Good-bye Gracias-Lempira, Honduras

My host brother Jonathan has his typical Honduran cofé con pan (coffee and bread) breakfast before leaving for school.

Doris (my host sister on the left) and her friend return from school.

As a way of representiing a conclusion to my service in Gracias-Lepira, Honduras, I will outline the patterns under which church and clinic usually 'operated'--if you want to describe the actions in that way. I'll share a few small observations/lessons from being a participant of the two groups and touch on my transition to Buenos Aires, Argentina.

Oscar, Carmen, Carmen's mom (all rom the Evangelical church), and Ada arrived early for our last recorder choir participation at the Baptist church.

Some more of my 'alumnos'

La Iglesia Bautista Vida Nueva:
As I briefly mentioned after my first week in Gracias, I was initially a bit distracted by the loudness of worship services in the local Baptist church that my host family attended. Within several weeks, my ears were 'attenuated' to the intensity and I began to understand the basic program that the services followed. The agenda is as follows:
-The service coordinator for the week greets the congregation and visitors are pointed out (or self-identify themsleves) and are greeted and welcomed to the service by the congregation.
-There is a welcome song (led by a praise group) that the congregation sings while greeting one another, exchanging hand-shakes and hugs throughout the church.
-The service coordinator leads the congregation in a reading (on which the message focuse) and a prayer
-The stage is then opened to members of the congregation who want to express for what they are especially thankful to God that evening
-Special participations proceed, if any exist (during my attendance these included recorder choir, brigade blessing, baby presentation)
-The praise group leads the congregation in several worship songs
-The service coordinator leads the congregation in a prayer for the offering and people proceed to place their donations to several baskets at the front of the church, continuing to greet each other en route
-Several more worship songs are lead by the praise group, ending with a slower, more meditative song
-The Pastor (or a visitor/youth leader in his absence) offers the evening's message and concluding prayer
-The praise group leads the congregation in a final song after which members freely dismiss or disperse themselves for more greetings
I have admired the simplicity, cheerfulness, and all-engagement of this church's services. Each element seemed to add to represent and celebrate what it means to be part of Christ's family and a disciple of His. The second week, when a speaker mentioned finances as one of the things we must must manage before God (in the light that they are not our own), he cited Matthew 6:23, where Jesus instructs as part of the Sermon on the Mount that people be in peace with their neighbor before bringing their sacrafice to the alter. I had never heard this verse used in the context of financial service in the church but think it beautifully explains how congregtions (and Christians, throughout) are challeneged to be peaceably whole and to represent this harmonious state by contributing into one basket what they can. Likely the same thing can be said for the idea behind communion (although it doesn't seem that they regularly observe this act). I am not sure from where their worship traditions arose, but I have enjoyed getting to know several of the subtle variations in worship style and believe that they are worth learning from.

Staff at the clinic

La Clinica San Lucas
A day at the clinic begins around 7am when the nurses prepare things for the doctors and the cleaning staff members beautify each room. At 7:30am, all staff members gather for a devotional, led by one amidst by turn. After a reflective comments/discussion and a circle of prayer, the clinic begins its daily operations. There is a 12-2pm lunch break and the clinic closes at 4pm, allowing most staff to leave for home by 5pm. I will share several bits from devotionals that have been memorable regarding the ideas of 'connecting the dots' and 'stepping stones.' One morning, we watched the graduation speech delivered in Stanford University by Steve Jobs, where he mentioned needing to connect the dots of seemingly insignificant circumstances in his life to understand his bright and successful moments. During a morning in which we discussed Psalm 19 (one of my favorites), I noticed that the second verse--"Day unto day uttereth speech, and night unto night sheweth knowledge"--might suggest that the 'stuff' that we are supposed to take advantage of and gain from every day is as subtle and ever-present as the cycle of day and night and that it is up to us whether or not we 'connect that day's dot' with the previous days' dots or simply live to get one day older. Wondering about my experience in Gracias as a whole, I thought that 'dots' might be better represented as 'stepping stones.' I am convinced that if we have actually connected a moment's 'dot' (whether it represents a day or year), it will inevitably influence the trajectory of the consecutive 'dot,' thus serving as a 'stepping stone' along the journey.

The terrain between Honduras and El Salvador

In transit to Buenos Aires
While I struggled to keep upright for four hours sitting in the middle (as one of three front seat passengers) when we bounced up and down the winding mountanside northwest from Gracias to the airport in San Pedro Sula, I wondered about how differently I was relating to the signs on the road, homes near the road, and people on the sides of the road than I had when I arrived by the same route seven weeks ago. As we ascended from San Pedro Sula and flew accross mountanous terrain to San Salvador, I wondered if I felt any connection to the city of San Pedro Sula, the country of Honduras, or the region of Central America. I found myself persuaded that I might have gotten a taste of several patches of Gracias and could only claim affection for a small part of the small city and a fraction of it's residents. Rather than feeling that I should/could expand my 'conquest'--if that is a useful label--I am satisfied that I was able to find a sense of home (even if superficial) in a land and amidst a people to which I did not initially belong. The experience and process of doing so, applicable to any location, is valuable in itself. As I descended from the dark night sky into Lima, Peru for my connection flight to Buenos Aires, Argentina, I marvelled at the glorious patterns of the citylights that lined the land like sequens on black velvet as far as one could see. For some reason, I associated this scene with the Spanish conquest and Incan Gold. Did this bright scape reflect the wealth of the place? Do I prefer a well-lit city to a neighborhood where the sun sets at 6pm and the electricity regularly fails from 6:15-7:30pm? I wondered like what the Harrisonburg or Dulles Airport (Arlington) nightscape appears from an airplane and what the asthetics suggest about living in the place.

