The Amazon Woman and other Evolved Species of Homo nerdicus

Diane McTurk must have been quite the vibrant beauty. Even now, the sparkle in her eyes betrays the intense passion that was responsible for the existence of Karanambu. As the Jane Goodall of giant otters (see picture), she refers to her “water dogs”, Benouni, named after the river, and Peche as “my heart, my love, my prides”. With a mischievous pet racoon nicknamed “The Bandit”, she is a most extraordinary lady. Nestled at the confluence of the Amazon and Essequibo Rivers, the eco-lodge also attracts an array of avid nature lovers: ornithologists, entomologists, caiman experts, and fish enthusiasts. These visitors are as interesting as the species that they study.

Donald, a professor from Syracuse, was on a 2-month expedition with his grad student studying the largest freshwater fish in the world, the Arapaima. At an adult length of 3m, the Arapaima is an obligate breather with ineffective gills; this particular feature makes population counting very easy because every 20 minutes, these fish must travel to the surface to breath. After showing us his slideshow and video presentation after dinner, Donald excitedly explained, “And so, we’re here to look for a species that might resemble the 1830s specimen at the Paris Museum of Natural History. The British Museum of course also had a different sample, but this was lost in storage – imagine! Such an important display lost forever!” He face was aghast before he continued, “And this paper published in the early 1900s that refuted the original paper that purported 4 different Arapaima species was based solely on the opinion of one biologist who felt that there was only 1 species – that’s it, no evidence, just an opinion! Well, clearly from the specimens that we’ve found here, there are even more than 4.” This man badly needs a T-shirt that says: Carolus Linnaeus is my Hero!

As a fellow Canadian from Waterloo, it was comforting to talk with Mike about Canuck matters, but it was really his Black Caiman project that got our attention. In order to monitor the population of caiman, much of the tagging occurs at night because the red eyes of these alligator cousins are easily visible with a flashlight glowing in the dark. We can attest to this since we travelled along the river well after the sunset and experienced the surprise of seeing 2 pairs of red eyes glowing by the shoreline. Indeed, a flashlight can also revel the green eyes of Anaconda hidden in the trees. In order to tag the caiman, the team would approach the caiman and with a metal lasso device, they would reign in the caiman beside the boat. After 20 minutes, the caiman would tire and the team would bring the caiman in the boat to be tagged before returning it to the water. The biologists would then be able to monitor movement of the population the following season. These real-life Crocodile Hunters take biology from the controlled lab environment and turn it into a thrill-seeking activity in the heart of the Amazon.

Aside from the fascinating species of human that we encountered, we were fortunate enough to see some truly beautiful animals, worthy of Natural Geographic documentaries. We saw the black-bearded saki monkey, the Amazon kingfisher, the blue heron, the pied plover, the red-shouldered macaw, vultures, and countless other birds, but the truly unusual animal was the Giant Anteater (see picture), which galloped at an astonishing pace across the Savannah. For us, this last adventure of our trip satisfied the childhood fascination that began in Grade 4 biology class when we learned about the ecosystems on different canopy layers and the highly adaptive wildlife that exists in this magical place.

Despite enjoying our time in Guyana, we are both glad to be coming home to the land of beaver, snow and café mochas. For all those in Toronto, we can’t wait to see you!

Diabetes/Hypertension Workshop Weekend

All the Community Health Workers of Region 9 and one from Region 8 congregated at the Bina Hill Institute for the weekend. Some arrived on Friday, but the majority had an early start to their Saturday to join us for eggs and delicious fresh-baked bread. We had a fun educating everyone with some of the knowledge that we had gained from medical school and residency. You realize that you did learn something worth imparting to others after the near decade of education! Unlike our own training though, we made the lectures as interactive as possible without the “pimping” and everyone seemed happy to participate.

In turn, we learned about some of the interesting differences in Guyana’s healthcare. Since patients do not have glucometers, one method of diagnosing/regulating diabetes is to see if ants are attracted to a patient’s urine because of the excess sugar spilling out of the kidneys. Fortunately, Pro-Natura was able to supply glucometers, lancets, and Accucheck sticks, which should improve the abilities of CHWs to diagnose diabetes more accurately! We were glad that we were able to help people for at least a short while, but struggled in responding to valid concerns raised about limited supplies. It is Pro-Natura’s hope to be able to replenish these supplies periodically, but sustainability and introduction of technology appropriate for that country is always an issue. It was heartbreaking to hear one of the CHWs say optimistically, “Once the battery runs out for the glucometer, perhaps we could fundraise to get new ones.”

