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Interview Marianne Holtz
ADM's Steve Sapienza
interviews this former nurse for the International Rescue Committee
for"Survivor's Stories: Americans and Landmines" |
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MR. SAPIENZA: If you can tell us what day, month, year, did you leave for Congo, formerly Zaire, and why did you go?
HOLTZ: I had been working in Africa for about a little more than a year with International Rescue Committee, as a nursing coordinator. I had gone home at the end of the project that I was working on, and was waiting for a new assignment, in July of 1994.
While I was waiting for this new assignment, I received a telephone call asking if I could go immediately to Zaire. This was because of the crisis that was occurring with the Rwandan refugees, and there was an immediate need for medical personnel to go in. And in fact, there was an outbreak of cholera, which was proving to be quite serious.
So I went on a few days' notice, into what was then Zaire, is now called the Congo.
SAPIENZA: Can you just sort of describe for people what was happening in Rwanda at that time, that was causing this crisis?
HOLTZ: Okay. This was after the genocide occurred in Rwanda, and the civil conflict that ensued over that. I'm not a good historian, but basically what was going on was that the government of Rwanda had fallen, and his, was being taken over by a new group of people, and the losing faction was fleeing the country, taking with them the people who were sympathetic to them, their families, and so forth.
The country was fairly divided as far as the type of people that were there, and much of the conflict has been described as between two different types of people, but it was actually more of a political upheaval -- it's really the on line description, they're going to cut this out, but that's okay --
SAPIENZA: Could you just sort of describe about the refugee flows that were as a result of this Rwandan genocide?
HOLTZ: There were hundreds of thousands of people were fleeing across the border on a daily basis. I think the final count was upwards to a million people within a few days, had crossed the borders into Zaire, and into Tanzania, and some few into Uganda, and some of the other countries there.
This was a monumental crisis. There had never in the world been such a mass exodus of people within such a short amount of time, and disease was breaking out, and people were dying. There was fears of infecting the local population, and causing all kinds of pandemonium and crisis to the people who were living on that side of the border.
SAPIENZA: Where did you fly into, and then, from there, where did you travel?
HOLTZ: I was living in Idaho at the time, in McCall, Idaho, a small town in the mountains. I had to go to Seattle to catch a plane to Amsterdam, where I met up with a group from Holland. Some had come from the United States, some were from Holland and a few other places.
We grouped together there for a day, and then headed out as a group to Nairobi, and then were flown by small aircraft into Zaire, and we pretty much hit the ground running; within a few hours, we were out in the camps, in a makeshift situation, trying to deal with cholera on an incredibly massive basis.
SAPIENZA: What part of Zaire is this?
HOLTZ: This is the eastern part of Zaire. It's right adjacent to Lake Kivu, which shares a border with Rwanda, on the western side of Rwanda.
SAPIENZA: So when you arrived, did you actually set up a field hospital, or was that already there?
HOLTZ: There were one or two tents were put up. There were people there who were scrambling to put up more tents. The situation was that a branch of an organization called Doctors Without Borders had been there in that town for a number of years, working on some small health projects, and so they already had a small base to operate out of.
So they quickly expanded that base, brought in more people and more equipment, and the organization that I was actually hired by provided me and several other Americans to this group as their employees, and we worked for them. That's called secundment, and we were secunded to this other group.
SAPIENZA: So when you arrived, could you describe what the scene was like? What was going on?
HOLTZ: When we arrived, it was difficult to imagine, but it was one of the most horrible things I have ever seen in my entire life. There were literally bodies everywhere, and it was warm weather, the smell of decaying human flesh, which is a unique and very disgusting smell, was everywhere.
We had a place to stay, but it was in town, basically a tent put up on the lawn of a home, where we stayed in the tent. And then we were trucked out to these large rough encampments of people, going along the road, we would see bodies where people had just not been able to walk another step, had literally laid down and died.
It was so surreal and macabre that these bodies were there. You would see small children sitting next to dead bodies, and nobody able to stop and render assistance to small children.
The bodies were swelling because of the deterioration, and there were strange jokes being made about when these things were going to explode, it was that disgusting.
To get into the camps, we had to pass through packs, people milling around, begging for assistance. It's just, it's very, very difficult even now to describe what it was like.
I was put in charge of a tent full of people, and basically, the thing to do was to get them re-hydrated, either with IV fluids, or with oral fluids, as quickly as possible.
They would bring more and more and more people into this tent, and I was literally laying them down side by side, and asking them to turn on to their sides so they could pack them in as closely as possible.
