Mission Accomplished!

May 23, 2008

Today was the last day of work. The main project was to complete the screening of all windows in the bunkhouse. The screens were mounted with a staple gun and then some were secured with strips of wood. During the process, we ran out of staples and went looking for some in town. No stores had staples to sell. In the end, I was at an appliance store and the owner offered to give me half a box of staple and refused payment. He knew we were working in Manari and he wanted to donate the supplies.

Ricki Sheldon continues to have problems with the angio-edema. When she woke up this morning her face, eyes and lips were seriously swollen. I offered her a shot of epinephrine and she accepted. In 15 minutes she was in great shape. In an hour, she was starting to swell again.

Ricki also needed to go home today. So as I drove her to the Brazilian border, I stopped off at the hospital and had the medics take a look at her. She was given a prescription of prednisone, aspirin and anti-histamine. She was also given an anti-histamine shot and sent on her way. I suspect she will be in good shape soon and I look forward to getting e-mail from her that she has made it home safely.

As of today, our project is complete. It has been successful. I am still able to drink water out of the tap without getting sick. This site is now fully capable of supporting RAM medical teams and the volunteers that are part of such teams.

The men and women who have accomplished this task have done a phenomenal job. I look forward to working with each of them again soon.

Jim get's to fly

May 22 2008

Today has been another lazy day on the Savanna. The heat arrived early and stayed late. Soon after breakfast, Jim was on his way to meet Terrance at the airport. A pregnant woman who required a C-section was overdue and in need. Jim was excited and prepared to deliver if necessary. I knew it would not be necessary, but I always encourage the worst-case scenario mindset.

Jim should have returned by lunch, and when sunset was just a few hours away, it was time to make a call to find out what was happening. Jim and Terrance were getting a meal and relaxing after recently returning from the flight. The flight was delayed for hours due to poor weather at the pick up site. But the plan was also changing.

Before launching the flight, there were now two pregnant women requiring aeromedical evacuation. Then there was a call for a 4-year-old boy who had fallen from a tree and broken his arm. It was getting busy for this remote location. Jim was anxious to get flying.

In the end, the pregnant woman who required a c-section was found to have delivered the day before. The other pregnant woman refused transport. The boy with the broken arm was taken to Aishelton District Hospital and Terrance and Jim then flew a student nurse from Aishelton to Letham. The 17 year old woman was leaving for her first time and all the family was there to say good-by and Jim said they were all crying.

Meanwhile, back at the ranch, the kitchen was completed early in the day. I found time for a nap and for some reading (I am reading Three Cups of Tea.).

Additionally, Ricki has suffered some sort of allergic reaction and has been suffering angio-edema. This is an allergic reaction that is not as severe as anaphylaxis, but is still a significant problem. She has swelling over her eyes, face and lips. She has rashes on her torso and is generally uncomfortable. I have given her multiple doses of Benedryl and there has been little response. If she is not better tomorrow, I will give her an injection of epinephrine.

The evening ended with us all crossing the border to Brazil for dinner. Bo Vista is a Brazilian border town of about 8000 people. They have paved roads and streetlights. The people are friendly and the town is safe. Our cook, Zelda, is from Bo Vista and wanted to show us around the town.

Tomorrow, we will start making some screens to keep insects out of the rooms. There are no other projects planned. Saturday we will pack and Sunday we start the long journey home.

The Grand Opening!

May 21 2008

The workdays are slowing down as the project nears completion. We are continuing to make a kitchen in room 10. We are finding small tasks that are in need of completing. And we are looking towards our journey home.

While we flew in to Letham, our plan to leave is to 4WD to Georgetown. This will take about 12 hours (in good conditions) and will require us to cross a river on a ferry. Our plan is to leave at sunrise in Sunday, but we are now hearing that the ferry may not be operating on Sunday. We have received contradictory reports from reliable sources. We may find ourselves camping on the edge of a river and waiting for a ferry to arrive.

Today was also a day celebration for us. We planned a barbeque for this evening. Terrance and Diane came out early to learn about how to operate the various systems that are now part of Manari. In an effort to make it a bit special, I asked the team to do a through cleaning of the whole area. We mopped floors, through out the trash and rearranged the furniture in preparation for guests.

At 1700 guests started arriving. We had representatives from the local Red Cross, the Peace Corps, the hospital medics and administrators and friends of Terrance. There were nearly 20 people here. We barbequed beef, chicken sausage and hot dogs. Everyone was well fed and all were impressed with the work we have completed.

This was also an informal time to talk with the local hospital medics and administrators about some joint training. They have expressed an interest in sharing their knowledge in tropical medicine with us and have said that they believe we can offer them some valuable training as well. I expect to pursue this at a later date.

