Tuesday, May 24, 2005

Turning this ship around

Last evening I prayed, I prayed to God to help us out a little here. Coming to Honduras this time I had many more expectations and a great deal more anxiety. Jenny too. She has given up her whole career in Mexico to fulfill a calling. She is finding out what Anita and Steven have already learned. Just because God leads you somewhere it does not necessarily mean the road will seem smooth. Where she comes from in Mexico it is very much like the States. They have fancy cars, fancy clothes, nice homes, heating and air-conditioning, bathrooms and hot water. She had a prestigious job and a decent salary. After her husband died she recognized that there was more to life. The bulk of her family is here in Honduras and so it all seemed to make sense. All that said it is not easy to give up for ever the comforts you know so intimately. Where am I going with all of this….

Since my arrival I think I was just going through the motions. I was absorbing the energy that Jen was sending which was one of desperation, anger and doubt. She has two children in college and this was probably not the most convenient time in her life to make such a drastic change. I can relate as I am sure many of you can as well. Last night as we seemed to be reaching rock bottom, with the Youngbergs needing to go to San Pedro to beg for a loan to cover the cost of the loss from the vocational school, Jenny throwing up her arms with the ignorance of parents and the prospect of changing a medical system in a country where I can’t get them to bathe made it all seem just plain impossible. However, suddenly we found ourselves laughing and talking about how God has influenced our lives. I’m not a bible pusher even though it may sort of sound like it right now, but something changed for us all with just that small conversation.

This morning I got up and I had hot water! It was a miracle…..maybe? ……actually two electricians from the states had arrived to help complete part of the new daycare area and they were not about to take cold showers. They went out back to figure out why the hot water wasn’t working, low and behold they discovered the people who live in the huts on the plantation had figured out how to work the pop off valve to get hot water so it was constantly empty. With great gratitude I began talking with the electricians, discussing the plans for a telemedicine system here and all the trouble I’ve had with up loading via satalite when suddenly the one electrician said that I was in luck as he worked with K-Love a giant satalite driven radio station in the US and he was sure we could work out something to increase the bandwidth. Then Jen arrived smiling and energized. She said “ Bridgette, I done prayed last night and I recognized what you all have been trying to tell me. I need to look ahead not behind, if I keep up with my thinking I’ll go crazy and rot here.”

Our first order of business was to speak with the local doctor to get his input on what would be the best improvement for the medical system here. We told him about some of the technology we could offer with some non-specific ideas about using electronic medical records and community health nurses. Then we waited patiently for him to be a neigh sayer. He is a crafty businessman and very successful. He doesn’t’ have any motivation to change the current system as he benefits quite a bit the way things are. However after barely a pause at all he lurched forward and began speaking with great enthusiasm. He was very supportive and he spoke the truth….it will not be esay and there are a great many obstacle but we need this! That was sooo great!

Then we went to see the Youngbergs and found out that the banker called them and asked if they needed a loan, they didn’t even have to try to find him. He had heard we were struggling and was proactive in helping. Anita and her mother nearly fell off the chair.

"It seems like we may be able to turn this ship around afterall".

In the end I recognized what changed…..we prayed, we let go and let God……

Monday, May 23, 2005

Bugs, Strides and Common Ground

Bug update: It took me a few days to de-bug my quarters, thanks to a bottle of Raid I smuggled in. It also took this many days to convince the plantel grounds keeper that having a bee hive outside my door was really not my idea of neighbors and I wouldn’t be lonely if suddenly they went away. This year I have added one more level of protection above and beyond my mosquito net, I have hung all my bags to avoid as much as possible bringing home more friends with me than what I left with. I do not wish to have a repeat of that event. More on that at a later date.

I had a successful day today. I was able to connect to the University by satalite and actually arrange for a mental health consult for one of the children terrorized by the bus shooting. I can honestly say I never had to council a child who witnessed her friend being shot in the face. I felt professionally crippled. What do you say……..I can’t imagine what the men and women in Iraq are going through daily. We have tragedy in the US that mentally traumatizes but it is not the usual and it is likely that a person will never have to live experience again……I can not promise her that, I can’t promise her safety. I decided that as with any traumatic experience for children it is important to let her talk about it as much as she needs to, giving her permission to experience all of her emotions rather than attempting to make her move on and bury those thoughts. We are going to have a group meeting for those involved and others who want to attend because they are experiencing fears. We’ll see, I would still like some professional advice.

Yestarday the guardsman caught two men trying to steal trees from the far corner. This is a beautiful plantation and some of the trees are very old making them worth quite a bit of money. They were able to cut down 3 pine trees before they were caught. One man they actually arrested the other escaped but everyone in town knows who he is so it is just a matter of time before he gets snagged. I don’t know what they were thinking. It is pretty difficult to hide a three story tree crashing to the ground mid day! The other two they had taken in the night and they were much smaller.

A note on road construction……they started working on the road that passes by the plantel ( a dirt road) last year when I was here, they put up a sign this week anouncing it would be only 8 more months to completly pave a 1.5 mile stretch. Not so different from Rochester.

And so I complete the day with chocolate cake that was made to celebrate Jen’s daughter coming home from college, three cultures, two radically different lifestyles, one common ground……chocolate!

Sunday, May 22, 2005

Back to Work

It’s 4:30 in the afternoon and I feel like a slab of bacon lying on a rock in the desert. The Hurricane passed and with it the cool weather. It had been so cold I was sleeping under my clothes layered over me like a blanket. The people here are not used to that kind of weather. In the end we had a load of rain but no major winds and no major mudslides. The government called it a national emergency and closed up the country in preparation. We were lucky because just like Haiti, there is no infrastructure to support a major storm. In October of 1998 Hurricane Mitch developed as a tropical wave in the Carabean Ocean and quickly grew to a devastating storm the crushed the coast of Honduras. Half of the mountain above Pena Blanca collapsed and washed out hundreds of little villages, killing thousands of people. The city of San Pedro was flooded and many people drowned. At that time there was a bit of warning and the government tried to evacuate cities and villages at risk but residents were afraid of looters and they didn’t want to leave what little they had. Honduras has yet to recover completely from those losses.

Now that the rain passed it was busy day in the clinic. Typically we see a great variety of illness some we can treat and inevitably some we can not. Today we ran the gamut from minor aches and pains to major social atrocities. One has only to listen for 5 minutes passed the chief complaint to get to the true illnesses behind many of the presentations. As I have said before, in this society it is very male dominated with woman having so few social rights. We are treating a few HIV patients and sadly enough the women do not feel they have the right to protect themselves from getting the disease. There is a feeling of powerlessness to rebel because of a lack of self worth combined with the economic constraints associated with the risk of single parenting. But that is not all, even deeper rooted in the social structure, there seems to be a sense of moral obligation to support the man’s wishes, even though they recognize it is a life threatening situation. There seems to be a similar situation in India which is leading to world health crisis as the number of HIV patients sky rockets daily. The awful part of the whole mentality is that a man with HIV is not shunned, but once a woman becomes positive…..they are worthless.

We are also still fighting the battle against TB. Right now the government still has no funds to treat the disease appropriately and resistant cases are popping up more and more frequently. We had a man today for which the health department did not even try to treat. We don’t have the resources to treat him either. Our hands remain tied in every way possible. We can only educate on how to prevent the spread of the disease. As you can see public health is equally as important as medical therapy.

We are meeting with the local doctors this week to discuss the pooling of resources. Hopefully we can develop a more effective medical model for the region. I recognize that to some this seems like a pipe dream, but if no one ever dreams it how can it come true…….

Friday, May 20, 2005

The Hurricane

The people in town are aware of the hurricane, word travels fast around here because it is such a small place. The children have been sent home from school. There is unfortunately nothing to be done for protection. Mother nature will have her way. I need to not spend much time with this letter as I must get back to the plantel before the bulk of the storm hits.

There is so much that happens in a day here it is difficult to convey. I feel more sad today as I am faced with more hurtles than I counted on and I feel more alone this time because my access to the outside world is not as strong. Learning the fate of a few of the children I cared for last year also broke my heart. Many of the changes we made though were positive and still have remained in place. Most importantly the bulk of the children are well and the dirty diapers are being burned!

I think one of the other pieces that is effecting me is the overall moral of the plantel which is bad this month. The orphange is not getting paid the money they were granted by the government for education and it has put a tremendous stress on the already small funds we had. People are frustrated and tired. It is difficult to get away from the many injustices I spoke of yestarday.

There was also a tragic event yestarday which effected a few of our families. A gang attacked a bus in a near by area and killed one boy and wounded several people. They were students and workers comming up the mountain on public transportation. Crime is a reality here but usually it is not so close. Pena Blanca is a small quiet village so this is not so common here. We are not in danger on the plantel because we have security guards and no one wants to hurt the hospital as many people rely on it, there is also nothing to steal. That said I would be lying if I didn't say it hurt my moral a bit too.

I will not give up. I came here with a purpose and I intend to accomplish as much of it as possible. Jen and I have tossed around a few ideas and we will continue. We both have extreme faith. We still have a vision of establishing a descent health care team with doctors, residents, nurses, social work and hopefully mental health workers to take care of poorest people. I try to remember that in the US it was once like this and we will need to evolve in much the same way.

The rain is harder now I better go....

