Thanks for the Sunshine

Tuesday, 25 March 2008 00:00 Tzu Chi Foundation
The sight was breathtaking from aboard the airplane, but Bolivians on the ground were in dire straits. Due to abnormally heavy and frequent downpours since November 2007, much of the nation had been flooded and people had been driven from their homes, triggering the declaration of a state of emergency. Local Tzu Chi volunteers, joined by their counterparts from three other countries, helped provide daily necessities, medical services, and love, thus bringing some sunshine to this inundated land.

Bolivia, once a cradle of the great Inca civilization, is now one of the poorest and least developed countries in South America. About 60 percent of its population live below the poverty line. Spread among the rugged Andes Mountains with a highland plateau, hills, and lowland plains in the Amazon Basin, landlocked Bolivia has a diverse landscape that stretches from 6,542 meters (21,460 feet) to 90 meters (295 feet) above sea level.

We nine volunteers from America changed planes at Miami, Florida, and headed straight for La Paz, the capital of Bolivia. En route we had our fill of a panoramic view of the snowcapped Andes mountain range, the highest outside Asia and the longest anywhere. After landing at the La Paz airport, located at 4,100 meters (13,450 feet) above sea level, four of us experienced dizziness, headaches, wheezing, and nausea. Though very uncomfortable, we sat quietly through the altitude sickness as we waited for the next leg of our flight to Santa Cruz, our final destination.

Weather patterns are not as predictable as they once were. The first quarter of the year is usually the rainy season in Bolivia. But in early 2007, it rained so much that about 90 percent of Bolivia was flooded. Tzu Chi held a distribution in May and a medical clinic in August. Then came November. Prolonged rain caused many rivers in several departments to overflow their banks and flood nearly 80,000 homes. Santa Cruz Department, the granary of Bolivia, was almost reduced to an ocean of water.

The rain just kept coming down, and flooding spread to many more areas. Even La Paz, situated in the highlands, was not spared. Communications were cut off by landslides and washed-out roads and bridges. Isolated villages were unable to send for help, and anyway there was no way to bring assistance in. The government declared a state of emergency.

In the latter part of February 2008, we nine volunteers from the United States rendezvoused in Santa Cruz de la Sierra, Santa Cruz, with Tzu Chi volunteers from Argentina and Paraguay. Santa Cruz de la Sierra, often called Santa Cruz for short, is the capital city of Santa Cruz Department, the largest of the nine "departamentos" in Bolivia. Accounting for about a third of Bolivia's land area, the department occupies an area about ten times the size of Taiwan.

Uniformed angels
"Welcome to Santa Cruz, and thank you for bringing us sunshine! Local Tzu Chi volunteers Guo Zhao-qing (郭照慶) and Liang Cang-rong (梁倉榮) greeted the three-nation delegation to Bolivia as the sun made a rare appearance through the thick, dark clouds. Now we had a four-nation delegation to bring aid to the needy in Santa Cruz.

First, volunteers from the four countries were divided into groups to pack relief goods, including rice and medicine, into individual portions for distribution.

Earlier, when local volunteers went shopping for distribution goods, they felt the pinch of soaring prices in the marketplace. Rice had doubled in price, but the volunteers had no choice but to buy rice, lots of it. All told, they took delivery of 245 very large sacks of rice, a total of about 11.2 metric tons (24,690 lbs). The big heap of rice was divided into 5,600 two-kilogram [4.4-pound] bags to be distributed to flood victims. Each household would get two bags of rice.

Since it is common for infectious and skin diseases, and even colds, to break out after a flood, some medicine and a sheet of directions for how to use the drugs were also packed into medical kits to be handed out. The medical kits, along with the bagged rice and other daily necessities, were then put together into a larger bag.

Unlike the previous relief distributions, which were carried out by skeleton crews, the two distributions this time around were fully staffed, thanks to many members of the local Chinese community, who perhaps rose to the occasion because they were moved by the selfless help that Tzu Chi provided on previous occasions.

All those materials and bags had to be stored somewhere, even after the bagging operations. And people had to have places to work when they bagged and got everything ready. Some volunteers came through for this. Liao Zhi-xiang (廖枝香), in addition to mobilizing her employees to help out, quite literally emptied her home to make room for the volunteers to work. Likewise, Ke Cui-juan (柯翠娟) appropriated half of the space in her restaurant for this cause even though the place was usually jam-packed with paying customers, many of whom Ke had to turn away during the distribution preparation period. "Earthly wealth has to take a back seat to disaster relief," Ke said as she continued working on the bags.

