Navigate / search

The Boys at the End of the Road

The boys had been there all day long; three scruffy looking kids, probably 9, 10, or 11, years old, inseparable, taking in all of the unique goings-on. The Americans had come to their small village of Matazanos and had set up their health clinic at their school. The Maine Dartmouth Family Medicine Residency program and Long Island University, School of Pharmacy, had teamed up for the third year to offer medical services in and around the municipality of Colomoncagua. This would be their last full day of their trip, and Laura and I had tagged along with them. It would turn out to be a most successful day, seeing over 100 patients in this very remote area.

Matazanos, Colomoncagua, Intibuca, Honduras
Matazanos, Colomoncagua, Intibuca, Honduras

Matazanos is one of these tiny villages splattered all over the remote area of Southern Intibucá, never far in distance from the central municipality, but always a memorable trip. We took two pick-ups. With the team, the supplies, and the translators, the cabs and the beds of the pickups were packed tight. As we wound along the narrow, rutted out, washed out, muddy pass, I would hear whoops and hollers from the passengers in the bed as we slipped into a rut, climbed steeply up a hill, or passed under branches.  The road is here for the occasional truck — never a car — that has to bring something in or out of Matazanos. The locals walk trails that are more direct, and probably in much better condition. In any case, the less than seven mile journey, even less on a straight line, took us about forty-five minutes before we reached Matazanos at the end of the road.

We arrived at the school, first through sixth (they were building the kindergarten), to a throng of children who, thanks to us, had the day off. The group panicked at first, thinking they needed to see each of the kids. But that would not be the case, they’d only see the kids who had health complaints. About mid-morning, all the kids got treated to a yoga session where they got to stretch like the mountains, the sun, cows, dogs, and cats, and make wonderful sounds. It was great exercise, disguised as a fun game (or perhaps a fun game disguised as a great exercise). The kids loved it.

Extreme Yoga
Extreme Yoga

I kept noticing the three young boys. They played in the yoga game, and loved it. Unlike the other kids who wandered in and out of the school, these three hung out all day long and seemed to be having the time of their lives.  At one point, the three of them were lined up with their faces pressed against the bars of the window to one of the classrooms. Inside, the pharmacists and the pharmacy students were preparing the medications for the providers’ prescriptions. They were reading books and using apps on their telephones to understand the medications. The young boys had never seen anything like this. For them, it was the magic of alchemy. The Americans might just as well have been performing brain surgery.

Around lunch time I got a couple of minutes to speak with them. Their first question to me was where I and the visitors had learned English. I don’t think they understood when I answered that English was their first language, just as Spanish was theirs. As we were packing up, the boys were finally getting ready to leave. I got a few more minutes with them. I learned their names and a few other things. They wondered what the United States was like, but they had absolutely no context in which they could understand. All three of them had traveled to Colomoncagua (a one hour walk) which, for them, was the city. Though one of them had been to Camasca (a 45 minute car ride), that was as far as they had traveled. None had ever been to La Esperanza, the one place in the whole area that actually could qualify as a very small city. I asked them what they hoped to do when they grew up. They answered by way of their experience – they wanted to be farmers. I asked about being a policeman, or even a doctor like the ones they were seeing today. They giggled, such a fanciful idea from the strange gringo.

Checking out the Pharmacy
Checking out the Pharmacy

Their worlds are so small and their opportunities so limited. They will not go to school beyond the sixth grade. They will never travel beyond a ten to fifteen mile radius. But, oh boy, do they have curiosity! And I wondered who would ever nourish that curiosity? Who would ever help them to give some form to unfocused dreams? I0n a sense, Maine / Long Island gave them a great gift today:  the ability to catch a glimpse of possibilities. Perhaps it is only a moment, a passing entertainment; something like taking a peek behind the tent at a traveling carnival. Still, isn’t there a great deal more hidden in the curiosity of young children? Maine / Long Island opened a door, and beyond the door, an unknown world. Perhaps if Maine / Long Island continue to come and build relationships (they already have and they have every intention of continuing), one of these boys, or any number of the children who come to know them, may find a new road.

The Boys
The Boys

Curiosity is a powerful thing. It won’t be satisfied or stifled. It is, of course, what causes many from here to dangerously cross borders and arrive without documentation or permission in the US. But curiosity, well-formed and given proper context, yields discovery and invention.  Maybe, with the help of persons of integrity and generosity, such as those from Maine / Long Island, some of their curiosity and their dreams will flourish into new life.

