NAPO TO BABAG TALES LCVIII: Rain or Heavy Rain

RAIN IS A FACT OF life. Rain is omnipresent. It appears then it is gone and might come back and be gone again and so on and so forth. Almost half of the year, maybe more, it rains for a whole day and sometimes for a full three days when weather is really that depressing. To be honest, we cannot do nothing about that except stay indoors and count sheep or watch DVD to your heart's content.

For those of us who do not conform to a conventional way of thinking, rain is something that we give respect to. Respect is not disdaining its presence but taking it as a chance to embrace it like a brother. If you do not respect it, you will get sick, feel cold or curse heaven. I would rather be wet on an outdoor sortie on a Sunday than staying under a roof and blame rain for a missed opportunity. I would rather have my body develop a stronger resistance to the elements by living within that context.

You have to adjust your way of thinking by adapting to the way how nature works. Resisting is spending for medicine and hospital. Adapting is relishing what you do, especially outdoors, regardless of situations and events. I cannot explain how most, born in a tropical country besieged by strong typhoons year after year, cannot yet comprehend this situation and rather adapt to a cinematic way of life, free of cares and perfect weather.

Rains have come to be part of my world and I do not mince words at it like I used to do in my younger days. The older you get, you get to appreciate of things great and simple, even if it had caused you grief in the past. Rain plays a big part in all our life. It brings blessings or it may bring inundations. I would not want the latter but have to live with it. Yes, heavy rains have caused me misery in the past like staying awake waiting for flood to subside while your neighbors are blissfully asleep.

It had rained a few hours ago on this gloomy morning of July 5, 2015. Shio Cortes and Val Cruz III of the Cebu Provincial Disaster Risk and Reduction Management Office will lend their time to teach Wilderness First Aid for my wards at Camp Red Bushcraft and Survival Guild. This is a rare opportunity to learn from people who know their business well and it would be unfair if I confine this activity to ourselves and so I invited people from the Visayan Trekkers Forum where Barry Paracuelles, Neil Mabini, Randy Alforque and Chad Bacolod thankfully accepted.

We start from Napo after a short motorcycle ride from Guadalupe. The ground is wet and parts of it are muddy. We will be on a short walk only to a place where I see a good potential to host future outdoor activities. The name of the place rhymes as Camp Xi. It is a small open plain found beside the Sapangdaku Creek but it is three meters above the stream. It is totally safe and high enough from a flood. A lone family make their living there farming adjacent hills and selling firewood. It has a water source.

We arrive there at 09:30 and immediately my wards set up a fireplace. Coffee breaks the humdrum of the uncomforts caused by partly-soaked socks. Holes on overused rubber soles seep inside like mine. My 5.11 Tactical shoes are starting to disintegrate and I am afraid I may have to acquire a new pair. It had served its purpose well. It had taken me from Mantalongon, Barili to Mantalongon, Dalaguete to Poblacion, Boljoon over the rugged spines of southern Cebu last February and May and a host of long training hikes in between.

In the center of a flat piece of ground, a black laminated plaited-nylon sheet is placed. Any time soon, the outdoor lectures will start. It did start at 10:40 after a short prayer by 10-year old Michaela Lim. I see two other minors and six college students who did volunteer work with Camp Red on a pre-school opening outreach. This is just amazing! All stood in a big circle, braving the rain that have started to fall.

On top of the plaited-nylon sheet is a black tactical-looking bag lent to us by Cpt. Jose Gochangco JAGS (Res) of the 5TAS Brigade of the AFP Central Command for this occasion. The bag contains all the wonders of emergency medical response. It is an emergency medical bug-out bag and everybody is toying with the idea of owning one even if it is a smaller version.

Shio starts the introduction about Wilderness First Aid. It touches on the whole context of WFA and then the overview of emergency response which are focused on Locate, Access, Stabilize and Transport or LAST. Then he distinguishes the difference between Search and Rescue as against Search and Recovery.

Val demonstrates how the Primary Assessment is performed starting from the sizing up and assessment of the scene of incident and the manner by which the victim is found. First thing to do when examining patient, if unconscious, is to feel the airway if patient is breathing and then check pulse. Where no breathing and pulse are felt, proceed to CPR or the cardio-pulmonary resuscitation. Again check airway. There may be obstruction of foreign objects else, if patient is healthy but only choking, proceed to effect the Heimlich maneuver.

If patient is injured, proceed to the management of bleeding by (a) direct pressure, (b) through elevation and (c) by placing pressure points. The fourth – by tourniquet – should be applied as a LAST OPTION only! The rule of thumb would be that the affected part where tourniquet is placed should be released from pressure every fifteen (15) minutes and that tourniquet should be applied to not more than two (2) hours. Failing that, it causes suffocation and permanent damage of arteries of the appendage.

For this part, the participants are urged to join in and use triangular handkerchiefs, bandannas or any other type of thin clothing as cravat bandage to wrap imaginary wounds or to stabilize fancied dislocated joints among themselves. Then these same cravats are used to perform a tourniquet on each other. A more sophisticated tourniquet appeared that could be performed by even on himself. It is called the Combat Application Tourniquet.