The clouds are so white (reflect at light so well) for being composed of dust and water

I concluded my final week in Gracias with a visit to a small village with the social worker and Dra. Raquel to hold a fluoridization and extraction clinic for a six grade school, presenting a Russian 'lesson-ito' for Pastor Carlos' (clinic director) English class in the local uniiversity, and visiting the town's aguas termrales (hot springs). I am enjoying spending time with my aunt, her husband, and their twin two-year-old boys in the city of Buenos Aires. So far, I can't seem to believe that I am not in Europe. I hope to continue exploring the city over the weekend, to spend time with family, and perhaps make several day-trips into downtown next week. [Wednesday, February 21st (the morning that I arrived), there was a terrible train accident in one of the lines. This makes me remember Honduran tragedies that occured before I left (a jail burned down, killing most of the inmates, and the capital's market also burned, claiming most vendors' investments and livlihood). I am sure I could name more misfortunes if I vigulently watched the news, but it seems that pain and suffering are never far from any human nation or people (for this most personal and most universal experience is the essence of humanity)] Warm, sunny, end-of-summer greetings from Buenos Aires!

Christendom and Globalization

 

The dental/medical brigade banquet at the end of the week was hosted in the town's castle. A high school dancing class performed several traditional Honduran dances.

I like how in Honduras town limits are always announced as "welcome to so-and-so a town," instead of the plain "entering---" that I mostly remember from the States. Someone in La Campa was brave enough to lasso themselves to a tree and paint a nice welcome sign on the mountainside.

Isn't this a pleasant purple-green flowering tree/bush? The main Catholic church is seen in the background.

Christendom in La Campa: the heart of Latin American History

Over the weekend, I traveled to a small historic town named La Campa with Dra. Raquel and Don Alfonso Carranza, an anthropologist who teaches history and art at the local university. During the half-hour drive there, I marvelled at how many villages, homes, families, and people Don Carranza could affably recall as we passed certain landmarks. His simple but reverent interest in the lives of various villagers and his excitement in understanding their cultures is admirable. Perhaps because he initially studied botanical anthropology, he takes a holistic approach to understanding the workings of a place by including its terrain, vegetation, and inhabitants and studying the location's history, economy, and culture. Although he only spoke Spanish, I've remembered some of his phrases and find them worth quoting throughout this post. When Dra. and I expressed our marvel at how many people's lives he knew about, he said, "The best part of life is friendship." He would often go on 'a rabbit trail,' talking about one of his publications or some extensive topic but would pause as we passed a dirt road or homely house by saying, "parenthesis" to talk about "the man who lives in that delightful house who doesn't need anything but salt as he makes all his clothes and food" or how this or that village came to be. In La Campa, we casually visited various parts of the village, including a Catholic church, where I believe the heart of Latin American history lies. Although a devout Catholic, Don Carranza discussed the often shameful history of Spain and the Catholic church freely. He described the exploitation of indians that occured with the establishment of each village and how similar trends continue today, even if the Cahtolic church has been replaced by other powers and indians have different names. He explained that the typical Spanish village was centered around the church. On one of its sides would be the plaza and municipal buildings and the police station/jail on the other. The rich would settle around these three landmarks and stay within the premises, unaware of and uninterested in life on the outskirts. I wonder if something similar still exists in Latin America today. Honduran interpreters accompanying the brigade last week explained that they enjoyed going to the villages with brigades because otherwise they would never know about or visit those communities (some of which are not accounted for in the major cities' census bureaus). Is the drastic socioeconomic difference between large city and mountain village a result of these communities living mutually exclusive lives?

At this point photos might speak better regarding my impressions of La Campa:

Before we went inside the church, Don Corranza explained, "Religion and power have always been together," referring to this double headed eagle at the shrine of a royal saint who once had some influence in the town.

This image of Mary reminded me of the nativity scene (as there were animals). I found myself searching for baby Jesus...in vain, for there were only two children or village images worshiping Mary alongside the animals. I suppose this is why Catholicism is often accused of pushing Jesus to the margins of their faith.

This large painting interested me...It appears that it depicts people with royal and religious head-dresses and rosaries in hell (where the light bulb is appropriately placed) and nude angel-looking figures suspended in a space between the inferno and heaven...I'm not sure who the two figures in the clouds are. Dra. suggested that people might place candles at the painting for their ancestors' sake (who might be in purgatory).

This cross, as many crosses from the Christendom era, is a symbol for "the church making peace with war." The 'holy mission' seems to be depicted as that which requires the heart's blood dripped into a golden cup, under which two swords cross in front of a ladder.

