By Kevin Herrera
Daily Press Staff Writer

MAIN STREET — While the average 16-year-old girl is fascinated with pop music, fashion and that cute guy in her history class, Caitlin Meredith had more important things on her mind at that age. Instead of hanging out at the local mall or lounging at the beach all summer, Meredith chose to fly to Ecuador and build latrines to prevent a cholera epidemic.

It was there that she first realized her calling: to provide sorely needed medical services to remote villages all across the world.

“When I got there, I looked around and wondered where the nearest hospital was,” she said during an interview near her family’s home on Ocean Park Boulevard, just blocks from the beach. Meredith grew up in the San Francisco Bay area, but spent much of her childhood visiting her grandparents, who lived in Santa Monica. She now calls the city her “refuge.”

“Of course, my immediate concern was what was going to happen to me, and in the second day I was there, I was attacked by a dog,” she said. “I thought I needed stitches, and I thought, ‘There’s no 911 here.’ After spending the whole summer there, I realized these people are going without health care; to travel one or two days on foot to the nearest doctor was just not an option.”

Now 30, Meredith, the daughter of a former San Francisco County health official, holds a master’s in public health from Tulane University and has just returned to Santa Monica after spending eight months in the western region of Darfur in the Sudan, where she worked with Doctors Without Borders/Medecins Sans Frontieres, or MSF, to provide displaced villagers with medical care. (There is an information session on MSF tonight at the agency’s local office, 2525 Main St., at 7 p.m.)

The region is currently a war zone, as the predominantly African Sudanese Liberation Army battles with Arab militias known as the Janjaweed, who U.S. officials said are supported by the Sudanese government in the capital of Khartoum. The fighting appears to be over religious differences between the Muslim north and the non-Muslim south, with farmers and their families stuck in the middle. According to the United Nations Commission for Refugees, there are more than 200,000 displaced Sudanese living in the border region near Chad, Sudan’s neighbor to the west, and a total of 2 million who are now homeless. Most are living without adequate shelter, food or water. There are very few roads, fewer schools and almost no hospitals.

The Daily Press caught up with Meredith between crises to talk with her about Darfur, MSF and why she can’t stay in Santa Monica for more than a few months without feeling the need to leave to help the less fortunate.

Fighting has flared up again in the Darfur region. Just today (Friday, Jan. 27) thousands of villagers were forced to relocate because of the armed conflict. Was that something of a concern for you, having to move constantly to avoid danger?

“Well, I was based in Yala, which is the capital of Darfur, and the security situation within that town was relatively stable. There are curfews you have to observe, and you must be cautious about where you travel. Most of the violence is primarily against people from the Sudan who are from Darfur and not concentrated in the more urban areas like Yala. Where there’s farmland or contested land where aid workers are traveling across, security deteriorates and it’s bad for everyone. Where I was based most of the time, there wasn’t security issues in my day-to-day life, but traveling to sites outside, there are many precautions taken… You receive security training as part of your orientation… Most of the danger was directed to our Sudanese staff.”

Were there armed guards?

“MSF never employs guards. We rely on the relationship with community and communication with community leaders to establish that trust and our neutrality from all the other factors. When you hire a guard, you become a force instead of people who are there to give aid to the people.”

Did you run into any dangerous situations while you were there?

“I wouldn’t characterize my own situation there as being in danger. There were situations when we were doing supply runs, especially after the rainy season comes, where you have a six-ton truck that is full of fuel and medicine that you are delivering. On one particular trip, our truck became stuck in the mud … a familiar situation. You know that if you don’t get the truck there, people who are relying on the supplies will go without and that can be deadly, so there is a lot of pressure on you to make that delivery. It’s dangerous to be stuck out in the open because there are roaming bandits, lawlessness. That makes delivering aid much more difficult. You are vulnerable. There are a lot of things to think about, such as how long you can dig before you have to abandon the vehicle because of curfews. Anyone out at night is suspicious. Because of the danger and the need, the situation becomes much more meaningful than just a truck stuck in the mud.”

Where you torn between the two factions fighting, or was politics the last thing on your mind?

“My focus was primarily on the patients we were seeing and their needs. When they are completely reliant on aid services, your focus is on what’s directly in front of you. As an epidemiologist, I was concerned with diseases, such as measles, that could lead to an outbreak and have potentially devastating consequences for a high-density community like in the refugee camps. You need prevention, education and rapid response to prevent the spread. That was my immediate focus … meeting the needs of these people who, because of the conflict, had become completely dependent on aid services.”

What diseases did you see that posed the most danger?

“Something as simple as diarrhea posed a major threat. For most of us traveling from the western world, a case of diarrhea is not life threatening, but in a situation like this, where there is malnutrition, children’s conditions can deteriorate rapidly and then getting them back to a healthy weight can take a long time and timing is critical. Before they get to a doctor, there is a lot that could have been done to prevent it, such as clean water sources and adequate water sources. If you only have a small amount of water, mothers have to make hard choices and washing hands does not become a priority. They need that water to make their food. … Measles, for a population living in such close quarters, can also have a devastating effect as it spreads quickly. Before you notice an outbreak, it can be too late to do anything about it.”

Did you miss the comforts of home, a warm shower perhaps?

“Well, it was so hot, cold showers were what I had most of the time. You aren’t there alone, lots of ex-patriots and international staff, so we would often sit around talking, laughing and having fun. You certainly miss food that you can’t have access to and a white porcelain toilet, especially when you’re sick, which is bound to happen at one point. A normal dose of diarrhea was a weekly occurrence. But you can be amazed by what you learn to do without. You do have fantasies of a beach vacation, especially from living in Santa Monica, and other fantasies crop up, but also living there, it becomes your life. It becomes a home. Missing friends is the hardest. I did miss the grilled turkey sandwiches at Amelia’s Café on Main Street. I thought about those a lot. … Missed walking down the Promenade. It all seemed like this fantasy world.”



You enjoy helping people, but what else influenced you to become a public health professional?

“I find it interesting to see different communities’ interpretations of health and what they themselves want. As I move on in my career, I would like to focus more on HIV/AIDS as I did in Kenya, bringing HIV/AIDS testing and prevention to nomadic communities. It’s strange to see that a disease we associate so much with an urban setting and a specific part of the community here, you go into the most remote part of Africa and whole parts of a tribe are being extremely affected by this disease. Everything you learned about prevention, education, you have to change for those communities. I find that challenge very exciting.”

What do you think about the situation with your alma mater, Tulane University, and the surrounding community, which was hit hard by Hurricane Katrina?

“I have plans to go there in February to start looking at community reconstruction efforts and health projects. My former professors are involved. I feel such a disconnect because Katrina happened right after Darfur, so I wasn’t ready to, I was still in decompression mode. I feel like I’m ready now to deal with what’s going on there.”

Do you ever see yourself settling down in Santa Monica and getting …

“A real job?”

You said it.

“You know, I don’t know right now. It is getting harder and harder for me as my friends get married and have babies. Doing this, you feel a real disconnect from real life. The trick is having the balance between the two. I’m not done with international work, and I can’t imagine a day when I would say that. But now I know it’s not all or nothing.”

What is the biggest public health challenge facing Santa Monica?

“I cannot speak to that. I can tell you about Darfur, but I have not studied Santa Monica.”

What is the public health challenge facing all of us?

“I think all of us are affected by the huge number of people displaced who do not have the resources or do not have access to them because it is not safe. A lot of the health problems facing us result from people being forced to live unsanitary conditions because of a lack of security. … This does affect our psychic health. I know that I cannot feel healthy without doing something about it. I think it does affect our well being.”