to panic. So instead I had to concentrate on each step while doing it, specially when you get to the middle of the board, which is quite bouncy. Somehow I managed to stay dry.

Today I went to the clinic and started to get acquainted with the way things work and how things are done here. The last bit of the evening I spent with the GP, observing the consults. It was just after the power went down, and with it, the fans. The ObGyn also had to stop, since his ultrasound machine powered off. The room where the GP worked was by far the hottest in the place, with the sun hitting a window by his desk right on. I was melting and couldn’t stop complaining about it. He just kept patiently mopping the sweat of his forehead with a towel in between questions to his patients. The water was also not working, so he patiently rubbed some alcohol on his hands between patients instead of washing them. I admired his patience. It was getting late and I know he barely had time to eat anything today. How many doctors could function in these conditions and still keep a cool, patient and professional attitude…

The patients are many, and the issues very sad to hear about, sexual violence being among them. Fortunately MSF offers not only medical help here, but also psychology and social services. 

The things you see on the road

Written yesterday, posted today:

Yesterday I finally arrived in my mission: Apartado, Colombia. The original plan was that I was to get an early flight at 6am, with a connection in Medellin at 08 and arrive at 0845. But when it comes to me taking an airplane, something has to happen, right? So, I was not surprised when they announced that the  airport in Medellin was closed due to poor weather, and it didn’t reopen for 2 hours. I was also not surprised when I missed my connection to Apartado, because of miscommunication. Similarly, I wasn’t alarmed at all when the next flight was only late for mere 6 hours and I had to sit patiently at the air port with my i-pod. Looking at the bright side, at least my luggage made it, and actually got here before me, since it did take the connection I missed.

When I looked up Apartado on google, from my comfy chair in Canada, I didn’t find a whole lot of info, but it said that the economy was based on the plantation of Bananas and Platano. So I imagined a few banana farms. Well, was I ever wrong… this is banana LAND. Coming down on the plane, as far as you can see on the horizon, it is banana trees. Amazing… everywhere you look there are banana trees. I mean everywhere, with their bananas carefully covered with blue plastic for bug protection. I thought the plane was going to land on them.

Anyways, that was yesterday. Today I was put on the road already, and didn’t even had time to unpack, but rather had to repack everything (or rather a few MSF t-shirts, a hammock, mosquito net and essential items) in my “new” (in reality used, but new to me) MSF backpack. We got into the car early, at 0730am, bound to Rio Sucio, a small community in which there is a “hospital” and MSF has a small clinic.

I was quite impressed with the road initially; narrow but decent pavement. But that was just the start. We take a turn to the right and then it’s welcome to the moon. Big craters, mud and a lot of bouncing. I realize now why MSF cars have tall roofs: to avoid head injuries from banging your head so much. We did this jumping around for 3 hours, our skilled driver didn’t get stuck once, and there were occasions when I was sure we would get stuck.

On the road I saw many interesting things. One of them was the “bus”, which consists of a small truck that looks like a 4x4 jeep to me.  It would beep when passing a village and people jump on the back. If the back is full, then they jump up on the roof. We passed several of them with the roof packed with people trying to hold on to this little metal bar. I have no idea how they manage to hang on while the truck negotiates the big holes and the mud, but they must do it since I saw nobody lying dead on the road.

We stopped at a small village for a break and a little girl, obviously curious about this big white truck and this funny people with white t-shirts mustered the courage to approach us and ask questions. She was 12 and I was happy to notice that she looked healthy and well nourished; she was also attending school. The village was very poor, that was not a question. But I saw several children on their school uniforms, carrying their books and looking at us with curiosity.

We continued our journey to Rio Sucio, passed a military roadblock with no difficulty. They just looked at our little flag, that the car has with the MSF logo on, and opened the gate without any questions.

Although we didn’t have to stop for the military, we had to stop for the cows. About 100 of them, or maybe more. Walking quickly with the cowboys on their tails. Cows gone, we kept going.

Finally arrived in rio sucio around noon. We leave the car at the entrance of town and proceed to the MSF house by boat. The town is flooding. I got to meet some of the MSF team at the clinic briefly: one GP, a ObGyn (that comes once a month), one nurse, and a bacteriologist.

At the house I met the coordination team and we went out for lunch. When walking on the street, the water was going up almost to my knees, but just low enough for the rubber boots, so I did not get wet. Lunch was good, beef, rice, beans and platano (of course).

