An enriching and amazing experience is how Dr. José Ángel Zayas Power describes the two occasions in which he participated in the Henry Reeve Contingent, Specialized in Disaster Situations and Large-Scale Epidemics, created in 2005 by the leader of the Cuban Revolution and with a record of service in over 20 countries to date.
”I have learned to improvise, look for solutions with the few resources at hand,” stated the Deputy Director of Medical Care at the Fructuoso Rodríguez Orthopedic Hospital, speaking to Granma International, who traveled to Nepal in 2015 and Ecuador in 2016 to treat victims of high magnitude earthquakes.
Zayas, also an Orthopedic, Traumatology and Comprehensive Family Medicine (MGI) specialist, states, “On the first mission, I received a telephone call at my workplace and the director explained that he needed to choose two orthopedic specialists immediately. We completed a rigorous process of paperwork for the journey and were waiting for 12 days. The runways in Nepal were damaged due to the earthquake and it wasn’t safe to land the plane.
“On May 11, we departed for the Asian country and, shortly before landing, the cabin crew informed us that another earthquake had just struck. Once on the ground we unloaded the over 24 tons of cargo, which included medicines, medical equipment, a complete field hospital, antiseptic products, dry foodstuffs and provisions.
“The next day we traveled to the disaster zone, fortunately there was a medical center with minimal structural damage located there, which we used to conduct inquiries.
“A large team of MGI specialists traveled with us and helped conduct home visits to people living in remote areas. We performed surgeries on people who hadn’t been able to receive medical attention during or immediately after the earthquake, as they were in areas a long way away from the city.
“I remember a little girl dragging herself across the ground in a refugee camp. She had a cast on one of her legs. After transporting her, the entire emergency team sprang into action. We called the Nepalese authorities while various specialists from the brigade gave her a clinical assessment. We had to perform an emergency operation in order to save her ankle. We even nicknamed her “3,000” because by then we had performed that many surgeries.”
What was the reaction from the population?
We were the first Cubans to work in Nepal, there wasn’t a Cuban medical brigade there. Before setting off, we received information about the characteristics of the place, but we didn’t know how the authorities or population would react. We worked for three months out there, and the brigade performed surgeries to treat appendicitis, gallbladder, and genetic conditions, abdominal and groin hernias. At the end we were very pleased; our work had changed attitudes toward Cuba and the Revolution.
How did you overcome language barriers?
After arriving we were introduced to a group of volunteers, young people who had graduated from Cuban universities, who acted as our translators. Every member of the brigade speaks English; however only different dialects are spoken in remote regions, which obstructed communication. As we became more familiar with the population we learned keys terms to be able to communicate. We learned the basic expressions of each dialect through repetition.
Did you encounter cultural barriers?
In Nepal, we had to adapt to a culture very different to that of Latin culture. For example, women are only allowed to visit the clinic if their husband gives them permission. There, we used our intelligence and respect.
Cubans are known for being affectionate and willing to collaborate to solve problems. However, first and foremost we respected their norms.
When assessing women we asked for the husband’s consent and we always had a translator there to facilitate communication with the women. We sought similarities according to the individual’s sex, if the patient was a man he would be treated by a male nurse, if a woman, a female nurse.
Communication with Cuba?
The head of the brigade would give daily up-dates on the situation to the Cuban Ministry of Health. The brigade director would speak to sector Minister Roberto Morales Ojeda, Deputy Minister Marcia Cobas, Foreign Minister Bruno Rodríguez, at various times during the day, who were informed of the actions we were undertaking and the results.
What was your experience like in Ecuador?
The mobilization for Ecuador was sudden and very quick. The earthquake struck on April 16, and the following day they called me at home to ask if I was available. They phoned again at 6pm, but by 4pm I had already received the notification to go to the Central Unit of Medical Collaboration. We touched-down in Ecuador on the morning of Monday, April 18, at the military airport in Manta.
The 7th Party Congress had been taking place in Havana and we listened to the closing ceremony of the momentous event in Ecuador. We were also joined by a rescue brigade, which accompanied us on this type of mission for the first time.
The rescue team was based in the disaster zone in Puerto Viejo, and we set up in a prison. We joined up with the Cuban Medical Brigade already serving there, as well as volunteer professionals from other countries. We worked for about 12 days. We received a visit from President Rafael Correa and Ecuadoran Health Minister, Margarita Guevara.
We were working in dangerous conditions; there was destruction and the collapse of all social institutions all around. On the request of the Ecuadoran authorities we moved to the city of Jama and found a ghost town.
Fortunately the polyclinic withstood the shock of the earthquake and we used its facilities to provide medical attention. We set up the basic operating conditions but were unable to erect a surgical unit with all the necessary equipment, so we began offering minor surgery services in the Emergency department.
There was an increase in accidents as a result of building recovery efforts and we received complex cases. I had to improvise surgeries, and put all my knowledge to use in order to save many people and rescue their upper and lower limbs. I ended up performing almost 700 operations, on both children and adults.
