Evacuate

Paradise Lost 

Easter Sunday 16:00

A few months later, after an epic five-day journey including a 4×4, bus, truck, ox cart, wading through rivers, trudging through bogs, and a blissful speedboat, I finally arrived in Andavadoaka, Madagascar. I would spend the next three months here diving, researching, and working in a remote paradise on behalf of a nonprofit called Blue Ventures.

The expedition began wonderfully, diving or boat marshaling in the morning, studying in the early afternoon, capped off by soccer matches on the sandy white beaches.

Our expedition numbered about 24 people, mostly Europeans and Americans exploring the depths of the sea. On my second dive, we discovered a new coral reef site no one had ever found before, though our GPS system ran out of batteries and we were unable to record its location.

During the third week, on Easter Sunday, the local villagers challenged our expedition crew to a full field, full-length football game. After 29 expeditions compromising 29 separate research teams, the locals had never lost, due to the fact that after the first half, the Europeans just could not keep up in the unbearable heat.

Fortunately, an oncoming hurricane clouded the afternoon, bringing a cool air that leveled the playing field. The match was the best game I had ever played though we lost 0-1 in the 89th minute.

Diving had been canceled for the next few days due to the turbulent weather, so we all heavily celebrated through the night drinking obscene amounts of beer and togagash, a lethal, and I think maybe illegal, Malagasy home-brewed spirit.

My right eye began to twitch with pain early in the evening but I attributed it to the dusty playing field and early morning dive.

I awoke the next morning with a dull headache and an inability to open my right eye due to an intense pain that had nothing to do with a hangover. Even opening my left eye caused excruciating pain to the right. My hut-mates Kyle and Derek guided my blinded and weary body to our on-site medic.

Craig, a paramedic and ex-military doctor perfectly suited to deal with illnesses in remote areas, struggled to rouse himself that morning though eventually sat me down in his make-shift clinic. Examining my eye with fluorine, he saw a volcano-shaped crater in my right cornea.

Obviously concerned, he immediately satellite phoned a specialist in London. As Craig suspected, I had a corneal ulcer and was to be administered antibiotic eye drops to dissipate the bacteria, and was also given Codeine for the pain. With drops and rest, we were assured via our specialist in London that the ulcer would dissipate, making me fit to resume work in about a week.

Craig taped both eyes shut.

I spent the next 24 hours completely blind, groping my way about camp with the aid of my friends.

Things Get Worse

Tuesday 14:00

Since I had been administering eye drops hourly throughout the night, I awoke with no pain in the eye but was very tired and underslept. I spent the day in darkness, adjusting to being blind, with time slowly sloshing by in the way it does when humans get no rest. Things seemed to be getting better and I was optimistic. Craig replaced my eye dressing later that afternoon and cleaned out all the, medically speaking, “gunk” in my eye. Once cleaned, I looked at Craig with my good eye shut.

I saw a world of only lights and shadows.

“Craig, I can’t see anything,” I said.

“You are shitting me,” he responded, grabbing the satellite phone to call London.

I was done. Expedition over.

I called a quick meeting with the staff to let them know I was being evacuated. In spite of some really heartfelt condolences, I felt sadness and dismay more than anything else at that point. As I ambled my way back to my hut to gather my things, I saw Craig out by the football pitch on the phone. I went over to overhear the diagnosis, in the vague hope that this was expected and might somehow still be handled locally. I was dead wrong, and instead heard words that I will never forget in my life:

“Right…I see…Right…And when you say ‘urgent’, what exact time frame are we talking about?”

I froze. Being thousands of kilometers from any hospital in a remote, desolate area, the skies darkening by an oncoming hurricane, the word “urgent” had no meaning.

Craig hung up.

“You have hours,” he said.

Derek, my Scottish hut mate, swore he would get me there on his back if he had to and we laid out plans for the hike.

Mission Critical

Tuesday 16:00

I ran back to my hut to get my medical information and then ran to Jenny and Tristan’s hut, the expedition managers.

They took out their emergency procedures folder, full of evacuation contacts and available medical staff in Madagascar and South Africa. The four satellite phones were distributed between us to start going down the list of available aircraft that could make it to the site and evacuate me.

My first call was to United Healthcare to get information on coverage for this medical evacuation. With the now very real possibility of never seeing again being front and center in my mind, I wanted to skip this step. Costs became meaningless in a medical emergency. Jenny, however, being the prudent manager, pointed out that it was the first step in the medical evacuation process. It said so, she pointed out, on the weathered yet colorful PowerPoint slide, detailing all necessary steps for an emergency medical evacuation.

So I rang.

A chipper woman from an Indiana call center picked up the phone. Here was a phrase that would confuse any call center operator:

“Hello. My name is Bart and I am in an emergency situation. I am in a remote expedition site on the southern coast of Madagascar. I need a helicopter or seaplane to evacuate me immediately. I have GPS coordinates of a nearby football pitch to use as a landing pad. Is this covered by my insurance?”

