Thursday, January 4, 2007
We picked up a few more schoolchildren on the way, then stopped at a small church to wait for Kristina and the group from Kabakaburi. Here a small tributary called Waiwaru Creek branched off from the Pomeroon. The next leg of our journey would lead us up Waiwaru, all the way to the creek head. This posed some interesting challenges when the Kabakaburi group finally motored by in their boat. Altogether, we had about 35 travelers, and the one boat we had was a large 20-footer, big enough to hold all of us and our supplies for the weekend. The challenge lay in the fact that the boat was at least 10 feet across, and here at the widest point of Waiwaru, the waterway was only about 25 or 30 feet across. How would we fare closer to the creek head, where it was sure to get narrower? Brushing aside such concerns, and without any other option, we all clambered into the vessel, one that was normally used to haul produce to market but which now puttered upstream with a whole crew of Amerindian schoolchildren, teachers, parents, and three clueless Americans (besides Kristina and myself, we also had Shanna, another Volunteer from our group who had come up for the weekend to visit Kristina and wanted join in on the trip). The first quarter-mile or so up the creek was relatively calm and uneventful. We passed the small houses and farms of the villagers who had made their homes along the sides of the creek, and the residents looked up from their breakfasts and morning chores with bemused expressions on their faces. The children were all talking and joking excitedly with the thrill that always comes at the beginning of a trip. Shortly after we passed the last house, the lighting grew noticeably darker as the creek narrowed and the vegetation on either side of us grew thick and closed in on the little waterway. Palm trees drooped towards us and trailed their fronds in the water, while taller trees arched overhead, their branches and lush foliage intertwining in a canopy so thick that at times it blocked out the sky. Here and there shafts of morning sunlight pierced through the thick green roof of leaves, decorating the muddy brown creek water with a spackled pattern of light. Moss, vines, and branches dropped low in front of our faces, forcing us to bat them away. Some trees grew long, smooth, tube-like extensions that pointed straight down towards the creek, their tips dipping under the surface and sucking up water for much higher branches, like an elephant’s trunk. It was like a scene from
Sir Mirthland (all male teachers are addressed with the prefix “Sir,” while females go by “Miss”) stood on the prow with a huge log (whoopass stick) to try and break up some of the branches and vegetation before it got to us, in one case even chopping one trunk in half, a particularly large but fortunately wet and rotten tree that had threatened to block our path.
He was eventually forced to give up his position, however, as the boat kept bumping into submerged logs on the sides of the ever-narrowing creek, causing sudden jolts that threatened to topple him into the water. The whole experience--ducking under tree trunks, bouncing off the sides of the creek, the laughs and shrieks of children when someone had a particularly close call with a branch--it was like some bizarre virtual reality video game, or an obstacle course on a TV game show. It occurred to me how funny it was that the only points of reference I could come up with from my old life back in the States were artificial scenarios, like amusement parks, movies, video games, or TV shows. Meanwhile, for the Amerindians in the boat with me, even the ones who had never taken this trip before, this was all taking place not 5 or 10 miles from their own houses. In any case, after many more minutes of bouncing, jostling, and ducking, we finally reached a huge, massive tree that had fallen all the way across the creek. We could go no further. So we all piled out of the boat with our bags and onto the tree trunk, crossing over it to far bank, where we trudged through mud the rest of the way to the creek head.
There was a trail here that led through the rainforest and would eventually take us to Akawini. Most of the group set off at a brisk pace, with some of the older boys even trying to race each other while carrying heavy loads and wearing only flip flops or running on their bare feet. Being more sane (and lazy), and wanting to take my time to enjoy the sights and sounds of the rainforest, I slowed down and brought up the rear with the other PCVs. The trail was pretty overgrown in some areas, and occasionally we had to cut through the bush to get around big trees and piles of branches that had fallen across the path, but for the most part it was fairly well traveled. We trudged up hills and down slopes, crossed a couple small streams, emerged every now and then into sandy clearings, and trekked through heavily forested areas where the ground was wet underneath my shoes, the canopy overhead blocked out the sun, and the calm quiet amidst all the leaves and branches cast an almost respectful silence. Every now and then we would stop to take deep breaths of the fresh, slightly sweet-smelling forest air, or to snap photos of any plants, flowers, or mushrooms that caught our eyes. Butterflies with wings that opened up to reveal iridescent blue patches fluttered across our path, and little lizards darted off the trail to the side as we approached. I managed to delay on of the little guys long enough to pose for a picture before he was off and scurrying away again.
