According to ongoing scientific research by the World Mosquito Program, a multi-government funded organisation that monitors mosquito-borne diseases, increasing global temperatures are leading to significant seawater ocean warming, the scenario being that mosquito swarms are forecasted to increase and spread significantly by 2080. One result of this, according to the projections, is that northern cooler-climate countries normally considered to be out of the malaria, dengue, yellow-fever and zeka-virus danger-zones, will become endangered as mosquito’s habitats spreads to areas of Europe that have never before experienced the risk.
We can ourselves attest to this to some degree. Over the last couple years we have noted mosquitoes swarming over salty seawater, whereas their normal habitat is considered to be standing stagnant freshwater. During late 2023 and early 2024, many locals we met in the Caribbean predicted significant rises in hurricane activity based purely on their perceived sightings of unusual mosquito activity – we were told in no uncertain terms by Dominican Republican fishermen that 2024 would deliver an increase in category five hurricanes and so it proved – hurricane Beryl was the earliest and most southern cat-five hurricane on record, wreaking havoc through Granada and the Grenadine islands not usually at great risk from named storms…
I didn’t sleep anything overnight once Marie had left in the ambulance to Guaymas. I still had our one local SIM card we shared for data hot-spotting, I figured I would need the SIM in the short-term. Readying Sänna to be left on anchor, I rode the dinghy over to a Dutch sailboat anchored nearby to ask if they could keep an eye on Sänna while I was away onshore. I explained my reasons, the Dutch guy, Arthur, offered to drive me to wherever I needed to go but by now I had Danny DeVito’s rental car. Arthur also told me about the serious outbreak of dengue fever down in the Nederland Antilles islands – I explained that we had sailed from there, this was where we had both got the dengue, we had sailed north from Curacao to the Dominican Republic. He was apologetic, almost as if he shared the blame.
Then, unexpectedly, while talking to Arthur, I received a WhatsApp call from Marie, she was using the hospital Wi-Fi. She was fine, she said, she had been examined by the surgeon, receiving excellent care and was now once more bedridden with intravenous drips delivering high-level morphine, antibiotics and saline. Marie said her main problem right now was that no pillows or blankets were supplied by the hospital, she was freezing cold in the hospital air conditioning and uncomfortable on the bed lying flat on a plastic mattress protector. She asked if I could call at Walmarts or somewhere to get pillows and blankets – I later learned that hospitals in Puerto Rico considered pillows the biggest source of superbug infections. Marie also messaged me the Google maps location of the hospital. I got myself ashore, the same security guard on the gate asked me how things were. I explained – he said the two guys who had driven us almost cross-country to the Salinas hospital would be happy to drive me Guaymas. I thanked him, saying I had a rental car which was parked outside of the gates. He took one look at the wreck of a car and said, ‘look, I think you’d be best getting a ride, I bet that thing isn’t even insured.’
By the time I had shopped at Walmart, got myself some breakfast from Subway and tracked down a second local SIM card it was nearing midday. I still had the two-hour drive to Guaymas, Marie had messaged me to say her blood test, X-Rays and and CT scan were now back with the surgeon, she was expecting the surgeon to visit shortly – and the hospital had taken a three-thousand dollar initial deposit on her credit card. I told her what the local doctor had told me about the infection bursting inside of her abdominal wall but I left out the bit about life-saving surgery. I was reasoning that, if this was the case, they would have emergency operated by now. Maybe this was good news. On the drive over to Guaymas, Marie’s son Henry called on WhatsApp.
We had been keeping family and friends generally updated but I had messaged Henry during the night to explain the enormity of what had happened. Of course, Henry was fraught with worry, he told me that himself and his German girlfriend Emma were booking flights to Puerto Rico straightaway. Henry & Emma had already made plans to join us in the US Virgin Islands with those flights already booked, he explained that they would now ditch those flights and get themselves to Puerto Rico. This was good, I felt relieved, things were beginning to improve, I would value Henry’s help, support and assistance. Henry could also help me sail the boat, he had spent inordinate amounts of time on Sänna since a young age – in his early years, when we more-or-less full-time lived onboard, we had home-educated Henry on the boat. Henry is vastly experienced, he knew his stuff.
