Did you ever feel like you were getting lost in the shuffle? Mountain Area Health Education Center (MAHEC) must have felt that way while they were visiting Camasca on their brigade a few weeks ago. They were here for two full weeks, doing amazing work, but we must apologize for not giving them a lot of attention. I feel like I need to put some effort in my excuse for being so inconsiderate. There were only five of them: three physicians, one pharmacist, and one exceptionally talented fifteen-year old named Henry (son of Amy, one of the physicians). Five people can easily get lost, right? Besides, the whole time they were here, we had all sorts of other, bigger brigades coming and going. Our first ever surgical brigade demanded a great deal of our attention. Not to mention Brown/Wingate in Guachipilincito, VCU/FFPCS in Pinares, and a dental brigade jumping back and forth between Concepcion and Santa Lucia. February was one tremendously busy month. So, if the five people who spent time in Camasca felt as if they were neglected, you are probably right, and we’re sorry. But no one ever complained.
Perhaps I’m being a bit hard on myself. Truly, these five individuals were not at all demanding. If the squeaky wheel gets the grease, the quiet wheel simply turns unnoticed. The MAHEC brigade members unpretentiously arrived in town and checked into the local hotel. They got all their meals at the restaurant. Every day, they simply walked over to the health clinic or they spent some time at our bilingual school doing health screenings and playing with the kids. Henry, the fifteen year old who has fallen in love with the little town of Camasca, spent his days at the bilingual school. Henry was doing so well at the bilingual school that we were trying to sign him up as a volunteer. There’s that crazy little catch about having to finish High School.
He and his mom had been here before. MAHEC is very familiar with and well known by the town of Camasca. It wasn’t any big deal for them. I guess they just kind of blended in. Their service was actually profound, but it was administered with such subtlety that it demanded no praise. I realize now why it was that the few times I had the fortune to visit with them I felt so relaxed. It was as if they were saying to me, “Look, just leave the special china in the cabinet. We’re good with the plastic ware.” There’s an integrity in such service that we would all do well to emulate.
They seemed to do it all on their own with very little help from us. But lest you all think that we didn’t notice the amazing work you did, the beauty of the just relationships you committed yourselves to, and the special place you hold in the hearts of the people of Camasca and particularly the students at our bilingual school, we just want to say THANK YOU. I’m sure you’ll be back. Don’t forget to tell us when you’re coming.
Extracting Pain vs. Inserting Wellbeing
Long before our arrival at Shoulder to Shoulder when Laura and I were contemplating living and working in Honduras, we took a few exploratory trips to discern where we might find a site. We attended a conference in Copan Ruinas for NGOs serving in Honduras. At this conference there were a number of folks who regularly came to Honduras on dental brigades. The dentists were bragging about the large number of extractions they had accomplished. The braggadocio with which they expressed their accomplishments gave me the sense of a gunslinger carving notches in the ivory handle of his pistol. It didn’t seem to us as if ripping teeth out of peoples’ mouths would be something that most dentists would celebrate. Yet, we were in the proverbial Rome, and we would do as the Romans.
Now having lived in Honduras for some time we can easily understand why the practice of extractions, particularly in rural areas among people of extreme poverty, is so common. Dental care is either nonexistent in remote areas or inaccessible for poor people. For most suffering with chronic pain from infections and other dental complications, extractions are the only option. The dentists that come on brigades to pull teeth are offering a service that is greatly appreciated. Yet, this approach has some terrible, tragic consequences. The more these extractions become available, the more dental care becomes identified with extractions. The notion that dental care is about prevention, hygiene, and regular professional attention is completely lost. Among poor people and in extremely remote areas of Honduras, ongoing, professional, dental care is considered unnecessary.
Whereas extractions might be graciously appreciated and absolutely necessary to relieve chronic pain, this is certainly not development. Actually, it is its opposite: stifling the opportunity for an understanding of the need for good, dental hygiene and ongoing professional service. It standardizes a substandard praxis that will never promote development. It is disrespectful, basically yielding to a belief that poor people do not deserve anything better than a compromised response. Why does this inequity exist? Why are we willing to relegate dental care to the pulling of teeth? Why is there little emphasis on dental hygiene and professional dental care? Why would we acquiesce to a notion of dental hygiene and care that would never be accepted in the developed United States? The answer to these questions is not challenging. It’s because it is the easy response.
Charity, commitment in service, and development are never easy, though perhaps we would want them to be. They require engagement and investment. They require partnering. They require appreciation and respect for the potentials among the people served. They requires years, lifetimes really, of time, talent, and energy. Shoulder to Shoulder, particularly under the leadership of Jan and Larry Tepe, envisioned something more meaningful and sustainable in terms of oral hygiene and care among the people of Southern Intibucá. Shoulder to Shoulder established dental clinics with professional full time Honduran dentist in order to create and sustain the development of a culture of wellness. The simple response would have simply been to yank out pain where it was found. The just response is to eradicate the insidious systemic conditions that create the pain in the first place. The simple response takes a brigade of limited time, involvement, and relationship. The just response takes a sustained commitment of years and decades, an investment in the dignity and potential for a people’s development.
