Mission to Morocco

Day 7:

October 23, 2009 - by Ryan      Today was our final full day in Marrakech so we needed to accomplish a lot before returning home. After  breakfast we made our usual journey down to the Hospital to do some final post operation filming. Around twelve o' clock we traveled to a near by orphanage which cares for children that as the staff phrased it are put in "difficult situations".  Garrett and I had planned to travel to a place like this the whole trip in order to educate children in the importance and practice of dental hygiene.  
    Once inside, we made our way up the stairs. There were about thirty children crammed around a few small tables.  They all had colored pencils in hand and were working away in their coloring books.  
    Thanks to an American doctor we were also able to supply them each with a tooth brush, tooth paste, and floss.  First Garrett taught the group how to brush properly, then I showed them how to use floss. To my surprise the children had never seen floss before.  Through a translator I was able to explain the proper way to use floss.  I was caught a little off guard when they all gathered around to see how to open the floss.  This distracted me a little from what I had planned to say, so I tried to make the process simpler and easier to understand.  After seeing the local culture and the conditions in the hospital it becomes evident that as educators one must take nothing for granted.  This is why the last thing I said said to the children is that they cannot share or reuse the floss.  To Americans this sounds obvious and absurd, but to people in this country do to the poverty, items like that are often reused.  This once again shows the clear differences in the culture.
    After we distributed the supplies to the children, we spoke with the Karima, the founder of the orphanage.  She told us of the history and the origins of the orphanage, as well as what the children's day to day activities are.  We exchanged information, and I informed her that we would continue to send supplies to them through mail.
    When we returned to to the hotel we learned that one of the members of the local team had arranged for us to attend an orchestral performance.  Around eight in the evening we drove to performance.  It was in a large building with huge decorated columns of sand stone.  The inside was set up similar to that of a typical Greek forum.  The roof was covered with solid black plastic which is retracted during the summer.  The entire set up was spectacular.  To the left and right of the stage were two large photos of the King Mohammed VI.  The orchestra played beautifully for the remainder of the evening.  The sound resonated off the spherical theater which was quite captivating, and relaxing. It was a nice way of ending a long productive week.  As I later joked, it was a good way of ending the trip on a high note!

Day 6:

October 22, 2009 - by Ryan Day 6:

    It was the final full day or surgery for the team.  After this evening three members will be leaving at 4AM on their way back to America.  Before their departure we were able to visit the Souk, Morocco's shopping and tourist mecca.  

    As I mentioned yesterday, this country is mostly Muslim and filming people can often be considered insulting and can be down right dangerous for us.  Before we went to the Souk we were warned of the laws against filming there without proper documentation.
     Filming in places that have limited access or are even guarded is dangerous to us and to the equipment, especially in foreign countries.  However,  trying to get those kind of shots are a vital part of documentary films.  It is our responsibility to try and capture what cant ordinarily be seen.  Today at the Souk our boundaries in terms of filming discretely were most definitely pushed to the limit.  First off, going in we knew that we would not be able to use our primary camera due to its cumbrous size.  For times like this as well as normal B-Roll or secondary shots, we use a consumer grade HD hand camcorder which is a fraction of the size of the primary camcorder and can be more easily concealed.  
    We started filming the area with the camera to our side staying within groups trying not to be seen. Within about two minutes we were approached by a policemen who demand to take our camera.  At first we pretended that we didn't understand what he was talking about.  I didnt want to loose the footage or the camera.  I reached in my pocket and handed him 100 Dirham. Dirham is the Moroccan currency.  The officer looked at the money, took it and walked away.  We got off easy.
    Initially walking up to the Souk is a powerful experience.  It is a huge square filled with thousands of people. In the center are small movable restaurants that shine bright white from a distance.  The smoke from the meals being prepared is vast and hangs over the entire square filling is with the smell of foods like lamb, escargot, and poultry. Scattered amongst the crowd are groups of people gathered watching gypsies, and various street performers.  Then there are merchants with goods like tonics, scents, oils, and creams with their product laying out on large rugs. The boarders of the square are lined with shops with everything from clothes, jewelry, live animals, metal wear, and even fossils.  Then there are the alley ways that seems to drain to flood of tourists away from the center of the square.  The alleys also contains similar merchandise.  
    As like a lot of Marrakesh, garbage is dumped into the streets for collection rather then into garbage cans.  This as you can imagine makes crowded places like the alley extremely dirty.
    When walking in the Souk or down the alleys, one needs to be extremely careful of your surroundings. The most dangerous part it the sporadic motorcycles that speed through the crowds.
    Though a beautiful and striking aspect of Morocco, the Souk is a crowded place where one needs to have their wits about them.  It was a nice place to visit, but not one that I anticipate returning to soon.