Despite the other routes available, it was clear that many villagers still used this trail to get to and from Akawini. There were logs cut to clear the path, or placed to prevent erosion. At one point, we even passed a huge tree that had been felled, and whose trunk was being carved to make a dugout canoe--which I jumped in for any impromptu photo shot.
The raised dirt path in the middle told us that this was the Akawini cricket ground, and we could hear the distant sounds of a group of villagers singing together in unison. Perhaps due to the Discovery Channel-ish trek we had just completed, I had a sudden vision of a group of villagers joining hands, singing, and coming out to greet us, the children rushing forward to place garlands around our necks. Fortunately, nothing that cheesy happened, and we walked forward to see that the singing was coming from a local church service being held at a house nearby.
Meanwhile, the rest of our group was gathered at a small shop, waiting patiently for the slow-ass Americans to catch up. After breaking for lunch, we walked over to a stand of trees, where a long dock had been built, about a hundred meters in length. Walking out along the dock, I emerged from the clump of trees and beheld a breathtaking site. Before me, as far as the eye could see, lay an immense, wide open plain. Only far, far away, at a distance that must’ve been a mile or two, I could see the rough outline and multilayered hues of grays and greens that marked the edge of the rainforest. In the vast space in between this horizon and myself lay an expanse of tall green grass, waving softly in the wind. Peering over the edge of the dock, I now saw that I stood not over solid ground, but a body of dark water. What I had mistaken for a field of grass was actually this same body of water, with tall reeds and river grass growing from it and forming broad swaths of green. Only here and there had a current formed, carving a winding ribbon of water through the expanse of reeds, off which the sun reflected in glittering sparkles of light. In the distance, an occasional crane or egret flapped lazily--a graceful white form moving slowly above the sea of green. This was the savannah.
Eventually, a boat came by to take us to our next stop. The
“She took a plunge and busted up she head,” was the message relayed to us. Sighing, we exchanged exasperated glances, wondering to ourselves if it was ever possible for something NOT to go wrong out here. Here it was, not more than an hour after we had arrived, and already we had an injury. Fortunately, one of the village health workers, an experienced lady called Auntie Sophie (Auntie being used as a term of respect for any woman of middle-age or older), had decided to come along on the trip, and we were told she was attending to the child at the local health post. Still, we decided to drop by and see if she needed any help. As soon as we reached the door of the health post, our initial exasperation suddenly gave way to alarm and concern. I first noticed a small crowd of wide-eyed young children gathered at the entrance to the health post, looking inside. Then, looking down, I saw a trail of large blood drops leading along the path to the health post, and just inside the door, several bloody footprints. I felt a sinking sensation in my stomach, and thought to myself: “Uh oh. This is not good,” as I followed the bloody marks into the main room and my eyes trailed upwards to the source. There, in an open tiled shower stall in the back, stood a young girl of about 15 or 16. Her hair was matted with blood, and her face was smeared with it, heavy clots and trickles still running down the temples and cheeks. At first I thought she had on a dark red shirt, then I realized it was actually a white blouse, only soaked completely in blood. Kristina had arrived before me, and had already donned gloves and was holding the wound closed as Auntie Sophie tried to suture it back together. As I approached closer, I could see that the blood was coming from a long, 5 inch gash at the top of her forehead, and crossing over her hairline. The wound was crescent-shaped, and its curve had essentially cut a semicircular flap from her scalp, which peeled away to reveal the thin layer of membrane and tissue covering her skull. The good news, if there was such a thing, was that her skull appeared to be intact--the injury was limited to the skin of her scalp, leaving the thick bone of her forehead unbroken. The bad news, of which there was plenty, was that she had obviously lost a lot of blood, we were far from any advanced medical care, and the lone health worker who usually manned the Akawini Health Post was young, inexperienced, and looked straight-up scared by the mess before her. Fortunately, Auntie Sophie was a pretty good hand at suturing, and had already taken charge and was working on her second or third stitch when we arrived to help. Kristina held the flap of skin in place as Sophie continued to suture, while I went in search of antiseptic to sterilize the instruments, which were lying in a bloody tin at the patient’s feet. The poor Akawini health worker, who couldn’t have been more than 20 or 21 years old, scurried about her health post, rooting through the disorganized mess of the supply closet to fetch requested items. She had the same wide-eyed expression as the children standing in clusters around the door (whom I promptly shooed away) and often appeared at a loss to find even the most basic items, such as scissors. I shuddered to think what would happen when similar or worse emergencies arose in the village, with only this lone health worker to handle them, a young woman who had only just recently completed the meager 2 months of training that was all the Ministry of Health provided to such remote workers. Perhaps born out of necessity produce by such dire circumstances, most Amerindians have incredibly high tolerances for pain. This was evidenced by our current patient, who was leaning quietly against the wall of the shower, grimacing slightly when the needle pierced or tugged at her skin, but otherwise remaining fairly calm, composed, and most shocking of all--still standing upright. She had been given several shots of Lidocaine to dull the pain, yet it was still an ordeal that I could not imagine having to go through myself. Indeed, though we have found that the Amerindians amazing calm in the face of such calamities sometimes carries over to ourselves, Shanna, Kristina, and I later remarked to each other that it seemed as if we had felt more pain and anguish just looking at the wound than the patient had felt herself. Finally, after what must’ve been at least TWENTY stitches, the wound was closed up. We had been forced to cut off a good chunk of her hair to clear the skin around the injury, and the stitches certainly weren’t a pretty sight, but at least the bleeding had subsided somewhat.
