Assistance?

The building closest to the health center in Río Sucio is a dilapidated cement block structure that was never finished.  Outside the gaping doorless entrance an acrid wisp of smoke from the last of a burning trash pile wafts upward.  In this tragic environment some of the poorest of the poor eek out a living.  I am fortunate to share bits of that life with them.

Here lives Fernando[1], a diabetic man in his 40s, his leg amputated from complications of diabetes.  He has been 5 months without his medicine, and his blood sugar shows it, 500% above normal limits.  When he was displaced from his home by the violence he lost all his official documents, so he doesn’t qualify for services at the clinic next door.  I am able to give him enough medication for the upcoming months.  The cost of his medications are less than $10.

I make my way among the mix of plastic sheeting strung over twine, old cardboard, and rusted sheet metal that section off individual and family living areas.  I make my way over to Luisa, a woman in her 70s with an enormously disproportionate abdomen.  She struggles to breathe and talk while sitting on her mattress of boards, shrouded by her mildewed mosquito netting.  She has been sleeping in a sitting position for weeks, as her lungs fill with fluid whenever she lies down.  She also stays awake worrying about snakes behind the boards in the ceiling, not necessarily delusional thinking.  She complains when she eats, that occasionally worms leave on their own volition from her nose and mouth.  Her ankles are twice their normal size, her lungs full of fluid from her heart failure.  I give a heavy dose of diuretics (furosamide) and refill the medicine that helps her heart pump better (digoxin.)  Before I leave I also give her medication for intestinal parasites.  When I visit the next day she has had 50 visible worms leave her intestinal tract, with 33 more joining the exodus over the next 24 hours.  She is very relieved to be able to rest laying down. 

The health center finished seeing their daily quota of 25 patients by 11:00 a.m.  Unfortunately for the local population, being assigned to work at the Río Sucio Health Center is seen as a punishment post for most of the medical providers who spend their 4-month rotation here. Home visits are almost unheard of.

The town of Río Sucio is largely built over marshland.  The rough-hewn board shacks and houses are largely built on platforms over the swampy murk below.  While traversing from board to board over the fetid mud and water from shack to shack, there is much laughter, especially if one falls in.  Shouts of “Turtle! Turtle!” bring people rushing to see who has fallen in.  The visits to these homes / hovels is almost inevitably filled with the sharing of worries about pain, concerns about life lived, nearness to death, and the path of life each has taken to be where s/he is.  It is exceedingly difficult to visit these homes, and even harder to leave for those bound by their terminal cancer, uncontrolled seizures, partial paralysis from a stroke, Parkinson’s or other debilitating illnesses.  While I recognize the importance of our work in development and support for local efforts there are days when there ethically I cannot leave people suffering, and the assistance work needs to continue.  Certainly while millions of individuals, families and entire communities remain displaced from their villages, jobs and secure life, the need for direct assistance continues.

Or Development?

On the other hand, our principal hope is to leave in place a structure for local health workers to continue to improve the lot of their communities.  This is the reason that the majority of our efforts focus on courses and supervisory visits in the communities. 

One of our recent courses with the nine advanced promoters focused on trauma repair, suturing of tendons and deep tissues.  As usual, the promoters went to the task with great enthusiasm, to such a degree that they frequently had to be cautioned: “Your suturing needs to be done with less deep stitches…”  “Inject that a bit more delicately…”  It was a very successful course, but one that we would like to reserve for those who are working on accidents and not the war injuries too common in this country.  By the time the promoters returned a moth later they had almost all put into practice some of the techniques they had learned, utilizing the new instruments (forceps, scissors, clamps, suture, local anesthesia) they received.

A recent 1^st level course for student Health Promoters focused on respiratory illnesses.  Everyone gathered around as we dissected a pig.  When the lungs were removed, we blew into the trachea so that all could see the effect of air going into the lungs.  One of the promoters was so impressed that he repeated the same dynamic when he returned to his community the next week.  After the anatomy class, parts of the pig were used for practice in suturing with the 2^nd level promoters.  Regardless of the theme being taught, our constant methodology is to teach basic theory mixed with practice, practice and more practice.  The results are beginning to show in some of these communities where we can see an increase in appropriate diagnosis and treatment of the basic illnesses they encounter.  It is hard to recall that only a year ago, no one could accurately take a temperature.