I can remember a woman there attempting to nurse a baby, and of course, there was nothing for the baby, the baby was so dehydrated, I took the baby over to another care provider so the baby could get some intravenous fluid to try to save the baby's life.
When we brought the baby back to the mother, the mother died; it was that fast.
I can remember a young man, who having nothing to vomit into, had turned over an attempt to vomit outside the edge of the tent, so that it wouldn't get on the other people, and he never rolled back. He died that quickly.
The bodies were being stacked up just like cord wood, to be picked up by the people who had the horrible job of collecting the bodies and burying them as quickly as possible.
SAPIENZA: How long did things continue at this?
HOLTZ: That went on for several weeks. Eventually tents were put up, and it was fairly decent, but it was a long time before we even had cots for people to lie down on.
The soil there was very, very rocky, sharp, sharp rocks, and it must have been terribly uncomfortable for people to lie down on that. But you never heard a complaint; people were so grateful to get any kind of assistance they could.
It was an incredible scene.
SAPIENZA: How long did you spend in that area?
HOLTZ: I was there a total of about six and a half months. During that time, things settled down, became more organized. It's very hard to describe, but people actually began to get down to their mode of functioning, get in touch with their families, small businesses began to be set up in the camp, people would manage to find something to sell.
Fruits and vegetables, for instance, things like that. In six months' time, it changed from this terrible chaos to a fairly organized village, if you will. A village of the rudest kind of little huts, though. It was just hard to imagine what it was like.
SAPIENZA: Let's fast forward a little bit. Can you describe from that point on, until you came back to that area of the world, you went home for a while, then you
went back. So what events happened there?
HOLTZ: The agency that I was working for finished the project that they had determined to do in the camp, and decided to focus all their efforts inside Rwanda, trying to rehabilitate healthcare systems so that the refugees, when the time came, could return home and there would be something there to support the ongoing needs.
All of the infrastructure in the country had been damaged during the conflict. Physical facilities had been damaged and looted, and the trained professionals were nearly all gone. The few that were remaining in the country were struggling to provide health services for the people who were there, but it was with great difficulty.
So I went inside Rwanda and worked for another approximately five months, doing this kind of work. And when that project then had finished, I returned home for some holiday, and rested, if you will.
And then returned back to Zaire, working for a different agency, and going back into the camps, but this time I was nurse coordinator for a field hospital in one of the camps.
It was no longer the emergency situation that it had been; it was settling down to a more routine, day to day living situation, but there was still the diseases of people living in too close a proximity, and in too rough conditions. Diarrheal diseases, pneumonia, malaria, things like that. Childbirth, children's diseases, the routine things, and this is what I was doing.
SAPIENZA: You were there working for roughly seven weeks, and then you had a day where you had some time, you had a rest day. Can you describe the events of that day, and what happened?
HOLTZ: I had been back in Zaire seven weeks, and we worked seven days a week, but tried to make some hours for a little bit of rest and relaxation, particularly on Sundays. And one Sunday morning, we had some work we needed to do, organizing our supplies and getting ready for an audit by UNHCR.
So we decided that we needed to take a few hours of rest before we started that work, so we decided to take a ride out in the country. A couple of our colleagues had gone out to one of the national parks to spend some time overnight at a camping facility, and we thought it would be a good idea to go out and have a cup of coffee with him Sunday morning before we got to work.
So we drove out to the park headquarters, and found that the park rangers weren't going to let us in unless we paid the $70.00 admittance fee, which we decided was a little too high for a cup of coffee.
So we turned around and headed back, down the same road, back into town, so that we could get busy and do our work for the day. And we passed over the same stretch of road that we had come by the first time, in the morning, and we didn't make it the second time, returning back to town.
I have no memory from that point on, because I have complete amnesia, but what I am told happened was we ran over a land mine that had been put in a bit of a hole in the road. And the truck we were driving was thrown about 30 feet off the road, and from there on, my life was destroyed, and I was nearly killed.
I lost both my legs, my back was broken in three places, a great deal of damage was done to my face, and it was just a miracle that I lived to tell the tale.
SAPIENZA: What was the miracle? I mean who, how did the rescue happen, and who took care of you in such a remote area?
HOLTZ: By coincidence, a nurse who was working for the International Federation of the Red Cross happened along the very same road, shortly after the explosion, and she stopped and rendered first aid, and was able to get some fellows to help get me out of the car.
And she was able to get me to the Red Cross hospital, which was probably approximately five kilometers back up the road. We had just passed it.
