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Cover Story August 17, 2006


 

 

by lyle e davis

You and I have seen the television coverage of the tsunami devastation . . . of Hurricane Katrina’s impact on Louisiana, Mississippi, and the Gulf Coast states in general. But it’s one thing to see it on tv and read about it in the newspapers . . . it’s quite another thing to be there in the middle of the destroyed areas . . . amongst the people who are frightened, dirty, tired, sick, and literally don’t know where their next meal is coming from.

Recently, we were moved by the touching story of Dr. Amy Witman, a medical internist with the Scripps Clinic, and a resident of San Elijo Hills. She spoke to our Hidden Valley Kiwanis Club of Escondido recently and we sought to tell her story in a feature article of The Paper.

She not only took an unpaid leave of absence from her position at Scripps but, thanks to some generous sponsors, she paid her own way to India ($3000). It’s not necessary for us to labor over the words and write the article on this amazing woman, however. Dr. Witman does a beautiful job, in her own words of describing the horrible situation she and her colleagues encountered in the two devastated areas. Read, feel, and learn.

Medical Tsunami Relief in India

On January 22, 2005, a group of 62 people left San Diego as part of a medical relief team to the southeast coast of India that was hit by the tsunami. My name is Dr. Amy Witman, a San Elijo Hills resident, and I was part of that relief team. The experience was so amazing and horrific all at the same time.

Project Compassion, a local non-profit based in Rancho Bernardo, coordinated the trip.

After 46 hours of travel, we arrived at our hotel in Ongole, on the southeast coast of India. We arrived at about 8:00 am local time, tired and quite weary from our travels.

Most of the people in this region of India are called "untouchable."

"Branded as impure from the moment of birth, one out of six Indians lives - and suffers - at the bottom of the Hindu caste system. They are Untouchable…. They are outcasts-people considered too impure, too polluted, to rank as worthy beings. "
National Geographic Magazine, June 2003

Their caste system includes a very strict hierarchy which is determined by the family you are born into. It has nothing to do with disease or illness. If you are born to an untouchable family, there is nothing you can do to get out. And your children will also have the same fate. It is technically illegal to discriminate on this basis in India, but that is lip service only.

These are the people we went to serve. We were saddened to learn their own countrymen won't touch them, smile at them, or even look at them. This title of "untouchable" couldn't be further from the truth. These are beautiful, wonderful, kind-hearted people. I learned on this trip that people really are the same everywhere - they love their families, live in communities, and have ups and downs and joy and pain.

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Dr. Amy Witman’s photo of the Indian woman cited above.

I asked one older woman if I could take her picture and told her she was beautiful. She said she wasn't beautiful and seemed almost ashamed. I said indeed she was beautiful and wanted to show her. She allowed me to take her picture, but she didn't smile. It is indeed a beautiful picture, and I showed it to her on the back of my digital camera. Then she smiled a huge, cover your whole face smile.

What kind of world is this that by simply showing her she is a worthwhile, beautiful human being brings such novelty and joy? I'm glad I was able to bring that to her, but saddened that she had spent the rest of her life believing that she was somehow "less than."

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India claims this beautiful Indian child is an “untouchable?”

 

Our hosts who coordinated the details of our travels in India were an orphanage and their pastor, Brother Joseph. We traveled to the orphanage each day for breakfast and dinner, and these children (250 of them) were so friendly and giving. They loved shaking hands and learning our names. They especially liked having their photos taken with our digital cameras so they could see the picture right away.

Each day we traveled an hour by bus to two small fishing villages, Ullapalem and Pakala, which were devastated by the tsunami. Even before the tsunami, this region in India lived in immense poverty. Most of the "homes" in the villages are huts made from palm fronds with dirt floors. Most are approximately 8 by 10 feet, single room structures and house anywhere from 5-15 people. They don't have electricity, running water, or plumbing. There are no cars, most travel is by foot and almost no one has shoes. They subsist day to day on fish, rice, and water buffalo milk.

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Typical Indian ‘home’ seen by Dr. Amy

The most amazing thing I learned on this journey is that 85% of the world's population currently lives in this level of poverty. Geographically, the United States is quite large, but compared to the billions in the world population, we are but a tiny part. Hundreds of millions of people in India, China, Africa, and South America know nothing other than this type of staggering poverty.

On the first day, we traveled to the beach and viewed the physical tsunami damage. On December 25th, there were 250 fishing boats, trees, and huts on that beach. Now there is nothing. It's just empty for about ½ mile. There are no people because the villagers are afraid the tsunami will come again. They don't really know what a tsunami is, or that it was triggered by a large earthquake in the ocean far away from them. They believe they did something to anger their Hindu gods who sent the waters to punish them. Each village lost about 45-60 people in the tsunami.