Back in the house I had more briefings and a look at my schedule for the next month. We are going on an explo mission in a week to a small aboriginal village called Urada. We will have to drive to a certain point and then proceed on foot for 3 to 4 hours. At least we will have some mules to help carry the supplies, but there was a big debate here on how to carry the water. There are 9 of us going, and we need at least 3L of water per person per day. That is a lot of water to carry and I am not sure how it is going to be done, but I trust the expertise of these guys.

Tomorrow I am going to the clinic and getting to work finally. But first I have to survive the night with the rats. I can hear one somewhere in my room and have already found “evidence” of their presence. They reassured me that with the mosquito net I am safe in my bed, and that ultrasonic rat repellents have been ordered along with fumigation the end of this month. For tonight I just have to tuck in my mosquito net tightly and pretend that what I hear is a bird. If only I had my cat here…  But overall I am very happy to be here, and very happy to be able to help. 

Yo Pito, tu pitas, el pita...

Written Aug 13, posted today. Image from Colombia Reports.

Yesterday a car exploded in front of a big building here. It was 0530 in the
morning, so luckily the damage was "mostly" material. Or I think I should
say that the most noticeable damage was material. Buildings all around it
have broken windows, all the way up to floors that are very high up from the
ground. I can only imagine the force of the blast to cause such damage. As I
have written on my previous entry, the mental and psychic damage in this
country is already very serious, and incidents like this one certainly don't
help. 

I have driven by the place twice while going places. My cab driver alerted
me against taking pictures; he said we would be lynched. I understood. This
is not a tourist attraction for me to be taking pictures of. It is a true
tragedy. We drove by it in silence and I said I silent prayer. Thank God
nobody died.

Yo Pito, tu pitas, el pita..

Pitar, in Spanish means to honk the horn (of a car), and boy do they ever
like doing it here. I don't know.. there must be some sort of excitement,
heat or whatever that they feel when they honk that horn. Maybe it is their
way of relieving all their accumulated frustrations. Since they can't go out
on the street and yell, maybe honking the horn is the next best thing. I
really don't know. What I know is that it is very annoying and after a while
it loses it's purpose of alerting someone to something, since you are just
filtering the sound out of your head.

The other day we were stopped on a traffic jam (as usual) and there was an
ambulance somewhere behind us with the siren on. Since cars don't fly, there
was absolutely no way of moving the cars out of the way for the ambulance to
pass. So, what is the logical thing to do? Well, if you are Colombian, to
honk the horn! So, a horn concert started until the traffic started to move
again.

Canadians are the complete opposite. Even when they have reason to do it,
they don't. For example, in Canada, if there is a red light on an
intersection, you can still turn right as long as there is no car coming.
You just need to stop at the light, signal, and turn. Because in Brazil you
always have to wait for the green light, I am often waiting for the green
light even when I could be turning right. I just forget about it. You would
think that the person behind me, who also wants to turn right would give a
little beep to wake me up, but no. Nobody has ever beeped me. They just sit
behind me and wait for me to make up my mind. That's just the way Canadians
are I guess, very patient people.

Colombian fear and paranoia syndrome

Sadly I have reached the conclusion that the Colombian population suffers with what I have named the “Colombian fear and paranoia syndrome” (CFPS).  It is a syndrome characterized by a extreme paranoia that everybody is “out to get you” and fear that chances are that the worst that can happen, might very likely happen, therefore it is very important and necessary to take all the possible steps to avoid it from happening.

Take for example, the simple act of taking a taxi. There is a whole huge set of rules and precautions that one must take before and while taking a taxi. You can take the risk of stopping a car on the street, like we do in north America, but that is considered risky. The safest way is to call the taxi from your home. The company will then give you the license plate of the car and a password, which is the last two numbers of your phone. So, when the car arrives he will ask you for the code and you get in.

During the taxi trip, I have been told (by several people) that it is advisable that you call somebody from your cell phone and tell him/her what time you will be expected at your destination. This way, if you don’t show up when expected they know something is wrong and it also tells the driver that it is not a good idea to kidnap you because somebody will miss you right away.

I have also been told you can’t give the taxi drivers large bills, because they often have false bills and will give you those for your change. Talking about false bills, it is very common for people here to actually check if a note is false or not when you pay something.

