Our curiosity was piqued one day when we saw a group of unfamiliar I-Matang sticking out like a thumb whacked with a winch handle. There were two “groups”, one called Water For Life, the other, an individual philanthropist. They had all arrived at Tabuaeran (Fanning Island) by cruise ship and were staying until the next ship; during their two weeks, each had a number of humanitarian tasks they wanted to accomplish.
This group came to test the ground water in many of the areas, and to build some water tanks for catching rain; they travel on their own time and at their own expense. As at Kiritimati, most locals drink the ground water, which is sometimes contaminated with bacteria if the well has been placed too closely to the “toilet facilities”. Human waste is usually dealt with by 'doing your business' on the shore where the waves should eventually wash it out to sea (making it a good idea to watch your step when walking along the shoreline), or by going into the bush. Some families have a toilet area, but many do not, and even the schools do not have a toilet – the kids just go into the nearby bush. Many folks boil the water but this doesn't address the second problem, which is the high salinity in the water. Lots of sugar is used to cover the salty taste, which contributes to the high rate of diabetes here. The rain cisterns are a simple design, using local or easy to get materials. The rain off of the traditionally-made roofs (made from pandanus leaves) is too contaminated, but many of the maneabas and schools have corrugated metal. The Water for Life folks built a few tanks, finished off some they had started a few months earlier, and did their best to pass on these skills and to convince people of the importance of having safe drinking water. The real challenge is the follow through – some of the partly done tanks could have been finished in the intervening months without too much difficulty but weren't. The group was hopeful that there were at least a few people who seemed keen to learn. In the meanwhile, the nurses' clinics now have tanks for good quality water, as do some community areas.
We were fortunate to meet this most remarkable man. He is an outgoing, enthusiastic individual who has taken it upon himself to bring medical supplies and eye glasses to the Line Islands. He and his wife had been on a cruise that stopped at Kiritimati (Christmas Island); they had brought medications with them when their research revealed just how limited supplies were. While there, they quickly learned just how important these supplies were when the life of a little girl was saved by the antibiotics they had brought. Carlton said that running the ranch he had bought after selling his newspaper business was not fulfilling enough; he decided to put some of his energy in to helping out a place that WHO (the World Health Organization) lists as one of the most medically needy countries. He had three goals for this trip: bring medicine and other medical supplies; bring and distribute eyeglasses; and, provide a means for the three nurses on the island to communicate with each other. Although Carlton gets used eyeglasses from the Lion's Club and some donations from pharmaceutical companies, he is not a registered charity and personally bears the majority of the expenses. His friends tell him that the Kiribati government should be caring for its own citizens, and although he agrees, he notes that the government isn't, so he does. This man is doing a lot more for the good reputation of Texans than certain other unnamed Americans.
The three nurses were very pleased: how frustrating for a professional to know what is wrong, how to fix it, but not have the means to do so. In addition to the more obvious medical things like pharmaceuticals and bandages, he brought LEDs, small solar panels, and batteries for each clinic to provide some lighting, as well as cabinets for storing the supplies. One clinic was a small cinder block room separated from the nurse's home. It had the new cabinets, a counter with some mostly empty shelves and linoleum tiles over the cement floor. It is on this floor, on a pandanus mat, that women from that village come to give birth. The other two clinics were simply part of the nurses' homes. Patients were often seen and treated on the nearby raised platforms which were made from coconut fronds and covered with pandanus leaves, hardly a sterile, or private, environment.
Carlton was excited to learn we were on a sailboat, as he was looking for a way to get some of the medical supplies to Teraina (Washington Island), 80 miles away. We'd had no intention of going to this tiny island which would put us further downwind from Hawai'i and where the anchorage and the pass were reputed to be dangerous (parts of Bruno's yacht still remain on the reef), but how can you say no to a guy like that? Truly, he was doing so much that we were inspired to go the extra (80) mile(s). Using the SSB radio, the nurses between the islands arranged that we would anchor at Teraina and a dinghy from the island would brave the pass to pick up the supplies, worth more than $10,000 (although listed as $800 to avoid nefarious use). Interestingly, we had a pretty good passage after we left Teraina, which perhaps we could attribute to good karma; I hesitate to conclude that since it means we must have done something really rotten before leaving for Fiji!