This saint appears so holy and earnest (I might even mistake him for an image of Jesus), but does the large spear seem to belong...does it bother us...does it represent the man's earnest loyalty to an unspiritual authority?

If anything puts me at ease (or into pleasant meditation) in a Catholic or Eastern Orthodox church, it is the candles. Some are tall; some have burned short. Some stand erect and others tilted. Most are uniform but occasionally one that stands out appears in the midst. Some are placed in nice holders and others are adhered in their own wax. ...but all inherit the same fate in the wax pile after burning out.

A side door in the church is securely locked and blocked by a bench-like pew, but there are several peep-holes that allow exchange between the interior of the curch and the outdoors. 

Another Catholic church is called "the church of the children" because, as Don Corranza explains, nearly all the children of the town died from a cholera outbreak and were buried in a common grave in the church yard.

Globalization: churros and fresca trod the path for medical missions teams

Driving up mountainsides to various villages with the brigade last week (and to visit the historic town over the weekend), I noticed that these narrow dirt roads were lined with plastic packaging and bottles from refined foods just as the paved main roads in Gracias. From some views, cascades of trash were seen to descend from the road down the sides of the mountain. After bouncing around on dusty and rocky roads for over an hour we would arrive at a village with the brigade to find a line of people near the school (ready for our services). On the opposite side of the street, vendors would set up booths, selling typical street foods, fresca (pop), and churros (chips). I wonder if their profits increased significantly during the brigade when people had to wait in line all day. I was somewhat astonished to see various children whose teeth were extracted minutes ago reappearing with a soda or bag of chips. Within the first day, this became a common sight and eventually lost its strangeness. Now, I wonder if at least three things mentioned above are intimately interconnected. Could it be that when remote villages gain access to the market of refined foods, their streets become polluted and their health (oral, in the least) deteriorates? Maybe the introduction of an urban (or global) diet is responsible for damage to the terrain and health of rural villages. The trucks bearing refined foods have only to make their rounds for a short time before the road is 'paved' (or at least trodden down) for medical brigades. Both the necessity for these projects and the means of getting to the location are provided by the expansion of refined food markets. Ailment of the villagers is noticed readily and measures to treat the symptoms or effects of disease are taken (though no one actively questions why the disease has only then flourished or what could be causing it to do so). But I wonder at what point ecological ailment will be noticed. Will brigades from the States also arrive to extract the diseased ecological anatomy? Is there an organization that cares for Honduran terrain enough to fund such projects? Will someone eventually look at the big picture and bravely try a different approach? Again, I am faced with questioning the accuracy of existing medical brigade aims in addressing the actual causes of perceived problems. [My freshman biology and general chemistry class vocabulary have come in handy in this discussion--that is, the difference between accuracy and precision and the distinction between actual and proximate causes...Thank you EMU!]

As we awaited a typical village lunch (fried chicken wih fried green bannanas) under a tent 'comedor' (eatery), I noticed the surplus of Pepsi soda fridges surrounding the restaurant tents. Water was not available in the eateries. Don Coranza pointed out a Pepsi soda fridge beside the municipal building and said, "Where you see Coca-cola and Pepsi on every corner, you can be sure poverty is near." Whether the presence of superfluous soda is a cause or effect of poverty (among many other things) is hard to discern, but the trend may give us one more reason to stay away from those fizzy empty calories. : )

How's this for the restaurant kitchen? Watching your food be prepared is a plus. The absense of refigeration might be a problem, but perhaps it's no issue if most of the menu's food is deep fried.

This señora helped prepare our lunch. Her daughter showed us a little puppy sleeping in the corner of the tent. She said she found him on the street and has decided to become the pup's adopted mother. His name is 'colita' (little tail) and she tells him stories of animals and princesses to put him to sleep.

More history and customs of Gracias:

-15 years ago, there were no cell phones or land lines in Gracias. My host parents were tconsidered crazy for moving away from San Pedro Sula (a major city) to a place where they could only communicate with family through a central office telephone. They decided that the move was part of committing their family and life to service in the San Lucas clinic.

-5 years ago, there were no moto-taxis in Gracias. According to my host mom, people walked everywhere, lived closer to town, and had more time to converse, although some adhere to their walking customs even today.

-It is normal for Gracians to invite you to their birthday party by word of mouth a fore-night in advance. At the party, it is acceptable to ask to take some food home.

-It is customary in Gracias for the best man and maid of honor to pay for the church wedding decorations.

-An apodo is a nickname. Some Gracians go exclusively by their apodo and you may never know their real name (whereas in large cities only family may assign you a nickname).

-Macizo and puncha are used to express surprise or impression, like 'cool' or 'wow.'

La Campa, like Gracias, has a catracho (Honduran male) depicted near the plaza. I wonder if this is to honor the hardworking legacy that indians (and the populations that have replaced their working role) have carried on since Spanish settlement. Public schools are in session...so my host mom and I see less children waiting for the coffee-picking trucks on our morning walks.

