Category: Universities

December 3, 2014
My wife Laura and I spent yesterday mountain climbing. It wasn’t intentional. We were visiting San Marcos de la Sierra. From where the bus dropped us off we walked straight down, probably 1500 feet to the town center. A little later in the day we visited a second community of San Marcos called Aguacate, on the other side of the highway. We walked back up to the highway, then descended the other side, probably about 2000 feet. Returning to the highway at the end of the day to leave, we took the shortcut up, a harrowing path that most mountain goats would think twice about traversing.
The people who live in San Marcos face these difficult uphill climbs daily, both literally and figuratively. There is little to no income or jobs in San Marcos. Most families are subsistence farmers living hand to mouth. They are isolated in this most remote, rural, and rugged territory. Poverty means malnourishment, poor health, shorter life expectancy, more risk of child mortality, less education and little opportunity for success, and all of this while scaling mountains.
 

These people are easily lost and forgotten, even by the rest of Honduras. That is why what is happening with the Universidad Nacional Autónoma de Honduras (National Autonomous University of Honduras, UNAH) is something very special. When Laura and I arrived at the center of town, we saw an unusual sight. The presence of even a car or truck would have elicited special note, but here were three large buses from UNAH parked alongside the church.  They had brought in the seventy plus students and faculty. Generally we think of brigades, medical or otherwise, as coming from the outside, foreigners with abundant foreign resources. But here were Honduran students and faculty responding in a generous and intense way to the needs of this small municipality and its people. The commitment of UNAH to the people of San Marcos clearly articulates a powerful message:  You are not lost nor forgotten by the rest of Honduras.
There would only be one full day of the brigade, so it was no surprise to see the long lines outside the public school building where the doctors and nurses were. We’ve become somewhat acquainted with the medical brigade motif. But things here were different.   The most obvious difference was that there were no translators. This allows for a deep sense of trust and respect, something that for all the best intentions of foreign brigades cannot be reproduced. We had already met the engineering students in the main plaza area of the town, discussing the town’s unique water problems and how they might be addressed. At the clinic area itself, in each of the examining areas, a law student or a lawyer was present for legal consults. Here were doctors, nurses, orthodontists, lawyers, engineers, teachers, biologists, and so many more. It seemed every profession discipline that could possibly assist this small town community was present. We even met a social worker. Laura and I are both social workers, and we had long since given up on meeting a Honduran one. It bought us great joy.
So why were all these professions present at a one day medical brigade? It seems the university’s commitment is way beyond the one day brigade. As the mayor of the town, whom we met with later in the day in Aguacate, told us, this is a “convenio” (covenant agreement) that will last for decades. This is not about giving a person a lift up the hill one time, leaving them off at the side of the road to wait for the bus, then scooting off to Tegucigalpa in your Land Cruiser. No, this is about commitment and building relationship. This is a partnership. The brigade was for a day, but the relationship is ongoing. They’ll come back next year for another day’s brigade. But over the course of the year, there will be a great deal of communication and ongoing work; the mayor with the university, the university with Shoulder to Shoulder, the health center of the town with the university, the various local associations with the university, and so on. Francisco Portillo, the social worker, explained it to us as an ongoing needs assessment and a continual search for creative resources; going up and down the hill.

We had a great day climbing mountains. We thank Manuel, one of Shoulder to Shoulder’s health promoters, and Carlos, Shoulder to Shoulder’s health data collector, for guiding us around all day; Paola Barrientos, nursing department at UNAH, who has a ton of energy and is thoroughly dedicated to this project; Doctor Maricela Figueroa, one of the brigade leaders, who graciously shared the inclusive mission of their work; the mayor of San Marcos; and so many others.
…. and if there are tall mountains to climb, we’ll climb them together.

November 22, 2014
She hasn’t had a good night sleep since coming to Honduras.  It isn’t sleeping in a tent on a concrete floor under the stars.  The tent, after all, is placed over a semi soft mattress.  It’s not the time change, only an hour’s difference.  The tropical warmth doesn’t seem to bother her, even though she does live in Wyoming and it is mid-November.  Those squirmy and crawly things are close by, but she’s not the type to jump up on a chair at the threat of a mouse.  What is it then that keeps her awake half the night?  She had once been told, and always believed it to be true, that roosters only crow to greet the sunrise.  Actually, and this is not scientifically proven, roosters crow because they abhor silence, beginning their wrenching screams sometime around midnight and only slowing down sometime after dawn.  Unfortunately, here in the frontier region of Intibucá, in the small village of Agua Salada, this tone-deaf choir outnumbers the human population by at least three to one.

