Friday, April 13, 2007

Wash Your Hands!

This from my buddy Gita who left CRS to work as a PR chick at the Red Cross (I forgive you!). Check out Relief Web for more information, uplifting or depressing, depending on your frame of mind, on what's going on in the world to help people who are not as fortunate as you and me.

Indonesia: Improving water and sanitation through community training in Aceh - Apr 5: Relief Web

By Gita Modgil, Canadian Red Cross, in Banda Aceh, Indonesia

Yanti walks towards her house in the Walubi temporary living centre where she has been staying with surviving members of her family since the 2004 tsunami destroyed her home.
Along the way, she meets her neighbour’s daughter, Putri, who is washing her hands. “Are you using soap?” asks Yanti.

Putri smiles, says a big “yes” and runs off to play with her friends.

Yanti is part of a new group of community-based outreach workers, who are leading efforts by the Canadian Red Cross to bring hygiene care and sanitation promotion to communities across Aceh.

“I encourage them to wash their hands with soap after latrine use. When preserving cooked food, always cover it with a lid. They listen to me carefully and try to follow the instructions. It’s the first time they’re hearing these messages,” says Yanti.

Around 114 community health volunteers have already been provided with Participatory Hygiene and Sanitation Transformation (PHAST) training by the Canadian Red Cross. PHAST training uses innovative approaches and tools to promote hygiene, sanitation and community management of water and sanitation facilities.

“The underlying basis for the PHAST approach is that no lasting change in people’s behaviour will occur without understanding and believing, and this requires culturally sensitive and appropriate health education. The training method employed by Canadian Red Cross uses tools that are very participatory and visual, like community story telling,” says Meiry Nasution, a hygiene promotion coordinator for Canadian Red Cross.

Canadian Red Cross is combining the PHAST training with much-needed sanitation facilities for over 16,000 people spread across 12 temporary living centres in Aceh. These include the construction of bathing and washing areas, latrines with improved safety features for female users (such as lights, locks, and garbage bins for disposal of sanitary products), septic tanks, as well as providing cleaning materials.

“After the tsunami there was an increase in stomach aches and diarrhea but even before the tsunami we used to suffer from scabies and other skin diseases. But the interventions carried out by agencies like Canadian Red Cross have assisted us in reducing that. Because of the PHAST training I know that my children would get these skin diseases because they would go to the bathroom in front of our house and then play near that area,” says Dahaiyar who recently received PHAST training.

Yanti, her friend Mala, and the other community health workers in Walubi bring together the whole community on one day each month to clean the temporary living centre. Yanti puts together a list of responsibilities for each member during the community service day known locally as ‘Gotong Royong’.

“I like to see the barrack clean. Even though we don’t get a salary, we do it for our community. The training gave me the knowledge I needed to make my community better and safer,” says Mala.

“The volunteer community health workers are the lynchpin of our efforts to bring quality health care to people and to change their health and hygiene habits. The tsunami has given us a window to raise the bar in the areas of hygiene and sanitation,” says Natalie Jette, the water and sanitation delegate for Canadian Red Cross in Aceh.

Wednesday, April 11, 2007

Yes Virginia, shopping really does cure all ills.

Singapore was fantabulous, even if my hall pass from Banda Aceh was to cure the bronchitis I couldn’t shake for a month. The only reason the dr. in Singapore thinks I didn’t get rid of the bronchitis is because my inflammation wasn’t being treated. The antibiotics were fine. So, even if the bacteria had been slayed, my lungs were quite the holiday retreat for new ones wanting to breed.

So, no magic potion in Singapore, just the right concoctions of meds to cure all my aches and pains. Also nice to have meds with the little sheet of paper in it telling you all about the drug. And in English to boot. Tired of logging on to the Internet just to find that the medicine I’ve been given is not allowed in the United States, is really intended for veterinary animals, or the Web site is all in German.

I can see now why these ‘wellness holidays’ are so popular in the US and Europe. You know the ones; you need a triple bypass, but US insurance is so ridiculous that you book a flight to Singapore, Bangkok or India for your surgery and a little spa and shopping while you recover.