Even more amazing, the patient, whose name we learned was Othel, was still perfectly calm, cognizant, and composed. Her behavior belied the same strength and fortitude that I had observed in other Amerindian women, such as when they gave birth without the benefit of any analgesics or painkillers. In fact, she even appeared in good spirits, and smiled and laughed with us as we cleaned, disinfected, and bandaged up her head, joking about the fashionable new style she displayed with her gauzed headband. A picture from our “salon”:
If anything, the emergency had certainly answered our previous dilemma of what we would do to occupy us all afternoon. After mopping up the blood, I emerged from the health post with only a couple hours before dark, so I made my way down to the dock to bathe in the river. I also decided to have a little swim too, and found the water surprisingly warm and quite refreshing. It was a surreal moment, backstroking in the current, with the reeds of the savannah stretching out to the distant, forested horizon.
Despite all the excitement and tension of the day, I found a calm peace settling over me, which not even the half-joking warnings of electric eels in the water could disturb (though you can be damn sure I avoided diving or jumping in the water, after seeing Othel’s injury!). Later that night, after dinner, we all gathered around a cleared area in front of the school and set up a big bonfire, using logs of dead, dry bamboo the children had gathered.
A large crowd of local Akawini villagers and children, as well as the headmaster of the school, gathered together on rows of benches arranged before us. Several speeches of official welcome and thanks were exchanged between our two groups, and then the assembly of Akawini villagers formed our audience as the Kabakaburi and St. Monica Health clubs staged an impromptu concert. The children gave informative health talks on filarial, DEC salt, malaria, etc. A group of small kids from Akawini then chimed in with some of their school songs and memorized nursery rhymes. Soon the concert devolved into an improvised “Night at Akawini” talent show, with anyone and everyone jumping up to perform songs, tell jokes, etc. Othel, the girl who had busted her head, stood and sang a rendition of Dido’s song “White Flag.” I was impressed that she knew such a contemporary pop hit, and even more impressed that she was on her feet and performing for an audience just a few hours after receiving 20 stitches and losing a good deal of blood. I had some of the students perform a humorous skit I had seen at a National Youth Health Camp that I’d helped out at in December, about a doctor and his four patients, who each pass on to him their illnesses, with the last patient being a pregnant woman. At one point in the night, the children and some of the teachers began clamoring for the three strange foreigners to jump in and perform. We tried to refuse but were practically pushed out into the center of the circle. At a loss for what to do, I started breaking out the theme song from the TV show The Fresh Prince of Bel-Air. “In
I had fun joining in on some of the call-and-response games, and the assorted variations of duck-duck-goose and musical chairs that seem to compose nearly all campfire games. The cool, clean, fresh night air smelled wonderful, and I stepped back for a moment to breath it in deep and gaze with a smile at the scene before me--a ring of schoolchildren, holding hands and singing by the warm, flickering glow of a campfire, the stars and moon shining brilliantly overhead. We called it a night around 10pm, and tried to get some sleep in the hammocks strung up inside the school building--not an easy task with all the mosquitoes, bats, and typical late-night adolescent sleepover high jinks (fart noises, snickering, loud pretend-snoring, etc.) By 4am the next morning, people were rising and bustling about, and I forced my tired and aching body up and out to take one last swim in the savannah as the sun rose pink and gold above the horizon.
