Thursday, June 23, 2005

The Last Days

The joy of hope and cooperation is tempered by my sadness. It is nearing my last hours here and once again I have mixed emotions. One never feels as though they have accomplished enough in the bottomless pit of poverty. I was buying a skirt and shoes yesterday at a local store and the guilt was tremendous. I know that buying things helps the store owners whose clothes hang from the ceiling rafters month in and month out. But it reminds me of the have and have not situation we live. It forces me to reconcile my own desire for success and convenience against my desire to help a group of people I love achieve a better life. I know that every penny I spend not just here but when I get back home, could buy more food and medicine. How can I accept that?

For now I must look back at this month one success at a time, some great and some small but with each taking us a step further than we were before. They officially have electronic medical records……there is a mirror in the girls dorm which we hope will improve hygiene….the local physicians have hope for a better way…..there is a village deep in the mountains whose children are protected for a few more months from consumption by parasites…..families have been reunited after months of separation…..a little girl will live to see her first birthday against incredible odds…..another will walk…..and as for Anothony he will continue to smile………

Water and Rain

The rainy season has begun. We have had 7 straight days constant down pours with violent lightning storms. I am starting to understand how Noah must have felt, but the only animals I could gather right now are a mouse, 3 goekos and a giant spider. I have gotten used to the mouse living under the sink. I am sure it’s a girl because she likes my clothes. I call her poo for obvious reasons.

With the storms we have been with out electricity for several days. It will flicker for a little while but ultimately kick out. This has put a damper on the internet connections. We have been fortunate though to still have water in most places because we operate on collecting system that uses pumps in the dry season and can catch rain in the rainy season. It is amazing how crafty the design of the plantation is. Dr. Youngberg did a lot with a very little.

Speaking of water we received wonderful news yesterday. It began over “burgers” at a fairly local restraunt/bed and breakfast which caters to the American way of life. I heard a group of gringos talking and being the shy girl I am forced my self to go and chat. It turns out they have invested a bunch of money into building a new clinic nearby to serve the poor. They actually knew about us but hadn’t made any contact to find out our story. Their funding was clearly superior to ours because they have corporate sponsors and we survive on personal donations. I was pretty direct in the conversation discussing the goal we have of unifying the medical system in Pina Blanca to better serve over 50 villages that feed into the town. At one point I flat out asked why they didn’t try to work with us instead of building their own infrastructure from scratch. I didn’t get an answer but the seeds of thought had been planted. Two days ago a bus full of doctors and contractors showed up at our door. They came to get a tour and understand what we were about. They brought clothes and books for our smallest children. They were really wonderful and so excited to see how much we had to offer. In the end they said they wanted to help us finish the new dorms for the children. You see, the hospital as we call it, that we currently have, is built of wood. The children live in it along with 50,000 termites, a dozen bats and couple hundred rodents. In this building is also the small clinic we operate throughout the day and our “kitchen”. When it rains the water pours in along with the wind. It’s constantly damp and the stench will knock your nose off. God help us if we ever had a fire, with the severe lightning storms it is a constant worry. We need new buildings to get the children out of the hospital as soon as possible, at which time we will tear it down and start building a new more modern hospital that can protect the children from the elements. Last evening we had a meeting with them. They made clear their intentions to help. They can’t fund it all but will help to the degree that they have excess. They also said they were going to help us get a water collection/purification system at a low cost that would help us guarantee our water supply to the whole plantation. If this really happens we could utilize more of the ground for growing crops. A major barrier to increasing our agriculture has been the inability to keep the ground watered in the dry season.

We are holding our breath but we are hopeful……..

Summary of the project goals

The trip to the mountains went extremely well despite torrential rain. We saw 80 people in one day. Most for simple parasite medication but 30 consults were other issues ranging from on the spot abscess draining to more tragic diseases that I could not help. There were tears and smiles to fill the void of emotion I initially subconsciously tried to create as I saw the massive crowd accumulate before my eyes. Each time I travel into the mountains my mind races my heart in an inner battle to overcome the feeling of helplessness generated by the knowledge that my resources are too scarce to care for all the people I will see, the knowledge that there will be several I will turn away with out conclusion with out treatment, the knowledge that I too will leave some to die and some will die in spite of my attempts, my frailties will be revealed to me and only me for those who come expect I know it all. I climb the dirt roads full of trenches and remnants of landslides which manifest, physically, the mental journey I am on.

It is through this experience that I remain able to focus on the goal….the goal to develop a medical system that finally allows for more than just medication delivery but attempts to address education as well as prevention. A system that empowers the local physicians with tools to obtain tele-consults from US physicians who want to help, x-rays, lab values and tools that help them deliver the kind of care that they dream of in their hearts. I have set the wheels in motion with my job this year at the University of Rochester Medical Center to arrange for multidisciplinary teams to rotate through the clinic creating a win- win atmosphere of collaboration between Honduras and Home. There are times when I wonder if there is anyone out there as crazy as me who really wants to do this, who can tolerate the physical and emotional flux. I remain encouraged by reports of other universities who have heard of the site and wish to participate as well. We have developed a website to manage the visits and we made a video documentary to help orient volunteers to the inner workings of the site. If anyone is out there who is not in the health field but wishes to give a little time to a great cause there is no lack of need for multiple other types of work and expertise that are needed.

And now I must sleep, my arms are scorched and my soul is restless with anticipation of what the future holds…..

Acquisition of Compassion

Anthony suffered a major set back. He had been doing so well. We were careful with his diet and gentle with the anti-worm medication. He was working up on his diet, his swelling greatly subsided and he had begun playing with the other children. Then his world came crashing down. He awoke yesterday morning with face more swollen than when he first came to us. He wouldn’t eat and he had little energy. We suspected his kidney’s and did a very simple urine test which demonstrated he had developed nephrotic syndrome. Jenny and I were surprised. We have seen lots of complications but this we hadn’t seen. Nephrotic syndrome is an immunologic disease launched against the kidney’s which can be triggered by multiple different entities. It was necessary to get him to the main hospital in San Pedro in case he needed dialysis. It was so sudden we were afraid that steroids might not be enough. He knew something bad was happening as we scrambled about poking and prodding him. He knew he would be leaving to go somewhere but where he couldn’t understand. His eyes were large and helpless. He held my finger and tears began to well up in his eyes as sweat beads poured from his forehead. I felt like a traitor as we took him to the bus stop. In his arms I placed a small teddy bear and I kissed him on the forehead as I explained he’d be back soon. He wasn’t buying it. Sarah a worker on the plantation was in charge of getting him to the hospital and caring for him while he was there. The hospital doesn’t have enough funding to provide a nursing staff that can give medications and baths and do treatments so when a child goes there they must be accompanied by an adult to stay with them 24 hours a day. Sarah is great with the children an experienced mom and a good one at that. She swept him up in her arms more gruff than I would have but this is her life and her world where children get sick everyday, their parents leave and don’t come back, they have needs that go unmet and sometimes they die. Sarah had that wall of emotional experience that she used as a guard to ward off unwanted sadness. It worked and in some ways her cold strength, like a bluff in poker, protected the children from the level of worry we each held inside. I couldn’t sleep last night wondering what would happen, what would they do to him, how frightened he must be, wondering about parents in the States that lay at night and worry when their child is in the hospital even when to us it seems like a straight forward admission to them it may be terrifying for all the same reasons. Compassion I did not know I did not have till now that I have it…….
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