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Hurricane Pauline A young Mexican mother carried her baby 45 minutes through
the torn landscape to stand outside the Red Cross distribution center in hopes
of finding some food and clothing. The people in her village heard on the radio
that a hurricane was expected but no one believed it. The destruction hit hard
that afternoon at about 12:30. She, her husband and three children huddled in a
concrete block cupboard they used to store their pots and pans. Terrified, for
four hours they held onto each other and waited. When they emerged four hours
later everything they owned was gone and their house was destroyed. Now she
stood and waited with hundreds of others devastated by Hurricane Pauline. We have trained for disasters but this was the first time
we had been deployed. Seeing the suffering in Mexico, we felt compelled to go.
My wife, Debbie, is a Registered Nurse and used to work at Harborview in the
Emergency Room as a trauma nurse. We are both members of the Christian Medical
Response Team. CMRT is a disaster response team for Kitsap County and the State
of Washington. We have experience in large crowd medicine and have provided care
at Endfest and Bumbershoot among others. Two years ago part of our team went to
India and worked in an orphanage hospital. This was the first time we would be
going to such an acute disaster situation. We went in conjunction with the
Northwest Medical Teams based in Portland. We had only 48 hours to prepare. My office staff and
patients were extremely supportive. Without their help it would have been
impossible for us to uproot our lives and leave. A friend was able to stay with
our children so their usual school routines could continue. The folks at Mt.
Constance Mountain Shoppe helped us gather our supplies. There were so many
unknowns. We weren’t sure where we would be sleeping or what we would be
eating. The advanced team was reporting Cholera, Malaria and Typhoid so we knew
we would be busy. Loaded with water filtration equipment, sleeping bags and
antibiotics we flew to Portland to meet the rest of our team. At 5:30 the next morning we met the three members from Northwest Medical Teams. Our team leader, Paul Chiles, MD also had a degree in Pubic Health. He had extensive overseas experience and keen insight. He had done his thesis on village health workers in Papa New Guinea. His understanding of the village health system would prove to be very valuable. A Paramedic and a Registered Nurse from Oregon were the other members of our team. We flew to Los Angeles and then on to Mexico City where we ran into a snag in Customs. Northwest Medical Teams sent nine boxes of medical supplies with us and labeled them “Humanitarian Aid”. The Customs officials confiscated the boxes and told us that all supplies for the hurricane had to be processed through a centralized clearinghouse. We were told we would be able to get them out but after two days of negotiations found ourselves carrying a lighter load. Each of us had packed quite a bit of medical supplies and all of our antibiotic supplies in our personal luggage so we did have enough to get started. We left Mexico City determined to press on. After adjusting our tickets to correct for the Customs delay we arrived in Oaxaca that evening only to find out in the morning that the next leg of our flight was booked. We hired a charter flight and made two trips to get our team and limited supplies to Huatulco located some 150 miles south of Alcopulco. The small single engine plane turned out to be the best way to see the disaster area. We could see where the landscape went from lush green to defoliated brown. Rivers were overflowing and roads were wiped out. Mud had flowed like lava. The Mexican Red Cross was based out of the airport in
Huatulco. The army had trucks and “Hummers” staged at the airport as well.
With helicopters flying in and out it looked like a scene from M.A.S.H.. We
introduced ourselves to the Red Cross physician in charge and made plans to
cover part of the area. The temperature was about 95°
and the humidity exceeded it. The area we were assigned was one of the most
inaccessible. We left the airport talking about hiring mules and drinking water. We were based in Porto Angel at a small hotel that survived
the storm. They had to truck their water in and truck their waste away. Even the
hotel owner did not believe the warnings. He was still wearing the bandages from
the flying glass. From our hotel we could look down on the Red Cross
Distribution center and watch the supplies ebb and flow. We debriefed the
advanced team and heard stories of destruction. Most of the roads were washed
out and they had hiked into some of the villages that had been cut off. Much to
our surprise and delight they told us that they were not seeing the epidemics
that all of us had expected. It was, no doubt, a set-up for an epidemic but the
people were doing extremely well. They were seeing the usual diseases of poverty
but the dreaded Cholera was no where to be found. The diarrhea and associated
dehydration can kill thousands within just a few days if medical care is not
available. What a joy to find it was not present.
The advanced team packed up and left the next day. Early the next morning we went to the district hospital and
met with the government disaster planner. Their extensive plan was well
organized and staffed. The hurricane disaster was divided into four districts
and each had a disaster planner. There were ten “Health Brigades” from
Mexico City that were doing a house by house check in each of the villages
within our district. Anyone with a fever was being checked for Malaria and
anyone with diarrhea was being checked for Cholera. In four days they had
already finished 50 villages. There were two cases of possible Cholera that they
were watching closely but there were no cases confirmed! Their plan was so
impressive we told them we would call them if Mt. Rainier ever blows. The following day Dr. Chiles and I went with the Health
Brigades while the other team members ran clinics in two of the villages. The
poverty and destruction were intense. People with so little lost so much. We met
one man who just sat and stared off into space as his children played at his
feet. His house had dissolved into a pile of dirt. Although I couldn’t
understand Spanish I knew he was speaking despair. The story of the Three Little
Pigs was indeed true. Those that built their homes out of straw or sticks lost
everything. As we traveled through the villages it became apparent that they had
been spared the epidemics and therefore didn’t need a disaster medical team
but rather needed supplies, food and construction help. After checking with
Northwest’s home office the decision was made for us to return home a week
earlier than planned as they prepared to send construction teams as soon as
possible. It was a long trip with plenty of bumps in the road but it was meaningful none the less. We had trained and prepared for disaster medicine and this was a valuable experience giving us more strategic insight. Working along side the government teams rather than in competition with them allowed us encourage and support them. We ran a few clinics and saw some patients but perhaps the greatest impact was that on our own hearts by a young woman and her baby who lost it all.
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