The one about finding your "specials"

This post was written by Katie and I for the Peace Corps Panama tri-annual magazine “La Vaina” inspired by the theme “This I Believe....”

“You are the books you read, the films you watch, the music you listen to, the people you meet, the dreams you have, the conversations you engage in. You are what you take from these. You are the sound of the ocean, the breath of fresh air, the brightest light and the darkest corner. You are a collective of every experience you have had in your life. So drown yourself in a sea of knowledge and existence. Let the words run through your veins and let the colours fill your mind until there’s nothing left to do but explode.” – Jac Vanek.

We’d take this quote one step further to include people, real life humanoids who affect the way you see and experience the world. As our pal, good ol’ Jac Vanek mentions, it’s what you learn from and take from your surroundings that truly influence your being. There are people who you engage with that influence your way of thinking and experiencing. But then there are those people who completely rewrite the way you live. Those are called the “specials.”  If you’re lucky enough to find a special in your life, hold on tight because they’ll teach you a million things. 

Bea, here is what you’ve taught me:

1. How not to freak out so much when lighting a gas stove.
2. That making a habit of sweeping the floor actually makes the house feel cleaner.
3. When you don’t like what someone is doing, sometimes the best thing to do is to be honest and actually tell them that (sass optional).
4. If your goal is to be the President of America, then you should tell people your goal is to be the President of America.
5. You can tell someone that you “hate” a piece of their clothing that you have never even seen, and it doesn’t mean that you love them any less.
6. If you like something about somebody, tell them to their face (it makes them feel really good and they will remember it when they are feeling down).
7. Even though a flag that you don’t want is half price, don’t buy it...because it’s a flag you don’t want.
8. If you can win the race, do it, because it’s called a “race,” not “a share circle.”
9. Being flexible, open-minded, and curious can co-exist with having strong opinions and expressing them without worrying about what others think.
10. Sometimes it’s better to stop talking and just say, “See you later freakazoid!”

Katie, this what I have learned from you:

1. The best way to play board games is in teams, especially when one half of the team takes Trivial Pursuit cards from the 1990s to bed and studies them.
2. Intellectually superior human beings listen to podcasts morning, afternoon and night. Music is for squares...except if it’s a parodied song played on the ukulele.
3. Ten minutes of volleyball a day does human good.
4. A good sense of humor, coupled with living by the phrase “Yes, and...” is the best way to become a improv specialist and better person.
5. If someone else does the cooking, you should always do the cleaning.
6. When someone says something really funny and you feel a huge belly laugh brewing, ride that wave, baby, ride it all the way!
7. Even though you may fully believe that paper books are morally superior and the only way to truly preserve the beauty of literature, it doesn’t make you a hypocrite when you buy a Kindle. 
8. If someone comments on a ten-year-old picture of you and says, “Wow, you’re wearing the same outfit!” it’s probably time to go shopping.
9. You can know everything about someone and still have stuff to talk about everyday.
10. Having a curious and analytical mind coupled with an uncanny ability to speak without ever taking a breath can lead to some of the most powerful and impactful conversations you’ll ever have with a friend who will eventually become your life mate. 

Specials are what make life great. They are the people who you can never get enough of, who you will always want close, whose glance you exchange whether or not they are physically present. You can meet them at camp, at track practice, on study abroad, while working at the deli, and in Peace Corps. Specials transcend age, class, and fashion sense. Wherever you happen to meet them, you’ll know quickly that they are a special. You start figuring out which one of you is Ernie and which one is Bert, you stop having to say "my sister" and can just say "Jenny" when telling a story. You will start wondering what they will look like at 40, 60, or 80 because you know you will still be looking at them in one way or another. We believe in the power of finding your specials.

The one about my community's emergency medical system

This story is a throwback to my service in the Dominican Republic, but on the anniversary of our very first week of providing emergency medical care with the Paramedic team in Manzanillo, I thought it fitting to document our process in the annals of history. Enjoy!

One sunny afternoon, I was sitting with my neighbors drinking coffee in our plastic chairs trying to catch a breeze. I had been in site for nearly six months and felt that I had a pretty good grasp on the dynamics of the place. The hospital administrator rolled up to our growing street gathering and took his place in the low-back plastic chair on the corner. “Bea,” he said to me, “I need a favor. We need an ambulance for the hospital, can you get us one?”

Fast forward to nearly two years later, and I never did get that hospital administrator his ambulance, but what we did do together as a community was create an emergency medical system staffed by local first responders who use a basic mobile phone software to provide pre-hospital care to emergencies in my site of Manzanillo in the northwest corner of the Dominican Republic. But let’s back up!

After that fateful conversation I had that afternoon with the hospital administrator, fondly known as Papito, I started investigating the idea of an ambulance donation. I did a Google search and sent a mass email to friends and family back home. I also sent many emails to organizations I read about online and one finally took the bait! Little did I know, this connection would turn into a full-blown emergency response system project (and subsequently sour me at the idea of ambulance donations as legitimate forms of aid). I heard back from Trek Medics International, an organization dedicated to “improving emergency medical care anywhere.” And so I began a series of intense conversations with the Executive Director, Jason, who pushed me for more specific answers to my “can you donate an ambulance” question. As it turned out, when I dug a little deeper within my community, I teased out from the hospital administrator that what we really needed was a collaborative solution to the actual problem of inadequate pre-hospital care and a lack of reliable inter-facility transfer capacity.