Thursday, May 19, 2005

First Day Back to Honduras

4:00am comes early here. The rooster screams like clock work outside my window and there will be no rest for the weary.

Yesterday we drove up from the City. Our trip up the mountains would not have been complete if it had gone smooth. Through a long and convoluted story we ended up with a car which was “in good shape” which someone lent to orphanage in exchange for their truck just for the weekend. For those of you who know me know cars and I just have bad thing for each other. About ¾ of the way it started to over heat. Now imagine a car full of gringos sitting along side the road with 1 ton of luggage. Yeah you guessed it …..It would be a really bad thing. Luckily we had about 2 cups of water with some juice between us and we managed to limp it along to the entrance of the orphanage.

They finally brought to my room……and when I looked at the porch I actually started to laugh because it was just to perfect….they put a bee hive box outside my door and the whole porch was swarming with bees. I asked Jenny if this was a joke, she was laughing just as hard as I was. No, she said it’s not a joke they were told to figure out a way to get the bees out of the rooms and I guess they decided this was the way….. provide them with a home of their own! Okay so I thinking “I can do a lot but I am not going to walk up there, not gonna do it”. Jenny agreed and kindly invited me to stay with her last night until we get the whole situation straightened out.

Today I will check out the Clinic first to get a general idea of what has worked and not worked over the past year then we have planned a meeting at 2pm with the heads of each department to try and re-organize. We have a plan to improve work ethic and try to make some progress.

Jen said that the children are doing fairly well right now. Her biggest problem for the moment is a girl with epilepsy and mild mental retardation. She is having more frequent seizures and refusing to take medications.

I will try tonight to see if I can send email in town. We lost our satellite connection at the orphanage because the company was basically ripping them off. They were charging $900 dollars a month. We also have no phones because cellular company sent them a bill for $11,500 for which they refused to give a report of the calls made. Jenny and Anita spent the day yesterday in the court house filing a complaint. Some businesses here think because there are ties to America there must be money. It’s damn mess.

That said, and despite the bees and the car and the luggage I am glad to be back….I think….

The Interim Evolution of a Plan

After the leaving the plantel in Honduras it took time to readjust. My life in the states seemed extravagant and the guilt tremendous. Imagine the guilt you feel when you have ordered desert even though your full….now amplify that about ten fold. Every time I wanted to go to dinner or buy clothes I kept hearing a voice in the back of my mind whispering ..….that would be 1 box of lice cream or that would be 4 little beds or I could pay for another case of antibiotics with this money. The nightmares were relentless. After wrestling with my emotions and learning to acknowledge my anger over the severe injustice in the world it became clear to me that there was only one solution for me personally. I would dedicate the rest of my life and the skills God so generously provided me to people in need and in this moment those children need me and there are plenty of people in the poorest areas of our American cities who are suffering in much the same way.

The next year was filled with emails and calls and blessings from above. I was flying back from the American Academy of Pediatrics annual convention and I met a wonderful and very kind hearted gentleman who happened to be from Kodak. He related to my stories from Honduras and had a few of his own. Since that time we have been working toward developing a medical model that will work for the rural areas of Central America. There are, as Tracy Kiderer put it, “Mountains Beyond Mountains” to struggle with and climb before we get there, but if we don’t try then it matters to no one, if we try has the potential to “matter” for many.

Over the year there were several donations to help make things possible, Kodak donated a dental cam toward the project, Post Central a film editing company, provided a high tech lap top for collecting medical records in the field, fellow physicians and nurses from Rochester donated medical supplies, clothes, medical books and computers. I contacted every organization I could and was able to purchase several boxes of medications to take back with me.

Now I sit a year later loaded up like a pack mule trotting through the airport. If you saw me you would think I was homeless. I had on a dress with a big old straw hat (right out of a bad re-run of Hee Haw) a fluorescent rain coat tied at my waste and my stethoscope slung around my neck (I really did try to fit that sucker in my bag but it just wouldn’t go). To top it off I was lugging 2 body bags, a cheap black suitcase on wheels (which suddenly only wanted to turn sideways) and there was a giant camo bag stuffed to the brim on my back….ugh! The people at the baggage check were polite and supportive of my cause. Although they tested my bags for illegal drugs but didn’t hold me up. Now security was fun….. you have to practically strip naked to go through the little detector things and you have to take lap tops and electronic devices out of your bag and place them in bins along with your clothes. So here’s me hat shoes two jackets into a bin. Then I had to unpack my entire camo bag with the 2 lap tops, video cam, extra hard drive and camera then re-pack it on the other side and because I was traveling internationally I got to do it all a second time in Miami! …….Note to self……don’t use underwear as padding material in the future. The good news……they didn’t think I had a gun this time ( I left my ottoscope at home) and so they let me pass. I’m only half way there and Lord knows what will await me at the other end….

Monday, May 16, 2005

In the End

This will likely be my last email from Honduras. I will be heading to San Pedro in the morning. I plan on staying overnight in a hotel so I can decontaminate and grab a few hours of R&R prior to departure.

Over the past few days we've been working hard to tie up loose ends. A few of them simple, like, getting the curtains up where the children sleep to keep out some of the cold night time mountain air, completing the 30 little foam beds and burning the old ones. We also needed to de-lice the kids one last time which includes convincing the teenagers that having lice is not a fashion fad so they better start using the cream I gave them 2 weeks ago or else!

Then the few loose ends not so simple....

There is a woman living here in the tragedy of her own life and still allowing it to cloud her soul with anger, bitterness and contempt. She was married at a young age and bore 7 children. Her Husband had run away early in their marriage, for a brief time which resulted in an illegitimate daughter. Over the next several years he would beat his wife with in inches of her life on multiple occasions. His cruelty did not cease with his wife. Their youngest son was a mute. He ordered his wife to lock him up in a shed behind their hut and starve him to death. She could not. She would sneak away in the darkness and slide him food when ever possible. The man became extremely frustrated that this kid wouldn’t die, he felt they were too poor to care for such "waste". He eventually gave up after 4 years and released the child. His alternative means of decreasing the grocery bill was to shoot the oldest child and fracture the skull of the middle child. Quickly cutting the bill by 2/7ths. With the death of the children and the distance it placed between himself and his wife he decided to take his illegitimate daughter into his home as a trained concubine. With fear of her life and that of her remaining children his wife never left. One day the illegitimate daughter escaped to our orphanage. She was quickly found by this barbaric man and he took her back up into the mountains. It was this event that finally freed his wife. She learned of the orphanage through the illegitimate girl and believed it could provide her and her children shelter. She left in the night with no clothes or food and the 5 remaining children. She left the illegitimate child behind. I relate this story because we have been trying to pick up the pieces for her and get her back on track. It is certainly not simple and she too has hostile behavior which I can only assume is learned. We have been running interference for her children to prevent beatings or undue harm. It's not like the US where you can just call child protective. This story is sadly not so unique here. The poverty resulting in social decline that brutally demoralize a society, a culture, a family, a child, reigns supreme here in the hills…... This, a loose end I can not tie up, will haunt me.

Behind a locked door some weeks ago I spoke of the clothes and the old blankets that I found. I did not speak of the children I found. Two children had been being kept under lock and key by their mother when she worked on the plantel during the day. No one knew. It was terrifying and tragic. The good news is they seem no worse for wear at first glance but the reality of the torment will not be evident for years to come. We have been working on this as well. Again, years of mistreatment handed down through time is not an enemy easily defeated.

Now, after 30 short days, I have found pockets of peace and joy scattered amongst the rubble of a poor poverty stricken community forgotten by everyone except God. I have grown to love these children for what they are, at complete face value. I will not forget the lessons they have taught me...... the power of loss and strength, pride and community, hunger and heartbreak, need and want, desire and disappointment combined with the overwhelming ability of the human soul to find happiness in the face of a living hell. More importantly though I've learned about humility, my humility.

In time the names will be lost from recent memory, the building layout will seem foggy to my recollection and yes, I will forget about the bugs, but a piece of my heart will always be ....at home......somewhere in Honduras.....

Thank you God and all of those who have walked with me through this enchanting time.....

In the End

This will likely be my last email from Honduras. I will be heading to San Pedro in the morning. I plan on staying overnight in a hotel so I can decontaminate and grab a few hours of R&R prior to departure.

Over the past few days we've been working hard to tie up loose ends. A few of them simple, like, getting the curtains up where the children sleep to keep out some of the cold night time mountain air, completing the 30 little foam beds and burning the old ones. We also needed to de-lice the kids one last time which includes convincing the teenagers that having lice is not a fashion fad so they better start using the cream I gave them 2 weeks ago or else!

Then the few loose ends not so simple....