My wonderful hospital was RIGHT ACROSS THE STREET from an amazing shopping mall. I made sure I had enough time to window shop before my appointment. I’m certain I didn’t look to out of place with my little Coach bag in one hand and X Ray films in the other drooling at Marks & Spencer.

Not enough time to do any damage to the Visa, but I did make it to my doctor’s office in time. I was only one of about three Caucasian people in the entire medical facility, and also probably one of two above the height of 5’2”.

After more hours of testing, breathing into various contraptions, more X Rays and the like, I was released. He wanted me to stick around for a few days, but silly me, I wanted to get home to the kiddies.

The X Ray alone was worth flying to Singapore. When I first showed the doctor the X ray from Banda, he just said politely, “not the best quality I’ve seen.” He showed me the old Banda X ray and the new Singapore X ray side by side to show me that my lungs were good (a.k.a no permanent damage from a month of inflamed tissue). Wow! While it looked like whoever took the Banda X ray had an astigmatism, I felt like I was taking some virtual reality tour of my lungs when looking at the Singapore X ray. It was like I was swimming among the bronchioles. And all for about $30 US.

Anyway, back at the hotel room, eating a late lunch so I could take a handful of pills, I started negotiations with SOS for my flight back. I settled into bed that night thinking I would be leaving Monday morning (giving me a day to relax in Singapore. Visions of a massage and many heavy shopping bags danced in my head.) Then the phone rings and my case worker tells me brightly, “Alright then! You’re all set! The driver will be at your hotel in the morning to pick you up at 6!”
WHAT! So close to a shopping mall and yet so far,… I begrudgingly turned on the light, and started repacking, feeling sorry for myself. Couldn’t get back to sleep, so turned on the telly and watched some Disney romantic teen movie that was actually quite cute and worth watching because I’d never get away with it at home. Why? Because my four boys (yes, Rob is included in this mix) would rule there was:
Too much kissing
No talking animals
Nothing getting blown up.

Then, I started having the world’s worst foot cramps. Both feet, my muscles contracted so much you could see them moving in my shins. I couldn’t walk, much less move. I sat in the bed wondering how long I should let this go on before I call the hospital to come get me. Thinking maybe I was having a strange reaction having washed down steroids, antibiotics and other stuff with some sushi and a Tiger beer. Then I thought, nah, life can’t be that cruel. After an hour they subsided and I got a few hours sleep.

Next morning, I dash like a mad woman through duty free shops picking up presents for everyone. Toys for the boys, more books for drama king, scotch for Rob. They actually have a scotch taste testing thing going on – at six in the morning! Really can’t think of anything more disgusting, quite frankly. No thanks on that one. Give me a Starbucks any time.

Then, I land in Medan, one stop from Banda. Still in partial paradise. I have ALL DAY to waste until my flight that late afternoon, so I find a taxi to take me to the shopping mall. (Really, what else did you expect?)

I get there at 9am. It’s Sunday, so nothing opens until 11am. Including Starbucks. I walk every inch of that un airconditioned, dark mall. I get excited about a Thai restaurant on the third floor. Bummed out when throughout the day I keep checking back and they have no customers. Have learned not to eat in restaurants that have no patrons after New Orleans experience. (Went to restaurant where first I cut into chicken to find it is still raw. Send back. Get chicken back. Go to take bite of rice and find a little baby cockroach on my fork. Gives new meaning to the term ‘dirty rice.’)

At the end of my day find dumbbells in supermarket (called Hypermarkets here because like Walmart, they sell everything), and heft 20 pounds of sand in plastic, computer and large purse through airport. Try not to kill anyone by dumb bells rolling around in overhead bin on airplane.

Find nice American family with a little blond baby about Sabrina’s age and attack them! Can’t take my hand off that baby’s head. Happy to be going home, even without my Singapore shopping experience.

Monday, April 09, 2007

More Health Issues in Heaven on Earth

Okay Joel, this one’s for you!