The promoters now come in from 32 different communities, speaking Wauunan, Emberá, and the Chocó version of Spanish.  They are Indigenous, Afro-Colombian and Mestizo, women and men.  It is an exciting process to hear them make connections and discover their commonalities, in spite of the differing armed groups that dominate in their various river basins.  One of the Indigenous promoters recently exclaimed “I used to think that when you Afrocolombians were displaced to other regions that you got everything you needed while we Indigenous suffered behind the blockades put up by the paramilitary.  Now I see that we all suffered the same!”

Next week we add our 1^st level midwifery course to the efforts here.  We hope to be able to prevent some of the deaths attributable to preventable neonatal (newborn) tetanus as well as the common Group B Strep bacteria.  Complications of pregnancy and labor will be taught during this course as well as we try to change the illness and death rates of both infant and mother.  The midwifery course will be challenging, as many of the Indigenous midwives are monolingual in one of the two separate language groups, but we have an excellent Guatemalan midwife here who has spent years teaching women of other language groups how to safely monitor pregnancy and deliver children under these conditions.  She herself lived through the violence of the war in her own country and is most adept at understanding the situation here.  A month later she will be teach complicated delivery procedures and prenatal care to the advanced health promoters, while I teach an “essential medicines” course to the 1^st level. 

There are many needs here in the region.  The first and most crucial is the need to end the war by stopping ALL money and hardware that keep this war going.  The destruction and death caused by the U.S. military presence here is incalculable.  The shift to $2,000,000 a day in support for teachers, health/medical personnel, and other constructive efforts will bring a true end to the war and good friends with it.  Our efforts here hinge on the thread of security conditions, which are made less secure each day by the armament and clamor for continued war.  It is reassuring to see so many groups of faith, human rights organizations, and people of good will both here in Colombia as well as in the U.S. striving to make a positive change in both of our countries.  Both Julie and I are blessed to be in this project, working with these people.

We are constantly in need of financial and material needs, and are grateful to the numerous individuals and groups that support our efforts.  We are currently seeking another medical member of our team as well and hope to have a volunteer by the end of the year. 

There is so much to do in areas of positive, constructive world change.  It is encouraging to us here in this region to hear of work being done on environmental impact and awareness, gender equality, racial justice, fair economic distribution, organizing for anti-war/violence/militarism efforts, and work that keeps unjust empire from growing while encouraging community building.  I leave you with the words spoken at Wellington United Church of Christ, in Chicago and in many places of faith who bless the world with a different presence than that of war and retribution:

Go forth into the world in Peace

Be of good Courage

Hold fast to that which is Good

Render to no one evil for evil

Strengthen the fainthearted

Support the weak

Help the afflicted

Honor all People

Love and Serve God

Rejoicing in the Power

Of the Holy Spirit

As my dear partner Julie and I prepare to have our first child in Río Sucio this month, we ask for your prayers, good wishes, or whatever positive energy / Spirit you can share as we all continue this wonderful effort of building a new world.

Curt Wands

Links:

Concern America: http://www.concernamerica.org/

Ecumenical and Faith links on Colombia: http://www.churchworldservice.org/colombia_denom_work.htm

Links to Colombia Policy/Human Rights/Security/News: http://www.ciponline.org/colombia/background.htm

The Struggle for Water

While we are surrounded by water here, there is very little access to potable, or drinkable, water.  There is no central pipeline in Rio Sucio (translation is Dirty River), no central filtering system, cistern, or other community-wide collecting system for water.  Drinking water is drawn from the same river where the boats pull up with their 2-cycle engines, where the sewage system consists of floating latrines, where the dishes are washed, the fish are cleaned, teeth are brushed and clothes are washed. 