Arriving at the Guaymas Surgical Hospital, thanks to Google maps was easy enough. Marie had messaged saying she was on the fifth floor, I proceeded to the elevators which were guarded by a stern-looking receptionist who was checking identities and reasons for visiting. She spoke no word of English – strange considering this was US territory. The receptionist admonished me, I had no idea what she said though she was clearly barring my entry to the elevators. I got angry, arguing with her in English while a queue formed behind me. The woman behind me tapped me on the shoulder, saying I was being denied entry because of my dress code – I was still wearing my tee-shirt, shorts and flip-flops, it was hot and sticky here in Puerto Rico. The woman behind me explained to the receptionist that my English wife was up on the fifth floor – no matter, this cut no ice, I needed long trousers (called slacks in the US), a collared shirt and respectable shoes; the fifth floor was the emergency and life-preservation floor, there was a policy of showing respect for families grieving for those not expected to survive. Jeez! Now I was stressed. My new friend then explained there was a Walmart store just across the street, I could purchase the clothes and shoes I needed there then return. I was annoyed, I was angry.
I made my way back to the hospital entrance – a security guard intercepted me who had listened to the whole argument beside the elevator. Look, he said, there’s a staff elevator just around the corner, I will take you there. Walking with him, the guard told me he loved English people and was a big fan of Manchester United. I smiled, most foreigners support Manchester United, I told him I was a big Nottingham Forest fan and that, once before, many years ago, we had won the champions league. Yes, he said, twice. My new friend took me to the staff elevator and accompanied me up to the firth floor, explaining to the security guard on the fifth floor that I was with him and had the necessary clearance. The guard took me to the managing nurse, he explained who I was in Spanish, the nurse showed me to the room where Marie lay flat on the bed.
I found Marie in reasonably good spirits except she’d had no sleep during the night – she was so pleased to get the pillows and the Walmart blanket. The good news was that her abdominal pains had reduced enormously since the infected wound had burst open. The surgeon had explained to her that it was a form of pressure release, the forming puss had caused pressure pains and infected her whole abdominal wall in the process; with the puss and pressure now gone there would now be much less pain. The surgeon was waiting for the CT scan results to see if there were any internal organ infection – he had also explained that, if there were, then there was little a surgical operation could achieve, he could not remove infected organs vital to functioning life. Care would be given on the basis of making life expectancy as comfortable as they could. He explained that haemorrhaging dengue fever, when it attacked the abdominal regions, was considered extremely dangerous though there was around a 50% chance of full recovery. He confirmed the abdominal pains would reduce considerably now the wound was open – it would need to be kept open, in the meantime Marie was being given maximum doses of morphine but, more importantly, a culture swab had been taken of the infectious puss and an antibiotic was being blended and constructed purely for Marie – this was being done in their labs right now with the sample results having been sent to the US mainland.
We waited not long for the CT scan results, the surgeon came while I was there. He was beaming with a smile – Marie was extremely lucky, the infection had not burst through the internal membrane of her abdominal wall, only to the outside. There was still large areas of infection so everything now rested with the high-strength blended antibiotic which would be ready and introduced by intravenous drip within the hour. Nervously, I raised the question of costs and how we could pay, the surgeon was aware that Marie had no medical insurance. Look, he said, don’t worry about costs right now, Marie had already been placed upon a low-income health scheme – if she did carry medical insurance then she would be on a different care scheme altogether, one especially designed for those who are insured or with recognised health plans – the eventual costs would then be three times higher than those with no health insurance. Then, he said, we could always sail away from Puerto Rico and never return, he winked. I was shocked, in no way could we accept this extremely high level of emergency care then abscond without paying. I’ve never done anything like this, neither had Marie.
