Stormy Weather

It was a dark and stormy day... But not cold. 

A driving drizzle and tropical bluster for the 

most part.
 
At the risk of having you think I'm a sociopath, I 

feel the need to clarify some bits from yesterday's post. 
(I felt you shudder... Did you think that I had cannibalized 

the body? It's not that bad.)
Thank you for your concern and sympathy, but I feel fine. 

I'm not in shock or traumatized. I am not afraid or even 

particularly stressed. Surely the death was early and 

unfortunate. For his friends and family and patients, I feel 

sympathy. But... Mostly I feel that if one must die, 

this was a nearly ideal passing. (Are you backing slowly 

away yet?) This man, a Dr and a man of faith, was here in 

Honduras on an a trip he'd been making annually for a decade. 

His death was instantaneous. He was actively surrounded by 

people he loved and trusted, in a place he knew and delighted 

in, doing work that was joyful and fulfilling. 
There were no accidents or errors or sloppiness in the treatment. 

Even I was able to enact my Red Cross training precisely as I'd 

practiced it. I saw the hole in the process, and filled it by 

making sure the ambulance came, that the EMTs received true 

and precise information and directions upon arrival.
No horror. No misgivings. A swift and honorable passing.  
That's the first thing.
The second is this. I see that I used some strong words 

regarding potential harm or incident. No immediate threat 

existed. Potential threat. 

Not the same. The Unknown variable is something to be 

cautious of here, but we aren't sitting around in anguish. 

It's all ok.
 
So... If you're still with me. Back to today:
It was a dark and stormy day. Yesterday's beach, full 

of merry-makers, was covered by water that came up to the 

road. 
Breakfast at 7:30. I'd slept poorly (and there was a big 

cockroach in my sink when I got up in the night, so I had 

a little spaz over that(forgive non-PC childish expression)) 

and so arrived groggy again. I'm still ailing from some new 

incarnation of this illness which has moved into my throat, 

chest and sinuses. Add in the equilibrium-bashing Malarone 

(my anti-malarial medication), and I'm functioning, but 

not in top form. 
 
Breakfast, followed by some more indecision. 
I declared my intention to find something interesting and 

scenic/historical nearby,should anybody care to join me or 

offer alternate stimulation for the day. The official organizer, 

Nancy, is clearly and understandably distracted by her new 

duties of managing arrangements for the Dr. And his family. 

Another Dr, Jeff, has essentially taken over as Operational jefe. 

This is good.
 
Visited a 16thC fort (Oama) and saw a bit of the countryside. 

Interesting triangular construction (of fort). Also some 

history of ceramics and weaponry, piracy... Blah blah. Not what 

you want to hear from me, I know.  One especially lovely part 

was the Jicaro tree. (Please Wiki) 

This tree was coated, trunk and limb with epiphytes and orchids. 

The tree itself was a wonder. The fruit/gourd looks like a pomello-

sized Granny Smith, but they are used to make maracas. Additionally, 

the flower is .... 

It's worth a look online. 
 
We are 51...kilometers (I think)... from the Guatemala border.
 
Went to a small local marketplace in the afternoon. Animals you'd 

prefer I don't describe roam the streets. People are out walking, 

shopping, normal.  A good sign. 

Talked for a while about fruits with vendors, and to both a 

pinata-maker and a wizened woman making paper flowers. 
 
(You're waiting for the shoe to drop.)
Post-market, I understood that a couple of people were going 

to scout again. So I went to nap.
Oops.
I missed a medical drop. Not a clinic. The village in flux, 

Colonia Suyapa, had been deemed safe. Several had delivered 

basics in 45 minutes to a small group there. 
I was sacked out until dinnertime.
 
At dinner, the mood was improved. But the Ministry of Health 

(issuers of essential Death Certificates) are .... On strike. 
O.K.
And...We may be able to get this process expedited after all. 
So...I'm just not riding the rollercoaster anymore. 

Que sera, sera. 

No matter the body, the leader, the Ministry, the Bishop, 

the cartels...*my* plan is to return home Thursday as scheduled.
Where was I?
Yes. Right. Dinner. 
We planned tomorrow's clinic. I'm excited. It involves walking in. 

