Project MARC
Reaching out to forgotten island communities by sharing our resources, time and love to help create a future for all children
Trip Logbook
January 2007Nelleke's 2001 Trip & Photo Report (part I)
(Report I)Port Vila, May 30, 2001
Dear Family, Friends and Project MARC Supporters,
We safely arrived in Port Vila (Vanuatu) yesterday, May 29th.
I apologize for having you worry about our whereabouts for awhile. In the South Pacific one can never count on anything being available or functional: the day before we left I tried to send this report. However, the little email office in the marina remained closed that day. It simply had a hand written note on the door saying: " be back tomorrow". So that was that and we had to sail without being able to inform you about our departure.
We had a good time in Fiji. Rivendel was by far not as "molded" and "cockroached" as the year prior to this one and more systems had survived our absence than the year before. The only setback was that we again had to replace the entire battery system. Replacement of the standing rigging (the steel cables and fittings that hold up the mast), replacement of all the lines,and fabricating mosquito screens were the other big jobs we had to take care of this season.
(l) Rivendel II in her Vuda Point Marina "dugout berth" (still hanging from the Travelift slings)
(r) Nelleke applying blue bottom paint; a very hot job in the tropics!
Immediately we learn how to sweat again! Being in the tropics, is one thing, but doing a lot of physical labor in the heat of the day is yet something else! I had however, no crew to take care of, which freed me up for my share in the workload and Henk and I had fun getting Rivendel "shipshape" again. The only thing that was difficult to cope with were the many mosquitos, good thing there is no malaria on Fiji: I would have definitely had it by now!
One sad thing that happened was (Henk briefly mentioned this in an earlier message) that we got robbed. We made an involuntary contribution to the Fiji economy of FJD 1850 (about US$ 900). Both of us were gone for approx. 20 minutes to attend a wedding that took place on one of the boats, during that time someone who exactly knew what he was looking for, came into the boat and took our money (several people were working on our boat and since they were Yacht Help staff, we trusted them). When I reported the case, it turned out that this had been going on for over a year and when I started to talk to other boat owners many reported to also having been robbed.
The marina had conveniently never taken action and also never warned anybody that this was going on. The police did come into action, but turned out to be dysfunctional . They stayed for a full hour, made us fill out lenghty reports mumbled something like: "well, yu learned someting then huh...." and disappeared. They returned a week later with the message that the robbers had been caught, the money had already been spent and the thieves had only confessed to taking the money from Rivendel.... The story was just a bit too convenient and as of today I still have very bitter feelings about the whole incident. We would rather go somewhere else but have very little choice to go other places unfortunately. It took me a while to find my peace back, but I am sure the Lord meant for us to learn something from this and as always: He will provide!
Two days before departure our friends Peggy (teacher) and George Kornreich (MD) from Houston Texas arrived, ready to sail with us. No exciting sea stories this time. Our 5 day trip was real easy and pleasant with trade winds from normal directions and strength. Two sperm whales, lots of dolphins and flying fish took care of the entertainment. Rivendel was obviously happy to be at sea again and Thank God I didn't get seasick at all this time!
George and Peggy steering Rivendel II safely to Vanuatu We arrived in Port Vila early in the morning; Moses and Lemara, the couple that runs the marina here, had heard us on the VHF radio and had arranged to bring the Immigration, Customs and Agriculture officers to our boat. Within an hour we were cleared in (a real treat, where these procedures often take an entire day!). The officers told us that they had just cleared in "Flying Angel" the previous day.
Their crew had some stories to tell, they had gone through a storm in the Tasman Sea and experienced 60 knots of wind; they had quite a bit of damage to their boat but all were well.
Dennis Breed and Jerry Lancaster, two physicians also from Texas, had also arrived and within an hour we had arranged for our first lunch meeting in the restaurant at the waterfront where we finally were able to match names and faces. It was remarkable to sense everyone's excitement about the project, many of them had gone out of their way to bring equipment, parts and supplies. Jerry told us how he had prayed for a portable Xray machine and a day before he left, an out-of-state hospital had felt compassion for the project and decided to send him one for the project to keep!. A true gift from God! Even more blessings appeared to be on the horizon: the boxes were said to have arrived and to be waiting for customs clearance.
Today we had our first meeting with the Ministry of Health and found a temporary place for our huge ( one cubic meter each) containers. The "homework" we did here in Vanuatu last summer is definitely paying off: all the people we contacted are helping us one way or another!
During the next five days repairs will have to be made to both Fying Angel and Rivendel and the boxes will have to be transported from the "big ship" dock to the storage and then have to be unpacked. The floor for the clinic has to be built onto Flying angel and the deck tents will have to be attached. In the local hospital our mosquito nets will be treated and within a couple of days all volunteers (nine in all for the June team) will start on their preventative malaria medication.
We are all in high spirits and anxious to get started!
Love to all of you!
Nelleke
(Report II)
Dear Family, Friends and Suporters,
As I am writing this second report Rivendel is safely anchored in Ranon anchorage in North Ambrym and so is Flying Angel.
We are still in extremely good spirits and mostly healthy and....very sweaty!
Of course not everything goes according plan but there are also parts of this expedition that have developed beyond expectation!
