Who Do I Call My Countryman?

By Jeffrey J Pelton

In the summer of 1994, an estimated 80,000 desperate Cubans and Haitians attempted a mass migration to the United States across the Caribbean Ocean in makeshift rafts and boats. Those that survived were rescued from the sea and taken to the US Navy base at Guantanamo, Cuba, where US Navy Seabees constructed massive tent cities in a large-scale humanitarian mission code-named Operation Sea Signal. The US Air Force deployed two field hospitals to provide medical care for the migrants, many of whom had suffered injuries and exposure at sea, and most of whom had not had any regular medical care in their native homelands.
Driven to this act by desperation and uncertain of their fate, many of these migrants began injuring themselves, inducing illness and feigning illness in an attempt to immigrate to the US by reason of “medical parole”. These are the human interest stories from that mission. These stories and events raise larger questions of how and why people come to America, and how they might behave once they have immigrated. Some of these disturbing behaviors led many US military personnel who served on that mission to question whether there is a litmus test for immigration to the United States. Many of those migrants would have made good countrymen. But a large number would not, and yet they probably did make it into the United States. The character of a nation’s people shapes that nation’s destiny. As the US begins to grapple with the long-festering problem of illegal immigration, the stories from this mission are worth hearing.
Includes 34 photographs.

• Language: English
• Publisher: Jeffrey J Pelton
• Release date: Dec 18, 2013
• ISBN: 9780991234608

Book preview

WHO DO I CALL MY COUNTRYMAN?

Experiences with a Mass Immigration to the United States

Jeffrey J. Pelton, MD

Colonel (Retired), USAF

Smashwords Edition

Copyright 2013 Jeffrey J. Pelton

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ISBN-10 099123460X

ISBN-13 978-0-9912346-0-8

Ebook formatting by www.ebooklaunch.com

This book is dedicated to the peace and security of the United States, and to the protection of its borders. It is dedicated also to the successful assimilation of the oppressed peoples who legally immigrate here, and whose character defines the nation's citizenry and shapes the nation's destiny.

And to the men and women of the U.S. Armed Forces, for their sacrifices and compassionate efforts in bringing freedom to a world in turmoil:

"O beautiful, for heroes proved, in liberating strife,

Who more than self, their country loved,

And mercy more than life".

FORWARD

When I returned from my Operation Sea Signal deployment in the Spring of 1995, I resumed my treasured role as a cheerleader at my children's sporting events and practices. There I spontaneously shared some of my many deployment experiences, and those of my colleagues, with the parents of my children's teammates. Those exchanges usually ended with the other parent startled, dismayed, concerned, laughing, or sad, depending on the experience I had shared. But they almost always ended it with, You should write a book about that!

What follows is the human interest story that unfolded before me while US military forces attempted to care for over 80,000 desperate Cuban and Haitian migrants, all of whom attempted a simultaneous mass immigration to the United States across the Caribbean Ocean. This is my portion of that story, as I witnessed it during one three-month phase of the year-long duration of Operation Sea Signal. It is really two stories. One is the story of the experiences we all shared there, including the events, the migrants, and our military personnel. The other story is my reflection on those events, particularly regarding the larger issue of immigration. Not everyone can come to America. The place is only so big, and there are cultural, social, political, and other issues. So who can come? And how?

This book was actually written over several years, as I penned my stories and recollections, and did a little more research on Operation Sea Signal, in general. It has been completed at an important time in American history, as the country begins a long overdue discussion about illegal immigration and what should be done about it. I hope this story contributes to that discussion in some small way. More importantly, I hope that the country makes the right decision.

Jeffrey J Pelton, MD

Bethesda, Maryland

October 2013

Contents

Chapter 1: Not Where Anyone Wanted to Be

Chapter 2: Medics and Marines

Chapter 3: Tent Cities and Cultural Collisions

Chapter 4: A Cuban Flower

Chapter 5: Hints of Trouble

Chapter 6: Something Never Seen Before

Chapter 7: Down the Rabbit Hole

Chapter 8: Scary Things

Chapter 9: Turning Points

Chapter 10: I'll Fly Away

Chapter 11: Aftermath

Chapter 12: Lessons and Reflections

Glossary of Acronyms and Terms

References

Photo Album

CHAPTER ONE: NOT WHERE ANYONE WANTED TO BE

I could see my friend Tom in the distance, stopped at a bend in the road. He was staring off at something beyond the bend, which I could not see. This was a familiar bend in the road, at the US Army Security Checkpoint at Migrant Camp Hunt, about halfway on the eight-tenths of a mile walk from our encampment to the field hospital. I walked this familiar stretch of road every day, and as I continued walking this morning, I wondered what Tom was looking at. He seemed to be staring a long time, and I soon closed the distance and came up alongside him. I asked him what so interested him, and without breaking his reverie, he pointed.

