The caring side of the rally Barcelona-Dakar
Racing, timing and participants won't be the only thing to talk about in this year's Dakar. The city of Chinguetti, in Mauritania, will be the destination of more than two tons of medical material, meaning a big change in many people's lives
The rally Paris-Dakar is often accused of leaving nothing more than dust after crossing Africa, but there are also solidarity initiatives within the caravan of the most famous rally of the world. In addition to service trucks filled with school and medical equipment, the Dakar is an invaluable chance to bring the Western world closer to Africa's reality.
Dr. Xavier Mir, Head of the Hand Microsurgery and Surgery Unit of the USP Institut Universitari Dexeus, will be the architect of one of the solidarity initiatives that will be carried out in this edition. Within the structure of the KTM Repsol team and on board of one of the two T5 cars prepared for the fast assistance of the Repsol riders, Dr. Mir will be facing a double challenge; taking care of the health of all team-members and getting a very special shipment safely to its destination.
After 25 years of professional work, during which he has taken care of several elite sportsmen --more recently Pedrosa, Elias, Melandri and Aoyama-, this is going to be his first time in the Dakar. Thanks to the co-operation of two hospitals, a private one -USP Institut Universitari Dexeus- and a public one -Hospital de la Vall d'Hebron- from Barcelona, Dr. Mir will be taking approximately two tons of medicines and essential sanitary products to the hospital of Chinguetti, a city located in the centre of Mauritania, with 6.000 inhabitants. A small amount of help that will probably allow saving many lives, including that of many children, in a country where the infant mortality is of approx. 12% and the average life expectancy of around 53 years of age.
To transport all the material Dr. Mir will be counting on the support of the Repsol Epsilon team in the truck class, the Mitsubishi Motors Repsol ATS Studios team, the KTM Repsol team and the ASO among others. The MAN truck driven by Jordi Juvanteny, Jose Luis Criado and Francesc Pardo, which will be competing in the 6x6 class, has made large space available to carry part of the shipment inside. The KTM and Mitsubishi teams have done the same, while the ASO has made space available in one of their airplanes to transport the most fragile medicines and sanitary products.
Who motivated you to take part in this adventure?
"As a medical specialist in arm, wrist and hand surgery for many years, I've had the chance to operate several sportspeople. Last year I operated the three riders of the KTM Repsol team, Nani Roma, Isidre Esteve and Marc Coma, and we established a good relationship. After last year's Dakar, they asked me whether I would like to do the Dakar and I began to get excited with the idea. One day, Jordi Arilla, the team owner, offered me the possibility to go to the Dakar as part of the team. I was a bit surprised at the beginning, but then the idea began to mature."
What will your trip to Africa consist of?
"I'll be travelling in one of the service vehicles of the KTM Repsol team together with the mechanics, the physiotherapist and the press manager. I'll do the whole rally route but my main task will be taking the whole material we've managed to gather to the hospital in Chinguetti, in the northern part of Mauritania, during the resting day the rally is going to spend in Atar."
Once you accepted going to the Dakar, what made who bring up this humanitarian enterprise?
"The original idea was just participating as a passenger in a service vehicle and, taking advantage of the fact that I'm a traumatologist, taking care of the team-members in case I should be needed, but in no way as a doctor, because the rally has it's own medical team. Once I accepted, I thought that we should do something more. Talking about it with the USP Institut Universitari Dexeus and the Hospital Vall d'Hebron, I noticed that there was a large sensitivity regarding this issue and a strong wish to help, so we all started to think what we could do. We thought that it would be a great idea to make use of the Dakar caravan to get medicines and sanitary products to the hospitals of the less favoured areas."
The possibilities offered by Africa are unlimited. How did you decide where to act?
"Once we had decided that we would take the material to Africa, the second issue was deciding where to take it. We first considered which is the poorest country and where it would be more feasible for the material to reach its destination. We rejected Morocco because it is the richest country of the four crossed by the caravan, and from the poorest we chose Mauritania. Both Mali and Senegal are down in the South and our limited infrastructure and possibilities to move, make it easier for us to get to Mauritania. Once we had decided the country we used the Internet to look for the existing hospitals and to see which are public and which are private. We wanted to take it to a public hospital because the private ones have some more means and we also wanted to avoid the material being kept by somebody who would then sell it or not to reach those who needed it most. That's why we want to take the material personally. We didn't find any public hospital in Atar, they are all private and under French protection, and the public hospitals are located too far in the South, in Nouakchott, the capital. Atar has the advantage of being the place chosen for the rest day and the assistance teams are going to be almost three days out of work, so it gives us a certain chance to move around. We found a Spanish hospital in Chinguetti, a two-hour-drive away from Atar. It is a private foundation called "Fundacion Chinguetti" that does not charge for its services, it's free. The hospital is lead by a Spanish doctor who works there all by herself and has trained some male nurses and women who act as midwifes and help out during deliveries. This little action has already allowed to reduce infant mortality during birth from 50% to 25%."
How did you decide what material would be more useful to take?
