TWECS Eye Care Mission 2013, Philippines: After Typhoon Haiyan

These dispatches were written by Dr. McDougall on a February, 2014 mission to the area of the Philippines devastated by a “Super Typhoon” in November 2013. 

We have arrived safely in Tacloban, and the first impression of the devastation is staggering. Flying in gave a sweeping perspective of the damage from the typhoon: in the outlying areas there are entire hillsides covered in Palm trees that have seen stripped of all of their foliage, with no green at all, just miles and miles of 20-30-foot-tall palm sticks that look like toothpicks that have been stuck into the boggy wet ground. And the as we fly over the city and into the airport, the man-made structures are just torn apart, and strewn all over the place, just like you see in the online pictures. But, as is often the case, photographs don’t do it justice, and in this case in a really bad, bad way.

ship-villagedestructionroofless-house

Ironically, as our plane rolled in, we noticed the side of the airport wall has a huge “welcome to Tacloban” mural on it, and it has been completely ripped in half, and is crumbling and decaying in wetness.  All of our baggage, equipment, and donated glasses made it here safely, which is always a concern, because without that, we really can’t do too much.

One big difference already on this trip compared to previous missions is the kindness, generosity and thankfulness of the Philippine people. Everyone so far has been going out of our way to help us help them. And one older local man on our flight to Tacloban introduced himself, shook my hand, and thanked me for coming to help his people, without really even knowing what I was doing.

And the people here really do need help. It is literally unbelievable. From the airport, we loaded into a big open bus to drive to our hotel. The devastation on the ground is even worse than from the air. Buildings have been completely flattened, twisted, and blown apart. There are cars turned upside down on bare trees. And everywhere there are makeshift tent cities that people are living in large groups. Horrible tents, more like combinations of garbage and UN relief tarps piled up against any standing structure, with multiple families and children covering under each one. The level of garbage and debris piled up, a lot of it on fire, is staggering, and everyone is just living amongst it. I guess your day just has to keep going, despite the conditions, but it is heartbreaking to see. It is on the level of the garbage dump cities that we saw in Nicaragua.

When we first left the airport, almost everyone had their cameras out, snapping shots of the devastation because it seemed so unreal…like something you surely couldn’t describe, something you needed a picture of to prove it was real. So snap snap snap. Then after about five minutes of the same visual picture constantly, everyone kind of put the camera down because it was like, this goes on forever. What was probably a 20-minute ride through town was some of the most staggering moments I have ever experienced. Everywhere, and in every direction you looked there was something or someone that had such a sad and moving story of loss.

I cannot imagine the chaos this must have been two months ago! Or the terror everyone must have felt as it was happening. I would imagine you wouldn’t have been able to see anything, and the noise from the natural force, and the material destruction must have been deafening. I’m sure it has left most people in post-traumatic shock and now living in unsanitary, horrible conditions.

We were meeting with some officials yesterday, and they said they were going to make sure we would have access to help the poorest of the poor. Marina said “that’s pretty much everyone,” and that seems so true.

We had breakfast with some Philippine Department of Health officials yesterday in Manila before we left (the typical Philippine breakfast of garlic rice, two sunny side up eggs and some meat like pork, chicken or fish: I had adobo pork which was awesome, and the mangos here taste like three times the mangoes at home) and one I the officials said to us: “I can’t believe you are going there. Don’t drink the water, and did you know there is leprosy in Tacloban?” (Not because of the typhoon, rather just more as a descriptor of the state of poverty that pre existed.). Thanks for boosting our confidence!

Another quiet official said to me after some time: “You really don’t have to worry about Al Qeada in Tacloban, there is lots of military relief going on.” Hadn’t even crossed my mind, but great to hear!

Today, we are going to go to the hospital we will be working out of to assess the conditions and start to prepare. We will also travel around a bit, and go to some of the tent cities and evacuation centers to try and filter out some of the people that need our help the most. We will get a much broader picture today, and I am kind of nervous about that, emotionally. I do feel really safe with the group I am with, and as usual it seems like a great group of people so far, even though I’m just starting to get to know them.