Overall, the workshop was well received, and it was our pleasure to host this event. The CHWs complimented our simple explanations for complex concepts, and they were very grateful, as most had never had formal teaching on either topic. They expressed the hope that other doctors could come to Guyana do more education on topics like parasites, obstetrics, and anemia. We hope so, too; however, when presented with a quarter-sized lesion about 3mm deep on the heel of girl, who casually informed us that this had been inflicted by a piranha during a school picnic yesterday, we must admit that we have limited experience on certain endemic problems!

NB We're off to Karanambu for a couple of days, stay tuned for what I imagine will be some pretty awesome photos when we return.

Workshop tomorrow!

Between the hours of 2-4pm, it’s uncomfortably hot even if you’re just sitting. You pray for rain to relieve the stifling heat. You try to distract yourself by focusing on other tasks or dream of immersing yourself in an ice glacier. Everything slows down and crowds are often seen at the picnic table trying to find some relief from the occasional breeze. Today, everyone was momentarily atwitter when Alphonso brought the head and tail of a rattlesnake in a jar containing alcohol. Apparently, it was hiding in the brush near where I child was playing and luckily, someone had prevented a terrible accident.

As for work, we’ve got into the habit of completing more demanding tasks in the morning. This isn’t difficult since we go to bed at 8:30pm and are usually wide awake by 6am or earlier! Today was particularly tedious printing out our handouts on an ink-jet printer circa 1988. We were just happy in the end to have something to give our Community Health Workers.

Nick left for the Rupununi Expo in Lethem yesterday. It’s a 2-day festival showcasing the local arts and crafts of Region 9. Interestingly, there’s another festival in May called the Rupununi Rodeo, which sound very much like the Calgary Stampede. It’s a family event where ranchers show of their skill and there’s generally a lot of partying. It would be fun to survey the local goods this weekend, but we don’t mind that we will be missing the event, because we will FINALLY host our workshop. Everything is ready (see picture of radioing in lieu of a phoning), and we hope that it will go smoothly. There’s been so much anticipation for this that we can hardly believe it’s tomorrow.

Frames of Reference and Shifting Perspectives

“Back at home, we have a machine that cleans your clothing for you. How do you know when it’s done? Well, you hear a BEEP. Yeah, and we have another machine to dry your clothes.” We could hear the girl giggle incredulously as Nick offered this explanation for laundry in North America. At the same time, we could hear one of the students singing a Christmas Medley of Jingle Bells and Silent Night as we woke up to another typical day in tropical heat.

When you’ve been in Bina Hill or any isolated community in a developing country long enough, you find it incredible that this world can exist concurrently with the sphere that you just left. You wonder: How could this be? How can you have thirty different flavours of cereal at Loblaw’s and none here because there isn’t even any milk? How can people complain about slightly bruised oranges at the local market while people here have virtually no source of citrus and it’s a wonder that they don’t develop scurvy? People in Canada have numerous concerns about the healthcare system, yet people here have zero access to healthcare in rural areas and even in Lethem, there are no physicians in-house on the weekend. How is this possible? We can remember spending hundreds of dollars on textbooks for school and here, classes are taught on the blackboard alone and are dependent on the expertise of the inevitable foreign visiting teacher, who can realistically only teach a few very basic subjects for a limited time.

Even so, you catch yourself missing things from home like chocolate milk, movie theatres, and sushi. All of our stomachs gurgled when we watched a movie on the laptop that featured a Ben and Jerry’s. You vow that you will never ever take these things for granted again, knowing that you will, but hoping that you will remember this important lesson.

Funnily enough, Nick replied to the girl after she completed what had become an uproarious laugh over the washing machine description, “Well, you should come see it one day.” She replied, "Yes. I would very much like to visit your country some day." When faced with this type of conversation on cultural exchange and despite knowing better, you can’t help but think, “Yes, yes! Come to Canada, we can take you to Raptors Game. You can get almost any type of fruit no matter what time of year. There are streetcars for the public to use. There's a Tim Horton's every other block to serve you coffee and donuts practically whenever you want. You’d love it!”

More adventures on the way...

We’re pretty excited since we were able to secure 2 days next Monday after our week-end workshop at Karanambu, an incredible eco-lodge along the Rupununi River founded by Diane McTurk. Diane is one of the world’s experts on giant sea otters and truly an inspiration. She saves orphaned sea otters and nurtures them at Karanambu before they can be re-released into the wild. The lodge’s mandate is to preserve the Rupununi ecosystem and the Amerindian way of life. We should be able to fully appreciate the minimally disturbed wildlife at this rustic locale.