Maine / Long Island
Maine / Long Island

Wyoming, Home Away From Home

It’s been a particular long and challenging brigade season. From January 7 through March 26, 2017 we have given welcome to six separate medical teams onto the Frontera. Apart from these official medical brigades, we have also hosted two groups traveling with our board president, Wayne Waite, who came to strengthen and extend our education mission, as well as a couple of special visits. During that period, there has only been about ten complete days when we were not hosting visitors, about 100 of them in all. We pick them up at the airport and transport them from there to here and all around. We make sure they have hotel rooms, tents, mattresses, mosquito netting, or at least a stretch of ground upon which to sleep. We provide them translators, or we sometimes are their translators. We make sure they have food to eat, beverages to drink, and guard against a Honduran microbe that might make them ill. We see to it that their journeys and the services they perform are meaningful for them and for us. It’s a lot of work. And so, when the Wyoming / Agua Salada brigade flew back to the States on Sunday the 26th, we did breathe a sigh of relief to know we wouldn’t host another brigade until the last week of May. Still, it’s a bitter sweet feeling. Yes, we will have a little more time to rest, but we will also miss our friends.

Wyoming – March 2017
Wyoming – March 2017

Wyoming is the best example. They were the first brigade that Laura and I met when we took our position with Shoulder to Shoulder in November of 2014. Linda, the leader of the Wyoming brigade, was there then and she has been on every brigade since then, a total of six trips. Though we’ve never been to her home in Wyoming, she’s become a dear friend. The same for Ron, the doctor, and Larry the dentist, who so often travel to the small community of Agua Salada.  It’s sad to see them leave and know we have to wait another eight months for their return. We will miss them. They too, I think, will miss us.

They really can’t be called visitors anymore. There is too much familiarity. Linda, like the student that sits in the same seat in her classroom, sits on the same seat on the bus for the six hour trip to and from the airport every time.  And she scurries every time she arrives in Agua Salada so that she can place dips on her favorite place to sleep. On this trip, Ron introduced me to a man for whom he removed a skin tag from his eye years ago before the clinic was even built. Larry extracts hundreds of teeth on every trip, but on this trip he proudly announces that a few patients are asking him to save a tooth rather than simply yanking it out. This is progress — a result of years of working to change a cultural understanding of dental hygiene. Larry is also intimately familiar with the septic system at Agua Salada. It doesn’t work so well, and there is nothing that will breed familiarity better than intimacy with a broken septic system. They don’t live here, to be sure. After a week or ten days, they fly off again to homes in Wyoming, very far away from Agua Salada. But they don’t really qualify as visitors anymore. When was the last time you sent your dinner guest out to unclog your backed up toilet?

Linda and student Justin Preparing for the partera luncheon
Linda and student Justin Preparing for the partera luncheon

But this is what makes this service of Wyoming so special and effective in terms of a mission of development. There are a lot of brigade groups that come to Honduras. There are companies here that serve their every need. Like Laura and I and Shoulder to Shoulder, they pick them up, provide for their transportation, housing, and food, and present them to communities where they perform their services. But it is the differences between those companies and us that are striking and telling. First, that’s all they do. They have no medical mission apart from the groups they host. They have no relationships with the towns and the people they bring the groups to. The groups they bring are not committed to the people they serve. They see them once, they pull some teeth, give out some Tylenol and anti-parasitic medicine, and in one to two weeks, they are flying back to the States. This is not a bad thing to do. It’s definitely valuable service.  But, in the end all they are is visitors. Visitors are not invested, and because they are not invested, the work they do is not transformational. There is no development. Wyoming, on the other hand, comes home to Honduras. That is what makes the difference.

Bringing about life in joy
Bringing about life in joy

Larry recognizes a change in the sense of dental hygiene only after years of attempting to teach people the value of good, dental care. Ron sees a man year after year who he was fortunate to once remove a skin tag from his eye and give him better sight. Linda knows the parteras (midwifes) well enough to ask them about the children they have brought into the world. She hosts a luncheon for them. They share their stories. The eighty-six year old midwife, who has been one since she was fourteen, tells how she has never taken a payment for her work. Instead she explains to the group how after the birth, she does the laundry and cooks the meals for the mother who needs rest. Linda, well familiar with this woman’s life journey, asks her how she involves the father in the birth of the child. Then something truly incredible happens. The eighty-six year old midwife takes the role of the husband. A student takes the role of the mother.  The student taking the role of the mother sits on the midwife’s lap, who encloses her in a tight embrace. It makes us all laugh. But we see how it takes commitment and embrace to welcome life into the world.

