Tsunami scare

Just recovering from the tsunami scare from yesterday.  My boss Emily showed up at my casa about the time I woke up.  I thought I had overslept but she quickly informed me that an earthquake had hit Japan and we were being evacuated because a tsunami was expected to hit the Galapagos islands in the afternoon.  We went to the office of ICE Galapagos to rummage through the donations I had brought down and grab some diagnostic equipment, painkillers, and a few antibiotics.  Then it was a lot of hurry-up and wait.

Our group gathered at a local house.  Then we planned lunch.  Then we ate.  Then we talked.  Five or six hours after the first news of a problem we finally we loaded up in a truck and headed to Bella Vista, at 100 meters or so above sea-level; certainly a safe place.  Then we sat around in the house where one of the volunteers is staying and watched the news, read, and took a little paseo around Bella Vista to see what everyone else was up to.  No real medical issues came up, and finally we were ready to head back down to town, after the worst was over (we heard about a few damaged boats and waves dirtying the shops along the malecon, the seaside main drag through Puerto Ayora).  Then came the worried messenger; aparently there was a sick baby at the clinic, and he needed an incubator.  Seemed like a strange request, but Emily, another volunteer named Risa (she is also a medical student here in Ecuador), and I headed over to see if we could help.                

 

Septicemia, most likely, said the doctor.  Possibly meningitis.  The baby was one month old and came in breathing poorly and apparently convulsing.  “Do you have anything to help with the convulsions?” he asked.  I had a medication (benzodiazapene) that might have helped but the doctor was concerned about the baby’s breathing.  He wanted phenobarbital, and we had none.  He had given antibiotics but didn’t have everything available that he wanted to give.  I had brought only antibiotics for gastric problems, and the baby didn’t have a fever, so my acetaminophen (tylenol) was no help.  I asked about the basics I had learned for suspected meningitis and septicemia: lumbar puncture? No equipment available and no testing facilities.  Blood and Urine Cultures?  No laboratory facilities.  The baby’s lungs sounded horrible - Chest X-ray?  Machine is in Puerto Ayora and technician retired came the response.                    



Yes, that is a baby under the bucket

The baby was breathing around 60 times per minute (too fast) and working pretty hard to do it.  Because there was no mask available that would fit his tiny face, they had placed a modified clear bucket upside-down over his head with a hole in the top for the oxygen tube to provide a super-oxygenated atmosphere for the baby to breathe.  His oxygen saturation, a measure of how well his red blood cells were carrying oxygen, was good, but he continued to breath too rapidly.  His best chance was a flight to the mainland, but flights were suspended and his condition was so fragile I’m not sure he would have survived the flight.  When we finally did send him down to Puerto Ayora and the hospital, it was around 1 a.m.  I stayed behind and talked with the family while the doctor and nurses made the transfer.  After the doctor returned, I headed to our temporary headquarters and slept a few hours on the couch before being awakened by the roosters, the dogs, a crying cat, and several other sounds I couldn’t identify.  I made it to my home late morning and stopped by the hospital to check on the baby.  About the same, only his heart-rate was down in the 60’s (beats per minute) when I saw him; way too slow.  The family told me that the doctor had said the infection had damaged his heart.   The doctor also said that the baby was in no condition to travel.  I hope that he is able to make the trip to the mainland tonight.

 

  Shortly after I finally arrived at my place, my landlady, who has been on vacation for a month and whom I have never met,  came home and asked how things were going.  I told her fine, other than I had no water and that the toilet was, well, I was still trying to find the appropriately delicate words in Spanish for “the crapper is plugged up and it’s not pretty” when she marched into my room to take a look.  Without a word (or any sign of gagging) she left and promptly returned with the necessary equipment.  She plunged the shitter which had been chronically non-functioning since I arrived.  I was horrified to watch this complete stranger wrangle my duker, but she was unbothered.  As she explained to me that everything was taken care of, I couldn’t help but notice the plunger dripping onto the tiles of my room as she spoke (don’t worry, I’ve since cleaned it up).        

This is not a river!  It's Puerto Ayora!
Swells like the tide every 5-6 minutes
this morning



 

This shows where the waves were during the night -
about 3-4 meters above mean sea level



Puerto Ayora cleanup



She also turned on the water so I don’t have to fill the tank from the shower any longer, and I have another source of water (other than the shower) for cooking and cleaning.    I decided to go back to tortuga bay and then get some food.



cheap eats



                 It’s been an interesting week.



Tortuga Bay

crabs and homo sapiens at Tortuga Bay