In the heart of the villages which are set back a little from the shore, there are a few homes which lay in shambles, and many huts which are just missing. There is standing water one mile inland that has not evaporated because of the sheer volume.

The biggest way the tsunami affected these villagers was by destroying their food chain. They are fishermen who no longer have boats or nets. They've lost this food source and the meager income from it. The rice paddies were flooded as well, and cannot be re-planted for 3-4 years. The town well was contaminated, so they now walk up to 3 miles for "clean" water. These people do not own the land, but work it for a meager income - men earn $2/day, women earn $1/day. The only crop that was unaffected, ironically, was tobacco.

We set up a free medical clinic each day in Pakala and Ullapalem, seeing patients from morning till night. Our team of 62 split up between the two villages. We took care of over 4000 patients in the few days we were there. People waited in long lines to see us at clinic, and many walked 6-7 miles from neighboring villages to see us. Most of the people I saw hadn't eaten for 1-3 days.

Some of the health issues were directly related to the tsunami. I took care of a man who was pushed by the waters into a tree and fractured his ribs. The fractures were healing but still quite painful. I also saw a woman who was swept up in the waters who told me she "…went under the water and died. Then I finally came to the top and lived again." She had aspiration pneumonia from the salt water in her lungs which caused irritation and subsequent infection.

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Dr. Amy Witman, kneeling, foreground, tending to a patient with throat cancer in the Indian Hospice Unit

Most of the health issues we saw, however, were more chronic problems with little or no solutions. There was a lot of knee, back and neck pain from the lives of hard labor they lead. Vision and hearing problems were prevalent, and related to chronic poor nutrition and lack of healthcare. Rashes and infections are also common due to the poor sanitation.

I saw one man who really touched me. Paramedics on our team scouted the village for people who were too sick to come to clinic. They found a 60 year old man on a cot on his front porch, covered head to toe by a white cloth. Fearing he was dead, the paramedics approached. As they got closer, they heard him moaning, obviously in a great deal of pain. When the paramedics returned to the clinic and found me, I grabbed my medical bag and made a house call.

This man had throat cancer which had spread to his brain, and he was sent home to die. His family is poor and couldn't afford any pain medications, not even Tylenol. He was only semi-conscious, so we gave him injectable pain medications and fluids. We left liquid Tylenol with his sister to use through the night. When I returned in the morning, I was surprised to find him awake and smiling. He called me an Angel for caring about him and taking his pain away. I couldn't do anything for his metastatic cancer, but I treasure my time with him, knowing that I relieved his suffering in his final few days.

The conditions in India were quite hard for most of us on the trip. Much of India, even modest sized cities, don't have toilets. Most of the time they either have nothing or, if you're lucky, they'll have a ceramic hole in the ground. They don't even know what toilet paper is, but thankfully we were warned before we left and were able to bring our own. Their sewers are simply open trenches that run at street level and really smell.

In our hotel, there was a pipe coming out of the wall high up which is a shower, but it didn't work. We had no hot water although a few people did. It was very hot - 90+ degrees and 95% humidity. There were lots of mosquitoes outside and fleas in our beds. We worked hard and got really sweaty and dirty each day, so I was happy to have my "shower" at the end of the day - cold water in a hand held bucket that I poured over my head.

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Time to leave India. The children were heartbroken, as was the medical staff. Note the tears in the child above.

On our last day, leaving the orphanage was harder than any of us anticipated. The children cried and so did we. We gave each of the 250 orphanage children their own page of stickers, which was a real treat for these children who have no personal belongings or home other than this orphanage. After playing with them quite excitedly for a few minutes, the strangest thing happened. The children started putting the stickers on our faces as a way of saying thanks for coming, caring, and everything we had done. These children with nothing freely gave until it hurt. We have a lot to learn.
The health problems, poverty, and discrimination are too immense to fix in one medical mission trip. But it wasn't until after I returned home that I was able to realize that it was simply our presence and caring that was most treasured and immensely helpful.

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Houston’s Mayor Bill White - the guy who made things happen, fast, in Houston. He’d call the hotels and vendors, telling, not asking them, they were going to help in the relief effort for Katrina victims. Everyone responded. Deep discounts and/or free services. (Chances are they knew if they didn’t assist, they’d be losing a lot of the Houston city business.)

Brother Joseph is setting up a program through Project Compassion where all money donated (nothing goes to overhead since there are no paid personnel) will purchase new boats and nets for the villagers. This will allow them to tap an unending and rich food source and make some income again. If you would like more information about this program or Project Compassion's future trips, go to www.ProjectCompassion.org or call 858-485-9694.

