Category: Health

It’s been a particular long and challenging brigade season. From January 7 through March 26, 2017 we have given welcome to six separate medical teams onto the Frontera. Apart from these official medical brigades, we have also hosted two groups traveling with our board president, Wayne Waite, who came to strengthen and extend our education mission, as well as a couple of special visits. During that period, there has only been about ten complete days when we were not hosting visitors, about 100 of them in all. We pick them up at the airport and transport them from there to here and all around. We make sure they have hotel rooms, tents, mattresses, mosquito netting, or at least a stretch of ground upon which to sleep. We provide them translators, or we sometimes are their translators. We make sure they have food to eat, beverages to drink, and guard against a Honduran microbe that might make them ill. We see to it that their journeys and the services they perform are meaningful for them and for us. It’s a lot of work. And so, when the Wyoming / Agua Salada brigade flew back to the States on Sunday the 26^th, we did breathe a sigh of relief to know we wouldn’t host another brigade until the last week of May. Still, it’s a bitter sweet feeling. Yes, we will have a little more time to rest, but we will also miss our friends.

Wyoming is the best example. They were the first brigade that Laura and I met when we took our position with Shoulder to Shoulder in November of 2014. Linda, the leader of the Wyoming brigade, was there then and she has been on every brigade since then, a total of six trips. Though we’ve never been to her home in Wyoming, she’s become a dear friend. The same for Ron, the doctor, and Larry the dentist, who so often travel to the small community of Agua Salada.  It’s sad to see them leave and know we have to wait another eight months for their return. We will miss them. They too, I think, will miss us.
They really can’t be called visitors anymore. There is too much familiarity. Linda, like the student that sits in the same seat in her classroom, sits on the same seat on the bus for the six hour trip to and from the airport every time.  And she scurries every time she arrives in Agua Salada so that she can place dips on her favorite place to sleep. On this trip, Ron introduced me to a man for whom he removed a skin tag from his eye years ago before the clinic was even built. Larry extracts hundreds of teeth on every trip, but on this trip he proudly announces that a few patients are asking him to save a tooth rather than simply yanking it out. This is progress — a result of years of working to change a cultural understanding of dental hygiene. Larry is also intimately familiar with the septic system at Agua Salada. It doesn’t work so well, and there is nothing that will breed familiarity better than intimacy with a broken septic system. They don’t live here, to be sure. After a week or ten days, they fly off again to homes in Wyoming, very far away from Agua Salada. But they don’t really qualify as visitors anymore. When was the last time you sent your dinner guest out to unclog your backed up toilet?

But this is what makes this service of Wyoming so special and effective in terms of a mission of development. There are a lot of brigade groups that come to Honduras. There are companies here that serve their every need. Like Laura and I and Shoulder to Shoulder, they pick them up, provide for their transportation, housing, and food, and present them to communities where they perform their services. But it is the differences between those companies and us that are striking and telling. First, that’s all they do. They have no medical mission apart from the groups they host. They have no relationships with the towns and the people they bring the groups to. The groups they bring are not committed to the people they serve. They see them once, they pull some teeth, give out some Tylenol and anti-parasitic medicine, and in one to two weeks, they are flying back to the States. This is not a bad thing to do. It’s definitely valuable service.  But, in the end all they are is visitors. Visitors are not invested, and because they are not invested, the work they do is not transformational. There is no development. Wyoming, on the other hand, comes home to Honduras. That is what makes the difference.

Larry recognizes a change in the sense of dental hygiene only after years of attempting to teach people the value of good, dental care. Ron sees a man year after year who he was fortunate to once remove a skin tag from his eye and give him better sight. Linda knows the parteras (midwifes) well enough to ask them about the children they have brought into the world. She hosts a luncheon for them. They share their stories. The eighty-six year old midwife, who has been one since she was fourteen, tells how she has never taken a payment for her work. Instead she explains to the group how after the birth, she does the laundry and cooks the meals for the mother who needs rest. Linda, well familiar with this woman’s life journey, asks her how she involves the father in the birth of the child. Then something truly incredible happens. The eighty-six year old midwife takes the role of the husband. A student takes the role of the mother.  The student taking the role of the mother sits on the midwife’s lap, who encloses her in a tight embrace. It makes us all laugh. But we see how it takes commitment and embrace to welcome life into the world.

If they were visitors, none of this would happen. Trust, dignity, and an abiding understanding of the worth of relationship is what engender development. The students that come are indeed visitors. They are there for the first, and frequently only, time. They learn techniques in the administration of medicine. They learn about the challenges of providing health care in a developing, resource challenged area. But they also learn that without an abiding commitment and the dignity of relationship, its value is limited to the effectiveness of a single intervention. But health, well-being, and development:   these things require that you take the time to become comfortable in someone else’s home. These are the things that Wyoming brings to Agua Salada.