A very cool-looking, fuzzy, legume-like plant grows out of the wall that encloses the Catholic 'church of the children.' Don Carranza (upon Dra.'s inquiry) informd us that the plant has a terrible taste.

Epiphytes grow on trees, roofs, and electrical wires in the area, but I have never seen a cactus epiphyte. Don Carranza suggested that the 'palomas' (pigeon) friends helped the cactus make its way up the church roof.

...And last but certainly not least, Don Alfonso Carranza, himself, in front of the main Catholic church. He explained that the grapes that decorate the church exterior are purely Spanish (as there were no grapes in Honduras...neither were there bananas or oranges, two of the most prevalent fruits today). He said that food is very significant in religious symbolism and art because "there isn't much more than food and God"...."and if God isn't providing for your necessitites, you search for another." I'm thankful to have met Don Carranza and to have learned from interacting with him during the daytrip. I might not study anthropology instead of dentistry (as he had suggested), but I may be interested in the field in my free time...Anthropology seems to be the most natural human occupation--that is, trying to understand nature, people, place, time, and how the four come together.

In the past week, I have found myself in the role of interpreter--on the brigade with Americans, in the clinic helping to search for a piece of hardware for the dental air compressor in a neighboring city, and interpreting a phone conversation from Spanish to Russian and vice versa (a first!) for a church acquaintence who had worked with an elderly Russian couple in Manassas, VA for several years but had no way of communicating with them without gestures that physical presence allows. It is hard to believe that I am in my final week of service in Gracias. Dra. and Carmen, the social worker at the clinic, have promised a village visit by the end of the week to show me their community health and dental education efforts with children. In a week I will be en route to Buenos Aires, Argentina. ...Happy late St. Valentine's day!

Language, streams, and villages

This main street  passes the plaza and part of el centro. Above the silver car, you can see part of the Evangelical church where I hold recorder lessons with one group of kids--yes, this is the church in which we were locked one Saturday morning. The street was unusually quiet so I didn't feel especially stared-down while I took a picture. The small red vehicle is a mototaxi, a three-wheeled cart-like mode of  transport around and outside the town of Gracias. I'm not sure why this one has a Texas plate (most don't have plates but some decoration, often a Christian symbol or phrase). Upon asking my host sister, Doris, if the mototaxis ever tipped over (when we once chose an especialy fast driver, jostling around on the rocky dusty roads), I was informed that what I would be told would alarm me. For various reasons (perhaps including this minor one), I prefer walking.

Musings on language:

-What is the difference between understanding a new word out of context/description from a conversation and looking it up in the dictionary for an English equivalent? Is the urge to look the word up bad? When does one know the meaning of a word or idea?

-As I come to understand more than I can necessarily respond to, I find that I don't have to "understand" all of the conversations directed at me. As a foreigner, I can get away with"no entiendo" until the person loses interest in discussing whatever undesirable topic with me. Is this bluntly evil or a plausible part of being a foreigner?

One afternoon last week, after working at the clinic, I visited a local botanical garden. It wasn't anything fancy, although a woody area surrounded by the city was impressive, but I found this fern especially pleasing to the eye.

Sky vs. earth perspective and a speech from the stream:

In Honduras, when you walk down the street, you must watch each step, surveying the rocks, dust, and uneven curves of the path. This necessity is intensified in the dark. One evening, as we walked to a neighbor's home for a prayer meeting, I really wanted to just look up at the sky instead of bending my head down to the dusty road. I wondered, "What is it that draws us away from the earth and towards the sky?" Is it simply the mystery of something we can't touch or fully understand? or the feeling of transcending something ordinary here on earth in the moments that we look up at the stars? Defending the earth, I wondered how we can learn to appreciate it more. In some ways, it is much more amazing (or should be more important to us) than the sky. It is this dusty earth that holds us securely in place, from it we are constructed (when organic matter is fixed with energy from the sun and incorporated into our bodies), and, while it has such claim/authority over us, it humbly conforms to the actions of our hands when we call it home--actions which are often damaging. Perhaps the dusty, rocky, uneven surfaces that are called streets and those that we condemned for their irregularity should be an indication of the ugliness of our actions--those affecting the once-beautiful land. We should direct our sight to the earth more often than just when necessary to avoid tripping--if not to realize its amazing mechanisms, to at least recognize how humans have trampled the life out of the life-giving earth.

On my walks to/from the house, I have often noticed several very polluted streams. On one of these sightings, it struck me how naturally and indifferently the water ran over, through, and under all the debris. It made me a bit queasy...I wanted to ask the stream, "why do you deal with it, why do you so easily submit, why don't you rebel as you ought to and evade the insulting pollution?" But the water just trickled on, obeying its eternal duty, creating ripples as happily as if it were the most serene and well-kept fountain. I pitied how easily we mistreat and pollute the earth, including water sources. I thought how I would avoid the stream because of its pollution. I speculated at all the diseases and infections that come from such tainted streams. This water source cannot be trusted...only because humans have not honored the once-existing trust. When the books of Proverbs and Psalms mention the righteous staying on the land and the wicked being removed or rooted out, is this what is meant?...That we must distance ourselves and protect/treat the effects of 'contamination' from such streams only because we have transgressed against them? What a pity. What are the acts of righteousness that will keep us in the land, then? These might be care and close association, both operating under a trusting honor. I hope to so conduct myself as I settle each of my new homes, never growing comfortable with the sight of a mal-treated stream or joining in the efforts that bring it to such a state.

