Monday, June 18, 2012

Honduras 2012: Reflections and Perspectives

The Joshua Tree- La Hicaca, Honduras
Having returned one week ago from our latest medical relief trip, I find it helpful to pause and reflect. My reflective thoughts have previously been published here.

From the 2012 medical team:
  • Aside from the satisfaction that came with providing medical care to a population that otherwise wouldn't have access, I was most struck by the warm, welcoming spirits of the people we served. They lived simply, subsisting off the land, and yet they had everything they needed: family, friends, nature, love. Moreover, their necessary faith in a higher power to make the sun shine, the crops grow and the rain fall conferred on them, I think, a certain sense of humility that many Americans are perhaps lacking. How many of us in the US, living in materialistic luxury that many Hondurans could probably never fathom, are truly appreciative of all we have, and how little we actually need to be happy? 
  • The trip was an extremely humbling experience for me. The daily lives led by the the people in La Hicaca are extremely different from anything I have previously experienced. Their graciousness and genuine good spirits make me realize at times how trivial the things I tend to worry about really are.
    The brigade was both the most difficult and most rewarding experience I have had. It was truly a life-changing experience
  • Father Pedro's insights were very enlightening (click here access video interview with Father Pedro). In addition to discussing health care and public health interventions, he was adept at describing the social context of health in La Hicaca. He said the community was full of violence unchecked by law enforcement which was not trusted by the local community. There is a breakdown of the family structure and a lack of the institution of marriage. It was hard to miss the parallels between rural Honduras and urban Richmond.

Patient Care, La Hicaca, Honduras, June 2012
  • It is easy to not appreciate or even realize all you have until you have seen otherwise.  After spending a little over a week in Honduras for a second year in a row, of which the majority of the time was spent in a small, poverty-stricken, mountainous village, I have once again come home with an increased sense of awareness and am truly grateful for everything I have here.  Growing up in the suburbs in the United States, it is easy to take for granted all of the amenities that are provided.  Basic needs such as access to clean water are met without any thought.  All I have to do is decide whether or not I want to add ice or use my Brita.  Getting to a destination that is 15 miles away is easy in my car on paved roads, yet I still find myself getting frustrated being stopped by red lights or getting stuck behind a car that is driving at a speed less than the posted limit.  For someone in this small Honduran village, clean water is a luxury and getting to a destination 15 miles away would probably be a full day’s trek.  There are no roads or street signs, no one has heard of a Garmin, and the journey is usually made on foot.  It is hard to believe that in such a modern world where people constantly live in excess and worry over petty things, there are still places where basic needs for survival can be nearly impossible to obtain.  
  • It's difficult to imagine that within an 8-day span, you can feel as though you've seen and learned so much from a world completely unknown to you before. I don't quite know what I was expecting as I was flying into the country. Poverty, people in poor health, and lack of showering were all things that I had prepared myself for. But what caught me off-guard was that amidst all of the poverty, a greater sense of happiness, pride, and strength existed amongst the people of rural Honduras whom we were fortunate enough to meet during our time there. It was astonishing to me how, even though they didn't even have shoes to protect their worn, weathered feet, or proper nutrition, these Hondurans willingly trekked hours to the clinic doors and stood in the boiling sun, patiently waiting to be seen, dressed in the finest of their clothing, with smiles on their faces. Many of them walked back home knowing that certain chronic ailments of theirs would not, and could not, be treated by us, and yet they were simply happy to have been given so much attention and care by our medical group. 

    Eye glasses station, La Hicaca, Honduras, June 2012
    We were fortunate enough to be able to walk around the village when we weren't in clinic, and the people of La Hicaca proudly, graciously, invited us into their small mud homes. Again, seeing how happily they lived, without complaint when they only possessed the barest necessities of life, made me wonder why it was that we, in a neighboring, FAR wealthier continent, lived in such lavishness and yet still did not seem to possess the same happiness and gratitude for life. So I was slightly disappointed in myself when I returned back after such an experience and found myself easy slipping back into my daily routine. I don't know what I was expecting; perhaps that what I had seen would change my world views so much that I would feel inspired to  make drastic, minimalistic changes to my own life. Yet, I came back and it was almost as though I had never left. But I think another thing that I had learned from this trip was not to underestimate people's ability to adapt to whichever environments they may find themselves in. I'm not only talking about the people of rural Honduras, but about the amazing individuals with whom I traveled to La Hicaca with. I know that many within our HOMBRE group had never before gone more than 2 days without hot showers, toilets, cars, or our mobile phones. And yet, we all managed, with little complaining, and a lot of laughter and good morale. 

    So although I re-adapted to my life back home without much trouble, I know that doesn't mean I will forget many of the important lessons that I learned on my trip. I know that I will continue to participate in as many of these incredible relief brigades as possible in the future. And in times when I can't find the means to travel on such international trips, I will always keep in mind one important thing that I learned from going on this trip: that even a little bit of time and caring to those in need can go a long way. 