We got into a daily rhythm over the next week. I contacted Danny DeVito to ask if it was ok to keep the car and what would be the cost. He said to keep it, it was free, but I needed to drive carefully because the car wasn’t insured. By now Marie was beginning to eat more but was struggling with the hospital food, we agreed that, on my daily drives to Guaymas, I would call at Subway for her favourite teriyaki chicken salad. We got into a nice routine, I would leave the hospital late-afternoon to drive back to Salinas and Sänna before dark, in the evenings the Dutchman Arthur would invite me over to his Dufor yacht Dream for a beer. We got to be quite good friends. Henry called to say he and Emma would arrive in three days time – once I had told him the emergency situation was passed, he decided to sequence his visit with holiday leave from his job plus it would give more time for Emma to arrive from Germany. The antibiotic blend was doing its job, Marie improved daily though she was still weak with bouts of nausea from time to time. Marie was now sharing a room for two, for the first couple of days the second bed was empty though on day three it was occupied by a woman who only spoke Spanish. Her family would visit, at least six of them on each occasion, they tried their best to speak English using Google translate but it didn’t really create a budding friendship atmosphere. The consultant again came to visit.
This is the situation, he said. He reiterated to Marie that she had been extremely lucky, she would be released from hospital care the next day but must rest, the healing period would be at least six months if not longer. I again asked about the costs and how was best to meet them. The limit on Marie’s credit card and mine would not be sufficient, he advised. The cost of the blended antibiotics, the culture biopsy and CT scan had had to be sent to the US mainland, there was the cost of the overnight hospital stays, two additional CT scans and the blood test also sent to the US which again confirmed haemorrhagic dengue fever in her white blood-cell counts. Marie would now need longterm specialist care, the wound could easily infect again and we could not afford this level of continuing treatment calculated upon US healthcare costs. The surgeon advised that Marie return to the UK as quickly as possible, which seemed logical and reasonable under the circumstances. Our biggest problem right now was that we had no insurance cover for medical repatriation flights back to the UK – all flights from Puerto Rico transited through the United States and Marie was in no fit state to go through any transit layovers – nor, under the circumstances, could the surgeon provide the required medical certification the airlines would demand to accept Marie onboard. We could try to travel on a US airline clandestinely but, if it all went wrong, and it easily could, with the aircraft having to divert for an emergency landing, then we would be facing extortionate airline fees and unpayable legal costs – and US legal fees to boot. What were our options? Well, our options were not good.
Puerto Rico to Antigua
Again, the consistent easterly trade winds were still gonna be our big problem. The nearest destination with direct UK international flights was Antigua – a not-to-be-taken-lightly destination of around two-hundred and eighty miles as the crow flies from our current location, directly into fifteen to twenty knot winds with gusts probably reaching up to gale force – and the towering seas that go with it. It was certainly doable but only by breaking the voyage up into stages, by transiting through the Spanish Virgin Island to the east of Puerto Rico, then the US Virgin Islands and British Virgin Islands, perhaps the Dutch islands of San Maartine before trying to make a break eastward for Antigua when, if it happened, there was a lull in the trade winds. During this time, Marie would be in a much weakened state and not able to assist greatly, though knowing Marie, this would not hold her back in any great way. My problem was getting Marie to rest & recuperate enough to be safely allowed onto a British Airways or Virgin flight from Antigua to London.
Luckily, soon, Henry & Emma would arrive in Puerto Rico into San Juan, the capital. San Juan is approximately forty-five miles north of Salinas. The drive included toll roads which, Danny DeVito warned me, were not included in the insurance policy of the rental car. But there is no insurance on the car, I countered. Yes, he agreed. So he told me to go ahead, he would receive the toll bill direct then I could give him the cash. I was reluctant to leave Marie alone onboard Sänna while I drove north to collect Henry & Emma from the airport – they were arriving from Austin, Texas having transited from the UK. Marie told me she felt fine, well enough to travel with me. We left, arriving in San Juan early, Marie said she had a craving for a McDonalds BigMac burger so we found the nearest outlet on Google maps inside a nearby shopping mall. After we parked up, Marie couldn’t walk the distance, she got as far as the nearest public lavatories where she vomited in front of the cleaning lady. We left the mall without the burger. Having collected Henry & Emma we drove back south the Salinas. We decided we would give Henry & Emma a couple of days acclimatisation before pulling up anchor to leave for Isla Vieques in the Spanish Virgin Islands – a sailing distance of around sixty nautical miles to the east.
