Minutes before Holland America's Nieuw Amsterdam was scheduled to depart for Fort Lauderdale, Berit and Dan Wick received an urgent call at home. Without delay, the couple hailed a taxi to the port terminal in Cartagena, Colombia. Once aboard the vessel, Dan Wick approached an American stretched out on a hospital bed surrounded by the ship's doctors and nurses. The woman was pale and struggling to breathe; an oxygen mask covered her face. Her sister-in-law waited by the gangplank, filled with worry and concern.

Dan Wick accompanied Sue Wright in the ambulance, a bumpy ride along cobblestone roads. Berit Wick loaded Rosemary Cox and 16 days' worth of luggage into a car. By the time they reached the hospital, the cruise ship had sailed. But the Wicks stuck by the pair - strangers at first, advocates to the very end - until they were well enough to return home a week later.

"It's a sudden shock for people to find themselves in a foreign country, not speaking the language, not expecting to be disembarked from an enjoyable cruise and having a serious medical condition," said Dan Wick, a Californian who moved in 2003 with his wife and daughter to Colombia. "We are here for them, to be a familiar North American face, helping with logistics, language, and arranging to get them back home."

The Wicks are good Samaritans of a specific breed: The expats act as wardens on behalf of the U.S. State Department. Their voluntary role in the consular services program is specific in mission (help your fellow Americans) and broad in services (do whatever you can to achieve Goal A).

"I am often called upon to assist U.S. citizen-travelers who encounter difficult and often confusing situations that require immediate assistance, from stolen passports and money, incarceration for breaking foreign laws, political unrest, falling ill, and even personal conflicts resulting in physical assault," John Mackey, a four-year warden in Phnom Penh, Cambodia, wrote by email.

The program originated during the 1930s, when embassies relied on volunteers to disseminate critical information to citizens living abroad. The name derives from World War II air-raid wardens who patrolled territories in the United Kingdom and United States. The service resembled a phone tree: Participants would knock on doors and ring up landlines to deliver messages ranging from administrative updates (absentee voting, Social Security benefits) to code-red warnings (evacuation meeting points, natural-disaster shelters). These days, most of the 276 overseas missions can dispatch information electronically. Technological innovations have freed the wardens to focus more on American tourists whose trips have taken an unpredictable turn down an unimaginable road.

"These people get themselves into trouble," said Adriana Michele, a New Yorker who has dedicated more than 25 years to volunteering in Cartagena.

The wardens can help them get out of it.

Community spirit

Who are the wardens and, more important, how can you flag one down if you're in a bind?

The wardens are civilians - emphasis on non-State Department employees - with strong ties to their communities. They are typically fluent in the culture, habits, layout, and language of their adopted country. Elizabeth Gracon, a U.S. embassy official in Colombia, described them as "a local face on the ground."

Many of the volunteers have full-time jobs. Tommy Phillips, a three-year warden in China, is the chef-owner of Bread Rock Bistro, a popular expat restaurant in Yanji, in the northeastern province of Jilin. Jennifer O'Sullivan teaches yoga and runs a handful of bars and cafés with her husband in Siem Reap, Cambodia. Other wardens are retired or have iced their careers to pursue humanitarian projects. The Wicks, for instance, left Silicon Valley to volunteer at a school in Cartagena and start a foundation. Despite the wardens' divergent backgrounds, all share a charitable streak.

"They are Americans helping Americans," said Christine Fagan, a division chief in the department's Office of Overseas Citizens Services. "Also, the warden can give the local perspective."

Recruitment into the program is a casual affair. A consular officer might deliver an open invitation to join the warden network during a town-hall-style meeting or an embassy event. Or a member might entice a friend to join the club, as was the case with Phillips, a veteran who said he wanted to "continue to serve my country however I could."

Wardens are found in every country with a State Department presence. The size of the cadre depends on the destination and its level of development. Urban centers with strong teleconnectivity need fewer volunteers than remote areas with primitive communication systems. Communities without a consular office nearby also lean more heavily on wardens.

"They can assist Americans who can't get to the embassy," Fagan said.

Because of the program's informal arrangement (for instance, there is no training or manual), officials do not have a global head count of participants. But they can provide a snapshot of the warden census map: Lebanon, 90; Thailand, 73; Honduras, 25; Bangladesh, 23; Togo, 22; Chad, 18. Colombia claims 25 wardens, including four in Cartagena. I met the quartet during my October visit, but in arbitrary life, I would not have known their identities unless I had signaled an SOS.

So how do you, the American traveler, solicit help from a warden? You don't.

The chain of command starts with the embassy. The tourist or concerned family members in the States will contact the office for help. The staff might resolve the situation in-house or an officer might notify a warden for assistance. The issue might be an easy fix, such as replacing a stolen passport. Or it might demand a significant amount of time and emotion on the volunteer's part. For example, if an American dies abroad.

"We know a lot more about repatriation than I ever thought we would," Berit Wick said.

During last year's cruising season, the Wicks handled the arrangements for three deaths. Berit Wick still tears up over the memory of a Chicago woman who had been cruising with her husband three years ago when she became ill. She died while Berit Wick was in the ICU with her.

An increasing load

"¿Cómo estás?"

the MediHelp hospital nurse asked.

"How are you?" Berit Wick translated.

"I'm fine," Richard Adelson answered from his perch on a padded chair.

"Do you want anything from the minibar ... like a Scotch on the rocks?" Berit Wick joked, veering from the official script.

The nurse brought Richard a small cup of vanilla ice cream, a welcome break from the infirmary staple of rice, rice, rice.