Magandang gabi (Good evening)

January 24, 2014

We just put in our second clinic day, but it already feels like I have been here for a couple of weeks. I have to admit, when we first arrived here in Tacloban one of my first thoughts was: I don’t think I want to stay here for the next two weeks. But it is amazing how quickly you can adapt to things. The dripping shower at our hotel that I first thought seemed so bad now feels super-luxurious after a day of working in the heat.shipwreck

The outrageous power of nature, and the destruction it can bring continues to astonish all of us. Yesterday we visited a coastal port area of town, and we saw an unbelievable sight: 10 container ships that had been docked in the port were washed up, on a 16-foot wave, directly onto a shoreside settlement completely destroying everything in their path. The ships are just slammed and lodged right in the middle of where everyone was living, and where they now try to continue to live.

To try and imagine it: it would be like a two story wall of water moved the container ships docked in English Bay right into the front yard of my Vancouver house (and yes, I am talking about a huge container ship) and in its path all of the buildings and contents of everyone’s homes are scrambled up and dumped all over the place. As if everything was put in a huge blender and then dumped out over miles of land; a baby’s shoe here, a typewriter there, broken glass everywhere.

Ten container ships were washed up by a wave: like a two-story wall of water moved the tankers from English Bay right into my front yard.

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Walking around the debris of this devastated village

So despite all this wreckage and garbage and chaos, the people living here have an amazing resilience and determination to continue living despite the actual horror of their day to day surroundings. When our group was walking around that area, we must have looked like we were in total shock.

One woman who was living there in a shanty-style tent came up a woman in our group and said “Don’t worry, we are all going to be alright,” as if she was consoling us and trying to make us feel better. Unbelievable.

Little kids at the main evacuation center. The kid in the middle is doing a pose that almost all little boys do. The locals tell us it means “guapo” (handsome): to us it looks more like hip-hop swagger!

As always on these trips, and maybe just in general, the children are amazing. Super warm hearted, open, smiling and playing despite the conditions and lack around them. Kids are amazing.

The work in the clinic is as hard as I remember. A 10-hour day actually feels like a 24-hour stretch. It is really hot and humid as well, but it is hard to feel too sorry for yourself. The most common complaint we hear is that the typhoon “washed my glasses away.” One older woman hung onto a rail with one hand, and her granddaughter with the other hand for almost three hours while the storm ripped everything from them, including her glasses. Over two months later … she deserves a couple of free pairs! But even with a story like that, there are no “complaints” or requests for pity, just a simple phrase: “The typhoon washed my glasses away.”

My favorite patient of the day today: I saw a 22-year-old guy today that needed a really high myopic pair of glasses, but he had never had them before in his life. Not too unusual for a trip like this, but what was unusual was his response when he put them on: he said he felt so much safer. He has been worried since the disaster about his safety and how he can take care of himself. I think this has scarred everyone here in a deep way.

We are really just getting started here…we will work out of the Tacloban city hospital for the next two days, then move to the largest evacuation center in the center of the city (with 500 families, and over 2,500 people living in one large convention centre, also an unbelievably horrible sight), and then we will head out to the outlying regions that we hear are in even worse shape because of lack of electricity, clean water and relief supplies.

A Good Day

January 27, 2014

The way I feel at the end of one of these days: literally filthy to the bone and my feet pounding, is something that I have never duplicated anywhere else in my life. The shower at the end of the day makes me feel like a king. The day-to-day activities couldn’t be farther from my normal, but again the curve that you seem to adapt to new surroundings is so steep that I already feel in the groove. I suspect it will feel weird when I come home to not take all my clothes and underwear into the shower with me to stomp clean and hang on the shower rail to dry for the next day.

As we are finding out, the need for basic eyecare is in top demand at this point as the people of the Philippines recover. Of course the initial relief efforts over the last three months focused on emergency aid and trauma, and now people are trying to pull their lives back together and vision is on the top of the list. We kind of feel like the popular kids in school, because we are being literally overwhelmed by people needing our care. We are seeing 600-700 people each day, which is kind of beyond our capacity, but what can you say. Marina is such an amazing woman: her philosophy is every second counts, and the faster you work the more people we can help, so I am working at 95% all day long.

JoGlassesLady

The first pair of my mom’s donated glasses went to this lovely, gentle woman who is struggling to pull her life together by herself.

Keeping that busy all day is kind of a blessing, because it does sort of numb you to the painful stories that almost each person has. Literally everyone has been affected, no one was sparred. The teachers we see are especially poignant because each one has lost 10-15 of their class: not really knowing whether they have been displaced to a new area, have been moved to relatives because of lost parents, or have died.