We cleaned and packed up, heading back to the first island for lunch and to watch a community cricket game. Around 12:30pm or so, Kristina, Shanna, and I set out early for the hike back to Waiwaru Creek. A good thing too, as our tired and sleep deprived asses moved even slower and more painfully on this second day, taking us 3 hours for this return trip. At the creek head, we were supposed to by picked up in the same oversized produce boat, but the water level was low and we had a long delay as we waited for our ride to come. I used the opportunity to break out some of my authentic Crouching Tiger, Hidden Dragon poses among the tall stalks of the bamboo grove--a setting that reminded me of a Zhang Yimou period martial arts flick.
Finally, a scouting party we had sent out returned, having commandeered a small motorboat and two paddle boats to take us down the creek. Thus, broken up into a small floating convoy, we headed back out down the cramped, narrow waterway through which we had first arrived. The day was rapidly darkening, especially under the heavy canopy that overhung the creek. There was still enough light, however, for me to see when some of the children pointed and cried out “sloth, sloth!” about halfway down the creek. I looked over, and just a few feet away saw a large, fuzzy ball of white and gray drooping down from a low hanging branch over the creek. At first I thought it was a huge sack of cobwebs, it looked so still and lifeless. Then, a long piece of the sack detached itself from the rest of the mass and stretched out towards the water. Now I could see that this was the sloth’s arm, with a hook-like clawed hand at the end, which it was slowly extending down towards the water’s surface. Before I could study the strange, silent, peaceful creature further, we had puttered on through the deep green darkness of the approaching twilight. At the creek mouth, I bid goodbye to Kristina, Shanna, and the rest of the Kabakaburi group. The St. Monica schoolchildren switched boats with me, and together we motored and floated back down to our own village, dropping off students along the way. I looked out over the prow of the boat at the setting sun, feeling exhausted but happy.
Very nice. Just like McGuyver if he were an Amerindian. So yeah, things continued in this vein during my first few weeks (ok, ok, MONTHS) at site--the villagers chipping in and helping in so many ways to make me feel comfortable and at home. A table, some chairs from the school, a donated clotheshorse, even the occasional portion of food--"Sir, have you tried himarra yet?" I had it all, seriously. I finally realized things were probably getting out of hand after one antenatal clinic, when I found several women behind my house with cutlasses. No, they weren't angry girls from back home who had discovered the truth about my "heroic" e-mail dispatches from the "verdant rainforest." Instead, they were local mothers, come to help me weed my yard. And some of them were pregnant. I knew this because I had seen one or two of them at the antenatal clinic just a few hours before, when I had taken their blood pressure and advised them on the importance of a "healthy diet and plenty of rest." Apparently, they had come to help out and weed at the request of my ever well-meaning but somewhat clueless counterpart, the local Community Health Worker. Ahhh, nothing like having a team of pregnant Amerindian women performing hard labor for you. Haha, no pun intended. "Pregnant"--"labor"--get it? Yes, I know, shut up. Seriously, though, I told myself that this had to stop. I mean, granted the women were doing a fine job on the yard so far, and granted the one time I had tried weeding with a cutlass I came away with blisters and nearly vomited from exhaustion after doing just a few square feet, but REALLY, Phillip, this is ridiculous!
I mean, "C'mon!" I berated myself, "did you join the Peace Corps and come all the way out here just to have poor, pregnant villagers do all the hard labor for you?" And having failed to do that, I told myself, at the very least I should try and do my part to help out while I'm down here.
So within a few days I had built up my fried rice ability until I was a regular Yan Can Cook, much to the delight of my village. And that's when the requests started coming in. At first it was just from my neighbors and close friends, and I was more than happy to repay in a small way those who had done so much for me. Still, in all honesty, I could never quite understand why there was so much appeal in having me come and cook fried rice, especially when I was pretty much using the exact same ingredients that they would have used, and cooking it in damn near the same way too. Heck, in my opinion, many people I knew in my village could make fried rice a helluva lot better than my sorry ass could. But I guess for them there remained some intangible aspect of "Chinee' authenticity that I lent to every dish I prepared, which made it seem that much more tasty and special. In
sauce from crappy quality, tilt the bottle at an angle: good quality soy sauce, while
not exactly viscous, should leave a sort of smear of dark brown on the sides of the
bottle, and is not completely transparent, whereas crappy quality soy sauce is
watery and almost see-through and looks basically like salt water with black food
coloring (which it is). Another good sign is if the damn bottle has actual Chinese
characters written on it, and not something like, say, "Chief's Soy Sauce: made in
1) My hammock net might as well have been made of Swiss cheese, the way the bugs kept finding ways to get inside
2) and 3) As stated before the repellent and Deep Woods OFF mosquito wipes I had brought were pretty useless against the onslaught.