The winds steadied from the north – a stroke of luck meaning we would get a reach from across our port side. We made a steady seven to eight knots meaning that we had a good chance of making Esperanza harbour by nightfall. Having Henry & Emma along made all the difference though we wouldn’t linger, at sunrise the next morning we were again on our way. Our next stop Ensenada Honda, a tricky bay to enter in that there are many shallows with coral heads, though with Emma on the bows pointing out directions by viewing the immaculate clear waters we safely made anchor in about six metres depth. This was a good calm anchorage, Marie was feeling fine, we were beginning to enjoy the adventure – but the winds were beginning to turn easterly which would make it difficult to make further progress east. The four of us studied the wind forecast, from Isla Vieques we could turn northwards across the trade winds to Isla de Calebra to what turned out to be the delightful harbour of Culebra, the tiny capital of this wonderful island. Leaving Ensenada Honda we made an average of seven knots. Culebra was a sheltered harbour where we could provision up and dump our garbage. Marie was still feeling relatively fine, we decided to rest up a couple of days in this idealistic location.
We waited three days in Culebra – we needed the right winds to cross eastward into the US Virgin Islands. The wind-god Odin was once more on our side, there was a two day period of little to no winds, we could use this unusual wind interlude to make the relatively short distance of twenty nautical miles to the main US island of St Thomas, dropping anchor in the inner harbour of the main town of Charlotte Amalie. We quickly noted that Charlotte Amalie is cruise ship hell, the overpriced restaurants and US-style malls catering for sometimes three huge cruise ships at a time, disgorging up to twenty-thousand tourists per day… when these cruise ships leave at the end of the day, everything, the whole place shuts down. We found one restaurant that remained open, we got poor, incredibly slow service and scouring unfriendly waitress staff. When it came to pay the bill, the waitress let rip in Marie’s direction because we did not leave a tip. Seriously, this waitress was picking on her worst nightmare, all of Marie’s pent-up frustration let rip on this miserable specimen of American waiting staff, the type who feel it is a prime requisite to demand a tip even when the service, food and attitude is exceedingly poor. It would be wrong to name the restaurant.
Due to work-time restraints Henry & Emma were gonna have to leave us. Henry no doubt felt better about leaving his mother who was, realistically, by this time, out of any real danger. Our mission now was to get Marie to a stage in which she could safely take an air flight home to England. Our more immediate problem was to somehow make the two-hundred mile passage against the relentless trades to Antigua. I believed that, by being patient with the winds, we could do it. We had already made outstanding progress in circumnavigating eastwards from the Mediterranean to New Zealand, then south to north across the pacific from New Zealand to Alaska. Our voyages down through British Colombia, the west coast of the United States then through Central America meant that we were well used to sailing against adverse winds – our eventual passage from the Panama Canal, eastwards through Colombia to the Dutch ABC Antilles islands had on occasions been much lauded by experienced salty sail-dogs we had made friends with along the way. All we needed now was a break, a luck break – and a lucky wind break is exactly what we got.
We left St Thomas to leave the island of St John to starboard before crossing the imaginary sea border into the British Virgin Islands. There was no wind, nothing. We made our way under engine power into tiny Sopers Hole on the island of Tortola, British Virgin Islands territory. Technically, we should have made for an official port of entry but we didn’t care, all we wanted was to fill our fuel tanks with diesel, enough to get us all the way to Antigua. The windless window was gonna last at least three days, we could use this to get to exactly where we wanted to be. Odin-the-Terrible was truly with us.
We first off anchored overnight in the south bay of Peter Island, the perfect jumping off point to make the remaining one-hundred and seventy miles or so to Jolly Harbour, the Antiguan port of entry that beckoned to us with expectation. This was just a two day passage overnight, using the engine but the weather window that was forecasted looked like we might get a gentle breeze from the north – even better. At first light, we pulled anchor to leave Peter Island, a straight 120° bearing would take us all the way. Well, we got the light winds, we effectively motor-sailed our way under autopilot while enjoying the light breezes that kept the temperatures down and comfortable. At first light the next morning, after an uneventful night, we passed the spectacular islands of St Kitts and Nevis directly to our starboard side with our bows set firmly on Jolly Harbour in Antigua. Later that same day, as the sun set in a spectacular red sunset, we dropped anchor in the Jolly Harbour anchorage of Antigua. We both, together, cracked open a beer and drank a swag to Odin.
