Monday, April 25, 2016

Angela Lyttle, CNM - Turkey February 2016

Day 1 in Cesme  February 10, 2016
I arrived at my apartment around 3am this morning.
I am definitely still getting my bearings! 
I went with the coordinator to hotels today where refugees are staying. This local group collects supplies (food, clothing, etc) and does daily distributions to the local hotels.
I saw many babies to elders/family groups in the hotels - all primary care. Several people have severe frostbite after attempts to cross through the snow covered mountains. 
My biggest struggle is the language barrier, by far, which I expect to improve over the next couple of days. It often requires more than one person translating - from Farsi or Arabic to Turkish to English.
I also had to take some time upon my arrival to look up the medications that are all written in Turkish!
The people are all kind and helpful. Today there were volunteers from Holland, the UK, Germany, Mexico, and of course, Turkey. 
My phone is mostly off to save data. Hopefully I will find WiFi tomorrow!

Day 2 in Cesme February 11, 2016
So many friends and family worry about my safety. Let me assure you, I am very safe here. This is a resort town on the coast. When I am not working, it feels like a vacation.
I am completely overwhelmed by the kindness of the people here! With all of my food allergies, many locals have been concerned about me eating. Two women drove to the next town to buy me gluten free bread despite my protests! 
What I am doing here is very small - just 2 short weeks. This is the daily work of the Turkish people here. Their patience and thoughtfulness with the refugees is admirable. Please send your thoughts and prayers to the lovely people working here, and of course, to the refugees.

Day 3 in Cesme February 12, 2016

Yesterday the weather was nice, so most of the refugees in the hotels here left on the boats for Chios. A few new families arrived here, but I did not see as many people as I have on previous days.
There were a couple of people who I had hoped to follow-up on today. There were a couple of cases of indescribably terrible frostbite. These people were gone today. 
I hope that everyone arrived safely. We should hear tomorrow. (All of the families in yesterday's pictures are gone).
To give perspective: the other day a boat was intercepted with over 90 people on an 8 meter boat. 
Chios is very close. It is the island that can be seen in the distance from the coast of Chesme in this picture.
Tonight, I am travelling to Izmir to help deliver supplies for distribution to the refugees there.

Day 4 in Cesme February 13, 2016

Today was a really busy day. I have no idea how many people I saw. There are so many babies. I also saw some pregnant women who were happy to hear the heartbeats of their babies (as was I).
I saw a couple more cases of frostbite. One was an 8 year old boy - his toes are black and the bottom of his feet are black in places. He will lose all of his toenails. His was not the worst case that I have seen, but he is the youngest.
The refugees are very appreciative. Much is lost in language, but so much is found with kind touches, smiles, and laughter. At this time, most of the refugees who we see are from Afghanistan. I was a little concerned that the men would not want to be treated by me, but that has not been a problem. I have also been dependent on men to translate while treating women, and this has been okay as well. 
It is difficult to look in the eyes of the babies and children and to think of them climbing on a rubber boat to go across the sea. This organization encourages them to stay in Turkey. There are a few families who have stayed in Cesme. Most go.
The weather is bad, so hopefully no one will try to cross. I expect that the hotels will have even more people tomorrow.
It is amazing how quickly something that was completely unfamiliar becomes familiar. And how quickly new friends become good friends.
It is day 4, and I cannot imagine how difficult it will be to leave this place.

Day 5 in Cesme  February 14, 2016

The hotels were busy again today. There didn't seem to be too many new arrivals - I saw many of the same families who I saw yesterday. It is easier seeing them on the second day - I have some sense of their concerns, so it goes more quickly. It also helps to see the babies/children a second day.
My sweet boy with the frostbite was all smiles today. He gave me thumbs up after I finished dressing his toes smile emoticon
And seriously. These babies! Anyone who knows me knows how much I love babies. They are SO sweet!
It is really windy tonight, so I do not think any boats will try to cross. One family who has been here the whole time that I have been here said they were planning to cross tonight. I hope that is no longer the case.
Tonight was fun. Two of the volunteers hosted a dinner party for volunteers at their house. There were about 20 people there. Talking with a group of people here is fun/interesting - a combination of German, Turkish, and English tonight!
Love to all. I hope everyone had a wonderful Valentine's Day.