4) I had put on long pants and long-sleeved clothing like everyone else, but I swear to God, these things must have had 6-inch long proboscis (proboscises?) because people were getting bit through all number of layers--I mean, we were even getting bit on our backs and asses, which at first no one could figure out until we realized that they were coming up underneath us and biting us THROUGH our friggin' hammocks! And some of these hammocks are made out of pretty thick material!
5) At one point, I even grew desperate enough to try lighting one of the mosquito coils I had brought, but the sea breeze, which somehow wasn't strong enough to keep the mosquitoes away, was still good enough to blow away all the coil smoke and render it pretty useless. I tried lighting one and holding it next to me to really soak up the smoke, but only ended up burning my fingertips and nearly setting myself on fire instead.
6) Finally I was left with just my big-ass Ace-in-the-hole, a mondo can of aerosol Multi-Spectrum Insecticide spray--the kind where you're supposed to open up all the windows in your house and wear a gas mask before using with a 10-foot pole. Instead, at around 3am in the morning of our first night, itchy, sleepless, and covered with mosquito bite welts, I just uncorked the motherfucker and let loose at 4 inches from within my hammock. Unfortunately, with my mosquito net hanging around me, I was essentially spraying within the confines of a very small enclosed space, and so I nearly asphyxiated myself in my trigger-happiness. At the time I hardly cared anymore--I was like that Marine in Aliens, the psycho butch chick one, clutching my insecticide gas grenade to my chest and trying to take as many of the buggers down with me as I could.
Oh, we also saw a turtle come ashore to lay eggs on the first night. We were walking along the ocean at night with a warden when another guy signaled us from down the beach by flashing his light several times. After sprinting down to meet him, we saw an enormous turtle digging in the sand. Audley told us it was a leatherback. It measured a good 56 inches long, and was so big that when it dug its nest it shook the ground we were standing on. Very cool to see.
Hey, what's up? My name is Phillip Chan. I'm a Peace Corps Volunteer currently working in an Amerindian village in the rainforests of
I was working with a small class of about 8 or 9 kids the other day, conducting English lessons. The topic was adjectives, and we were having fun--I was picking out students and having the class toss out adjectives to describe them. "Cream-colored shirt," "tan shorts," "black belt," and so on. I even poked a few good-natured jibes at some of the boys--"short," "sweaty," "stinky--jokingly of course. Having demonstrated for them the use of adjectives, and having highlighted them in example sentences on the board, I then asked the students to turn to a page in their grammar books and work some similar exercises--copying sentences down and circling the adjectives and their objects. I went around to help them out individually, and found many students just staring at the sentences after copying them down. When I sat down and tried to go over them word for word, they could not follow along. They could not read. These are twelve and thirteen year old kids.
The weird thing was, I wasn't surprised, frustrated, or even sad. Their illiteracy came as no huge shock to me--it wasn't the first time I had worked with these schoolchildren, so I had an idea of how limited their academic abilities were. No, the weird thing was, I suddenly found myself angry. Just this pent up, bubbling anger that beat on my chest and pounded in my ears. I didn't want to freak out and lose it in the middle of the class, so I took some deep breaths and continued trying to work patiently with the kids. After all, I certainly wasn't mad at them. Yet, as I backpedaled my lesson all the way back to the alphabet and "sounding out words," I still couldn�t shake this weird pissed off feeling in my head. Yeah, it did create some difficulty--try sounding out the soft letter "a" with a clenched jaw!
I dunno, maybe it was because it was the afternoon and I was getting tired after a full day of teaching classes. Or maybe it was just the sudden, unexpected shift from high to low that I felt. After all, one moment I was having fun, truly enjoying myself as I joked around with the kids, and getting that nice warm and fuzzy feeling you have when you feel like you are actually "making a difference." Then, boom! all of a sudden you are reminded just how far behind you really are, and you come crashing down. It's like that Simpsons episode when Homer climbs
I think some of the anger came from not only realizing how much of a mountain these kids had before them, but also how unsurprising and almost acceptable this fact was. I knew none of the people around me, the teachers, the villagers, even the students themselves, would be surprised at the illiteracy I was encountering. Of course there were students who couldn't read. What do you expect in a community with no high school, where most kids stop going to school after age 11 or 12, where there aren't even enough rulers or textbooks to go around, and where most of the kids don't even wear shoes to school? As for the parents, they're probably too busy worrying about how to get by on less than $3 a day, which is all that the big foreign lumber corporation upriver is willing to pay its workers (a corporation which the villagers didn't even want to come into the community, but which pressured and manipulated them into signing a contract).