Other injuries which cause patient difficulty in their mobility are the muscuskeletal injuries which are simple fractures and complex ones which can be remedied by providing splints to the affected part to prevent unnecessary movements. Immobilizing the affected part is very important also when patient is a victim of a venomous bite. The purpose really is to delay the suspected venom or poison to travel quickly to the brain through the veins and arteries. Treat each bite as venomous or, at the least, as carrying rabies.

While the lecture went on, Ernie Salomon took care of the cooking for our meantime meal. Jhurds Neo, Jonathan Apurado and Francelyn Quijano assisted him. Food served were grilled pork, mung bean soup, pork adobao and it is laid on banana leaves, along with rice, another grand mimic of the Philippine military's popular “boodle fight” fete. Lunch was dished out at 13:00, a trying hour of empty stomachs yet warm enough to stave off the cold.

Shio then takes over where Val had left and proceeds with the presentation of the Secondary Assessment on a patient. The rain had not abated and we see Christopher Ngosiok assume the role of the “patient”, lying on his back on the black laminated-nylon sheet in the center of the circle. An umbrella protects his face while the rest of his body is exposed to the uncomforts brought by rain. This is real-world training in a place and condition not to anybody's liking.

It is very important to focus patient assessment from head to toe. Examination should be very detailed and complete. Vital signs that need to be addressed are the respiratory organs, foreign objects inside muscle tissues and the coherence of mental awareness of patient. If patient is unconscious, information about his condition before the incident should be retrieved from the persons close to him or those with him, otherwise the patient would provide you his allergies, his medications, medical history, last food eaten or liquid intake and the events leading to the incident.

The black laminated-nylon sheet are then turned over to the participants to try the patient assessment among themselves. By now, rains have stopped and “patients” are now more willing. Fritz Bustamante and Fritz Jay Hortelano applied what they just learned on Randy Alforque as the “patient” coached by Shio and Val while, on the distaff side, Faith Gomez is scrutinized by both Locel Navarro and Abegail Villariza.

Last topic is patient transport and packaging. First to be discussed are the easiest and which are the most commonly practiced like the single and the two-man carries. Then the most complex carrying-and-packaging methods are demonstrated where you need ropes or cords, sturdy sheets and some common everyday items. Evident of these methods are the Daisy Chain Package and the Georgia Litter Rig.

One improvised litter setup is using the ball cap and the small backpack to prevent unnecessary head movement where the visor of the cap acts as an improvised neck brace and the backpack's waist strap are used to hold the forehead from swaying side to side aside that it acts as a cushion to the back of the head. Officially, the training ends at 15:30 as the skies begin to show signs of rain again.

For this life-saving activity, Camp Red is indebted to Shio Cortes and we presented to him our token of appreciation in the form of a classic Swiss Army Knife Camper, courtesy of the club president, Jhurds Neo. Likewise Val Cruz III will have his token given during the scheduled 1st Cebu Search and Rescue Summit this July 29 to 31. We were fortunate that they have pushed on with this event even under the threat of rain and heavy rain.

Camp Red and the rest of the participants have gained additional knowledge in wilderness emergency response where improvisation and adaptation would spell the difference on the survivability of a patient, granting that professional aid and hospitals would be several hours away. Since we are masters of expediency, Wilderness First Aid blended well with our summary of skills and we could not have appreciated it better except than being under the tantrums of rain.

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NAPO TO BABAG TALES LXIII: Wilderness Emergency Preparedness

OPPORTUNITIES TO LEARN outdoor skills are very rare here in the Philippines, much more so in Cebu, as these are confined to alternative schools of learning, which are very expensive, and from the military, if you happen to be one. Free learning are even rarer. If you are a protege of a good teacher or a descendant of one then you are assured. If not, there is You Tube and other do-good websites. However, there are some individuals who share their time and knowledge without monetary considerations.

I teach a lot of people and I am not alone when it comes to sharing. We all know that the very respectable and very capable Dr. Ted Esguerra of the Philippine Everest Expedition Team had been making the rounds in Metro Manila and Luzon teaching emergency preparedness and wilderness first aid almost gratis and how everyone in Cebu would wish that Everest Doc would come down here and share his knowledge to us.

Much as we would like it, there is another one though that could do that part and he is a true-blue Cebuano; a native son of Mandaue carrying an illustrious surname that is connected with that city. He is no other than Shio Cortes. A trained paramedic with more than twenty years of experience. He honed his skills early when he was with the Emergency Rescue Unit Foundation (ERUF) and expanded it even more during his tenure with the Central Visayas Search and Rescue (CEVSAR).

He went as far as Guinsaugon, St. Bernard, Leyte with his team of paramedics and conducted countless rescue and retrieval operations elsewhere in the Visayas. Presently he is contracted by the United Nations for water search, rescue and retrieval work and trainings at the Democratic Republic of Congo. I have met him once during Camp Red’s EDC Parley in January after showing interest in what we do: Bushcraft and Survival.

Today, July 13, 2013, Shio will teach a free class on Wilderness Emergency Preparedness to fellow Cebuanos. Since it is an outdoors-oriented activity, I arranged it be held at the Roble homestead in Sapangdaku, Cebu City. It is a perfect venue since there is a good clearing with a number of bamboo benches under shady areas. Mango trees growing there could be utilized for ropeworks demo like single-rope technique.