And thanks very, very much to everyone who takes the time to read my dribble. I’m glad I am sharing this crazy experience with you. If only I could get smell-o-vision for the Internet. I’m sure there is someone at ESRI who can figure that out, right? Topographic information, temporal information, and now, how things smell,..(rhinographic information? Hola!) Anyway. I digress.

And thanks to Teri’s friend who wrote to me – I can’t respond directly because Blogspot keeps the information on who sends messages (But I KNOW WHO YOU ARE,.. Jim). Thanks for making my day!

Yes, I know I need to update more frequently, especially since I keep forgetting my password to edit this site. That is a sure sign I’ve been a big slacker in the ol’ keeping things current department.

Ah yes, spring. Or if you are an expat living in Indonesia, dry season. The mosquitoes seem to have gone away for the most part. The murky swamps that had overtaken empty fields between houses have evaporated leaving mounds of garbage and vast spaces for fort building by dirty little blond California boys (mine.)

Our efforts to become healthy keep getting undermined. I spent the last month attempting to get rid of a nasty bout of bronchitis that finally resulted in a plane ride to Singapore to get fixed. The lengths I will go to for a little shopping, eh?

We are very fortunate to have SOS health insurance. We’ve always had them in the past, but never used them. I’ve made up for lost time, calling them at every opportunity for Dengue, Malaria, eye infection and now this. If I weren’t living in Banda, I’m sure they would think I had some sort of Munchausen syndrome.

I did find it curious that we had to argue with the doctors about evacuating kids – they were ready to send the Lear jet down the minute I mentioned Jared’s eye was red when I called on the last round of “Guess who in the Richardson family has an infectious disease!” – but when I called about sounding like a gas furnace every time I breathed – for an entire month - and many prescriptions of antibiotics not working, all I got was a ‘Drink lots of water!’. Hmm,.. I know I’m not a nubile little kid. I realize I am a woman of a certain age. I do however think I have some worth to my family and they might want to see me fixed up. Instead, I felt like the British doctor on the other end was ticking off the box entitled ‘Send to glue factory.’

I tried getting fixed on my own. I started seeing various doctors; the first at a clinic next to our house. I took Rob’s engineering department translator to ‘run interference’ for me. Since I also brought a couple kids with me (foot fungus and coughing troubles, might as well get my money’s worth) we of course had the usual small crowd of looky-loos in the examining room. The male doctor apologized profusely for having to touch me but did the examination anyway.

As we were driving home, the translator asked me, “Do you feel like throwing up after you cough like that?” I answered yes. She agreed saying, “I remember right after the tsunami crying for hours and that made me want to throw up, too.”

Okay, WHOA! Not the same thing. I have a bit of a cough. Here is this amazing, resilient woman trying to draw a point of commonality between us. She is describing so matter-of-factly being in her family house on the second floor when the wave hits. Watching her mother and sister loose their hold and get washed away.

What do you say to this?

What do you say in your broken pig Indonesian when you are hanging out in the kitchen and your ‘janitor’ tells you about loosing her six year old child in the wave? She is so thankful that her family (one more boy who is 14 and a husband) were the recipients of a house from another NGO in the area. She is not angry and tells me how much she loves working at my house because of the kids. Oh, and she wants CRS to build her house now because CRS houses are big and her house is so small it doesn’t have a kitchen. (She’s bringing a letter to request Rob rebuild her house.)

What do you say when the man who is installing your new bathroom sink matter of factly lets you know his wife died in the tsunami?

My second doctor here in Banda was a lung specialist who spoke wonderful English. The translator took me to the clinic where the receptionist wrote my name down on a list, gave me a registration card that cost 6000 rupia (80 cents) and told me to come back that evening. I came to the clinic myself (Rob, serving as my driver that evening was charged with dropping off my work computer at the local computer store; it too had a bug).

The only expat in a sea of hundreds of Indonesians; I was terrified. It’ll take forever, I thought. I’ll actually finish this new Michael Crichton book I had to black market a kidney to afford at the Jakarta airport.