You wouldn’t think making reservations would be a problem, but since there are no ATMs and VISA is not accepted out here, we actually did not bring enough cash to entirely cover this expense. We’ve already been a little paranoid walking around with a big wad of 1000 Guyanese Dollar bank notes (the exchange rate is 200 GYD to 1 US)! Diane was kind enough to let us send her money at a later point.

Today has otherwise been a pretty ordinary work day. There’s a conference hosted at Bina Hill for WWF (World Wildlife Fund) and as a result, Tracey, the chef, has been preparing more elaborate meals. We actually had egg for breakfast and this pastry called bake – it’s deep-fried flour/water/salt. We’ve become something like Pavlovian dogs because every time the kitchen door opens, it’s a sure signal that the meal is ready and our mouths are inevitably salivating as we make our way to the dining area.

And then there were three

Things at Bina Hill are incredibly quiet since the Frenchmen left on Monday to continue their journey to Brazil. In typical fashion, they left their share of broken hearts among some of the girls. As with any isolated community, there are the usual relationship entanglements and a sort of social bubble forms where small ripples tend to become larger waves. Kathleen had to join Linzii in Georgetown to sort out their working VISAs. Consequently, some of the classes are cancelled, and the Bina Hill Institute students are having a decidedly lighter schedule. Among the foreigners, only Nick remains to eat with us at the dining table along with the many dogs that run around the complex – one actually delivered 8 adorable pups last week.

Since arriving, we have become something like the local medical experts. Medex Bartholomew, the other foreign visitors, and lots of students have approached us with medical questions on topics ranging from urinary tract infections to questions like “how can you tell if you have breast cancer?” It’s been fun for us to educate people informally, but without access to certain medications, our ability to treat is somewhat limited. This afternoon, Medex approached us about a young patient with 1 day of non-specific symptoms like feeling hot, muscle aches, and headache. In Canada, most doctors would attribute this to a common cold or flu, but here, malaria, typhoid, and dengue are also possibilities. There are illnesses here that we would only rarely encounter in Toronto, and they definitely require a modified approach.

It continues to be extremely hot, making it difficult to even think sometimes - a cool breeze is such a gift! The project seems to be going as planned, as we continue to develop our handouts, etc. We are glad that we picked some star fruit from the trees in Rock View to supplement our starch diet here.

One People, One Nation, One Destiny (Guyana's motto)

Today was thankfully much less eventful than yesterday. One of the nice things about living in a country for an extended period is the opportunity to have a more in-depth appreciation of the culture and history. At a population of 750 000, Guyana is the only English-speaking country in South America with a culture that has been more largely influenced by their Caribbean rather than Latin American neighbours. The country has changed hands between the French, Dutch, and finally the British. Here, Sir Walter Raleigh claimed that he found the famous lost city of gold, El Dorado.

In Amerindian, Guyana means “Land of Many Waters”; with its many tributaries including the Rupununi River, the Essequibo River is the third largest in South America. Unlike other regions of the Amazon rainforest, Guyana boasts a largely untouched natural environment, which has been minimally damaged by tourist activities. Guyana is known as the land of giants: the giant otter, anteater, armadillo, centipede, and of course the jaguar, one of the largest feline in the world and the national mascot.

When we visited a secondary school as part of our tour at Rock View, the children sang (see picture), “Living in Aranaputa in the Rupununi basin…we can be hungry….life can be hard.” Obviously, life in the rainforest can be unforgiving, and the song contrasted markedly with tranquil Cape Breton lullabies that we would sing in our Canadian secondary schools. Children as young as six years old walk to school by themselves and if they’re lucky, two or three might be able to simultaneously share a single bicycle for transportation.

Beside the school, there is also a small plant (see picture) producing peanut butter, a source of pride for those in the Rupununi. The peanut butter is exquisitely smooth and simply delicious. The children would eat this on cassava bread, which has a very thin crunchy texture, as their lunch. Despite these brief insights into Guyanese life, we must admit that the actual pulse of the country remains elusive to us.

Doctors without Supplies

According to our Bradt Travel Guide: “The Rupununi region is home to three of Guyana’s Amerindian tribes: the Wapishana, Makushi, and Wai Wai…They are mostly subsistence farmers, fishermen and hunters that often live without running water, electricity, medical care and modern forms of communication.” We experienced the effects of the latter two items first- hand today when one of the students fractured the 5th metatarsal of her right foot. Antoine and Nick brought the truck to find us finishing our scrumptious egg breakfast. We had some Tylenol for pain relief, and we created a makeshift splint out of a sock-covered wooden plank from the carpentry work area and triangular bandage.

We got a ride from the local forester, Imole, to Annai where we searched for one of the nurses to let us into the regional health centre. When we finally found the nurse, she informed us that the plaster of paris for proper splinting at the station had expired. The closest medical centre would be Lethem.