Day 5:

October 21, 2009 - by Ryan We hadn’t expected to be so physically and mentally drained this early in the trip. The seemingly endless line of patients has relentlessly weaved its way through the operating tables of every doctor.  As I’m sure anyone can imagine, standing for more then eight hours while concentrating on multiple tasks can be difficult and requires the help of everyone involved. This morning the other documenter was unable to accompany us to the hospital.  Do to severe swelling and tendonitis likely caused from standing all day with heavy equipment, the team decide it would be better for him to stay behind and recover.  Naturally this meant that I needed to pick up the slack and cover as much as I could in his absence.  The day was not off to a good start.
    Once at the hospital I continued our normal filming routine.  We try to capture the entire sequence of the day.  Starting with doctors and nurses prepping the operating room.  Followed by surgery, post operation consultation, and the evening lecture and dinner.  
    I began filming the nurses prepping the rooms and doing cleaning. Then made my way into the operating room. As I was filming, in the corner of my eye I saw a group of nurses gather and start talking to each other in Arabic and looking towards me.  You don’t need to speak Arabic to know when someone is talking about you.  Then one approached me, looking very disgruntled and told me that one of the nurses was very upset that I was filming her and is crying and how dare I film her without her permission.  I tried to apologized and told them I would delete the footage.  
    The reason I mention this story is to underline how different American and Moroccan cultures are.  This is not to say that Americans don’t get upset when they are being filmed.  The difference is in why they get upset.  Here as was later explained to me, it is majorly for religious reasons.  It reminded me that I needed to remember that I was in a Muslim country and don’t fully understand the inner workings and fragility of the cultural dynamics.  One needs to be sensitive at all times of cultural and religious boundaries, especially in a foreign country.  Usually this type of situation is easily handled with two people. One person contains the person as the other walks away with the equipment so that they don’t try and damage or take it.  
    Procedures ended earlier then usual this evening.  After attending the lecture we went to a restaurant, which was owned by a friend of an organizer in ISMS.
    After today’s experiences I think it is prudent to take a step back from what we are doing at the hospital.  Tomorrow I will try and take a tour of the city in hopes of gaining some more knowledge of the culture.  We will try and capture as much of the city and its people as we can, while remaining as respectful, discrete, and inconspicuous as possible.  
    

Day 4:

October 20, 2009 - by Ryan

It is difficult to recall, describe, and do justice to everything that has happened everyday. As I have done in the other posts, I will describe only a few key events of the day, and hopefully capture the essence and underlining theme that seemed to carry throughout the day.

By far the most difficult and interesting surgery of the day was that performed by the plastic surgeon.  He worked on a child who we had interviewed the day before. The boy had a large malignant tumor growing out from the forehead and out through the upper eyelid and eyebrow. 

            Yesterday the boy told us stories about his family and friends.  He explained how much he loved playing soccer.  When asked how he had been dealing with the ever enlarging bulge in his eye he merely said that he had thought it was something that he could never change, so he put it out of his mind, and tries not to think about it anymore.  The boy said all this without even breaking his smile.  This is why were here, to step in and improve someone’s life that normally would never have any way of have treatment like this. 

            The six hours of surgery to remove and reconstruct the boys eyelid was pains taking and tedious.   Due to the extensiveness of the tumor the upper lid needed to be removed.  In order to try and reconstruct the it, the eye brow was shifted in such a way that the boy ended up with a nearly normal looking upper lid, and would ultimately be able to have some use of the lid.

Day 3:

October 19, 2009 - by Ryan Surgery.  The first order of business was to start transplanting corneas.  The way this is done is by taking the donor eye and punching out the cornea.  The corneas are then sewn into the patients’ eye.
    As the day progressed the temperature began to drop.  Soon there after storm clouds began to gather over the city, a rare sight in Marrakech to say the least.  The clouds were accompanied by rolling choruses of thunder.  As the weather began to turn, so did the situation in the hospital.  
    As we were filming in the waiting room the lights began to flicker.  Power outages are never a good thing in any hospital, especially not one here.  The flickering turned into seconds without power, and then there was nothing but what remained of the sun making its way inside.  We realized that if we didn’t have power in the waiting room this meant that the operating room must be completely dark.  We grabbed our small camera lights and made our way into the operating room.  We managed to illuminate just enough of the surgery so that they could continue.  At that point everyone in the room thought that our problems had been solved. This was not the case.
    About fifteen minutes after continuing the surgery there was an unexpected surprised.  The anesthesia must have begun to wear off, the patient started to wake up.   For those that don’t know, while in this type of surgery there is a tube feeding down through the patients throat in order to keep their breathing normal.  When a patient wakes up early, a tube down your throat can feel almost as if you are being strangled.  The patient began to cough, and tried to get up from the operating table.  The doctor yelled for the anesthesiologist. The doctor yelled to us that we needed to control his movement or he would loose the eye in which was being operated on.  Once we had the patient restrained, the anesthesiologist managed to put the patient under.  This was most definitely the most tense and excited part of the day.
    As the doctors told me on the first day, when you are in a place like this, you need to be ready for everything.   I think I learned what that truly meant today.