This sign delightfully says, "Plant a tree."

During most brigades, the town school is closed for the day and used as a clinical space. People wait in line before we arrive and most stay until we leave, either curious by the gringo project or willling to receive all they can in their presence. The bland-looking sign in the tree says, "We care for forests."

From the school, another village is seen as well. The clouds seem frozen in a cascade down the mountains, ever lining their tops.

Villages--experience and kindled desire

During my second day in the villages with the brigade, I enjoyed getting to know the children (reading books and teaching duck, duck, goose and playing several of their games). No other gringos joined me so I was sunburnt on my own in this cause. Once we had played pato, pato, ganso for a while and didn't know what else to play, they said, "tell us a story-una cuenta." I said I didn't know any stories. They said "about animals, princesses, el libro"...it struck me that I didn't know how to tell them a Bible story and wished I had this capacity while they were so willing and eager to listen...'the book' seemed like a blunt reference to the Bible, but I realized they referred to my reading another book, like I had earlier in the day. Julie, the lady who provided the books, was busy with the doctors in what looked like an important meeting and the books were packed away for the day, so we went to play more games. I tried to play a game in which they stood still in a circle and passed on hand claps while a song was sung (as they got tired of running in the afternoon sun) but found that I knew no song to sing with them except 'gracias Señor por el pan" (thank you Lord for the bread) which didn't seem very appropriate for the occasion. They sang several songs about seemingly meaningless things--despite our earnest efforts, we didn't succeed in the game. I wish I had a song prepared to teach them at that opportunity. Not long after, the brigade team began to packed and left the village, many of the kids saluting me and waving as we left.

I'm not sure when it had occurred to me as an idea, but I would like to consider living in one village each week at my second internship site in Peru--doing cleanings and educating about dental infections while getting to know the villagers with various activities such as games, stories, songs, recorder-teaching, bracelet-weaving, cleaning streams/streets, while evangelizing with word and deed along the way. I envision 6 such weeks with two weeks in the beginning and end of my time in Peru that are truncated, which I could spend at the clinic site in Moyobamba in transition into and out of service. My brainstorming began with consideration of what it would take for me to be comfortable (safety, supplies, tasks, food, etc), then I wondered if it would be difficult to get 'plugged in' at each village....I realized I had assumed that people needed my service and would come to my theorhetical cleaning/education appointments and other activities. I thought I would consult whether home visits would be more worthwhile. But after being acquainted with the children in the villages during the second day of the brigade this week and having them invite me into the street and into their yard, I hope my earnest intentions would be recognized and embraced in most villages. After my experience that day, I earnestly recognized a calling to such an experience and hope that I can explore and embrace such or similar circumstances.

I thought about one astounding fact on the way home from the second day in the villages. I had heard one doctor the day before say that there was much disease in the villages and that most of it was preventable (this seemed to be a Eureka moment for the doctors--a rarity that provided a spark of excitement in the medical field). I was aggravated  that we still insist on treating even preventble diseases with chemical prescription and don't consider all diseases preventable (or at least manageable) by empowering patients and communities to care for themselves. I realized that, with a few exceptions, dental problems are entirely preventable, as they result almost exclusively from dental infections. On the bus ride, I wondered whether I would become overwhelmed in the villages with how insignificant dental problems are compared to other illnesses that I might encounter. In consolation, I decided that preventing oral infection is worthwhile and improves health at any level. Now, I wonder if orthodox brigades are mal-targeted. We can extract as many teeth as possible year after year, satisfying our need to do something to "help" (and place many fillings...and do many cleanings--even though these are closer to prevention on the gradient)...but if we do not try hard (or do nothing in the case of treatment-heavy projects) to inform and equip the people to understand that it is within their power to prevent dental infection and disease, we really are just beating our heads against the wall. These reveries help me validate my inspiration for planning village trips in Peru. I hope I will continue to be lead where I am most useful and where I will gain from the experience to better serve in the future. As far as my imaginings take me, such an experience would greatly shape my dental training and beyond. My most intense longing, kindled by interaction with the second day's village children, is to tell the stories of Jesus and teach songs about His life while there is interest and opportunity. Living in villages that aren't accessible by car, sharing the gospel message and its acts while explaining the dental infection dilemma...empowering them to make a difference in their mouth, life, streets/streams, and communities seems quite romantic and adventurous, while altogether meaningful. I was told by the Honduran interpreters that some villages are not charted in the city municipalities or known about by the urban population and that, frankly, most Hondurans neither know nor care about the existence of each other's villages. I suddenly care immensely for the spiritual, ecological and oral welfare of such communities. I guess it is a little selfish of me to spend so much of your reading time going on about my musings and desires, but I suspect that since you're visiting my web log you have the slightest interest in me and/or (if you can separate the two) my ponderings. If you are so inclined, I'd ask you to pray for the construction of plans for my second internship site--in Peru.