Our ride to Lethem gave us the opportunity to experience Southern Guyana with its egrets (cranes), manbirds (We’re not kidding. They’re huge birds with black heads and red necks), and vultures. There were several grass fires along the road; this natural ability of the savannah to maintain itself is really interesting to see for any biologist.

Fortunately, the hospital (see picture) was open and they had casting supplies, but no physicians. With cell phone reception in Lethem, we were able to call the student’s family. We ended up splinting our student’s foot and seeing another patient with right upper quadrant abdominal pain upon the nurses’ request. We started an intravenous line and gave the man some pain medication (the strongest that they had was diclofenac), advising him to see surgery for a cholecystectomy in Brazil – the earliest appointment would be tomorrow. Yes, our Sunday turned out to be a workday. Meanwhile, Nick and Antoine went to Rock View to enjoy the pool and ended up eating our lunch since we weren’t there!

On the 2-hour drive home, we crossed some very questionable wooden bridges including one that was in the process of being repaired (see picture). At one point, one wheel of the pick-up truck was essentially balancing on one wooden plank! As on several occasions during this trip, you really would rather not know all the details and let faith lead you. Perhaps, it’s best to gain some spiritual guidance from Guyana’s favourite Jamaican musician, Bob Marley: “Everything’s gonna be alright. Everything’s gonna be OK.”

Rock View Lodge

Rock View is gorgeous and really a model for other hospitality establishments. There’s an extensive garden of cashew and mango trees, purple cabbage, shallots, and golden apples (see picture). As you would expect, the food is quite delicious here and quite a novelty compared to Bina Hill’s kitchen where we eat a lot of starches like rice, plantains, and bread with very few fresh vegetables or fruits.

To start the week-end, we had a lovely 1.5 hour horseback riding excursion (see picture). Lisa successfully cantered for the first time on a horse! With all the distractions in Toronto, it has also been some time since both of us simply sat down and read. TV/YouTube really can’t compare to your imagination.

Upon some deeper reflection, the Lodge really has highlighted renewed appreciation for certain things that we tend to take for granted:
1. Clean drinking water
2. Unlimited toilet paper
3. FAN – this really makes a huge difference
4. Electricity all day with hot water!
5. A bathroom adjacent the bedroom
6. A malaria free zone negating the use of a mosquito net
7. Refrigerated items like milk
8. Coffee drinks
9. Reliable transportation like public buses
10. Basically…home! There’s no place like it.

The Rupununi

After organizing the workshop for next week-end by contacting all the healthcare workers by radio and sorting out some more details, we got a ride from a team with CIDA (Canadian International Development Agency) to Rock View Lodge, our week-end getaway destination. Don, an electrical engineer, and his partner, Monica, are in the process of installing internet to a neighbouring town up the Rupununi River.

We actually had the pleasure of visiting the Rupununi River (see picture) when Uncle Vincent (as in Chinese custom, Uncle and Auntie are used deferentially) invited us to come along after work for a fishing expedition. Every few nights, Nick, the Peace Corps volunteer, and he drive to the Rupununi to try their luck at catching bass. If you wish to swim in the Rupununi, you have to stay clothed because a parasitic mite known as a chigger (no, not a racial slur) can actually burrow like a corkscrew into your skin to lay larvae – ah, our daily dose of tropical medicine trivia! Swimming is probably not the safest idea anyway since a one-eyed cayman lurks in the waters. We shall happily leave swimming for the pool at Rock View.

Nick did manage to get a tug on his line, but the hook didn’t catch. According to Vincent, an Amerindian man has to prove his worth to the family of his potential wife by demonstrating in front of them that he can indeed fish, as understandably, survival depends on this. Looks like Nick will be single for a while!

Surviving in the Rainforest/Savannah

We managed to call the Chief Medical Officer to fax approval to the Regional Health Office over Skype – this in itself was a feat! Reception in the rainforest/savannah is just not that reliable! We are amazed that we actually got a weak connection. Hurray!

Over breakfast, we had an interesting chat with Anika, one of the post-secondary students at Bina Hill Institute. She was telling us about some of the rather unconventional teaching methods that they employ to teach tourism students. She and five other students were left in the rainforest for 24 hours as part of a survival course without anything but a lighter. During the night, they thought that they heard the cries of puma, but were happy to find it was only foxes in the distance! Despite the multitudes of poisonous insects and anaconda, her team survived the night with only a few bites. Makes Outward Bound in Canada seem like a walk in the park!

We are excited to be going to Rock View, a famous eco-lodge known for bird-watching in Annai for the week-end. There are lots of animals that live on the premises and nature hikes in the surrounding area, but more importantly, there is a pool!