Footnote
Our troubles were not quite over, but things were much easier. We arranged a return flight to the UK for Marie with Virgin Airlines. Her flight home, on the 18th April, was uneventful, with Marie’s sister Ali collecting her from Heathrow Airport. Two days later, Marie saw her regular GP doctor who immediately referred her to the same NHS consultant she was under in previous years. Both the cottage hospital in Salinas and the surgical hospital in Guaymas forwarded all Marie’s X-Rays, CT scans, blood-test results and bespoke medication lists, as well as all their surgical records to her NHS consultant back in the UK. Of course, all health treatment in the UK is free of charge under the National Health Service (NHS) – it is difficult to make comparisons between Marie’s care in Puerto Rico and that of the UK except to say both systems, Puerto Rico and the UK, each have been excellent. Marie was soon placed in the longterm care of the Tropical Diseases department at the Nottingham City Hospital – whose consultant was over-the-moon and excited that he had Marie in his care. Although he specialised in tropical mosquito-borne viruses – he had never before had a real live patient (nor deceased ones, he quickly pointed out to Marie)
In late June, 2024, just two months after we first arrived in Antigua, the boatyard much further south in Carriacou, where we had prior booked a longterm storage haulout, was completely wiped out by category five Hurricane Beryl, with most boats there wrecked. Beryl was the earliest, most southerly and most vicious hurricane on record. The Dominican fishermen who warned us of a bad hurricane season to come, based purely on their visual observations of mosquitoes swarming over seawater, were exactly right in their predictions.
We paid Marie’s medical bill in Puerto Rico using a combination of credit cards and bank transfers. We had no intention of absconding on the bill. I don’t wish to reveal the total costs, except to say it wiped out a sizeable chunk of our cash reserves. The treatment costs in Puerto Rico were reasonable and manageable – what crucified us was the costs of blood test examinations, culture biopsies and the blending of specialist antibiotics carried out in Florida in the United States. These costs were inevitable and considerable – highlighting the real benefits of the free healthcare we British receive under the UK’s NHS.
We ourselves are not wealthy people, we lead a basic lifestyle sailing on the ocean. We make our way without any bother or fuss, we don’t lord it to other people the life we have decided to live. Of course, we earn and replenish our funds in any way we can – we have set up a ‘buy me a coffee’ page for anyone who has enjoyed this read and feels they wish to donate a small amount towards Marie’s medical costs. Please see donation details below.
Finally, we wish to thank all those who helped and cared for Marie, who in many respects may have saved her life. My noted thanks go to Danny DeVito, not the movie star DeVito but the one who never insures his rental car wrecks. Also, the two ‘drug dealers’ who raced Marie to the Salinas hospital… over the bumpy wasteland that must have saved us all of five minutes. There were others – pharmacies, the French single-handed sailor in Las Salinas bay who told us to get to Puerto Rico fast and not least of all – the nurses, doctors and the surgeon who all cared for Marie the best they could.
Dave – August 2025
Dave & Marie left the Mediterranean over eighteen years ago to make their way eastwards circumnavigating around the world in their sailing vessel Sänna. Having crossed several oceans and transited both the Suez and the Panama Canal, they are now in the Caribbean Sea making plans to finally cross the Atlantic back to the UK.
Dave is an established freelance writer, author and publisher, having previously run his own business in publishing and marketing communications. For more information, please visit www.davidungless.com.
Buy me a Coffee
If you have enjoyed reading this post, perhaps you might consider ‘buying me a coffee’. This is an online donation system created specifically for freelance creators who often post their work online for little or no reward. There is no obligation to donate anything, it’s a purely voluntary means of supporting creative content. In this case, Marie’s medical costs which, we accept, was purely Marie’s fault for relying on auto-renew processing for medical and travel insurance.
Simply click the image if you wish to donate. Thank you for your support and contribution.
You can follow our circumnavigation adventure by clicking the WordPress Follow button below or by Liking our Facebook page at www.facebook.com/sv.sanna. Our blog page can be found at www.sailblogs.com/member/eastwards.
