Category: Brigades

“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.

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.

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.

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.

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.

Like most people, I know very little about medicine and the intricacies of my physiology. I probably should know a lot more. I’ve certainly been sick or injured enough times during the course of my life, and often dependent on the services of medical professionals. They always tell me what’s wrong with me, the diagnosis, how they intend to fix me, and the treatment. But I hardly listen. Maybe it’s because I’m afraid of my own fragility or mortality, but I’d rather just trust that they know what to do – close my eyes, take the medicine, and hope for the best. What’s most important to me is that doctors and medical professionals have a specialized knowledge of what makes me tick, and that they can treat me with unparalleled competence. I can then consider them gods, always able to fix me no matter how ill or broken I might present. Of course, this is a rather naïve way to approach that which is most important to me — my health and well-being.

We are privileged to see a lot of medical professionals who come to this tiny part of the world to practice medicine. I am always impressed by the wealth of knowledge they carry with them. They know all about biology and science, and they know how to perform exact interventions that make sick people well. This is of incredible value, and the people living here on the Frontera, without regular access to such expert knowledge and intervention, are eternally grateful. Perhaps they, like me, would want to think of these visiting, medical professionals as gods. Clearly, they should be honored and respected for their dedication and service, but there is something much more basic about health and well-being than knowledge and expertise. The really good, medical professionals understand these basic principles, shun the temptation to be godlike, and embrace the dynamic relationships that make individuals and communities healthy.

The Brown / Wingate mission to the small community of Guachipilincito has invested in these dynamic relationships over many years of service to realize a system of sustainable health and well-being. They were here again recently at the clinic they built and maintain at Guachipilincito. Dr. Harrison and a well-seasoned, professional team with dentistry, pharmacology, and students provided direct care, offering effective interventions. As impressive and important as this direct care is, the health initiative of Brown / Wingate happens beyond this direct care. At an earlier visit to Guachipilincito, they polled families at home visits, asking them what they thought could be done to make their community healthier. They said they wanted to come together in a social context and learn about how to be healthy. So on this trip, Brown / Wingate offered a health fair at their clinic. People who had never come to the clinic or seen a doctor, mostly men from the community, showed up. The medical staff screened for chronic diseases and found two individuals who were suffering with diabetes and didn’t know it. They are now receiving treatment and training to manage their disease. The community learned about health relative to nutrition, the extremely dangerous amounts of sugar present in soda, candy, and snacks that are unfortunately so readily available and cheap on the Frontera. The teenagers from the community offered a hilarious skit on maternal health and birth. Music, good food, stimulating conversation, and a rich sense of friendship guided the evening. Perhaps the visiting, medical professionals lost some of their god-like character in the evening’s festivities, but sustainable health and well-being within this community was certainly advanced.

Brown / Wingate’s “health fair” is happening in so many ways at Guachipilincito apart from those times when they visit and offer direct care. A feeding and nutritional program is ongoing, supported and run by nurse Lesby who lives in Guachipilincito and regularly buys and distributes fresh healthy food to families in need. Dr. Dan Harris came a week early to Guachipilincito to be invested in the life of the community. Dr. Simon Tanksley has remained in Guachipilincito and will be there for three months. He will treat individuals while he is there, but he will also learn from them. He will discern with them the best means of creating and maintaining health for individuals and the community at large. Meanwhile, Brown / Wingate will consider how they can deepen their commitment and service to this isolated and resource challenged area of our world.
The road to Guachipilincito from the neighboring town of Concepción is easily one of the roughest, most challenging in all of Honduras. It is a distance of less than ten kilometers, but it takes over forty-five minutes to arrive there in a four-wheel vehicle. You can almost arrive there walking quicker than in a vehicle. The people living there are desperately poor. It is a place where it is easy to become a god. Though that temptation is great, being a god is as unfulfilling as it is ineffective. Being a friend is so much more challenging, and ultimately so much more healthy.

Perhaps then, health is not solely about specific, expert interventions from people otherwise unconnected to their patients. Perhaps it’s about listening. Perhaps it’s about investment in committed relationships. Perhaps it’s about partnering with individuals and communities. Perhaps it’s about the recognition of the inherent dignity and sanctity of shared human experience. Perhaps health and well-being is everyone’s responsibility, not just those of the gods who happen upon a moment of crisis, illness, or injury. The Brown / Wingate brigade travels to Guachipilincito across the challenging terrain. Because they are committed to the ongoing journey of reaching the people there, they can claim that they are assisting in the creation of sustainable systems of health and well-being.