The Cuban landscape around the US Navy base at Guantanamo Bay, Cuba (GTMO, pronounced gitmo) was a rolling hillside chaparral, a red-brown clay earth dotted with strange yucca plants pointing like bony, green fingers to a usually cloudless, azure sky. Patches of bare earth were intermingled with low, dry grassy areas. Trees were rare, could be seen from great distances, and seemed oddly out of place. Morning and evening shadows of sunlight were long, giving the landscape a peculiar rugged beauty, but largely devoid of color. Tom had been staring at a bougainvillea, a brightly colored flowering vine plant, growing along the side of a corrugated Army storage container on the edge of the gravel road. This particular plant had fuchsia and white flowers, recently bloomed with the morning sun, an uncommon splash of color in this landscape. Against the earthen red and grassy yellow monotones, the flowers were brilliant. I stared as captivated as Tom, while he explained that he paused here every morning in his trek to the hospital, before facing the plight of the Cuban migrants that lay another quarter mile down the road at the field hospital.

Tom and I had journeyed to this place with the other members of the 59th Air Transportable Hospital (ATH) of the 59th Medical Wing, Lackland United States Air Force Base (AFB), Texas, deployed in response to an immigration crisis. In the late summer of 1994, thousands of Cubans fled the Castro regime for the United States, seeking freedom, political asylum, and a new life. The exodus was made on crude rafts and makeshift flotation devices, over the open Caribbean sea, in an attempt to reach the Florida coast. It was estimated that over 70,000 Cubans made this attempt. Migrants at these camps later told me they feared 10-15% of this number lost their lives at sea in the effort. The US military estimated as much, but no official figure was ever precisely calculated or published. The majority that did not die were pulled from the ocean by the US Navy and US Coast Guard and brought to the US Navy base at GTMO. There the Navy began attempting to house, feed, clothe and care for this teeming mass while the US Justice Department and the Clinton administration figured out what to do with them for the long haul.

The US Air Force (USAF) was tasked with providing medical care for the Cuban migrants, while the Navy handled facility construction, and the Army and Marines provided security. This joint service operation was officially titled Joint Task Force 160 (JTF160), and given the code name Operation Sea Signal. Tom and I were part of an Air Force group sent in relief of the original response contingent. Most of us were from the Wilford Hall USAF Medical Center (WHMC), the Air Force's flagship hospital at Lackland Air Force Base (LAFB) near San Antonio, Texas. The hardships we were to see in the lives of the Cuban migrants, particularly in the life of one remarkable young woman named Irma, would touch us and linger in our memories forever. Irma would serve as our interpreter during her stay at GTMO, and we would come to intimately understand her difficult situation in Cuba, her desire to flee Cuba, and the sheer desperation of her attempt to find a new life and to find hope for a better future. To many of us in the US military medical contingent caring for these migrants she became the face of honest, downtrodden people living previously under Communist oppression. The inscription on our Statue of Liberty reads:

Give me your tired, your poor,

Your huddled masses, yearning to breathe free,

The wretched refuse of your teeming shore,

Send these, the homeless, tempest tossed to me,

I lift my lamp beside the golden door.

Irma fit that description. Tempest tossed, she landed in our care.

Tom and I continued down the gravel road to the 59th ATH to begin the day's work, chatting about our favorite topic, which was how much we missed our families and wanted to be home. As the only surgeon, I was solely responsible for the surgical capability of the hospital. But having arrived on the back end of the Caribbean hurricane season, we found the original contingent feverishly rebuilding the hospital, which had to be relocated after a late tropical storm. They had moved the hospital by literally picking up tents by the corner poles and walking the tents up the road to higher ground. It was expedient and necessary to do so, as the storm brought sudden flooding, and did not allow time to disassemble and reassemble the tents. The original contingent laughed about this, describing the comical sight of large groups of medics carrying along their green General Purpose (GP) medium and large tents looking like odd green-shelled bugs with many legs trudging up the hillside.

