July 13, 2016

Not Dead Yet--adventures in Suriname

It’s been pointed out that I left off with us in a squall, 100 miles from the Suriname River and then went quiet. Sorry about that.

Navigating up the river was straightforward—we came in on the flood and rode it 30 miles to the moorings at River Breeze in Domburg. There we met the marina owners and settled in to the welcoming space with its friendly restaurant, well-stocked book exchange, pretty pool, clean showers and washing machine: Pretty much a cruiser’s paradise.

Our first full day was spent taking the bus into Paramaribo (and learned that buses are cheap, crowded, irregular and slow—we opted to rent a car after our first effort to economize). In the city we checked in; a surprisingly quick and easy procedure for us which turned out to be the exception, rather than the more typical experience. Then we hit a clinic to have my ear infection taken care of. $45 US and a trip to the Apoteek and I had a fistful of new antibiotics. Then it was off to the grocery store.

It’s been five months since we’ve been in a store that boasts more than four or five types of fresh fruits and vegetables, fresh milk or a selection of cheese, baked goods and chocolate.
Paramaribo street scene--all white wooden buildings with dark trim in the historic district

While most tourists probably hit a grocery store now and again for snacks or supplies—in our first four days we went to at least six different shops. We’d slowly wander up and down the aisles admiring options of things we’d long run out of, or never knew existed: real fruit concentrates from the Netherlands, tonic of a known name brand, corn tortillas, fair trade chocolate, sesame oil, bagels, fresh anything…

Who needs a museum?

The hardware stores, chandleries and supermarkets might seem like culture enough, but we did spend a day as tourists; visiting the main cathedral, the rum distillery and Fort Zeelandia, which was originally built by the English then taken over by the Dutch. Most of our time though has been spent trying to decipher Dutch names (why so many letters?), eating fresh tropical fruit (mmmm) and navigating the medical system.
the river at dawn
Just after I finally recovered from my ear infection and we were starting to plan an inland trip to the Amazon River basin-Evan developed symptoms of a heart attack: moderate squeezing pain in the chest, left arm was tingling/numb, he had some edema (swelling) in his feet and ankles and very high blood pressure. The marina owners provided me and Ev with a ride to the hospital and he was quickly admitted into an overwhelmed emergency room.

The experience was intense--the doctors train in the Netherlands, so that was good, but the vibe is developing world. It was the last day of Ramadan, and a holiday, so there were a number of well-dressed people in distress. At one point several ambulances from a car accident arrived--one of the young men died and there was a very public visitation/mourning in the small emergency room. He was a beautiful young guy and looked flawless (Ev saw the whole process of doctors working on him etc-it's a small emergency room) the disbelief in his death was raw and overpowering. At least 30 people were in to see him and were wailing.

Not long after this, the head doctor let us know that while Evan wasn't showing classic signs of a heart attack-he wanted to admit him for observation and to see how he did through the night. The initial EKG was negative (i.e. didn't show any heart irregularities or damage) and they did some initial blood tests which were also negative. But the next day one enzyme marker (CPK) went quite high, which can be a symptom of a heart attack. At this point the doctors admitted him to the cardiac unit for an angiogram-which they (English being a second language-and us not being versed on heart attacks) told us was surgery, not simply an exploratory procedure.

Communication was an issue for both Evan as the patient and me as the family. When I got home from the hospital I realized I had no idea *which* hospital I had left him in. The next day, when I called the hospital to track him down, I was told to come in and look for him-starting with where I'd last seen him. Payment had to be made in advance of the procedure-and my last contact with Ev and his doctors (before I lost them again…) was that based on the blood test he had definitely had a heart attack and needed immediate surgery and likely a stent-but first I had to pay.

Suriname is in a state of economic distress. Bank machines only give out <$200 at a time credit cards aren't accepted at any businesses (or the hospital) and the currency is devaluing on a daily basis. I was asked to pay a deposit. Initially I was asked for $4400 Suriname $$ or about $750 US, but when I returned with that amount I was told that because of the chance of Evan needing more intensive care in I'd need a deposit equalling 6 days in the hospital's Coronary Care Unit or $1200 US x 6 = $7200. And I'd need it by 7am the next day (it was now past bank closing) or they'd delay his surgery…

Eventually, the hospital accepted what I was able to pull together with the huge assistance of Ley and Neil (about $5200 US-we eventually were refunded $2200 so the total cost of care came to $3000). Ev had the angiogram and gleefully learned he has the arteries of a much younger man and that aside from the puzzle of the increasing CPK #'s and high cholesterol that needs treating, his symptoms were likely caused by some type of esophageal spasms-a very common source of misdiagnosed heart attacks.

He left the hospital as soon as he had recovered from the angiogram--something about noisy roommates, a 4 am bath time and the food at the place being a disappointment. Most meals consisted of four slices of bread and a condiment.

So we're back at home on the river-monkeys in the trees, birds overhead. We'll be leaving for Trinidad and Tobago in a few days: Our touring in Suriname limited to Paramaribo and the hospital. But we're all healthy and happy-which we were reminded is what really counts.

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