Letters from Jean - Report 1
Report 1
Dear friends and family, this is day 5 of the medical mission Jan 8 to 19 to Chapala, Mexico on the shore of Lake Chapala, south of Guadalajara. But this mission preparation started last summer and has been fraught with set backs and road blocks. This is a joint project of the Rotary Club I belong to, Festival City Stratford and Rotary Chapala Sunrise. If you have received these reports before, you will remember that we were here last year, working with the other Rotary club here, and that was a difficult mission. We were asked to return and we have been working and planning for about 6 months, the last month almost full time.
Why did we return? Last year, we were informed about small villages in the east end of the lake that are drastically under serviced in terms of health care and many of the children have varying degrees of kidney failure due to exposure to heavy metals, the source of which is not clear. Our presence last year brought attention of the local, provincial and national departments health and environment. While we cannot solve those big problems we can help accent the issues again.
Rotary Chapala Sunrise has given hosting duties to permanent missionaries in these villages, DWayne and Valerie Hartup and family of 3 children, with other Rotarians assisting as needed. They do not live in Chapala, but in one of the little villages and the village children are the friends of 10 year old Doogie and his older sisters, Katie and Olivia.
Dr Doug and Pharmacist David were not able to join our team as they are going to Nicaragua on a mission. We will work with a local Dr and pay him 500 pesos a day, $33.00 C. Through a friend here, Doug Scrimgeour, he located a pharmacist spending the winters here, living the summers in Washago, Ontario. Our team consists of 7 nurses including myself, a retired banker, retired teacher, retired Ontario land surveyor, 2 students including our Rotary exchange student from Germany, retired legal assistant, retired electrician, semi retired ultra sound technician, and a seniors recreation programmer who was a pharmacy technician in one of her former jobs. But what a great group! They all came when they could to help pack supplies and have been adaptive and supporting here through the challenges.
We were not able to bring any medications with us this year because despite 3 months of trying to get the rules and regulations from the Mexican consulate in Toronto and the Mexican government in Mexico City, it was futile. I did however, pull all of our in date analgesics, vitamins, gravol, and other over the counter medications off the shelves at the mission depot and the team members distributed them into their own personal effects boxes to go into the hockey bags. We were told that medications were inexpensive in Mexico and to purchase them here, so that was the plan. I sent down a list of about 30 basic medications to get price quotes on and then sent a list to purchase. However, 5 days before leaving, they refused to put in the order, so we arrived without a pharmacy. Now, we are scrambling!! We are running around to every little pharmacy buying all they might have like 20 doses of worm medication which does not go very far when we have to treat everyone.
I packed the last of the hockey bags Sunday morning Jan 7th, Just when you think you are all organized, Peter counted and double checked the hockey bags and found we were 1 bag short, which is better than having one bag too many packed. Brian came with the farm stock trailer on Sunday afternoon and we had lots of help loading the hockey bags. Another volunteer came to nap before we left but I was still packing my personal stuff so lay down at 10 pm but did not sleep. Brian picked us up with the truck and trailer, and we realize it has been snowing heavily after dark. It is pretty heavy going but even with stopping in New Hamburg to pick up Mary Lou, it takes a full 2 hours to get to the airport. Every one is there with a cart and the unloading goes smoothly, with people coming forward to pick up their two hockey bags. We have an agreement from Delta, that just came in on Sunday morning that we are approved for 15 humanitarian bags, but because I have to pay for all the luggage charges, we do a group check in by collecting all the passports and they did not weigh any bags there nor say any were over size. The accepted size is 62 inches, length + width + height. I had measured them all and the average of 32 bags was 60.59 inches and every one 50 lbs. When he found out what we were doing, the ticket agent only charged me for 13 of the 32 hockey bags and all of the agents wished us well. Nice. We arrived at the airport at 3 and just got to our gate at 5:45 in time for boarding.