Day 2:

October 18, 2009 - by Ryan

Today was the first full day of work in the hospital.  We arrived early so we could film the teams cars coming in.  When we first arrived, the main gate was blocked by a crowd of people that had gathered in hopes of seeing a doctor.  It took four guards to clear the way so we could make our way in.   Once inside, the hospital grounds were visibly crowded with people. It was arranged so that people were first screened at the main gate. At the gate it was determined whether or not people would even be allowed to wait for the chance to see a doctor.  
    Those lucky enough to wait, sat patiently in a tent in four rows of thirty or forty.  The doctors were each given their own small offices in which patients shortly began filing through. As documenters, we thought the most interesting and crucial story to start covering were those of the patients.  Through ten interviews we learned the stories of many patients.  Many of these people are people that without a mission like this would never have the chance of regaining any vision.  When asked, the primary motivation for waiting for hours in the hot crowded hotel, most individuals responded that they would like the chance at seeing there loved ones again.
    Coming from America, it was at times hard to envision the homes, which they described.  Many had come hundreds of kilometers from their homes in the desert. These are people that are mostly isolated from big cities like Morocco.  Many of the patients needed to travel hours by bus, and in many cases only to wait in the congested lobby.  
    As the day neared an end, it was evident that it would be impossible for the doctors to exam all the individuals.  This choice is most likely one of the hardest for any health care provider.  It is difficult to decide which patients will and will not receive treatment. This reality is unfortunate, but those decisions need to be made.  It is hard as a documenter to see the full spectrum stories.  Through the day you see people that are fully blind, that will have surgery tomorrow and walk out of the operating room with full vision. There are also those no treatment is available for. Lastly there are those that have waited all day but will never be seen. A truly shocking and heart wrenching reality.

Day 1

October 17, 2009 - by Ryan

After a seven hour flight from JFK international airport, we arrived in Casablanca. Shortly there after we boarded a small aircraft headed straight for Marrakesh.   As we made our way from one city to the other I had the chance to peer ten thousand feet down onto the continent of Africa.  It was unlike anything I had ever seen before.  For as far as I could see was only desert sands . After about 50 kilometers we passed over a vast mountain range.  The mountains were a brownish yellow color, and were visibly dry. As we crested the mountains small rivers and streams became visible.  It was amazing to see that wherever there was the slightest bit of water, there was an explosion of green on top of the otherwise bland brown-yellow backdrop.

            As we neared the airport one could see rows and rows of lush green trees stacked in neatly kept acres of land.  It was astonishing that such a stark contrast could exist within only a few kilometers.

            Our first order of business was to get the Corneas we were carrying for transplant, to the hospital for refrigeration.  After a stop at the hospital we were driven to a mountaintop home of a individual involved with the relief mission.  There they were waiting to greet us with local food and drink.  The home was made out of an orange clay and brick.  To my surprise they even had a small swimming pool.  As we toured the property the owner explained that they don’t use any chemicals to keep the pool clean. Instead, they fill the pool and what for algae to begin growing, once that happens the water is pumped out in order to water the plants on the expansive property.   I though this was a rather environmentally friendly solution.

After a truly authentic dinner, we made our may down the treacherous rocky mountain side back to the hotel.

Tomorrow we will begin the process of setting up a triage in which we will evaluate patients in preparation of surgery.

The Mission

October 17, 2009 - by Ryan

Today I began my week long relief mission with ISMS “Operation Restore Vision”. The mission is aimed at providing specialized ocular restorative surgeries/treatments to individuals that may not otherwise be of the means of obtaining such care for themselves.  With the help of my brother Garrett Reichelt, I will be documenting the stories, of the doctors, as well as the patients which will receive treatment. I will also be giving an informational demonstration to the local children, to teach them to take proper care of oral hygiene.  Through media, we hope to capture the true humility and humanitarian work of the relief team as well as all the other individuals who have lent their time to making this mission possible.

The relief team is comprised of five doctors who have specialties in various ocular subfields.