Author: Paul and Laura Manship

Linda Johnson, NP, the leader of the University of Wyoming brigade experience in Agua Salada, has just been recognized by the university in the reception of the Faculty Award for Internationalization. Congratulations Linda!!  Read about it at http://www.uwyo.edu/uw/news/2016/04/uws-linda-johnson-honored-for-work-in-honduras.html.

Wyoming University has been coming to the small village of Agua Salada for many years. They built the clinic there and have developed a very rich and meaningful relationship with the local people. Generally they see a great many people while they are here, sometimes as many as 100 a day. The service that they offer is stellar. They are busy from start to finish with little time to relax or reflect.

They were in Agua Salada this past Holy Week. This brigade did not unfold in the same way as past brigades. In deference to Lemony Snicket and Jim Carrie, we experienced a series of unfortunate incidents. Shoulder to Shoulder was a bit taxed this year with eight groups arriving in the month of February. This was an all-hands-on-deck experience. Whereas, we were often very challenged, stretched, and stressed, we managed without making any major mistakes. However, we did not follow-up to insure that the promotion of the Wyoming brigade had taken place in Agua Salada. It was also Holy Week. Everyone, including our staff, has Holy Week off. So Wyoming had a very slow start and they did not see the tremendous numbers of people that they had in past visits.

We were very apologetic, and because we have a long-standing, fruitful relationship with Wyoming, they were very graceful and forgiving in their response. Also, because it was Holy Week, Laura and I had more time to be present to the brigade. We were able to spend almost the entire day with them on Thursday. They were seeing patients, perhaps less than on pervious brigades, but they were busy. The mood was light while we were there, everyone seemed grateful for the opportunity to be there. On this particular day, the brigade welcomed the parteras (midwives) for an appreciation lunch. The oldest midwife from the community was present. Her sense of joy in being received by the brigade was extremely moving. Later in the day, we sat down to a meeting with the local health committee, and the Shoulder to Shoulder health promoter and nurse for the area. In the meeting that sense of mutual respect and appreciation seemed to deepen. The sharing in terms of what Wyoming could do to foster the ongoing health work within the community deepened an already secure relationship. I’m not certain, but I was beginning to have the feeling that the brigade’s less hectic experience was forging something even greater. Wyoming will be back in November and they will see a lot of patients again. They will return, perhaps, with even a greater appreciation for the value of the relationships they built and sustain. It only takes money to build a clinic. It only takes medical professionals and supplies to offer medical care. It takes so much more to fully invest oneself into the lives and world of others. Perhaps the series of unfortunate events had a fateful purpose.

Laura and I also traveled with the Wyoming brigade to Tegucigalpa for their flight out. On the night before their flight, we sat down to share in reflection on the participants’ experiences. Gratitude was a major theme; gratitude for the time and space to come to know the people of Agua Salada. The other theme present was the feeling that everyone had offered quality health care. I understood this as meaning that the service was offered with integrity and compassion.

I suspect that Wyoming brings their medical students to Honduras and Agua Salada in order to equip them with a Global Health Care experience. But this is not a box to be checked off on your resume of life. It is not accomplished by simply being there and doing the expected work. The satisfaction of coming to know another person from another culture in a foreign environment requires the willingness to give time, space, and respect. Wyoming sees a great many patients, but the real value they offer is in the quality of these encounters, and not their quantity.

Over the last couple of months Shoulder to Shoulder has a lot to be proud about in terms of the quality of medical services that we have provided to an isolated, and often neglected, people. We do this regularly, of course, by the contractual agreement we maintain with Honduras and the International Development Bank, providing ongoing care to over 65,000 persons on a daily basis. Still, that care is conditioned by the scarcity of resources. Our brigade teams from universities and other organizations augment that care by way of their generosity and commitment. Through February and March we have had nine brigades, and their efforts are best described as herculean. The overused adjective is awesome, though according to our experiences over the last two months, this adjective is clearly appropriate. Our first ever surgical brigade provided relief and healing to persons who had absolutely no hope for any attention to their discomfort and pain. Brown University partnered with Wingate University, School of Pharmacy to provide a level of care and treatment to the small village of Guachipilincito unparalleled in even the most developed areas of Honduras. Cleveland Clinic, Christ Church and pharmacy students from the University of Michigan literally changed the makeup of the small community of Camasca by arriving 34 strong, a sustained force for healing and wellbeing. Even mentioning these brigades, I do a disservice to the others who were equally impressive in their singular commitment to service in justice. I feel exceptionally privileged to witness all of this, and mostly I stand with my jaw agape knowing that I possess neither the skill nor the stamina to accomplish such awesome results.

