Disaster Blog November 27, 2103 Roxas City, Philippines The command center is a constant buzz. There is no air conditioning, so large fans run constantly with dull roar that has become the base of the noise in this room. To be heard above the fans, people must talk loudly. To be heard on the phone requires even more volume. Quite is non-existent at any time in the command center. Despite the fans, the heat is constant. My hair is soaked and by mid-afternoon my body odor offends even me. The humidity has also been high so once my clothing is wet with perspiration, it does not dry out. Throughout the day I am wet and sticky. With my hair going in every direction and my reading glasses on my fact all day, this is certainly not my best look. But the command center is the place to be. The command is a joint leadership with the Philippine government who is backed up by the United Nations. The governor has his office on the floor below, however, the real planning and logistics are here in the command center. There are few local faces here. The center of attention is the UN Office for Coordination of Humanitarian Affairs (OCHA). This leader, Fernando, is from Spain and seems to be very comfortable with the activity at the command center. He lives this world every day. The Canadian army has sent a disaster assistance response team (DART) and they are about 1/3 of the personnel in the center. They aircraft and other logistical supplies to move equipment and personnel. The have set up communications systems and are the main source of detailed maps that can be produced in house…except that their extra-large printer has died. Now these highly detailed maps have writing so small it takes a microscope to read them. At various tables can be found the representatives of many other governmental organizations and NGOs. UN High Commission on Refugees (UNHCR) is here. Save the Children, the World Food Program, World Vision, Action Against Famine and many others are here. Among the many global players, Remote Area Medical is standing tall; and I have the honor to represent our organization. I can remember in my early days of disaster work where I would walk into a command center and I was ignored. Unless I had a specific bit of information that was needed by the command, I did not exist. Is many ways it is a “good ol’ boy system.” You have to know someone to get an invitation to the game. Also, if you have the right reputation, it is also possible to get an invitation to the game. Finally, if you have neither the reputation nor the connections into the club, you can, on occasion, fake it. Now RAM has a great reputation after our work in the last few disasters and I hope that some of that reputation has disseminated to the other NGOs. But we are small and still unknown. Since I was not with Tom Kamin when he first presented himself to the command, I suspect there was a healthy sense of knowledge about our abilities in a disaster and an equally healthy presentation by Tom that we have always been on the team. However it happened, we are in the big leagues now. We literally have a seat in the United Nations command center located in Roxas City, Philippines. While that may sound impressive my seat is actually a flimsy plastic lawn chair and a basic wooden desk. We sit wherever there is an open seat and the Canadian army feeds us our wireless internet. In the center of the room four large tables are connected together to hold two large maps of the area. Every few hours a team of people will crowd the map table and make their plan. Sometimes the plan is to move people or supplies to an area. Others times it is a discussion of the amount of damage in a particular area. Throughout the day, these teams work in this environment where the only time the noise level drops is when the power fails (about six times a day), and the fans and wireless internet also fail. Despite the heat, the noise and the coordinated chaos, I am glad to be here and feel as if I am where I need to be. November 29, 2013 Roxas City, Philippines Last night was Thanksgiving. While most of the team had dinner together, I did not feel like going out so I had a military meal, MRE of beef stew and pound cake. I was perfectly happy with my meal. For the rest of the evening, I relaxed on the back porch watching the lightning in the distance and chatting with the other volunteers. The team from Kalibo arrived without any problems. The collected Tim at the airport and Tim had collected the meds and paperwork from the team in Cebu. I was surprised to find that despite the complicated plan with multiple players, everyone arrived where the needed to be. My days continue to be about logistics and supplies. The teams have needed more medications and purchasing them with my credit card or attempting to get cash from my ATM card cost me hours of time without actually ever getting any money. I have come to understand that the credit card companies have instituted so much security, the only person who can access my card is the criminal who has been charging $4.28 cents per month. However, if I report the fraud on my card, the company will shut it down and then my life will get even more difficult. Last night the team was back before dark. The evening was hot and everyone decided to use the hotel pool. Many of us did not have bathing