10,000 Miles in 30 Hours

My patient is delivered to her family outside the Manila airport

Editha was transported in a "Jeepney" to her hometown

April 17, 2011

Al Watan newspaper runs a story: "Undocumented house helper suffers stroke, paralysis: qualifies under amnesty"  The lady is pictured with my friend, Yolly who is a welfare worker at the Filipino Shelter.  Yolly told me about this lady who has not been back to see her family in 22 years and was now seeking amnesty so she could be returned to the Philippines for care. One catch: she would need to travel with a nurse. The problem: Filipino nurses who should love to get a free ticket home cannot get the time off work..."can you help?"

May 19, 2011

After much deliberation, the Philippine embassy granted permission and funding for me to travel with Editha. I took a taxi to an area of town where many Filipinos live and was met by a young gentleman who rents a room from Editha (a partitioned off partial room!)  Mueller was fluent and gracious.  Since finding her paralyzed in her bed 2 months ago, he and another housemate have cared for her like a mother in spite of his 6 day/wk job as an airline mechanic.  He walked me through a mall, out the back, into an apartment building and up to the 5th floor.  The tiny flat had become her prison-home since she was abandoned by her employers of 10 years without giving her back her passport. Fearful of harassment and arrest by Kuwaiti police, she stayed indoors where she earned money to send to her family by babysitting infants.

I found her in good spirits and well cared for without any skin breakdown at all.  Her speech was slurry but understandable. She was incontinent and could not sit alone or bear any weight for an attempt to transfer her to a chair. One of her meds is meant to keep her blood pressure & heart rate low...52 was a bit concerning! I requested her doctor be informed.  They made me a snack of rice muffins & tea and insisted I sit in the phone booth sized kitchen for refreshment before leaving. Through the window I could see many more such apartment buildings in close proximity.

Before leaving, Mueller & I walked to the pharmacy and priced a wheelchair which she would surely need. I gave him money from the Trash to Treasure cash bag to purchase it in case the Catholic church did not deliver one, which they did!

Ready to go?  Not so fast.  By the time we were ready, the doctor's consent had expired and Kuwaiti Airlines insisted she had to be hauled back to the hospital for another form.  The doctor never looked at her or checked her pulse as I'd requested, just signed the dotted line. They booked the tickets, with mine returning in ONE WEEK!  Whoa, alone in the Phlippines for a week, I don't think so.  Sadly, my friend Yolly who had desperately wanted to host me was off the island at the time.  I was re-booked for a rapid return.

May 23

I met the crew from the embassy around 9pm at the airport where they had Editha slung across the bench seat in the van like a bag of rice. I supervised her transfer and was then introduced to a frail but ambulatory man with a bandaged neck and asked if I could please look after him on the flights as well! Antonio spoke little English but gave me a toothy smile when I talked to him.  He has kidney failure and had just come from dialysis to the airport.  The daughter-like ladies who'd cared for him pulled out a lunch bag full of meds and asked if I'd mind to administer them.

All but one of the paper pushers left after getting us signed in and I grabbed a coffee for the long night ahead.  Sitting upright after being flat for 2 months proved to be the hardest part for Editha; by 11pm when they were still waiting to board, she dissolved into tears due to back pain....this was after I'd already given her ibuprofen. Fellow travelers stepped in to help and ordered anyone with a pillow to give it up!  This produced a pillow that we positioned to ease her discomfort until I persuaded the gate keeper to let us board.

The narrow isle of the airplane required we swing her onto yet a skinnier wheelchair where she still drooped beyond the doorframe, risking her elbows and floppy feet. With the kindness of the attendants, we managed to get her positioned in her business class (but economy service) seat where she would wiggle and squirm for the next 12 hours. Between repositioning her, massages, assisting with food, and all the medicines Antonio needed, I snatched only moments of sleep throughout the night. In her wakefullness, she told me about her 5 kids and broken marriage.  She told me about the typhoon that claimed the life of one of her daughters and 3 grandchildren last year; she lost her own house as well. Her kids were from the age of 10-20 when she left to work in Kuwait and she'd not seen them for 22 years.  Her oldest farmer-son would be the one to care for her.  I tried to imagine her life but found it very difficult to picture.

Flight attendants on the journey to Bankok were extremely nice and interesting to talk to.  One Filipino man was interested in the situation with domestic workers and told me how many of them were actually PROTESTING the governments initiative to require Gulf countries to pay a minimum wage to their exported workers.  I found this shocking that many would take whatever they could get just for a chance at any job.  Many of the staff expressed gratitude for the help I gave their citizens.  They are a very warm and gracious people.

Editha finally was hungry enough by our third meal that she overcame her fear of vomiting and gobbled down her food.  In order to keep her diaper dry, she drank a minimum of fluids.  Two hours after breakfast and her beta blocker, I reluctantly took her pulse (her lips were looking pretty dusky) and found it to be 49! I imagined ways to stimulate some adrenaline if need be...

It was 4:30pm and sunny in Manila as we came in low over large swaths of shanty town homes reminiscent of South Africa.  Green and palm trees as well as high rise offices were also visible on my ever-so-brief "tour" of the city.

Arrival in Manila was a blur of activity as uniformed porters scooped up my patient and raced toward immigration while I lagged behind with Antonio.  Their embassy staff met us and were very efficient at coordinating our entrance documents with the authorities. They sent a nurse who helped me to clean and change Editha in the back of a curtained ambulance outside arrivals before we went in search of the family greeting parties who had parked away from the airport.  In a crowded lot where brown shirtless boys also kicked a ball around, we stopped beside what is known as a "Jeepney Bus."  This very colorful open sided contraption is a staple in public transport in the Philippines.  I read that they became common after the US occupation when industrious Filipinos converted ex-US army jeeps into buses.

Editha's now 40 year old scrawny son climbed into the ambulance, his face etched with anxiety.  There were no hugs or tears, they just looked at each other.  I saw no recognition in their eyes as the intervening years had not treated either one kindly, I suspect.  I asked if she recognized him and she said "of course" but it didn't show at all. Grandchildren she had never met crowded around with big curious eyes as she was carried on a backboard into the folding lawn chair type cot that sat between the benches.  It looked like there was a cooler of food for the journey home. I sent the sheet I'd brought along with her to help in transferring her a bit more gently. A large man arrived and wished to speak to me about his "sister" and his ID tag read "MEDIA." He alone thanked me for my services and began questioning me.  I managed to quickly divert him to the local embassy representative to avoid giving information I shouldn't. I once more petitioned through an interpreter for her family to find a doctor to manage her care and medicines. I pleaded for physical therapy to be continued if if was available in the province. I wondered if the wheelchair would even have a smooth enough surface on which to roll to be of any use, along with the belt I'd made to tie her in...

By 6pm it was pouring rain and I was back at the airport waiting to check in for the 11pm return flight home via Bangkok. A last ditch effort to keep me there a few days longer failed when I could not reach Yolly by phone to coordinate a change of plans.  Alone in Manila for even a night was not something I was eager to try.  While waiting for the flight filled with Filipinos working in Kuwait, I was able to speak with two women who had been home for a visit and were returning to "sales lady" jobs they loved. Happily employed in Kuwait? Hamdulillah! (Praise be to God)