“Um, right…You need to…Wow…. I need to speak to a supervisor. Please hold,” she responded.

Placed on hold, I started listening to Elton John’s Rocket Man while standing in the pouring rain at the rate of 3.50 Euro per minute. After about the 280 Euro mark, I realized I was not getting anywhere trying to explain my grievous situation. These are all the real answers to the most inane questions I had ever heard:

“Madagascar… M-A-D-A-G-A….”

“Yes, the country.”

I hung up the phone and gave Jenny the “thumbs up” on insurance, anxious to get to the next step of calling various aircraft providers.

The storm hit full-on, with the rain coming down sideways in sheets. To receive reception, we needed to be outside in the open. Holding a useless umbrella, drenched to the bone, I spoke to a pilot named Lionel, yelling out the GPS coordinates of our football pitch. His response:

“Sorry, sir. With the hurricane, we cannot fly that far south until Thursday. Again, deeply sorry but there is no way we can fly.”

Everyone got the same response. Nothing could fly here for another day and a half. I looked out into the black, turbulent ocean. My left eye was beginning to twitch. The infection was spreading and I was stuck, thinking the dark ocean would be one of the last things I would ever see.

The Search Party

Tuesday 20:00

Search parties of two were organized.

Any vehicle found in the area was to be commandeered and brought back to the site. I could not go, due to my lack of sight and had to resort to packing and thinking of alternate plans. With help from the staff, I began to stuff my things into two separate packs. One pack had all my non-essential clothes and dive gear. The second pack had one set of clothes, a medical kit, my knife, money, and travel documents.

Evacuation may now be on foot or ox-cart to the nearest airstrip, near Morombe, where a plane may be landing. The hike could take eight hours, which could feasibly mean that I would be there by morning to await any evacuation aircraft.

Ordinarily, that is not a difficult hike for me though given an ulcerated eye and a hellfire storm it seemed impossible. Derek, my Scottish hut mate, swore he would get me there on his back if he had to and we laid out plans for the hike.

The search parties came back empty-handed. A 4×4 had left earlier that morning to Morombe, only to disappear in the storm. A ride to Morombe should only take 2-3 hours by 4×4 and 12 hours later, no one knew what happened to the car or its passengers.

Most likely, it had broken down along the way and was waiting for the storm to pass. Hiking was immediately ruled out due to the weather and lack of any sort of map. All options were spent for that evening and we awaited dawn for the last resort, evacuation by boat.

The Last Resort

Wednesday 05:30

Boat evacuation was always the last resort in all the planning, as the ocean was swirling from the storm. If the boat capsized then, well, that would have been the end. I did not sleep again and prayed that the morning would be calm. Upon first light, I saw the sun, indicating a passing of the storm. I grabbed both packs with Derek’s help and trotted down to the beach. A few staff members and friends loaded one of our dive boats with bottles of water and three reserves of petrol. Two local Malagasy staff were to accompany me and I refused my other friend’s touching offers to join us on the trip. The trip would take two to four hours depending on conditions, being rough in the best case scenario and quite dangerous in the worst-case scenario. Our dive boat was a rickety, wooden affair with little to say for safety measures. I donned an orange life vest and put on my dive mask to protect my eye bandages.

I looked like an aquatic dork.

After quick hugs and words of encouragement, the boat motored out into the swells of the ocean. The first hour was pretty solid travel but the further out we got, the worse the waves became. Some sounded like they were pounding the wood frame with steel hammers. One wave hit with such force that all three of us fell backward. My back was sliced against the satellite phone box and warm blood trickled down my back. We stopped twice along the way, once to refuel and once to let the skipper violently vomit from seasickness.

After three hours, we eventually floated up to Morombe. I waded through the waters towards the shore, carrying my bags over my head. The plan from there was sketchy at best. Once on shore, I set out to find some way to get myself to the airport. I had no idea how far it was, or exactly how I would get there. Finally, my luck changed.

A Savior

Wednesday 08:30

I observed a family eating breakfast on a terrace by the beach. I quickly went over to explain my situation, hoping the eye patch, a blood-stained shirt, and the medical kit I was carrying would be a universal sign that I needed help.

I was wrong.

My boat guides had disappeared without a trace and had carried off the satellite phone with them. Baffled and furious, I made my lonely walk towards the family. Not being able to speak the local language, I resorted to my basic French to communicate my situation. I desperately tried to explain to them in my awful French that I needed a car or directions to the airstrip, but nothing was getting through.

I needed immediate transport for evacuation. They smiled and nodded, and served me coffee and a baguette. As I sat down to eat, I took out a pad and paper to draw some pictures of a car, a plane, and then a hospital. Suddenly, a voice rang out

“BART!!!”

