Six o’clock news

This morning as we were getting started, a member of the National Congress entered our training and spoke for a few minutes. But more importantly, he listened for a while. He wanted to hear what we were teaching the boat captains. Just a little while after that, presumably after speaking to the congressman outside, a crew from the La Ceiba television station and a photographer from the newspaper showed up and watched our training for a while—the odds are good we will be on the evening news.

The government had decided to close the lobster fishery all together in Honduras. But after pressure from the divers and the boat owners (and the rest of the fishing industry) they have decided on a two-year extension. But in that time, they dive community has to make serious steps to fix the problems. The government wants to see the number of divers injured each year drop off sharply. Actually, the government has made no promises after this two year extension, but the boat owners believe if they can fix things, the government will allow them to continue.

Over the last three days, Dr. Mejia and I put on an eight hour training program for 54 dive boat captains touching on everything from oxygen first aid, to stocking first aid kits, to how to prepare and use a Foley Catheter. We prepared certificates of completion for each of the participants to show what they had done. We just found out that the boat captains association (APICAH) has laminated those certificates and boat captains will be required to display them (along with other certificates showing their equipment is in good working order) or they will not be allowed to leave the dock and harvest lobster once the season reopens in July. That is a tremendous step, and is also an indication of why every boat captain has taken the training so seriously.

I can only hope that more organizations with a stake in the lobster industry in Honduras get involved and work to make things better. It’s not a simple fix. It’s not the “evil boat captains” taking advantage of the divers. It’s not the “drugged out divers” not following the rules and getting hurt. Neither of those things exists–at least not as a group. Everyone has a role to play to fix the problem, keep more divers healthy and protect the fisheries here in Honduras. They will have to work together to do it. Things look promising from here on out, though. We will just have to wait and see to make sure each group follows through on its plans.

More later, but after the conversations I have had on this trip with the stakeholders in the industry, I am more encouraged than before.

“We plan to use this information…”

“We plan to use this information to have fewer injuries among the divers this year.” That is what two of the older boat captains said to me as they left our training today. Wow. Pretty incredible feeling, and a little daunting, to realize they are putting so much hope on the information you are giving them. I hope they manage to do it. It will be an uphill battle and attitudes and practices will have to change on both sides for it to happen. They all realize they can’t continue on this way, though.

In the 13 months from December 2009 through the end of 2010, Dr. Mejia treated 130 severely injured Miskito Indians at his clinic. These divers had significant weakness and paralysis. There wasn’t a minor injury among them. The government wants to shut the diving down entirely. Or at least keeps making noises about it. So, if the boat captains want to keep fishing, and the divers want to keep earning a living, they have to find a way to do it—without jeopardizing life and limb.  No one expects this will be easy, but at least they are making efforts.

Next week, Dr. Mejia is planning to spend a week or more in Puerto Lempira working with the divers as well. He wants to educate them in the same way that we are educating the boat captains. Yesterday we chatted about the idea of training some of the disabled divers as boat medics who can care for an injured diver and not require the boat captain to do it. I can’t think of a better person than a previously injured diver to discourage bad diving habits and encourage good ones.

But while today may have ended on a high note, it started out a little crazy. When Dr. Mejia picked me up at the hotel, he told he me he had just heard on the news that the city was going to shut down power to the eastern end of town at 8 am. We planned to conduct our training today at the offices of the Association of Industrial Fishermen for Caribbean and Honduras (in Spanish, the acronym is APICAH for Association Pescadore Industrial…). And those office are on the eastern end of town. So, we got there and waited. Eight am passed so we thought we were safe and we began to set up. Just as we were about to get rolling, the air conditioner turned off. It was 8:30 am. So much for being prompt. Since most of what we planned to present included laptops and projectors, we had to move.

Across town we headed in caravan to Dr. Mejia’s clinic. There was barely room, but we made it work. Everyone just got close and friendly. I will easily concede that today was not as good as yesterday. The captains were not quite as serious in the afternoon. And the two men who spoke to me at the end were some of the prime instigators of the disruptions. Not that they were intentionally causing trouble, just wisecracking and talking amongst themselves when we were attempting to explain something. But, in spite of their inattention, even they got it. They understood the seriousness of the day and it’s importance.

A very cool feeling. So far, we’ve had a tremendous opportunity to speak to 40 boat captains in two days. Tomorrow, another 19 or so. And that is nearly all of the boat captains working in Honduras with Harvesting Divers. A pretty tremendous accomplishment. Will they all change? Not even close. But a few will. And the word will get out that those boats are better to work on. And the Miskitos will change, too.

One step at a time.  

