Blog Archives - Page 42 of 73 - Shoulder to Shoulder, Inc.

May 15, 2016August 4, 2023

Elevations

Most of my life I’ve kind of hung around at the same altitude, give or take about 1000 feet. I suspect that is mostly the case for anyone living in the US. Our elevations don’t vary tremendously from day to day or hour to hour. That is not the case here in Honduras where everywhere you look there is the remnant of another volcano standing in your path. Almost every Saturday morning I wake up at 1624 feet in Concepción. I get on a packed bus with thirty some other people, at least as many backpacks, and sometimes a chicken or two and begin to climb. About one hour and forty-five minutes later, having traveled along 34 miles of road a total distance of 22 miles, I find myself in La Esperanza at 5577 feet. It’s colder and clearer, the air much thinner, and the whole world seems changed. On Monday morning, I do the reverse, shedding layers of clothing on the way down. Everything changes in the rapidity of ascents and descents.

Rapid changes in elevation is what best seems to describe Maine-Dartmouth’s experience on their recent medical brigade to Colomoncagua, Intibucá. It’s safe to say they started out at or about sea level in Maine. Because of the irregularity of flights from Maine to Boston to Tegucigalpa, their odyssey lasted almost two full days, and, by the time they caught up to us in La Esperanza, they were exhausted. Flying in and out of the heavens, they were diverted from their final destination in Tegucigalpa to return to almost sea level at San Pedro Sula. Back in the air quickly thank God, they arrived at Tegucigalpa, 3248 feet, where Shoulder to Shoulder was waiting for them. Up and down a few dozen times more in an escort van, they finally got to the highest city in Honduras, La Esperanza at 5577 feet. Oddly, the weather they experienced, the damp and penetrating cold, might have reminded them of the late April weather of Maine that they had just left behind. There only for one night, their elevation changed drastically again, falling about four-thousand feet to arrive in Concepción. After a brief bathroom break and tour of our main clinic in Concepción, they winded back up another mountain pass to finally settle in Colomoncagua at 2576 feet. Talk about a roller coaster.

Older Man's Consult — Older Man’s Consult

Laura and I usually spend a good deal of time with brigades on their way in and their way out. We hear about their expectations on going in and share in their reflections as they leave. We might get a half day with them at their work site, but we’re busy taking pictures and they’re busy seeing patients. We did see Maine-Dartmouth on their way in. But we wouldn’t be available on their way out as we were already committed to important meetings. Because we would miss them on their way out, we decided to spend the weekend with them in Colomoncagua. We were so pleased that we got such a close up view of their rich experience.

The varied elevations, their varied experiences, and their varied characters and personalities weaved and waved in and out of their time together. But without diversity, harmony cannot be achieved. José was born and raised in El Salvador, a literal rock’s toss away from where we were, but Barbara had never been on a medical mission trip and spoke no Spanish. But their voices blended in a theme of service and compassion. We witnessed them working among the simple townspeople at the San Marcos clinic. They had come from so far away, had traversed high peaks and low valleys, and yet they all seemed as if they belonged. Laura and I felt privileged to be part of this concerto of care.

The next day was yet an entirely different experience. It was Sunday, it was May Day, it was Nancy’s birthday, and it was certainly time for fun. After a great breakfast and a visit to the local market where hand crafted leather belts, woven shoulder bags, and other local goods were purchased, we headed out to see the beauty pristinely hidden within nature. The waterfall dominates the natural amphitheater where the stone walls rise majestically above us. One further elevation to consider and explore. I watched them all under the curtain of the water’s fall. They surrendered to the experience of the moment, defined and enhanced by it, elevated to great heights and plunged to great depths. It is all so very enriching.

April 23, 2016August 4, 2023

The Character Of Service

The character of each brigade team that travels here to shoulder with us is unique. Some of them are much more seasoned than others and they know what to expect. Others are new to the game and they can be timid and uncertain. The seasoned groups are generally not as much work for us, but frankly they can also be a bit demanding. The newer groups are very open to direction, but, sometimes unable to be initiating, they require a great deal of attention. Sometimes the individuals on a team are overly fearfully, but others might be over confident. When we pay proper attention to a group’s character, we can help them process their emotional states such that they can feel at ease and focus on the work they have come to accomplish. This is the nature of what it means to be present to another culture, to be challenged by another language. It can be a transformative experience, but it takes patience and understanding on our part as leaders as well as on the part of the participants. We find that almost always this happens, but sometimes we have to work at it harder than at other times.

We didn’t know what to expect with the Buffalo School of Medicine that recently visited us for a week throughout the southern territories of Santa Lucia, Magdalena, and San Antonio. The Buffalo School of Pharmacy had visited us last year, and we thought of this group as returning. That was not the case at all as the School of Medicine is completely independent of the Pharmacy School. Being a new brigade group then, we expected that they would be timid, even a bit insecure. Our preconceived notions sometimes fail as with Buffalo who were anything but timid. The first year med-students planned out their medical mission trip and they did an excellent job in preparation. They researched the type of organization with which they wanted to involve themselves. Patrick, who had long-term experience in Mexico and Peru, and who was competent in his Spanish, wanted an organization that was providing regular health care and invested in a sustainable model of service. He and his team did not want to “parachute in” to provide health care that would have little or no follow-up care. They found Shoulder to Shoulder to meet their criteria and they studied the organization. When they got here, their questions were intelligent, insightful, and well related to the work they’d be doing. They were a good three steps ahead of first-time brigades and they hit the ground running.

We were fortunate to spend some time with them on their first night and next morning in our main clinic in Santa Lucia where they would be housed for the week. We had a special treat on their first night as it corresponded with Ever Bonilla’s, our Brigade Coordinator, birthday. Cake and coke is a time honored Honduran birthday tradition, as is the honored guest getting to wear some of the cake’s ingredients. The Buffalo students, residents, and faculty had no trouble joining into the celebration. We met up with them again about mid week in the small, isolated community of Las Marias, Magdalena. They had no trouble joining in here, either. Often at a field medical site one can sense a certain disconnect between the patients and the visiting team. It is to be expected in an environment of such cultural diversity. The people are always well served and tremendously grateful, but still a palpable feeling of hesitancy and awkwardness is in the air. This was not the case at Las Marias with the Buffalo team. There was a sense of belonging, order, and flow that carried a sense of relaxation and confidence. There were a whole group of kids there, who are sometimes forgotten. But today they were being treated to chasing soap bubbles, having stickers attached to their shirts, receiving toothbrushes, and then happily being medically examined. The Medical Students were seeing the patients and then consulting with the doctors. There was a grace of movement in the whole process.

At Ever's Birthday Party — At Ever’s Birthday Party

Throughout the week, the Buffalo team met with local doctors, nurses, medical professionals, and health promoters. They took overnight shifts for our emergency department at Santa Lucia. The conversations, the professional sharing, the willingness to be invested was again key to a feeling of belonging. It is a tremendous thing to offer service for people who are recognized as having need. But leaving our service there, simply responding to need, is a one way-street for which there is no way to return. Seeing people for who they are beyond their need, recognizing the dignity of their lives, and valuing their cultural experience as potentially enriching your own, this is service that is empowering. It takes so much more than specialized expertise and talent. It takes humility, commitment, and grace. The gratitude it generates for all who are involved is life enduring.

I assumed a particular character for the Buffalo brigade team based on my bias. How happy I was to be wrong. Whereas I thought it was my job to lead them by the hand through their challenging experience, their embrace of the people they came to serve taught me a great deal about the privilege of service.

April 12, 2016August 4, 2023

Quantity vs. Quality

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.