Posts Tagged ‘Brazil’

How to catch an alligator

posted on July 31, 2014

KP physician and wife hazard a hunt in dangerous waters of the Amazon

Editor’s note: Kaiser Permanente physician and educator Martin Shearn and his wife Lori traveled to Brazil in 1973 where Dr. Shearn served as chief of staff for the SS Hope hospital ship docked in Maceio, a poor coastal community in Northeast Brazil. The couple took a few days off from their health care duties to venture into the Amazon River region in September of 1973.

Last in a series
By Lori Shearn
Heritage writer

Igapo

This photo shows an igapó, a flooded jungle channel in Brazilian Amazon country. The Shearns took a canoe ride through an igapo with their guides to catch a caiman jacaré they named Jose Dos Santos. Wikipedia Commons photo

We’d learned to trust our new young guide on the strenuous and magical jungle hike he’d led earlier in the day. An Indian, Manoel had lived on the Amazon all his life so he knew the rivulets and the inlets as well as the paths where there was terra firma to walk upon.

That night after dinner we embarked in earnest on our highly anticipated alligator hunt. Manoel had caught a jacaré¹ once before, he reported, and he had seen another one near where we’d docked our houseboat. We were extremely excited, bundled up in our canoe, aware of the dangers of the hunt. The mystifying sounds of the myriad of the Amazon’s night creatures made for an eerie scenario.

Just as we got ready to depart, a tremendous upheaval almost tipped the canoe as our cook Milton lowered his huge body into the back of the craft. He insisted his presence was essential to record the event on his brand-new tape recorder. Aliomar, our main guide for the Amazon trip, also came along. We were all in a gay mood, all giggles, as Milton planned (in jest) how he would fix the jacare for breakfast.

We could see Aliomar’s eyes shining with anticipation, for as our guide he wanted us to have a good time. Of course he also was a joyous young man on the hunt for a lark. Manoel, on the other hand, burdened with his responsibility and aware of the dangers, was solemn and quiet, acutely attuned to the sounds of the night. He sat in the front, paddling; Aliomar, Marty and I sat in the middle, and Milton weighted down the back. Manoel carried our weapon: a lengthy stick with a nail-like protrusion at its tip, and we each had a flashlight.

My mind was racing: How big was he?

We were gliding silently over the dark mirror of the river. We soon entered a nearby flooded riverbed (igapó).² We were told to shine our flashlights in slow circles over the surface – on for only a minute, then darkness again – on for a minute, followed by darkness. We could hear whispered conversation between Manoel and Aliomar, then scary sounds presaging all kinds of danger. There were lots of nervous giggles and jokes from each of us and then more silence. Suddenly – shhshhshh – Aliomar seriously hushing us: “I see one!”

Both of the young men became very intent, concentrating on the darkness ahead. Manoel directed their actions. Slowly we crept along the watery thicket, flashlights continually scanning the surface. “Look ahead there,” Manoel whispered. And then I saw two distinct red spots, obviously eyes paralyzed by the light and blinking in terror. It really was an alligator, he was clearly frightened and so were we! My mind was racing: How big was he? What if he lashed out with his tail and overturned the canoe and his family came along to capture us for a meal?

Marty still had not seen the eyes. He had to see them! We shined the flashlights again. Oh yes, there they were. Oh, how exciting! Gingerly, Aliomar maneuvered the canoe closer and closer to the spot. Hardly a sound. Then there was just a small tree between us and the shining red eyes.

When our trepidation subsided, I carefully drew close enough to admire the jacaré and even rub his smooth belly.

We were real hunters now, and while we caught our breath, Manoel kicked off his sandals, stealthily stepped into the water and with his bare hands reached out for our prey. There was a lot of splashing in the brief scuffle, and then, he had him! He held the alligator by the neck, the creature continued to flail his tail and his jaws attempted to snap. Manoel handed the jacaré to Aliomar and they allowed him to snap onto the wooden side of the canoe where he struggled for a while and then began to relax.

When our excitement and trepidation subsided, I carefully drew close enough to admire the jacaré and even rub his smooth belly. His eyes were on alert, but the perfect fingers on his front and back legs were now relaxed. He was resigned to his fate, whatever it was to be. We named him Jose dos Santos and jubilantly brought him back to the big boat.

This is what the alligator the Shearns caught in the Amazon looks like. Wikipedia Commons photo

This is the type of alligator the Shearns caught (and released) in the Amazon. Wikipedia Commons photo

Overnight, our nervous sleep was punctuated by a dozen giant toads that seemed to croak their disapproval. We were all up early the next morning. The river sparkled like a jewel and Jose was still in the washroom where we’d tied him up before we retired.