How did you organize your work-rest routine?
We worked non-stop. As we lived in the hospital, I was called on at anytime, even while sleeping. Our MGI (Comprehensive general medicine) specialists and the nurses traveled around remote areas looking for victims. Myself, the surgeon, and neurosurgeon stayed at the hospital. We attended all emergency cases no matter the time. As such we avoided sending patients to the closest hospital which was over an hour away. The MGI specialists attended births and despite not being gynecologists, have the experience of years of study.
We faced appendicitis surgeries, children with seizures, and other emergencies. We also saw car crash accidents. Sometimes relatively quiet days would be interrupted by aftershocks.
I remember the day when at 11am I was operating, and the windowpanes and medicines fell out. The patient was the first person to get up and the nurse suddenly asked me if he could leave. For a few seconds, I felt the earth shake, reaching a magnitude of 7.2 on the Richter Scale. A very unpleasant experience.
The brigade remained positive despite the tremors, and we put up more field tents to provide more medical attention. We continued working until the aftershocks began to subside and everything returned to normal.
Although Cuba has never been hit by a high magnitude earthquake, does academic training received on the island come in handy when combating these disasters?
Here we undertake the “Ejercicio Meteoro” (Meteoro Exercise) several times a year and constantly adjust it to the current context in order to be better prepared to deal with the impact of any kind of weather event. We also apply this knowledge outside of the country.
For example in Ecuador, I performed a genuine war-time surgical procedure. The logistics were delayed and I had to work in extreme conditions.
What was the reaction from the Ecuadoran people and government?
The Ecuadoran people genuinely adore us Cubans. They are extremely grateful to the medical professionals because we treat many of their health problems. In our work we are characterized by constant motivation, a hand on the shoulder, sincere friendship, warm care, and humanism.
When the people of Jama found out we were returning to Cuba, they wrote a letter to the government of Rafael Correa thanking him for our presence and requesting that more Cuban health professionals be sent to the town, in order to continue the work started by the Henry Reeve contingent.
Just before boarding the airplane, Cuban Ambassador to Ecuador Rafael Dausá, presented us with a letter from the President of the National Assembly of Ecuador, Gabriela Rivadeneira, praising our work. I think Cuban doctors, given their humanist training, win the heart and affection of the people.
WHAT FAMILY MEMBERS THINK
Zayas' wife, Yipsi Yaquelín Armas Roque, states that the news of a mission always comes as a shock, disrupting the daily routine and, despite efforts to cope while he is away, his absence is always felt.
“Psychologically the family gets very tense over fears about where he’ll go and how he’ll survive out there. You start to worry about what he’ll eat, where he’ll live, if he could catch a disease. What is more, we notice his absence; the lack of his advice; decisions over which path to take when problems occur; as the person who helps to ease the daily burdens. As his wife, I miss the loved one you wait for every day to talk about work and family concerns.”
And the return?
You think about their return the same day they take the plane, and want to welcome them with something completely different in order to satisfy their taste. I think about making him his favorite dish and telling him all about the best things that have happened in the family while he has been gone.
He always arrives home tried and I want him to sleep as much as possible to regain his strength. Then come the visits by relations and friends, the house turns into a long party for several days.
How does it feel to have a family member of such acute human sensibility, able to leave his loved ones to help people in other countries?
It’s very gratifying. You never stop admiring them and loving them more.
Zayas’ oldest son Reinier Zayas Padrón noted what worries him most when his father leaves: “I always think that no matter wha,t he will always come back to us, although we might not be able to comprehend the true dimension of the mission he is going to fulfill. We eagerly await his return, and we know that he is a responsible person and will take care of himself, and is someone who knows how to look after his colleagues, and we trust that they look after him too.”
Do you notice his absence within the family?
He is the support that keeps our family together. I have half sisters and he doesn’t have any children with his current wife, so he is the one that keep us all together although we don’t live in the same place. When he leaves, he leaves me in charge of looking after my sisters and hopes that I’m able to resolve any problem that might occur.
How do you communicate with him?
At the beginning there isn’t any communication. He goes to places that were completely devastated, so there isn’t any basic electricity, water or telecommunications services. Once minimal conditions are established the emails start to arrive.
What was your father’s return like?
We were very excited to see and hug him. The fear that something could happen to him disappears, and daily life returns to normal, just as if he’d never left. Friends start to arrive to welcome him back, and he talks about his experiences, of what he learned out there. When he leaves we constantly check the news in the papers and on television, to see if we can see him in some journalist’s report. He has been in the news, and friends and neighbors have contacted us immediately to let us know, and we constantly receive phone calls from people asking after him.
How do you feel when your father’s name is mentioned?
Immensely proud. I see my father helping many people in need. His work is recognized, and his friends note that they are amazed by what he does. We, his children feel a great sense of admiration. We don’t see him as a hero, but we know that he performs heroic feats.
