Monday, December 20

the blind children - 0830 friday

8:30 Friday morning and I'm sure T.G.I.F. applies much more to a December week in Africa than its New York counterpart as I wake up homesick and ready for the weekend. I unlock my small photo office with its lone porthole and switch on my Powerbook.

I think of a shivering Rockefeller center with noisy tourists and ice skaters gawking at this year's steroid fed tree. A dressed up Madison Ave with inviting twinkling lights and occupied yellow cabs hurtling past its windows like locusts. $80 Christmas trees on 23rd and 6th that don't fit into the trunk, browsing in Union Square's craft market with thirty stalls selling the same thing, one stop Christmas shopping at Virgin and the late night walk from the Angelika to the Mercer.

It's my first Christmas not at the family or girlfriend 's and yes, there are lights and trees and carols and door decorating contests and things green all over the floating hospital ship that is my home but it's always 95 degrees and humid and the thought of Christmas a week away just makes me giggle.

It's 2:30 a.m. in NY and six months ago I'd be sitting in a booth chasing vodka with cranberry or orange listening to 99 problems. But this morning those 7 eye patients are arriving from Nattitingou, a town 500 miles to the north of Benin. It's a story I've been following, and I clean out my hopelessly cluttered outlook inbox as I wait for the call.

It's quite a story... A few weeks ago, Donna, who heads up the eye program onboard my big floating hospital, came into the lunchroom to find it filled with its usual hungry rabble of about 450 nurses, surgeons, technicians, day workers, translators... There was only one seat available, so she sits down next to a Dutch missionary Marjan who is talking about these seven blind children. Marjan is upset because she wasn't able to get these children from their orphanage to our Screening, where we saw thousands of patients to schedule surgeries. Enter Donna. Donna just happens to have eye appointment cards on her, and invites Marjan to bring the children. Marjan breaks into tears, she can't believe that Donna can help her, Donna is happy, and I can't wait to meet and photograph these special kids who are driving 14 hours to be cured and have perfect vision. That's what life is like here, utopia.

Cut to 11 a.m. in a small examination room on the dock and I'm sitting on a crate of medical supplies snapping pictures. The kids are all here and Marjan too, after a long and trying journey. The children look shell-shocked and just plain terrified, but I'm glad they are here and I smile as I hear three of them threw up on the way here, the experience of car travel their first. I'm shooting fast as they are brought into the room one by one and examined, but once we get to Crystal, I put down the camera and realize it's not going well. Donna and Helen, who are examining their eyes, are throwing unsettling knowing looks back and forth, and I start praying. I'm no expert at eyes, having been blessed with 20/20, but even I can observe an eerie similarity in their vision. They can barely see, some can see outlines of a moving hand, some can see that big A at the top of the board a few meters away, but the cataracts we thought we'd be able to remove with surgery don't seem to be the problem with their vision.

It's just me and Donna and Helen in the room now and boy this is going to be rough on Marjan and even rougher on these poor children. It seems their eye conditions have all been caused by severe trauma, probably blows to the head as infants that have detached their retinas. They really do look like they've been beaten, so that fits, but I don't understand why we can't help them see well with an operation and all our western medical technology. Yet we can't. With high end equipment, top eye surgeons flying from the States and Europe to volunteer their time, not a single one of them can we help, and now we've got to break it to the children and Marjan.

They bring Marjan back into the room first, and within a minute she's bawling and saying it would have been worth it if there was only one and I'm rubbing my eyes with my shirt and wondering what it must feel like to be blind and now Marjan's stopped crying so we bring the children back in the room and huddle up. I've got the kid that couldn't really see anything by the shoulders and I'm squeezing him as Helen is speaking or maybe it was Donna and I think we're all softly crying as the children are told that they won't get operations, and that there is no hope for surgery in the future.

Marjan is smiling hard now as she tells them they will spend the afternoon in Cotonou and have a nice lunch and ice cream. I've just met her this morning, but I'm in awe of this woman who can put such a happy face on such a great loss. The bad news slowly registers with the children as we are still holding them tight and they take it with a sad, soft resignation. We pray for them and release them into the bright light of midday.

We tell Marjan to come back after lunch to pickup some stuffed animals for the children, later we make them gift bags with animals and 7 maracas I bought, and I arrange to make a trip to the orphanage to visit the children the day after Christmas. It's feels like the very least I can do.

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Tuesday, December 14

dental - 0710 tuesday

710 and breakfast is coffee like motor oil from the galley's huge silver drip maker and I'm down the gangway of the Anastasis with the keys to the gray Cherokee. I'm following the Mercy Ships dental team on their way to a village on stilts about an hour from Cotonou, Benin and the port where our floating hospital is docked. The plan, I'm told, is to pickup crates of equipment and supplies by the land clinic in nearby Godomey, drive to the river, pile into small boats, and setup shop somewhere in a remote stilt village to screen and treat as many people as possible.

I've got 2 camera bodies, charged batteries and all my lenses for this one and I turn off the main road towards the river and head into the marsh. Ten minutes and 47 potholes later our small convoy reaches the riverbank and we begin piling the equipment in two waiting dugout canoes powered by small outboard motors The dentists wear red and faded pink scrubs and unfortunately are taking too many pictures and ruining my action shots of them as they wave $149 digital cameras around but I suppose I'm being too harsh as we are passing white egrets, swimming fisherman, naked children running alongside the riverbank, intricate colony like structures of fish netting...

