Interview with Victor Hugo Sevilla, a doctor who lives in Pedernales, the town at the epicenter of the earthquake that ravaged parts of Ecuador on April 16. Sevilla was in Quito when the scale of the tragedy became apparent. He returned immediately to Pedernales to serve his community.
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What is the first thing you did?
I went to deliver the things I had brought. I visited a family friend who had not eaten all day. Then I went to see my laboratory. I am one of the lucky ones, because my work things, the instruments, were intact, although everything was on the floor and my apartment was a mess. It was not destroyed, but it was as if a gang had ransacked it. Then I walked around the park, in the middle of town, filled with mountains of rubble; buildings with the fallen floors stacked on top of each other like books on a shelf. I saw a house that had moved to the middle of the sidewalk; it was intact, but in the middle of the sidewalk. And we started to see the sites where a friend had died, a family I know, a patient … (silent). I went to the health center, but it was abandoned. Everyone had been taken to the stadium, which was packed. I worked there on Sunday afternoon, but the seriously wounded had already been evacuated. By that time, 1,200 patients had been treated, 230 had been evacuated by land and two by helicopter.
A medical clinic had already been established at the stadium?
It was already there and people were moving around frantically. There was a very rapid response.
Besides medical care, what else could you do?
I dedicated myself to locating people and supplies to support us with medical care, which seemed insufficient. On Monday at eleven o’clock at night I received a van to attend to the people. We had four clinics and a pharmacy area with medicines donated by private companies. We made arrangements for patients who had not been attended to in Pedernales Stadium. The sun was a frightening thing. I think the size of the earthquake far exceeded the capacity for organization. Not only were people inexperienced with earthquakes, but with organization. I met some unpleasant neophytes; they were people from the Ministry of Health. I had the opportunity to take the mobile unit, with a surgical unit from Cuenca and a dental unit. In Pedernales, we were no longer seeing serious injuries, but there were people from other places who had been rescued by motorcycle. And they were bringing them to Santo Domingo, to Bahia de Caraquez and the journey to Pedernales was much shorter. But this put the spotlight on the stadium, where all the attention of the disaster was concentrated.
What was the technical reason for treating patients at the stadium?
It may have been down to security. Because no building was secure. Another reason may have been that the emergency response center was there, with the State, the local government, rescue teams and even the dead. I thought it was a mistake to put patients there. People were attended to on the lawn, with IV drips hanging from the tubes of tents, meanwhile the health center was abandoned. We went to clean up the health center, it was a mess but we cleaned it and adapted it to the medical unit. We began to see around 130 patients a day there.
And how were people, psychologically?
You could not talk to people about tomorrow. For example, a woman arrived with a case of hypertension. And you could not tell her that she needed another treatment in two weeks. People could not look ahead fourteen days. I will not, doctor, because I am going to die, was the answer. People did not admit to having a future. That was like … (silent).
Like the end of the world, they would not admit that life would continue …
As if it was all over, as if there was no prospect of another life. Even after the first emergency had passed, people did not envisage a future for themselves.
Considering the impact of this, how was the issue of medications dealt with?
I think the government did a good job of handling the initial situation in terms of medicines. What they needed there was painkillers. We also used medicines for the chronic diseases that frequently appear in these cases. From Thursday April 21, people’s needs changed, with fewer external injuries and more diarrhea. So we took a large amount of oral salts. And on Friday, respiratory diseases started to appear. We were out in the open, everyone sleeping on the ground, with the dust from the machines working in the debris, dust from heavy transport and dump trucks. That was the visual panorama, but the smell was terrible.
What was the smell?
Initially it smelled of feces, of sewers. Pedernales had no running water or sewage system before the earthquake. Then there were wells and wastewater pipes that had broken. By Tuesday 19, it already smelled like death with an intensity that was insupportable. But on Wednesday that smell decreased.
There has been very little talk about Pedernales before the earthquake and what has been lost for tens of thousands of people.
Many people thought that Pedernales was a small town, a cove of artisanal fishermen. But it’s not like that. Shrimp farming was the town’s main source of income. And this has had a detrimental effect. This is a very productive society, but the people there only work three or four days a month. Shrimp farming only takes a few days per month. And shrimp farmers already have their crews. Poor people work on one or two shrimp farms and live like that, doing nothing for the rest of the day. The activity of the poor people of Pedernales is informal and precarious. The men work in the shrimp farms and the women in shrimp processing. But it is not fixed or constant work. Very few find stability with this activity. In general, the people seem resigned, as if things just don’t happen in Pedernales. And it’s the same with tourism. Because it only works in high season. It’s a way of life that builds a difficult society: you see buildings and hotels, but poverty in Pedernales runs very deep.
Pedernales, with more than 50,000 people, is a large town for the area …
50,000 people in the urban area alone and 200,000 in the area of influence; the four parishes and surroundings. But it is the fourth poorest part of the country; it’s a terrible contradiction. The area produces, I believe, 12% of the country’s exportable shrimp. (In the area of Pedernales there are 11,000 hectares of shrimp ponds in production. Each hectare produces 15 to 20 quintals. This represents at least 9% of the total national shrimp production). Shrimp production in the area is worth between $60 and 80 million a year, but that wealth is not seen in Pedernales.
These shrimp farms were lost?
The greatest damage is to the physical structures. Larva laboratories were destroyed because they were poorly made. Some shrimp farmers I know can rescue part of their farms; others, nothing.
What about the people, where will they go, how will they work?
The exodus occurred because of this too. People left without knowing where they were going. I assume that at least three out of ten people left.
That’s a very tough question. How will the hotels recover? Of around 20, only two remain. Only in Pedernales. But try and find anyone who wants to stay there.
How do you see the future?
When I arrived in Pedernales in 2014, I realized it was a society without social structure. And it is noticeable even in local leadership. I see Pedernales as having suffered a pruning. A cut to the ease with which people obtain and dispose of things. People with options don’t attend health care services in Pedernales. They go to Santo Domingo, Bahia, Guayaquil. Purchases are not made there. People who obtained their wealth in Pedernales do not look at Pedernales. If this dramatic situation makes people recognize themselves as a society, I think Pedernales will improve a lot. The buildings, the material is being reconstructed, but what cannot remain on the floor is the social fabric, the community identity. This has to be raised up, firstly by putting a stop to informal and precarious labor. We must create stability. We must commit to going in that direction on a permanent basis. We must rebuild the cities, not only physically, but with a social base. If we had nothing on the surface, we must find what lies underneath. Pedernales is crucial for the country. Geography and communications make it a central and alternative point between Manta and Esmeraldas. I see the future out there, but now we have to solve this serious problem of the earthquake, this apparent darkness, and then fight because hopefully there is some light at the end of the tunnel.