I have found a taxi driver that actually has a seat belt that works on his back seat and that drives well. So I call him directly to pick me up and with that, I thought I could dispense with the CFPS for a while. One day he was caught up and couldn’t pick me up. Worried that I would have to risk getting a cab from the streets, he reviewed all the “taking cab” rules with me on the phone, including the rule “mirrale la cara” (something like look into the driver’s eyes and decide if he is nice or not).

Everyday I learn some new rule directly derived from CFPS. Today I learned that when you are in the car you don’t leave your purse on the seat, visible to somebody outside. They can break a window to grab it or something like that. You also always lock the door.

Other rules include, carrying change handy, so that you don’t show anybody how much money you have. When paying with credit card, I always have to show them a piece of ID, write down the number on the receipt, sign AND write my phone number.

To sum up, here everybody is assumed guilty until proven innocent. You can’t trust anybody and you can’t help anybody. You always have to assume the worst, and hope for the best. I can only imagine what has taken place here that has transformed the conscience of the Columbian people into this state of constant alertness and fear.

Apologies

I apologize for the lack of postings this week. I have written two, but I can't post them until I get the ok from my head of mission. So, I am waiting...

Touristing

Written Sunday, posted today

So yesterday the new president of Colombia took office here in Bogota. The friday before, there were concerts and other celebrations around town. I wanted to go watch the fireworks, but was not allowed to go, due to security reasons... I also wanted to go watch the new president take office, but was promptly told by MSF that I could not go, security reasons again. One of the Colombians here told me that 8 years ago when president Uribe took office, there were some bombings. So instead I had to just content myself with hearing the helicopters and jet planes flying above my apartment all day long while my spanish teacher patiently tried to explain to me what the hell are tiempos compuestos and all that jazz (spanish is so difficult.. but I am making porgress).

But today I was free (a little bit more free). My teacher and her sister took me around Bogota to visit and, of course, to practice spanish. By the way, do you know why the airport of Bogota is called El Dorado? Apparently, a long time ago, the local indigenous tribe (the Muisca) would offer gold to the Gods by throwing it in the lake of Guatavita. Therefore, the european explores have searched that gold for a long time and believed that there was a place here where gold was very abundant: El Dorado. Interesting, no? Anyways, there was a lot of gold that the caciques used to wear and I was impressed by the nose jewels...they are so big! I am so glad that the nose fashion did not stick around. That´s got to be uncomfortable.
I love walking around really old places, like the streets of Candelaria here in Bogota. They have the magic power to transport you to a different time and a different place, and I like to imagine what the sounds and smells would be like, what people would be doing, what kind of faces I would see, etc.

Candelaria is the neighbourhood where Bogota started. There is a big square (Plaza de Bolivar) with a nice church and the government buildings, and in the middle of it all there was.... a llama! Yes, so of course I took a picture with it. Such a cute llama.

We also visited the exposition of Botero, a famous Colombian artist who paints everything fat and big. It was very therapeutic as I felt very slim, specially when standing beside the sculpture of this huge naked model. Must be why people like his paintings.
Also had the opportunity to eat the typical dish of bogota, a soup called Ajiaco, very, very tasty. I recommend it, but the bowl they served me could have easily fed three Raquels.

Anyways, this it it for now.

Must be my luck

Written yesterday and posted today: (I apologize in advance for my english, but my head is a complete mess of languages right now and I imagine it is going to get worse)

Three days now without my luggage... I am starting to get worried and cranky. The good news is that they have at least figured out where my bags are. The bad news is that they are still in Vancouver and won't be here for another 2 days. Well, if they are in Vancouver at least my chocolates are not melting.

Must be my luck, because I tend to have major incoveniences when I am traveling long distances. The fist time I went back to back to Brazil, they wouldn't let me into the plane to go back to Canada because there was some stamp, that I didn't know I needed, missing on my passport. I had to spend a day in Sao Paulo begging the Canadian embassy to stamp it. Then, the next time I went to Brazil, a major airline went backrupt exactly on the day I was flying with them and cancelled all their flights. Another day stuck in Sao Paulo's chaotic airport filled with people and trying to find a flight to my city (which they never reimbursed me as promised btw). Another time I got seriously lost on my way to the airport in Sao Paulo and just about missed the flight (and by just about, I mean literally having to run like a mad woman at the airport to get in). Anyways...now, when something bad such as loosing my luggage for 3 days happens to me, I am not surprised anymore. Must be my luck.