There is a woman living here in the tragedy of her own life and still allowing it to cloud her soul with anger, bitterness and contempt. She was married at a young age and bore 7 children. Her Husband had run away early in their marriage, for a brief time which resulted in an illegitimate daughter. Over the next several years he would beat his wife with in inches of her life on multiple occasions. His cruelty did not cease with his wife. Their youngest son was a mute. He ordered his wife to lock him up in a shed behind their hut and starve him to death. She could not. She would sneak away in the darkness and slide him food when ever possible. The man became extremely frustrated that this kid wouldn’t die, he felt they were too poor to care for such "waste". He eventually gave up after 4 years and released the child. His alternative means of decreasing the grocery bill was to shoot the oldest child and fracture the skull of the middle child. Quickly cutting the bill by 2/7ths. With the death of the children and the distance it placed between himself and his wife he decided to take his illegitimate daughter into his home as a trained concubine. With fear of her life and that of her remaining children his wife never left. One day the illegitimate daughter escaped to our orphanage. She was quickly found by this barbaric man and he took her back up into the mountains. It was this event that finally freed his wife. She learned of the orphanage through the illegitimate girl and believed it could provide her and her children shelter. She left in the night with no clothes or food and the 5 remaining children. She left the illegitimate child behind. I relate this story because we have been trying to pick up the pieces for her and get her back on track. It is certainly not simple and she too has hostile behavior which I can only assume is learned. We have been running interference for her children to prevent beatings or undue harm. It's not like the US where you can just call child protective. This story is sadly not so unique here. The poverty resulting in social decline that brutally demoralize a society, a culture, a family, a child, reigns supreme here in the hills…... This, a loose end I can not tie up, will haunt me.

Behind a locked door some weeks ago I spoke of the clothes and the old blankets that I found. I did not speak of the children I found. Two children had been being kept under lock and key by their mother when she worked on the plantel during the day. No one knew. It was terrifying and tragic. The good news is they seem no worse for wear at first glance but the reality of the torment will not be evident for years to come. We have been working on this as well. Again, years of mistreatment handed down through time is not an enemy easily defeated.

Now, after 30 short days, I have found pockets of peace and joy scattered amongst the rubble of a poor poverty stricken community forgotten by everyone except God. I have grown to love these children for what they are, at complete face value. I will not forget the lessons they have taught me...... the power of loss and strength, pride and community, hunger and heartbreak, need and want, desire and disappointment combined with the overwhelming ability of the human soul to find happiness in the face of a living hell. More importantly though I've learned about humility, my humility.

In time the names will be lost from recent memory, the building layout will seem foggy to my recollection and yes, I will forget about the bugs, but a piece of my heart will always be ....at home......somewhere in Honduras.....

Thank you God and all of those who have walked with me through this enchanting time.....

Danger Still Lurks At Every Corner

Looking back now, when I first came to Honduras I heard a great many bad stories about crime, kidnapping, corrupt government news and carjacking but truth is I didn't really think it affected me because I'm not criminal nor I do I hang out in shady areas. Well I was wrong.

Last year the man who is responsible for my ability to email, his name is Dago, was coming back from San Pedro at night a year ago. (I believe I have mentioned the warnings we've had about night driving in past emails.) He oddly enough heard a round of fireworks in the distance just about 30 seconds before a large truck pulled up beside him flashing them a quick look and a head gesture that suggested Dago should back off. Dago looked in his rear view mirror in time to see a car flipping off the road behind him. The truck sped off apparently chasing the car in front them, two seconds later the man from the truck stuck his hand out the window and fired a few shots at he car he was chasing causing the car to flip off the road. Dago told us that story a while ago but it stuck with us.

We needed to go to San Pedro for a follow up appointment regarding my illness. It had been a long day, a long wait and there were several errands to run. We went to the hospital to try and find the boy from the mountains. We learned from a girl that comes down from the mountain every few weeks that the boy with the mass in his groin actually did leave with his sister for San Pedro but never returned.....we couldn't find him in the hospital. Needless to say the day drug on and soon it meant placing us in the dark for the way home. "Yeah they say it's not safe but is it overblown?" "Do we really need to be that strict and careful?" We all thought the same way and there were 5 of us in the car coming back together in the dark.

Suddenly on the same tiny little dirt road Dago spoke of before, only 30 minutes from home, we saw a lot of lights in the distance. As we came closer we could see it was two large trucks stopped in the center of the road. In our attempts to be careful we were watching the road hard and luckily had spotted them quite early (about 1/3 of a mile away). We slowed down our approach in time to see them jog the trucks to cover more of the road making it impossible to pass. We came to a stop, still quite a ways back, and debated for about 30 seconds whether to wait or proceed or turn around. It hit us all at the same moment...."don't sit here that's what they want!" We simultaneously but anxiously yelled for Anita to turn around. She gunned it and did a donut right in the middle of the road, turning us 180 degrees. We sped off in the other direction as fast as that beat up dodge could go! We drove an extra 55 minutes out of the way to arrive safely back at the plantation. All a little shook but no worse for the wear.....

Progress

Small respite, big payoff! Found I had a renewed energy for continuing with our plans. I was also able to see of the accomplishments we've achieved. For instance, we fired a worker in the kitchen. She refused to do what was best for the welfare of the children. This was an act of tough love. The girl had been raised here on the plantation, but she was sort of like ....well, Typhoid Mary and it was too great a health risk to keep her on. Actually, I believe she has reached a point in her life where she needs to move on to the next step. She has a high school diploma so she's got a shot.

Other accomplishments: teaching them to cover the food to keep flies away. We had a trash pit built that they burn every night to keep the dogs from getting in the diapers (still chuckling about a comment....but, what will the dogs eat now?) Cleaned up the clinic ...except for the hidden room that was kept a secret until a few days ago (more on that later). We have hired a nurse in place of the girl in the kitchen. Arranged a new work schedule that has an adult supervising the children on each shift instead of older children. We painted most of the hospital in pastel colors...pastel not usually my scene but it's better than dreary, rotten brown. We are getting a handle on the lice and scabies. Still no shoes, floor still wet, the new beds aren't finished yet (can't get em dry) and not brushing their teeth so many of the front teeth are rotting out. Lastly, strep throat and pneumonia keep kicking our butt.

The answer to last problem is multi factorial but I'm finally making head way. I'll explain. One of my favorite past times here is playing a game called "Where's the Medicine Now". It's been like asking your child what happened to the homework! Great for after dinner entertainment, not so great for running a hospital. We have noticed that we are seeing all these children and giving them medication orders but mysteriously the children haven't been responding to our oral regimes only the Intramuscular treatments that we give directly. Well... doesn't take a brain child to figure out something didn't add up. In fact, what we found was, the medication was going nearly everywhere and anywhere except into the proper children's mouths. Each shift check we were replacing medicine, so of course we thought they were giving it. But alas, when we began to question the workers about the abnormally high consumption, we heard the following..... "the children spilled it", "we let all the children have a little taste cause they like it so much", the dogs took it", "It just disappeared in the night". We also found "medication potpourri". A mixture of medications with no names and not ordered by us, being given willy-nilly for every complaint. So I made medication administration records that did not require the ability to read and write. We are making each shift responsible for the medication via salary or product deduction for missing supplies and we're trying to educate them on the uses of various classes of medication.

I'm really not patting us on the back but acknowledging improvements, the real importance of team work, communication and persistence against all odds......because that's what I need to remember.

PS: Isadora, our child that was wheel chair bound, can cruise furniture by shuffling....I've got high hopes.

Progress

Small respite, big payoff! Found I had a renewed energy for continuing with our plans. I was also able to see of the accomplishments we've achieved. For instance, we fired a worker in the kitchen. She refused to do what was best for the welfare of the children. This was an act of tough love. The girl had been raised here on the plantation, but she was sort of like ....well, Typhoid Mary and it was too great a health risk to keep her on. Actually, I believe she has reached a point in her life where she needs to move on to the next step. She has a high school diploma so she's got a shot.

Other accomplishments: teaching them to cover the food to keep flies away. We had a trash pit built that they burn every night to keep the dogs from getting in the diapers (still chuckling about a comment....but, what will the dogs eat now?) Cleaned up the clinic ...except for the hidden room that was kept a secret until a few days ago (more on that later). We have hired a nurse in place of the girl in the kitchen. Arranged a new work schedule that has an adult supervising the children on each shift instead of older children. We painted most of the hospital in pastel colors...pastel not usually my scene but it's better than dreary, rotten brown. We are getting a handle on the lice and scabies. Still no shoes, floor still wet, the new beds aren't finished yet (can't get em dry) and not brushing their teeth so many of the front teeth are rotting out. Lastly, strep throat and pneumonia keep kicking our butt.

The answer to last problem is multi factorial but I'm finally making head way. I'll explain. One of my favorite past times here is playing a game called "Where's the Medicine Now". It's been like asking your child what happened to the homework! Great for after dinner entertainment, not so great for running a hospital. We have noticed that we are seeing all these children and giving them medication orders but mysteriously the children haven't been responding to our oral regimes only the Intramuscular treatments that we give directly. Well... doesn't take a brain child to figure out something didn't add up. In fact, what we found was, the medication was going nearly everywhere and anywhere except into the proper children's mouths. Each shift check we were replacing medicine, so of course we thought they were giving it. But alas, when we began to question the workers about the abnormally high consumption, we heard the following..... "the children spilled it", "we let all the children have a little taste cause they like it so much", the dogs took it", "It just disappeared in the night". We also found "medication potpourri". A mixture of medications with no names and not ordered by us, being given willy-nilly for every complaint. So I made medication administration records that did not require the ability to read and write. We are making each shift responsible for the medication via salary or product deduction for missing supplies and we're trying to educate them on the uses of various classes of medication.

I'm really not patting us on the back but acknowledging improvements, the real importance of team work, communication and persistence against all odds......because that's what I need to remember.

PS: Isadora, our child that was wheel chair bound, can cruise furniture by shuffling....I've got high hopes.