In the first report I mentioned that we were waiting for Customs clearance in order to be able to get to our boxes. It took several trips and daily telephone calls to the MOH (Ministry Of Health) to get this important document, but on the morning of June 1st I finally have the document in my hands. I walk straight to "Pacific Transit" to give instructions for the boxes to be released. I wish you could have seen my face when I am told: "mais non madame...zee boxes are not on the shiep...." My mouth literally drops open and as of today I still am in the dark about who sent us the email that the boxes had arrived.....
So, no boxes then, that is a tough complication, just about all medical instruments and supplies are in the boxes, also the tent we are supposed to be working in at the beach, the water filters, the pots and pans for the team kitchen and the generators to power the Xray machine. Needless to say that I am pretty depressed when I have to break the news. But the team is not much affected by this news: no supplies... not a problem, we are going to make this project work, it will be fun to improvise and pioneer. My spirit is immediately lifted. I cook for the team that night and nine people ( Don Koons, EMT and Med student has completed the team and first mate of Flying Angel, Jaime Fernandez has also decided to join the team and to offer his technical and emotional support). After dinner Rivendel starts to look like a medical clinic (or actually more like the Hope Alliance warehouse!) when we put together bits and pieces that were either hand-carried by the team members or part of Rivendel's medical supplies. It turns out that we have much more than we expected. Several team members are donating their personal medications and we are also receiving donations from other cruising yachts, the news has traveled fast, especially when a big article about the project with the heading "US MEDICAL SUPPORT BOATS HELP RURAL AREAS" appears on the front page of the local news paper. Central Medical Store in the only hospital in Port Vila offers us medication that we can "borrow" ( we are also waiting for an express shipment by plane from UK that is delayed, just like the big boxes coming by ship).
(l) Flying Angel in Port Vila; the special foredeck tent covers the wooden floor of the clinic
(r) Project MARC receives front page coverage from Vanuatu's leading newspaper
The blessings are endless; we are in need of a dinghy with outboard engine large enough to transport the team and/or patients and within two days of searching we purchase the perfect inflatable for the project. Its former owner is also interested in the project and offers support in several ways.
In the meantime we are of course delayed, the crew of Flying Angel is still working on its damaged engine and the team is working on setting up the clinic. After several calls to our shipper in the US the boxes still haven't been located, but that Monday morning there is the biggest double rainbow I have ever seen.....yes Lord, thank you for reminding us!
The next day the boxes are located, they are in New Zealand and will be in Vila on June 18. The shipment from UK is also located and will arrive on the 10th.
One morning when I leave the boat, there is a man sitting on the cay, he looks vaguely familiar and then I remember: this is HangHang, the brother of the Chief in Ranon who we met last year on Ambrym. He has traveled by copra boat to Port Vila together with Chief Tokon Sam to earn some money for the schools on Ambrym, and is looking for a job. Good, we can use a local person to help us build the floor for the medical clinic on the catamaran, he gladly accepts the job, and within a couple of days the floor is installed.
Port Vila's market; a cornucopia of tropical produce! On Sunday the whole team accompanied by chief Tokon Sam and HangHang visits the Presbyterian church; as all churches in the tropics an open church without outside walls. It is Pentecost, and the chuch is full, not a seat is left. When the pastor starts a wonderful sermon about the Holy Spirit, the wind starts to blow through the church: God wants us to know that He is with us and we are in awe of His message. It is custom that all two hundred people shake visitor's hands after church (which we do with a big smile).
The next day we have a meeting with four other cruisers who are all offering help with the project. Lori and Louie from "Awestruck" give us their complete medical emergency kit and offer to go with us to Ambrym: they have a generator that can power Jere's Xray machine. Jenny and Chris, the couple that just got married in Fiji, offer to stay till our shipment arrives from the UK. They will pick it up and bring it to us in Ambrym. Then there is Willie, the German/Canadian solo-skipper of China Moon, who simply says he wants to be part and help and, last but not least, there is Dutch/German Kees Gorter with his boat "J' Arrive". Kees is the first patient for our doctors; in an unfortunate manoeuvre he breaks a rib! He then decides to give up his plan to go to the Phillippines (where he has 12 adopted children he wants to personally deliver toys to) and dedicate himself to the project this summer. Kees has many valuable skills and so does his first mate Daniel Fisher, a social worker from Switzerland and former crew member of Flying Angel......
Yes these are blessings, too many to count.
On Wednesday June 6th we are ready to set sail, however it now blows 35 knots and reports are that it is nasty out there. Since we have several people who have not sailed before, we decide to wait it out. HangHang tells us to wait till the weekend the people on Ambrym are cleaning the beaches and the villages and they are preparing a ceremony, we are expected Monday morning at nine.
When we leave port in the early morning of Sunday June 10th the weather has settled down and we actually have a wonderful sail. Peggy and George are still on Rivendel. Dennis and Jere are sailing with Kees and Daniel on J'arrive and Don and HangHang are sailing with Jim and Jaime on Flying Angel; a whole convoy....
Because of confused seas quite a few team members get seasick, but that is soon forgotten when we arrive on schedule Monday morning at 9.
