Chapter 80

Every three years or so, there would be a humanitarian mission trip to Mexico run by an alumni of Waterloo. Although it was never advertised as such, it was a much more organized version of the VOSH humanitarian mission trips. Supposedly at least…

There were simply more tools at your disposal in comparison to VOSH. The trip had sponsored medications and unlike VOSH, where the organizers said there may be a surgical team that will come later to help out, there was a guaranteed surgical team that came after our trip.

I signed up for this back in the fall term on a whim and honestly, had forgotten pretty much all about it when winter term came around. Between all the extracurricular activities I was doing, it seemed that the best thing to do would be to cancel this trip. I was stretched too thin. Though the trip was during reading week, I desperately need that one week break to catch up on all my school assignments and studies. 

By this I mean…I really should have canceled…

But I didn’t. 

The main reason for this? As you’d expect, doing so many hobbies during the school year meant that by the time midterms came to be, I was swamped. Just on the top of my head I recall having to pull a good 2 all nighters on the midterms alone. This thoroughly brought me once again to my spiral phase in school. I felt inadequate about being an optometry student. Though I had passed my midterms with relatively okay standing, my insecurity based on how hard I had to try to keep up with them amidst all of my hobbies left me craving the boost in confidence I got from my last humanitarian mission trip with VOSH. 

Long story short, I got insecure from how much I needed to try and keep up with my studies and instead of realizing that it was because I was too busy, I decided to drown the insecurities by doing a humanitarian mission trip. 

Now, to my past self’s credit, it did kind of work…

Before we went on the trip, we had some training sessions with the main optometrist who was running everything. Though I wasn’t spectacular at any particular skill for optometry, I felt that nothing seemed unfamiliar. 

When reading week drew close and our group of volunteers flushed out more of the plan on how to handle things when we got to Tepehuanes, Mexico, I felt like I had an inkling on how things would turn out. This being my second humanitarian mission, I felt like it was going to be breeze since I knew what to expect already. 

However…Things were very different this time around… 

This trip was only around 10 days. That meant it was a few days shorter than the Moldova trip. And yet, it felt way longer. 

On the last day of school before reading week started, a friend of mine who was also going on the trip, managed to get his dad to drive both of us to the airport. At Toronto Pearson Airport, we met up with our fellow colleagues who were also going on our trip. All in all, there were around 10 of us total and we all got along fine. 

But then, right there at the airport, the bump on the road. There was a mix up with our luggage. Unlike with VOSH, where the company made arrangements for the donated glasses to be shipped directly to the city the eyecare professionals were traveling to, we had to bring along our own suitcases of donated glasses this time. The scuffle part was that it seems there was a mix up on the tickets for our luggages and it seems like the luggages was booked to be flown back to Canada as opposed to being flown into Mexico. While this was an inconvenience, it wasn’t a major issue and naturally, after chatting with the airline staff and a very short delay, we were able to make it past this. 

It’s important to note now that our flight was kind of late at night. The plan was to take red eye plane rides to Mexico to maximize our time with patients in Tepehuanes. That is to say, the plan was that we’d sleep on the plane. To that end, the minute I got on the plane, I shut my eyes and tried to fall asleep. It didn’t work. I was fully awake. Completely conscious just to be puzzled by why the plane seemed like it had been in taxi for a good hour or so. As it turns out, that was no accident. The plane was being de-iced. 

Reading week was always around the middle of February for Waterloo students and unfortunately for our group, ended with a large snowstorm. Our second bump in the road. The skies were covered in white and the plane was unable to fly out without thorough preparation. The thing with thorough preparation? It takes a lot of time…

By my accounting of events it must have been a good hour and a half before the plane finally took off. While an hour or so of delay doesn’t seem like a big deal, our problem was that we had a connecting flight annnddd guess what? We missed that flight. 

When we landed in Mexico City Airport, we rushed to the terminal of our connecting flight just in time to watch our plane take off without us. Then, we were stranded. More bumps in the road. 

The main optometrist called the city we were supposed to be in and told them about the situation at hand. There was little we could do now. All we could do was wait inside the airport and hope that we can get another connecting flight over. When we first landed in Mexico City Airport, it was close to around 4am in the morning. I think that by the time we finally found a flight and got ourselves back on schedule it may have been almost 4pm. Based on my social media posts, we lost about half a day from the blizzard and missed flight in total. 

Then, more complications for transport. 

After a very tortuous stay at the Mexico City Airport, we eventually got it all sorted and made it to Durango. But unfortunately, we still had to go further. Tepehuanes was not a location you can get to easily. Unlike Moldova, this place needed 2 flights and then a 4 hour long drive to get there. Although Moldova may have been a bit poor, it was still in close proximity to the first world countries in Europe. Tepehuanes on the other hand, was pretty much surrounded by desert. 

Since we landed in Durango at night time, 12 hours past when we were supposed to be there, the van that was booked to pick everyone up had left. While waiting for a new van to come get us, our group decided to take inventory of just how much sleep we’ve gotten so far…

Just to recap…

We left for Mexico City Airport on the 15th of February. When we got to our Toronto Airport, most of our group had been awake for around 15 hours. This was normal and to be honest, just a typical day.

Due to delays from the blizzard however, by the time we got into Mexico City Airport, it was in the early morning hours of the next day, February 16th. Since I couldn’t really sleep on the airplane, at this point we were hitting around 22 hours of no sleep. 