We volunteered to help Carlton with his eyeglass clinics but didn't arrange a way to get to the first one; we thought we would go with him, but he had actually gone the day before and spent the night. We took the ferry across and had a nice walk of about an hour and a half, albeit a bit hot in the mid-day sun. I admit we were hoping for a ride back, but instead nurse Nukai lent us two bicycles, with instructions of where to leave them near the ferry landing. We happily began pedaling toward home after a tiring afternoon at the clinic, but not too long into the ride, the pedal fell off! We couldn't get it to stay on without a wrench and so Bjarne had to cycle one legged for the rest of the way. I think it was almost as tiring as walking. Transportation to subsequent clinics was in the back of a pickup truck, a slow and bouncy way to travel.
By the fourth and last clinic, we were quite an efficient team and had all learned a few more Kiribati words. The first step for a “patient” was to visit Bjarne, who screened them for distance vision, using the universal language eye chart (E's facing in different directions). Many people had never experienced having their eyes tested so a few got mixed up and would cover one eye with the “spoon” but then close their other eye. This created some entertainment for the others in the line, but it all seemed good natured. Bjarne explained, communicating with words and hand gestures that when he pointed at one of the E's, the person should point in the direction it was facing. Often they would barely flick a finger to indicate the direction of the letter so Bjarne had to become adept at interpreting the subtler hand movements of the Kiribati. If a problem was noted with their distance vision, the next step was to see Carlton, who determined a prescription by using a refractometer to measure the curvature of the lens. This nifty piece of equipment is quite expensive but he was able to borrow one with a deposit; the prescription is not quite as accurate as that determined by an optometrist, but the gadget is portable and can be used by a lay person. Prescription in hand, the person would then come to me, where I would try to find a pair of glasses that matched the prescription and hopefully fit. After a while, I got better at shaping the frames (I found a little butane torch and pliers in Carlton's kit) when we had a really hard to fit situation. We weren't measuring astigmatism but some of the the glasses had such correction, thus it was important for a person to try a few pairs on if there was more than one of a given prescription. Some of the people were very shy about saying what they preferred and I had trouble conveying that I wanted them to indicate which one was better. Sometimes someone would translate, otherwise we muddled through and it got easier when I learned to understand the word for “good”. Kiribati people don't nod in the affirmative; instead they kind of lift their head and eyebrows a little. I was never quite sure when someone was agreeing with me. We also had an area for folks to pick up reading glasses. We left this for the nurses or one of the women from the village health committee to run as our hands were full. People just tried out different reading glasses (all labelled according to strength) until they found ones that helped them to read the sample text. We often had a good audience of curious folk watching the proceedings.
These clinics ended up being a much bigger time commitment than we thought due to the overwhelming gratitude of the nurses and villagers. In fact, I perceived a bit of competition developing regarding which village could be the most hospitable. At each clinic the local women provided us with large containers of food, which they finished off after we had eaten our share. Their efforts were appreciated, but the local foods were not always kind to our digestive systems and Bjarne was quite sick one day from food poisoning.
There were also three parties that we attended. At these events, in addition to great quantities of food, the locals danced and sang for us. Naturally, there were speeches all around, and we were also asked to tell the folks a bit about ourselves. At one party there was even a band. Then the party would liven up more with lots of people dancing, usually in pairs, or sometimes in a fun conga-type line in which the followers all copied whatever the leader was doing. There was very little rest for us I-Matang, who were frequently asked to dance. At one event, Bjarne and I were each asked to do a solo dance. Not being particularly gifted in this field, we each decided the best thing was to set dignity aside and have some fun. Thus, we each hammed it up as we undulated around the maneaba, with our hips encircled by fern fronds. Bjarne even finished his routine up with a front roll. Where else can you have such an experience?