It is -8 and snowing so the plane has to get de-iced, which is a really interesting process with different coloured spray on the top of the plane and running down the windows than what is put on the wings. We are in the air 45 minutes late but the pilot says he can get us to Atlanta on time. It was obvious that was not going to be and we asked the stewardess where and how to get to our gate for the Guadalajara flight. She advised that the fastest runners should do just that and then when they arrived, they would hold the plane. When we got on, they shut the door! But, for all but two of our group, they took our carry on bags and said they would ‘meet us at the gate in Guadalajara’. Nothing arrived, not our checked luggage or our carry ons, not even the wheel chair and the walkers for the ones with the air casts, nothing. We have to hunt for a Delta rep who fills in all of the forms. Someone was smart enough to say take photos all our own stickers. After 1 1/2 hours on the ground we are out and met by some Rotarians and our Rotary hosts DWayne and Valerie Hartup in sunny warm Mexican climate, dressed in our winter clothes.
Lunch was a beer or a drink from the local OXXO, a Quickie store, and then board the bus for the hotel. A truck had been hired for the luggage but, of course, we have none, not even carry ons. Chapala is about 35 minutes south of Guadalajara and that beer is so refreshing.
Check in at the Monte Carlo Hotel is quick and easy. There are no triple rooms, so I find myself in a king sized bed in a nice room all by myself. All of the rooms look out over the vast gardens, the huge pool a distance away by the lake, across the lovely lake to the mountains on the other side. This is OK! A couple of Rotarians took us to Walmart to pick up sleeping attire for those sharing rooms, and other necessities duplicated in the missing hand luggage. Dinner was ready at 6 and a $3.00 glass of wine was a nice touch to the palate. I had nothing to unpack and tried to start this letter, but at 7 pm (8 your time), I was solo in a huge bed and fast asleep, knowing that many challenges would face me tomorrow.
After a huge breakfast that most of us could not finish, Dwayne and Valerie came at 9 to go over details of the schedules, both for the mission and social invitations, knowing much depended on when our luggage arrived. Doug Scrimgeour, our friend from Blythe, Karl Dyer, who helped us last year to find a community in need when we were booked to see yuppie teenagers and teach them sexual health, and 3 local nurses who wanted to give us the lay of the land in terms of local health issues and challenges. Also attending was the Pharmacist from Washago Ontario living here for 6 months of the year, who agreed to work with us. The local nurses stressed that we should do a lot of health teaching which of course we understand to be a priority and are prepared to do. Apparently, there is a lot of ‘flu’ in the area, the people do not get flu shots, symptoms of cough, runny nose etc, which sounds like common cold. With all of the health teaching the local health professionals wanted us to do, they followed with what their basic treatments would be, worm medications for everyone (we always do that) and provide a multivitamin and a vitamin C for everyone long term! This did not seem like good medical treatment to me, but I listened. The answer to treatment for hight blood pressure and diabetes was the same, healthy eating, exercise (not a problem here as they have to walk everywhere and everything is worked manually, low salt diet, no coke or pepsi (big problem her because their water is not always good) but not necessarily provide pharmaceuticals. The Canadian pharmacist did not want us to give any antibiotics, in case someone was allergic, (always a question for any medication), said everyone should have vitamins and Vitamin C as our treatments and he said we did not need him and to basically have a good life.
I was devastated at their seeming callous regard for persons unfortunate enough to have Hypertension, Diabetes and other true infections like pneumonia and tonsillitis. As we still did not have any medications to work with, except the bottles of Tylenol and Ibuprofen, iron, vitamins, Calcium etc that we brought in our own personal boxes and turned over to be the start of the pharmacy, I had to go shopping. We went to a little discount pharmacy that Dwayne and Valerie know and I priced medications to purchase. The Vermix plus for worms and parasites that the pharmacist recommended was way too expensive, about $4.00 for each person, but the Albendazole that we normally use (and what the locals would too) was $0.20 cents a treatment. I was able to purchase enough for about 40 doses. The multivitamins would cost a dollar a day for each person and the Vitamin C was more than $2.00 for 10 tablets. I asked about the cost of oranges. You can buy oranges, 2 Kg or about 40 oranges for a little more than $1.00. Does this make any sense? I was in such a quandary about the message of basic teaching and yet not following through with sustainability. I did purchase a medication for gastritis, (took one myself for my huge acid stomach dealing with all of this), and cleaned out the little pharmacy of basic Amoxicillin as an antibiotic , some Metformin, basic treatment for Diabetes, and a water pill as treatment for high blood pressure and Tylenol suspension for kiddies with fever.