It's a half hour in canoes with motors and simply fascinating. As we enter the village, we see the houses are indeed built on stilts, hovering over the water, They are crudely constructed of thatch but surprisingly inviting. It's a makeshift Venice. A primitive network of canal-like waterways missing stonework and bridges - fine art and tourists but also that Venetian stench or sewage and refuse.

We're almost there and the boat's driver is hurriedly pointing at my head as I'm standing up taking pictures with my back to the quickly approaching bridge I duck under at the last minute. Ok so there's at least one bridge and my head was almost hanging from it. I must be more careful.

We arrive at a dock of sorts - a flat strip of riverbank with a few dugouts tied lazily to a pole in the ground, and head towards the building we'll be using for the screening. Now this "we" tense I'm using may sound silly to you as I'm just the photographer but I promise will make sense later.

We arrive and find 400 people lined outside a semi-dilapidated building I find out is the local medical center. It's surprisingly crude and we find it difficult to push our way through the crowd and enter.

Inside, there's certainly not much to work with. A few benches that look like church pews, a sink with barely running water, an old mattress littered with old syringes bolts and pamphlets. There's a surge of the crowd as Dominique, the dental team's tall, fearless, French speaking team leader tries to make order outside and I plan my escape route in my head. Too bad because there isn't one as I notice iron bars on the outside of all the windows and I just pray that everything settles down.

In a matter of minutes, the team has setup three stations in the room and laid a variety of shiny chrome and silver utensils out on a makeshift table in the center. By stations I mean wooden chairs set about 5 feet apart and pews arranged across from them to form a waiting area. I'm kicking myself for forgetting the flash, as the light is better in a medieval dungeon than in this clinic, so I head outside for better light and better air.

Past Dominique who has somehow brought order to the now peacefully waiting crowd, and as I walk backwards in the marsh, I take my obligatory establishing shots. I am again amazed at how vibrant the clothing is. The colors are vivid and unique and some of the ladies carry multi-colored umbrellas to thwart the blazing late morning sun.

Standing in the middle of the marsh, wearing western clothes and pointing my camera at 400 people, I'm not exactly inconspicuous, and the village children accost me. A lot of people practice voodoo here as some of the kids are camera shy (voodoo practitioners believe a photo can steal the soul) but once they see close ups on the digital camera back, they are Nikon's and mine. They love posing and drag me to a roofed but open cement structure down a narrow walkway through the marsh for better light and atmosphere. Soon they are taking pictures of each other, and with 15 children laughing, grabbing and twisting the camera buttons and lens I decide it's time to head back into the clinic before I need to replace the equipment.

Back inside and I shoot a couple of shots I'm still dissatisfied with because the light's no better so I put aside the cameras and try to figure out what's going on...

Turns out the system being used here was first tried by our very own Dr. Russell in a Guatemalan prison and is being perfected here. This is extreme dentistry. Although I can't confess to ever watching a full episode of Survivor, I'm sure if I had, a reference here would be found and quite fitting.

The patients enter after being screened outside and are given a number. That number is then written on a bib with a black Sharpie, which is hung around their neck. They are brought from the pews to one of the stations, and examined by a dentist. The dentist then will inject them with Lignocaine or lidocaine as "we Americans call it"- I'm shocked to find out noone's used Novocaine for many many years. Anyway, the patient then sits back down on the pews and waits for the anesthesia to take effect as the next person is brought to the musical chair. At each chair is a translator, who also holds a small flashlight (no electricity here) and the patient's hand or arm. A dental hygienist hands over the sterile tools, which are rotated in from big buckets in the corner filled with hygienic solution, and as they work without suction, blood, and lots of it too, is dabbed with cotton gauze held by tweezers.

Let me just say that I feel a long way from my last appointment in Dr. Pia Lieb's Park Avenue office where I comfortably watched Zoolander on Sony cinema goggles and chugged nitrous oxide.

There are so many people outside waiting I get bitten by the need to do something. I want to help and not just take pictures, and as we have 4 licensed dentists and only three stations, I grab the one on break, and we hurriedly setup a fourth station. Ten minutes later I'm playing dental assistant, aiming the flashlight, unloading syringes, cleaning equipment and dabbing blood.

Up close and personal and you realize how really thankless a dentist's job is. As many of these African patients have never been out of this stilt village, let alone to the dentist, and toothbrushes barely exist here, you can imagine the state of some of their mouths. The Mercy Ships work here is mainly limited to bad teeth pulling, and although I wish I could tell you it looks a lot more sophisticated than a yank with a clean pair of pliers, it's doesn't. But the dentist I'm working with is highly skilled, and after a few probIem teeth, I quickly see how difficult it is to get them to come out clean with the roots attached.

Some of the patients have come in extreme pain, some with terrible infections and open sores caused by these bad teeth. Although we're truly helping these people that have come and lined up hours before our arrival, they are not effusively grateful. It's with the usual dread that most in the west have always felt (although maybe not patients of Dr. Lieb's) that they sit down and go AAHH.

Everyone's running on adrenaline and it is a real rush being able to help with the removal of all these problem teeth. As we can only work on one side of the mouth at a time, patients with problems both left and right are given return appointment cards for free treatment at the land based Godomey clinic.

Quitting time is just before 5 and we've seen every patient waiting in that long line, treated more than 100, pulled at least 128 teeth (the count tallied on napkins), and scheduled another 210 at the land clinic. Another day in Africa for me and new found respect for the Mercy Ships dental team.