But, on to more interesting things. Yesterday I had another day filled with briefings and I would call my day yesterday as my reality check. The impression I had from my comfortable couch in North America while watching the news, was that Colombia's problems and conflicts are mostly a thing of the past, and things are a whole lot better now. I have watched comercials on TV encouraging tourists to come and visit. But yesterday I got the true picture of the reallity here painted for me, and it was an eye opener to realize all the issues going on. The number of displaced people because of armed conflicts is huge, and these people have very difficult access to health care. The private agency that works for the government to provide health care does give them a card, to have access to the services, but since there are no services near the isolated vilages, that card is pretty much useless (but, of course, that private agency is collecting government money for providing the supposed care to them).

Besides access to services, the consequences of decades of armed conflicts are huge in terms of mental health, sexual violence and similar problems. Recently, MSF has published a report called "Three times victims" about the issue of mental health that I recomend you read, to open your eyes.
Also interesting is this video with photographies.

Anyways, that was yesterday. Today I started my spanish lessons. My spanish teacher is an elderly lady, sweet as pie and with a patience the size of this world. I spent the morning with one of her sisters and then she took me for a walk (also to buy some essential items, since I have nothing). Anyways, I saw this really nice building, where the Canadian embassy is and I wanted to take a picture, you know, to show that Bogota has nice buildings too. But I was stopped by a security guard that said pictures of the building are not allowed. I could take a picture of the street (which I would post if I had my USB cable..) if I wanted. That's when again I was forced out of my illusion that all is well here. When you can't even take pictures of a building...

In the evening I was surprised with one of my teacher's family member having a medical emergency. So I ended up the day at the hospital, which I was very curious to see anyways. I suggested we called an ambulance, to which they replied me that it would be faster to take the taxi. So there we go again with the cuco drivers. Once we got there, although the place was full and there were no chairs for her to sit initially, I must say that she got in relativelly quickly and was triaged appropriately. The hospital looked quite old and simple, but other than that I can't say much. She had to pay 2,600 pesos to be seen (which is actually quite cheap, if you have any money at all... I wonder what happens to people that have no money). But anyways, other than that I can't say much else. I had to leave before it was late so I didn't see much. I am pleased that I was able to interview my first "patient" in spanish and I could understand what was going on.

That's it for now. Looking forward for what else is going to happen.

Bogota - a city under construction

First, I would like tonappologize for the lack of pictures, because my USB cable is in my luggage, which is still lost.
Bogota - a city under construction

Bogota looks a lot like other big cities in Brazil, a crazy maze of streets with drivers just as crazy, chaotic traffic, crumbling pavement and graffiti painted walls. 
Bogota has one distinguishing feature: it is under construction. Everywhere you go there is yellow construction tape and make-shift plywood or plastic walls marking construction zones. Lots of new buildings going up and whatever is not going up, it is for sure going down. I don't mean literally, like demolitions, but I mean physically in terms of physical appearance and general looks. Buildings look quite in need of some repair and fresh paint in the best cases. Some cannot be saved at all in my opinion.
Sidewalks are also another item in desperate need for repair. Today I had to go get my immigration register. I got a nice Colombian guide (an MSF human resources  employee, properly dressed with a down style jacket on top of another heavy jacket, complete with gloves... I was boiling just looking at her) and she took me walking to another place in town to take pictures. I'll tell ya, those sidewalks can cripple somebody, but somehow I managed not to fall and just twisted my foot a cpl of times while trying to walk fast and hold an umbrella at the same time. 

When it was too far to walk, we took the taxi. I kept trying to put my seatbelt on in every taxi we took, but there is no such thing as seat belts for back seat passengers. One of the cars actually had one, but it was tied to the back of the car in a way to prevent you from using it. So, since seat belts wont save me in case of an accident, praying is the only option left. And believe me, it is pure miracle that any taxi driver in this country can have a life expectancy longer than one year on the job. Anybody heard of car lanes by any chance? What about keeping distance from the car in front of you? Signaling BEFORE you jump in front of another car? 

Well somehow I made it alive, and enjoyed a day of briefings and paperwork. Our guest house is very far from anything luxurious, but it is comfortable and clean, with no bugs so far. I share a room with a friend that also did the same course in Germany with me, so it is really nice to have a familiar face around. She will be going to a different project here, but we are having all the briefings together, which is nice. 

