Montana de la Flor, January, 2009
A Daily Log: By Doctor David Goo
We met the rest of the team the next day at the airport, and after our brief hellos and introductions, we were quickly loaded into the big school bus to Esquias, where we would spend the night.
The church we stayed at in Esquias was wild, as there was an all night vigil being held there, in celebration (if not response to) the fiesta being held in town for a two week period of time. The fair was busy with small stalls of food, games of luck and skill, and music. We ate at Tacha’s house, our old friend from El Guante, and it was a great meal, cooked for us by her family who lived across the street. All that night, hundreds of worshippers streamed through the courtyard of the church where we slept. At 0400 loud reports of huge firecrackers shook the building and woke most of us out of whatever sleep we had gotten so far.
We woke the next morning to load the supplies on a large
truck, and split into groups so we could fit into our vehicles. New to the trip
was Carlos, our driver from
We arrived on the mountain to find the roads in terrible condition, but with a little slipping and sliding, and the expert navigation of our drivers we arrived safe and sound. Unpacking the truck we found the school full of many items, including a rotting rat in the back storeroom. We were able to clean out all the supplies in there, and replace them with our bedding, luggage, medical and food supplies. It was a long day but we were able to get prepared for the upcoming days without having to start clinic the same day as we usually do.
The next days are somewhat of a blur but the sequence was the same. Up in the am, clean up your bedding and personal area, eat breakfast, and get ready for patients by 0830. The first day we stayed in Ceiba, the town we were based at, and saw patients, medical and dental. Lunch always provided a needed break in the middle of the day. We finished with patients in the late afternoon, cleaned up and then had dinner. Just after dinner, we would set up our sleeping areas (mattress, mosquito net, sleeping bag, flashlight), and then relax for a while before turning in. Some of the group stayed up later than others and one night we even had a campfire to sit around. The shower situation initially was dismal. It began with a bucket of cold water, splashing it on yourself. However, by the end of the second day, with the electrical and plumbing efforts of Angel, Fausto, Frank and others, we ended up having lukewarm showers coming out of an electrically heated showerhead. What a luxury!
The first day we saw about 250 total patients. The last patient of the day was the
hardest. A group of people had come from
a village four hours away on horseback and wanted to be seen. The group number was around 20. We told them they could be seen the next day,
but they insisted we see one of them, a 14 month old baby with trouble
breathing. The child was in severe
respiratory distress and had a history of asthma. He was on some medication but it had run
out. The child had not been able to eat
or drink and was very ill. The team gave
the child medications and breathing treatments, but they did not seem to be
helping much. It was decided to keep the
child with the team, feed the family, and give the child repeated breathing
treatments. A makeshift mask was
fashioned out of bubble wrap, and the child received similar medical care as he
would have in any pediatric emergency room in the
second day on the mountain, we hiked up to Monterey, the village where Julio,
our guide and host in the MDLF lives with his family. This year we had 3 horses
that carried our supplies up to the school house where we held clinic. This was a big improvement over last year
when the team had to carry all the supplies ourselves. The team did well getting up the mountain,
and only a couple of members struggled some with the steep climbs and slippery
paths. They should be proud of the
physical accomplishment of holding a clinic so high up in the remote mountains
of the MDLF for the second year in a
row. The team functioned well again, and
we were able to see about 160 patients there.
An elderly woman who lived close by was unable to make it to the clinic,
so after Frank checked it out, a small team went to investigate at the end of
the regular clinic. Down a steep
slippery hill we went into a dark house with dirt floors. The woman was lying under a blanket, in a bed
with four posts made from sticks, with tattered plastic sheets hanging from
them. Gasping to breath, the senora had
been bedridden for 8 days, and barely able to eat or drink. Her lungs sounded terrible, and the situation
looked grave. Marianne McNeil, an
emergency room nurse gave an antibiotic shot (which made the women hop around
the bed in pain – giving us hope that she was stronger than she initially
looked), some pain medication, antibiotics for the next week, and an inhaler to
help her breathing. The interpreter,
Philip Goo, had to give the husband the bad news that his wife was very ill,
and without further help, might even die.
It was a difficult situation for all involved. The team then regrouped, ate a meal of
tamales that Julio’s wife had kindly provided for us and then went back down
the mountain. Before leaving the
mountain, we called Carlos Delgado, MD, one of the founding members of the
initial team to MDLF, from Julio’s cell phone atop the mountain( the only place
to a get a cell phone signal in that area).
It seemed odd to be able to call from a mud shack back to
Lavanderos is small town about 5km away from the school house in Ceiba. They too have a school where we set up the medical and dental clinics. New in the area was a pond full of tilapia. Littered around the pond’s banks were empty Kids Against Hunger bags, the bags of rice and protein that Gehlen provides for these starving families, two new sources of food for the community. We saw about 120 patients that day and had a nice lunch in one of the families’ houses that were near the school. Carlos and Frank had gone to get more gas and water, so after we had seen all the patients, Susan, Philip and I walked most of the way back to Ceiba, stopping to watch the Sunday soccer match along the way. It was nice to see that area on foot, but we were happy to get a ride from the Land Cruiser as it eventually came back up the road. In the evening we had a mass for Frank and Dick’s sister, led by Father Jim Tigges. The ceremony was very moving and emotional for all those present.
The team packed up and went to
In the morning, we saw about 60 patients and began the
process of repacking to leave, saying goodbye to our friends, and giving and
receiving gifts. We took our usual group
picture, and then headed off the mountain. The group stopped in a quaint quiet
Dinners and cooks:
Each year a group of dedicated women come to cook for the team. Typically, members of the team tend to get ill from the change in diet they have, and the presence of new bacteria. Montezuma’s Revenge, or Traveler’s Diarrhea infects the GI tract, leading to diarrhea, fever, chills, dehydration and stomach cramps. This was not at all unusual on the previous trips when the group was based in El Guante, where there was running water, electricity, and refrigeration. In fact, the first two mission trips I participated in, multiple members in the group needed antibiotics, and IV fluids, and were incapacitated from working for days at a time.
A true tribute goes to our cooks, Dulce, Lillian, and Fatima. None of the group was ill, and to my knowledge, no team members has ever suffered fever, chills and diarrhea while in the MDLF. This is amazing taking into account the lack of refrigeration (save a large IGLOO cooler), and the huge number of meals that need to be prepared (25 members, 3 meals a day, 6 days). The cooking area is in a 10 x 10 foot room, with propane stoves set up on student’s desk tops, which serve as pantries as well. So much work goes on from morning to night that it is hard to believe it. When the team is dead tired at the end to the day, the cooks are still cooking the evening meal, and then washing dishes when everyone else is finished. Before anyone else gets up in the morning, the cooks are up, making the requisite coffee, and starting the breakfast. And for those vegetarians, a special effort is made in addition. Cooking at times becomes a communal activity and even the drivers help with some of the preparation.
But that is only part of the story. The food is DELICIOUS! Certainly food always is better when you are tired and hungry, yet the food that is prepared by our cooks is truly outstanding. What you are served is true home cooking, infused with the love and care that is instantly noticed on your taste buds. Comfort food, that fills your stomach and soothes your tired body, is the salve that sustained our labors. As with any group, each member was indispensable, but the cooks were essential.
Carlos, Juan, Julio, and Mochin.
Two years ago a mission trip nearby in