Monday, March 06, 2006

Reflections from Kathy Roeder

Kathy Roeder was the doctor on the January 2006 Deep Run East MAMA Team to Honduras. Below she reflects on Day Two at the village of El Buen Pastor - the Good Shepherd.

Day 2 – El Buen Senor

Honduras is a place of many beauties and many sorrows. Today was one of the days when both were so evident and so confounding.

Our trip today was to an area that I have not previously seen. Although the trip was long, it had a beauty that I had not expected. The Ulua River Valley is wide and bountiful. The rice fields and the cane fields go on for miles, much like the cotton and tobacco fields in North Carolina. And, far off in the distance, in all directions, are the mountains. They tower over the fertile valley, looking majestic against the blue cloudless sky. By all indications, this should be a great day

We traveled to the village of El Buen Pastor – the Good Shepherd. It has presence on arrival, unexpected and, in retrospect, unwarranted.

All the buildings are of block, not adobe, all with tin roofs, not thatch. They are surrounded by luscious pink and magenta flowers, some planted and some growing wild, defying all odds. The street is well-maintained, rough scrabble but with no potholes. And there are trashcans. I have never seen these in any other village of Honduras.

It is a complete rebuild since the devastation of Hurricane Mitch in the 1990’s that all but destroyed the entire country. And the leaders of the village are proud of what they have accomplished, with good reason. In addition to the reconstruction of the village buildings, in the same place as it previously occupied, there is a gathering of villagers from the former village place as well as those from other villages, displaced by the catastrophe.

We set up our clinic in a not-yet-finished school building. One room is completely out-fitted for the children and the other two still need windows, doors and furniture. We cleaned out the two unfinished ones, borrowed some furniture from the completed room and set up our clinic. Good community leadership from one woman kept the crowd in check and made our job easy at the outset.

A short while into the day, I was asked to see a patient, a middle-aged woman, out in the courtyard. (There was a very high step into the classroom-clinic and she was too weak to enter). I went out to this area, in a very public place, with the crowd tightly around us, to talk to her, to try to determine the problem. She was a known diabetic, had had no medication for a few weeks and now was very weak and tired. A brief exam and it was quickly determined that she was nearing a diabetic crisis. She desperately needed more than we could provide; she needed care in a hospital. We scanned the crowd for help. Does she have any family that can help? Will anyone help her get to the hospital? With each question, the crowd around us widened. No one came forward to help her.

Patient after patient came to see me. And I started to notice a trend. The children were clean and cared for and more times than not, brought by their grandmothers. I started asking,

“Where is Mama?”
“She’s working in the US”, I was told.
“And Papa?”
“Tambien.” (Also).
And the mother who, in front of her children, told me she would be leaving for the US in February, to meet her sister in LA, leaving all the children with their grandmother. She had no money, no transportation, nothing. She was ready to run, with strangers, to an unknown place that she expects to be better then here. If she makes it.

And another mother who offered me a two-week-old baby for adoption since she could not afford to feed the baby as well as the older children.

Sitting before me at one point is another young woman, beautiful but troubled. Twenty-five years old, mother of four children, all of whom are with her, the youngest just a few months old. The children have no complaints except for the never forgiving “granitos” and I ask her about the baby, as I do many of the women,

“Is this your last child,” I say, “or only your youngest?”
With this, I try to open a discussion on birth control. But this time, I had a young woman who broke into tears in front of me.

“If I get pregnant again, I may kill myself”, she tells me.
“And then I won’t be here for my other children”.
She explained to me that she cannot take ‘the pill’ because of phlebitis and although her husband has agreed that there should be no more children, they could not afford the price of a tubal ligation. ($17).

As the morning wore on, I began to wilt. This was a depressed and depressing place. The village was new, the buildings will survive another hurricane but the people will not. They have lost hope. The spark that I have seen in other villages is absent from this place.

Is it too new? Is it the lack of strong family ties? Is it the absence of men and women of strong integrity to find some hope? What are the grandmothers to do, when all the middle generation is gone? Who will take care of them? And what hope is there for the future, in this town with the look of prosperity?

It is truly a place in need of the El Buen Pastor.

As I reflected on all that I had recalled about that particular day, now feeling unburdened, perhaps because I had shared it with others I began to recall some other events. Events much less depressing.

The previous day, at the village of Gracias de Dios (Thanks be to God) we had met Pastor Juan Ramirez. It was in his home and his church that we had worked all day. He is an intense but gentle man, on first impression without humor but on knowing him, a subtle and dry awareness of the world. He had asked to accompany us on Tuesday and we had readily agreed. His knowledge of the country and the village mind is invaluable to the ‘Gringo”. And it was he who encouraged us to visit a certain house for our Home Visit.

The patient was a young man of 25, a mason by trade, who had developed a hernia acutely while working. He had been taken to the hospital and operated on immediately, telling me that it was an incarcerated hernia, a severe situation. Correct care was provided, he was discharged 3 days later and sent home. One week after surgery, he was carried to the clinic for suture removal and then carried back home. He has been in bed constantly for the past two weeks, in the home of his sister and is terrified of getting up. He fears something will ‘break’ again.

After examining him to determine that he was in no danger, he was encouraged to sit on the side of the bed. I asked some of the other strong young men in the family to help, and all of them, after washing their hands, came to assist their friend. Again, with encouragement and some gentle prodding he stood, and walked to a nearby chair. He obviously was in some pain, but just the event of walking again gave him the courage to now continue his recovery. As we departed we prayed with the family and we all cried a little. No, it wasn’t a miracle but it certainly was an answer to a prayer.

On our long trip home, with the afternoon chatter in the back of the van, Juan sat in the front quietly singing in Spanish. Sancto, sancto, sancto – Holy, holy, holy. Lord God Almighty.

Holy, holy, holy! Lord God Almighty!
All thy works shall praise thy Name,
in earth, and sky, and sea;
Holy, holy, holy! Merciful and mighty,
God in three Persons, blessèd Trinity.

We all rest in the hands of God.