Nope, no one around me would really be all that shocked that the twelve-year-olds in my class couldn't read--one reason I was determined to keep a straight face and look calm. Inside, however, part of me wanted to shout and throw things, to grab someone by the shoulders and shake them, hard, screaming "Can you believe it?!! These kids can�t read!" and have them be as shocked and upset as I was.
It was kind of like seeing a terrible crime go unpunished, or discovering a grave injustice but not having anyone to blame or bring before the courts. There are no superheros to swoop in and save the day. The bat signal is broken out here. And really, who the fuck was I to play the self-righteous whistleblower. The only reason it was so shocking to me was because I came from a home and culture where it was expected, no, demanded that every child learn to read when he was just a few years old. Hell, reading had been part of my life for so long, and seemed such a natural, ordinary, and expected thing to me, that at first I found myself at a loss as to how to even begin teaching it to my students. If one of them had asked me "Sir Phillip [as teachers are addressed here], how do I learn to read?" at that moment I would've replied "Read?? Jesus, I dunno, you just do it?" To me, it was almost like asking how to breathe.
But that's just me. I'm a privileged-ass American, with upper middle class parents, who was sent, nay forced to go to the library every week as a kid, who was educated at great public and private schools, who graduated from college with 16 years of formal education under his belt (and with Asian parents, that should really count for at least double, plus the violin and/or piano lessons). And I use to whine and cry and get all depressed about this as a kid, like when my parents made me stay home and study instead of going to the movies with my friends.
But hey, that's where I'm from. I come from a country where half the population is overweight or obese to the point of being a public health emergency, while the other half is busy starving themselves or sticking their fingers down their throats and throwing up perfectly good food just to look like the skinny-ass chicks in Cosmo or on Entertainment Tonight! I come from a country where, even when gas was above $3 a gallon, people were still lining up to buy huge SUVs and cars that are actually modeled after military vehicles, yes, MILITARY VEHICLES. Meanwhile, out here the cost of gas hurts so much that a mother has to fucking think twice about going six miles to the nearest health center when her son is fucking lying goddamn unconscious in her arms!!! (see post below from Thanksgiving) Excuse me just a second, but WHAT THE FUCK IS WRONG WITH THE WORLD?!!! Jesus H. Christ man, are you kidding me??
But I should calm down and get the hell off my self-righteous soap box. Because, yeah, I come from
...and later breaks it down gettin' jiggy wit it, to the shock of the village schoolchildren
In other news, saw a dead man today. He was wrapped in a sheet and plastic.
Too much alcohol + the river = bad combination.
My first Thanksgiving in
"Phillip," she addressed me, "we have a patient at the school."
Knowing that they would only approach me at my house like this if it were an emergency, I left my tea and grabbed my bag to follow her back to the school.
"What�s the problem?" I asked her as we hurried past a bamboo grove and up the school hill.
"A child, he just fall down this morning and not get up," she said.
A few more questions, and it became clear that the child had lost consciousness abruptly during the regular morning line-up. My next thought went to my counterpart, the community health worker for the village, who also owned one of the few motorboats available for medical emergencies.
"Has Rosita arrived yet?" I asked the teacher.
"No, she not come in yet."
I cursed silently to myself, knowing that this meant she was probably out of gas for the motorboat, and would be paddling up to work and wouldn't be in until later in the morning. As we approached the school, I prayed that the kid had just fainted or something and that he would come to shortly. However, my heart quickly sank when we rounded the crest of the hill where the school sat, and I saw the child in question. He was sitting propped up on a bench outside, supported by the head teacher and surrounded by the rest of the staff. He had obviously just thrown up, as vomit covered the small cream-colored button-up shirt and khaki shorts of his school-issued uniform. It had collected on the ground below him, forming a small pool of bile and rice. Though the head teacher was propping him up, I could see that the moment she removed her arms the child would collapse, as his whole body was limp. His complexion was also quite worrisome, his face a sickly pale gray hue. As my mind and heart raced, I tried to think back on various first aid training and procedures, but all that flashed in my mind's eye were visions of cheesy safety videos I had seen, and me feeling slightly embarrassed while shaking a big plastic mannequin on the floor and shouting "Jim, Jim, are you okay?" at it's rubber head and limbless torso. Snapping back to the present, I put a finger under the boy's nose and was relieved to feel his breath coming out steadily. I then tried to feel for a pulse, placing a couple fingers on his neck and wrist (did it matter if it was the right hand or left hand?) Having a hard time finding the right spot, I thought, "ah, screw the manual," and just got down and stuck my entire damn head next to his chest, placing my ear up to his heart. Thankfully, I heard a soft lub-dub beating steadily. Quizzing the teachers, I found out more about what had happened. The boy, named Simeon, had been out on the field playing cricket and running around as usual with the other children before the morning bell. Then, when lining up with his classmates to start the schoolday, he had suddenly gone limp and collapsed, the children behind him catching him as he fell to the ground. While unconscious, he had vomited up a little rice and bile, but no blood. I asked if he had a seizure, and got a no. It is a distressing thing to be looked to for help, but to feel powerless in your response.