I found my room down a dark, dirty hallway full of people. Paint peeling off walls. Trash pushed aside next to the walls. Concrete floors and walls. Lo and behold, the man sitting at a little wooden desk outside the doctor’s office actually had my name on his list. He gestured for me to take a seat on a wooden bench in the hallway and wait my turn. I tried reading between little kids sneaking over and staring. I’d look up, smile and they’d run shrieking away. I know the haircut I got in Bali wasn’t the best, but really,.. (My friend, who we will call Michelle because that is her name, told me “You may be past the age where you can pull off bangs.” Ah, the French; so honest.)

Within minutes I was being seen. One of the first things this doctor said to me was ‘thank you.’ Thanks for coming to Indonesia and helping Aceh get back on its feet after the tsunami. It was so nice of him. Embarrassing, actually.

Then he evened out my karma by sending me on a scary adventure to have my lungs X Rayed in Banda Aceh at night.

He instructed me to go to the General Hospital and give them a little piece of paper in an envelope. I thought for sure Rob knew where the General Hospital was. He didn’t. First on the call list was my friend who happens to be the director of another NGO. He basically gave me a talking to for not opening a case file with SOS (I subsequently did) and refused to tell me where the hospital was because he wasn’t certain it would be safe. Next person on the call list was a local engineer from Rob’s work.

We found the hospital. Not easy; they aren’t as obvious here. Not many lights, not a lot of activity.

Walked in to the front area which happened to be the emergency room. People on gurneys crane their necks to look at us. Man in a white shirt says he’ll take us to radiology. He speaks English, has on a white shirt (white is an official hospital color, right?) We follow him. He leads us to an open hallway with mosquitoes, murky lighting and more peeling paint. He says a few Indonesian words to some people who seem very busy and tells us to wait. He disappears.

I’m beginning to feel like I am in all the horror movies I have ever seen. Hanging out in a run down hospital with people you can’t communicate with. I’m afraid I’m going in for an X Ray and coming out without an appendix.

It reminded me of getting my face X Rayed in Cairo (sinus infection there. Beginning to think I shouldn’t be living in these types of places.) While they had me draped in a lead apron about six feet away from me in the same room were a bunch of workers doing remodeling. And smoking.

All of sudden, the busy people started to lock up. Rob grabbed the last of them; a man with a plaid shirt who had a handful of keys. He tells him our plight. The man gestures for us to follow him. We start the trek back to the front of the hospital. Then, the man starts to walk across the parking lot,.. Away from the hospital

At this point I grabbed Rob arm and told him, “On Oprah they say if you are ever abducted never to leave the area where you were first captured.”

Rob gives me a weird look, but asks the man to stop and explains again that we need an X Ray. The man chuckles, nods and gestures for us to follow him across four lanes of traffic. No wait, this is Indonesia. No one actually travels in a nice queue,.. there are about seven lines of traffic including one for chickens and goats.

Rob tells me, “It’s okay. He’s got keys. He’s official.”

We play real life frogger and come to another little store front where there is a bevy of human activity and a big X Ray machine. I pay my money and wait my turn, striking up a conversation with a nice gentleman from the States who had some little chest pains and came to this X Ray toko to ‘have it checked out.’ I’m seeing white noise again. I want to dig in my purse and thrust all my rupia at him screaming, “Get out! This is your HEART we are talking about for God’s sake!”

I get my X Ray and the man in the plaid shirt with the keys turns out to be a radiologist who takes a look at the film and determines allergies are my problem. Very helpful. (Not)

By the time I’ve been through three more doctors in about two weeks and find myself in a lab trying to hack mucus up into a little cup in front of EVERYONE in the waiting room (I am FEMALE. I do NOT do those things. I also can’t burp the ABCs like the four men in my immediate family and I am proud of this.) I decide “UNCLE!” I sit in the truck and call SOS on the handphone and tell them I can’t continue like this anymore. I am sick of feeling like a martyr not caring if I live or die. I want to LIVE! I insist they find me a real doctor. They oblige and start the wheels turning to ship me to Singapore.

Which, as Paul Harvey used to say, is the “rest of the story.”