When I find myself sipping a glass of filtered and chlorinated water I recall with just a glimmer of consciousness the significance.  To have a similar sip would be a rare luxury for most people in this remote, conflictive region of Colombia.  Many of the patients who come in for a physical exam complain of dizziness as they stand, a darkening of their vision, signs of “orthostatic hypertension” caused by dehydration in 99% of the cases here.  Many come in complaining of a burning sensation when they urinate, but there are no signs of infection in their urinalysis, just a heavier specific gravity, indicating lack of sufficient liquid intake.  Water…  It would have taken little more than a few quarts of water, each with a few tablespoons of sugar and a quarter teaspoon of salt to save at least three of the five children who died last month in the community of Marcial.  Moreover, clean water would have probably prevented their diarrheal illnesses in the first place.  How easily I have often reached for a tap and turned the knob, each time expecting a clean, clear stream of water. 

I can measure my proximity to or from larger cities by the

access to water.  In the remote Indigenous community of Marcial we bathe in the river, a turbid river with fast current after the rain.  With one hand I hold soap, the other grasping a raft at the rivers edge, as I try to not be carried downstream.  A 5-12 hour boat ride away in Río Sucio, (literally translated as “Dirty River”,) where Julie and I live, our water is gathered from rainspouts or pumped from the river, into a 250 gallon plastic tank.  The murky sediment is settled by alum, and chlorine is added to eliminate almost all the bacteria and parasites found within.  W then fill water from this tank into buckets, which we then dump over our heads to bathe.  Another 5 hours away in Apartadó we have a monthly trip to enjoy the overhead pipe that pours cold, clear, water (but still not drinkable without first purifying it) down upon us.  A 10-hour bus trip (or 45 minute flight) from here brings one to Medellin.  Hot water showers are available.  

Over the past two months, Julie and I were privileged to have a visit from friends who work in other countries.  They spent time offering courses and providing support in the rural communities we support.  One of our visitors is a biologist who did a microscopic study of the feces in the communities they visited.  In the Indigenous Emberá community of Quiparadó (pronounced: key-par-a-do) the study of 23 asymptomatic children showed 20 to have results positive for pathogenic, illness causing, bacteria and/or parasites (Ascaris-large roundworms, Giardia lamblia, Campylobacter jejuni, Strongyloides, Tricocefalo-Whipworm, H. Nana-tapeworm, Uncinaria-Hookworm.)  The three who were not positive included one child (who had been treated for parasites the week before) and two babies, presumably not yet crawling or drinking other than breast milk.  This entire community had previously utilized water tanks and a pump system from the river.  All were stolen by the paramilitary over the past years.  We have just committed to the community to replace their water tanks and to do training on maintaining pure water.  Each family will build a platform for their tanks.  Our commitment in this project is to help the communities non-violently defend their right to physically rebuild and to regain their rights as civilian and Indigenous community.  It is of particular importance to me, as a believer and participant in the creation of non-violent alternatives in these war zones, to confront destruction and offer construction. 

The community of Quiparadó continues to be plagued by the same paramilitary “Elmer Cardenas Bloque” that is involved with extensive human rights abuses and drug smuggling.  The paramilitary come and go as they please with no military interference in our region.  Many of the paramilitary uniforms still show the U.S. army insignia on their holsters.  None of this should not be a surprise in a region where the navy flys the “skull and crossbones” pirate flag on many of their small “piranha” class boats. 

The paramilitary are seen as having surpassed their time of usefulness for the U.S. and Colombian military.  The paramilitary’s blatant involvement in massive human rights violations became too well known, and narcotics cultivation, processing and shipment has become too much of an open issue to allow for continued support of paramilitary activities. 

Paramilitary soldiers occupying Indigenous homes in Mamey Dipudú,Chocó.

Even on our few days off to the coastal village of Triganá the paramilitary were present, drinking bee and sleeping in the hammocks outside our bungalows, occasionally dropping their rifles. 