suits, so we just wore our clothing. Deb, the current team leader, was swimming in full green scrubs. We must have looked like a bunch of crazy Americans, but we needed the dip. I called a meeting last night to welcome the new team members and to make plans for the next few days. I have found a new home for the team and we will all move their tonight. Last night I briefed them on the plan. After that, Deb took over the meeting and had an excellent debriefing of the last few medical missions to find what is working and what needs work. For the most part, everything seems to be going well. When the teams arrived in Kalibo, I assigned Deb as the team leader. She is a natural. As the teams have broken up for various missions she has assigned leaders below her. By her actions and her words, it is obvious that she takes the assignment of leader as a serious role and she shows significant concern for her team at all times. What impressed me more was how well the team responded to her and her assigned leaders. Everyone was positive. They work hard, and in the pool, they played hard and joked around. This group of people from across the country were a true medical team working for one common goal to help those in need. As a person who has experienced many teams, it is rarely the environment or the conditions that make the experience miserable or excellent for the team. A team deployed to a 5 star hotel in New York City will be miserable if they do not get along. But the team that lives in the mud together and works with each other in the most grueling experience will have an amazing experience that will last a life time. The team is not doing field amputations, however our orthopedic surgeon did one surgery two days ago, but the basic mission in a grueling condition with a team that is positive will give our volunteers the gift that will bring them back to us again. Deb is the magic that is this team. Another team member arrived last night. Josh is an EMT from San Diego. We worked together at Balboa Ambulance. He is excited to be part of the team despite the fact that the exciting part of the disaster is over. He quit his job to take a volunteer assignment because his employer would not grant him leave. His young enthusiasm will be a positive addition to our team. As for me, he mentioned to me that I am very different here than at home. At home, working on the ambulance, I am described as “intense.” Here, I try not to bring my frustrations back to the team each night. I mention that the day was good or bad, but I don’t bring much more than that. It seems that in this location, I am exactly opposite of who I was in San Diego. I’m good with that. As Josh chatted with the other members of the team, I was able to see how my own networking has been part of this team. Tom and Gaelan were recruited by me. I kept contact with Jim Keany and the Vermont Medical Team. These people have mobilized other people to join our team. Jim has mobilized dozens of doctors and nurses for this mission. In a way, I feel like I was part of that. And again it seems that so much of what works for our disaster team does not come from some disaster response recipe, but from the networking of those who care. Today, our team will move into the new housing I have found for our team. I hope they will like it. There will be plenty of rooms and I think we will have a bed or cot for every member of the team. One bathroom is in good shape and one is not very good. We only have one shower for many people, so that will become part of our daily lives. The water pressure is low, but the place is safe and with plenty of room. At the hotel, our teams have had to pack up and move from room to room every few nights. Here, the team will have a permanent base. No one will need to bring a tent. We will all be tighter in the evening and there are restaurants located on the street below. Additionally, our house is located directly above a small pharmacy that may be able to supply many of our items for the team. It is not easy living, but I hope the team appreciates it. For a free home that RAM can use indefinitely, I think we have a great place to be. At the meeting last night, I also explained to the team that as we are moving away from true disaster medicine and as we are creating a new home, I want to increase our organization of our supplies and equipment so that the place is not constantly a disaster zone. I have also requested that they participate in short training meetings that will occur a few times a week. Deb has agreed to do some quick classes on epidemiology and a discussion of some of the disease processes that are of concern for local outbreaks. The WHO has also requested to bring and educator to our team in the next week to educate us about the same subjects. It is my hope that besides simply working people and sending them home, that perhaps I can assist them in learning more about the disaster, more about tropical medicine, disease outbreaks and the management of such outbreaks. While our volunteers may or may not return to RAM on another disaster, if I can get this information out to our volunteer, then perhaps we can make an even greater impact as these volunteers continue to deploy around the world.
Posted on: Fri, 29 Nov 2013 03:28:04 +0000
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