"Let's first get him down to the health post--we have a bed we can lay him on there," I directed. A teacher hoisted Simeon into his arms, remarking on how absolutely limp the child was. He flopped like a rag doll in the man�s arms, and the image conjured distressing thoughts in my mind. I ran quickly back to my house to get my spare key to the health post, which, in my haste I had left behind. I also grabbed a bottle, filled it up with drinking water, grabbed my sugar jar, my flashlight, and my copy of the Merck Manual of Medicine. Back at the health post, I did the only thing that came to mind from First Aid training, putting the child into the recovery position on his side, with his head tilted in case of any further vomiting. When I checked his breathing and pulse again, they both still seemed stead to me, though these facts grew less and less comforting as the minutes ticked by and young Simeon failed to regain consciousness. With the school teachers clustered nervously around, I continued to run through a series of checks: eyes: closed but twitching, pupils: moving and dilated when I shined my flashlight at them, mouth and jaw: clenched, arms and legs: limp, breathing: shallow but steady, pulse: steady, complexion: regaining some color, scalp and head: no injuries. Mostly it felt like a bunch of frantic acts of desperation--me flailing about and tossing random things in front of what felt like an oncoming tank. As I mixed up some rudimentary rehydration solution (sugar water and salt) for him to drink in case he came to, and as the schoolteachers debated his condition and various substances they could use as a smelling salt, I raced through the possibilities for his loss of consciousness. If he had just fainted, he would have come to by now. Was he epileptic? But then, why hadn't he had a seizure? Could it be insulin-related? Was he diabetic or hypoglycemic? No one seemed to think he had diabetes, but with the lack of medical care and laboratory or testing facilities out here, I also knew the chances that he had ever had his blood sugar levels tested were highly unlikely. From the teachers, I learned that he had possibly had previous episodes like this.
"How do you know?" I asked.
"His aunt told us that he does fall down like this when he was little," they informed me.
"His aunt? Is she here then? Where?"
"Yes, she's at the school."
"Can I talk to her?"
Sensing my confusion, the teachers smiled and told me that the 'aunt' was younger than Simeon himself, six years old, and was at the school because she was also attending classes today too. Great, I thought, so the only relative we've got here is a six-year-old schoolgirl. By now, an hour had passed, and the schoolteachers seemed to be comforting themselves with Simeon's "more stable" condition. I suppose, the way they looked at it, remaining unconscious for an hour is a way of being stable--I mean, I guess you're not going anywhere or doing much during that time, right? Nevertheless, I was pretty sure that remaining unconscious for longer than a few minutes was definitely a cause for concern, and surely posed grave dangers to the child. As I fought my rising sense of panic, it once again struck me how resource poor and ill-equipped our villager remained in case of medical emergencies. I had no thermometer to take temperature with, or even a blood pressure cuff, as Rosita carried the only sphygmometer in her medical bag. In the adjoining room was our one medicine cabinet, stocked with a paltry and constantly dwindling supply of very basic drugs--mostly just aspirin and other over-the-counter caliber medicines, as well as a basic antibiotic or two which was surely worthless by now due to overuse and induced drug resistance.