Boat captains

Today, Dr. Elmer Mejia and I spent more than 8 hours talking to a group of 18 boat captains about oxygen first aid, the causes of diving injuries and how to better care for their divers. And the amazing part was, they never stopped paying attention. Even more amazing—there wasn’t a single monster in the room.

Every time I talk about the Harvesting Diver project, it seems like the boat captains end up being the ones who get blamed for exploiting the divers. Unfortunately, it doesn’t seem to be that simple. If they were exploiters, I can’t imagine them taking an entire day out of their lives to learn about providing first aid for an injured or disabled diver. There is the liability side of it, of course, but if they were forced to be there, I don’t think they would have had the attitude they did.

We spent the entire morning addressing the skills and information necessary to provide oxygen first aid, using the DAN course. Because Elmer was translating for me, and they asked a lot of questions, we spent more than an hour and a half working our way through the knowledge development portion. They preferred that over a subtitled video—they wanted to be able to ask questions and learn more. We went over CPR and everyone took their turn on the manikin. And each person got a round of applause when they were finished. Doesn’t sound like a group of monsters to me.

In the afternoon, Elmer took over with a more detailed lecture on dive accidents. And then taught the boat captains how to prepare and insert a Foley Catheter when the divers surface but aren’t able to urinate. I didn’t hear a joke or a single person make a snide comment like they weren’t willing to do that. Maybe it was peer pressure. Maybe today was just the best of them and the next two days will even out a bit, but I was impressed.

My guess is the next two groups of captains will have the same attitude. Makes things much harder to figure out.

Lionfish side note: Lionfish are an invasive species that aren’t supposed to be in the Caribbean. But they are here. This is the one fish that everyone (the fishermen, the environmentalists) agrees on. We need to eat them into extinction—at least those on this side. Not the ones in the Pacific. Throughout the Caribbean, people are organizing fish rodeos and encouraging restaurants to prepare them. So, today we had Lionfish Ceviche as a snack and then fried Lionfish for lunch. First time I’ve had it. It was good. Not terribly fishy and had a good texture. So, eat up world. Lionfish is the next delicacy. And we are supposed to overfish this one!

Lobster Symposium

More than 150 people attended the opening presentation of the “Symposium of Spiny Lobster” that began today in La Ceiba, Honduras. The meeting is all about the sustainability of the lobster harvest, throughout the Caribbean, with a focus on lobster here in Honduras. And it just so happens I’m on the agenda, too!

Ok, I knew I was coming down to lecture and provide training for the boat captains who take the harvesting divers out to the dive sites. I just didn’t know it was this big of a deal. Pretty impressive, all together. And that opening presentation had some really interesting statistics on the state of lobster harvests as well. I have asked for a copy of it so I can reference it later–after it is translated of course.

After that opening, though, the wheels came off a bit. Last week, I sent a shipment of equipment and materials to use in the training this week so it would be here in time for me to use. And it arrived in San Pedro Sula last Thursday. And that is as far as it got. For some reason it got hung up in customs.

At first they needed additional information from Dr. Mejia. And that delay tripped it up. On Monday the Customs computer system was down. FedEx finally retrieved the box yesterday. When they confirmed it to us this morning, but said it might take a day or two more to get it out to us Dr. Mejia and I jumped in the car and drove three hours up the road to pick it up. That’s one way.

The organizers of the event were very understanding, and actually somewhat apologetic since they knew it was their own governmental system that caused the delay and not us. We’ve rescheduled the four groups of boat captains into three and will get all the training done beginning tomorrow. Just the way it goes. We begin at 8:30 in the morning teaching oxygen first aid. I’ve honestly taught this DAN program to more than 500 students and in a couple different languages (through interpreters) but I am really looking forward to these programs the next few days. I can’t think of a place it has ever been more needed or a single class that I think could have a better chance of directly improving the life and health of a human being. That is pretty cool.

The picture above is of the opening presentation. But more important to me is the fact that the men sitting at that table are the divers themselves. I met a couple of them last year when I was in Puerto Lempira. At the time, they commented that people had come to meet with them before. Those people took pictures, made promises and then nothing happened. It has been slow in coming, and this is a first step, but I hope they see that we are trying to do something to improve their lives.

Full circle

The sights, sounds and smells of a place like this come back quickly when you step outside. The semi-controlled chaos on the streets, the brush fires set to clear away growth from the fields, the odd combinations of English and Spanish on the road signs and streets. The heat and the ever-present humidity. But there is also optimism and an energy that is hard to beat.

It was a little more than a year ago when Dr. Matias Nochetto and I joined Dr. Elmer Mejia in La Ceiba, Honduras to see what we could do to help out the hyperbaric chamber here and, in turn, help out the Miskito Indians who harvest lobster.