If they were visitors, none of this would happen. Trust, dignity, and an abiding understanding of the worth of relationship is what engender development. The students that come are indeed visitors. They are there for the first, and frequently only, time. They learn techniques in the administration of medicine. They learn about the challenges of providing health care in a developing, resource challenged area. But they also learn that without an abiding commitment and the dignity of relationship, its value is limited to the effectiveness of a single intervention. But health, well-being, and development:   these things require that you take the time to become comfortable in someone else’s home. These are the things that Wyoming brings to Agua Salada.

 

Wyoming —  welcome home wherever that may be.

It’s a Bird, It’s a Plane, No It’s OSU

We were so pleased a couple of weeks back to welcome Ohio State University and Buckeyes Without Borders to the Frontera of Intibucá for the first time. It seemed a bit strange that it was their first time here on a brigade in as much as Shoulder to Shoulder has been all things Ohio since its founding twenty seven years ago. It was somehow appropriate that they stayed in Santa Lucia where Shoulder to Shoulder first stepped foot on the Frontera. The presence of history was with them. In some ways it felt like we were welcoming our distant cousins for dinner for the first time. But in other ways they were truly new and unique.

Buckeyes Without Borders reached out to us in the Fall of 2016 to discern the possibility of arranging for a service trip. They are a professional student organization. Most of them were Doctor of Pharmacy students. They were excited to come and they certainly trumped up the interest for their first excursion with Shoulder to Shoulder. They faced the challenge of finding medical providers to join their brigade. At first this looked grim as they only found one provider and she wasn’t from OSU or even Ohio. But we managed to hook them up with three additional providers looking to join up with existing brigades. That changed the distinctive Ohioan flavor as the doctors came from across the US, giving the brigade an intercontinental flare. They ended up with twenty participants. That’s a pretty big number for us and presented us with a few additional challenges. They stayed at the main clinic at Santa Lucia, taking up all of the available bunk beds and mattresses; a few of them slept on couches and floors. They did field clinics each day, so they all piled into the beds of three pickup trucks and bounced along rough roads for an hour or more to arrive at distant villages. It was a good thing they were mostly young.

So the “Ohio connection” kind of set us up to think that this would be a familiar experience. But it was anything but familiar. New and innovative, Buckeyes Without Borders has opened up a new chapter for Shoulder to Shoulder and our service to the small, isolated communities in the rural Frontera.

At the clinic in Santa Teresita
At the clinic in Santa Teresita

About a year ago I was walking to the clinic in Concepción and I noticed a group of about six children looking up into the sky and pointing at something. Naturally, I looked up but didn’t see anything out of the ordinary. I went over to them and asked them what they were so excited about. One answered me, “It’s a plane, right?” and then I noticed what I had missed before. A jet stream slowly marked a path across an otherwise blue sky. I was of course too familiar with seeing jet streams to even notice, but to these children it was something new and exciting. About two months ago, I and Laura were at the bilingual school. There’s a large soccer field just beyond our property. First we heard it, then we saw its descent to the soccer field. A military helicopter was transporting some important figure to Camasca. Everyone came out to see it, and of course school was interrupted for the moment as all the children gathered to gawk at the once-in-a-life-time sight. Other than the birds, things usually don’t fly above us or descend among us here on the Frontera. When they do, they cause great excitement.

In a sense, OSU and Buckeyes without Borders flew above us and descended among us. Actually, this happened quite literally. Laura and I met up with the brigade the day they traveled to Santa Teresita. In this very small, isolated clinic, the brigade saw about one-hundred patients who had been lined up since early in the morning.  In the early afternoon, the crowd had thinned out a bit, and I stood outside in the blistering heat. I heard a buzzing, and assumed a nest of bees had been disturbed. But then, in a déjà vu sort of way, I noticed a group of children looking up and pointing. Once again, I couldn’t see what was causing the excitement. Paul Woo came with the brigade group as a cameraman, videographer, and documentarian. Apparently, among his apparatus he had brought a radio controlled drone that was now circling the heads of the remaining residents of Santa Teresita and videoing the scene. This is not a very ordinary sight in Santa Teresita and I imagine for years to come families will be talking about it. Later in the afternoon we traveled to the river that borders El Salvador so that we could take a swim and cool ourselves off. There were a number of locals there. The arrival of the large group of Americans got everyone’s attention. Then the drone came out again. The Americans were oblivious. The Hondurans fixed their gaze upward. Manna from heaven.