From Dr. Michael Stevens:

Breakfast, La Hicaca, Honduras,June 2012
The people we see when we travel to La Hicaca are some of the poorest in the world, and face terrible health pressures such as sub-standard housing, poor access to clean water and sanitation, and a heavy burden of chronic illnesses (intestinal parasites, chronic musculoskeletal overuse disorders, chronic skin problems, et cetera). The medicine we practice in this setting is simple, raw, and emphasizes high-yield measures such as anti-parasite medicine administration and health screening. We have worked hard to maximize our impact over the years, and finally are addressing chronic health issues such as hypertension and diabetes, in addition to de-worming people and addressing acute health complaints. Having come to the same community for the past 5 years (often multiple times per year) we have developed strong ties to the community, its people and with our community partners and the local ministry of health; we are heavily invested in, and have developed deep friendships with many of the people in this area. Actualizing this work is an almost herculean effort, and is only possible via the efforts of many people across numerous organizations-I am especially grateful for our excellent students who give of their limited time and resources to fund raise for these trips; I am also indebted to them for what they teach me about selflessness, humility and service. I am humbled and count myself privileged to be able to witness students and residents being transformed by their new perspective on health and poverty. This always serves to remind me of what is important in both medicine and life; in their growth I find renewal. I am also grateful for Pat Mason and Gonzalo Bearman; both have showed considerable dedication and resilience in continuing our efforts to provide medical care to the people in and around La Hicaca: they have done this largely without personal benefit or recognition in the face of significant challenges. Most especially I am grateful to the people we see in Honduras-the perspective I gain when I participate on these trips is incalculably valuable, and I am allowed the awesome opportunity to practice medicine and public health in their rawest and truest forms. I am grateful, beyond measure, for what our patients have taught me-and continue to teach me-about humility, kindness, generosity and resilience.

From Dr. Pat Mason:

“Water, water everywhere and nary a drop to drink”

Water has always been an important part of my life and something we often don’t even think about in the US. Whether it’s for making our morning coffee, washing our car or watering our plants, we just know that when we turn on our faucets it’s always there.

Water Filters, La Hicaca, Honduras, June 2012
As I sit safely back in the US, with my overpriced cup of coffee and reflect on our recently completed 8th medical trip to Honduras, the old saying comes to mind. Once again water played a huge part of everything we saw and did while on our annual trip to La Hicaca, Honduras. While many in the US may not really give it a second thought, water is clearly a major driving force for many people of the world including those in La Hicaca. Its importance cannot be over emphasized and was clearly evident in every experience we had during our visit.

Upon our arrival and after a 20 hour travel and preparation day, the trip to La Hicaca was made even more exciting by water. The river crossing on the road to La Hicaca is always a little anxiety provoking but with the recent rains in this part of Honduras the crossing became even more exciting. After making sure all of our vehicles were in 4 wheel drive we ventured into the swollen river. Amazingly each vehicle made it safely across despite the water being up over the tires. What was just a nerve racking crossing for us is often a major ordeal for the people of Honduras. Needing to walk several hours on the mountain to get to the nearest store or hospital, the swollen river can become a major ordeal that influences the success or failure of a journey from this isolated little area.

Following our safe arrival into La Hicaca, our team of 19, which included students, doctors, a nurse and members of the local church and Health Ministry, settled in and began 6 days of clinics.  For the first time we had elected to spend our entire time in the central little village of La Hicaca. People from the surrounding areas (a total catchment area of over 2000 people) were each to come at scheduled appointment times. Through the hard work of the team we were able to see 440 adults and children. Each person received medications to prevent and treat worm infections as well as having their hemoglobin levels determined. All children had their teeth varnished to help prevent tooth decay, a major health issue for each of these communities. A Honduran dentist was able to join us and examined 50 patients for their dental concerns and we were able to provide over 150 reading glasses.

Through the generous donations to the Golden Phoenix Foundation, we were able to purchase over 400 vaginal speculums so that the Honduran health team who accompanied our journey could perform PAP smears on many of the adult women. For some, this may have been their first potentially life saving screen.

We were able to continue our clean drinking water project. While we were there the pipe that takes water from the local cistern was broken. This meant that the entire community had only the river (the same one we drove through and the cattle frequent) as a source of their drinking water. We were able to culture both the river water as well as that in the cistern and found that each not surprisingly was filled with E. coli (one of the major organisms found in stool). Fortunately most families around La Hicaca have already received their water pots and have clean drinking water.  Through the generous donations of our friends, we were able to purchase and distribute almost 100 additional water filters. This means that we now have over 150 water filters in use, serving more than half of the 280 total families in our area. In addition, every family who has a child less than 5 years of age has a water filter providing clean drinking water.

A highlight of our trip was being invited to the small little church in La Hicaca and be part of the Baptism and First Communion Ceremony of 7 children from the community. As we watched Father Pedro perform the joyous ceremony it was not lost on me the spiritual and healing power of the water that he was slowly pouring over the heads of these young children. It was such a wonderful honor to be apart of this experience and share the joy with the families and the community. 

Our last experience with water or more specifically the lack of water was going 6 days without the ability to bathe or shower. I do have to say that the entire group who came this year maintained great spirits and proved that if everyone smells than no one seems to notice it. Of course I would have hated to be the other people back in Olanchito when we finally made it off the mountain.

As I reflect on our trip, I am reminded how critically import water is. How too much of it can be such a burden to people who must live under these conditions and whose only means of transportation is walking. I am reminded how life sustaining clean drinking water truly is and how such a large portion of the world is without it. How much a struggle it can be to perform simple functions such as bathing or washing clothes. I am encouraged however that through the generous donations of the many friends of the Golden PhoenixFoundation, we are able to help so many families obtain clean drinking water through our water filter project. For only $25 we are able to provide clean drinking water for a family for up to 2 years. It’s amazing that so much can come from so little money. As I continue to return to my little 2nd home in La Hicaca, it’s is my hope and desire to eventually be able to change the old saying to “water, water everywhere and now plenty of water to drink”.

For more visit the VCU Global Health and Health Disparities Program website

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