Today I found a perfect patient to give a pair of my mom’s glasses to, a really sweet older woman who is living by herself, and whose home was completely destroyed by the typhoon. She was totally unable to see anything up close, so it was of course hard for her to cook and clean and take care of herself. I imagine that mom must be very happy to pass a piece of herself on to this woman who is in such a desperate situation. It felt so nice to have a moment with someone from so far away, who was getting a gift from my mom, especially knowing how much my mom loved to give gifts. It seemed like a perfect fit, and she was really touched by the fact that the glasses I gave her came from my own mother.

otherBrad

This is Neehar (whose nickname is, unbelievably, “Brad”), busting out a “guapo” pose with his new specs, which are very strong for his age.

The bond between parents and their children is so strong, that stories involving kids and parents are often the most gut-wrenching. One of the most memorable patients of the day was a 10-year-old boy, named Neehar, who was very nearsighted (over -7.00 diopters of nearsightedness), who had lost his glasses during the typhoon. One of my favorite things about this type of trip is that you often get the sense that there is some type of spirit working through you: out of the 18,000 eyeglasses we brought with us I easily found just the perfect pair for him (actually two pairs). His exact prescription, perfect size, and cool enough that he felt great about himself in them.

His mom was so pleased. She told me that when the typhoon hit that she was at work and Neehar was staying with his grandfather who was babysitting him and his sister. After the storm settled and she was able to make her way home, she found that her house was completely flattened and destroyed. She had to start a search for her children and father in the chaos of the aftermath. No electricity, no cell phone, no radio, no transportation. Can you imagine having to search for a child in what was essentially a war zone? How horrible and anxious she must of felt? As it turned out, the grandfather had taken the children to his house, which was not as badly damaged, but they had all been moved to an evacuation centre. It took the mother over a day to locate them. I just can’t imagine the scar that must leave.

We wear name tags on our clinic “uniform”, and the mother told me that her son’a nickname is Brad, and that he has been called that since he was young. He thought that was super cool, and so did I. I have several photos of the two of us hamming it up gangsta-style in his new glasses. Life is beautiful.

Tindog Tacloban

January 29, 2014

“Tindog Tacloban,” which essentially means “Rise up, Tacloban,” is certainly the unofficial slogan of this city post typhoon. You see it on signs, t-shirts, and graffittied everywhere. It is quite an inspirational sign to see everyone adopting, and reflects the spirit of the people. The locals are choosing to be survivors, and to rise up, as opposed to victims who want pity.

I have been learning several interesting facts about typhoons: a typhoon is essentially the same thing as a hurricane (just a different name in this region, but meteorologically the same). There are typically so many typhoons in the Philippines that people take them quite casually, as they are usually nothing more than a heavy rainstorm with wind, and that played a major role in the level of destruction. Experts were able to predict the course of the storm well in advance, but the local people were simply told to expect a typhoon, and a “storm surge”, but the term storm surge meant nothing to them. It would be like telling a Vancouverite to expect some rain, but then deliver a biblical flood.

In fact, there are so many typhoons in this region that the Philippine government names each one alphabetically starting each year with “A.” This one was called Yolanda locally (although international agencies called it typhoon Haiyan in their own naming system). Here in the Philippines they have already rounded the alphabet and the next one will start with “B.” This typhoon, Yolanda or Haiyan, was the fifth-largest typhoon/hurricane ever recorded, and the largest one to hit land (most of the biggest ones occur over open ocean and die out before they hit land).

mosquito

Here I am working triage at the intersection of “Mosquito Alley”, and “I.V. bag Lane.”

The storm lasted for about three hours, and people say you couldn’t see anything but white, and the wind was carrying debris and pounding it everywhere, the most lethal being the huge sheets of corrugated metal that most homes were made of.

One of the main concerns for our team is Dengue fever, which is a virus passed by a mosquito bite. The symptoms are extreme fever and aches, bleeding gums, and more, usually requiring hospitalization. I have rubbed so much DEET repellant on every inch of my body that I must almost be toxic to myself. Working at the hospital, I spend most of my time in the “triage” section where we determine the flow of examination for each person. The triage line up is down a long dark hallway (dark so we can more effectively use our equipment, and long because there are several hundred people in line at any one time), and we have affectionately called it Mosquito Alley because it swarms all day long with those flying vectors of disease. Reminds me of summers camping in Alberta! The repellant is really effective, I only have one bite so far.

larry

Heartbreaking: this is Larry on the first morning we met him, having a breakfast we bought for him.