We were presented with various handicrafts, blouses made in the Kiribati style, and even lava lavas with our names embroidered on them by the nursing team. These women are remarkable: they are constantly on call, work with very limited resources and support from their government, take care of their families, helped organize and run these eye clinics, and still made time to feed us, fête us, and embroider for us! The resources on this island are quite limited, yet we found the people were very generous.
On an earlier visit, Carlton had provided the head nurse (Arote) with an SSB radio so she could communicate with the physician on Kiritimati (164 miles away), and with the other nurse on Teraina. On this trip he brought a fixed-mount VHF for Arote, and hand-held VHF radios and solar panels to power them for the other two nurses. Bjarne helped Carlton to set up the antenna for Arote's radio, located between the other two clinics, and there was no problem in communicating with the other two nurses. However, the two smaller radios (Nukai's and Rena's) didn't transmit quite far enough to reach each other. After consulting with Bjarne, Carlton arranged with Gordon West for some larger outdoor-mounted antennas to be sent on the next cruise ship to augment the hand-helds. Stepping up to larger radios would mean too much drain on the small batteries and solar panels that were providing power. The plan was to get the equipment off the ship as quickly as possible so Bjarne and Carlton could rush around to the two clinics (which were of course in opposite directions) while the tourists had their few hours in the sun, and then get Carlton loaded onto the ship and headed for home. It was arranged for Bjarne to finish up anything that didn't get done. On the day of the ship's arrival we were awakened early by howling winds and blasting rain. Nasty squalls plagued the island all morning and for a while it seemed doubtful that Carlton and the Water for Life people would even be able to get off the island! Certainly no tourists were coming ashore, which meant a lot of lost revenue for the islanders. In a testament to the high regard they have for Carlton, a contingent of women braved this weather by taking the early morning ferry over to say goodbye to him. The seas remained rough but the NCL crew managed to get the antennas onto the island and the visiting I-Matang safely back to the ship, where they could all enjoy a well-deserved rest, not to mention the cruise ship buffets (who's jealous?).
Nothing happens quickly on these islands and it took us three days to get the last two antennas set up, although the actual work didn't take long. On the first day, we discovered the ferry wasn't running at the times we thought so spent a couple of hours arranging transportation across the pass for another day.
On the second day we borrowed bicycles to get out to the other clinic, where, after a visit with the nurse (Rena) and some neighbours, the antenna was quickly taken care of. As arranged previously, we were then taken by guides on a long bike ride (almost an hour) to see a very peculiar coconut tree. Somehow it had grown in big loops - amazing! One of the guides quickly climbed up, and then cut notches in the tree for his companions. Even with the notches BJ got only partway up, and I didn't even try. The bike ride was fun: it took us along what seemed to be an old road, very overgrown and narrow now, left over from when the island was important from a communications standpoint. We had to carry the bikes across various salt water inlets, and dodge the ubiquitous puddles along the way. On the way back we abandoned our guides and went a little further into some woods that Bjarne had come across previously, where the white birds seemed quite curious about us. They would hover just above our heads, but again, only if the camera had been put away!
When we returned from seeing the fantastic tree, Rena insisted on feeding us and we had a pleasant visit. Her neighbour, a blind man, entertained us by playing guitar. By late afternoon we loaded ourselves onto the bikes, along with a fairly heavy pumpkin, and some other food. We were also carrying water bottles and a lunch that we hadn't needed. Along the way, we stopped to visit our friend Bwaraatu but it was getting late so we didn't delay for too long. Just a bit further down the road, we ran into the nurse's aide, Teburenga, who invited us to visit. We were starting to know too many people – it was now hard to get anywhere without stopping and socializing! Teburenga was pleased to introduce us to her husband and son and insisted we take some bananas with us. Good thing we said we didn't need too many: as it was, a half dozen hands were hacked off, which Bjarne perched precariously on the cross bar of the bike. The provisions made cycling a bit of a challenge but were welcome since we were leaving for Hawaii in a few days.