All meet at the parking lot of the Our Lady of Guadalupe Parish at 7:00 AM. When we think that we have a lot of interested participants, we move out for Napo on board three vehicles each driven by Xerxes Alcordo, Ramon Corro and Aljew Frasco. A total of twenty-seven people came aside from Mr. Cortes and this blogger. We walk trails, cross streams and climb steep ground until all arrive safely at the Roble homestead.

We choose a shady place underneath a mango tree with bamboo benches. All participants take their spots and make themselves comfortable as possible. After a short introduction and prayer, Mr. Cortes started the outdoors seminar through the discussion of personal safety, the proper skills, adequate knowledge, appropriate attitude and equipment reliability.

He remind everyone that the responder must utilize whatever material and supply on hand depending on common sense and practicing this at home will increase your preparation should you encounter one outdoors. Legally, a rescuer is always liable and should never take unnecessary risks or perform any medical procedures unless it is absolutely necessary.

He goes on to the next chapter which is the Primary Assessment and Survey. It is summarized as the 3 ABCs of Emergency where:

    A is Assess (scene assessment), Airway (ensure an open airway) and Alertness;

    B is Barriers (gloves and masks), Breathing (check breathing) and Bleeding; and

    C is CPR, Cervical Spine (immobilize) and Cover (maintain temperature).

This is followed by the Secondary Assessment and Survey and it may commence once the rescuer sees no immediate life-threatening problems beginning with a Head-to-Toe Examination to look for signs of swelling, deformities and pain. Then check SAMPLE which is an acronym for Signs and Symptoms; Allergies; Medications; Pre-Existing Medical History; Last Meal Eaten; and Events. Then assign a Team Leader for an effective Emergency Management.

Mr. Cortes went on to remind all that the feeling of being in the outdoors is a trend which is something new to venture and, therefore, a very dangerous idea. Some find a peer’s story and experience very compelling and lures them to try the outdoors in an instant without preparing themselves. Most outdoor accidents happen because of poor judgment. People often forget what nature can do to them and fail to anticipate how things can really go wrong out there in the wild. Obtaining proper training, however, ensure an individual’s success.

As part of preparation, you should have a survival kit with you. Some maintain an EDC Kit or a Bug-out Bag and it should fit to the individual’s requirement according to the kind of journey or the type of environment he or she intends to venture out. Adding a personal utility rope, a personal Prussik set, extra carabiners and a hasty utility strap would increase functionality and flexibility.

Since ropes will soon become part of your kit, it is best that you are knowledgeable about basic knots. These come in either as stopper knots (overhand, figure-of-8); loop knots (bowline, double figure-of-8); load knots (Prussik, timber hitch, munter hitch, Kleimheist); and splice knots (square, sheet bend). For emergency harnesses, you may have three options to choose: Hasty pelvic diaper, Hasty chest harness and the Swiss seat.

After lunchtime, the lecture proceed on to Self Rescue Skills. It is a very technical discussion that allows proper presence of mind in relation to the angle of the cliff and the load tension of the rope. Under such circumstances, self-belay techniques are confined to the Dulfersitz technique, which require a low to medium angle of not less than 45 degrees; the carabiner rappel; the munter hitch set up; and the rope wrap. Also, Prussik friction hitches are used in Single Rope Climbing or Rapid Haul.

The last part of the lecture is Patient Packaging. Everyone is reminded that the patient should be kept as comfortable as possible as he or she may be still in a state of shock and quite disoriented. The patient’s body temperature should be preserved and there should be few disturbance or movement on the affected part.

For that matter, there are, at least, three ways to carry a patient. First is the Buddy Rescue which could be done either in Man Under Technique or Utility Backpack Technique. Then there is the Hasty Harness Technique which are appropriate with either the Hasty Harness Belay Set Up (for lowering and raising) or the Hasty Harness Drag. Then last is the Improvised Litters and Stretchers. This could be done with apparel or equipment makeshifts, tarpaulins or ground sheets and with the Daisy-Chain Package.

In all the discussions, Mr. Cortes was able to explain to the participants about Wilderness Emergency Preparedness with such versatility and authority and have unselfishly used his experience and his equipment, particularly his supply of sanitized medical apparatus, for that matter. This blog, being one of the organizers, together with Camp Red Bushcraft and Survival Guild, appreciates very much for the time that Mr. Cortes had given to his fellow outdoorsmen and, for that, we are quite indebted.

Special thanks to Maria Iza Mahinay for becoming a willing “patient” and getting wrapped up and packaged. Another thank you each to Mr. Alcordo, Mr. Corro and Mr. Frasco for providing vehicles for this activity. Lastly, our thank yous to the Roble family for generously giving us the space to conduct our lectures, firewood for our cooking and the green coconuts which made the place a natural resting area of local and foreign backpackers.

This outdoors lesson has equipped the participants the needed knowledge to make all their outdoors activity a much safer endeavor. I may someday meet some of them along the trail and that would make me feel secure knowing they are around.

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