One of the most heartbreaking things I have encountered so far isn’t something I’ve seen at the clinic, but is just outside the hotel we are staying at. There is a young boy, maybe 11 years old, who is homeless and living and sleeping on the street. He told us his name is Larry.

He lost his mother and father in the typhoon, he has no brothers or sisters, and no relatives to live with. He is just living in the street trying to cope amongst the mess of the city. When we first noticed him, he was just hanging around first thing in the morning and he asked us for some food. So of course we gave him some of our breakfast, and watching him hunch over right on the spot to eat was one of the worst things I have seen.

Since that morning, he has really come out of the woodwork, and now he is part of our morning routine. Each one of us wants to try and help him, more effectively than just giving home some food, but it is hard to know what to do.

One ironically sad but bright spot for Larry is that he is only one of many children in this same situation in Tacloban. In that way he is not alone. And what is likely to happen, and what we are hoping for, is that some of the kids he plays with, or meets on the street might have families or relatives that will eventually take him in and care for him. It is the Philippine way to take care of each other and to share.

A Pen for Larry

January 29, 2014

Yesterday was our last clinic day at the Tacloban City hospital, and we went out with a bang, seeing over 750 people, which must be some kind of record for us. The last day at a site is always kind of tough, because we know we will have to turn people away: the best solution for this is to give out 750 “tickets” to the first people to arrive in the morning and then to tell everyone else that there no point in waiting around all day for hours, with no chance of being seen at the end. At least in this case we could also direct people who can’t be seen to our next clinic spot which is a city only about 30 minutes away.

Tomorrow we re-set up our clinic in a city called Tanauan, on the same island of Leyte for 3 days, then we move to the city of Basay (on a different island/province, but still only 40 minutes from Tacloban) for another three days, and then we pack up and head home. I am just taking one small step at a time instead of thinking of that whole journey.

Today was our “rest day” in between clinic sites, but it was still fairly action packed. We woke up at 7 a.m. to head to an inner-city elementary school so we could catch their daily “flag ceremony,” which is an assembly before class where they sing the national anthem, and say a school pledge. They were expecting us (because we planned school vision screening off all 800 children that day). We arrived a little early, before the assembly, and jostling around with all of those cute children was like an energy boost for the team.

larry-drawing

Here is a much happier Larry, several days after breakfast , and after I gave him a pen. I will always remember him more like this.

After we finished the vision screening, we distributed hundreds of pounds of clothing to the kids (each child got two or three or 3 pieces, and then it was like free-for-all swap and trade session in the school yard!) from the relief containers that had been sent from B.C. in advance. In each city we will be distributing relief goods through schools in the poorest areas to make sure the items people back home donated goes directly to the people with the most need. I think it is an interesting, and very effective way of distributing relief supplies, because some of us were nervous that trying to give away so much stuff can be an aggressive exercise in survival of the fittest. Delivering the items to children, who would listen and politely line up, avoided an aggressive process.

Yesterday I gave Larry, our street-living best friend a pen: and he has already drawn me a couple of pictures as a gift in return. One picture is of a house, that he says he would like to live in (complete with a TV antenna and a room with a water faucet), and one picture is a very detailed drawing of me, complete with my clinic uniform, pens in my pocket, a goatee, what looks like a mullet hairdo, and a beer in my hand!

It is one of the nicest gifts I have received. Another example of when you give, you always get more in return: I have always believed this, and this trip confirms that principle.

Brad-drawing

A street-child named Larry drew this portrait complete with goatee, TWECS shirt and a beer in hand!

Yesterday at the clinic, I saw a little, tiny seven-year-old girl with congenital cataracts in both eyes that have made her essentially blind. She lost both her mother and father in the typhoon, and she has been taken in by a distant relative who she calls her aunt.

When we told the aunt that this little girl was functionally blind from hyper-mature white cataracts (and I mean totally blind, as in she can barely see how many fingers you hold up a few feet in front of her face) the aunt obviously didn’t know and was very upset. She said she thought it was strange how distant-acting this girl was, and how strange she thought it was that she got so close to everything to look at. We explained that glasses really can’t help this, and that having surgery in at least one eye would be the only solution, and that it would be best to be done as soon as possible so her brain could develop some useable vision. A cataract surgery for one eye in Tacloban would cost 16,000 pesos (which would be about $350).