Henk and I go ashore to meet with the chiefs and there we are asked not to leave our boats since the ceremony is postponed till tomorrow.... (they later change their mind and welcome us to go ashore). It is actually nice to recover for a day. The doctors go to the clinic in Nabul with nurse practitioner Joseph (45 minutes by dinghy plus 20 minutes walking) and we start setting up the catamaran tent clinic. People in dugout canoes are starting to surround our boats, curiously looking where the "American's Mobil Clinic" is and laughing hysterically when skipper Jim Fitch demonstrates his trademark "bomb" diving technique off the bow of Flying Angel.
Discussing the Project with community leaders In the afternoon a handwritten program is delivered to us, with the following contents:
"PROGRAME OF WELCOME AND OFFICIAL OPENNING OF MARC PROJECT OF MOBIL CLINIC AT RANON VILLAGE IN LOLIHOR AREA
- 7.30 ARRIVAL COMMUNITY
- 8.15 MARC MEMBERS ARRIVAL SALU SALU PRESENTATION ( wre are given a handmade flower wreaths)
- 8.20 STRING BAND WELCOME
- 8.30 WELCOME SPEECH CHIEF L.FLEX
- 8.35 SPEECHES
LOLIHOR CHIEFS REPR. CHIEF JOB T.
" WOMAN " WINSIE T.
" CHURCH " R.TOREN
" HEALTH " DR JOSEPH ATEL
N AMBRYM AREA ACC SECARTARY GEORGE R.
LDC SECARTARY JOHN R .
MARC PROJECT MANAGER RESPONSE
- 9.15 OFFICIAL OPENING PRAY FOR PROJECT PASTOR N.T.M.
- 9.20 PROJECT PROGRAMME DECLARETION LDC CHAIRMAN
SIGNED
LENGKON WILLIAM
What can I say.... we are stunned. These people have looked forward to this for a year. By the end of the program I have tears in my eyes.
An interesting detail is that the prayer in Bislama speaks about God as the "Big One on Top"
We are offered "drinking coconuts" and there is time to meet with everybody: nurse Alice does not have her glasses anymore: she had to give them to a "higher authority" who couldn't read his Bible.... I will replace her pair as soon as the boxes arrive.
Doctor Joseph has received the much desired Doppler stethoscope on schedule ( in January) but shyly admits that he doesn't know how to work it. Doctor Dennis promises to teach him
Today (Wednesday) similar ceremonies are scheduled in secondary and elementary schools; the children are adorable. Surprisingly, the secondary school has all the supplies they need (sponsored by the US Peace Corps) but in Primary school there is absolutely nothing, the first graders sit on the floor, the second graders have desks, there isn't a pencil or a piece of paper; I can't wait till the boxes arrive!
The rest of today is spent to organize the clinic an sort out problems with water, garbage and how to power the Xray machine.
Dennis goes with Doctor Joseph today to attend Joseph's prenatal clinic in Nabul and learn about local procedures.
While Dennis is there a baby is delivered (with use of the Doppler!), it is our first Project MARC baby and he is named Dennis! In the afternoon a very very sick baby with a bronchial infection is brought into the clinic by his desperate parents. After treatment Dennis judges the condition of the baby too unstable to send him home. He takes baby and parents with him in the dinghy and right now they are all peacefully sleeping in our mobile clinic tent on Flying Angel. Kees has repaired the water pump and the solar panels for the Nabul clinic. Jere is hoping to set up his "Xray clinic" in the library of the Secondary school and is hoping that the Acting Principal will let him use their generator.
The entire team is happy but very tired and enjoys "Happy hour" and a good dinner on Flying Angel.
The day ends with a harrowing experience. An hour earlier the wind has picked up and when Kees and his crew return to their boat by dinghy, they find an empty spot instead of "J' Arrive". Rivendel immediately pulls anchor and starts a wild search. An hour later we get a strong image on the radar and "J' Arrive" is found five miles off shore with her anchor dragging and it is midnight when everybody finally gets some well deserved rest (for a complete story please read " The solo departure of J'Arrive" on the www.terrawatch.org website).
Tomorrow is the big opening day. We will start at 6.30 with a meeting and open our clinic at 7.30. Everything is organized into details by the chiefs: out of no fewer than 16 participating villages, two or three selected villages will send their patients each day: a (handwritten) list with the patient's name and medical problem is provided for each village.
While we are looking forward to have the weekend off and visit the volcano, the chiefs have put us to work and have scheduled visits of the team to those patients who are unable to walk.
This is all so exciting, I am almost stumbling over my own words, and this all without the boxes....
God still works miracles!
Nelleke.
(Report III)
Dear family, friends and supporters,
We are awakened by a lot of noise on the beach and cannot believe our eyes when we, still tired from last night's adventure, peek out of the hatch.....
The beach is full of people waiting to be seen at the clinic!
Besides being excited we also do have a lot of anxiety... can we live up to these people's expectations... will we be able to overcome the language barrier... do we have adequate medications and will we get the Xray machine to work....?
Throughout the day some problems get solved, other problems are added.
Solved are the problems with the Xray machine: one of the villagers owns an old diesel generator that Kees Gorter manages to repair and rewire for 110V. The villagers also carry the heavy generator up the hill to an old French trading post, now serving as a community house, and help Jere construct a dark room from rolls of black plastic sheeting. By the end of the day the "Lancaster Xray Clinic" produces what may be the first-ever Xray exposures developed in North Ambrym: test images of Kees' ribs and Jaime Rodriguez' hand (see website story of "J Arrive").