And there was a very, very good surgeon there, who amputated my legs, what was left of them. And got me ready for evacuation out to a hospital. The nearest hospital that had the capability of giving me the kind of care that I needed at that point was in Nairobi, Kenya.
So I was air-evacuated out to Nairobi, and I spent three and a half weeks in that hospital before my condition was stable enough for me to be flown home to the United States.
SAPIENZA: You later heard or found a copy of the report from the Nairobi hospital, which told you exactly how close things were?
HOLTZ: Yes. I have a report from the physician who cared for me there, was in charge of my care, and he noted that when I came into the emergency room that evening, my blood pressure was extremely low, my pupils were fixed and dilated, and I was told by the medical coordinator of the organization I worked for, who also had met me at the hospital on my arrival there, that the doctors did not expect to admit me to the hospital.
SAPIENZA: Things were a lot closer, or you learned things were very serious and severe on that trip from Zaire to Nairobi.
HOLTZ: I was in a coma from the time of the explosion until several days after I got to Nairobi.
It was anticipated that I was going to die in the emergency room. By this time, I had received about eight or ten units of blood transfusion that were collected from friends and co-workers, other people from all over the world who had come to work in those refugee camps.
And I received about a total of 20 overall. The American Embassy in Nairobi maintains a list of blood donors, people who can be called in in case an American person is injured in that part of the world.
I exhausted the list of the people with my blood type, and I could have used more, I'm told, but that was all there was. When my son finally was able to come, a couple of days later, he told me that he was asked to come in and donate some blood before he was even allowed to come in to visit me. The need for blood was that urgent.
SAPIENZA: After you made it back stateside, what sort of surgeries, rehabilitation, what sort of things happened here in the U.S.?
HOLTZ: It was three and a half weeks before I could leave Nairobi. I was on a ventilator during much of that time, and the primary issue was that I couldn't be on an airplane on a ventilator; I needed to be breathing on my own before I could leave.
I finally reached that point, and it was possible for me to leave, and the arrangements were made. I wasn't able to make the trip in one shot, so I went to London, stayed at a hospital there for three days, and then finally arrived in Seattle, Washington, where I was hospitalized for my continuing care and rehabilitation.
I was only in that hospital about a week before I was transferred to the rehabilitation floor. I received some surgery there, primarily the reconstruction of my face, which was begun while I was there.
One of the most frustrating things was that my jaws were wired shut for four weeks, so during all this time, I had never been able to speak, because my jaws were wired shut, which was very frustrating, and also had a considerable number of tubes down my nose and this and that, practically every place you can think of a tube being.
I spent a total of three months in the hospital.
The rehabilitation was extremely difficult, partly because of my broken back. I had been kept completely flat while I was out of the United States, because the method of managing people with a broken back is a little different.
In our country, a patient would be immediately put into some form of a brace or a body cast, to allow them to sit up and be up, but I had not been in a sitting position for over four weeks before they finally got me up with a back brace on.
If you've ever been through this, you know, it is extremely difficult to sit up again for the first time, when you've been flat on your back for a month.
So it took quite a long time for me to get back so I could even stand up, and then learn to walk again.
SAPIENZA: The footage that you showed me from the Seattle news piece... can you talk a little bit about where that rehabilitation was taking place, and what type of rehabilitation that was?
HOLTZ: It's been such a long time now.
SAPIENZA: You said it was roughly 1996?
HOLTZ: In 1996, then, I spent, let's see, I got out of the hospital in January of 1996, and spent another nine months, I think it was, as an outpatient receiving rehabilitation. I would go to the hospital initially four times a week, and then three times a week, and then two times a week, for physical therapy.
I was not able to return to my home in Idaho until I was able to finish this rehabilitation; in fact, I never returned to my home in Idaho as a place to live. I lived in the mountains in a small town, and my home was such that it would have required massive reconstruction for it to accommodate me now in a wheelchair, and unable to walk up stairs, and things like that.
So I never lived in my home again. And that was extremely difficult. The only time I went back was to supervise the packing up of my furniture, and I left.
SAPIENZA: During your rehabilitation period, 1996, 1997, you were given information about the international campaign to ban landmines, and you were motivated to get involved.
Maybe we can talk about how, during this period your son gave you some information, you were motivated to go from there...
HOLTZ: Well, I was in the hospital in Seattle. One of my family members, one of my sons brought me some information about the international campaign to ban landmines. At this time, the campaign was collecting signatures, and he brought me one of the petition forms, and while I was in the hospital, I just needed to practice, anyone who came to visit me was asked to sign a petition, or take a petition and bring it back filled in.