After explaining this to the aunt, I feel like I could literally see the weight added to her shoulders. It was so sad for both the little girl, and for the aunt, both of whom are overwhelmed by their lives right now.

We are hoping to arrange for her to get surgery on one eye hopefully at no cost, through one of our teammates who has a connection to an ophthalmologist in Manila who will do special surgical cases at nominal fees. If he can arrange it he is going to contact the aunt the only reliable way she has….Facebook! I couldn’t believe it. The best use of Facebook I have ever heard of! Maybe it’s time to join?

A Proud Moment

February 1, 2014

There is a rooster right outside our room that starts his morning call at about 4:30 a.m. and I have taken to calling him Jicky (which is the nickname Walley and I have for our dog, Jackson). Although every morning he wakes me up too early, just like Jackson does sometimes, I am finding it comforting to say to myself “Jicky, go back to bed, it’s too early.” It’s a nice reminder of the amazing life I have at home. I have new level of gratitude for everything and everyone in my life.

Moving to a new clinic spot is a bit hectic, but is also kind of a nice change of pace. Tinauan has been just as hard hit as Tacloban, and the 30-minute drive there in the morning re-emphasizes the depth of the destruction. It just goes on and on and on.

This time, we are not in a hospital, but at the community hall, which also houses the mayor’s office, and is kind of a central hub. A Doctors Without Borders group has been in the space for the last week, so people are used to it as a busy place. Due to the masses of crowds, and also because it is the mayor’s office there is a ton of security (meaning army guys in fatigues with M-16s, and police) who are helping to control the situation. Today there were over 900 people swarming around trying to get registered for our clinic. One of the army guys says this is the craziest he has seen it, and because we eventually cut off the line at 650, we expect tomorrow to get even crazier.

One of my duties in triage is going down the line of people, and culling out people who need to have their eyes dilated with drops, based on the level of their distance acuity. The drops we use sting quite a bit, and make people’s eyes water, so we offer them a piece of toilet paper to wipe their eyes with, because there are no tissues around, and our team brought an abundance of TP. That would not fly at my office in Vancouver!

toilet-paper

Here is my favourite photo of me “handing out toilet paper” with the backing of the army guys and their M16s. Triaging on the street with the army truck back drop is a bit different from my normal clinic setting.

So at one point, I am out on the middle of the street putting drops in eyes, with one army guy scribing my records, and another army guy with a gun following us along. One of our team mates came and took a picture, because it looked kind of comical and he showed it to me later. It basically it looks like I am doling out toilet paper to a long line of senior citizen Philippinos: me, two army guys, an M-16, a roll of TP, and a long line-up. I already know that is going to be my favorite photos of the trip!

I had a really proud moment today, and I remembered feeling this way occasionally on previous mission trips. It seems like its not that often in life where you catch yourself in the moment and think: wow, I just did an awesome thing. But today it happened when I helped teach a young legally blind boy how to use a variety of low vision magnifiers for the first time in his life. He was around 10 years old and has a congenital condition called nystagmus, rendering his vision at “counting-fingers” both in the distance and at near.

I showed him how to use three different high-powered magnifiers for close vision, and he took to it like a fish to water. Within maybe 10 minutes he was already really proficient with them, and he kept saying the printing “looks so big, it looks so big.” He was literally beaming. His mother and his teacher were with him hoping he could be helped, and they were beaming too. I really think that just opened up a world for him, and I am so proud to be a part of that. This story had nothing to do with the typhoon, but was worth the 13-hour plane ride here!!

Silver Lining

February 3, 2014

One of my favorite things I have read about generosity (whether it is giving of your time, your knowledge, or your skills) is that when you are generous…you may actually become poorer (literally), but you will always feel richer. I already feel significantly richer.

In addition to the eye care project, we are also distributing clothing and household items that were container-shipped to Tacloban in late November. Two 40-foot containers were packed (and I mean packed) with donated items that were collected from people in B.C. soon after the news of the typhoon disaster.

The idea of collecting and packing two containers full of relief aid and sending it to Tacloban (post-disaster) from Vancouver sounds like a great idea, but in reality it is a complicated and logistical puzzle that only very, very dedicated (and connected) people can put together (like our mission leaders, Marina and Derrick, and their children).