On the third day, we lifted our borrowed bikes onto the early morning ferry and joined the morning commute on the other side of the pass. The line of 10 bikes moved snake-like as we wove around the large potholes, puddles and palm fronds. The 30 minute ride to Nukai's clinic was pleasant, with only one interruption when a boy came running after us calling “I-Matang, I-Matang!” He was very enthusiastic, running quite a way, so I stopped to talk to him. At Nukai's home (the clinic) we found that she had prepared a breakfast for us, but we had already eaten. We needed to wait for a while until someone arrived to help erect the pole for the antenna, but once the job was finished, the reception to the far clinic was much improved. Whenever Bjarne is around for too long, electronic problems come out of the woodwork so he had a look at a couple of things. We ended up taking a solar panel back to Freya so a blown diode could be replaced and a fuse added to protect it if the panel was hooked up backwards again. Nukai then informed us that she had arranged for all of the women of the health council to prepare a big lunch for us, and let us know that the women would be offended if we didn't try something from each person's contribution. Obligingly, we dug into the various dishes. As we had arranged an extra ferry run in the middle of the day, we could not stay quite as long as she wished. Despite the kind hospitality, we were glad we had done so, because we had the usual long list of chores to do on Freya before taking off on passage.
We made the arranged ferry, Bjarne quickly fixed the solar panel, and then we tidied up for our guest, Teburenga. She generously brought a lovely blouse for me and an embroidered lava-lava for Bjarne. We gave her some sewing needles and t-shirts for her family to thank her, and had an enjoyable visit. The only problem was that she was enjoying herself too much and asked to stay on the boat longer when I suggested we get back to shore at 1730h. That was all well and good except that as the sun set, she then told us she was nervous about going home in the dark by herself: she thought drunken men might chase her. The “good” women of Kiribati don't go out at night by themselves. She lives about a 30 minute bike ride away and we had already returned our borrowed bikes to Roland. We were not happy about this development, but didn't feel like we could abandon her. Bjarne and I quickly jogged to the NCL compound where we found Roland, who lent his own bike to Bjarne. We didn't ask him to open the bike shed for me to get a bike as well, so Teburenga was surprised when only Bjarne came back. She got him to stop a little before her house so the neighbours wouldn't see her with a man she wasn't married to. I hung out at Roland's, watching a movie while I waited for BJ to return. I don't know if it was poor planning on Teburenga's part or if it was an attempt to get us to visit her home. She had suggested we all go to her place for supper, and even that we stay overnight, both offers we declined, stating that we had work to do for our passage. Hard to say what that was all about, but inconvenient nonetheless.
On the day we were leaving, after sorting out some complications with customs regarding the extra stop to drop medications at Teraina, we learned that Rena's radio wasn't working. Not the best timing, but better than after we left I guess. Off Bjarne went on a motorcycle; dodging obstacles makes the trip about 30 minutes long. The problem was a poor connection from the solar panel to the battery, leaving Rena with a very dead battery. Once diagnosed it was easily fixed, and happily, a local fellow asked to be shown what the problem was, and how to fix it in the future. Ironically, the island was left in a better state with respect to communications than we were: as we said our goodbyes over the radio while motoring out the pass, poor reception caused us to notice that we had no antenna! We were reminded of the large bird that had whacked into the top of the mast a few nights before; guess it had done more damage than we'd realized.
One can become cynical and disheartened upon hearing story after story about corruption and incompetence, but Carlton and the Water For Life people found ways to contribute despite these realities. They haven't changed the basic structure of Kiribati life, but they have positively affected the lives of many individuals; who knows what ripple effects that might have? These humanitarians are also to be admired for focusing on what they could contribute, and not becoming overwhelmed by the enormity of the needs. They are an inspiration and it was a pleasure to meet them.
Note: Carlton is looking for folks who can help him deliver medical supplies between Christmas (Kiritimati), Fanning (Tabuaeran), and Washington (Teraina). If you are interested, or want to assist in some other way, email us and we'll put you in touch with him.