So, I’d found the jackpot organization that could help me tackle this – now what? After a series of conversations between community members, we unanimously agreed to invite Trek Medics to send a team down to investigate the possibility of starting a pilot program. One thing led to another and the big boss, Jason, decided that Manzanillo was the perfect place to launch their newly developed Beacon technology (essentially a way to crowd-source transportation and medical attention, like emergency Uber). Working under the supervision of the local fire department, we gathered recruits who had to interview, study, train, and perform simulations for several weeks before we allowed them to “graduate” as community first responders. Simultaneously, I was training local dispatchers and working with the fire chief, Ramoncito, to give the fire station a central role in the new service as dispatchers of local emergencies.

The team of responders (fondly referring to themselves as “paramedicos”) also had to prove themselves as reliable partners with real skin in the game. For example, they initially offered to help the local civil defense during Holy Week and stationed themselves for service at the beach when the holiday crowds flocked to Manzanillo’s beaches. There they encountered a number of patients with problems ranging from wounds to dehydration and intoxication. While no serious patients were treated (thankfully), their simple presence on scene proved to be a small, but critical first step in their growth: it showed the community that the response team was more than just a good idea, it built their confianza (trust) in our new service exponentially.

Then, we had to start giving our responders bigger tests so that we knew we could safely grow. This included: handling simultaneous emergencies; ensuring that a sufficient number of available first responders were distributed equally as the coverage area expanded; training our team members as instructors in order to train neighboring communities, introducing a new version of the Beacon software funded by Google, and learning to use newly minted motorcycle ambulances the organization donated to our local fire station. And on and on it went...one good idea snowballing into a thousand more - all community-driven to make a well-oiled emergency medical system.

There is still so much to do, but for something that started as a simple conversation over much-too-sugary coffee, it is now the primary method for emergency transport in my rural community. Today, six months from the date I finished my service in the Dominican Republic and have moved on to a similar Peace Corps Response position in Panama, we still have a fully functioning emergency medical service in Manzanillo and have expanded (with help from USAID and other generous organizations) to the entire province. Locals are the crux of the organization and run the entire operation. This was a project that never would have functioned without a vested community interest (especially as I knew nothing about first aid myself before it started!). Key community members were part of every decision and the driving force excited about this organizations entry into Manzanillo. After initial contact with Trek Medics, I became a critical community organizer, but I was never the driving force.  As Jason reminded me various times throughout the process, “We can’t want it more than they do. They have to be a part of every step.” A very valuable life lesson, indeed, especially in the realm of international development.

The one about clinics

I suppose I haven’t really written much about the actual work that Floating Doctors does when we are on clinics! Usually, I just text people and say, “I’m headed on a multi-day clinic, be back Thursday just in case you start to worry and think I got abducted by aliens.” These multi-day clinics happen twice a month in far-off communities sans cell service, electricity and running water. They are usually where Peace Corps Volunteers live and/or we have a great community contact who leads the planning operations. On Monday morning, all packed and ready with thousands of dollars worth of medicines, equipment, vitamins, and soap, our medical team climbed aboard a huge dugout canoe and sailed three long hours away from our base of operations to a small beach village called Playa Verde. And once we touched down, there begins the three-day roving medical clinic for Ngobe populations.

Last week, over our three-day clinic, we saw almost 250 patients from Playa Verde and the surrounding communities. We see things ranging from your average child with worms, babies with scabies and a woman with heart palpitations who we do an EKG on. Then there’s the gamut of pregnant ladies, from the 9-month pregnant woman with her baby in the breached position (not head first) to the 17-year old who swears she didn’t know she was pregnant (Ngobe version of  the MTV show “I Didn’t Know I Was Pregnant”). Doctors from all over the world (England, Austria, Denmark, France, Nashville, Canada, Jacksonville) come to provide medical care in these communities for weeks at a time. It’s a pretty fascinating operation we run, full of insanely smart and intense people who all love to teach. So much so that I myself now know how to find the four requirements to bill an ultrasound to insurance in the US: 1) head position, 2) placenta placement 3) fluids in placenta and 4) heartbeat. I’ve learned how to tell when a woman is ovulating, what scabies looks like, how to give a regime to a diabetes patient, the correct medicine to correct high blood pressure, how to take blood sugar levels, measure blood pressure, search for cavities, pull teeth and how to say all this stuff in Spanish. It’s a wide world of medical knowledge out there and I’m soaking it all right up, practically could be a doctor myself!

I’ve been to four multi-day clinics and they are usually an exciting affair. On one, we have to hike four hours up a hill to the middle of nowhere and a community of thirty houses, yet we see over two-hundred patients from the surrounding communities. Another is on the beach overlooking beautiful pristine water and another at the mouth of a river pouring into the ocean. We sleep in hammocks under raised wooden houses and eat rice and beans for three days straight. We poop in latrines that would make my mother gag and bathe in the ocean. I love it. I’ve seen so many wonderful places that many a tourist could only dream of!

I think the Floating Doctors do great work, we bring medical care where there is none, literally. If they have an emergency, good luck. If you’re giving birth, no pain medications and it’s on a wooden floor. Broken foot? Keep going to work. Breached pregnancy? Hope the midwife can turn it around. It’s amazing the amount of medical attention these Ngobes can give with the minimal (non-existent) resources they have. That said, what limited resources we, too, can bring is paramount to their increasing health outcomes. That paired with the Health Promoter Practitioner Course that we are starting to implement (ie. my entire reason for being here!) is going to be critical in these areas. Health care and education is so important I don’t understand why it’s still so hard to access for so many places! Makes me want to be in the global health field forever watching this stuff...but if I did that, who’d run for president in 2036?