Folded

After a very long night Friday due to nausea, bugs and bad dreams from something in the medical field we call poly-pharmacy (which in English jeans too dam many drugs). Three antibiotics, an antifungal, an ant malarial and lets not forget the wormer……I feel like a sow being readied for market. Under the pressure, shamefully I folded. In every country sadly enough there are the “Haves” and “Have nots”. I am somewhere in the middle here with enough to buy things but little to buy and no resources to use what is bought making me a “Pseudo Have”. Deciding to become a temporary “Have”, I through my camo bag in my circa 1975 Hyundai (on loan) and drove to the lake where the 4 star resort hotel is located and laid down the plastic! I wanted a hot shower, warm food and a chance to lounge by the pool all day!

The hotel was really beautiful. As you drive in you first notice the grounds, a lot of it. It is isolated without competition from other monstrous hotels and knick knack shops that are the routine in most resort cities around the world. The landscape was impeccable with a combination of fantasy island meets golf course with the lake off in the distance and the grounds completed by two horses grazing about. There was a stereo typical Tike hut bar with an octagon shaped pool. Brilliantly colored flowers, all sizes and shapes, lined the walkways and the architecture was quite modern with giant angled columns finished in light mustard colored stucco. Up close the place was a bit run down. It had a faded sign out front, rust in the door frames and the halls inside were empty. Apparently it had been closed for years and only recently re-opened.

Literally the only person there, in the spirit of it all, I ordered a Pine Colada (yep took a risk on the ice thing but figured with the amount of antibiotics on board it would take a bacterium the size of a small child to grow) and laid out my towel by the pool….. sun blazing (for once no rain, as if even God new I’d had enough), a perfect light breeze and promptly burned myself to crisp tortilla! Yep in 2 hours time I had a sun burn that made me look as if I painted my self with pink nail polish. Ugh!

I stayed long enough to get cerviche and their version of filet mignon. The cerviche was excellent but I’m not really sure what part of the cow (if it was a cow) was in my filet but all in all it was pretty tasty stuff especially given my vegetarian diet of beans rice!

All in all it was a beautiful few hours with lots of time to ponder life and what meaning this whole experience has brought to my life. There was a surreal moment when I was standing out on the veranda overlooking the water, alone, with the sun setting, pouring a bright light across the land in front of me in stark contrast to the thick dark clouds folding in around the mountain peaks in the distance…..I felt peace and sadness simultaneously. A world so beautiful both because of its rough undeveloped crust and in spite of it. In time it too will be overdeveloped and sprawling taking on a new set of social problems and inequities. We fight one battle only to bring on a new one but that is the nature of progress. The people here don’t realize that and have a difficult time understanding the nature of our interventions, can’t help but wonder if they might actually be the wiser sometimes…..

Folded

After a very long night Friday due to nausea, bugs and bad dreams from something in the medical field we call poly-pharmacy (which in English jeans too dam many drugs). Three antibiotics, an antifungal, an ant malarial and lets not forget the wormer……I feel like a sow being readied for market. Under the pressure, shamefully I folded. In every country sadly enough there are the “Haves” and “Have nots”. I am somewhere in the middle here with enough to buy things but little to buy and no resources to use what is bought making me a “Pseudo Have”. Deciding to become a temporary “Have”, I through my camo bag in my circa 1975 Hyundai (on loan) and drove to the lake where the 4 star resort hotel is located and laid down the plastic! I wanted a hot shower, warm food and a chance to lounge by the pool all day!

The hotel was really beautiful. As you drive in you first notice the grounds, a lot of it. It is isolated without competition from other monstrous hotels and knick knack shops that are the routine in most resort cities around the world. The landscape was impeccable with a combination of fantasy island meets golf course with the lake off in the distance and the grounds completed by two horses grazing about. There was a stereo typical Tike hut bar with an octagon shaped pool. Brilliantly colored flowers, all sizes and shapes, lined the walkways and the architecture was quite modern with giant angled columns finished in light mustard colored stucco. Up close the place was a bit run down. It had a faded sign out front, rust in the door frames and the halls inside were empty. Apparently it had been closed for years and only recently re-opened.

Literally the only person there, in the spirit of it all, I ordered a Pine Colada (yep took a risk on the ice thing but figured with the amount of antibiotics on board it would take a bacterium the size of a small child to grow) and laid out my towel by the pool….. sun blazing (for once no rain, as if even God new I’d had enough), a perfect light breeze and promptly burned myself to crisp tortilla! Yep in 2 hours time I had a sun burn that made me look as if I painted my self with pink nail polish. Ugh!

I stayed long enough to get cerviche and their version of filet mignon. The cerviche was excellent but I’m not really sure what part of the cow (if it was a cow) was in my filet but all in all it was pretty tasty stuff especially given my vegetarian diet of beans rice!

All in all it was a beautiful few hours with lots of time to ponder life and what meaning this whole experience has brought to my life. There was a surreal moment when I was standing out on the veranda overlooking the water, alone, with the sun setting, pouring a bright light across the land in front of me in stark contrast to the thick dark clouds folding in around the mountain peaks in the distance…..I felt peace and sadness simultaneously. A world so beautiful both because of its rough undeveloped crust and in spite of it. In time it too will be overdeveloped and sprawling taking on a new set of social problems and inequities. We fight one battle only to bring on a new one but that is the nature of progress. The people here don’t realize that and have a difficult time understanding the nature of our interventions, can’t help but wonder if they might actually be the wiser sometimes…..

A Regular Medicine Day

Thankfully a run of the mill day! We had a little boy who cut off the tip of his finger with a saw (no plastic surge eons to argue with just good old fashion cleaning and dressing), then a drunk who fell over a bush..... face meets pavement, face looses, depression and teen pregnancy counseling. Sounds like Rochester:)

We also had a child with a psuedoseizure. Now this one is kind of interesting. A rebellious teenager who gets in a knife fight with one of the workers daughters, gets kicked off the plantation, travels 3 hours to grandma's but grandma won't have her so she returns to her mom's house (which is the back two rooms of the clinic we have been cleaning), tells her mom if she doesn't take her back she's going to kill her and oh by the way I'm not going to school either. She's 14. So why the pseudo seizure? Well the plantation owner said that the only way she could stay was if she worked on the grounds picking up garbage and she needed to apologize to all those she had threatened and attacked. So she through a fake seizure and a pretty good one at that, because she didn't want to clean. Everyone came running to get us yelling and screaming....quite dramatic. When we arrived she stopped shaking and just acted passed out. So we checked her over to be sure she wasn't really sick, she was still not responding so we got a big needle and syringe, said we would have to give her a shot to wake her up and she squinted open her eyes to see the needle and miraculously came to.

As for the little ones, we are concerned about our inability to keep them healthy. Their immune system is shot because of malnutrition and chronic parasites, complicated by the fact that we can't keep them warm and dry and someone keeps stealing their shoes (they sell them in town for cash). We have put up curtains, given numerous hygiene lectures, and played the role of Russian prison guard checking on the staff at each watch but the minute we turn our backs they go back to the same old routine. We can't change the building they are housed in and getting the kitchen to keep the flies off the food is purely insurmountable. We have a few cards left in our hands to play so I'll keep you posted.....

Into the Mountains

Feeling better steadily, still a little uncomfortable now and again. Am looking forward to even better days ahead.

Taking advantage of improved health, I pushed ahead and organized the trip up into the mountains for yesterday. Got up at the crack of dawn, snagged the 4 wheel drive pick up truck owned by the plantel and a couple of able bodies to help me load a few boxes of blankets into the back along with some stagnant clothes and old shoes. Given the delivery of new clothes from the Mormons last week (Wal-Mart a la cart) Jenny and I had gone through the children's clothes and collected some of the rattier things which I tossed on the truck as well. Felt a little bad giving out "triple hand me downs" but even if they used them for rags or stuffing for a bed mattress it would be more than they had before.

Now, Jenny has been feeling a little down since I became ill. She has realized that when I'm gone she will be here alone. As you can imagine it's extremely difficult to get things done solo around here. She's also concerned about her daughters education....quite frankly, there isn't any! Well, actually that's an over statement of a sad fact. They do have a school here but it is sporadic at best. Sometimes the kids go to school for only 1 or 2 hours and they send them home and the teachers have a bare minimum education themselves. For instance, Monday, Nana (Jenny's daughter) came home furious, she's 15. Apparently the teacher told her she spelled surgery wrong and the teacher made her write it 10 times in her note book the correct way. Sounds logical right? Well that's all well and fine but the teacher said it's spelled S..U..R..J..E..R..Y not s..u..r..G..e..r..y as Nana had spelled it. Given that her mom's a doctor she's probably got that one down pat wouldn't you think? but the teacher insisted she was wrong. When Nana pulled out her dictionary to disprove the teacher's allegations, the teacher stated "well that's a different kind of surgery" and moved on. All this said Jenny decided not to go to the mountains with me so she could straighten out some things at home.

I was uncomfortable going alone with only a driver but, so be it, figured it would work out in the end. Miraculously at the last minute the daughter of the plantation owner (who speaks English and had nurse training) radioed that she would like to come. Perfect! So, off we went with our blankets, clothes, wormer, vitamins and few medical supplies I through in my camo bag, just in case.