Day 6 in Cesme  February 15, 2016
The hotels are filling up since it has been windy and the boats aren't crossing. The weather is nice and sunny, but windy. Many children were playing outside today, which was nice to see.
What I have noticed is that upon arrival, the refugees are usually closed up in their rooms, they feel cold, and they sleep for a day. So many people have a cough and many of the babies/children have a "fever". (This is what they tell me - I have yet to see an actual fever).
The babies are usually dressed in 3-5 layers of clothes, sometimes a snowsuit, almost always a layer of fleece or similar heavy material. (It is over 60 degrees here!) So, the babies are " hot" with "fever". I have " cured" many babies just by peeling off layers!
We also tell them to open the doors/windows and get fresh air into the rooms. There are usually 10+ people in each small room, so the rooms get really hot and stuffy. And of course, if one family member gets a cough, then everyone gets it.
It's fun returning to see families who have been here for a few days. They clearly start feeling better after some rest, and everyone is more relaxed. The kids start acting like kids smile emoticon
For the last couple of days, after doing our rounds at the hotels, I have been trying to sort through all of the medications that have been donated. It is a tedious process, but I am learning these Turkish medication names wink emoticonThere will be medical volunteers here on a regular basis now, so I hope to create an organizational system with the different medication classes that will be user friendly for future volunteers.
Tomorrow morning, I will be going to Torbali where there are several Syrian refugee camps. From the pictures I have seen, the conditions are heartbreaking and terrible. We will take food and supplies, and I hear that there will be many pregnant women and babies for me to see.

Day 7 in Terboli  February 16, 2016
Today we drove to Terboli - about 1.5 hours from Cesme. We visited 3 camps where Syrian refugees are living. If I understand correctly, they work as tenant farmers. They earn a small wage from the farmers for working in the fields, and then pay the farmer a large portion of their salary to live on their land. The conditions are far from ideal with no running water or toilet facilities. These are people who are staying in Turkey - not crossing over to Europe.
We went to three camps. There are so many children. I saw five 1-2 month old babies, and many women are pregnant. I was concerned about one baby and recommended taking her to the hospital. I was told that they cannot go because they do not have IDs and do not have money to go. The hospital will turn them away. However, I was then told that the baby and other children were seen by doctors yesterday who are bringing medications for them tomorrow. This is a problem that I see - there is such a patchwork of organizations - one provider has no way of knowing what another provider has done.
I am really tired tonight - it was a long and exhausting day. I will say that I am thankful that U.S. hospitals have EMTALA and language access services - even though they are often a pain to access.

Day 8 in Cesme  February 17, 2016
Most of the hotels were empty today. Over 600 refugees landed on Chios last night, another 150 today. At least one boat attempted but returned - I don't know the details (if the boat had trouble or if they were returned by the coast guard). Several of the families I have been visiting were on this boat.
When I hear "smugglers" are being paid huge sums of money to take refugees across the sea, it makes me think that this is a secret operation. It isn't. Just walking down the street, one will suddenly be passed by a group of refugees carrying all of their possessions heading toward the shore. Morning, afternoon, night - it happens at all times of the day.
The 8 year old with frost bite and his family left on the boats.
Last night, I went to a lovely dinner at the seaside with a new volunteer. As we arrived to the water, one of the families I have cared for was at the shore - they have a 2 year old girl. I must say my heart broke a little to see her just moments before they start the next leg of their journey. I hope they are safe.
I also found out a little bit more about the last camp that we visited in Terboli. While the first two camps were tenant farmers, the last was not. At the last camp, the people do not have jobs or any income. The overall health at this camp was much worse than the first two where everyone seemed relatively healthy. With an ID, the Syrian refugees can get jobs. This group does not have IDs.