A third sign (the first one that struck me) in the schoolyard reads, "Smile at life." I think this should include both your own life--your optimism--and the life that surrounds you--care for your neighboring creatures.

A post-script (or preview) on cultural identification:

While various brigades have been in and out of the clinic (and especially now that I am involved in one of them), I have noted a struggle in identifying with the americanos. I feel so much more comfortable around the Honduran interpreters, the local clinical staff, and even the local patients. Vainly or not, I feel like I have to partake in the proud and thus awkward task of validating my existence (with my resumé of credentials) while interacting with folks from the States. They operate with outstanding efficiency (no Latin-American delays), strongly emphasizing team-work, but it seems (unfortunately) that this strong team effort exasperates the "innie-outie" or "us vs. them" xenophobic tendancies that Americans often project. Instead of being respectfully or gratefully accepted for offering a hard-working helping hand, I feel that I might be rejected membership in "the team" because I'm not staying in the box that was constructed for me or that my presence goes beyond the agenda that was prepared months ago. As I sat down to a TV dinner with my host family after the third day on the brigade, I realized how much I appreciated belonging to a Honduran family, which unconditionally accepts me, allowing both space to participate in the family and room for reclusion. I am calling this part of my post a post-script or preview because I don't think I am done unwrapping this issue of cutural identification...so stay tuned. : )

I'll complete the week as part of the brigade (this sentence is inevitably awkward and short, revealing its mood about the content). The Evangelical group recorder choir will play this weekend (the Baptist group last week played Amazing Grace wonderfully) and I look forward to possibly visiting La Campa, a historic town nearby, with Dra. Raquel and one of our patients, a local university historian who is writing an analysis of the local history, is running for Honduran congress or senate, and has offered to guide a trip to the site during its festival (February 5-24, I think). Dra. and I will start the following week in the newly built dental office--this will be my final week working at the clinic in Gracias. [That statement sounds so hollow--like an object in mid-air, falling from extreme heights, needing to anticipate something. I feel like I should insert "Selah," like in the Psams, to indicate a need for pause and thought] Nonetheless, I am eager to visit my aunt's family in Argentina before beginnining service (that has yet to take form) in Peru. Pictures throughout this post are from the street, a botanical garden in town, and a village school yard from this week's brigade. Except for a moderate sunburn from earlier in the week, I am doing very well.

Musings on mercy and medicine

 

Gracias’ castle is near downtown, elevated to offer a view of the whole town. Although there were saws renovating various statues around the castle, the site is a spacious and quite place that offers spectacular views of the mountains and town. I hope to find myself there several more times.

The Celaque mountain range reminds me of the Shenandoah Valley. I am eager to go to the villages in these heights next week with a dental brigade.

Meeting mercy on the plaza:

After Saturday morning's recorder lesson at the evangelical church, I decided to try spending some time on the plaza, rather than returning home in a hurry to my dark room or the quiet sleeping house. On the plaza, I tried not to be conscious of locals looking at me (I realized that a gringa leisurely reading a book may look especially conspicuous to local eyes). One thing to mention about my walk up to the church that morning: A middle-aged man near a truck parked close to the road folded his hands in a prayerful position and said, as he leaned towards me, "buenos dias, princessa." I smiled and tried to look friendly as I replied, "buenos dias" and kept going, either subconsciously or purposely not glancing at him. What could such a greeting mean from his side and towards mine..."princessa"? He might not take much care to explain if I asked, but I suppose I am seen as a spoiled royal.

Anyway, back to reading on the plaza....an elderly plaza-sweeper greeted me but passed. Then, another middle-aged man came by with some boxes, selling something (to which I said, "no, gracias"). Finally, a third man came by, squatting by my bench. He started by excusing himself for bothering me and explained that he was diabetic with some other acute health condition and was not in the condition to work (or else he'd be on the floor) and had to pay some government agency 200 lempiras and he had kids but couldn't work because of his condition...and that he went to the church (he pointed to the catholic one near the plaza) to pray to the saints that God would provide in his desperate situation. He said something about empanadas (a common food sold on the streets) and oranges...and my help. I asked if he had visited the clinic (knowing that San Lucas won't make a sick man pay if he can't). He said he'd been there and had many examinations. I couldn't tell if he had been prescribed medicine that he couldn't afford or had simply stopped going to the clinic. I was eager to blame him for his misfortune, thinking that he could do SOMETHING without overexerting himself or that he could get initial treatment and work to repay the cost. Not ready to involve myself in his labyrnith of troubles, I chose to act simply and in a way that I could clearly explain, saying that I needed to buy oranges (something I had planned to do on the way home) and that we could go together to buy some for him and me. I should have said fruteria (where I planned to go) but he said mercado and I followed him. On the way, I told him (upon his asking) that I was from VA (he has friends or relatives in the Carolinas) and that I was returning (or leaving from Gracias is all that concerns him) in February (never mind that it is at the end of February). He greeted many people on the street as we passed through el centro and I was slightly annoyed at having to stop the mission at hand for friendliness that didn't concern me (although begging may not be a task of great dignity for him--or perhaps others clearly knew this drill). In any case, he led me far into el centro (where I had never gone before) to the market, which is a small area saturated with merchants under a low dark roof and narrow isles. I decided that since I was already uncomfortable so far away from the streets I knew well that I didn't want to enter the small busy spaces. Not waiting for the man to lead me into the market, I approached a woman at the corner and asked for two bags of oranges. I said "aqui esta señor" handing him one of the bags. He thanked me and said "Dios le bendiga." I replied with the same and "adios," heading across the street and in the direction of home.