River Fun
River Fun

Things fly over us and descend among us causing great excitement. It’s mostly about the novelty of it all. The jet flying overhead in Concepción and the helicopter descending into Camasca stirred up the crowds by the sheer oddity of happening. And yet, no one’s life was altered, nothing really was permanently changed, just something out of the ordinary. OSU and Buckeyes Without Borders were certainly out of the ordinary both for Shoulder to Shoulder and for the Hondurans in and around Santa Lucia they came to visit. But they did more than drop from the heavens. They met people, they served people, and they connected. They will be remembered not only because they flew in, presented themselves as something new and unique, then flew out again. They will be remembered because they invested themselves in the lives of those whom they met. They too will remember how they were touched by the people they came to serve. Yes, flying overhead and dropping out of the sky is certainly impressive and exciting. I suspect when OSU and Buckeyes Without Borders return, those who they came to serve will point back to the sky and become enlivened. It will not be because they are seeing something unfamiliar. It will be because those whom they have come to know are returning.

 

Thank you Buckeyes (and those who are not) for dropping out of the sky and finding us.

As the Crow Flies

“As the crow flies…” is a great expression, probably a little bit overused in the US.  We don’t hear the expression here in Honduras very much. Primarily, I guess, because we don’t have too many crows. We do have vultures, “zopilotes” we call them, and they fly across the mountains with great ease. Perhaps that’s more the reason why the expression doesn’t get used that often here. It is just a little too depressing to think on how quickly a zopilote crosses from one mountain peak to the other, a matter of a minute or two, and then to think that the same trip takes up to an hour or two in a four-wheel drive pickup. It’s just a little bit too humbling to think that nature is that far ahead of human ingenuity. Here, the terrain and the elements of the natural world continue to present tremendous challenges to human dominance. Perhaps not so much in the US. Here, we prefer to not remind ourselves how much easier it is to be a crow or a zopilote.

View from Pinares Clinic
View from Pinares Clinic

The Frontera is a really small place, less than 700 square kilometers, smaller than El Paso, Texas. But, there are no straight lines and nothing is ever level. One goes north to arrive at a destination to the south, or up in order to go down. This counterintuitive travel is yet worsened by roads that would not merit the designation of a road in the US.  Steep volcanic mountains are breathtakingly beautiful, but living within them is hardly practical.

San Marcos de La Sierra is the first municipality that one encounters in the Frontera, driving south from La Esperanza. The road here is still at a high elevation and one doesn’t really see any evidence that people live here. Virginia Commonwealth University and Fairfax Family Practices have been coming to this area three times a year for many years. They were just here once again. We dropped them off at the school and clinic in Pinares and we came back about a week or so later to pick them up. If we didn’t know what they do while they are there, we might assume they just hang out and admire the tremendous vistas they are privileged to view. But we do know better.

Old Woman with walking stick
Old Woman with walking stick

Hiding behind those mountains, across ravines and beyond the treacherous slopes, are about 9000 residents. Few of them make their way to the health clinic. This is not surprising. They are poor, simple people. They have all they can do to maintain a small home and, if they are fortunate, a small plot of land on which to farm. They travel to a river for water. They collect wood for a fire to cook humble meals.  They battle daily with a harsh, unforgiving environment so that they can stay ahead of a mortality curve. They remain unseen, forgotten, abandoned, invisible if you will, except for the zopilote vultures that circle their heads. If anyone is going to know these people, if anyone is going to care for them, treat their illnesses, recognize their dignity, then it demands going to them. They can’t come to us.

VCU / Fairfax inside the clinic
VCU / Fairfax inside the clinic

We sometimes look naively upon a just response to inequity and poverty. It would be easy to sit outside the school at Pinares where VCU / Fairfax houses their service team and admire the beauty of majestic mountains. It takes insight, compassion, and even sacrifice to gain the view of a zopilote that flies beyond the mountains with ease. For the doctors, students, translators and volunteers, they brave the rough terrain to make their way to unseen, ignored people who live in poverty. They climb into the beds of pickup trucks, squished in among the bins of medical supplies, and bump along to destinations where most anyone would not dare to go. They stare down the cliffs as they go. They stop when they can go no further with a car because the road has fallen down the mountain. They sling their supplies over their shoulders and into backpacks. Then they walk. Perhaps even as they trek along, they wonder about this odd journey:  going south to arrive to the north, and up in order to get down. Then they finally arrive in a little village, a place mostly unknown. Maybe they look up and see a zopilote circling their heads. Perhaps they indulge themselves with a knowing smile.