While Ke, Liao, Guo, Liang, and many others were hard at work getting the distributions ready, members of the Tzu Chi International Medical Association (TIMA) went to Hospital Municipal Frances (HMF) in Santa Cruz to set up facilities for a free clinic which was to be held concurrently with the distributions.

Homes posted
After driving on a stretch of road that appeared to have been repaired just recently, we arrived at Troncos, one of our distribution sites, on the morning of February 27. However, our trucks with all the relief goods were nowhere to be seen. Apparently, they had run into some problem en route, probably getting stuck in the mud on the treacherous roads.

The Troncos tent city was in San Julian, northeast of Santa Cruz. In front of their tent entrances, the residents set up stoves improvised mostly with clumps of dirt. The moisture-laden wood that they burned produced a tremendous amount of white smoke that nearly suffocated everyone in the vicinity. The hygienic conditions were troubling.

Of the 600 or so families living there, many had been there more than a month. They were not hopeful that they were anywhere near the end of their stay. Worse, they were not sure what they could do after they did leave the tent city.

Mrs. Andrea Castro, queuing up with many others for the relief distribution, told us that her family had lived in the tent city since January. "Before the floods, we raised hogs for a living. But the downpours were so intense that we had to be evacuated. The flood water was pushing up against the roof of our house when the helicopter got my family out." Though they did get out just in time, they alone got out. Nothing else did: neither their belongings nor their hogs. All that they had left were the clothes that they were wearing. "The water has not receded after so long. God only knows where our hogs ended up and what we're going to do for a living."
Mrs. Guadalupe Gosman and her family, who farmed for a living, also had been in the tent city since January. They were rescued by a boat. Sadly, as was the case with most other victims, none of their farming implements and belongings made it out. As she told us about her family's plight, she began to sob. We asked her when she expected to go home. She said, "Our house is still under water, and so is our hope for the future."
Another tent resident, a teacher, said that many people had lived there for about a month. Children from three schools crammed into tents for their lessons, but the tents kept collapsing under the strong winds. "I pray every day for outside help to put the children in more secure and permanent quarters where they can focus on their studies," she said, tears in her eyes.

The distributions
Thankfully, our trucks finally arrived with all the goods intact. It was about noon with the sun shining overhead. Some of the waiting people helped volunteers unload. However, out of the blue, heavy rain started falling. We scrambled to cover things up or move them into tents. When we had shielded the relief goods from the falling rain, there was almost not a dry spot on any of us. We were all drenched.

Amazingly, the recipients remained lined up patiently in the rain, probably so as not to lose their places in line. Apparently, this distribution really meant a lot to them. Zou Yu-ru (鄒裕儒), a volunteer from New York, strongly urged them to take shelter from the downpour.

The tents sagged under the drenching rain, and so did our hope for a successful distribution. "That had to be the heaviest downpour that I have ever seen in more than a decade of international relief work with Tzu Chi," commented Zhao Wei-gong (趙惟功) of New York.

After about a half hour, the rain tapered off, much to the delight and relief of all. Then everyone moved quickly to make up for the lost time. Volunteers respectfully handed over the 45-kilogram [99-pound] bags to the recipients. Each bag, containing such necessities as macaroni, wheat flour, sugar, cooking oil, medicine, and rice, could maintain a family for several weeks. Many of the flood victims broke into smiles, something quite rare for many of them these days. A total of 580 bags were given out.

A larger distribution was staged two days later at Guarayo, one of the 15 provinces of Santa Cruz Department, located northeast of Santa Cruz de la Sierra. The prefect [similar to a governor] of Santa Cruz Department, Ruben Costas Aguilera, and his wife, Sonia Vincenti, kicked off the distribution. The first couple also presented the Tzu Chi volunteers with certificates of appreciation, certificates of honorary citizenship, and some mementos.

Many eligible recipients for this distribution lived in a flooded area 40 kilometers (25 miles) away. Some of them were unable to come in person because they could not afford the cost of travel (30 bolivianos, or four U.S. dollars). Ten recipients who were present on site received the distribution on behalf of those who were absent. They went back with a large chunk of the day's total distribution: enough relief goods for 600 people!
Handling so many bags and so much weight--some volunteers literally weighed less or not much more than a bag of the distributed goods--the volunteers understandably were fatigued and sore after a while. A woman recipient gazed at the volunteers and uttered shyly, "Tzu Chi, I love you." Magically, all the soreness and any thoughts of taking a break dissipated from the volunteers, and they kept on bowing and giving out one bag after another.