Tomorrow I have more briefings and I get to meet my Spanish teacher, who apparently is quite the character. I am happy that I am understanding most of what people say, as long as they speak slowly, and they can understand my crazy mixture of Portuguese, Spanish and English

The international me

As I sit here at YVR with nothing to do, waiting for my delayed flight to Mexico City, I realize that probably everybody around me thinks that I am Mexican. Actually, the mexican a employee who came to help me find a currency exchange booth first greeted me with "hola", instead of the usual hello. It's ok, I am used to that. Usually, in BC people always think that I am east Indian, and the majority of the east indian patients talk to me in punjabi before even asking where I am from. I have been asked many times to go help translate something when I am working in big centers and people don't know where I am from originally. What can I say, I guess I must have an international face.

My background has nothing exotic about it. The typical brazilian mixture of portuguese and south american natives. I thought I was the typical brazilian mulatta. If you go to Brazil you will see lots of me. But funny enough, I have learned that most brazilians living abroad have similar problems and are taken for just about any nationality, but Brazilian. Facebook has a community called "you know you are a brazilian when..", and they mentioned that nobody can figure out where you are from. I have to agree. They also mention a lot of other funny and interesting facts about being a Brazilian. My Brazilian friends will laugh reading it and my non Brazilian friends will learn a bit more about us if you want to check it (just ignore the pictures people posted and read the text on the left side). You can tell me if you agree with the description or not :)

It is extra funny to see the surprise on people's faces, specially my punjabi patients when they finally find out where I am from. They aways give me back a smile, and usually enquire further about carnival and soccer. I of course have always loved to talk about my home country, so I welcome the dialogue and make a new friend.

Anyways, I guess we should be boarding soon, so Colombia, here I come!

Nurse's superstitions

I grew up with a very superstitious grandmother. Leaving my shoes upside down would kill my mother, breaking a mirror would give me 7 years of bad luck, same thing if I opened an umbrella indoors, etc, etc. It was a very big list of forbidden things and curses. Well, if any of them were true, my poor mom would have passed a long time ago, and since she is alive and well, I can say that I do not believe in these things.

On the other hand, there are some nurse's superstitions that I cannot explain, because they really do have consequences. The most notorious one is saying the "Q" word in emergency (quiet). It is pretty much the same as swearing for ER nurses. You just don't say it. Don't even think about it. But I personally find that even more effective than saying the "Q" word is to bring a good book to read when it is quiet. That is just guaranteed to supply my shift with an endless stream of business to the point that I won't even get a break, never mind read a book.

Another interesting fact is that things come in bundles. You won't put a chest tube in for months and then, all at sudden, in a week you have done 5. One time we had to put 3 in a day! Similarly, deaths will usually happen in 3s.
We also receive bundles of patients. One day it will be like an ortho clinic, everybody broke something. Then the next day it will be peds clinic and we will be drowning with sick children. Then we can have the next day of the abdominal pains, followed by a day of chest pain patients, and so on.

I remember when I first started working in Smithers (after nursing for 4 years), and I was checking out their anaphylatic reaction tray and protocol, and I thought to myself (I didn't even say it aloud): "um.. I have never had to actually give anybody an epi shot for allergies, I should review what is the dosage". By the end of the week I had given so many shots, I new the dose by memory and was now treating somebody with such a severe reaction that we had to put him on an epi drip while waiting to transfer him out! Similar situation when I was showing my student our TNK box (a super clot buster used in certain heart attacks) and I commented that I hadn't had to use it in a long time. Well, that week I used it twice.
I don't know what it is... the power of positive thinking? Or I should say negative thinking? I don't know how to explain these things.

Anyways, here is a recent interesting thing. I had been thinking the last cpl of weeks that I should buy a lottery ticket before I leave Canada. Just because, you know, no specific reason. I usually don't buy lottery tickets, but I don't know why I was actually thinking about that. I never got around to buying it, and I never said it to anybody that I wanted one. Then yesterday at work I was surprised by one of our housekeepers saying that she was organizing this group to buy lottery tickets for the 50 million jackpot and that she needed one more person. Well, isn't that interesting? So, just 5 days before leaving canada, and 5 bucks later, I actually got the ticket that I wanted. I find that intriguing... Now I just need to figure out how to win. My friend seems to have it figured out, and said that the tickets are resting below a special rock and a four-leaf cloverleaf. So, who knows, I might just be a millionaire by monday! :)