Shocked to hear my own name in literally the middle of nowhere, I jumped up towards the direction of the voice. With my dilapidated vision, I saw a petite blonde woman running towards me from the beach.

Great, I thought, not only am I losing my vision, I am also losing my mind.

She hugged me and then started asking what had happened with my eye since I last saw her on Sunday. A ray of light hit the recesses of my memory. I had met Heather at the local village bar three nights prior. She was working on a separate octopus conservation project in the area, and had left the morning prior in the 4×4 that everyone thought had wrecked somewhere en route.

She led me back to her room where she bandaged my back, changed my eye dressing and cleaned me up a bit. I still had fluorine dripping through the bandage yellowing my face, and for the first time in days, I saw myself in a mirror. I looked like death. Bic, her 4×4 driver, appeared at the door. Heather rapidly explained to him what was happening and sternly told him to find a car as soon as possible. Without a word, Bic jumped on a bike and pedaled off towards the village. As we waited for his return, she started gathering her things and stuffing them into her bag.

“What are you doing?” I asked.

“Bart, you can barely see and have no real idea where you are going. You can’t speak either French or Malagasy. I am not going to leave your side,” she responded.

I started to believe.

Air Rescue

Wednesday 09:30

Bic not only found a beat-up pickup truck with fuel, he also found my two guides and our satellite phone. All of us jumped in the back of the pickup and took off for the airport. I could not help but smile for the first time in a long time as Bic gave my errant guides one hell of a bitching out session for stranding a blind me while our crew drove to the airport.

Upon arrival, the airport proved to be nothing but a long concrete runway and a run-down white shack harnessing antennae. Bic, Heather, and I jumped off the back of the truck and its driver sped off without waiting for payment or showing any concern over what would happen if this place was deserted. No planes, cars, or people were about.

Dead silence hung in the air.

We walked up to the shack, which had a worn-down brown door. Above the doorframe, I saw the word “Deptarture” crudely and incorrectly written in blue paint. I opened the door and saw a small Malagasy man sitting at a desk with a VHF radio. By the looks on our faces, I do not know who was more surprised to see the other. He spoke no English, so Heather took over in French. This was literally the entire conversation:

“This man needs to be flown to a hospital. Is there a plane coming today?” asked Heather.

“Yes, Madame,” he responded.

“When?” she asked.

“Sometime,” he responded.

“Where is it going?” she asked.

“Somewhere,” he responded.

Heather and I looked at each other and shrugged. Both of us had been in Africa far too long to argue with this impeccable logic. We went back outside and sat in the shade, awaiting a plane to arrive sometime and to take us somewhere. I still had the satellite phone but decided to wait an hour or so before calling back to camp. After all, no “Plan B” existed anyway and I needed to conserve the battery.

After 30 minutes, the tiny drone of a small jet pierced the air. Air rescue! The three of us ran to the tarmac, watching an ancient Cessna hobble towards a landing. Heather squeezed my hand.

“Here’s your plane, Mr. Bond!” she yelled, laughing.

Out of the plane popped a shaggy looking pilot named Josh. Josh was a Canadian working for Mission Air Force; a Christian based organization specializing in small aircraft delivering aid supplies to remote areas in Madagascar. Unbeknownst to me, Jenny back at camp had continued sending SOS signals for my evacuation and MAF caught wind that I needed to be extricated from Morombe to Tulear, a larger town where I could connect to the capital.

At first, he rejected taking both of us, saying he only had room for one person. I explained the full extent of my injury, claiming that without Heather, I would be dropped off in Tulear with poor vision needing to find urgent medical care. Seeing this, and being a good Christian, he forced room for three in a plane meant for two. I got strapped to a large cargo box with a five-point buckle and Heather took the co-pilot seat.

Away we went, flying two quick-land reconnaissance missions en route so that Josh could test out dodgy dirt runways as potential drop-off points for medical supplies. Both landings failed but we aborted quickly, and all survived another day. One hour later we landed in Tulear, a city underwater after the hurricane.

The Mystery Man

Wednesday 11:00

Heather and I jumped off the plane, carrying our bags down the runway. I was trying to form some sort of mental plan for getting tickets to the capital city of Antananarivo when a 4×4 literally cut us off and drove up on the runway before we could get into the terminal. An older white man with crisp white hair, chewing a cigarette came towards us. He looked at my patch and in a thick Belgian accent said:

“Bart, I assume? I have a ticket for you to get to Tana at 1700 today. You owe me $130. We have six hours here in Tulear to find you a doctor till then. Get into the car.”

I looked at Heather and we threw our bags in the car. She asked if I knew who this was. I had no idea. He wasted no time and I never got the chance to ask his name, how he knew I would be there at that moment, or any question that would explain his baffling entry into an already bizarre journey. He just happened to appear.