While I enjoyed my early morning swim, Milton the cook decided Jose would like a swim also. He made Jose a halter out of rope and dangled him into the water near me. Horrified, I thought Jose was free, and I was not convinced that it was safe to swim in the Amazon with a live alligator.

All through breakfast we bragged like successful hunters of old, recounting our tales of courage. And Milton had it all on audio tape! We played the great adventure over and over. At last the sun was high enough for us to get our photographs – triumphant hunters posing with our vigorously kicking prey, holding him this way and that for better angles.

Finally, we gave him his freedom back. He hesitated when he hit the water, but soon he carefully tested first one arm, then the other, and then with a powerful swish of his tail, he was gone. None of us will ever forget him. Quietly we all hoped he’d swim far enough away that we wouldn’t encounter him, bent on revenge, in our next dip in the mighty Amazon.

Martin summed up our adventure on the Amazon succinctly and excitedly in a September 1973 letter to friends back home:

“Lori and I just returned from an incredible journey on the Amazon replete with piranhas (Lori caught and ate one), lizards, alligators (caught one of those also) and various exotic birds.” (Martin had skipped the piranha experience because he was allergic to fish.)

“The submerged jungle called igapó was the most beautiful (sight we’ve seen). Ever changing and unchallenged. A remarkable experience and all the more so with not a single beer can or other evidence of garbage.”

 

¹Caiman yacare, jacaré in Portuguese

²Igapó (Portuguese pronunciation: [iɣɐˈpɔ]) is a word used in Brazil for blackwater-flooded Amazonian forests.

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Project Hope mission fulfills promise in Brazil

posted on March 13, 2014
Molly Beth Guest of Vermont posted this photo of her grandmother with a Project Hope child in Brazil in 1973.

Molly Beth Guest of Massachusetts posted this photo of her grandmother with a child who was helped by Project Hope volunteers in Brazil in 1973.

Editor’s note: Kaiser Permanente physician and educator Martin Shearn and his wife Lori traveled to Brazil in 1973 where Dr. Shearn served as chief of staff for the SS Hope hospital ship docked in Maceio, a poor coastal community in Northeast Brazil.

By Lori Shearn
Heritage writer

Fifth in a series
For the year we spent with Project Hope in Maceio, Brazil, we were ever aware that the sick and disabled in the region were hoping against all odds that the American doctors on the big white ship would cure them.

While in Maceio, the Hope staff admitted 1,400 patients for treatment in SS Hope’s 108-bed floating hospital.  They performed 1,135 major surgical operations that required a total of over 1,350 hours in the ship’s three operating rooms.

Many patients’ health was improved and many were cured. Some became worse (for any number of unknown reasons) and some died. Like in any hospital, anywhere, most patients demonstrated diseases in the worst possible form.

Some of my days were spent working very closely with the patients. I assisted the staff working as a ward clerk. In addition, when the need arose, I filled in as admissions officer.

I enjoyed introducing patients to their first exposure to the Hope Hospital, an American institution. They were frightened and confused. Fortunately, I could understand and speak Portuguese well enough to allay their fears.

Bill Kooiman, chief purser on the SS Hope on the way to Maceio Brazil in 1973. Hope alumni established a volunteer fund last year to honor his memory.

Bill Kooiman, chief purser on the SS Hope for many years, on the way to Maceio, Brazil, in 1973. Hope alumni established a medical volunteer fund in 2012 in his memory. Project Hope photo

The stories of the children were particularly touching. There were hundreds of children born with cleft palates and/or lips. The magic of plastic surgery for those who were admitted for the procedure was incredible, but unfortunately, not every child who was afflicted could be accepted under the criteria worked out by the community and the doctors.

Four-year-old Moises was the very first patient of the year.  His tiny face was split by a complete cleft lip, which was overgrown with an enormous protuberance obscuring half of his face.  Nevertheless, he never stopped smiling and he became poster boy for Project Hope with his photograph in all the newspapers.

The operation was successful in creating a beautiful new face for him. His young parents could not believe their good fortune, and after Moises discovered a tiny rocking chair, he spent his days in the hospital happily rocking, melting the hearts of each of us who passed him on the hospital floor.

The parents who brought 9-month-old Manuel knew their baby was very sick. He was the youngest of many children, and they wished to relieve his suffering. He had a brain tumor and he was comatose, but there was just the slightest glimmer of hope that if the tumor were benign, its removal might save the child.

Upon surgery, the doctors found that the tumor was indeed benign, but its location was such that it could not be removed without impairing major brain functions.