Other good news is that the secondary school (a boarding school for Malampa Province), has running water and can provide our mobile clinic with water (Flying Angel has a capacity of 300 gallons, whereas Rivendel only carries 120 gallons). Secondary school students have offered to do laundry for the doctors and the chiefs will provide fresh fruit and vegetables in exchange for medical care. We can deposit our garbage on the beach and the people from Ranon will burn it for us. The language problem (some people speak a little English or French, all speak Bislama but people speak mostly their own tribal language: (120 different languages in Vanuatu) is made a little easier by translators volunteered by chiefs and/or teachers. A little "dinghy ferry" is rigged to bring patients to and from the catamaran clinic). The chiefs have organized for us to see patients from two to three villages per day and that first day the catamaran clinic team sees a total of 32 patients.
Problems added are: skipper Jim is ill (the doctors briefly fear that he might have malaria) and first mate Jaime is partly out of the running since he has severely damaged his hand and broken his thumb during the rescue operation for Kees' boat. That leaves all the cooking (for now 11 people and sometimes also a patient or one of the local nurses) to Peggy and me since everyone else is simply busy with other project tasks. Meanwhile, Peggy and I have immediately been tackled to teach in the mornings at secondary school, which we both really enjoy, but we are a bit rusty and it takes some preparation. Flying Angel keeps having problems with the head (toilet) and - like many other items - the replacement head is "in the boxes".
Also, with so many patients our small supply of borrowed medication is quickly running out. The outpatient clinic team has discovered that a large percentage of the patients they get to see has knee problems due to carrying heavy loads up and down the steep mountain trails on a daily basis, and that there is little they can do about that. They give out as much Ibuprofen as we have, but by the end of the day we have run out and obviously that is not the preferred solution. The work of the doctors is hindered by the absence of our cots (in the boxes!). The stretcher (annex examination table) we have borrowed from CMS is very low and doctors Dennis and George have to examine the patients while sitting on their knees.
Accomodations on Flying Angel are a bit more "basic" than we expected and some of our older volunteers are, understandably, not one hundred percent happy although they try hard not to complain. Henk and I try all we can to keep everyone healthy and smiling but I can't help thinking at the end of the day that this is maybe a bit more than we all bargained for. However nearly all patients appear to be extremely grateful and so far only one patient was mad: the doctor had not given him any pills and everyone else had received pills... (the truth was that there was nothing physically wrong with this patient that would justify the use of pills...)
The last patient is seen at 6 pm that day, Peggy and I are sweating in Rivendel's small, poorly ventilated galley and where as the dinner smells pretty good, Peggy and I smell like.........
But when all eleven of us sit cramped, tired but very happy and satisfied in Rivendel's cockpit that night, a small fleet of canoes paddles quietly around in the dark and angelic voices softly sing native songs for us.
What an incredibly sweet Thank You......
The next day we see even more patients and we are starting to run short of antibiotics, Ibuprofen and pain killers. But....here arrive the yachts "Awestruck" and "Ingrid", both loaded with the boxes from"Echo", a pharmaceutical distribution company in England! This immediately lifts everyone's spirits and many more patients can be helped.
(l) One of the beautiful swimming holes near Ranvetlam
(r) Presbyterian Church in Fanrereo accepting a gift banner from First CRC in Salt Lake City
We have managed to keep the weekend free for the team. There is time for laundry (salt water only), swimming (we haven't seen a shark yet) and time to talk and re-evaluate.
The girls go see a movie on one of the yachts while some of the the guys go on a wild pig hunt.
In the afternoon we all walk to Fanla, the cultural center of Lolihor and the center of North Ambrym's much feared black magic, and have the privilege to enjoy "kastom" dances. It is a historic moment for Project MARC when Henk presents Chief HangHang James with a copy of the Memorandum of Understanding.
The boys have returned from the pig hunt and managed to conquer two wild pigs: they immediately start to make preparations for a barbecue. That night we have a potluck on the beach and eat wild pig. Today Willie with China Moon has also arrived, our moving community keeps growing.
We see three emergency patients in the weekend: a little boy who has almost cut off his hand with a machete, six kids with open boils and a French cruiser with a soar throat. Our doctors never complain.
We go to church in Ranon and in the afternoon a few of the guys go diving. Jimmy catches a large fish and makes a fantastic dish for all eleven of us. What adventures, what challenges, what fantastic rewards, what blessings from " The Big One on Top"
Amen.
Nelleke
(Report IV)
Dear Family, Friends and Supporters,
Hard to believe, the first team has finished today!
It has been a rewarding first month, as Jere Lancaster (our radiologist) put it: "Incredible to see God at work, using us as his tools".
Between 300 and 350 patients have visited our mobile clinic during it's first 2 weeks of operation. The impressive organization of the Lolihor Development Council and the village chiefs is paying off. Local "health workers" and "translators" accompany each group of villagers. Hand-written lists with patient names and medical indication are even provided.....
We are definitely a bit overwhelmed these first days. Our original schedule called for working hours from 7.30 a.m. till noon and the afternoons off. But with a beach full of patients still to be seen and knowing that these people often have walked more than an hour to make it to the clinic, the doctors decide to work through the day, more often than not till six at night.