Day 9 in Cesme  February 18, 2016
This is going to be a long one, friends. It was a big day, and I have a lot on my mind.
I have said it before. I will not pretend to understand all of the politics involved in this crisis. What I do understand is that no one decides to travel toting toddlers and babies or their elderly mothers/grandmothers in the worst possible conditions. No one climbs on a rubber boat or puts their baby on a rubber boat, telling us they understand the danger, they understand people are dying, but they still feel like this is their best chance.
The morning started earlier than usual when we were called to the Jandarma (a military branch) station because they had 70 (mostly Syrian) refugees who were stopped from crossing. We took food, water, milk, baby care items, etc and I saw all of the people who had any medical needs/concerns.
The Jandarma officers were kind to the refugees - I was glad to see this.
What is fascinating to me though, is that when there is need/crisis - it wasn't a government agency, or a non-profit agency, or similar that was called. It was a local man, a boreci (like a baker) who was called to provide assistance.
This group that I work with Imece Inisiyatifi Cesme is unofficial and made up entirely of volunteers - Ali is the boreci who coordinates, and then many others: web designer, architect, social worker, university students. It amazes me that there are so many refugees here, and the only group working with/helping the refugees is this one. At least once a day, I am asked if I am with the UN. Nope. Just a volunteer.
The hotels were very busy today - some large rooms contained as many as 20-30 people. I saw more people today than any other day, I think. The weather is nice, and so many people are crossing. We saw many people heading to the shore tonight. Everyone who I spoke with today was planning to cross tonight. Several families were returned to Turkey last night and plan to try again tonight. Some families spoke of multiple attempts.
So, I have been thinking, if life is made up of a series of small moments, here are some of mine from today.
At the Jandarma this morning, I spoke with a young Syrian man who speaks English fluently. He told me about his house being bombed and his street was destroyed. I had no words to respond. His whole family was on a different boat last night, and they made it to Greece. He will try again for the fifth time tonight. He and his family hope to return to Syria when it is safe.
At the Jandarma this morning, a man, maybe in his forties, who spoke very little English befriended me and sat with me as I saw people. He professed his love for me. He has a tremor (neurologic) - he asked me to prescribe medicine for him. Apologetically, I told him that I could not.
At the Jandarma this morning, an adorable 4 year old with nearly blonde, curly hair and blue eyes who was interested in me from a distance, but scared of me when he was close. I gave him medicine, which he quickly spit out, spraying it everywhere.
In a hotel, an elderly woman (I would guess 70s? She seemed so frail.) who had a wound on her forehead. I removed stitches that have been there for twenty days.
An older man whose blood pressure was dangerously high. I strongly recommended the hospital. He won't go. He plans to go on the boat tonight.
An 11 year old girl wearing a shirt that said, "Life is like a box of chocolates." I had a man interpret this for her. Her response, "Eh. I don't like chocolate." I got a good laugh!
And my favorite moment of the day... The 8 year old boy who I have been treating for frostbite was on one of the boats that was returned to Turkey. We found them in a different hotel than where they had been. While I know his family wants to be in Europe, and they will try again tonight, I was so happy to see his sweet face and know that he is okay.
I have not shared pictures of people other than the pictures shared by the Imece Inisiyatifi Cesme photos. I think there is sometimes a fine line between exploitation and information, and I don't wish to cross it. But tonight, I will share a picture of this sweet boy (and one with his two little brothers who wouldn't be left out). Say a prayer for him and all of the others crossing tonight.

Day 10 in Cesme  February 19, 2016
The hotels were busy today, but I saw fewer people today than yesterday (maybe 150?, it's really too difficult to keep track). I also saw some people on a roadside who were staying in a cemetery.
A quick word on the hotels because I have been asked about them... As I discussed in a previous post, Cesme is a coastal tourist town. Since it is off-season, there are only about 30,000 people currently in Cesme. In the peak of summer, I am told there will be 500,000 people. So, there are many empty hotel rooms now. The refugees pay for their rooms, but rates are lower since it is not peak season. It stands to reason that once the tourist season picks up, the refugees will no longer be staying in the hotels. From what I have seen, the hotel owners who are accepting refugees are kind and helpful. They have a sense of what the overall needs are when we arrive.
I heard that many boats landed on Chios last night before midnight. However, there were also many families in the hotels today who told me that they walked to the boats last night and waited, but it was too windy to cross. So then they walked back to the hotels. I don't know exactly how far this walk is, but I know they were outside for many hours. The young children were especially tired.
I have heard from a couple different sources that the Turkish forces are now using water bombs to turn boats around back to Turkey. This seems especially dangerous given the overloaded, small rafts and risks for hypothermia.
Tonight, two physicians who speak Farsi are coming. It will be so wonderful to have providers who are able to speak directly with so many of the people here. I have been the only volunteer medical provider here for most of my stay (that I am aware of). I hope that once the physicians are settled, I can do further work getting the medication donations organized for future volunteers. The last few days have been too busy to work on this.