In all, 2,200 families received the much needed goods on that day. Thus for both days of the distribution, a total of 2,780 bags were handed out to help more than 10,000 people. Mrs. Aguilera said that as a woman, she felt honored to be able to work with a charitable organization founded by a female. She shared with the tent city residents her thoughts: "I hope that we all learn from these Tzu Chi volunteers. They have come from far away places to help us. Let's plant their seeds of love in our own hearts. Cultivate those seeds so that they can sprout and grow, and let's go out and help others someday."

The medical exchange
"When I suture, I take extreme care to shield the patient from all unnecessary needle pricks. Better my finger than the patient's intestine that gets a prick unnecessarily," Dr. Chen Fu-min (陳福民) said to his audience. Dr. Chen, a surgeon from Cleveland, Ohio, and his TIMA colleagues conducted a free clinic at Hospital Municipal Frances (HMF) in Santa Cruz. This clinic focused on surgeries, especially on hernia repairs and gallstone removals.

Many HMF surgeons, physicians, and nurses came to observe or help the TIMA surgical team, filling the operating rooms to capacity. They seemed to be reliving their days in medical school when they made the rounds with their professors, soaking up all the techniques and nuances necessary to be good physicians.

Dr. Chen showed the local surgeons his best techniques for hernia repairs, which he had fine-tuned through years of medical practice. His techniques can be performed simply and quickly with near perfect closures and minimal chances of recurring.

In contrast, the surgeons at HMF typically sewed the muscle tissues first, and then sewed on plastic mesh before closing the skin--a time-consuming technique that leaves the wound hard to suture completely, frequently resulting in a recurrence. Cases in point were found right on the spot: Of the nine hernia repair operations done on February 27, six were to repair recurrences, something that Dr. Chen's techniques could have helped prevent from happening.

Dr. Yao Fan-sheng (姚繁盛) of New York noticed that the Bolivian doctors did not know how to administer local anesthesia. Instead, they would put patients under epidural or even general anesthesia, complicating the surgery. Dr. Yao, a professor of anesthesiology, presented several textbooks on the subject to HMF for reference.

Li Zu-lian (李祖漣), a veteran operating room nurse from Maryland, shared with her local counterparts the importance and procedure of tallying operating instruments and supplies. Items such as scalpels, surgical needles, and gauze must be strictly accounted for in each operation to prevent any regrettable and unsafe incidents of leaving such foreign objects buried and sewn inside the patient.

Because HMF is short-staffed, usually only a maximum of eight operations can be performed in a day at the hospital, a record that the free clinic broke. The TIMA members all seemed so experienced, knowledgeable, efficient, and willing to share. The host doctors asked whether TIMA could station physicians in Bolivia on a regular basis to teach them, to be their mentors.

"During these last few months of flooding, I had my dark moments when I really had a sense of helplessness," admitted Dr. Fernando Lacoa Mendoza, the superintendent of the hospital. "I was about to give in to the unrelenting situation at the hospital. I couldn't even manage to squeeze out a smile. Now you are here. You have expelled my sense of being alone and given me a shot in the arm. We have so much to be thankful for. We are moved by your visit and all you have done here. We will make arrangements to attend the TIMA annual conference in Taiwan in September."
In a small ceremony at noon on February 28, Dr. Chen Fu-min presented Mrs. Aguilera with the keys to a bus. When Tzu Chi members were here in August 2007 to run a free clinic, Mrs. Aguilera requested that the foundation donate a 30-passenger bus so that local physicians could organize free clinics of their own. Her request was granted just half a year later--courtesy of Tzu Chi members in Bolivia.

Forty dentists in Santa Cruz de la Sierra promoted giving dentures as gifts so more people could "smile happily." Dr. Zhang Gong-feng (張恭逢) of Los Angeles responded with the gift of a set of mobile dental equipment kits to Dr. Duberty Soleto Ledesma, a local dentist. This equipment makes a mobile dental clinic possible, greatly enhancing the local dentists' capacity to conduct clinics in remote areas.

Hopefully, with the equipment donated by Tzu Chi, local Bolivians--the prefect, first lady, surgeons, dentists, hospital administrators, doctors, and nurses--can extend their reach and bring a better life to more of their fellow countrymen

By Chen Ci-zhen, Yang Ci-fu, Zou Yu-ru, Fan Sheng-zong, and Cen Hui-yi
Translated by Tang Yau-yang
Source: Tzu Chi Quarterly Summer 2008

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