It becomes clear that much of what we are doing is primary care, supposedly to be provided by local nurse practitioner "Dr. Joseph"and by the village aid post workers. But most people never make it to Joseph's Health Center in Nopul and all village aid posts in Lolihor district have been closed for a long time. The patients come to Flying Angel with series of complaints ranging from pain in the chest, problems with knees, headaches, diahhrea ear aches and vaguely described pains they had, sometimes twenty years ago..... They are surprised and almost irritated when the doctors (using the translators), ask more questions such as: "Where exactly in the chest is the pain?". Well, they just said that: right there... fifteen years ago and yeah... here too, last year....
It becomes clear that these people never have seen a doctor and don't know how to make the decision to seek medical help. The same counts for the students of the secondary school, a boarding school for a relatively privileged group of children from Malampa Province (consisting of Malekula, Ambrym and Paama..). To our surprise many of them complain of "heart disease" (translation after many questions: they feel their heart going fast when they play soccer or other sports....). No idea of how the body functions and when a doctor is needed.
However, most of the problems do need medical attention. Emergency care is provided in the form of stitching up fingers and thumbs nearly cut off by the large machetes. Everybody, including the little kids,walks around with these large knives used mainly to cut coconuts. Many children come with ear infections and boils, especially on the legs. About 70 percent of the patients come with knee problems, often combined with shoulder, chest and lower back pains.
It does not take the team long to figure out what causes these frequent orthopedic problems. The explanation is that the gardens of these people are located high up the mountain. Every day they climb the very steep, narrow and often muddy trails with heavy loads (50 pounds is no exception!). Often children in the 6 - 10 year range already do their share of the carrying. No wonder the knees give out after so many years. There is neither an immediate cure nor a llasting solution to this. It is a bit frustrating to our doctors who realize that an enormous amount of Ibuprofen is needed to relieve the pain but that this is hardly an adequate solution. We have a pretty intense discussion among ourselves that night (over a delicious fresh fish dinner). Creative, though not necessarily practical, ideas to help solve the problem vary from introducing mules or donkeys to the island, create gardens closer to sea level by making the soil more fertile and productive or starting an Ibuprofen factory on the island, and when we are eating desert, a delicious chocolate cake made by skipper/ chef cook Jim, we still haven't solved the problem of course. In the meantime, people are on the waiting list for the "wonder drug" while we still await the arrival of "the boxes".
(l) Young firewood bearers on North Ambrym's black volcanic beach
(r) Elvina carries her load with a proud smile but is likely to develop shoulder and chest problems later in life
On the 18th Henk and I sail Rivendel back to Port Vila, accompanied by skipper Kees Gorter from "J'Arrive" and patient Sule who needs to undergo eye surgery in Port Vila. It is a tough trip with hard winds and Sule gets very seasick, but we arrive safely two days later. That very day the big freighter with our boxes has come in, two days late and perfect timing! Clearing customs provides no problems and pretty soon we are opening our treasured boxes which take up the entire space in the office of "Pacific Transit". We immediately have the complete office personnel standing around the boxes which makes us realize that these people too are poor and often live in carton board boxes. So we create a little Christmas: they all get presents, bibles and, if needed, reading glasses. Even Danielle, the French lady who is the director of Pacific Transit and who has helped us so much, needs glasses, because, for years she says, she hasn't been able to read the pages with the rates for the shipping....
After this "Christmas in July", there is no stopping them; they all help and work hard to get the boxes empty, organized, repacked and transported in their miniature truck to Rivendel. They even bring us lunch and at night we are invited for a barbecue at a friend's home.
Using the "Namba Net" (an SSB radio frequency for cruisers), we are able to round up two more boats who will help transport our supplies: "West Wind" and "Blue Banana" come to the rescue. With the contents of the big boxes, new stores for the team on Flying Angel plus newly arrived dentist Pam Hilbert and daughter/assistant SueLin (a medical student) with their luggage, Rivendel nearly sinks under the load, we only dare to fill the watertanks half full. But once more we have a rough but very fast (120 NM in 20 hrs) passage: "Quite the ride" as SueLin puts it!
When we arrive it is Christmas all over again: Ibuprofen and antibiotics for the patients, supplies for the schools, fresh food for the team and a dentist, the first ever to operate on Ambrym.
In addition to the medical tasks, we have also worked hard on the educational aspects of Project MARC. Whereas we didn't really have a plan or an agreement with the government, other than delivering supplies, we are begged to do some teaching, in particular about hygiene.
Peggy gives it her all and gives a well-structured lesson about hygiene.
We encourage the kids to ask questions but do not get one single reaction: they are simply too shy .. I think I have a solution: I give them all a piece of paper and tell them they can ask us any question they like. It works: they write down more questions than we can answer. How old are we and how many kids do we have how is life in Utah and in Texas and can we bring them watches, camera's and "spi glasses" (boys only question). One question really puzzles us: " What causes IG or Igen and how can it be treated?". Peggy finally figures it out: IG stands for Hygiene and they have not quite understood the word "hygiene", so we go back and Peggy explains it once more in detail. After a few weeks and a couple of presents all the kids are feeling free to come and talk to us and it brings a big smile to my face when I sit on Rivendel's deck looking back at a days work and I see the girls on the black sand beach waving and yelling "Hi Nelleke...".