Dr. Larry Tepe, Dr. Elizabeth Mueller, Emily Mason, dental hygienist, and Cathy Doughman, dental assistant, were recently here on a one week dental brigade. They saw a great many patients. I’m certain they did a few extractions. But more important was their attention given to our Honduran dental staff. Dr. Larry spent a good deal of time repairing and maintaining our dental equipment, critical to the ongoing care at both clinics. There were long conversations in professional sharing such that the ongoing dental services continue to advance the sustainable development already achieved. There was no bragging about how many extractions had been accomplished, no notches carved into the dentists’ pliers and clamps. The success of the brigade is subtle. It is not easily identified. The celebration of the success is not to be found in the swelling of a dentist’s ego. Rather it is present in the advance of a people.
A particularly ironic occurrence on the brigade should be noted. Dr. Larry came on the brigade realizing he was actually in need of an extraction of one of his wisdom teeth. He, like most of us, would have liked to put this off. But the pain and discomfort became intolerable on one particular morning. So many US dentists have come to Honduras and extracted so many teeth. It somehow seems poetically appropriate that Dr. Larry would solicit Dr. Idalia Marilez Ramos to extract his tooth and relieve him of his pain. She did it with grace and expertise and Dr. Larry was the one who was grateful. The competence and professionalism of Shoulder to Shoulder’s dental mission is a source of tremendous pride. Shoulder to shoulder, the development of sustainable systems of well-being, make possible that which was considered impossible.
Photographs courtesy of Emily Mason’s Facebook
Acceptance
Eleven years ago over Christmas I was feeling ill in my stomach. I had to be convinced to go to an emergency room. I drove myself up there. Seven hours later I was waking up in an operating recovery room with the loss of about sixteen inches of large intestines and my appendix and the gain of a colostomy bag. I had a perforated bowel. Who knew? The colostomy bag was successfully reversed some two months later, thank God. Then about five years ago, I was diagnosed with kidney cancer. A kidney along with the cancer was removed, and I have not had any further difficulties. My first thought in reflecting on those experiences is how grueling and anxiety provoking were those periods of my life. My second thought, a little less self-pitying, is to be grateful for the treatment that in both instances saved my life. Imagine how fortunate I am. Two professional surgeons with years of training and experience were readily available to cut out significant organs from my body. I had health insurance to cover the extreme cost of such an important intervention. It is an incredible world we live in when such highly specialized skilled services can be channeled with ease in order to benefit someone who suffers great physical discomfort even to the risk of death.
But, this is not so the world over, and it is certainly not the case for us here in this isolated and often forgotten territory of Honduras. For people here, there simply is no access to surgery. The closest hospital might be six hours away. Even so, the surgery may not be available there and the cost would be absolutely prohibitive. Many simply have to accept living with great discomfort, and in some cases there are much worse consequences including shortened life-spans. Having lived in a land of such fortune as the United States, it bears heavy on one’s conscience to witness such inequity. Some might shrug their shoulders and say that things are the way they are, and there is little to do to change it. Others find it unacceptable to shrug their shoulders, but instead shoulder the burden. They provide the witness that the inequity does not need to be.
Such a witness is Dr. Rolando Rolandelli and his surgical team from Unidad Hospitalia Móvil de Latino América (UHMLA). Sixteen persons (four surgeons, three anesthesiologists, one assisting physician, three recovery nurses, three operating nurses, one floating nurse, and one translator) came to La Esperanza, HN to provide gastro-intestinal surgeries through the week of March 20 through March 26. They united their good-will with Shoulder to Shoulder and the hospital surgery team and staff. They performed sixty-two procedures (50 surgeries and 12 office procedures). For these sixty-two persons this was not even the most remote possibility, and yet it has happened. Many of these persons literally owe their lives to this incredible undertaking.
“The only thing necessary for the triumph of evil is that good men (sic) do nothing.”
It is not clear who first said this, but John F. Kennedy often cited it. It is a very interesting quote in its premise. It does not attribute the triumph of evil to a lack of good persons, but rather to the lack of good persons’ actions. Most of us are good, but too few of us actually act. Dr. Rolandelli and his team do not accept the inevitability of inequality. They are unwilling to do nothing. What they did, and what they continue to do, actually changes the world. It is not our goodness that is laudatory; it is the willingness to act. Perhaps someday even the people who live in the Frontera of Intibucá will also not need to accept living in physical discomfort and the threat of death when the resources to treat them are readily available in other parts of the world.
There are at least sixty-two persons who have benefitted because a few good-willed persons did not accept inequality.
To discover more about UHMLA, or to become a good person of action, go to
Facebook: https://www.facebook.com/UHMLA/?fref=ts
Website: http://www.uhmla.com/
photos courtesy of UHMLA via Facebook page