However, in areas like our Chocó the paramilitary are still seen as necessary by the government and army.  The navy and army allow passage of paramilitary boats en route to their nearby bases without a second look.  The concern for the U.S. anti-drug effort is a policy that frequently conflicts with the military goal of eliminating political opposition.  The anti-drug war in Colombia has resulted in cheaper, more highly refined and more available cocaine in the U.S. as well as a negligible decrease in the land surface used to cultivate drugs.  Military tactics do not stop narcotics problems.  The continuation of the decades old counter-insurgency war is what this war is really about, with the principle concern being the threat to U.S. corporate economic investment.  The Occidental Petroleum pipeline is a blatant example of the U.S. military presence defending companies that invest in presidential campaigns.[2]

Symptoms of a policy out of control:   - U.S. Army Warrant Officer Allan N. Tanquary and Sergeant Jesus Hernandez of the 7th Special Forces Group based at Fort Bragg were arrested by Colombian police on May 3 for providing over 30,000 rounds of ammunition to the paramilitary.  The exchange happened in a gated community where many U.S. military and contractors live and work in.  The amount of ammunition exchanged in this one incident is sufficient to kill every person in every rural community we work in.    - Robert Charles, the recently retired Assistant Secretary of State for International Narcotics and Law Enforcement, advocated for the renewal of Plan Colombia in the right wing newspaper, The Washington Times, on May 11.  He claimed that Plan Colombia combats Colombia’s “culture of lawfulness.”  The recent arrest of five U.S. soldiers as they deplaned in Texas from their tour of duty in Colombia with 16 kilos of cocaine (U.S. street value of cocaine, according to White House ONDCP figures, at between $10,000 and $36,000 per kilo) demonstrates the corruption that is inevitable with the current drug policy.  Even at the highest levels of the “anti drug” campaigns we see this corruption.  In 1999, U.S. Colonel James Hiett was the coordinator of U.S. anti-drug activities in Colombia when he covered up the smuggling activities of some $700,000 worth of cocaine and heroin to the United States by his wife who used diplomatic postal services.  (He received a mere 5-month sentence after pleading guilty.)   - Twelve members of Colombia’s navy were arrested three days ago for producing and trafficking cocaine.  This is no surprise given last years discovery of dozens of bags of cocaine and heroin hidden in the engine room of the country's flagship vessel, The Gloria, days before it embarked on a six-month trip to the United States and Europe.   - The Bush Administration recently increased the number of U.S. military personnel in Colombia from 400 to 800, in addition to the 600 “private military contractors” performing various roles here.  It is past time for us to call these “military contractors” what they are: paramilitary and mercenary forces.  These paramilitary forces are mere thin covers who provide “plausible deniability” to official U.S. government policies when atrocities or tragedies occur (as in the capture of three U.S. paramilitary who were shot down, and are still prisoners of the FARC guerrillas.)  Cost savings is not the issue in the use of these troops, but rather an escape route for those accountable in government.   - In the recent massacre of 8 civilians near San José de Apartadó, Colombian military officials claimed they were no closer than 2 ½ days from the site of the massacre, yet hundreds of troops stationed at 17th Battalion headquarters are a mere 3 hour road trip and 7 hour hike from the massacre site.  The head of the 17th Battalion, General Héctor Jaime Fandiño Rincón, was trained in the U.S. “Small-Unit Infantry Tactics” course in at the “WHISC/ School of the Americas” at Fort Benning, Georgia in order to become “familiar with small-unit operational concepts and principles at the squad and platoon level… [to] receive training in planning and conducting small-unit tactical operations.”  In December of 2004 he was promoted to the rank of Brigadier General.  Serious, independent investigations as to whether the 17th or the 11th Battalions were involved should be mandatory before more military aid is extended to Colombia.    - Recently another 8 U.S. Black Hawk helicopters were provided from the U.S., each capable of flying 184 miles-per-hour with a 7.62-mm machine gun that can effectively fire 200 rounds per minute 1.1 miles away.  This is the same type of U.S. provided helicopter that killed 7 children and 11 adults in the village of Santo Domingo, Colombia in 1998 using a U.S. supplied AN M47 fragmentation grenade and fuse.[1]  The U.S. government also sells the UH IH Huey helicopters with its 7.62-mm (0.3-in) Minigun, that can fire 4,000 rounds per minute.  The U.S. has provided at least 60 Black Hawk and UH-1H Bell helicopters.    - Just this past week, a bill was passed, authorizing $731 million to Colombia next year, 80% of which is military funds (I cannot in good conscience call military funding “aid.”)  This works out to over $2,000,000 per day in funding that goes largely for weaponry, training and destruction.