And then we are back in Vila once more, after a 40 hour slog against 20 - 30 knot tradewinds, and the five members of the June team (Dennis, Jere, George, Peggy and Don) are ready to fly back home. They are tired, a bit dirty and longing to be reunited with their loved ones, but spirits are high. We have become a family and there are tears when we say our goodbyes... All of them want to come back to Ambrym next year and go home with an experience they will never forget.
For Henk and me it is cleaning the boat, stocking up, doing repairs and welcoming the new team members who are starting to come in tomorrow.
Up to a new adventure.
Love to all of you!
Nelleke.
P.S. Sedona I have found our poster girl "Miriam" back, her real name is Elvina!
(Report V)
Dear Family, Friends and Supporters,
Part of the first team (Don Koons) is still aboard Rivendel II when the next team already arrives; Holly Reighard, Rick Luger and Ray Godin all arrive on the very same day with different airlines and at various times. Jane Gyllenskog is expected two days later. They help with errands (more supplies from the big boxes), repairs and stocking up and spend two wonderful sunny days in Port Vila.
I am able to get the temporary licenses again from the Ministry of Health (MOH). A time-consuming chore every time since these documents can only be signed by the Director General (DG) and the DG is often "overseas". I finally get the documents, after three trips and four phone calls to the MOH and a last minute signature at five minutes before five signed at the DG's home......
I am also able to contact the local Rotary president (have to try my best French, since that's the going language here) and get the letter necessary for the Rotary grant application. For the same purpose I get a letter from MOH. All these errands are like pulling teeth and take too much of time I really don't have.
The day before we leave, Henk takes me to a small place right at the waterfront where our boat is docked; it is for rent and would be fantastic to have available for MARC office, storage and stranded MARC team members or access luggage. Rental property is scarce and very expensive (we earlier found one large basement room, without view windows or any facilities other than a sink, for the price of $750 per month). The appartment has two bedrooms, a large room with a counter and hookups for kitchen appliances and is only $340!!
Yet, after thinking real hard I turn it down, the MARC budget is too tight. I fret about it all morning... did I just make a big mistake....? On my way back to Rivendel I run into Henk who is coming back from the email cafe which, for a change, is open and working today! "Good news" he yells... "somebody has made an offer on our house and it looks serious!" Oops, is my first thought, maybe I have made a mistake..... I pray about it and take a taxi back to the real estate office....the appartment is still there and an hour later I have signed the rental contract and MARC has an office here in Port Vila!!! We celebrate that night: the team takes us out to dinner and we have a great time.
In the meantime we are still waiting for Jane; she has sent us an email informing us that she is stranded in Fiji (no plane available) and is waiting to pick up a connection, probably via Australia..). Jane finally arrives one and a half day late and more dead than alive from the long strenuous trip (from Nandi Fiji they have rerouted her to Sydney, from there to Brisbane and from Brisbane to Port Vila!!). Unfortunately we have to leave immediately as the dental team needs to be delivered in Santo within a few days. Jane crashes in one of the bunks and doesn't wake up until we are back in the Ranon anchorage, 24 hours later..
A lovely trip this time, very light winds and we are mostly on the "Iron Genny" ( motoring rather than sailing). Ray gets the fishing pole out and a few hours later Rick reels in (after a 15 minute wrestle) a beautiful Wahoo, enough for two dinners.
Holly gets seasick, Rick gets queasy and Ray really enjoys the sailing. We are blessed this trip: for long hours we see the red, bellowing steam clouds of the volcano Benbow on Ambrym, a fantastic sight during the clear starry night.(Thursday June 5th)
With Flying Angel all is well, while we are in Vila, Pam and SueLin have turned the "Lancaster X-ray House" into a dental clinic. They have treated approximately 80 patients during the nine days of work. They are a joy to watch, they look very professional and the patients submit to treatment with full confidence.
The majority of the patients need extractions because cavities until now have gone untreated (Pam is the first dentist on North Ambrym ever....). The cases are usually straightforward, only once in a while an X ray is needed. Tooth decay seems to develop mainly by the fact that people have no toothbrushes and have not been taught to use toothpicks to clean and
keep their gums healthy. The diet doesn't seem to cause much decay or plaque. The drill is used only occasionally for fillings, and it is really a sight to see the drill as well as the "watersuction" device being operated by the pressure from our hot green,"multipurpose" dive tanks!
As we have noticed earlier, people's treshhold for pain is much much higher than we are used to. When I video in the dental clinic and watch the lady who just gets shots to prepare for the extraction, her face shows delight as if she were undergoing a facial instead of a dental procedure. An older man, who has come in for an X ray the day before comes in to have some roots removed. Pam and SueLin proceed with their preparations and apply the shots. As Pam is checking the patients status, he all of a sudden changes his mind, gets up from the table and says he wants to go home.... Pam lets him go..
The plan for the July team is to see those patients who need follow up, patients who have been referred by nurse practitioner Joseph, handle emergencies and set up the beach tent for patient treatment. In addition some team members will walk to the higher villages in the mountains, to see people in their huts who are unable to walk to the clinic. Since we haven't been able to recrute a doctor for this team, Henk, though still a bit rusty, is the licensed doctor for this month.
We have barely dropped anchor, at 8 in the morning, when skipper Randall from "Westwind" informs us via the Namba net that yesterday night a boy has fallen out of a coconut tree; he appears to be unconscious and probably needs stitches. Welcome home....