Becoming so impressed by incredible undertakings, achieved with such professional talent and skill, it is easy to miss a more subtle offering of compassionate service. The University of Minnesota, School of Nursing, under the leadership of Dr. Marti Kubik, recently visited Santa Lucia and the surrounding small communities of that municipality. Like the other brigades, they too offered professional service and care of exceptional quality that impresses and astounds. The School of Nursing plans their service with great attention to the needs of the ongoing medical interventions that Shoulder to Shoulder will continue to offer once they have left. It is a very well thought out brigade, and very much meets with our mission and philosophy of providing sustainable, quality health care. Laura and I met up with them on their last day in Santa Lucia. They were offering trainings to health care volunteers who live in some of the remotest areas of our territories.

These volunteers are perhaps some of the most uncelebrated individuals within our health care system. They do not have job descriptions. They receive no compensation. They are provided very little by the way of training. They are placed very low on our organization structure. What they do have are hearts of compassion to be present to those suffering within their communities. On this day they were filled with gratitude as the nursing students recognized the importance of their presence and commitment. They had a workshop on nutrition and how to maintain healthy habits of living. They learned how to transfer persons having become physically challenged and dependent. They learned about end of life care. Watching this, I could almost physically note the aura of gratitude present among these humble, sincere volunteers. The integrity of their service met with the recognition from the nursing brigade of the value of their service. Whereas the particulars of what they learned in the trainings will most certainly benefit the persons they return to in their communities, the appreciation of who they are and what they do is the pearl of incalculable value.

Certainly we should all be impressed with the awesome undertakings of skilled professionals over the course of these last months. The quantifiable results of such herculean efforts should be celebrated in full voice. But let us not forget that things need not be extraordinary in order to be recognized and appreciated. Some middle-aged woman is sitting in an adobe hut with her neighbor who is in her last moments of life. She has few skills save for those that are born of a compassionate heart. Her presence and attention to her dying neighbor honors the value of her neighbor’s life and her own. The nursing brigade from the University of Minnesota is also honored and appreciated in the sacred exchange.

If you follow these blogs you will know that the last blog featured MAHEC’s five person brigade in the small community of Camasca. They did excellent work, but their presence was subtle. Shortly after they left, Dr. Brent Burkey and the brigade he put together from Cleveland Clinic and Christ Church arrived in the same community of Camasca. This brigade was anything but subtle. When they agreed to add seven pharmacy students from the University of Michigan, the brigade totaled 34 persons. In this little town of Camasca, the presence of 35 North Americans speaking English does not go unnoticed. The 34 managed to stay at a church in the center of town, but the translators they hired needed to be housed in local homes. For the ten days they were here, Laura and I had a lot of fun just walking into the town and seeing them. They were all over the place, walking about in small groups, hanging out in the central plaza, and engaging the townspeople. For that short period of time it seemed as if Camasca had become Main Street, USA.

Of course they did so much more than just walk around and hang out. The medical teams went out in two groups every day to the smaller surrounding communities. They saw and treated patients, held health fairs, and established empowering relationships. The community service folks spent time every day at our bilingual school offering a day camp with music, storytelling, and art projects. They also involved themselves with projects in the town, the most prominent of which was the mural painting of the walls to the town’s sport center. For all of the brigade members, there was a spirit of joy and celebration that imbued their time with the people of Camasca. The town sponsored a welcome party. At the going away party everyone took part. The brigade members witnessed traditional Honduran music and dance while the town enjoyed some folk and perhaps a little rock and roll.

This celebratory spirit seemed to grow and transform the town. Perhaps the symbolic metaphor of that was the painting of the sport’s center wall. Bright colors replaced the chipped and faded paint and icons of faith, peace, service, and community were prominently displayed; a permanent gift of remembrance and hope. One particular project on the wall seemed particularly poignant. One late morning the children at the bilingual school were bussed down to the wall in small groups of four. Each child from the school and other children from the town got to dunk his or her hand into a can of paint and leave his or her impression against the wall. The hands formed a snaky trail along the wall. It expressed the wonder of the journey of life.

When people come to know one another, when they move beyond differences and fear, something truly wonderful occurs. Things get built, people get served, celebrations erupt, but most importantly the beauty of life is revealed. One of the young women on the brigade, a student at the University of Michigan, wrote a thank you note to the mayor Julio and his wife Iris. Iris and Julio have long been faithful and committed partners with the work of Shoulder to Shoulder. Iris shared with us the thank you note. The young woman writes, “It was an honor to have been able to come to your town and serve your people. I hope and pray that I can one day return to Camasca and see its beauty again.” Camasca is indeed beautiful, even more so now for having enjoyed the experience of finding new friends.

Photography courtesy of James McClintock