Community Meeting
Community Meeting

This is how we discover people. We make our way along treacherous journeys. Once again, VCU / Fairfax has made their journey to reach a poor, forgotten, invisible people. The people they have met are happy and grateful for the encounter. For this journey, to have arrived to where the crow flies, everyone has been enriched.

A Gentle Breeze

We’re in the midst of our brigade season. We started February with UHMLA’s tremendously successful surgery brigade in La Esperanza. At the same time we welcomed the Brown / Wingate team to their clinic in Guachipilincito. Dr. Harris came a week early for that trip, and Dr. Tanksley has stayed on and will be there until May. The small MSHEC brigade, that I’ll speak about more, came just as the first two brigades were leaving. VCU / Fairfax / SAGE is presently working in Pinares. Board members and a whole bunch of good hearted individuals interested in assisting us in our education and nutrition missions are arriving this week. When they leave, we’ll transport our new mission partner, Ohio State University, to Santa Lucia for their generous medical mission. When they finish up, Wyoming will travel to their clinic in Agua Salada. That gets us finally to April, and Laura and I will finally breathe.

Health Fair at San Juan de Dios
Health Fair at San Juan de Dios

Don’t get me wrong, all of these people are incredible and they do incredible work. It’s just that we find ourselves a bit overwhelmed in February and March with the barrage of these groups. And where everything is new for all of them, Laura and I find ourselves doing the same things over and over for two months straight. It’s oddly ironic that this onslaught corresponds with the start of February and Groundhog Day. We pick up, transport, and drop off the various groups that all begin to look the same. We give them the same orientation, the same history of Shoulder to Shoulder, and when we answer the same question for the twenty-seventh time, we do our best to make it seem like we’ve never heard the question before, “Is it safe where we’ll be staying?” But these people have generous hearts, they are providing invaluable services, and just because things are commonplace to us, we need to be aware that these are once-in-a-lifetime experiences that inspire, enrich, and enliven those who come here and those whom they serve. We do our best to keep that attitude in the front of our minds. Still, we find ourselves yearning for the unique experience that can touch us as powerfully as it touches them and those they serve.

Dr. Kyle with a patient
Dr. Kyle with a patient

And how will that happen: with a lightning bolt, or by way of an earth shaking event? Elijah looks for God in the strong wind tearing apart the mountains, then in an earthquake, and then in a fire. God is not there, but God is found in a gentle breeze (1Kings 19:11-13). MAHEC came to Camasca and every afternoon they sat on our porch. Ostensibly, they came to use our internet that by luck is better than any internet available in the town. But for us, their daily presence was a gentle breeze that reminded us that there is a sweetness to life that should not be sacrificed for all the tremendous work that we are given to accomplish. It was an opportunity for us to find something much more profound than all the important work that we do. We became invested in coming to know a few very special people. It is the gentle breeze of friendship.

Braxton at the bilingual school
Braxton at the bilingual school

There were only seven of them: doctors Keith, Kyle, Winona, and Amy; the pharmacist Irene, the pharmacy student Melissa, and Amy’s 13 year old son Braxton (who spent his days at our bilingual school). They were humble and unassuming, four of them veterans to Camasca and the MAHEC brigades. They fit in to Camasca as if they were already residents and family of this town. Because they were so unassuming, it would be easy to forget the great service they provided. Every day they went off to the surrounding communities with Dr. Rolyn, the medical director for Shoulder to Shoulder here in Camasca, to provide field clinics and home visits for many who had not even seen doctors for years. They held a health fair in San Juan de Dios and that community received them with music, food, joy and appreciation. Braxton had a great time with the younger children at our school. On Saturday we brought  them to the waterfall just over the border in El Salvador. On Sunday, Laura joined them on the climb up the Cerro Brujo (Witch’s Mountain). But every afternoon, they sat on our porch, stretched out in a hammock, and watched folks pass by on the main street below our house; a gentle breeze that softens and sweetens life.

Mahec with friends at the waterfall
Mahec with friends at the waterfall

For Laura and me, MAHEC gave us a great gift by the ease of their presence. We want to thank them. For Camasca, MAHEC’s service was exceptional. But here too, I think it is the gentle breeze that will be missed. Amy, Winona, Keith, Kyle, Irene, Melissa, and Braxton are friends of so many here in this small, quaint town of Camasca. The only payment for friendship is friendship. It is not something achieved, but only enjoyed as a gift of the heart. I walk out on my porch every afternoon and I feel their absence. I smile to know that they will return again. The gentle breeze focuses me on what is truly important.