A jeep will schlep the bags. We will schlep ourselves uphill, in 

the mud, across 2 streams/creeks. I am looking forward to it.
Because of the shift in personnel, we have decided on a new 

organization and process. I will handle in-take and funnel the 

patients according to age, group and needs. We have only pediatric 

drs now so some issues for adults can no longer be treated.
We wrapped up dinner with a bit of levity, swapping iPads and 

smartphones and watching funny and crazy YouTube clips.
Fading some, I stretch my arms over my head and arch back. 

Noel, seated next to me puts his hand lightly on my back and says 

in a voice low and urgent, "Jenna, stand.

             

up. now." ... I promptly stood and pivoted. Under the back of my chair, a palm-sized tarantula. 

No. Not kidding. Once I stopped spewing expletives, I tried to convince the group to eat it. But no 

takers. What a group of wusses. :)
 

Cha-Cha-Chachahuala

When you plan a trip for a group, it's a good idea 

to have some kind of special treat, present, or 

experience scheduled for the last day. That way, no 

matter what happens,even if it's beyond your control, 

you've left people with a little proverbial sugar on 

their tongues, and chances are that'll color the trip 

favorably when they remember how it all went down.
There was no such manipulation here, and yet, our last 

day was a joy and a success in every way.
Down from 4 doctors to 2, and a handful of others 

departed early, we remaining 12 (from 19) had some 

rearranging to do. I was pleased to take several roles 

today- in-take, translator, and dispensary - as it gave 

me opportunities to work on vocabulary and other skills.
In 8 hours (8:40-5:00) we treated 285 people.  
 
The village of Chachahuala (cha-cha-wa-la) is more 

concentrated than Barba Chelas, less polluted than 

San Pedro Sula.
The weather was ideal: warm, but with some cloud cover.
There's no hitch to report today.
At the end of the day, we were weary and worn, but decidedly 

pleased with the outcome and our work. The group visits 

these three villages annually and so several group members 

have relationships with people in the communities.
What more can I say?
No tarantulas. No death. No illness. To robbery. No trouble 

from traffickers. No accidents.
Veritable bliss and harmony.
Take a moment to sigh with contentment and relief.
(Now go on and admit that it's a less exciting email 

without a bit of trouble. Com'on. )
 
it's been called to my attention that I have neglected a major 

and important theme in my writing. The food. 
This IS unheard of for me. Usually I relish the opportunity to 

tell you all about what I eat and see, and send photos. To fill 

this hole, I'll tell you a bit now.
Admittedly, I have been a far more conservative eater here and 

now than I usually would be. Additionally, I've had fewer 

opportunities for diversity in food exploration. Most of my 

meals have occurred in 2 hotels.
In summary... The food isn't very interesting or notable. 

Each morning I have some oatmeal which is tasty, milky and 

sugary. And also a desayuno tipico (Tab, you'll be glad to 

know what normal Breakfasters order if we return) which is: 

small, hot, flour tortillas (thick and delicious) on a plate 

with small piles of scrambled eggs, black refried beans, 

crema, cheese similar to cotija, and a piece of ham. Tasty 

enough.
For dinner, the best things I've had were shrimp in garlic 

butter and another plato tipico, add plantains and beef to 

the breakfast plate (minus eggs). 
The seafood has been good, if over-cooked consistently. I've 

had a lot of fish. Even in the village at Barba Chela, where 

they made lunch for us, the freshly caught whole fried fish 

was excellent. When I asked where it had come from, the cook 

pointed to the vista out the window, and indeed, I could see 

the ocean just a few miles away down the mountain.
The most flavorful thing here has been the fruit. There's no 

contest for fruit that actually gets to mature on the vine/

tree. The bananas here bear only distant relation to our own 

mouth-coating, firm variety. These are creamy and tender, 

unaffected by refrigeration. Yesterday they villagers brought 

me fresh young coconuts to drink from when I was thirsty. The 

water was lightly fermented , refreshing and revitalizing.
 