This photo comes from 1960 during the inaugural voyage of the SS HOPE to Indonesia, when American and Indonesian nurses worked together to help patients with tropical diseases.

In 1960, Project Hope and Indonesian nurses worked together to help patients with tropical diseases. Today, Project Hope is again working in Indonesia to improve maternal and child health. Project Hope photo

The parents remained on the ship faithfully throughout the baby’s surgery and convalescence. Manuel was terribly important to them. Even though (in 1973) 50 percent of the children in the Maceio area of Northeastern Brazil did not live to be five years old, parents were not in the least matter-of-fact about losing a child.

Manuel’s death was slow and terrible, and all the family and staff suffered with him. The saddest blow of all came on the day Manuel died and we learned that the parents could not afford to buy a coffin.

Throughout their ordeal they had held up pretty well, but not to be able to bury their baby properly presented an unbearable burden.  Fortunately, staff donations paid for a tiny coffin for Manuel and his body left the ship for the last time.

Maria Luisa was 12 years old. She was brought to us because of a basketball-sized tumor on the side of her neck. It caused her to hold her head at a permanent angle. How much anguish that child must have suffered!

Her experience with the local hospital nine years earlier was heartbreaking, but typical, as described by her mother:

“When Maria Luisa was three years old, a small lump appeared on her neck. We live a four-hour bus ride from the hospital, but I brought her in to see the doctors at Santa Casa (the local community hospital). They said it was some kind of a tumor and they wanted to do some tests on my baby,” her mother told me.

The local hospital performed a biopsy on Maria Luisa and two weeks later, the doctor told her mother that the biopsy had been lost, and that they didn’t know what to do for the child.

At that point, the distraught mother went home, expecting the tumor to kill her baby. Instead, years later on the Hope, they saw that the tumor had continued to grow and grow and somehow, the child had learned to live with the grotesque burden as best she could.

Hope found the tumor to be benign, not malignant, and doctors were able to remove the gigantic cyst that weighed 20 pounds. Her neck muscles had to be retrained to hold her neck straight, but after convalescence and physical therapy, Maria Luisa went home without the huge tumor to a new life.

The stories of Maria Luisa, Moises and Manuel have stayed with me and I feel gratified that we were able to touch their lives, even though happy endings were sometimes elusive.

 

 

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Hope in Brazil: Lori Shearn’s memoir of South America

posted on December 16, 2013
SS Hope
The SS Hope, previously a U.S. Navy hospital ship, sailed as a roving medical oasis from 1958 to 1973. Kaiser Permanente physician Martin Shearn, his wife Lori, and their three children spent time on the ship in Brazil on its last voyage.

Forty years ago, in 1973, Permanente physician Martin Shearn took on a year-long assignment with the humanitarian organization Project Hope. As chief of staff on the SS Hope, Dr. Shearn’s mission was to bring knowledge of modern medical care to a poor coastal town in Northeast Brazil.

Like Permanente physicians who render crisis care in storm-ravaged places like the Philippines and Haiti today, Dr. Shearn and his wife, Lori, embarked on the adventure with a dual goal: to help others and to enrich their own lives by experiencing the culture of a South American country.

Lori Shearn, an active participant in the mission, took copious notes throughout the Shearns’ year in Brazil. In recent years, she has turned those notes into a memoir that reveals the intricacies of adapting to a strange culture and how at times attempts to bridge differences can result in a comedy of errors.

The Shearns’ adventures offered cultural lessons in time warps, creepy and ubiquitous creatures, South American pomp and circumstance, the joys and dangers of Carnaval, the rigors of providing medical care to those never treated before and the thrill of alligator hunting in the Amazon.

 

Lori Shearn took plenty of notes on the Shearn family trip to Brazil in 1973.
Lori Shearn took plenty of notes on the Shearn family mission to northeast Brazil in 1973.

By Lori Shearn, Heritage writer

It’s hard to believe, but it all began because Spanish seemed like the extension course that most conveniently fit into our schedule that fall in 1970.

Oh, of course we knew that they speak Portuguese in Brazil, but it all began with Spanish.

Spanish class was going rather well, so we decided that we should be going someplace where the language is spoken. A Mexican vacation, perhaps, or why not a medical service somewhere in South America?

Martin, my husband, was an internist, a physician who has educated a great many young doctors in a group practice in California, and he was also affiliated with the university where he taught. Inquiries around the medical school produced a slew of opportunities for a Spanish-speaking doctor who wanted to participate in a medical mission to South America. We considered them all.