The picture above shows the local store and second picture shows the general meeting area for meals. The kitchen is on the left of the meeting area and the washrooms are just behind. The two teachers, two Frenchmen, one Peace Corps guy, Lisa, and I played a rousing of game of “Asshole” and “Uno” around this table swarmed by moths last night – an activity that really reminded us of teenage years at overnight camp!

Getting settled

Our room was like a greenhouse of stagnant air despite having our windows wide open last night. Cynthia will never forget the sensation of waking up to something crawling up her hand and praying that it was a gecko. Much to her dismay after she turned on her headlamp, it turned out to be a large cockroach, thus highlighting the need to tuck the mosquito net in under the mattress for all corners of the bed. Thankfully, it cooled down later in the night, and we managed to drift to sleep.

Work was fairly productive; we did an outline of our sexual health talk and divided up the diabetes/hypertension workshop. We’ve arranged to travel to the nearby town, Lethem, on Friday to speak with the Regional Health Officer for his final approval. Medex Bartholomew highlighted a need for reliable on-line resources, which we were happy to compile. We might be giving some other talks depending on demand from the other villages.

We had a fun lunch discussion with Linzii, who teaches tourism to post-secondary students here at the Bina Hill Institute and Antoine, the young French wanderer (see picture). Linzii is a fellow Canadian from Manitoulin Island who is part of a leadership program designed to empower young students. Antoine seems to have taken a year off on a whim to travel the world with his friend, Jeremy. They liked the landscape in Bina Hill and decided to make some extra cash; his only complaint is the insistence of the establishment to refrain from taking his shirt off irrespective of the heat. It was a hilarious when upon perusing Lisa’s DVDs, he stopped at Anchorman and asked if this movie had something to do with fish.

The students at Bina Hill range from age 14-22 and apply here for a self-designed curriculum. Subjects taught are dependent on the expertise of available teachers. There is a large thatched wooden circular airy building where classes are taught and a computer room for students to learn about Information Technology. Students from the secondary school next door come to the Bina Hill kitchen for lunch (see picture).

Arrival in Bina Hill

We arrived in Annai at noon today via yet another small airplane (it seems that this trip was destined to help Cynthia conquer her agitation with flying) and were driven to Bina Hill by Vincent and Medex Bartholomew through some fairly heavy rain. After unpacking, we did some preliminary exploring of our accomodations in the middle of the rainforest. Our adjacent room windows are visible in the picture, and the teaching classroom is upstairs. There is a store, which carries basic supplies, within the complex. Unfortunately, the store is out of bottled water and toilet paper currently, and the owner says that the supplier delivers goods sporadically. This might be a moment to panic, but not to fear! Our experienced travellers brought solution to purify water if necessary and plenty of wet-wipes for those unexpected situations. Oddly, there is plenty of juice at the store: orange, punch, grape, pineapple, but no water.

There are several foreigners living nearby. Millie is from the UK, and she is teaching biology at the local secondary school. Apparently, the closest hang-out where you can get some cold drinks is 15 minutes by bike or 45 minutes walking. There are some random French guys who are here only briefly to make some extra cash before continuing their tour around South America.

As for the project, we have started alerting the Healthcare Workers by radio about our workshop and were further told that some of the young female students might benefit from a frank discussion about sexual health, something that they would likely be more comfortable discussing with female doctors. Looks like we will be doing a bit of high school guidance class!

The landscape is quite remarkable here. There are Macaw parrots that fly around the trees, and we saw lots of interesting critters even on our short walk. The Bina Hill institute is nestled in the forested mountains, making it a scenic location for schooling. It is getting dark and they will be shutting down the electricity soon; this means that we will have to charge our computer so that we can watch our 1 episode of Rome later tonight! As you can imagine, bedtime is pretty early here.

Week 1: Georgetown, Guyana

After missing her connecting flight from Miami to Port of Spain in Trinidad/Tobago, Cynthia was relieved to finally join Lisa in Georgetown on November 4 after several flight cancellations and delays. We have been in Georgetown for 1 week finalizing approval for our project by speaking to the Minister of Health; we will be leaving for Bina Hill tomorrow, Nov. 18. Since we were in Georgetown for the week-end, we decided to arrange for a trip to Kaieteur Falls, the gem of Guyana. At a height 5x that of Niagara Falls, Kaieteur Falls is a truly spectacular sight in the middle of the Amazon rainforest. It is about 1.5 hours from Georgetown by plane; the plane ride itself was an experience! We also took a dip at the base of Orinduik Falls, the perfect end to a day in the sweltering heat.