The Adelsons capped off a very busy week for the Wicks, who also receive calls from the port agents about incoming medical cases. Sue Wright was the first patient to disembark, on a Wednesday in mid-October. The ship also dropped off an Indonesian crew member with a torn esophagus. The next day, the Cartagena hospital received a Washington woman who had hit her head on a tree branch during a shore excursion and lost consciousness. An interpreter had accompanied the hearing-impaired cruiser. The Wicks had to juggle conversations in English, Spanish, and sign language. On Saturday, the couple helped a German woman and her partner, who suffered a stroke aboard their sailboat. On Sunday, a crewman with a broken tooth arrived. So did Richard.

"It was very frightening. I can't imagine if I had been left in a strange country and couldn't speak the language," said his wife, Barbara Adelson. "It was such a relief knowing that there was someone to help us."

During Richard's hospitalization, the Wicks provided Barbara with an internet phone, so she could converse with her children in the States. They compiled a cheat sheet of essential Spanish words and phrases for Richard, including tengo sed (thirsty), dolor (pain), and pato (bed pan). They confabbed with doctors about his condition and translated their diagnoses. And they called the Adelsons' travel-insurance company numerous times, updating the agents on his recovery and submitting the information required for reimbursement. They also invited the family (son Brian later flew down from Philadelphia) to bunk at their four-bedroom condominium. Amenities included hot showers, home-cooked meals, and fast friends, including Wright and Cox, who were also guests.

"They've made me feel so amazing," Barbara said. "I feel like I've known them forever."

On Monday night, the hosts and their visitors gathered around the dining table on the balcony. The air was warm, and the harbor shimmered under the city lights. Dan Wick said grace. Everyone uttered, "Amen." Then they dug into the spread of salmon, salad, and mashed potatoes, and drained a bottle of wine.

On average, the Wicks tend to about 60 impaired travelers a year. About two-thirds are American, and nearly half stay with them. They still remember their first case from about eight years ago. A young woman ran out of money. They visited her at her hostel while she waited for a government loan to finance her trip home. Over the years, as more cruise lines have added Cartagena to their itineraries, the number of cases has ballooned. When the couple moved to town, about a dozen ships docked there. Now a staggered parade of 225 vessels sails in from October to May. Back then, they didn't know much about medical procedures or the mechanics of travel insurance. Not so now.

On the day the hospital released Richard, the Wicks submitted a fit-to-fly form to the insurance company. They explained to the Adelsons that the company would arrange and cover their travel expenses to Philadelphia. However, the process could take several days. A second option: Pay out of pocket, and fly back tomorrow.

"I want him home," Barbara said.

"That's wise," Berit Wickreplied.

The next morning, Cox, Wright, and the three Adelsons boarded the same flight to Miami.

Emotional bonds

Finally, a quiet day.

Though cruisers surged through town, there were no calamities or crises. I stopped by Adriana Michele's jewelry shop, which was thick with tourists ogling emeralds. She invited me into her office, which was tucked behind the maze of glass cases.

"Things were easier back then," she said of Cartagena in the mid-1980s. "There weren't that many tourists."

Michele and Hortensia de la Rosa, her Colombian assistant and an honorary warden, receive three to four calls a year from the embassy. One oft-repeated story involved a mentally unstable mother who threatened to jump off a building. Another involved a bipolar man who succumbed to the darker elements of the city.

"Some people have drug problems and hook up with prostitutes," she said.

De la Rosa joined the conversation and shared a tragic tale about a young man and his uncle, who had taken him on a bonding trip. The 20-year-old, who had cocaine in his system, toppled off a 14th-floor balcony. His parents and grandparents flew down when he was in a coma. De la Rosa helped them at the hospital and, later, with repatriating the body of their loved one.

"You get to know them," de la Rosa said of the victims, "and you can't avoid getting emotionally involved."

The attachments tug in both directions. Earlier in the week, she had told me about a family from New York who were traveling in a van to Barranquilla when it crashed. The husband's rib pierced his lung. Over the Christmas holiday weekend, de la Rosa and Michele tracked down a doctor who could operate on him immediately. During surgery, de la Rosa held his wallet and clothes while waiting. Later that evening, she peered through the window of the recovery room. The American gave her a thumbs-up.

De la Rosa paused and reached into her purse. She pulled out a crumpled letter. The typed note was from the American to the U.S. ambassador to Colombia. She pressed a tissue to her eyes as we read the note together. He wrote that de la Rosa "was there to help my family in any way she could." He proceeded to list those ways. He concluded with: "That relationship produced real results for us. We will never forget."

A few months later, de la Rosa and Michele received a certificate of appreciation from the U.S. Embassy in Bogotá. The accolade sits on a shelf in Michele's office, framed and under glass.

A last look

On my last full day in Cartagena, I took a break from the hospital visits to explore Old Town, a walled labyrinth of Spanish colonial buildings and festive plazas. When I left the medical center, the Wicks had been translating preop instructions for the German sailor and were trying to locate a Mandarin speaker for a Chinese crewman in the ICU. I felt a twinge of guilt as I wandered in and out of shops and drank cup after cup of Colombian coffee. In the early evening, I received a text from the Wicks that they were finally leaving the hospital.

We met for dinner at an Italian restaurant in Getsemani, a spirited neighborhood emerging from a tawdry period. Over pasta and wine, we reviewed the patients of the week. Dan Wick showed me an email from Wright, who thanked the couple for their help and hospitality. He shared a message from Brian Adelson, who wrote that he didn't know how his parents would have managed without them. Dan and Berit Wick were touched by the gratitude, but they didn't linger long on the events. They knew that as each case closes, another one opens.

The next afternoon, they were planning on visiting a cruiser in a Barranquilla hospital. The man had pneumonia and no money. That was all the information they knew - and, for their mission, all they needed to know.