On Flying Angel a medical kit is quickly put together and pretty soon the boy, who in the meantime is "back with the living" has the big gap in his head stitched up and his badly injured foot taken care of. The rest of the day is messy, the team is supposed to go to the Joseph's clinic in Napul, but the engine of the new Project dinghy was left broken and things in the mobile clinic are a mess. Rick frantically tries to repair the engine and almost gets blown out to sea (no oars in the dinghy and engine quits...). Fortunally I witness what is happening from Rivendel and row like crazy in Flying Angel's small dinghy to recover Rick (and the dinghy). Further efforts are unsuccessfull; a part is needed and it has to come from the US. Eventually, however, the dinghy drivers all learn to start the engine with a simple piece of rope and a hard jerk.
Food supplies, water, diesel, gasoline and propane are all in short supply and need to be managed by us more cautiously in order to make it through the month of June. Living on a boat is a very delicate balance!
In the meantime, all cruising boats that are carrying Project MARC supplies arrive in the anchorage, one after the other. Siddique, a boat from New Zealand, Glory Days (met them earlier in Port Vila) and Blue Banana all need time and attention and need their supplies dropped off by dinghy at Rivendel or Flying Angel. Blue Banana hast lost its engine and is towed in by Glory Days who has taken over the MARC supplies. Blue Banana also brings Yael, a girl from Israel who has heard about Project Marc, asked Blue Banana for a ride to Ranon and now wants to help the project.
This has to be done in the proper way, if possible at all, and I have to find her living quarters somewhere on land. Two hours later that problem is solved; the two peace corps teachers Kristy and Eric will take her in for a while. At night we cook our wahoo for dinner and just another day in paradise went by.
The next day Pam and SueLin visit the schools and look into the mouths of roughly one hundred and seventy school children, to get and idea of what is needed for next years visit.
Yael receives and email from her family and needs to go back to Israel as soon as possible. West wind and Glory Days are helping to get Blue Banana's engine back and as soon as the repair is done they will sail Yael back to Santo where she can catch a plane.
The day ends on a cheerful note as Ranon and Fanrereo have organized another farewell party with presents for Pam and SueIin. In the meantime I have unfortunately gotten sick and I miss the party. I am too sick to help Henk sail to Bokissa island where Pam and SueLin need to be dropped off. They want to spend a few days diving before returning to the US. But Ray offers to go with us and once more we are blessed with very mild conditions and have a very quiet trip mostly on
the motor, giving me a chance to recover and rest.
While we were gone the new team (Holly, Jane, Ray and Rick under Henk's supervision) has settled in and on Monday they are ready to go.
Here is what happens on a typical day in paradise:
Before breakfast a man with a bloody mess on his hand sits patiently on the beach. No one will ever ask to be helped or inform us that there is an emergency, we have to notice them and invite them over to the clinic. About fifteen patients are patiently sitting on the beach and so are the assisting health workers and the translators. Rick pendles the dinghy to shore and ferries the patient, who appears to be the husband of the primary school principal, over to Flying Angel. He has gone fishing at dawn and the fish he hooked has ripped out his fingernail and bitten off the top of his index finger..... Ouch... He gets stitched up and medicated and is immediately the hero of the day once back on the beach.
(l) The beach tent clinic in Ranon proved to be our second viable "mobile clinic" option
(r) Nurse Jane examining Killian , the "head masta" of the primary school in Ranon
Thirty people come in for reading glasses, mainly for the purpose of reading their Bibles. One woman looks familiar and when Jane fits her glasses she accidenly gives away: oh these are much better than the ones I got yesterday.... Jane becomes strict: she does not get the glasses. Three people come in with glaucoma and for some who have pterygium problems she issues sunglasses. She doesn't buy the mock complaints of the young man who come in later that afternoon, just to get the
fashionable sunglasses....
When Rick and Ray are not there the women come by for "female advice". One young lady with back problems (Holly has given her Ibuprofen) comes back later to see Jane and asks very shyly:" Can those pills help me get a baby......?"
A mother comes in with three children, all children have a fever, a runny snot nose and ears of which the drums are bulging... How old are the children Jane asks. The mother has a painful look on her face and finally sighs...."this one 92, that one 96 and (after a long pause) this one the year my mother dies".
The usual "Ibuprofen patients" show up for their sore knees and backs, many just want "plaasta" (bandaid) and a bazillion kids with deep boils on legs and arms keep the team extremely busy. Jane thinks some of the wounds are scabbed over but at further inspection it turns out those are not scabs, but firmly packed black sand....
One girl with lice gets shampoo and some good advice and then the sun is already going down, it is 6 o'clock when the last patient leaves.... a total of 79 today...
Needless to say the team sleeps well, though going back and clambering on to Rivendel in a dark stormy night is often and added stress factor. Sleeping on a rocky boat is also not everybody's piece of cake, certainly not Holly's!
When the work on Flying Angel is finished we split the team in small units. Rick and Ray set up the beach tent and will work with Jane and Holly using the beach tent as clinic instead of "Flying Angel".
Henk and I go up into the mountains to visit those patients who are unable to walk to the clinic, the trails are often steep, narrow and muddy but they lead us through paradise. Birds are singing, exotic flowers are blooming and the sun filtering through the ages old trees makes walking through this garden of Eden a celebration of The Lord's creation.