Tomorrow, the plan is to leave here by 10am and return to 

San Pedro Sula. Once there we'll tidy up some loose ends with 

the medication and clinic business, and then .... Explore the 

market place. I'm hoping to have a few hours of that as for me 

there's no better way to get to know a place than to see their 

cottage industry arts and crafts, and by that virtue, what they 

value, cherish, crave. I may have more to tell you from the 

airport afterwards.
 
Thank you for your ears and eyes. It's so satisfying to translate 

my little adventures for you. 
I wonder if I could get work as an Adventurer for Hire. What do 

you think? Imagine... You hear of an opportunity for something 

interesting or wild or strange. Part of you would like to go, 

but constraints of time, inclination, aversion to travelers 

diarrhea prevent you from setting out. You could pay for *me* 

to go and I'd not only give thorough reports back, but I'd 

return with flavors, sights, scents and sounds of the 

experience! I'd help you be a sensory intensive armchair 

traveler. Like the Shrek in 4-D ride at Universal!
Think about it.... My passport is ready for the next 10 years, 

and I'm current on all my vaccines. 

Ya'll Ready for This? (Barba Chelas, Honduras)

You're not going to like this... Today was Backward Day.
Another grey, rainy tropical morning. I arrived at 

breakfast to a grim-faced group. 
"We've been robbed," Nancy said.
(A little morning slow) hm. Robbed. Of what? What "we"?
I was asked to return to my room to check valuables.
Oh. Right. I've been robbed. Of my iPod. Otherwise items 

intact. My iPod had been on the bed when I'd gone to dinner 

the previous night.
Meh. Vaguely bothersome. Replaceable items don't phase me. 

Nothing personal.
Wasn't even surprised really. While I'm not accustomed to 

being burgled... Or am I?.... The locks here could be 

opened with a butter knife and a flick of the wrist. I'd 

mentioned it when we'd first arrived.
Really though... No biggy. Replaceable, and all the 

files on my computer at home. Could hardly be less 

offensive a theft.
 
I filed a 10 second report with the Front Desk, and 

off we went! Barba Chelas Clinic! Finally, back on track.
A 20 minute ride took us to the end of the paved road 

at the base of the hills (mountains for you Easterners. 

Hills... Good ones, for the Left Coast). We loaded a jeep 

with the 50lb bags of medical supplies, hygiene items, 

books and toys. And as the truck bucked and slithered up 

the hill, we trekked up in the mud and drizzle of the 

morning. It was a beautiful start to the day. Honestly. 

The walk, while rigorous, was jungly and full of plants 

and birds and varied terrain. It felt great to get some 

exercise and air. We crossed several streams (nothing 

more that 15' across and a foot deep). The only notable 

structure was a large estate... An orchid farm. Otherwise 

the hills and dales had shacks tucked into nooks and among 

the vines and trees. There were organized and wild, groves 

of bananas and cacao. Papayas, passion fruit vines tying 

cacao and pomello trees together. Eucalyptus and bamboo, 

and dozens that look like dinosaur relatives of flora from 

home. The only thing we were warned against was... Jaguars.
I won't tease you. I saw no jaguar. 
 
Slightly damp, but warmed and happy, made it to the Village. 

Village being a loose term here. I saw 1 house, 1 school 

building where we established the clinic, and craning my neck, 

a chapel. The other homes were tucked away along footpaths.
Remember, the Clinic program has changed as we now have no 

Dr for adults. I am on in-take. It is far less taxing than 

my previous job as now it's simple conversations and only 

in Spanish. We had only 178 patients today (9am-3pm) 

- now down to 2 Drs -  which left me some time to play 

with the kids. Sandy, a nurse in our group, brought 

bubbles - a genius move - so a dozen kids age 4-11 

and I, blew bubbles, told stories and ran around the 

yard for a while. Another smash hit was the scores 

of tennis balls we handed out (half of which likely 

ended up in the ravine by days end).
 
