Impressive

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.

Nursing Brigade at the Clinic
Nursing Brigade at the Clinic

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.

Health Volunteers Stretching
Health Volunteers Stretching

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.

Transferring Roll Play
Transferring Roll Play

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.

Don't Mind Us, We're Fine

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.

MAHEC brigade at the bilingual school
MAHEC brigade at the bilingual school

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.
Down time at the school
Down time at the 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.
Henry with the kids
Henry with the kids

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.

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.

Surgery in Honduras by UHMLA
Surgery in Honduras by UHMLA

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.
UHMLA / StoS Team
UHMLA / StoS Team

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.
Dr Rolandelli with young patient
Dr Rolandelli with young patient

“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.
Dr. Rolandelli with Dr. Susan Kaye
Dr. Rolandelli with Dr. Susan Kaye

There are at least sixty-two persons who have benefitted because a few good-willed persons did not accept inequality.
 
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photos courtesy of UHMLA via Facebook page