The Belgian went straight to business and I showed him my list of medical contacts in Tulear. He shook his head at all of them.

“Sheet…sheet..all dees are sheet. You egg-spect to see again with these dackters? Ha!”

He put the 4×4 into gear, said he had a better idea and proceeded to make calls on his mobile phone. Driving through puddles the size of swimming pools; he made multiple calls, fluidly switching from French to Malagasy. We pulled up to a clinic where he made some inquiries. He shook his head and we got back into the car.

More calls, another clinic, another shake of the head.

Finally, he spotted a nun driving in the opposite direction. Cutting her off with his car, he started asking her questions. He finally nodded and said that the Catholic Mission had an eye doctor that would arrive in a few hours. He dropped off Heather and I at a small hotel and I paid him the $130. He scribbled the name, “Doctor Moray” and the address of the Catholic Mission on a scrap of paper. I thanked him profusely and he just shook his head and lit a cigarette.

As he drove off, I realized that I never caught his name.

To this day, neither I nor any of the Blue Ventures staff know who this man was or how he knew about my arrival to Tulear. All I know is that he saved my vision. For that, I thank him with all of my heart.

My Eye Gets Cut Open

Wednesday 14:00

After dropping our bags into our room, Heather grabbed a cab to the Catholic Mission. We had nothing else to do but wait, so we figured we might as well do it at the clinic. The cab, a 1960 Renault hatchback, waded slowly through the sea that was once Tulear. Water began to flow into the car. Amazingly, the car made it the entire way to the mission without breaking down.

A yellowing building with boarded up windows greeted us. With all the doors and windows closed, I decided to take a quick nap on the front stoop, exhausted from three nights without sleep. Using my backpack as a pillow, Heather and I passed out only to be awakened by the same nun from earlier in the morning. She pointed to a small white building with an open door.

I walked into a room lit only by the sunlight, housing a bruised looking desk and an old shelf. In the corner, a Malagasy man in faded blue overalls hobbled over. His arm was held firmly to his side and he spoke with a pronounced stutter, most likely the result of a recent stroke. His broken English was surprisingly good and he pointed us in the direction of Doctor Moray. I opened a metallic green door to find another Spartan room, this one housing a few diagrams of the eye, a faded eye chart, a sterile metal table, and an ancient ophthalmoscope. I sat in front of the ophthalmoscope, awaiting the doctor to examine my eye.

To my surprise, the man in the faded overalls sat on the other side. The man I took to be the janitor was actually Doctor Moray. Heather pulled out my medical documents from Craig, which outlined the chain of events that had led to my evacuation. Dr. Moray shoved these aside and told me to put my chin on the ophthalmoscope. The light went on and he muttered a few things to himself.

“You have an un…. (pause). An…Un…ulcer,” he said matter-of-factly.

Relieved that he at least got my problem correctly diagnosed, I said yes.

”It n-n-needs to be removed,” he said, slowly rising to his feet. “Now? Here?” I exclaimed.
“N-n..n….(pause)…Now,” he stuttered, beginning to wash his hands. I looked again at the desolate room and at Heather.

She smiled weakly.

I ran through the corridors of my mind, seeking another option. I could bolt out the door…but to where? I still had hours until the flight to Tana and hours counted. And once I arrived in Tana, I did not know what I’d find there. Heather had no ticket, so I would be going alone.

“Fuck it,” I thought. Let’s make this happen.

I laid down on the metallic table. Heather came up and took my left hand in hers and pressed it against her chest.

“Be brave, baby,” she said.

Popsicle sticks were placed in my mouth to bite for the pain, and numbing drops were put into my eye. I realized then that I would still be awake to watch a knife go into my eye. I heard the faint, sterile clicks of instruments being placed on a metallic plate.

“What kind of instruments does he have?” I asked.

I felt Heather turn around. She squeezed my hand tighter. “Sweetheart, you really don’t want to know,” she answered. Nothing prepares you for watching your own eye be cut open.

Nothing prepares you for an operation in an unlit, unpowered room in the frontier of the world.

And nothing prepares you for having it done by a doctor partially paralyzed by a stroke. The next step just happens.

“L…L…Look but duh…duh…(pause)…do not move your eye,” commanded Doctor Moray. His nurse switched on a cheap flashlight.

“Jesus,” I thought. “This place doesn’t even have working lights.”

White light flooded my eye. I saw the faded glint of a knife. I bit down hard, held my breath to keep absolutely still, and looked forward with the fury and passion to see again. The knife flicked once. Then again. And again. My eye recessed into my skull under the pressure. White pain seared my brain. Heather squeezed my hand tighter and tighter.

“All done,” said Doctor Moray.

I sat up and looked at Heather.

I could see nothing out of my left eye.