And so I was able to collect quite a number of signatures, and I became aware of what was going on with the International Campaign to Ban Landmines. I really hadn't been aware of it prior to that.
Talk about learning about it the hard way; this is not a way I'd recommend to anybody, but I certainly became acutely aware.
Interestingly enough, three of my sons have been in the military, and they were horrified that they had been the ones that should have been taking the risks, and yet, it was me who was injured.
And the reality is, that's the way it is with landmines. It's the military that takes the so-called risk, but it's the civilians that are taking the injuries. And the statistics certainly tell the stories.
I think we don't think about that so much in the United States because not a large number of civilians to date have been injured, but with the number of us that are taking jobs abroad like I was, or our tourists just want to go places, the reality is, more and more of us are going to be injured by landmines.
And I realized this, and realized that I had better start showing people that if it could happen to me, it can happen to you, and it will happen to somebody you know, one of these days.
After I got out of the hospital, I actually had received a letter from Ken Rutherford, and later a phone call from him. I knew Ken slightly, because we had both worked for the same organization, and in tandem at the same place.
I had been working on a project in the area where he was injured, and had finished my project just as he was coming to work on his project. So while we worked for the same employer, and worked at the same location, we were there at different times.
But nevertheless, we had met one another in the main office, and had a slight acquaintanceship.
Ironically, when I had been visiting my mother, that summer when I was home, she showed me an article about Ken which had appeared in the Readers Digest, and remarked that maybe some day an article would be written about me.
I remember telling her, "I'd rather not have such an article written about me." Because it was about his landmine injuries, and how he was recovering from them.
I didn't realize that she was predicting what ultimately was going to happen to me, and in fact, did.
SAPIENZA: If you could explain just briefly who Ken Rutherford is, to people who might not know.
HOLTZ: While I was in the hospital, I received a letter from Ken Rutherford, who had himself been injured by a landmine while working in Somalia.
I was somewhat acquainted with Ken because he and I both worked for the same organization in 1993, when he was injured.
I had worked in the same area that he was then working in. I had been there just a few weeks previous to his arrival. My project was finished, I was leaving, he was arriving to work on his project there.
So we shared some experiences in the same organization, and in the same place, but not at the same time.
He and Jerry White were putting together an organization to be called Landmine Survivors Network. Later, after I got out of the hospital, Jerry came to visit me while I was staying in a small apartment in Seattle, and asked if I might be interested in doing some kind of work with this fledgling organization.
At that time, I didn't know if I was ever going to work again, although it looked like it was not highly likely. But I thought I might be able to do something, at some point in time, and so we became interested in what we were doing, and I did eventually begin working with Landmine Survivors Network, as a volunteer, and participating in some of the activities with the International Campaign to Ban Landmines.
This stage of the Campaign to Ban Landmines was a lot of public awareness, and organizing groups in different parts of the world.
I hadn't been out of the hospital very long when I was asked to participate in an awareness tour that was beginning in New York City.
So I went to New York City, and spoke at a gathering at the Church of St. John the Divine, and then went to Minneapolis and spoke to some groups there.
This group went on to other cities, but I was not in any condition at that time to do more than that, so I bowed out, and lent my support in other ways.
I then went to some of the -- what were they called? -- I was asked to go to one of the sessions of countries that was part of the...
SAPIENZA: Is this with regard to the...
HOLTZ: The Ottawa, yeah.
SAPIENZA: Conference?
HOLTZ: Right, the pre-sessions that they did in different parts of the world. I forget what those were called.
SAPIENZA: Are they plenary?
HOLTZ: No. Prior to the signing of the treaty in Ottawa, there were some preliminary meetings held in different parts of the world, and I was asked to go to the preliminary meeting to be held for central Asian countries.
And this meeting was in Aschabad, Turkmenistan.
So I went to that meeting, to participate as a landmine survivor, and to urge the people participating in that conference to come to Ottawa to sign the treaty.
And I then went to Ottawa for the signing of the treaty later that year, and was there for that conference and meeting, and the signing of the treaty.
SAPIENZA: Can you just give me one sound byte on, you were at the conference, and the Ottawa treaty signing, and what that meant for you. So, you were at the treaty signing in 1997? '98?
HOLTZ: No, '97.
SAPIENZA: '97, and what did it mean for you?
HOLTZ: I went to Ottawa in December of 1997 for the signing of the Ottawa treaty. This was a tremendously important experience. It was wonderful to see people from so many different countries, coming together on this issue.