When I was 15 and became a christian, there was a song that really spoke to me and led me along the medical/mission field called "Here I Am Lord" and the chorus goes like this:

"Here I am Lord. Is it I Lord? I have heard you calling in the night.
"I will go Lord, if you lead me. I will hold your people in my heart"
Dan Schutte 1981

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I'm a huge believer that we can all make a difference in the world by volunteering and serving others. And we should start with small things like smiling when you walk past someone on the street, open a door for someone, or let someone in ahead of you in traffic. Then I encourage people to join service organizations like Kiwanis, Habitat for Humanity, local food banks, serve meals at a homeless shelter, literacy programs, Big Brother/Sister programs, and so many more. Not every program is right for every person, but try a few on for size until you find the one that's right for you!

And then hold all God’s people in your heart!




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Houston’s Convention Center



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Katrina’s Victims Come to Houston

Bill White is the amazing mayor of Houston, without whom this whole relief effort would not have been possible.

We were sent primarily to run the medical clinic at the shelter located in the Reliant Center which housed about 20,000 evacuees at it's peak. Thanks to Mayor White, we had donated a medical central supply area, the mobile pharmacy supplied by Walgreens that parked inside as well as the mobile Xray truck they brought in. The University of Texas did a really fine job setting up this clinic that we took over.

Lost during huricane is one of the hundreds of "LOST" posters that were posted up in the shelters where families were looking for loved ones. (See photo, bottom left).

The Convention Center was just one of the shelters that held about 25,000 evacuees. The Houston Astrodome is another shelter that held a similar amount of evacuees. The Red Cross utilized St. Agnus church, which had donated its building for use as a site where 10,000 evacuees a day would go to receive checks, standing in the blistering heat for eight to 10 hours in line. Many of them suffered from the effects of the heat. So, addressing yet another need, we set up a makeshift clinic there to care for them. The public health department also brought out a mobile bus and set up a vaccination station in the parking lot and vaccinated many people.
Scripps Team 1 is only 1 of 3 teams we ultimately sent to Houston.

While in Houston, some observations:

Fiona Pearl was a 93 year old black woman who I had the pleasure to see at the Red Cross distribution center at St. Agnus church. She felt dizzy in line and was brought to me. She's quite a refined woman who simply felt much better getting out of the heat. I was slow at the time with no other patients, so we talked a while.

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Georgia Rollins
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Fiona Pearl

She told me how much she missed just sitting on her front porch and visiting with her neighbors. That sense of community, of belonging, or knowing everyone and what your day was going to hold. She really didn't know where she was going to go or how she was going to get through the next few weeks as she had very little money and she was very worried. But most of all, she'd lost her support system of "front porch friends."
Georgia Rollins is an 85 year old black woman who I also saw at St. Agnus church. I was quite busy at that time, but the paramedics came running to get me and said "doc, go to the front of the church NOW!" I dropped what I was doing and said "which way is the front?" since it was a circular building and my first day there. Several people pointed in one direction and I just ran with my stethescope in hand. I kept running down skinny halls and through doors until I hit the lobby and found Georgia on a stretcher surrounded by more paramedics. She had an oxygen mask on and was gasping for breath. I quickly listened to her chest and air was indeed going in and out - a good sign. I asked the paramedic what her oxygen level was and it was 100% - also a good sign. And it didn't really make sense with how much she was struggling.

So we moved her out of the lobby and into a back hall where I could talk to her and examine her more closely. I found out she had emphysema and was on oxygen at home in New Orleans. She had to evacuate without her oxygen and had been without it for three weeks now. She'd been standing in line in 95 degree heat for two hours. But by now she'd been in the air conditioned building and on oxygen for about 10 minutes and was still no better. So I asked her to tell me a little more about her home and evacuation. At this point she started to cry. She told me how frightened she was to leave her home and her oxygen. And how terrifying it was when she waded through the water, seeing many dead bodies float past her. She was certain that would be her fate as well since she had to leave her oxygen behind. She wept. For about 10 more minutes she just wept in my arms.

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The day the tsunami hit this Indian beach had 250 boats and many fishermen on it. Now it is barren . . . the fishermen are dead. The boats are either gone or ruined. Below, New Orleans had its devastation too. Here, a beach area being surveyed and survivors sought.
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But amazingly, after she wept, she was calmer and breathing easier. She no longer needed the oxygen mask. And slowly her smile returned. While I had been caring for her, the Red Cross workers had been processing her paperwork such that her check was ready by the time she was feeling better in my make-shift urgent care. Which is when she produced this beautiful smile for us.

 

 

Therapeutic crying. It's amazing the healing power it has. All our fancy expensive technology and this simple medical technique was what most of these people needed. They needed to be heard, to tell their story, to be able to say it out loud for the first time, to know it's ok to be scared, and that there are people here to help.



I was blessed to be a part of this amazing relief effort.

Amy

 

 

 

 

 

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