It took about an hour to climb up the winding dirt road that had huge gullies in it from the torrential rains we've been having. It was a beautiful day. I was grateful because the truck was an open bed and 40 wet wool blankets wouldn't do anyone much good ( not to mention that I had to ride in the back). As we went up in elevation the terrain changed only slightly but there were several coffee plantations and the vegetation was more stunted.

We drove through several villages each a little poorer than the one before. You might say a hut is a hut, but I have learned in fact, that is not the case. Some huts have the boards super tight and the roof is raised slightly up off of the top of the wooden walls allowing the smoke to escape from the oven ( I use the term oven generously, it is anything from an open pit fire to a slick little contraption of stone and metal sheeting that is elevated on concrete blocks and holds a wood fire). Other huts have the roof smack tight on the walls and there is no oven just a fire pit outside. A really nice hut might have separate rooms or an attached over hang that allows them to eat outside protected from the rain. Some have a shotty little outhouse. The less fortunate resort to the woods or the rivers and streams as a latrine. I also learned about bathing along the way. There are three, well four options. The fist of course is indoor plumbing. The second is interesting, as you climb the mountain there are veins of water streaming down that they can stick a pipe into and get fresh mountain water to bubble out, then using a burlap sack they make a two sided shower curtain for added privacy. The third way is just to use the toilet water ie. streams and rivers or the fourth way which is not bath at all.

Although in writing this I sound a bit flip, actually, I was really impressed with the resourcefulness they showed. They have minimum to no education and no resources. They essentially spend their entire life camping. Also worth a comment is the difference between residents of Pina Blanca and the mountain folks.....overall cleanliness was much better in the mountains. They were more poor but more proud. What they had was neat and orderly. There was less trash and above all else....they were happy. In Pina Blanca the conditions are crowded and dirty. There is no ownership and they have just enough education to make them miserable.

Our destination was a small three building school which encompassed all ages. The orphanage tries to reach this destination 2 times a year to administer wormer and vitamin A. We were eagerly greeted by about 15 kids all less than six years old, and 2 school teachers. We quickly realized there was no water for the kid's to take the meds and we had no containers to put them in to take home....oops! Luckily I had duct tape! We had the kids line up along the truck each with a little piece of paper from their school note book into which we folded the medicine they would need to take over the next three days and we duct taped it shut (now,... we all know of 102 ways! to use duct tape).

As we were giving out the medicine I began noticing all of the rashes, boils and odors of illness the children had. I began to worry because I brought a few extra meds but not a ton. My mission was blankets and wormer not mobile clinic. I just couldn't ignore all these things, or could I? Soon many of the residents of the area got wind we were here and flocked to the truck. One of the teachers was instrumental in quickly making a list of the neediest families. We gave them the blankets first. At the same time I started using what little supplies I had brought to treat the kids first and then the adults. My camo back pack contained alcohol, bandages, a few scalpels some ointments, pain meds and antibiotics. One by one I treated them until the last little girl, with diarrhea so bad it was caked on her legs had approached the truck. She needed medicine for amoebic dysentery which I didn't have. So we through her on the back of the truck and headed for her house. It was a well kept little hut just off the road. Her mother was apprehensive as we explained her child's needs and our lack of supplies. We wanted to take her with us but she wanted no part of that. We tried everything and offered to pay for their way back home which was her main concern, but still no. Not knowing what else to do we gave her some instructions on hydration and left promising that if she would come with the workers to Pina Blanca in the morning we would find a way to get her home. It was unsettling. Death is always an option for these little ones.

After that ordeal we started through "town" the kids all running behind the truck. We trudged up long trails to little huts here and there that were off the beaten path to deliver jackets and the remaining few blankets.

One particular hut we were urged into. As you walked in the door it reeked of rotten flesh. In the corner lay a man all of about 4 feet tall and wasted. He was feverish but cognizant. His mother was anxious and rapidly telling his story. They spoke of boil that started about a year ago the size of grape. They were seen in San Pedro at the free hospital. He was given a script for medicine and a follow-up appointment. Neither of which they could afford and so he went untreated. The woman explained that they scrape for food (which was obvious by her stature)and although she felt horrible they had had no other choice. Her husband had been ill (we soon discovered he'd had a stroke)and wasn't able to work in the field so they were basically starving. Honestly, I dreaded pulling back the sheets to see what lay beneath, but there was no one else, so I did. The boy had a growth (a tumor of some sort), not a boil, that was about the size of my hand and inch thick extending from his groin. It was pus covered and rotten. The sickening feeling of helpless overwhelmed me. Unfortunately it would not be the last before nightfall. Obviously we didn't have what this guy needed but we did have cash. So we gave them some cash and arranged to get both he and his sister to San Pedro to the hospital for palliative treatment. When I left I was fearful they may use the money for food instead but at least they now had options which they had been lacking most.

On to a few more homes and then we were brought to a building in the center of town. In this building was an old woman with weathered skin and urgency in her voice. She wanted us to see her husband. We gladly agreed and she rushed out back to get him. As came through the door my heart sunk yet again. He too had weathered skin and moved slowly under the weight of arthritis. His belly distended as if were 8 months pregnant and his eyes a dull burning yellow. He smiled as if I were a long lost granddaughter and reached for my hand, trembling. I had been down this road before...in Bolivia my colleague and I were presented with the same situation...a man with end stage liver failure of one form or another. I remember my colleague being sort of cold when he told this man's family he was dying. It bothered me and I questioned why at that time but now realize that there is switch inside of you that trips when the load is too heavy to bear and you become disconnected. My switch was tripping....I tried desperately not to let it happen. Anita, the plantation owner's daughter saw that it was a difficult moment for me and she distracted us briefly by ushering out some of the children who had gathered. In the States end of life issue happen all the time, I've been trained in handling them and am about as comfortable with it as one can be. But in the states you can easily say "we've run all the tests, tried all the best medications and this is where things stand", but here I've tried nothing and not performed a single test. What if I'm wrong? He'd been to San Pedro already months back and they sent him out with water pills and no explanation. Compounding my anxiety, I had to have the conversation through a translator. As the conversation started, he seemed to already know from the tone of my voice and the way he was feeling what I was about to say. As I told him there was no medicine that could help him he interrupted with a smile and said "yes there is, it comes in the form of small squares of ground, that will cure everything" then he chuckled and we prayed aloud together in Spanish with his wife looking on....

PS: The little girl with diarrhea made it to the orphanage this morning:)

Sunday, May 08, 2005

My Own Illness

Living in Pina Blanco feels like a dark paradise. You enter looking around at what nature has offered.... lush greenery, beautiful flowers, an amazing array of birds from the exotic to the plain, cute little lizards of varying shapes and sizes, all delivered on a river the color of emeralds which runs through the center of town. On the surface it's embracing, but just about the time you've got your arms wrapped around it you realize that it's all poisonous. The air smacks of mold and dust, the warmth on your face turns quickly to a burn, the water is polluted and the soil filled with worms just waiting to be delivered to your mouth. You must be careful who you shake hands with, forget about hugs and you find yourself praying they don't breath hard for fear of TB. Somehow or another I have passed through those phases and now have come to accept it at face value. I do hug now and I have eaten their food and yes I have become ill in different ways, but I'm not sorry.
I haven't written for several days because I became so ill they needed to take me to the hospital in Guatepeca. It is more north and about one and half hours away which is closer than San Pedro by a little, more importantly the road is much better so it can be reached in an hour and 15 in a pinch. I was pretty out of it when we arrived, Jenny had to leave me there because night was falling and the rains came...a bad combination for driving. It was a Christian evangelical hospital there were no bugs and it smelled of clorox. Both a relief. If you can imagine the hospitals of the 40's in the US with the nurse uniforms, ancient equipment and extreme formality it was much the same. My doctor spoke broken English quite well but not a single other person. He trained at a good school in Guatemala which was a second relief. It was impressive how efficient the hospital was run. The nurses each had a job and they had checks and balances with regards to medication. The student nurses came and helped you to the bathroom, they put your shoes just so and folded the blankets just so. Dinner was not possible the fist evening but I had three humble meals on the second day mostly tortillas with soup which was more than I had eaten in days. (I have been blessed with the feeling of going to bed hungry.... a feeling foreign to most of us, but not so foreign around the world....trust me when I say, thankful takes on new meaning). After a day of IV antibiotics and afraid of the cost of staying on in the hospital I decided to take the IV on the road and administer from home. We do it all the time in the US right.....true, but lets just say it's a little more challenging in Honduras.
First of all they said that we had all the supplies we would need....well I arrived home and much to my surprise in the box was only multiple vials of medicine and a single needle! Second of all they were kind enough to let me leave with a heparin locked IV in place (this is that little thing that sticks in your arm and hurts like hell when you bump it) but they didn't give me any heparin to continue it's use. Now a drug addict may have been psyched ...." ah, I got a needle some medicine I'll spit on it to clean it up between use....no problem". As you can imagine I was not so elated.
Jenny and I tried to drive around in a down pour that evening and find more supplies (I'm sick as stink and not supposed to get that stupid little IV wet). After multiple trips we finally found ourselves knocking at one of the local doctors doors at 9 pm begging for at least heparin so I wouldn't have to get a new IV in the morning. That night I gave myself 15 injections with that one little needle and proudly hep locked the IV for the night. The next day went better and we were able to get the rest of the things I needed. I'll spare you the rest of the saga ending with I'm feeling much better and I'll pull the plug if need be, but leaving early will be a bit heart breaking as I have oddly enough gotten used to this place and my work is not yet finished.
Goodnight
Bridgette