Day 11 in Cesme  February 20, 2016
Things change in an instant around here. The hotels were mostly empty today. Apparently, the police here are now threatening the hotel owners with heavy fines if they allow refugees to stay.
It is unknown if the refugees who had been in hotels made the crossing to Chios, or if they are hiding somewhere near the seaside. 20 boats landed in Chios (probably 1000-1500 people), so many of them probably crossed. Of the refugees still left in the hotels, many said they tried to cross last night but were stopped by police.
The two doctors who speak Farsi arrived today with friends - one who speaks Arabic. It is great to have them here and to break down the language barrier.
I'm struggling a bit today. Feeling really angry actually... I don't understand why people, HUMAN BEINGS, are being treated so badly. I don't understand how the rest of the world can turn it's back and say it's not our problem. It IS our problem. We all share this planet. We are all responsible to one another. We have enough resources. Every person in every country should have the basics: food, clothing, shelter, clothing, safety, access to healthcare, a way to make an income. It really isn't too much to ask.
Sharing pictures of the abandoned town where the refugees were staying just 4 weeks ago. Where they may return if they are unable to stay in the hotels.

Day 12 in Cesme  February 21, 2016
I don't have too much to update today.
I spent my morning being a tourist. I visited the Cesme Castle. The views over the sea were beautiful - there was a very clear view to Chios.
Walking back from the castle, I ran into a couple having tea at a cafe who have helped translate in one of the hotels. They kindly invited me to join them. Their families are Afghan in origin, and they came to Turkey on their honeymoon. They came to Cesme to visit, and have ended up staying for several days just to help the refugees here. They are incredibly lovely people. Sitting, talking, connecting - this was the most important part of my day. We are all one people.
After tea, I went to the depo and worked on organizing the medications. I got everything sorted (a pretty big task!). Now I am just working on the most efficient, user-friendly way to store everything so that future volunteers can easily access what they need (and hopefully not have to spend so much time translating all of the medications).
Pictures are from the castle. Chios is easily seen in the pictures looking out across the sea.

Day 13 in Cesme  February 22, 2016
This is my last day in Cesme. It is difficult to say goodbye both to the other volunteers and some of the refugee families who I have come to know.
Very few refugees are staying in the hotels now. One hotel here was fined 30,000 lira ($10,000 U.S.) for allowing refugees to stay without passports. So, now only refugees with passports are in the hotels, and the hotel owners must show a list of people to the police every night.
This doesn't mean there aren't refugees here anymore - they are throughout the city, in the parks, in the woods, and returning to the abandoned town that I took pictures of the other day.
My little friend - the 8yo with frostbite - was still here today. His family has attempted to cross multiple times but have not been successful. They will try again tonight. It is gratifying to see how much his skin has improved since the first day that I met him. I made up a package for him with all of the wound care items that he needs. This family will forever hold a place in my heart. I wish all the best for them, but the road ahead will be more difficult than they know.
I also saw the elderly(?) woman whose stitches I removed the other day. She was feeling a little better, so today we heard her story. She isn't sure how old she is - she thinks maybe 50 or 60. She was in her home in Afghanistan when the Taliban came to steal money and other valuables. She fought the Taliban and kept them in her home until the police arrived to arrest them. She was so feisty and animated as she told us about this! Her body is bruised, and the cut on her forehead was a result of one of the men hitting her with his gun. She also got very tearful as she talked about leaving her home - she never wanted to leave, but was forced to leave to find safety. She wanted pictures with us, and took a picture with her phone! I got a picture as well, and I asked her if I could post it and tell her story. She said to post it everywhere and tell everyone!
I completed my project to organize the medication. It isn't that big of a deal, but I believe I'm leaving the medication supplies a little better than I found them. Medications are now grouped according to the type of medication and labeled. I also made it through all of the bags and boxes of donated medications and got them put away.
My heart is heavy as I think about leaving this place and these people. I am not sure how I will carry on this work when I return home, but I know that I cannot just leave it behind.