I stopped at several papelerias, looking for index cards (as I had planned to do), with half the intention of being sure that he wouldn't follow me. No index cards were found and I trekked home, comforted that no one was following me. I wondered if I should have bought some beans for him (for oranges might not be suitable for diabetics). I also wondered if all he'd told me was true or if he even cared that I had believed him. Would my oranges or my 'act of kindness' (no matter how awkwardly or stiffly effected) help him? I contemplated the other two men that had spoken to me on the plaza. They were doing their jobs (sweeping or selling), yet I had spent my lempiras in response to a beggar. Was I thus fueling this occupation? Should I have required him to make a straw box or woven bookmark in exchange for my mercy?...would this validate my mercy or give him a sense of self respect--is one or both necessary? I am not certain how the Biblical instruction of not turning away a poor beggar is to be put into practice...that is, how prudent or picky one must be. I don't think I should have acted differently (I couldn't have rejected him altogether, for sure). In reflection of the incident on my way home, I thought, 'Just in case mercy-giving could be a dangerous enterprise, as I felt a bit uncomfortable following him to the big market, I would choose to return from flute lessons promptly and not linger on the plaza.'

As I passed the town's hospital and neared home, I saw many cars parked at the building in which I am told women await to give birth if they come to the hospital early. On several of the trucks' beds were stacked boxes with "Samaritan's Purse" clearly and largely printed. I tried to think from where I remembered the organization, but supposed that these were donations to the hospital, birth-awaiting-house, or maybe just to everyone (hence the many cars parked on the street). I wondered if this was the way mercy ought to be given: professionally, formally, safely...impersonally. I remember being in Mexico and hearing criticisms of such "mass mercy" efforts: "The people have food...they don't need stale rice and beans and expired canned goods. They have clothes...they sell the donations on the streets. These mercies cause more strife and theft amongst communities than good." These were the described realities of poor neighborhoods in Mexico. The communities needed different 'mercies"--perhaps something more personal...something that would approach, acquaint, and know the need before rushing and forcing action or 'help.' Maybe that is what my experience on the plaza lacked--the assured knowledge. While personal, my 'mercy transaction' did not feel genuine or informed, nor did I feel content with the outcome. While I hope that my action has benefited, I have no way of knowing. Maybe it is okay that one does not 'check back' to make sure that assistance is justified, but prior knowledge of the situation and need is a different thing, I'm sure. 

...So I'm seen as a princessa, which is approached in hopes that she'd be willing to give up a few lempiras. Seen as belonging to the kingdom of the States, I am branded as some sort of money-containing purse (be it a Samaritan or ignorant/naive wealthy tourist). If it is within my power and choosing, I would rather be identified with a different kingdom--that which descends and dwells with...that which is able to trust and be trusted...that which might provide beyond the momentary and material.

Dra. Raquel invited me to lunch (yes this is a verb in Spanish, for sure: almorzar) at Villa de Ada. There is a hotel, several meeting rooms, pools, a small lake, and a restaurant. The lake houses a fish farm from which the restaurant prepares meals. I’m not sure if the ducks ever end up in the kitchen.

After forty minutes of waiting on the lakeside, our fish meal appeared. When Dra. ordered, she said ‘’fried fish.’’ However the meal was accompanied with Honduran sides that could stand as a meal on their own. The fish were as good as anything deep-fried and salty gets.

Quotes to sort as you please (I'm not sure how I've categorized/attached them, yet):

"I always lose. I don't know why I'm still playing," my host brother, Jonathan, said, describing his experience with playing marbles (and other games) at school with other boys. The struggle with being a 'cool' fifth-grader is so near to humans of all ages, even if 'cool' takes on a different character.

Annals of a Quiet Neighborhood, by George MacDonald (I have shamefully misspelled his last name in my last posts--apologies) Nonetheless, some quotes from a great novel:

"When God comes to man, man looks round for his neighbor."

"...the way to make indifferent things bad, was for good people not to do them."

"I think one safeguard is to encourage one's friends to borrow one's books—not to offer individual books, which is much the same as OFFERING advice."

"I know I am cowardly. But if I cannot dare, I can bear."

"No time can change the relation of cause and effect. The poison that operates ever so slowly is yet poison, and yet slays."

"The world will never be right till the mind of God is the measure of things, and the will of God the law of things. In the kingdom of Heaven nothing else is acknowledged."

The castle has four of these towers (one at each corner) with openings, much like those on the walls of the castle, for looking and battling out from. The first Honduran president is buried in the tomb on the left (no other tombs are visible)..