The face of Poverty

Raining here. I don't mind so much because today at midday it was still sweltering. We were in church, for a midday mass, they were all praying for peace and food while I was thanking God for the weight I lost so my thighs didn't stick together on the pew.
In retrospect, I guess, I have put a big emphasis on the bugs here and how they have affected my experience. Truth is I have realized it's easier to talk about the roaches then to hash out the human suffering that is surrounding me. It seems as though it is a forsaken place. When I was in Bolivia, where there is an equal share of poverty, we stayed in the city most of the time. When we briefly moved out into the country we were on a giant tour bus that made it all seem like one long drive through movie with out any popcorn. There were terrible housing situations....the cows and pigs would live in the house with the family all in one room with a small mud fence court yard and no bathrooms, just holes in the ground no dignity. It seemed terrible at the time, but,it felt different to me, that poverty had no face, it had no name and it certainly didn't know my name.
The poverty here is much more fierce, it burns like a hot poker. Jenny tells me they say it will be much worse as we go higher into the mountains because the people are freezing to death in combination with starvation. We postponed our trip till Monday in an attempt to get the plantation into a healthier condition, fast! The children have been coming down with pneumonia left and right. Marietta, a nurses aide and the closest we've got to a real nurse, noticed we have a few cases of resistant lice. Been treated with Right but it's not coming out. Two cases of new diarrhea as well. We are also preparing for a chicken pox outbreak. Our guard's son came in with it and his mother is pregnant which can be a lethal combination for the fetus.
After spending the better part of the day playing "Where's the keys" and beating our heads against the wall as a new form self gratifying Yoga, I decided heck with it we will go through the ceiling! So I grabbed one of the guys who was hanging out eating dry tortillas and we drug this huge ladder up the stairs to the hallway of the three doors. We tore down one of the ceiling tiles and crawled through the ceiling onto the other side. When we landed behind door number 2 which turned to be accessible to door number 3 also. There we found what seemed to be an abandoned apt. with boxes of junk in the entrance way. As I progressed through the rooms with Jenny behind me we were suddenly ambushed by a flock of bats! They didn't hit us thank god but we hit the deck. Thing is they weren't leaving the apt just moving room to room. Well we had come too far to go back now so I first asked Jenny if we got bit how fast did she realistically think we could get rabies treatment and satisfied by her answer of 4 hours I grabbed a broken window screen and we squatted under it moving room to room with the bats. Now I don't know if it actually protected us from the bats but it did make us feel better! We discovered boxes and boxes of blankets and clothes. So many things we could use. Everything was dirty and had evidence of the mouse buffet line but nothing a little bleach and some stitching couldn't handle. As for door number one well we removed the lock with a hack saw and found more of the same. I think the rat I smelled was a pack rat and it will take some time to get to the bottom of it. Jenny I have already decided to over haul the kids clothes take what they don't need or can't use along with the extra blankets and drive them up to the mountains where they really need wool blankets. Most of these supplies seem to have come from the army (brought after Hurricane Mitch). We think it was stored by Dr. Youngburg's wife (now 80ish) who from what we can make out wanted it all saved for a "rainy day" in other words if donations dried up and money got too tight. Well the rainy day is here and there is no sense letting this stuff rot. Funny how the Lord keeps giving us new missions.....Jenny and I learned about the people in the mountains and suddenly we find 15 boxes of wool blankets......

Thursday, May 05, 2005

Forsaken Commodities,Gringos and Progress

The weather has been sweltering combined with the humidity and all the dust I feel like there is crud an inch thick all over me. To top it off we were with out water for two days because someone broke into the line and stole the water. It's a big problem, not just with the water but also with the land. People come and just put up a shack. Literally, they clear a little grass, throw up a few boards and dig a whole for the outhouse and boom....your only retaliation is to shoot them. Squatters have taken over half of the plantation over the past 20 years. Obviously the 7th day Adventists doesn’t shoot them. That's part of the reason they have armed guards. I don't know how they got the water back and I don't want to know. As for the bugs it's been hell the past few days. The rain quit and they have decided to party, again I think they like me the most.....ah let's get the gringo! Seriously, I was standing outside my room minding my own business watching the children play soccer (they use the bushes as their goal posts....quite resourceful) when all of sudden I thought my legs were on fire! I looked down and there were a thousand ants on my shoes and then they begun gnawing on my legs. I had long pants on and socks but that didn't stop anything, they bit through the socks and crawled up my legs. I was trying not to make a big seen in front of everyone (can you picture that a stupid gringo jumping up and down and squealing like a stuck pick trying strip off her pants! I had to take one for the country) so I tried to bite my tongue and squash em under my pants as I ran to the room. By the time I was able to get the damn things off me, my legs were badly swollen and I didn't feel well all night. The following night I had just snuggled into my cot with the dog at my bedside completely exhausted when out of the blue the dog freaked out, yelping and running about, then he jumped through my bug screen and rolled around my bed still yelping as if he were just shot. I grabbed for the lights in time to see another one of those tarantulas crawling up the wall. This one was bigger and the eyes glowed red against the light. Disgusting. I started throwing match boxes at it cause that's all I could find. It crawled in the wall. Now I had turned on all the lights so naturally the night bees don't care that I'm trying to save me and the dog for the giant spider so they come swarming. Well I was pissed and I started swatting them with a shoe in each hand.....you know who one that war...it wasn't me. I was miserable again and I had no water to cool the stings. The dog wouldn't sleep in the room anymore and I spent half an hour trying to repair my bug net. Okay enough about bugs I'm just plain sick of them. I'm not so worried about exterminating my house in Rochester anymore cause there are enough bugs here to suffice for the whole world! There are good things here. I was running the other day and came upon a giant lake! I didn't realize how close we are to the only lake in Honduras. It is not at sea level but at 2,300 feet and it is beautiful. The area is so green and there is absolutely no development on the lake shore, it is just raw fields. There are a few Hotels (one of them actually a 4 star...sort of) located a ways back which capitalize on the view only. I was quite impressed. So maybe a few people wouldn't mind doing a little outreach here after all! Other cool things...You can buy fresh coconuts and pineapples on the side of the road also. Most importantly the children are innately so lovable. They expect nothing and are happy with anything. They want hugs and smiles. They love to try to say English words and they have learned to laugh in world full of uncertainty, insecurity, broken promises, cruelty, unfairness and countless other atrocities. When I hold their hand their eyes sparkle for those moments, just as though they feel they are the center of the universe. My heart melts like butter. It is a feeling all the money in the world can't buy and it's worth every cotton picking bug bite I'll ever receive. Sometimes I feel badly that I'll have to leave them. They have just started really opening up to me. They don't have a concept of time and haven't realized that Jenny and I will not be here forever. The older ones do they have been through this before and are more hardened, but the little ones don't seem to. The last few mornings 7 of the children age 8-12 have been meeting me at 5:45 am to run. We do about 25 minutes single file down the road. The dog follows up the rear and it’s a really rewarding time. The little girl in the wheel chair (Isadora) is pulling to a stand now if I hold down my hands for her she will grab them and pull up. She also says hands and feet in Spanish. It's wonderful really! As for the doors still mysteriously there are no keys to be found and as for the clinic we are going to paint it this week. Mom, just wanted to tell you that I bought you 30 little foam beds for mother's day. I figure you don't have a great need them at the moment so we are going to borrow them here for a while. Thanks! Love to all and more later!

Mother's Day

Happy Mother's day! Mother's day here is a very big deal. They had a little production at the main school on Friday Night in Pina Blanco to celebrate the coming day. The kids did cute skits and parents were supposed to come. "Supposed" is the big word here, there were only a handful of parents there which seemed rather odd until the preacher got up and gave a 45 minute sermon in which (granted it was in Spanish but...) from what I could make out and what Jenny translated he was promoting more children, woman's place in the home (cleaning and cooking) and how much of a privilege that is. Now I might go along with the privilege to be a parent thing but the rest...I don't think so. This may have been known in advance and that's why only 5 parents showed up. At noon the men cook a big meal and they try to have meat. Woman still clean up, then the men go get drunk! The kids have off of school tomorrow also. Now I can't generalize it to all of Honduras but that's the way it's done here in Pina Blanca.

I have to say I was asked to par-take in the celebration at the superintendent’s home. He's the one in charge of the day to day runnings at the orphanage from the mechanical/physical side of things. When I walked in to their home the first thing I saw was a giant set of bull horns with cowboy hats hanging off of them accompanied by the sound of Elvis in the back ground singing country. In the mean time he asked me if I could look at his new son's umbilical cord so I said okay. Well they had just delivered a new boy 9 pounds a few hours ago and she was sent home already. They don't fool around here. You go in to the adult hospital after your water breaks and you leave as soon as you can stand. I suppose at the rate they are having children here the hospital would be full all the time and there would be no one home to cook if they had to stay 24 hours. Sorry for the sarcasm.

So I passed the lice test so far no critters but I'm still itching my head all the bloomin time and I started loosing my hair today because I've been scrubbing it twice a day. At this rate I won't have to cut it, it will all just fall out.