We finished the clinic at 2:45 with all patients 

seen to the best of our ability. These villagers 

suffered none of the rashes and bites, coughs and 

diabetes of SPS. Walking those hills daily doesn't 

allow for nearly the same diet and there's very 

little pollution.  No electricity, running water 

or cell phones. The kids attend primary school 

in the one-room school house we were borrowing, 

and for high school walk two hours EACH way into 

town. It sounds like I'm recounting the childhood 

of Abe Lincoln.
The children were friendly, clean, and polite, 

and the whole visit was a joy.
 
On the walk down the hill, I visited the orchid 

farmer. Saw a number of interesting birds, plus 

leaf-cutter ants. The farmer had some wonderful 

parrots (scarlet macaws are native to Honduras).
 
Returned home to learn that the body of Dr Myers 

has been expedited and will be sent to Los Angeles 

Thursday morning.
 
A prompt and easy dinner.
 
Oh! And the hotel owner is going to reimburse me 

for the cost of my iPod. How nice is that!?
And here I am, 9pm, tucked in and safe and well. 

I feel a little like Glinda, a story I told the 

kids as iridescent bubbles floated past their 

heads and outstretched arms. 

What A Difference A Day Makes

24 little hours

I could have written 20 different versions of this email if I'd checked in as the day
evolved.


I'd like to start this tale with my preferred, "everything is o.k., but..." It isn't.
So instead, I'll start with, "None of your fears or concerns about my trip here have
been realized, and I am o.k."  This is true.

The day was full of indecision and false starts, much of which had to do with the
condition of a village this group usually visits. Colonia Suyapa is an inorganic
community of people who were hurricane refugees thrown into proximity by circumstance
to form a new village. No gel. No lasting unity (it seems) developed. This village
had been organized by a small church group. Church people departed recently due to
community indifference.
Enter chaos. Or... At least an element of Unknown, and around here at this time,
Unknown isn't likely to be a good thing.
Discussion, debate and strategy. All angles and options discussed.
No one wants to walk into a potential slaughter or kidnapping. So we stalled until
solutions evolved. Because really... we know very little.

We decided to ask local scouts to go and assess. (That sounds awful and sacrificial
as I write it, but it wasn't.) The rest headed to the hotel in Puerto Cortes to
unload, reorganize, and plan the afternoon clinic.
And so, an hour-ish drive from SPS, we arrived to a Sunday at the beach, the
Caribbean bathtub-warm and thick with happy families enjoying a nice splash.
Our hotel is immediately across the street from the sea.

I can't drag this out.
One of our Doctors died.
Of a heart attack.
Shortly after going to his room.
With several medically trained people here, CPR and other procedures were implemented
immediately. I ran relay and helped with information. The front desk clerk needed a
few swift kicks to the face before she could be persuaded to phone for an ambulance
again (they weren't answering the phone.). In fact, likely it wouldn't have mattered.
Noble and heroic effort was made to revive him, to no avail.

This brings us to 3pm.

And so we sat. And tried to plan to ... Return the body to his family in Los Angeles.
A task I hope none of us or you are set to again.
It was decided that we would abort the trip.
And then... Maybe not.
And then we had to.
And then not.
And... It turns out, you can't overnight a corpse. Shipping from Honduras: 5-7 days.
So... Some would stay.
Hotel and flight reservations were negotiated, booked, cancelled again, and again.

I went for a walk in the water for some space.... But not alone. It was fine. We
walked within sight of the hotel and 500 families.

The Bishop of Honduras was coming.
The Embassy personnel were coming (scratch that, it's Sunday).
The priests were coming.

At 7pm, the priest came. I invited her to sit by me. She looked like my Grandma Cel
and I felt very drawn to her. More still once we spoke.  I was sad to see her drive
away this evening.

Over dinner, more evolution. (Truthfully, I had never wanted to leave. But I was
having difficulty deciding to stay in this troubled spot on my own.)
Some would leave. And did.
Others would stay, but avoid the problematic village and hold clinics at the others.
And we shall. Though now we only have Pediatricians. And one of those is leaving too.
And then there were 2.
But... Now I am not needed as a Translator (in the same capacity) which means that
I'll be able to switch roles and work.... (No, don't be afraid, not as a Dr.) either
in the dispensary or in-take. Both would be interesting.
And so it shall be.
Maybe.
Unless something changes.
So... With the caveat that all of my predictions and plans may be moot when next you
hear from me, this is where things stand.
And while this morning we were 19, this evening we are 14, and one dead.
But not like you thought it might happen.