Following this, we waited a good 10+ hours inside the airport. Unable to really rest well because we had to be awake and adjust ourselves to any changes in the flight schedule. Though some of us dozed off here and there, I doubt any of us had a good rest from all of this. Being generous, this meant that we were at 32 hours of no sleep by the time we left. 

This was not what we had planned on doing on our first day to Mexico…

But still, we pressed on. 

So there we were, at Durango airport boarding a van to take us to Tepehuanes. The last stretch of our journey which only consisted of a 4 hour drive…Except, it wasn’t really just 4 hours… 

It was honestly hard to keep track of since, at the time, I was zoning in and out of consciousness. However, I distinctly remember that we had stopped various times to be searched by what looked like military personnel armed with assault rifles. 

Now, this wasn’t the first time I’ve seen an assault rifle. In Canada, we aren’t allowed to own any guns and therefore, it’s not commonplace to see any firearm in my country. However, in Moldova, we had armed patients! They just showed up and wanted an eye exam while packing heat. This is terrifying because why do you need to have a gun on you when you get an eye exam? Are there threats we don’t know about? Beyond that, more terrifyingly, WHY DO THEY HAVE FIREARMS WHEN THEY CAN’T SEE CLEARLY?

I’m pretty sure the armed men in Mexico were looking at our vehicle trying to see if we were carrying any drugs. While we had no cocaine on us, we did have tropicamide. A dilating agent for eye exams. Now, in Moldova, we never had this issue because one, the logistics of all our equipment and such were handled prior to our arrival and two, we didn’t dilate anyone. The Moldova trip in essence was more of a glasses distributing center whereas here, we had to assess ocular health more and thus needed the drops. Mercifully, this explanation of the drops being “medicinal” worked with the armed people and they let us through. Though I am sure this searching of the vehicle did stall us quite a bit of time. 

Now, you may think that being so sleepless meant that I probably knocked out when we were in the van…But nope! That would be too easy. I couldn’t sleep at all because Tepehuanes, being a very rural area and not particularly well maintained, had potholes galore. So on our last stretch of the journey, sleep eluded me once again because the metaphorical bumpy road we’ve been on since our first flight into Mexico had now become literally bumpy as hell. At some points, I felt like I was trying to doze off in the middle of a roller coaster ride. It seemed impossible. 

This was a rough time. Going back once again to my social media posts, it seemed that when we got into the town we were supposed to be in, it was around my 36th hour of being awake. But it was all okay. We made it! We now have a bed! We can rest! 

…for about 4 hours… 

That’s right, just 4. We had no choice. We’d lost about a day at that point and needed to catch up on the eye exams we promised. While you may think our group would fight tooth and nail to get more sleep, we didn’t. We knew our roles and responsibilities when we signed up. We also knew that some of the patients we’d be seeing have traveled for days to get to us. We can’t let them down. 

Sure we were tired but there was no point in crying about it. We’re here to work. For some of us we were simply too tired to complain but however we went about it, we moved on. With that in mind, the next day came quickly and, running on 4 hours of sleep in 3 days, our group got ready and headed over before the break of dawn for the clinic.

Now, I know that so far, it may seem like the trip was messy as hell and much worse off than Moldova. In fact, you may even think that I’d regretted coming on the trip the most at this point. But I really didn’t. I evaluated the humanitarian trip based on the amount of good we can do. To that criteria, it is still yet to be determined whether this trip was worthwhile or not. 

As I mentioned, in Moldova, I felt like we were only really just dispensing old glasses and then occasionally checking for eye health (inefficiently and without dilation might I add). As for the glasses, it was rarely the exact prescription we could dispense. As for the ocular health stuff? We could only really give the locals a form telling them what’s wrong with them so that if they see a surgeon in the future, they may be sped up through the process of getting treatment. Whether they’ll actually make it to a surgical team? Who knows? We were never told explicitly that there would be a surgical team after us. 

In Tepehuanes, with an assured handoff to a surgical team that was to come after us, the potential to make a difference was more palpable. Glasses were useful for fixing a lot of wrongs in the eyes but there are some things they can’t fix. The biggest concern we dealt with that can’t be fixed with glasses? Cataracts. A complication in the eyes that will happen to everyone with age and for which you absolutely need surgery. For some, between having the surgery and not was literally the difference between perfect vision and total blindness. 

I like to think about eye care and health care in general in terms of something called the QALY. This is known as the Quality Adjusted Life Years and it is a generic measurement of medical interventions that improve both quantity and quality of life. Essentially, I thought about my job as successful based on how much QALY I could improve. The things that usually made the QALY improve significantly when on a humanitarian mission? You guessed it, it was referring someone for Cataract surgery and having them get it.

In short, I was reserving my judgment of the humanitarian mission until it was over. Only then can I look back and think about how much QALY was improved from our presence there. So, despite all that has happened so far, I still had hoped that in the end, the presumed sum of QALY improvement would be much higher in Mexico than Moldova. This was the metric I chose to care about the most. 

When we left our hotel after our short 4 hours, it was still dark. But like I said, we couldn’t afford any more delays. We had to go in and set up. As our group walked to our temporary clinic with all our equipment in tow, we saw the sunrise. Amidst all the stray dogs surrounding us and the beat up roads we were trekking through, it seemed serene. 

A few minutes later, we arrived at our temporary clinic. It was a local hospital this time and there was already a line there waiting for us. 

Okay.

Time to get to work.