Speaking of critters....so I get pretty nervous here at night with everyone and their uncle carrying riffles and the drug trafficking that goes on at night compounded by the fact that I was told directly not to go out after dark. So I solved my problem and actually got a full night sleep! I brought "Rotan" in to sleep with me. He's a stray dog that hangs around orphanage. Yep he has fleas but what the hell I've got every other insect why not a few fleas. No I didn't let him on the bed....I do have limits.

Progress report on the clinic: We finally got it all cleaned up and all the crap out there. We mopped the floors and washed off all the furniture. The people here are pretty superstitious, none of them would help clean the room that the boy with AIDS died in a few weeks ago. I walked right in and started cleaning to try and show them it's okay. They just stared at me. People are really complaining that we threw out the termite and worm infested books as well. I drug a bunch of the muchachos down to take out the three termite nests. Really gross! Then we sprayed again with the diesel fuel and now it actually may be "move in able". I went back today to give it one more mob job with Clorox but someone stole my bucket. I think they thought if they steal the bucket I won't make them work:) oh and just so you know Sunday is regular work day here so I wasn't breaking any labor laws!

We made an unfortunate discovery today and will need to discuss the best way to handle it with Steven the director when he gets back. I was wondering about and noticed a small set of stairs. Oh course I went up them and found three locked doors....it felt kind of like one of those "choose your own adventure books" where you get to pick what to do next and then it sends you to some random page number that tells what happened.
When none of them would open I started to think of other ways to figure out what was behind them. You might say why not ask someone...because know one knows nothing here, if you get my drift. Jenny and I are constantly be sent from person to person for every little thing, a lot like trying to get through to someone from AT&T when you keep getting sent to a choose a number menu that ultimately brings you back to the number you called in the first place. Any who...back to the doors. Well because the place is termite infested I was able to peer through a few convenient holes on door number 1 and a gap in the wood panel in door number 2. I could not see a thing behind door number 3 because it was new. I actually was able to see boxes of clothes and blankets behind the first 2 doors. I cant' tell how old they are but peering through my little hole I don't think they are years of build up. I smell a rat. So I will have to keep you posted because the owner comes back next week and one the other family members comes back tomorrow. I have a feeling the office manager ( a separate person I haven't spoken of yet) may be hiding stuff up there. I'm nearly certain the owners don't know. Cause they just paid someone to make some clothes for the kids.

On the more medical side of things, we treated a bunch of people today but as is always the case word got around Jenny and I were here and a lot of wealthier people started showing up. We can't afford to treat them free when they are capable of paying and we aren't set up to be charging money. So we turned a bunch of non-emergent ailments away and told them to go the doctor that lives in town and charges 400 lempiros per consult...that's about 20 dollars.

A young man brought his son who had been a healthy 4 year old with apparently a great laugh that has been neurologically devastated for the past year secondary to meningitis. He wanted to leave him at the orphanage because he has 5 other children. Upon examining him we found good things and bad things. The bad was contractures in the upper arms and he has pneumonia. The good is he actually had decent strength in his legs, no lice and no scabies. We unfortunately had to turn the child away. We talked about it for almost an hour, the best approach. We felt that although it was hard for them he was actually not to bad off. He was clean and fed. If we took him he wouldn't be treated well by the staff because they don't take the time or care very much for the children they don't like. We are already having trouble getting them to care for our other developmentally delayed child. We felt sure the family wouldn't come back for him if we took him even just until the pneumonia was treated. And he needed physical therapy because he could walk if someone worked with him. That's what I'm doing with the little girl we have now. She's gonna walk I think but I have to work with her all the time. It is a bit of a foreign concept here. Children are kind of disposable. If they don't work right they just write them off. Now we didn't turn him out in the cold. There is a nurse in town who volunteered to get him to San Pedro where they can put him in an rehab program 3x a week. We gave them the medicine and a group of doctors from Virginia are going to help pay the cost of rehab. (the doctors from Virginia found him originally in a town 2-3 hours away and thought he'd be best at our little facility). Now I can't guarantee that the family wont starve him to death, but I also know he wouldn't do well here right now. Jenny who will be here long after I'm gone felt pretty strongly against keeping him. We think that because he looks so good right now the family probably doesn't have the heart to starve him and the physical therapy 3 times a week will keep him connected to a bigger medical facility then what we have.

Okay I could go on for hours, but it's dark now and I want to get home straight away.

Wednesday, May 04, 2005

3rd Post Sleepless and Starving

The days run together. Still not sleeping much going on 5 days now and it is starting to get to me. The food is scarce here and that's not helping much either. Imagine standing blindfold at the rear-end of a jet airplane when it's gearing up for take off....that's what it sounds like in my room as the rain falls hard on my little rusted tin roof at night. It's been raining every night and intermittently during the days. That's why they call it the "rainy season"! My room is pitch black at night. I tried to sleep with the lights on to keep the cockroaches away (as many of you suggested) but then I was swarmed with night bees. They come first one and then the next until there are so many with their buzzing so loud it sounds like they will eat you alive. I opted for the silent roaches and I don't get up till daylight even if I think I might wet the bed!
A disturbing occurrence yesterday, still not settled well with my stomach, I reached for my suitcase in the morning, sitting on the extra bed, covered with dead bees and suddenly out popped the giant spider, it had found a home under my suitcase! Unfortunately for him my suitcase broke his legs. Now trust me I was not analyzing the legs I was screaming my head off it scared me so much. I ran outside as if the thing could fly, and looked for help but alas there was no one. For those of you who know me well you know I don't kill spiders. Now I was in a quandary...to let it suffer or to kill it, thankfully though I think it died while I was deciding so I swept it out the door. When Jenny came by I showed it to her and she said "that's not a cane spider it’s a tarantula, bite yah they will and leave a big rotten hole" in her Jamaican English accent.
Enough with the bug thing which is an on going war...sorry got carried away there.

As for the lice and the children....well I ran the oil thing by the women who tend to the children, and the Vaseline, and the mayonnaise, but they would have none of it. We had trouble even getting them to let us cut their matted hair short. Jenny and I finally pulled the doctor card and told them it was medically necessary in order to put the medicine on them. Now, what medicine you ask.....well let me tell you.

We drove to San Pedro Sula down the mountain over the pot holes and through a mudslide. (With all the rain a huge mudslide closed the road for a bit, they opened the road but the mud kept falling till it no longer supported the water main and that collapsed leaving the towns down stream with out water). When we got to San Pedro Sula we went to the pharmacy and told him we had no money but we needed medicine for the children we were caring for, could he please give us some on credit. He agreed quite willingly and proceeded to fill our little wish list. We will worry about how to pay him later. The work Dr. Youngberg has done over the past 40 or so years has really been respected by the people who knew him and they support the plantation as much as they can.

A little about San Pedro Sula: It's a big city crammed into an area the size of Butler. (for those who haven't had the good fortune of visiting Butler it's about the size of a pimple on the butt of an elephant). They have fast food joints (actually they tote the largest KFC in the world complete with a life size statue of Colonel Sanders at the door...much of the chicken for KFC comes from Honduras I've been told), there are 3 giant supermarkets complete with armed guards in the parking lot and guarding the water. Water is a big deal here. Not much clean water anywhere. If you don't keep your gate closed on the driveway (everyone with a home has these big iron gates) people on the street will come asking for water. This happens more in the mountains than the city so I'm told. San Pedro is not short on shoe stores and the gas is 3 dollars a gallon. They have several butane engines here...kind of cool and environmental.
People drive insane!

Okay back to the lice story. So now we have the medicine but we can't treat them if we're not going to clean the bedding. Ah the bedding.....It consists of little foam mattresses and make shift blankets 2ft by 3ft, nestled in little cubicles built of plywood that sit up on tables (better than the floor! right?). The grown children have little cots like mine. Well, the women say it takes three days to dry the foam and the children will have nothing to sleep on. So I said fine we will buy new foam and start over so we have 2 beds for each child that way you wash one and have the other clean and ready. Okay that's great but what about the blankets...well we can't afford to buy them blankets so we'll have to make due with sewing together old clothes. Everyone agreed and we asked a man in town who was going back to San Pedro to get the foam. Several hours later he came back with out foam. It was $120. We had scraped together 50$. But a beautiful thing happened. When you’re doing your part the Lord does his! A bus load of Gringo's from Utah showed up out of the blue with bags of clothes and blankets new and donated by Wal-Mart. (okay for those of you who know me I still hate walmart but maybe there's a place in my house for a toothbrush or two from them). We didn't know they were coming and it was late like 7pm. They were Mormon dentists who were just passing through not even staying over night! it was kind of funny I heard all this commotion outside.... gringo this and gringo that, I thought they were still pissed about the hair thing so I peaked outside and I see this guy in scrubs running through the jungle out back totally lost. Long story short I took him to where the kids were sleeping and found this whole bus load of good meaning folks hugging the children and carrying them around, giving them toys. I barely had the heart to tell them they better delouse, de-scabby and de-worm before getting back to the states.

Ever feel like you were trying to move a mountain with your big toe? Getting people to make change around here is just like that. The people who run this plantation do a good job considering all the obstacles. It is no small feet to feed forty families with barely any income. Unfortunately the people have no hope and minimal education so they don't have aspirations. They are happy to do a little work for a little rice and beans. They don't want to a lot of work to earn a steak with a side of fries. If you know what I mean. Just as cutting the hair was huge, so huge one mother came and took her child, sick with asthma, back home because she was told we were going to cut his hair. (If you’re confused we also serve as a children's hospital to Pina Blanco.) So in trying to clean the clinic it's been rough going.