Then we heard about Project Hope. This is a medical organization that disseminates not only medical treatment, but more importantly, medical know-how. It was made to order for us, and further investigation disclosed that the next mission would be to South America, Venezuela to be exact, and that they were recruiting physicians for a two-month stint and that wives were welcome. We applied.

Project Hope makes a fascinating offer

Pretty soon a most surprising reply arrived: “With your qualifications, would you be interested in the position of director of medical education for this voyage?” What a fascinating offer. Medical education was the subject Martin knew best and to be able to practice it in a cross-cultural setting speaking Spanish was perfect.

Our three children were all in college, and for Martin and me, a leave away from the humdrum world of our suburbia was an attractive prospect. A slight change was mentioned at this point. Instead of two months, in this more complex position, we would need to stay for the full year.

The personal conflict of leaving our children alone for a whole year had to be overcome. I assured them that they could visit us (I got their tickets in advance) as long as they made arrangements with their schools for a leave, and I told them that they would have to have a job when they got there.

The next phone call from the Hope office requested Dr. Shearn to come to Washington to plan next year’s activities. “Oh, and by the way, the ship will not be going to Venezuela, but instead, to Brazil,” they told him.

Can we learn Portuguese in time?

What to do? Our Spanish-speaking adventure was to end up in Portuguese-speaking Brazil. Should we still go? Our emotional commitment had been made, so we felt the answer would have to be yes.

But how do you switch from intermediate Spanish to beginning Portuguese in three months? There were no Portuguese classes in our area. The first experience we had listening to a tape demonstrated the complicated pronunciation, which sounded like a combination of Czech and Romanian. Another totally new language seemed like too much to handle.

With a stroke of good luck, a teacher from Rio just happened to walk into Martin’s office as a patient. She offered to help us delve into the new mysteries of the Portuguese language. Slowly we progressed. She invited all her Brazilian friends to our house often and nobody was allowed to speak English.

Our new friends were all so impressed and grateful that we were going to Brazil to help people in the underdeveloped area of the Northeast that they wanted to help us learn the language.

Another bombshell challenge

In the next phone conversation with the Hope office, a new development was introduced almost immediately. Martin was apprised that there was no chief of staff since the man so designated previously had been reassigned. Would Martin take the position in addition to that of director of education?

Upon meeting the rest of the permanent staff members in the Washington orientation, Martin and I had a lengthy consultation and then decided that he had best accept this challenge too.

The ship was to sail for South America in two weeks with the full contingent of nursing, medical and support staff. Under the existing circumstances, Martin hesitated but felt he had to accept the broader role of chief of staff, however daunting. He vowed to make the year’s project a success, and he never regretted his decision.

Next time: Brazilians stage warm reception for the physician’s family.

 

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Third world nations seek Kaiser Permanente expertise

posted on February 23, 2012

By Ginny McPartland
Heritage writer

First in a series

Construction workers at Ghana job site, circa 1963. Volta River Authority photo

In the 1960s, dubbed the “Development Decade” by the United Nations, Henry J. Kaiser’s enterprises were literally all over the map. Kaiser’s companies were mining bauxite for aluminum in Jamaica, manufacturing cars in Argentina and Brazil and working on a huge hydroelectric project and aluminum smelting plant on the Volta River in the emerging West African country of Ghana.

Kaiser Engineers were also building a dam on the Bandama River in Ivory Coast, West Africa, as well as undertaking projects in various parts of India, including construction of a dam, hydroelectric plant, an aluminum plant, a steel mill and a cement facility. Kaiser Engineers were involved with the Snowy Mountain project – construction of tunnels, aqueducts, dams and hydroelectric plants in the mountains of eastern Australia.

As in his American ventures, Henry Kaiser’s enterprises on foreign soil developed medical services for workers at the job sites and often in the community. In many places, including Australia, India, and Ghana, the government required Kaiser to build hospitals at each of the construction locations.

Children began to go to school once Ghana became a republic in 1960.

“In a sense, this was a recapitulation of the early experience of our domestic medical care program, which had its origins in providing health care for workmen and their families at construction sites in the Western United States,” wrote James P. Hughes, MD, Kaiser Industries vice president of Health Services in 1972.

KP executives tapped to develop health facilities abroad

Clifford Keene, MD, Kaiser Permanente president at the time, was thrilled to participate in the launching of medical care projects in foreign lands.

“I went to Australia several times because Kaiser Engineers were involved in the Snowy Mountain Project and I was involved in the location and construction of hospitals there. . .I went to India twice, once for a period of almost a month. I found myself in places with exotic names, Uttar, Pradesh, Mysore, and Jamshedpur.