One of the things that our group has always been proud of is the fact that our eye-care mission donations are very hand-to-hand. Meaning we collect the eyeglasses in our offices at home, and then literally hand them out one by one to the appropriate people in the most need. No middle man, no corruption, no political maneuvering. Handing out these donated items from the container was also exactly hand-to-hand. I don’t even want to get started on how many bags of rice we drive by everyday, sitting in makeshift warehouses, while we see so many people in need.

So, today after we finished with a full day of 750 patients, we drove 600 lbs of donated items over to an “evacuation tent city” with over a thousand people living in makeshift tents in the sweltering heat. The conditions people are having to endure are almost unexplainable. The heat, which nearly melted my Canadian face off, is what struck me the most. I could barely take it for the hour we spent there, and people are living under tarps which must double the intensity of the temperature.

We handed out clothing, IMG_4177shoes, household items and toys. Each family lined up, amazingly politely and calmly, and everyone got at least a couple of items, and most kids got one stuffed toy, which seemed like an ultimate luxury in these conditions. I take so much for granted at home: it is very eye opening to see how happy someone can be receiving a couple of donated, used t-shirts.

The mayor of Tanauan came with us, along with a pack of army guys, who have kind of become my local posse. The Mayor is a first-term young guy who didn’t really bargain for his current duties when he ran for office, but he seems like a vey earnest and decent guy. He explained that one of the things that he thought was a high priority, after the initial basics were covered like food and water, was to give people hope. He said that the tent city we were visiting was composed of people evacuated from a very poor and transient neighborhood, and that the new development for them (now under construction) will have sewage and plumbing, which will be a major upgrade from their pre-Yolanda life. So at least there is a glimmer of hope, and a silver lining.

Emotional Typhoon

February 4, 2014

I hit a wall a couple of days ago. I didn’t really know it was coming, but it hit really hard. It was like I had my own personal emotional typhoon. We had finished a long day of clinic, and my roommate left to go for a walk, and a few minutes after he left I just completely burst into tears, and couldn’t stop them. You know that kind of crying where you are almost gasping for air? Well, that went on for about 10 minutes, and once I caught my breath I felt perfectly fine. In fact I almost immediately went for a few beers and dinner with the group as if nothing happened. I think my emotional dam broke after everything I have seen and heard, and after the pressure released, I was ok.

I gave away another pair of my mom’s glasses today at the clinic (after she and dad paid for me to go to optometry school, there was a kind of unspoken contract that mom could have as many pairs of glasses as she wanted, and rightly so…). I gave them to a specially selected patient that I waited for all day, and as I was telling the patient that these were from my own mother, and that they were quite literally the best pair on our whole trip (Fendi with encrusted jewels). I felt a twinge of where some of the emotional build up must have come from. Giving away something of your mother’s, no matter how much good you know it will do, and how much she would have wanted to give it, is still a painful thing to do. I had to keep reminding myself that giving away one of mom’s possessions had nothing to do with letting go of her or her memory. If anything, it will probably strengthen my memory of her through this act of giving.

The woman I gave them to was a fairly young woman, 47 years old, who needed a strong prescription for her age. I saw her coming down the line and just knew she was the right person. She had two little children with her, each under 10, and I pictured what it would be like if that had been mom, Sarita, and me trying to survive in these conditions. It is heartbreaking. I’m so happy we were both in the right place at the right time for me to pass on a piece of my mom.

The intense heat of the last few days has become a new, and fairly brutal variable on our trip. For most of the day I am beet red and pouring sweat to the point that patients in line ask me if I am OK. They are post-typhoon, but I look must look quite out of place and suffering, so they ask how I am instead of having pity for themselves. We are working partly outside, and partly in a non-air conditioned community hall now that we have moved to our new location of Basay on the island of Samar.

Our army posse in Tinauan has been replaced with a firemen posse in Basay and after clinic today they took us out on the fire truck (with the siren on the whole time causing quite a spectacle), for a tour around the destroyed town. In the heat of the afternoon, under the blazing sun, sitting on top of a metal fire truck that had been sitting out in the sun all day, I literally looked like a boiled crab when I crawled my way off the truck. I drink 2-3 liters of water per day, but never have to pee.