"Out of my professional habit and due to our complete ignorance of the real sanitary situation of the area, the first thing I thought about was taking plates, screws, fixing elements for fractures... But the doctor at the Chinguetti hospital told us that it wouldn't be of much use for them because they lacked much more basic things, so we established a list of priorities with her help. The first is that 12% of the children die due to diarrhoea because the water is polluted and they don't have antibiotics to cure them. These antibiotics are very expensive and specific. Second, the children loose so much water due to diarrhoea that they die due to dehydration, so it is also important to bring along saline solution to rehydrate them. Third, they have set-up a small operating theatre for births and small surgery for which they don't have the basic instruments such as forceps, scissors, gloves, gaze, suture thread... They don't have antiseptics such as alcohol or iodine to disinfect or wash their hands before a delivery or intervention, nor anaesthetic apparatuses such as masks. They don't have anything for fractures either, so we also take bandages and plaster, in addition to basic medicines such as anti-inflammatories and analgesics."
How much have you managed to get together?
"We've got a lot of material from the USP Institut Universitari Dexeus, the Hospital de la Vall d'Hebron and the American laboratory Smith & Nephew, but if we would have had more time, we would have been able to get more. We're taking some 2.000-3.000 doses of antibiotics, two boxes of instruments, saline solution, antiseptics, bandages, plaster... All in all we've managed to collect a bit more than two tons of materials distributed on three pallets."
Once the material has been gathered, the transport to Chinguetti has probably been a difficult question to be solved as well...
"This has been a complete merit of Jordi Arilla, who started to spread the news and move people. Everybody offered help within their reach to take the material in the trucks. Even the ASO has offered us one cubic metre in the plane flying to Atar to transport the most delicate things. Everybody has helped us in this aspect. Once the material has reached Atar, a group of Spanish nuns have offered us the chance to use their convent as a warehouse. We'll probably gather everything there and leave them some material as well to be distributed in a series of community clinics of the city. From Atar to Chinguetti, I made the mistake of thinking that we would be able to take it ourselves, but it won't be possible; first because the cars are in parc ferme and second because it's too risky. You have to know how to move because else the material wouldn't arrive due to the police and the mafias. We finally have planned to make it by means of a protected transport: the Chinguetti Foundation will send one or two trucks to Atar to transport the goods. We will go to the hospital either with the medicine transport caravan or with rented vehicles on January 9th."
Once at the hospital will your visit be mere protocol or have you planned any intervention?
"In principle we're going to check that everything is in its place, but I may have a look at some patients. The doctor told me that they have several children that need to be operated, not only in my field of expertise, but also children suffering from heart problems. We are thinking about the possibility of bringing some of those children to the Hospital de la Vall d'Hebron or to Dexeus in Barcelona to be operated here. I have not planned any intervention for the moment, because we haven't studied any case and the state of the operating theatres must be quite precarious, but I'll have a look at some children with congenital injuries in the hands... We'll see what we can do for them once we're there. The doctor will also prepare some dossiers of children and adults suffering injuries that are not from my filed of expertise so I can bring them back to Spain and let the doctors of the Hospital de la Vall d'Hebron or Dexeus have a look at them. It will be a first contact with regard to possible future actions."
Will any other doctor or medical personnel be joining you?
"No, I'll be the only doctor. Maria Reales, Communication Manager of the USP Institut Universitari Dexeus, who has been one of the persons in charge of coordinating the project will also be coming to Chinguetti. Some drivers or riders may be coming as well, but that's something to be seen once we're there."
How would you assess the work you'll be doing....
"It would be ideal to attack the core of the problem, for example to make the water of the well drinkable to avoid diarrhoea. But this is not within our reach, so we'll try to do everything we really can. Maybe what we're bringing will not solve all their problems, but at least it may reduce infant and mother mortality during birth, and improve the quality of the sanitary assistance. If we manage to do so it will be a big step forward. Something is always better than nothing."
Why did you decide to work only at the Chinguetti hospital?
"In addition to our limited knowledge of the terrain, we decided not to disperse the help. We have a limited quantity of material and little associations that offer us the necessary guarantee, so we prefer to focus our efforts here instead of spreading it. In the future, if the initiative bears fruit, we'll take the help to other places as well."
So you're planning to continue with the initiative.
"For the time being we're thinking about our work in a short term, but I personally hope that this initiative continues in future editions. With more time and more experience, we could try to work in other fronts as well, for example the treatment and prophylaxis of malaria, which is affecting southern countries such as Mali and Senegal. Everything will be studied. Everybody is telling me that I'll be wishing to come back next year."
So this is a personal commitment...
"Somehow, yes, but we'll make it all together. Besides, if I cannot do it, somebody else will be able to do it."
The Dakar is a physically highly demanding race for all those taking part. Have you prepared in any special way?
"I'm used to doing sport, but I have been doing a lot more lately, I'm jogging more... but always within my possibilities. I also joined the team during the last test in Los Monegros to learn how to use a GPS."
Is this your first time in a rally?
"I was at the Morocco Raid in June, but as a VIP. We made 500 or 600 Km by car, following the rally but we slept and ate at good hotels and restaurants. This is going to be something completely different, much harder, but an unrepeatable experience."