At the same time, as an American, it was embarrassing to hear our own country's continued stance on the use of landmines.
Myself, as a survivor of a horrifying experience, which I personally would not wish on to my worst enemy, and my own country still feels the need to cause this kind of suffering to human beings, and call it "protecting our service people."
I don't understand that type of thinking. I would not do this to my worst enemy. It is so inhumane, and so horrible, I would much rather that somebody had shot me clean, which any soldier would have done, if he had some complaint about me, and some war against me, and I represented an enemy.
But to do this to me, and cause this kind of suffering, to do it to a child, is inexcusable.
SAPIENZA: In your travels, your experience at the Ottawa conference, what can you tell the American viewers about how the U.S. is perceived by other countries, because of our position?
HOLTZ: I think that if more Americans would travel outside their country, live for a short time outside their country, get to know people outside their country, they would begin to realize that the United States is not always viewed as the strong and wonderful country that we believe it is.
But indeed, is perceived as a bully, and a purveyor of suffering.
People know that someone, somewhere is making money off of things such as landmines, and they know that the United States is a wealthy country. And put that together in their minds, and they wonder why in the world the United States feels such a need to profit off of the suffering of others.
It's unfortunately a commonly held belief in many parts of the world, and it's quite understandable why people are beginning to hate Americans. At times it's embarrassing to be an American.
And around this issue, it certainly is.
SAPIENZA: With regard to the indiscriminate nature of these weapons, the U.S. position flatly states that it's a defensive, can be used as a defensive weapon, and that they have ample reasons why.
But can you talk to the indiscriminate nature of this, and the fact that people like yourself, not soldiers, are the ones that get injured most frequently?
HOLTZ: Yeah. I'm not too articulate on this issue, unfortunately. There's lots of people who can say it better than I can.
SAPIENZA: Well over the phone, you talked about how war, I mean, we were just talking about this earlier, about those Peruvian guys, soldiers, I mean, they are treated as war heroes because they have a leg, or a landmine injury, whereas average people out there who run into these things, who happen to be in the majority of the people who run into these things, don't get that...
HOLTZ: We have come to believe that weapons such as nuclear bombs, biological warfare, are things that rational and civilized people should not do, because they're indiscriminate; they cannot tell who is the combatant, who is the person that poses a danger.
Landmines can't tell, either, and they're not under the control of someone.
If you put a gun in a soldier's hand, he or she supposedly defines his target, and shoots the person who poses a danger and is defined as the enemy.
And if you had that same soldier, given that same gun, began shooting down women and children indiscriminately, you would court martial that person.
Well how is it any different, when that soldier puts a landmine somewhere, turns his back, walks away, and that landmine, that cannot define the difference between a woman, a child, a combatant, a dangerous person, blows someone up like myself, or a child.
And bear in mind, the children by and large do not survive. A child under the age of six can be heavy enough to trigger the blast of a landmine, but doesn't have enough body mass to survive it.
A mine is designed to blow off the legs of an adult human being, but a six year-old child isn't much taller than knee-high. So there isn't much left of them, when it's blown off at the knee-high level of an adult human.
SAPIENZA: We talked earlier about.
You have written letters to your congressman. What are some ways that Americans, or what are some things that Americans can do to get involved in this issue, and make a difference?
HOLTZ: Americans need to speak up. They need to say that this is not to be tolerated. It's inhumane, we don't condone it, we don't support it, we want it stopped. We need to write to our people in government, to let them know our feelings.
We need to not support those people in government who insist on the use of landmines. We need to be aware that in doing this, we're also protecting ourselves and our own children.
Because our family, ourselves, we may wish to travel, we may wish to go abroad, we might want to take a job, travel, see the world. And it needs to be a safe world for all of us.
It's my belief, too, that we are not totally immune to landmines on our own soil. Mines are being used in Central and South America, for instance, to protect areas where marijuana is being grown.
People grow it here. It's very possible that they could be used here. I think it would be not too difficult to bring them home, and use them if one wished.
I was told that the mine that destroyed my life was very likely purchased in the local marketplace for
$2.00. They were readily available for $2.00 each in the local marketplace. What would stop somebody from buying a few, bringing them home in their suitcase?
They're largely made of plastic; there's not a lot of explosive in them. I think it would be not too difficult to manage to get them home, and somebody with the mindset of a Unabomber, or the people who destroyed the government building in Oklahoma City, and some of the other places in this country, would find them something of interest, and we'll find them on our own soil.
I think the time to get rid of them is now.
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