Kaiser companies helped design and equip this hospital in Akosombo, Ghana.

“So all of this was going on and it was just a big, spreading, challenging, wonderful, exhilarating kind of existence. While we were having all the troubles in the Permanente Medical Program (in California), getting reorganized, I was involved in these other challenges, which gave me satisfaction and sort of balanced the scales against the frustrations of dealing with the Permanente program.”

Ernest Saward, MD, medical director of Kaiser Permanente’s Oregon Region, traveled to Argentina in 1960 to help establish a medical care program for Kaiser automobile workers in Cordoba and Buena Aires. Saward said the Argentines didn’t trust the Kaiser organization initially and expected the company to superimpose a foreign health system on the community.

“The reaction back from Argentina was, ‘You folks in California put some millions in this and build us a hospital and everything will be all right.’ From what I’d already learned, I saw that if (Kaiser in partnership with the Argentines) put any millions in a hospital it would be confiscated within months. That was the nature of Argentina at the time. They play rough. Now I never personally got shot at; I was only threatened with a saber,” Saward said with a laugh in a 1986 oral history.

The river above the Ghana dam site was treated to eliminate the Black Fly that carried a debilitating disease. Volta River Authority photo

Saward and his artist wife managed over time to infiltrate the Argentine culture and make essential contacts for Kaiser. “They saw that we were somebody they could relate to, that (we) wanted to understand them and to understand what I would call their general, cultural events, and not be an isolated colony.

“They began to entertain us, and I spent hours lying on the living room floor, drinking red wine in front of a fireplace with these guys, until they finally understood what it was we were trying to do, and once they really got a feeling for what we wanted to do, they said, ‘Let’s do it’. We did it with the best medical group in town and with the best hospital in town, and it’s still going (1986) and it cost us in toto, $55,000.

“What had to be done in Argentina was to make an indigenous plan and not a foreign plan and (to make it go) it had to be done as an indigenous plan by what were respected elements in the community. (That’s how) we did it,” Saward said.

Requests for help from international community multiply

As Kaiser Industries continued to work abroad into the 1960s and 1970s, the challenges for providing health care kept coming.

Ghanaian physician at Akosombo Hospital, early 1960s

This was a period when African nations were gaining their independence, and the international community was interested in promoting industrial development to improve the economies of all underdeveloped countries. With new industry and its attendant growth, the budding nations were struggling to provide essential services to their citizens, both natives and newly arrived workers and their families.

To address these issues, seven hundred industrialists from 70 nations gathered in the San Francisco Bay Area in September of 1969 to figure out how to close the gap between the “have” and “have not” nations.

“There was much talk about the responsibilities of private enterprise in developing countries; about the need for more effective allocation of resources; about the need for business to interact with the society in which it finds itself,” noted KP President Clifford Keene in a talk to the Industrial Council for Tropical Health at the Harvard School of Public Health in Boston in 1969.

Kaiser’s people learned the hard way what this meant. In Ghana on the Volta Dam project, Kaiser leaders discovered pretty quickly that – despite the government’s well-laid plans – the company needed to initiate environmental programs to ensure safe water and pest-control measures to protect workers from the spread of debilitating disease.

Once the dam was completed, Kaiser began construction on a smelter plant to manufacture aluminum. “. . .the first responsibility was to provide care for the work injuries, since the existing health care facilities in the town were grossly overburdened,” wrote Hughes.

Health planners forced to improvise

For these foreign projects, many necessitating brand new cities or towns, Kaiser’s goal was to establish health care facilities for its workers, their families and often for the community at large. Hughes said in most countries where Kaiser had developments health care services had to be introduced in waves, depending on available services. Often, sanitation and safe water needs and the dire need for training of locals in basic care methods were the first priorities.

To provide health services, Kaiser Industries initially engaged the Kaiser Permanente Medical Care program. By 1964, however, Kaiser leaders realized the need for a separate entity and established the not-for-profit Kaiser Foundation International (KFI) to administer the foreign medical care programs. With Kaiser Permanente’s reputation on the rise, requests for consulting help started to come from places where Kaiser Industries didn’t already have a presence.

Between 1964 and 1969, the international group was engaged for medical care projects in 15 African countries. By 1975, KFI had been hired and paid for projects in 30 countries around the globe, including rural locations in California, Utah and West Virginia.

Next time: Kaiser Foundation International gets contracts to resurrect a hospital devastated by the Nigerian civil war, to train Peace Corps workers for African rural health projects and to consult on many foreign health care projects.

 

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