Wyoming —  welcome home wherever that may be.

We were so pleased a couple of weeks back to welcome Ohio State University and Buckeyes Without Borders to the Frontera of Intibucá for the first time. It seemed a bit strange that it was their first time here on a brigade in as much as Shoulder to Shoulder has been all things Ohio since its founding twenty seven years ago. It was somehow appropriate that they stayed in Santa Lucia where Shoulder to Shoulder first stepped foot on the Frontera. The presence of history was with them. In some ways it felt like we were welcoming our distant cousins for dinner for the first time. But in other ways they were truly new and unique.

Buckeyes Without Borders reached out to us in the Fall of 2016 to discern the possibility of arranging for a service trip. They are a professional student organization. Most of them were Doctor of Pharmacy students. They were excited to come and they certainly trumped up the interest for their first excursion with Shoulder to Shoulder. They faced the challenge of finding medical providers to join their brigade. At first this looked grim as they only found one provider and she wasn’t from OSU or even Ohio. But we managed to hook them up with three additional providers looking to join up with existing brigades. That changed the distinctive Ohioan flavor as the doctors came from across the US, giving the brigade an intercontinental flare. They ended up with twenty participants. That’s a pretty big number for us and presented us with a few additional challenges. They stayed at the main clinic at Santa Lucia, taking up all of the available bunk beds and mattresses; a few of them slept on couches and floors. They did field clinics each day, so they all piled into the beds of three pickup trucks and bounced along rough roads for an hour or more to arrive at distant villages. It was a good thing they were mostly young.
So the “Ohio connection” kind of set us up to think that this would be a familiar experience. But it was anything but familiar. New and innovative, Buckeyes Without Borders has opened up a new chapter for Shoulder to Shoulder and our service to the small, isolated communities in the rural Frontera.

About a year ago I was walking to the clinic in Concepción and I noticed a group of about six children looking up into the sky and pointing at something. Naturally, I looked up but didn’t see anything out of the ordinary. I went over to them and asked them what they were so excited about. One answered me, “It’s a plane, right?” and then I noticed what I had missed before. A jet stream slowly marked a path across an otherwise blue sky. I was of course too familiar with seeing jet streams to even notice, but to these children it was something new and exciting. About two months ago, I and Laura were at the bilingual school. There’s a large soccer field just beyond our property. First we heard it, then we saw its descent to the soccer field. A military helicopter was transporting some important figure to Camasca. Everyone came out to see it, and of course school was interrupted for the moment as all the children gathered to gawk at the once-in-a-life-time sight. Other than the birds, things usually don’t fly above us or descend among us here on the Frontera. When they do, they cause great excitement.

In a sense, OSU and Buckeyes without Borders flew above us and descended among us. Actually, this happened quite literally. Laura and I met up with the brigade the day they traveled to Santa Teresita. In this very small, isolated clinic, the brigade saw about one-hundred patients who had been lined up since early in the morning.  In the early afternoon, the crowd had thinned out a bit, and I stood outside in the blistering heat. I heard a buzzing, and assumed a nest of bees had been disturbed. But then, in a déjà vu sort of way, I noticed a group of children looking up and pointing. Once again, I couldn’t see what was causing the excitement. Paul Woo came with the brigade group as a cameraman, videographer, and documentarian. Apparently, among his apparatus he had brought a radio controlled drone that was now circling the heads of the remaining residents of Santa Teresita and videoing the scene. This is not a very ordinary sight in Santa Teresita and I imagine for years to come families will be talking about it. Later in the afternoon we traveled to the river that borders El Salvador so that we could take a swim and cool ourselves off. There were a number of locals there. The arrival of the large group of Americans got everyone’s attention. Then the drone came out again. The Americans were oblivious. The Hondurans fixed their gaze upward. Manna from heaven.

Things fly over us and descend among us causing great excitement. It’s mostly about the novelty of it all. The jet flying overhead in Concepción and the helicopter descending into Camasca stirred up the crowds by the sheer oddity of happening. And yet, no one’s life was altered, nothing really was permanently changed, just something out of the ordinary. OSU and Buckeyes Without Borders were certainly out of the ordinary both for Shoulder to Shoulder and for the Hondurans in and around Santa Lucia they came to visit. But they did more than drop from the heavens. They met people, they served people, and they connected. They will be remembered not only because they flew in, presented themselves as something new and unique, then flew out again. They will be remembered because they invested themselves in the lives of those whom they met. They too will remember how they were touched by the people they came to serve. Yes, flying overhead and dropping out of the sky is certainly impressive and exciting. I suspect when OSU and Buckeyes Without Borders return, those who they came to serve will point back to the sky and become enlivened. It will not be because they are seeing something unfamiliar. It will be because those whom they have come to know are returning.

Thank you Buckeyes (and those who are not) for dropping out of the sky and finding us.

“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.