Dichato’s long road to recovery

On February 27, 2010, a devastating earthquake occurred off the coast of Chile. Registering a magnitude of 8.8, the quake also triggered a tsunami that ravaged the Chilean coast. By the day’s end there were hundreds dead and more than 1.5 million people displaced from their homes. The recovery effort goes on to this day, with help from many, including Boston Children’s Hospital employees. Lili Peacock-Chambers, MD, recently visited the country as part of “Recupera Chile,” a multi-disciplinary post-disaster community development program. 

By Lili Peacock-Chambers, MD

Dichato, Chile, is a small coastal town, with a population of just 3,000 residents. A single road leads in and out from Dichato, winding though evergreen and eucalyptus covered hills, with beautiful views of the sea when breaks in the hillside allow. If you stand at the crest of the tallest hill, just past a mound of red earth and bulldozers that sit across from sprawling rows of wooden “mediaguas” (temporary shacks), you see the crescent shaped bay and the vast ocean beyond. Directly bellow the hill lays Dichato.

For the people of Dichato, moving from “arriba” (above) to “abajo” (below) still brings the heavy memory of 2010’s devastating earthquake. The trek, which connects the safety of the hills to the life-sustaining waters of the bay, is more treacherous than it was before the earthquake, but traffic along the path remains as constant as the tides.

I traveled to Dichato as part of a multi-disciplinary Harvard-based team called “Recupera Chile.” Led by Dough Ahlers, an expert in post-disaster community empowerment, our team set off to support residents in three small Chilean coastal towns as they continued to rebuild their communities. I was amazed by their resilience. Despite all their hardships our Chilean partners found a silver lining in the disaster’s aftermath—an opportunity for the communities to unite and redefine their identity and future.

As part of the health team, my main objective was simply to listen. Sitting by wood-fed stoves, I was welcomed into the lives of many Dichato residents over cups of warm tea. I began peeling back the layers of complex and chronic trauma that this largely indigent, rural community faces. The social disparities of their tourist-based economy were noticeably intensified and brought to the surface by the earthquake and tsunami. Two and a half years later, over 400 people still live in temporary shelters, with some refusing to move into to new homes built by the government in the land “below.” Intermittent access to medical care, lack of organized activity for children and small living spaces without privacy are common concerns of Dichato’s mothers and grandmothers, or ‘madres’ and ‘abuelas.’

After two weeks of listening to their fears and hopes I was most struck by Dichato’s residents’ hunger for knowledge. Teachers call for more training and mothers ask for tips on how to treat a burn, stimulate language development or get help finding an optometrist for their child. For decades Chile has invested in a health and education system strong enough to support the needs of its people, but access to these much-needed resources remains a challenge in rural areas like Dichato. Dichato does benefit from the vast networks of nursery and pre-kindergarten schools developed under the guidance of a previous president and former pediatrician, and in Dichato’s backyard sits a Chilean University Marine Biological institute, a playground for any aqua-enthusiast or budding scientist. Top-line Internet connections and communication technology create new roads between the town, the rest of Chile and the world at large. The political, institutional and environmental resources of the region are theoretically poised for action.

That’s where we came in. Under the mentorship of Judy Palfrey, MD, director of the International Pediatric Center at Boston Children’s, and Chilean child psychiatrist Mario Valdivia, MD, our team wrestled with the complex factors affecting the psychosocial development of children in Dichato, and identified clear points for intervention.

As in any community development effort that strives for sustainability, we’ll start small. We’ll advocate for the reintroduction of the merited Chilean educational and health programs that are currently not operating, like parenting workshops, teacher training and formal referrals and therapy for children with emotional and learning difficulties. We will continue to monitor the children’s overall well-being as they transition from the camps to permanent homes “above” and “below.” We will support the community as it comes together to create a clearer vision of Dichato’s identity as a whole, and dream of a collective future filled with possibilities.

As for myself, I can only hope that the mothers, fathers and children of Dichato will continue to grant me the privilege of dreaming with them.