On that visit, we learned how dire the situation was: more than 2000 men were disabled because of diving, and hundreds more joined them every year. And those were the men who lived through their injuries. Many others didn’t.

Now I’m back in La Ceiba. Dr. Mejia invited me down to help him put on three days of training in Oxygen First Aid and additional measures for the boat captains and owners. These are the men who care for (and are responsible for) the divers. This problem isn’t new and there isn’t an easy solution. If you shut down the diving—like has been proposed and the government has attempted to do—the men have no way to make a living and no way to support their families. Their only other option is smuggling drugs. But if something isn’t done, more men will die.

This scheduled training is a great first step. The boat owners realize they have to do something. They have to be more responsible. And they have to take better care of their divers. If they don’t , the government is prepared to shut them down for good. And then everyone loses.

So, I was thrilled to hear from Dr. Mejia when I arrived that he had been invited to speak to the Honduran National Congress in Tegucigalpa today and give his recommendations on how the divers can reduce their risk and how we can improve their care. That is a tremendous first step and a great recognition of the work Dr. Mejia has done. He has not been alone in this. Many others have pursued this project over the years. Groups have conducted training for the divers, lobbied the government and provided health care opportunities. The changes we are seeing (I say very hopefully) are the culmination of many different people working for many years to improve things for these men who harvest the sea.

The next few days should be interesting as we are going to attend a symposium tomorrow where various groups will be taking up these exact same questions. And then the training begins the next day. It should be an interesting week.

Hopefully this won’t just be a circle, but an upward spiral.

For more background:

• Alert Diver
• National Geographic NatGeo Newswatch
• Video documentary “For Cheap Lobster”

DAN Interns prep to improve dive safety

Stefanie, Jenna and Christa practice CPR from the DAN
Basic Life Support and First Aid course.

Each year DAN research interns come to DAN headquarters in Durham, NC, ready to make a difference in dive safety. And they will definitely contribute.

DAN Internships are as far removed from an envelope stuffing and filing internship as it is possible to get. They are actively involved in collecting research data in the field and in the physiology lab at DAN for that purpose. Before they go out in the field, though, they spend time at DAN learning about the organization and gaining a better understanding of diving physiology and research techniques. Since they will also be working with divers in field settings as varied as Grand Cayman and Scapa Flow in Scotland, they need to be prepared to respond to a dive emergency if one arises.

The DAN Education team puts them through the full suite of DAN programs including Basic Life Support and First Aid, Diving Emergency Management Provider (DEMP) course and the On-Site Neurological Assessment for Divers program.

This year’s interns are (as usual) standouts.

• Christa Landowski has a BA and MS in accounting and is now studying Biology at University of Houston Downtown working toward Medical School. She will be collecting dive profile data at Scapa Flow, Scotland.
• Jenna Wiley has a BS in Biochemistry-Molecular Biology from the University of California, Santa Barbara. She works as a Clinical Lab Scientist at California Pacific Medical Center in San Francisco, CA. Her initial assignment is to accompany the team from Duke and DAN to Inner Space in Grand Cayman for a field research project on technical diving.
• Stefanie Martina is a recent graduate of UNC Chapel Hill with a BS in Biology. She will be working in the physiology lab at DAN Headquarters on projects such as the Rebreather and Breath-hold studies.

New look and feel

With everything else going on at DAN (and there is a lot going on), we are still making progress on the course revision project. And at this stage, several things are going on simultaneously.

We’ve completed our internal and medical reviews of the student handbooks for the Oxygen First Aid for Scuba Diving Injuries and Neurological Assessments for Divers courses and those materials are now in the hands of our Communications Department. We’re moving forward with our reviews of the First Aid for Hazardous Marine Life Injuries and Basic Life Support and First aid courses as well.

The team in Communications has redesigned the cover art and interior pages to give them a new look and feel. The graphic artists there are now placing the text and photographs from photo/video shoots into the book templates. There will be all new photos and illustrations in the book and everything will now be in color. It’s always been a goal to keep our materials as inexpensive as possible, which is one of the reason we kept the interior pictures in black and white, but it is time with this revision to print every in color.

While all this is going on, the video production company is feverishly putting together the new course videos and DVDs. The efforts there are mirroring the student handbook revisions. A first cut of the Neuro video is ready and oxygen is in production right now. It takes a tremendous amount of time to bring together all the various scenes shot at different locations into one cohesive package that follows the scripts.

It’s an exciting time watching all the separate pieces come together to create a finished product. There are a lot of balls in the air, but we are still on track to have everything ready for release at the end of Summer.