One quick funny story before I go, first there are no rest stops on the highway so people just go on the side of the road....so this lady from the kitchen was telling me how she had to pee so bad on the way back from San Pedro last week that they pulled off the side of the road. Her husband came over and was trying to hide her "bonkie" and she kept yelling "no no ...No one knows my bonkie hide my face"! I had to chuckle

Until tomorrow......

Ps thanks for the emails and the advice!

Monday, May 02, 2005

Day Two Where Do I Start

I began the day yesterday sleep deprived, disoriented and clueless! The rain stopped briefly and the bugs were surprisingly not so thick. What the day would hold seemed exciting initially but quickly it was squelched by reality. Jenny is the Mexican physician that has donated some of her time to help her brother; he is the superintendent here at the orphanage. We met at 8:45 am in front of the office. The first item on the agenda was setting up a clinic. There were three options:
1)a room attached to the orphanage that was just outside the toilet rooms, it smelled like a barn, more like fresh manure, as they have the children use little fake toilets and just hose them out after breakfast right onto the floor. It was a small room about the size of a large walk in closet.
2)a house that is relatively clean but only 2 rooms and someone lives there already.
3) The old clinic (circa 1942)abandoned since about 1998. Sounds promising right? Well we arrived at the doorstep first needing to cross the yard, which contained a large obstacle called a bus! Not just any bus but a rusted machine with flat tires that resembled a bus and was home to their dental office. It came complete with a dentist chair and multiple rusted instruments, a washbasin and moldy partial dentures. I could see into the front room of the clinic through the walls. You see there were giant holes in the walls made from rot and termites. As we entered the smell was stale and it was disgusting. There was shit everywhere! Medicine drapes tools, catheters, braces just left in rotten boxes strewn all over from previous missions. There was evidence of a once thriving clinic complete with old exam tables and instruments used in the 50's and 60's. The Doctor had a personal library that was extensive but extinct and as I thumbed through some of the pages it was like stepping back in time. May add that I also learned the definition of bookworm. Most of the books had intricate holes in them through and through which contained occasional live species and multiple eggs. Termites had infested the entire building and all of its possessions. There were literally two-foot mounds in multiple areas where the bugs were nesting. The rafters completely infested and there was a giant mosquito mound in the gynelogic room it looked like a 50 lb bag of sand grit dumped in pile.
Jenny and I agreed that although the condition was sub optimal at least it felt like a clinic. Jenny left to go to town and I stood there for several minutes overwhelmed. This would not be the first time, I know. I kept hearing my mom's story of when we moved into the farmhouse. It too was dilapidated. Her and Aunt Phyllis stood thinking the same thoughts. "where do I start?” my mom said and aunt Phyllis replied, "right here" and she handed her a rag. They soon made pigsty into a beautiful home. I am not hoping for a beautiful home but I am hoping for a clean and organized environment. So I picked up a broom and began in the corner. I cleaned for three hours alone and was disgusted on a regular basis by my findings. At 12:30 Jenny came back and we both got little boost from knowing we were not alone. We went and rallied some of the kids and pretty soon the adults came and by 4:00 we had cleaned out so much junk and crap you could actually see the floor.
We finished the throwing away part today and now we are trying to get exterminating chemicals (diesel fuel) to kill the termites and fumigate the joint. I will have to keep you posted.
On a lighter note (believe me there is none)I met the children for the first time yesterday. From a distance they were so cute and tiny. There are about forty. They have little uniforms made of Mickey Mouse material. As I got closer though I began to notice lots of things. These children although smiling were plagued with various swellings and rashes and crooked bones. There hair matted with lice and boils. They instantly clang to me, a new face with loving arms. They were trusting. I fought back the tears so as not to make them feel ashamed.
That was yesterday.
I spent the evening trying to come up with remedies for lice and scabies that would be affordable and obtainable. Vinegar and soap may be all I can do for now. The story is much more heart rendering but I haven't time nor do you for the rest.
Today Jenny and I made a list of all we need to treat the children and I spent a long time on email trying to contact MAP international for more aide.
We were summoned by a young child to come to her home. Her mother was ill with some lung problem and she had a history of TB but was "treated" by the Honduran Health Dept. We arrived in the small stone hut which had a kitchen and three rooms all together separated by dividers of wood thatching. A woman lay there huffing and puffing not able to say much due to her extreme shortness of breath. She handed us some scribble and a few pills. She had in fact been treated for TB but not surprisingly she was under treated. They only gave her 2 medicines for 3 months instead of 4 medicines for 10 weeks and 6 mos more of double therapy.
Now she most certainly has resistant TB. She is only maybe 50 pounds and I can not help her. I gave her some inhalers and we place an IV through which we gave her vitamins and nutrition, but only one days worth. She had 3 children 3yrs old, 5ys and 12yrs. Her husband works in the cane fields. She will die in not more than 2-3 months.
We saw many others this morning each story more troubling, a child with asthma barely breathing, a baby with malnutrition and diarrhea, a handsome young boy the family's pride and hopeful future bread winner with a bad lymphoma growing out his arm pit. I can't even bring myself to talk about the sexual abuse. All this and I've only been here three days.
It's cathartic for me to write. If you have no interest just delete my email, it's okay.

Paca
Bridgette

Sunday, May 01, 2005

Day One Environmental Shock

Yeah limited email access but I'll take it:)

Made it safely however have had several mosquito bites already. Oh well so much for the super special triple steel bug repellant (I think we were lied to Karla). As for the trip down, not too many problems. Of course I got searched at every checked point with a fine tooth comb.... literally. They wiped down every bottle of medicine with a drug paper and ran it through the computer. At one check point three security guards were called over urgently to view the x-ray of my bag. They all looked at me at the same time with some murmuring and very abruptly took me to a back corner table where they questioned me heavily and tore through my bags forcefully, I was thinking holly crap what did I pack, then.....they pulled out my tuning fork and my Otto scope and began to chuckle somewhat embarrassed. Apparently these peculiar objects looked like a gun on the x-ray device. At any rate I made it to Honduras where they too were freaked out about all the drugs, just as they were about to put me through the ringer I whipped out my handy dandy letter from the Honduran Consulate (written in Spanish, so I have no idea what it said) and they waived me through.
We drove 2 hours on dirt roads with large pot holes that make Pittsburgh pot holes seem like minor divots. There were people carelessly crossing the roads as if getting hit by a 4 wheel drive pick up wouldn't be such a bad thing.
When we arrived at the orphanage at an altitude of 2,300 feet it was pouring rain and a thin man with a huge shotgun approached the truck. He is our security guard an ex Contra rebel with a story for another time. His presence was both comforting and disturbing.

I was dropped off at my room we unloaded the bags and boom they were gone. I walked in the door and the good news was I have my own bathroom, the bad news is I share it with a million cockroaches and a 4 cm sugar cane spider that seemed to have the run of the joint.

Yep nauseated! I did my best to clear the place of what I could and I made a fortress of netting around my cot to keep the critters from crawling on me in my sleep. It took me two hours to get it all set up. I'm not sure if it will work but it helped me to at least lie down. Didn't sleep a wink, afraid to close my eyes.

I have to go now I'm meeting the doctor from Mexico who I heard through the grape vine is very unhappy. She just got here last week and there are no supplies because they were bug infested and the clinic building has to be abandoned due to termites. We are going to try to put our heads together and come up with a plan.

paca
Bridgette

In The Begining A Search For Meaning

For years I'd dreamed of becoming a doctor. As each phase of my life passed I'd found myself with a new reason to dredge forward against what seemed to be at times insurmountable odds. Through family and personal illness, near death experiences, love and monetary constraints I continued forward. The sacrifices never ceased. During my residency I found that the joy I received by taking extra time to really connect and empathize with patients, an act so fundamentally important to the treatment of illness, was repeatedly stolen because of the need to conform to 20 minute slots as if that was not discouragement enough the looming red tape of medicine created by the constant fear of litigation seemed absolutely crippling to the patient/physician healing relationship. Dehumanization of disease and lack of empathy plagued the system. With the slow realization of these facts I found myself nearing the attainment of my dream with a numbing sense of sadness. It seemed as though my core was becoming bitter and the reasons I so desperately clung to were so far in the distant past that they were unreachable. "What am I doing this for...?" echoed in my mind with every 5 am alarm sounding.

The desire to throw it all away and go back to working at the Clearview mall in Butler, PA (my home town and my first job) seemed tempting; however, my loans (which could purchase a small island off the coast of Tahiti) prevented me from just such an action. So....... I did what every American does so well.... I went on vacation and like a "good" catholic.....I went to church.

Amazingly I believe God heard me. Despite my crabby, negative attitude he heard me. In a tiny two bottle wine store in a cheesy little tourist town in Southern Florida my life would change forever. I met a man that told me of a tragedy which melted my heart and brought to the surface the purpose I had lost.

Somewhere in Honduras a group of children were suffering at the fate of a tremendous loss. I was being asked to go there to do something about it.

And so begins my journey.....somewhere in Honduras.
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