The evening was perfect. A full moon presided over the event. A cool breeze was gently fanning the fire pit. The conversation was great. There was effective networking, and plenty of food. I even had a small audience where I could publicly thank the team for their work and dedication to the project. I was disappointed that Vic, Arthur and Better were not around for the event. I am certain that everyone would have enjoyed meeting the people who designed the water system.

Terrance also let us know that he would be flying tomorrow to pick up a woman with a high risk pregnancy. She was due yesterday and is expected to require a c-section. He said we could take on of our volunteers on this flight. I have assigned Jim Trimby.

Jim is an EMT basic, but works in construction. While he is not likely to deliver a baby in flight (and it has happened on RAM flights), he was mentally preparing himself for the trip and any worst case scenarios. But Jim also was notified by satellite phone that his home has been broken into. He has been thinking about returning early due to these events. So as the evening ended, Jim’s mind was alternating between medicine and problems at home. But I could see that in the end, he was more concerned about a pregnant woman that he has never met, than he was about the belongings that are missing in his home. I am certain he will be on the flight in the morning with Terrance. I look forward to hearing about this medical evacuation when he returns.

Another Busy Day

20 May 2008

It’s been another busy day here in Manari. The water system remains in great shape. Our electrical system is in great shape. I am still drinking tap water, and I am in great shape. Our days now are spent fine tuning the site, fixing small leaks and organizing equipment. We have even connected water to the main ranch house.

A main focus for today has been to create a kitchen in room 10 of the bunkhouse. Jim Trimby suggested the idea. The kitchen in the ranch house that we are using is little more than a roof over our head. We have dogs and cats running through the place while we are eating. If we eat too late the bugs swarming over the light above the table tend to fall into our food. It is not pleasant to have to chase a live insect through your bowl of rice By making a kitchen in room 10, we can close the windows to reduce the insects and when we have screens we will be able to reduce even more bugs.

To accomplish this, Jim has cut a few holes through the brick wall and run some piping. I bought a new kitchen sink to install. Marc Bacaro Paul Mauresca have taken a old dresser and cut it down to fit into the kitchen area as well as cut a hole in the top to hold the sink. They added a few coats of paint and it is looking good.

Dave Batt and Ricki Sheldon have been the main force in getting our RAM sign painted. It received a second coat of paint today. They also took down the sign from the main road that pointed to Manari and have given that a fresh coat of paint. The signs will go up tomorrow.

We are also doing some last minute organizing and cleaning. I have been sweeping and moping and moving equipment in preparation for a small party tomorrow. We have invited a few people for a barbeque. It is an opportunity to show off the new facility. We will also be using that day to train Terrance and Diane on all the electrical, water and chlorination systems since they will remain in Guyana for a few more years. I have even written a small operations manual for them to use.

Tom Kamin Departs

19 May 2008

It has been a busy day that lasted well beyond sunset. Tom Kamin left for home today. He accomplished much while he was here. He and Jim were the major force in wiring the electrical outlets as well as building our battery storage area, mounting the solar panels and designing our RAM Center sign. I look forward to seeing him on another expedition.

Between dropping Tom at the airport and running shopping errands, I kept the truck in constant motion. I met with the person building our steel bars for the windows and they were not yet complete, so I had to return later in the day to see if they would be finished.

While waiting for Tom’s flight, Tom and I had lunch with Diane and Medics Marcos. Medics Marcos is the lead medical practitioner here in Letham. He is not a doctor, but operates in a similar fashion to that of a physician’s assistance or nurse practitioner. He trained for two years with the government and after completing training the Medics are assigned to remote regions to care for the people located in that area. He prescribes medication, sets fractures, sutures people and delivers children. He is a quiet man and I have been told that even when the clinic is busy, he always makes the patients feel as if he is never in a rush. I enjoyed meeting him.

In other news, Marc Bacaro was able to fly a medical mission with Terrance on the RAM airplane. A 13-year-old boy fell out of a tree and broke his leg in a rural village. Marc is an EMT, but works as a project manager. I could see from his face when he returned that he was excited about the mission. He was full on energy and it gave him an opportunity to experience one of the many activities that are part of RAM as well as understand how he facility may be used in the future.

At 1600, the bars were ready and I picked up the bars and the work crew to bring them out to Manari to install them on the building. It took a few hours, but the job was done. We now have one highly secure room where we can store equipment and supplies without worry of theft.

Rest Day

May 18

Today is Sunday and I have discouraged any work today. Despite this, Jim Trimby worked from sunrise to sunset. He does not like sitting around. By the end of the day we had electricity in all of the rooms in the bunkhouse. As for me, the only work I did was to check the chlorination residual.