Back at the hotel, we heard that the luggage had arrived and to report to Delta. We hired a truck and I went with Dwayne and Valerie back to the airport to find them, to no avail. We called and walked the length of the airport 3 times, and was then told to go to customs in another building a mile away, which we did. We went though questions and then got to a ‘lawyer’ who said the luggage was still at the airport customs. Back there we went and found our way down a back alley to an officer who did not care that we had all of the yellow slips for the luggage to be inspected. If we did not have a Delta rep, there was no entry to the luggage. So, I paid for the truck that did not have any luggage and we went home to the hotel. While all of this was going on, the rest of the team explored Chapala and Ajijic (pronounced Ah-hee-heek).
Supper was good, but we knew we would not be working the next day. We did however, have a great team meeting, getting to know each of the members and the role each might play in serving our patients. Bed and sleep felt good. Wednesday morning, the priority was to get that luggage! I went to the airport once again with Carlos, the Rotarian who is in charge of transportation for us, and he owns a travel agency and knows his way around the airport. At the Delta counter, he told them of our problem and reluctantly, an agent was assigned to us. Carlos and I went through the same back alley with her, gave our passports for identification, went through security and we were taken to the area where our luggage was. It was all piled on carts, out in the open and in no way secure. The luggage had to all be identified to each person. The agent was looking at the yellow sheets and trying to identify one by one. With all of the identifiers we had put on the bags, and the lists that I had, I was able to do it much faster. A helper lifted the hockey bags onto each cart but the Customs agent just watched. Then I took my luggage through customs inspection. I had my personal box with some tylenol and vitamins and iron etc destined for our pharmacy and my own shoes, some Twizzlers for our hosting missionary family, the Team first aid box and the team first aid pail. They inspected every single item and kept telling me we could not bring in medications and I kept telling them they were personal and for the team. In the end, they said OK and could not get everything back in the hockey bags, so I packed it.
I said I had packed every bag, but no, they would not release the other bags for me, even with the yellow slips. So we called for the bus to bring everyone to the hotel along with their passports. My agent had said, if everyone arrived before 2 pm while he was still there, he would let all go through, based on my documentation of each bag.They arrived 45 minutes later and we all lined up with the carts and luggage. First through was Linda who had mostly reading glasses. He opened each box, looked through and started adding the numbers of glasses in each box AND the numbers of soap in the box, the number of used eye glasses cases etc. Then he asked for 500 pesos taxes for goods brought in. We said everything had no value because it was donated, and he wanted invoices but we did not have that for donated items. He insisted, we said we had no money and back and forth it went. We had been with him for 20 minutes, and there was 14 more people to go. We asked for the supervisor and he said it was him. In the end, another higher official was going off duty and waved him and us away and he said we could go. We had to re pack the bag. On to the next and then they started to take folks to other lines. Some looked at a few things, some looked at everything, some agents opened a zipper, felt around a little closed the zipper and said go. So, we got every single item without problem, just a lot of hassle. Some said thanks for coming, some said good luck, some said nothing. We called for a truck and we had luggage at the hotel at 4:30 pm.
We took our carry ons and some folks immediately changed clothes. When the luggage arrived, we carried it outside a room and opened all the bags and carried the boxes into the storage room and organized it all, setting some aside as not needed, divided other supplies into days 1 to 5 and repacked ready for the clinic tomorrow. What a relief to finally be ready for a clinic. Everyone had supper and went to bed, anxious for a work day.
Another problem I did not mention, is a lack of money. We sent money from our Rotary Club Dec 28 to the Rotary Club here, to pay expenses. That had been delayed because we did not have all of the information needed from Mexico. Then on Wednesday, our bank needed an 18 digit number and the money has been resent. So, I am paying all the bills with my credit card and my personal Mexican pesos, and racking up a huge debt here for hotel, meals, transportation etc. In addition, my debit card will not work at the two machines I have tried! The money has not yet arrived and I am told that bankers only work 9 to 3 in Mexico and everything is personally looked at through the system.
We are all well, and the challenges we face we are doing in perfect weather!