I am getting close to the end here, but am not letting myself think about it. I remember from training and running the marathon, that the closer you get to the end, and start to anticipate that it is almost over, is just the time you will get nailed the hardest. But we are close. I’m just trying to not think about it.

I also haven’t let myself think about all the luxuries we have at home, and all the food I want to eat (vegetables!). But I will indulge in everything when I get back, so watch out!

The Line Never Ends

February 5, 2014

The heat of the sun made today a little extra grueling for both our team, and the 700+ people who waited in line, some for 6 or 7 hours. We work on a first-come-first-served basis, and the line usually starts about 5 a.m. (in Tacloban after a few days the line started at 3 a.m.) and when we arrive somewhere between 7-7:30 a.m., the day’s quota is already in place. Even though the line up wraps around several blocks the people have high respect and courtesy for the elderly, and no one complains when we give priority to them. In fact many people in line will ask if the senior beside them can go to the front.

Despite the harsh conditions (and I don’t just mean from the typhoon but rather that we are focusing ourselves in poorer neighborhoods), there is an astounding number people who are 75-85+ who are aging very well. They look good, they see good, and can still tough their way through a five hour line up (not to even mention a natural disaster of this magnitude. It is pretty amazing really.

My roommate explained an interesting thing to me the other evening, which is that in Africa in very, very poor communities there is relatively little diabetes. When people start to get just a little bit of money, the rate of diabetes starts to skyrocket (a lot of soda and snacks) and is becoming a huge health issue, and the rates don’t go down again until basically people are “wealthy.” Possibly aging well is the only advantage of living in extreme poverty your whole life.

infection-boy

The tough little boy with the corneal infection and ulcer that he had suffered with since the typhoon.

I guess it is not just the seniors that are tough in our current barangay (neighbourhood). Today I saw a 12-year-old boy who came by himself to the clinic, and lined up all day because this left eye has been red and painful since the typhoon hit almost three months ago. He had one huge and deep bacterial ulcer in the mid-center part of his cornea, and another dozen small ulcers ringing all around the edge of the cornea. He must have had his eye scratched during the storm, or had something stuck in it, and over time the bacteria have just gotten ahold and started to ulcerated the tissue. His eye was also deeply inflamed from such a prolonged, untreated problem. But he was so tough in how he let us look after it, and I was so impressed at how he brought himself to the clinic.

We have brought some really strong drops with us, and because he is an otherwise healthy kid, it should resolve nicely pretty quick. I’m going to see him again tomorrow morning when we go back (I gave him a “priority note” so he can skip the line like a senior!). That would have been treated same-day in Canada, and he toughed it out for the last three months, along with everything else going on. What choice did he have, I guess? For most people here there is not a lot of choice in their situation.

We had not seen Larry, our kid on the street and official mascot, for several days and it was kind of making us nervous. But he showed up the other day looking unusually clean and fresh, new haircut, and in new clothes. We think he may have found some support from a couple of local families. I don’t think it is a completely happy ending, as I’m pretty sure he spent last night on the street again, but it least it is a start of something for him. Or so we are all hoping… that kid really needs a break. At least he is living in a country where, in general, people are very kind, compassionate, and family centered.

A Good Karma Finish

February 7, 2014

Yesterday was the last day of clinic, and in the end we saw over 8100 patients in the last 13 consecutive days. Most of that in sweltering heat, and unusual conditions.

young-girlsunset-rideOur entire last day went so smoothly, some of us felt like we were being guided by a positive force, a karma payback maybe. In fact, my day started with a small gift: as I walked out of the hotel in my TWECS clinic shirt an elderly woman approached me from across the street. She had been waiting outside the hotel since early that morning so she could “thank one of the Canadian doctors” for her eye exam and new reading glasses. She shook my hand and blessed me.

What a great way to start the day. The rest of the long, last day was typically hot and grueling, but so many incredible moments got strung together: a bad corneal ulcer on a little boy healing nicely from our care the previous day; finding exactly the perfect complicated prescription for a highly myopic girl’s first, and long overdue pair of eyeglasses.

Finding glasses that not only solved functional refractive blindness for many elderly, but that looked so individually customized to each one, I couldn’t have done any better in my practice at home.

It has been an honor, and my pleasure, to be a part of helping restore vision and dignity to the kind, patient, and perseverant people of the Philippines.

Tindog Tacloban!