I wonder if this style gate was placed after the castle forfeited its military use. It looks too delicate to keep out the enemy.

It seems that even the stone flooring has strategic patterning.

These folks consented to a picture. You might understand better when I say it is difficult to describe a Honduran (since their appearance and heritage is diverse). The older gentleman is Ananias, my host family’s ex-neighbor. When we visited them on my second day in Gracias, he enjoyed relating his Navy experience in Russia to my nationality.

The road to the castle is uphill and still simply dirt (with rocks here and there). I wonder if this reflects the castle’s authenticity (there is no paved road for tourists—they must, if they ever do, hike up the hill).

The castle dog (as I will call him) was very amiably allowed me to take his portrait as he surveyed the Celaque mountain range.

Musings about patterns in medicine and dentistry:

I was never drawn towards pursuing a career in medicine. The act of diagnosis and pharmaceutical prescription as a way of dealing with health problems (to me) hinted at a futile cycle of some sort. Hence I pursued dentistry, a realm I considered separate from mainstream medicine. The 'hands-on' approach to addressing problems in one or two appointments seemed like a very satisfying way of actually alleviating ailments. During my undergraduate shadowing/assisting experiences, I had begun to realize that dentistry is a bit more complex than initially met my eye (and that it resembles its close relative, medicine, more than I thought). Here in Gracias, I have found that most dental patients' oral health (and associated dental treatments) are very vulnerable to a cycle of recurring disease. Under such circumstances, dentistry can lose the shine to which I was initially attracted.

Like many ailments, dental caries are caused by bacterial infection. The resulting damage and prolonged bacterial persistance is augmented by certain environmental inputs or alterations. That is, bacteria chew away at your teeth, and what you chew might help them continue to do so. Most patients from Gracias and neighboring towns (country villagers only have access to dental care--extractions, at that--when brigades come to visit) are diagnosed with 4-16 cavities. Some decide to treat anterior blemishes in several days' appointments but leave posterior teeth to exract when they cause pain. The pity is that the bacteria flourishing in posterior teeth have little troube settling crevices where resin meets tooth. Eventualy, the restoration fails and filling cavities becomes almost as routine as a dental check-up. This reality crushes my beloved idea of dentistry as a skill empowered to permenantly 'fix.' There seems to be a missing link (or several) that causes difference in the way dentistry functions in Honduras as opposed to middle-class America. I think part of this difference lies in the existence of public health sectors in the States. Following are accounts that lead me to so infer:

One hot afternoon in the clinic, Dra. complained of wrist pain "from too many extractions" and said she was tired of being a dentist. [This is quite an alarming statement if you are about to begin training in the profession!] She said she'd rather be an actrress or soccer player (it turns out Honduran soccer players receive salaraies similar to government officials). Then she asked me what I would do if I wouldn't be a dentist. Not being very creative, I told her I would likely work in public dental health at least part time as a researcher in the lab. I had to explain to her that public health is concerned with the causes, progression, and intervention of various diseases in particular areas (towns, counties, states). I explained that there is special training for such a profession. She pointed out that the government must fund these projects, to which I insufficiently responded, 'yes,' neglecting to bring up the topic of tax dollars. In any case, no such thing as public dental health exists in Honduras, and people come to the dental office at their own discretion, asking for treatments they deem suitable, which the dentist might consent to give. I have heard Dra. explain several times that a dental cleaning and check-up does not (to patients' surprise) take care of cavities. She often instructs to brush after each meal and prescribes floss or mouthwash for some patients, but this is as far as dental education goes.

I'm not intentionally critiquing Dra. for insufficient instruction/education or the Honduran health care system for the same, but I would like to observe how much easier and more enjoyable an American dentist's job is as a result of public health dentistry's efforts. In the struggle against oral infection and disease, dental clinicians are on the front lines. [I recognize that it is problematic to turn health care into warfare but find the figurative positions of various groups noteworthy.] Public health dentistry is the supplier (or catalyst if you want to go chemical) of necessary actions and implementations that decrease the load on front-line clinicians. Populations are equiped with the knowlege and incentive to keep themselves healthy. Schools, towns, counties, and states are encouraged to adopt certain policy (no soda machines, water flouridation, etc). Clinicians, also, are given feedback from a single source on the situation of the area within which they serve. Also, new findings about clinical conditions often emerge from public health dentistry. When such support does not exist, dental clinicians cannot effectively treat populations (as the chair only seats one patient at a time). Untreated oral infections often overflow into the neighboring front-lines: medical practice. Shadowing with Dra. Julissa, one of the general medics at the clinic, I witnessed diagnoses of various facial skin, ear, tonsil, and throat infections attributed to oral Streptococci, as "his/her mouth is full of cavities." It seems that both medical and dental clinicians in Honduras would appreciate the efforts in which, as far as I know, public health sectors engage.

I have fully recovered from last week's cold. I am hopeful that Amazing Grace will be played in church by a recorder choir this weekend. Next week, I look forward to going with a dental brigade to the villages (Oh, finally...the mountains!). Pictures throughout this post are from today's fish meal with Dra. Raquel at Villa de Ada (a mini lake/resort) and a visit to the town's castle.