Doing medical missions well

The neighborhood street from the roof of my Peruvian home. A  mototaxi approaches and the neighbors prepare to grill plantains, tomales, and corn to sell on the street.

Two projects of San Lucas, Moyobamba:

During the latter part of last week, Ivet, Francis, and I visited Nueva York, one (of two) of the villages in which community development will occur during these two years. Just as in Flor de Primavera, we explainedto the whole community how we wanted to help the village improve their health and met with authorities to name specific goals they suggest for the village. Discussing how to take the pigs off the village streets or how to discourage cockroaches from moving from the forests into the houses seemed almost too simple as practices that constitute 'community development.' I wondered, "can't they identify and solve these problems on their own?...it doesn't concern us or require our expertise." However, these kind of conversations, those initiated by and concerning the villagers, are exactly the practice we want to encourage in community development. On the ~15km hike back to the city, I recognized some streams and rocky paths from the first trek home two weeks ago. I wonder what kind of connection or feeling towards the land and its surroundings people who tread the paths their whole life have. Is there resentment for the muddy streets (meaning that they live in remote, impoverished villages for which municipalities care little for) or apologetic reverence (being grateful to the land for sustenance but saddened by its mistreatment)? Some villagers, when asked if they are accustomed to living in the area after 8 years, reply that they have no other choice or opportunity but to exist in such a village. I think that if we ask refugees in various African or Middle Eastern countries, they would agree that there is value in the existance of home, a piece of earth to belong to, no matter its quality. Perhaps valuing and respecting your place brings about care that will better your home and thus your life in it.

At the beginning of the week, before leaving the city, I have the opportunity to observe various activities in the fisura labio palatina project that supports children with cleft lip and/or palate. Apart from the surgery, the families are encouraged to bring their child to group sessions that insure the development of the children, who are perfectly normal except for their surgically improved lip/palate. For the younger children (under school aged), parents are educated on stimulating their children to develop normally (eating just as vigorously and talking/interacting/playing just as actively as normally developing children). Various techniques of muscular and psychological stimulation are taught in this group session. Another group meets for music lessons, something that will help the school aged children in the program develop intellectually and muscularly (face/tongue). The recorders that I used for recorder lessons in Honduras will be used in this program. On a different day, a linguistic therapist meets with children one-on-one to read and converse, insuring that the child is developing emotionally, psychologically, intelectually, and muscularly (pronunciation). Lessons are tailored to each child's need and I found it inspiring that the instructor taught a lesson on emotional expression as its own emphasis to a child who was timid and often sad. All of these efforts, and their evident need and function, make me remember my experience from the operating room in my third week in Honduras. I had questioned what good a palate surgery would do a young lady whose leg would remain crippled. At the time, I thought that good in any amount was worth doing. But realizing how superficially a surgery on cleft lip/palate really improves a person's life (that the person only appears better), I wonder if all the cost associated with bringing a brigade of surgeons from abroad for a week of 50 surgeries is wisely spent. There is no question that various orthopedic, urological, opthalmic, and plastic surgeries improve people's lives; the question is whether doing only part of the job (surgery but no essential therapy) is worth doing it at all. I am led to believe that the brigade system of doing medical missions is not as wholistic or sustainable as one that involves less temporary local (or culturally belonging) people at the forefront.

My host family chose to identify their house with several plaques at the front door.

Nelly, my host mom, runs a bodega, the Honduran equivalent of a pulperia or small shop. This means fresh bread rolls delivered daily!

In our home's huerta (home orchard/garden), there are lime, avacado, and papaya trees, among others. Honduran homes all have an open space for plants and animals (chickens, dogs) in the middle, surrounded by a sidewalk/hall and rooms. This makes one feel as if living in the country when surrounded by the streets of a large city.

Dinky, commonly called Reina (kingdom), relaxes on the roof.

Huckelberry, the one (of three) dog privileged to stay within the home's walls, usually sleeps outside of Janet's (Nelly's daughter) room in the open hallway bordering the orchard/garden.

On my first Sunday in Peru, we gathered for a quick picture after the service at the largest congregation in San Martin, the Segundo Jerusalen Pentecostal church. Although there were an estimated 5,000 members in the church, the three gringas were noticed by the end of the service and asked to come to the stage to introduce themselves to the congregation. Awkwardly explaining who we were, from where, and our business in Peru, we were applauded for being present in their midst. Later we were told that there had been a prophesy that foreginers would visit the church (to be taken as a blessing).