The villages we have to visit are far from Ranon anchorage, we do the first part by dinghy along the shore. A translator from Ranon village travels with us, he knows where to bring the dinghy ashore and how to avoid the sharp coral. We leave the dinghy tied up on a small white coral beach and walk an hour to the first village.
We meet with chief Ramel from the village of Megham, he sets us up in the village's "nakamal" (meeting house) and we have barely taken our heavy backpacks with our movable clinic supplies and the entire nakamal is filled with patients, mothers with babies, older people, children and dogs... Henk and look at each other: this is not what the agreement is: the visit to the villages is meant for people who are unable to walk and come to the Flying Angel clinic.... But for a mother with a very sick baby a one and a half hour walk is of course very far.... so we just have little choice but to go to work. We ask for water to wash our hands and within an hour and a half we have seen and treated 16 patients. Of course all "pikanini" (children) get balloons, tooth brushes and the moms get baby clothes and soap.
One little patient still haunts me in my dreams: a little two month old baby who has stopped growing, the baby is alert, but weighs barely 7 or 8 pounds. We have asked nurse practioner Joseph's special attention for this little baby girl (Stebin is her name) and I am requesting prayer from all of you.
(l & r) The most gratifying mobile option prove to be the "village walk-abouts". Doctor Henk examining two elderly patients unable to walk the long distance to the catamaran or beach tent clinic.
We do visit a number of very old people in their huts and are often able to provide treatment and comfort, the bamboo huts are dark and unventilated and this is their entire world. I have to swallow when Henk treats a very fragile old lady for bronchitis, she is so thin and has lost most of her eyesight. Henk's very careful exam apparently hurts her, I take her hands and stroke her and I see a tear rolling down her cheek...
In one of the huts we are asked to wait; they want to bring in a young patient who is ill. Minutes later the entire village seems to be there when they carry in a big boy and want Henk to look at him and make him better. We both immediately see that this is a severely mentally handicapped boy. It hurts to tell them that there is really nothing we can do. But I am able to establish some contact with 11 year old Mario and where he is first very scared of the balloon I blow up for him, he recovers and makes eye contact with me. We encourage the mother to keep teaching him and working with him and we leave with a "bye Mario...see you next year...". he keeps following us with his eyes until we are out of sight.
On we go another hour through this incredible jungle and up to the next village; I bet we are a sight for a movie... In front is chief Ramel armed with a hughe machete, followed by Henk and me; our translator Billy makes up the rear also armed with a big machete. The same scenario in the next village: sick and old people in their dark huts, happy children as I pass out lollipops and the entire village waving us out.... see you next year.. sipa... (thank you in their language). It is completely dark when we walk the last of the trail and we are exhausted but very happy and thankful for what we were able to do today.
The next day I read the patient logs and add up numbers:
~ some 400 patients (approx 20 villages) treated in the catamaran clinic;
~ 180 patients treated in the beach tent clinic (July team, sofar);
~ 62 patients were seen in their huts or village (12 villages);
~ 80 patients were treated by the dentist;
~ 45 people were X-rayed; and
~ 165 primary and secondary school children were screened by the dental team.
That makes a total of 930 patients in North Ambrym. We also re-supplied one Health Center and two Aid Posts and repaired the running water system and the electric power supply for the Napul clinic. One nurse practitioner, seven health care workers and two assistent nurses received practical health training and thirty villagers were given education about the cause of arthritis. In secondary school lessons in hygiene and health were given; two schools were given a year's school supplies and..... fifteen children were sponsored by MARC team members to attend primary school for 1 year (about 30 % of the children does not attend primary because parents cannot afford the 1000 Vatu -- US $ 7 -- per term).
We are very excited about what we were allowed to accomplish and so are the people of Ambrym who have not only been our patients but have given us their friendship. They express their gratitude with an enormous party the last day we are in North Ambrym. We don't want this but there is no stopping them.
They slaughter a cow and prepare a wonderful dinner with laplap made from taro, maniok and yam . The stringband is there again and there are speeches from the chiefs and the president of the Loilihor Development Council. In their limited English they express themselves very well: thank you for the medical help it was much much more than we expected, thank you for giving it to our people for free and thank you for being our friend...
There is prayer and there are presents: Henk and I are presented with a palm leaf, impressive wood carvings (made by chief Joseph), handwoven mats and handcarved flutes. If that were not enough we receive two live roosters.... All team members are recognized with presents and it is an evening we will never forget.
Fortunately we have presents for them too: a portable drill, a generator for the village of Faramsu, a charger and a rechargable floodlight, two portable VHF transceivers and a laptop computer for the secondary school are part of our presents. The next day chiefs and principals receive are trained how to use all this new material. Chief Job is pretty scared when he looks at the portable VHF, but he is beaming from ear to ear when he is able to talk to Henk all the way from Faramsu high up the hill. Modern technology...... Mr. Bong, the principal of secondary sighs in utter amazement....... But they are all fast learners and this morning Henk and Nurse practitioner Joseph have a lenghty medical consultation by VHF radio. The main topic is little baby Stebin....
Love,
Nelleke
Project MARC Movies
The MARC@WORK movies on this webpage were produced by Peter Brouwer and Sylvia Steinert from video footage shot while traveling with Project MARC volunteer teams in September of 2005.