Our residual was 2ppm. It was a bit high, but safe to drink. This was the second day in a row where our residual was acceptable. To mark this auspicious occasion, I took my water bottle to the water tap and filled it up. With no other filtering or treatment, I drank the water as a final test to see if the tap water is potable. If I get sick in the next 24 hours, we will know we made a mistake.

Much of the rest of the day was spent just hanging out at Manari. We spent many hours fishing for piranha in our swimming hole. A few days ago some local boys caught three of them at the hole. As for us, we spent an hour just figuring out where we might find some worms, then after digging up a good supply and baiting some hooks, our worms were mostly eaten by bait fish with us only catching a few of the bait fish. They were quickly eaten off the hooks without us getting any piranha.

The evening ended with nice dinner and we watched another DVD; The Last Castle. The team is in good spirits. Our worksite is in great shape. Our water system is phenomenal. It will feel good to finish this project.

Dinner and a Movie

May 17 2008

It is Saturday and we have started to slow down. Most of our projects are complete. The water continues to run. We have continued to use the drip chlorination system and have been adjusting the rate. All plumbing projects have been completed. We have electricity, power outlets, running water and flush toilets in every room. The leaks in the roof have been repaired. Tom and Paul even built a brick barbeque pit.

I continue to work with the chlorine system. We are finally starting to get residual chlorine in the system. What I have noticed is that since there is no water usage at night, there is a high residual (5 ppm). The level drops off during the day. I need to find if 5 ppm is safe to drink. I will call Vic later and ask his advice.

The team was invited to the Dadanowa Ranch for a Birthday party tonight. Tom and I stayed back and drove the others into town to catch a ride to the party. It is a four-hour 4WD ride in heavy rain. We left the team in Letham and we returned back to Manari.

As we arrived at Manari, I could see we were both thinking the same thing. The site was an absolute mess with tools and trash scattered everywhere. The breezeway looked like a permanent construction site. But it did not take long to get it looking good. Trash was disposed of in the trash pit dug by Paul Maresca. Tools and supplies are now being stored in the refurbished rooms. Even our cook, Zelda, picked up a broom and started sweeping the dirt off the breezeway and cleaning the tables and chairs.

During this time, Zelda told us that her daughter was turning 17 today and wanted to know if her daughter could come out the Manari and stay overnight. We agreed and made arrangements to pick her daughter up at the border (she lives in Brazil). With this in mind, Tom and I decided it was time to have guests at our newly refurbished home.

We went out to get some chicken and invite some guests. We invited everyone we know (all two of them). Jeff and Diane were both glad to join us for dinner and a movie shown on my laptop.

After a few hours, Jim and Mark returned unexpectedly. They did not go to the party because there was not enough room in the truck for everyone. So they pitched in started cleaning. Marc and Tom improved the fire pit so that we could cook chicken easier. Jim continued wiring electrical outlets and bulbs into the building. The pace was gentle and relaxed.

At 1600 it was time to head into town. Zelda and I drove to the border (in Letham) to pick up her daughter. Then we drove into town pick up Diane at the nurse’s quarters. That was followed by a quick stop to get some last minute groceries and we returned to the Manari.

Diane was given a tour of the facility by Stan Brock a few months ago. She could not believe the change in the condition of the site. At the nurse’s quarters, she has to turn a water valve off and on to get her toilet to flush (she usually just dumps a bucket of water in the toilet to flush it), but here in Manari, our toilets are in great shape. The hospital in Letham does not have running water, but we have it in Manari. In Letham, the power to the city is turned off at 0100 hrs. In Manari, we have power at all times.

Jeff Ware showed up soon after we returned to Manari. He has been slowly watching the progression of the project, but was also complementary about the condition of the site after we had cleaned it up. We have three large tables in the breezeway. Seven wooden lounge chairs are situated in the middle with the fire pit on one side and a chessboard between two chairs. On our main table, we placed a ceramic bowl filled with local flowers growing around the site. Our home was looking as good as any home in Letham. Jeff could not believe that we had accomplished as much as we have.

After sunset, we took a moment to sing happy birthday to Zelda’s daughter then sat down for chicken cooked over an open fire, French fries, noodles, watermelon and a bottle of red wine. Our team may have arrived in rustic conditions, but we are now living as good as anyone in the region. More importantly, this facility will now be able to be used by RAM for continuing medical missions.

The evening ended with a movie, Spy Games, on my DVD player. The fact that we can pause for a moment to enjoy an evening such as this proves the success of this team.

Our primary goal was to provide water. We have done this. We are now able to chlorinate the water, but it takes more work than expected. However, we still have chlorination and thus, the water is safe. When we leave, this site will not be perfect; but it will be in great shape and capable of sustaining long-term volunteers and multiple medical projects. This team has done a great job, and at the end of the evening, I find myself filled with pride to work with such individuals.