The mood of the group we were replacing changed considerably when we arrived, and they could laugh about such things now. It was not so for them just a few weeks earlier, as they faced the initial onslaught of the migrants' suffering. The migrants had spent many days at sea, with limbs draped in the salt water, and exposed to withering sunlight, wind and elements. They were an admixture of age and gender, and many had pre-existing illness, for which they had received little care during their previous life in Cuba. Sea sores, festering ulcerated wounds created by the briny sea water, needed immediate wound care. Dehydration, malnutrition and sunburn were ubiquitous. All these problems had to be addressed while unpacking and building the field hospital. Most of this original contingent, like us, did not volunteer for this mission, and would have much rather still been home with their families. The family separation and difficult field conditions had lowered morale, which was made even worse by the seemingly endless wave after wave of thousands of suffering migrants in need of immediate attention. There were supply shortages, and even as order and organization of the situation took shape, questions regarding long-term solutions to this situation became evident. When our group had landed at GTMO, I saw the original contingent from the window of our C130 transport plane, lined up at a hanger on the tarmac, cheering wildly as we touched down.

The military rule of seeing your replacement eyeball to eyeball required that I find the previous surgeon and receive a briefing. The surgeon I was replacing was Major (Dr) Jeffrey Buehrer, a vascular surgeon and colleague of mine from the Wilford Hall USAF Medical Center in San Antonio. Sifting through the crowd on the tarmac, the sullen arrivals and the giddy outbound, I finally found Jeff. He looked tanned and swarthy, and gave me a hearty handshake. But his countenance reflected the difficulties of the preceding three months, and he very convincingly said to me as we clasped hands, I'm glad to see you, but I am so, so, so, so sorry you have to come to this place. There was something in the tenor of his voice and the repetition of the so, that unnerved me and instantly made me wish even more that I not be there. This communication apparently was so common at that group meeting that the commanders could sense the slumping morale in the new arrivals and called for their separation from the outbounds as quickly as possible. We fell into formation, collected our green canvas A bags containing our gear, and headed out to the ferry which would take us from the airport, crossing Guantanamo Bay and traversing from the windward side of the base to the leeward side, where buses would then take us out to the field site amongst the migrant camps.

Such a ferry ride that day normally would have been pleasant and comforting. The ferry bumped along with a gentle rocking over the slightly choppy water. The sea breeze was refreshing across our faces, the sky blue and the air clear. Some of our group relaxed on their A bags, some stared across the bay from the railing of the boat, some sat on the deck, backs against the metal walls of the cabin. But all were silent. It was pretty clear that no one wanted to be there. As we were soon to find out, neither did the migrants.

When Tom and I reached the field hospital on the morning of his bougainvillea revelation, we had been in-country for two weeks. Since the Operating Room (OR) facilities were not yet reestablished, I was assigned initially to the Emergency Room (ER), where I sometimes shared shifts with Tom, a cardiologist. The previous group had moved the hospital to a fixed facility, a small, U-shaped, single story building at the top of a hillside nestled into three surrounding migrant camps. It was rumored that decades previously it had served as a countryside police station for Castro forces before the Americans had incorporated the area into the naval base. It was the only building visible across miles of rolling hillside, the next visible structures being the Cuban guard towers abutting the mine field that separated Communist Cuba from the US Navy base. One wing of the outdated structure served as an inpatient ward, the other as the Emergency Room, while the interconnecting wing at the lower end served as an outpatient clinic. In the courtyard were two metal isoshelters, portable and expandable rooms that served as the Laboratory and X-ray areas. At the top end of the courtyard was a GP-medium tent attached to another isoshelter, which housed the operating room and surgical supply, and which would become my domain.