I'm hoping for a good sleep tonight.

First Day in San Pedro Sula, Honduras (Medical Mission trip)

I was wrong about the schedule this morning when I wrote.
Breakfast at 7:15.
Leave at 8:00.
The hotel, a Hilton, is nice by any standard. Large neutral-toned rooms w/ downy beds, and a chandeliered 2-story lobby. We are in an upper crust neighborhood. Houses are walled compounds, some with armed guards outside.

Four blocks from the hotel we turned off the paved road and started our ascent, a steep and rutted uphill climb in the van, toward the slum where today's church clinic was held.

Houses are cinderblock, sometimes painted, roofs are sheeted tin, sometimes shaped and colored to look like clay tiles. Occassionally thatched. Stairways are cut into the hillside out of the dirt. Lush plants, tropical, some coconut palms, some mandarins and bananas.

The ride took 10 minutes. Less than a mile. Maybe 1/2 to 3/4mi.
8:10. Unload up stairs (tiled) of grade and depth that remind me of climbing Chichen Itza. Shallow foot pads. Each step with higher facia than our customary 5-6in. More like 8-9" each, making even the 20 stair climb a little tiring.

Set up. 1 room church. In-take desk immediately to the left of the door. To the right, pews arranged into waiting room area.
8 pews arranged into 4 patient cubicles. On one side the Dr. (there are 4 doctors in all), on the facing pew the Translator (me) and the patients. We see a family all at once and address their symptoms and complaints one at a time starting with the parents and working down the row by age.

Beyond the exam areas, more pews and chairs set up as a Dispensary.
On the alter platform, the Pharmacy.
Post-exam/Pre-Dispensary Waiting area, outside.

I am with one of the pediatricians, but we also see the parent/s who come with the children. Our resources and treatment options are severely limited, but luckily (for us) most people suffer from the same-ish issues. Most of them seem very blunt about their problems. This may be a matter-of-factness based on circumstance. More thoughts on this later. Most have also come dressed in their finest for the examination. They ask for treatments for parasites (intestinal in this case) and skin rashes/bites/sores - recurring, but not made by something I recognize, vitamins, aches and pains mostly from lives lived hard, toting and birthing children and working in factories. Everybody has a cold and most have coughs and bad headaches. Some dizziness. We see a lot of high blood pressure among adults and the headaches we mostly attribute to that. Some diabetes. Some vaginal infections (no exam). Some eye problems from working in dust and smoke. One case, the only one we actively treated, impacted ear wax.
The "Exam" usually involves a primarily verbal relay with me in the middle. I ask Pt#1 for her ailment. She gives me a Symptom or two and I pause her to tell the Doctor. I open both ears and eyes and use them separately to hear, see, translate, summarize, relay between the doctor and the family. The patients have patience. The Doctor has less. I learned some new words for issues I couldn't have picked up elsewhere, as well as some colloquial speech which was at first very perplexing. They use here a construct that literally translates to "it hit me". This is said much as we'd use it in English... That we were "stricken" or "hit" with a illness or a powerful emotion, but for a long while today I kept withholding from the Doctor precisely what these patients said. It was clear (after some weird and alarmed questions from me) that they had not been physically assaulted, but I had trouble trusting my hearing in the cacophony of the space which held easily 40-50 people at a time (approx 25x40 sq ft.) and making a less literal translation.

Between 8:20 and 5:30, I stopped once to pee, and for 10 minutes to eat. The day passed quickly without any downtime and full mental engagement.
Between the 4 doctors, we treated 305 people in 9 hours. As this clinic was urban and air-conditioned(ish) this will be our easiest day.
Packed up and cleaned.
Back at the hotel at 5:50.
I came back to the room, napped like the dead, dined at 7:45.

Tomorrow we have a 10am call time. Then drive to Puerto Cortes on the coast, stopping to check one village (in flux) on the way.
No scabies today. (TBTG)