Tuesday, March 29, 2016

SPECIAL GUEST POST BY: Kate DiMarco Ruck

I am pleased to welcome my friend and teammate Kate DiMarco Ruck to tigerbug for a special guest post about our time in Athens.  Kate has been studying diligently for the last several years to become a lactation consultant, and got to put her skills to good use and discover a new mentor on the topic of infant feeding in crisis situations during this trip.  Below is a piece she wrote about some of her favorite moments from the trip.


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The Red Cross handing out duffle bags
The past few days have been so full, busy, exhausting and exhilarating. I can't believe we've only been here for a week! I'll try to summarize my favorite moments.
The refugees arriving on ferries has completely dried up. Anyone making it to land in one of the Greek Islands is sent to a detention camp and not processed through Athens. The last ferry we met was a few nights ago. We fit 2 or 3 carriers and handed out lots of hats and supplies. When unloading refugees off of the ferries, the port police have the buses there to transport refugees surround the loading dock after all the other passengers disembark. This gives the refugees little choice but to board a bus to be taken out of the port to a camp outside the city. I can't imagine the feeling of getting off a boat and having no idea what to do or where to go next. To be frozen with indecision and then realize you have very little choice. This night, a man who was blind disembarked. One of our volunteers helped him walk towards and board the bus. My team member,Kat and I knew there was a mom on the bus who had turned down the offer of a carrier. We had fitted two other parents who were now on the bus and thought maybe this mom would regret not taking one after seeing other parents with them. We made the decision to board the bus, wading through a crowd of Port Police surrounding the door. We met a family sitting at the very front. We asked them if they needed anything and the father asked for water. We didn't have any. We handed hats and gloves, emergency blankets and sleeping bag insulators to the teenage daughter. We asked the mother we were looking for if she changed her mind about a carrier and she hadn't. We left the bus. Once off, I realized I had a hat large enough to fit the blind man and hadn't given it to him. Did we dare go back on to pass it along? This is what I liked about having such bad-ass fellow volunteers. One of us would voice a thought, an idea that would seem to scary to undertake alone, another would validate that thought and would go along with the new plan. We got back on the bus and gave the man a hat. Back on the ground, we voiced our regret for not having water for the thirsty father. There were no vending machines in sight. Kat had a clean, empty water bottle with her and I had some water left over in my bottle. This wasn't enough so we combined it with water from another volunteer's bottle. We thought about how long this family could be on the bus with out food or beverage and decided to skip back on the bus, right before it left. Kat ran up the steps and threw her arm over the railing towards the dad, trying to not be noticed by anyone else. He took the bottle and we left the bus for the last time. As we were walking away, I saw him taking a big drink and passing the bottle to his family, and, yeah, that felt good.
How to safely make a bottle
We still spent our days walking through the camps, fitting the carriers, but also decided to volunteer at a gate, filling in where needed. Many of us worked in what's called the Emergency Room at gate E2. This was for handing out very specific supplies, tissues, a few baby wipes, sanitary napkins, diapers and making bottles of formula. All of these items are available from the supply container, you go to the ER in a pinch. We were trained on what to give out, how to make bottles (those of you who know me well know that this was a great conflict within me, especially since we had no means in which to clean these bottles 😟) and most importantly, to say NO to any other requests. Most of the knocks on the door were no. We don't have cups, we don't have tea, hot water is only for baby formula, we don't have sugar.
I wrote down, step by step, the process of making a bottle of formula, hopefully making it easier for a new volunteer to prepare them safely. We labeled each can as to the age appropriate for and tried our best to keep the prep table clean. 

Later on, at the daily volunteer meeting, CTF was asked to consider making a safe space for women and children within the camp. I was asked to head that project. I've never done anything like that before. I spoke with other volunteers, gathered information from other sites and talked to professionals about what would be ideal. As this is the end of my time in Athens, I messaged my proposal to the head of the camp. I don't know if it will be executed.
I also messaged the camp leader about improving safety with the formula bottles. I probably ruffled some feathers when I reported that it was unethical to be making formula in dirty bottles. I offered easy tweaks to their system in order to improve safety. I don't know if that will be executed either, but I feel good with speaking up. Especially since many babies have diarrhea and there have been 3 cases of Hepatitis A in the camps, two of them children. I also left an easy breastfeeding tool in multi languages that anyone can use to asses if a mother is breastfeeding or not. In an emergency situation such as this, formula feeding can be dangerous and the norm of breastfeeding should be encouraged and supported.
That brings me to yesterday, one of my favorite experiences here in Athens. I did the early shift at the ER, bringing carriers with us just in case. After our shift ended, my teammate, Ann and I worked the Tea Line, run by A Drop in the Ocean. The tea line is exactly that, men women and children line up in an (hopefully) orderly fashion, and we pass out plastic cups full of strong, hot tea. Traditionally, most people enjoy 10+ cups of very, very sweet tea a day, but at the camp, they get one cup in the morning, slightly sweetened and one at tea time. The tea is made in a huge vat over a large propane hot plate. In order to accommodate the long line, the station is set up far away from the water source, so it takes many volunteers to haul the water to make the tea. Once it is brewed, we form an assembly line to distribute. My job was to fill the plastic pitcher by dunking it into the vat and then pour the tea into cups. Ann hand me the cups and takes the full ones to the table where another volunteer hands them out and makes sure no one tries to get more than one serving. Yesterday was a no breakfast day, so done volunteers were able to distribute sandwiches, I don't know where they got them.
Vat of TEA
After the tea line, I walked over to Gate 1.5 and met up with a local IBCLC who was volunteering with the midwives. She knew one of my mentors in NYC and I felt lucky to be connected to her. I fit a few more carriers and after a while, Maria, the IBCLC,Karleen, a researcher visiting from Australia, the interpreter, a few mothers and children and I all squeezed into the incredibly tiny midwifery camper. Maria and her translator, Zhou Zhou had previously walked through the tents, looking for mothers with young children, 2 and under, and inviting them to come speak about their feeding experience. I ended up charting each visit while Maria took each history and counseled each mother beautifully. We were so happy that so many mothers were breastfeeding their babies, some were still breastfeeding their toddlers! We encouraged them to continue doing so, there was no need to stop if they didn't want to. What a gift these mothers were giving their children. In a camp where terrible coughs are heard and mucousy noses are seen everywhere, their children will be receiving preventative medicine many times a day. 
In Arabic and Farsi- the Midwifery and breastfeeding camper.
It was so joyful for me to be with these women. To watch the midwives work and reassure the moms. To witness a conversation translated by two interpreters, English to Arabic, Arabic to Kurdish and then back again. What pride these women felt in their children. This has sparked something in me and I feel like it is just the beginning for me and the path I want to pursue. I'm thankful to everyone who let me be a witness.
Done at 3pm after working a full day already, I walked with Karleen Gribble back to town to get some lunch, my first meal of the day. Karleen is a researcher, writing a paper on Infant Feeding in Emergency Situations. She interviewed me about my experience as a volunteer and with making the bottles of formula as a breastfeeding counselor. She will be presenting her paper at the Breastfeeding In Medicine Conference in DC in the fall and I'm so happy to be a small part of it.


Homeless Refugees at the port, catching fish (they got one, it was amazing!) with a luxury cruise liner in the background.