To an American-trained physician in his first humanitarian experience with a foreign culture, my initial experience with the migrants was shocking. In Cuba, conscription into military and government service is common. One way out of that service is illness, which allows the afflicted the beneficial side effect of drawing additional food and other rations from the government. It is well known even among Americans that illness sometimes produces secondary gains, such as attention and avoidance of work. Psychologists call this illness behavior. The Cubans had refined illness behavior into a subtle art form. Even the seemingly healthiest individuals complained of some malady or pain, which camp life apparently exacerbated into intolerable suffering. Though the original contingent dealt with legitimate and obvious problems associated with prolonged exposure to the elements at sea, the tide of these problems abated after a few weeks. In their stead came a wave of the histrionic healthy, whether unbearably bored of camp life, or desperate in their attempt to somehow get to the United States, even if it meant feigning illness.

I quickly found that interactive history taking, that is, questioning the patient in detail on his or her symptoms, was utterly useless. One of my first patients was an athletic young man of twenty-two complaining of crushing chest pain. The pain, he said, on a scale of one to ten, with ten being excruciating pain, was a ten. Furthermore, the pain radiated into his jaw and down his left arm, and was associated with nausea and lightheadedness. He also said he felt clammy and was sweating. I was alarmed, as these are the classic symptoms of a heart attack. But in a twenty-two year old? I then examined him. He seemed upset and in distress, but he certainly was not diaphoretic, as his brow was completely dry. His heart sounds were normal, his blood pressure was normal, his pulse rate was normal, and his electrocardiogram (EKG) tracing on the portable monitor was normal. In fact, his entire physical examination was completely normal! I stepped back and looked at him again. He certainly seemed to be in great distress, clutching his chest. I thought I noticed his eyelids fluttering a little. What was I missing? Although I was convinced he was fine based on my medical examination, I felt a trifle insecure. After all, I was a surgeon. I didn't regularly treat heart attacks, and when I needed to, I enlisted the help of an internal medicine physician (internist) or a cardiologist. So I consulted an internist.

The internist repeated all the above, concluded the young man was fine, and sent him back to the camp with a handful of the common, over-the-counter anti-inflammatory medication Motrin (Motreen, as the Cubans pronounced it). I would later learn that Motreen became as abundant among the Cuban migrants as the Caribbean sunshine at GTMO. There was nothing else to give them, the least of which was verbal assurance that they were not gravely ill.

I went on to the next patient, a young man of about the same age. He was rolling around on the portable cot, holding his forehead. I asked him what was bothering him. He said he had severe, crushing chest pain in the middle of his chest. It was moving into his jaw and down his arm, and he had a headache, and felt clammy and weak. My next patient had the same symptoms, as did the next, and the next, and the next. Someone was obviously coaching them. By the end of the day, I had seen over a dozen young men with these symptoms. By the fifth such patient, I stopped my interactive history taking, checked vital signs and obtained a five second rhythm strip from the portable EKG monitor. Then I handed him a small supply of the omnipotent Motreen, and told him where he could find the next bus back to the camps.

I found these initial experiences to be profoundly unsettling. Interactive history taking is the most basic tool of diagnostic medicine, as we are taught in our earliest years of medical school. Generations of physicians throughout history, from Mayo to Osler to Hippocrates, had stressed the importance of an accurate medical history as an essential first step in arriving at a correct diagnosis. How was I going to function without this quintessential tool of medicine? I also was not accustomed to having patients so readily fabricate symptoms, malinger and mislead. The physician-patient relationship is based on a reciprocal trust. My experiences with these young men began to redefine that relationship, in a way that I found mystifying and disturbing. As I was yet to discover, these men were but a harbinger of what was to come in my medical re-education at GTMO.

On my way back to my own camp, I would discuss these experiences with some of the other doctors, who found the encounters equally as disturbing. Those who had been at GTMO a while, however, had become callous to the Cuban illness behavior. The migrants, they explained, did not want to be here at GTMO. They had risked their lives at sea trying to get to America, and they were not yet finished with trying. Many of these behaviors, I would quickly learn, were desperate attempts to immigrate by reason of illness. Some of the most dramatic and shocking instances were yet to come.

Those first two weeks in the ER were hell. My encounter with the mini-epidemic of chest pain in those young men was just an introduction to the migrant illness behavior. In the next days I saw young women holding their heads in seemingly unbearable pain, men holding their abdomens as if their intestines had exploded, people claiming they