On Tuesday she is dragging a little bit.  Perhaps that’s why the brigade leaders have given her light duty, fitting and distributing reading glasses.  Still, when it’s real slow, she might be asked to assist with an injection or minor surgery.  On occasion the pharmacy gets busy and she’s called over to fill prescriptions.  On Monday, one of the leaders guessed that they saw about 120 patients.  Perhaps everyone had shown up on the first day, but on Tuesday there are actually more.  The word must be traveling to the more outlying districts.  Whether tomorrow will bring more, or whether it might start to wane, no one is sure.  But hundreds come, lined up for hours, to see one of the four doctors available; to get a diagnosis, a prognosis, a word of assurance and comfort sometimes in broken Spanish and sometimes via translators, a medication, a treatment, and some relief.

If that is all the Wyoming Brigade does, it’s certainly a great deal.  But the generosity extends beyond the clinic and into the homes and lives of the residents of Agua Salada.  They came with hygiene supplies.  They came with school supplies.  They now provide school scholarships for five local children and look to provide more.  This is not simply about a generous gift, but rather it is about the commitment of relationship.  The University of Wyoming partners with the community of Agua Salada and Shoulder to Shoulder such that enrichment, development, transformation, and meaningful growth are deeply rooted into the hearts of all involved:  brigade members, beneficiaries, community leaders, and all who are committed to the relationship.
Later in the day when the lines are receding, the young nursing student who hasn’t gotten much sleep due to the rude roosters, might have slipped away to grab an hour or two siesta.  She doesn’t speak Spanish, but all day long she’s been using the international language of play with children.  I spy her now with two girls, maybe seven and eight years old.  They are fully engrossed in a game of “patty cake” — mimicking, mirroring, and hand slapping.  The smiles on their three faces, the sign of commitment and love, are the most powerful medicine that the University of Wyoming has distributed all day.

Between June 11 and 22, a medical brigade from Virginia Commonwealth University joined Shoulder to Shoulder in the Pinares area of San Marcos de la Sierra. Since 2006, VCU has regularly visited this area. They visit three times annually, and generally include medical students, family medicine residents, and family medicine faculty. Over the years, they have brought dentists, sociologists, pharmacists, nurses, public health workers, and interpreters with them.
For two weeks, this group of physicians, medical students, pharmacists and PharmD candidates, MPH candidates, nurses, a paramedic, and student-translators from the bilingual school in La Ceiba engaged the community in the established Children’s Health Initiative (CHI) at local schools and treated patients at the Pinares clinic. The brigade also took in the U.S.A.-Honduras World Cup qualifer event, crowding into a small pulperia with most of the local community to watch the game. Aside from a few bruised egos, the American win did not cause any international incidents.
Every day, the brigade split into two teams. One group treated patients at the Pinares clinic, treating farming injuries, providing prenatal check-ups, pregnancy exams, and more. The CHI group hiked to a different school each day and set up health stations to address all areas of the children’s health. These included measuring height and weight, taking their hemoglobin, eye exams, fluoride rinses, and visits with physicians.
During one home visit, the brigade examined a 31-year-old patient who had been experiencing abdominal pain. The man had not eaten or drank anything for over a day, and hadn’t moved in two days. Entering the darkened home, the brigade was greeted by a prayer group who had been standing vigil over the sick man all day. The brigade members evaluated the man and determined he needed hospital treatment. As a team, the brigade carried the patient up the steep slopes to the road and drove him to the hospital.
The Pinares and outer communities in San Marcos de la Sierra are very remote and mountainous. Away from the main road to La Esperanza, many locals must walk for hours to receive medical attention. VCU’s CHI group enabled them to evaluate and treat a large volume of geographically diverse group of needy children in the schools. Throughout the year, Shoulder to Shoulder’s health promoters and home health medical teams visit these remote communities and homes to ensure that children, elderly, pregnant, and high-risk patients are receiving the attention they deserve.
Thank you to VCU for your tremendous team effort and support of the Pinares and San Marcos de la Sierra communities!