"We have to get this boy to the hospital," I repeated to the others in the room. The brief but tangible moment of hesitation that hung in the air following these words underscored how rare trips down to the hospital were for the folks in my village. With gas prices up, a chartered speedboat ride down to the nearest town could cost upwards of $10,000GD, or $50 USD, which for many families represented half a month's earning, if not more. When some of the teachers pointed out what seemed to be encouraging signs of recovery--twitching eyelids, etc.--I repeated firmly, "We have to get him to the hospital." I didn't like the look of his utter unresponsiveness, or his clenched jaw, or the simply fact that it had already been over a goddamn hour since he had first collapsed! "Where�s the captain?" I asked suddenly, referring to the elected head of the village. I remembered that the captain had access to a community engine which was sometimes stored in the village office nearby, and which we had commandeered to take to the hospital when a pregnant high-risk mother had gone into labor early. It was at that moment that my counterpart, Rosita, arrived at the door of the health post, having paddled up the 2 or 3 miles from her home. At first she was a bit bewildered by all the confusion, but after examining the patient and consulting with me, we both decided the best thing to do would be to take the boy in the captain's boat up to the hospital. Relieved that we were finally on the move, and worried about the time that had already passed, I moved to pick up Simeon and carry him to the riverbank. Before I could touch him, however, one of the teachers said she thought we should say a prayer to wish the boy well. Biting back my impatience, I bowed my head with the others as a mercifully quick prayer was said, and then finally I was able to pick Simeon up and carry him over to the waiting boat. I staggered to the dock, surprised at the heaviness of the little boy as he hung limply in my arms. The phrase "dead weight" flashed in my mind, but I quickly banished the thought and focused on getting into the boat without toppling the two of us overboard. The boat was just a small 15 footer, with a 15hp engine attached, and the only seats were planks laid across its width. After considering these for a second, I decided to just continue holding Simeon in my arms, with his legs draped over my right arm and his head resting against my left shoulder. A teacher and Rosita joined us in the boat, and then we were off, cruising down the muddy brown Pomeroon river, the wild green rainforest on either side of us, and me with an unconscious 8 year old Amerindian boy lying in my arms. The boy's house was along the way, so we stopped to alert his family. However, when his mother found out what had happened, she insisted on trying to rouse him herself, shaking him, calling him, even taking him out of the boat to bathe him in the river. Apparently this wasn't the first time he had collapsed, she informed us. When I asked if he had seizures in the past, at first she said no. Something occurred to me, and I asked how he behaved before collapsing in the past.
"He does shake up so," his mother said, and demonstrated what was pretty much a seizure. Aha! I guess I should've figured they just might not know what a seizure was. Now I could assume the boy was probably epileptic. Anyways, we kept insisting that we should proceed to the hospital, or at least to the health center, which was only a few miles further downriver (health centers are one level above health posts in the Guyanese healthcare infrastructure--they usually have more staff and drugs available, but still are a far cry from hospitals). It was obvious that Simeon's mother was hesitant to undertake the significant financial burden of a trip all the way into town. When I first arrived in my village, I was shocked and upset by the residents' hesitancy to pay for a trip to the hospital, even in the face of medical emergencies. When that high risk mother had gone into labor, I remember running around frantically like a chicken with its head cut off, trying to convey a dire sense of emergency to the other villagers, and becoming dismayed at their seeming lack of concern. However, by the end of that day I had learned a lot about the reasons behind the villagers' hesitancy to go running to the hospital for medical help. For one thing, when we arrived a the first hospital, no doctor or even a qualified midwife was on duty to handle deliveries. Secondly, the treatment the mother got from the lone nurse and nurse's assistant who were on duty bordered on abusive--disgruntled looks at this interruption of their lunch break, derisive comments about the mother's intelligence, manhandling when it came time to do a preliminary exam, etc. Indeed, when we found out that it would be necessary to transfer the mother to yet another hospital, my counterpart expressed relief on behalf of the mother, explaining quietly to me that she probably would receive better treatment this way, as "the nurses here do be rough." Even so, we found out later that though the baby was delivered alive, it passed away a few hours after birth. Though this outcome was particularly bad, it was still fairly illustrative of the shoddy medical care that villagers could sometimes be subjected to when coming into town for treatment. In the developing world, where quality medical care is already in short supply, it certainly does not help to be a member of the most underprivileged minority group, as aboriginal peoples often are. Thus, at first glance, the hesitancy to pay for the hospital trips could be seen as a sign of ignorance concerning proper medical care, or worse, selfishness and excessive frugality. However, taken in the context of absentee doctors, continuous "referrals," abusive treatment, "invisible minority" status, and other ills of an unsatisfactory healthcare system, the hesitancy to seek out such unreliable medical care isn't just understandable, it actually makes sense. I mean, who wouldn't think twice about coughing up half a month's pay for something that isn't guaranteed to help you at all? When a people have come to expect so little in a system, how can you ask them to have faith?
Nevertheless, back in the boat, we still felt that young Simeon should at least travel down to the health center, especially when several minutes of his mother's efforts failed to produce any further signs of improvement.
Unfortunately, the person in charge of the health center (along the lines of an RN in the States) had left just the day before to seek better pay and opportunities in another country. With a replacement yet to be found, the health center, as well as the surrounding villages such as ours that it served, was now without its most qualified health professional. This loss of the most educated segment of a population is endemic to many developing countries, and
"Hey Phillip," she said, noticing what date it was.
"What?" I asked, looking up from the riverbank.