Thursday, March 8, 2012

Journals From Belize: 2-7-12

Journals From Belize:
2-7-12 evening

There are some qualities of human nature that prove universal.  This is my thought as I watch a young boy about the age of 10 run concernedly in the direction of the school.  The buzz of children playing and fooling about in the road has long since quieted.  They are mostly, I imagine, already seated attentively in proper fashion, so to receive their first lesson of the day.  The boy hurrying down the gravel road is dressed in traditional uniform.   His olive colored pants are dark and rolled at the ankle.  His shirt is short sleeved and a color or blue that mimics the neighboring Caribbean.  The shirt too is collared with a few buttons at the chest and multicolored bead work that forms a cuff at the sleeve. 

in the library before recess
The children here seem to bounce and smile like no other I have seen.  The playfulness too seems universal, yet still I have noticed since coming to Aguacate a subtle difference in the disposition of the youths here.   I have noticed few if any actual toys.  Never the less, playfulness is in abundance.  Children come and go about the village with a freeness unseen back in the states.  Few wear shoes, but not from an inability to acquire them.  It is almost as if they would inhibit movement distracting from the spontaneity of youthfulness.  Laughter is one sound that out competes the seemingly constant caw of the chickens.

sweet Miss Emily

Brendan and Byron learning to play "Angry Birds"

my host Ronaldo
Today has been a measurably good day.  I have been staying surprisingly busy and have shared a part in treating several patients with varying ailments.  A doctor that we met earlier in our trip exclaimed that he could travel to any village in the developing world and consistently predict the first dozen complaints to walk through the door.  Diseases of poverty he explained are patterned and predicated by sub standard living conditions.  Regardless, I am finding our experiences both medically and socially enlightening.

When someone dials 911 in the states they simultaneously hand you the keys to their front door.  When you open that door their whole world becomes visible and you are entrusted with the discoveries you make despite not ever knowing them previously.  My experiences traveling about the village with Hilaria remind of this.  As the main Community Health Worker in Aguacte she too has been lent a lot of trust.  Working from home as well as from the community health post at at the center of the village, her presence here reminds me of that of an old town Doctor.  She diligently makes rounds frequently visiting the huts of the ill, young and old alike.

Hilaria at her home health post

proud to see the SOLO logo in Belize!

Yesterday we joined to visit an elderly woman who we found resting in her hammock as she watched over a boiling pot of Caldo.  She had been complaining of a strange rash that had appeared on her side well over a week ago.  She lifted her shirt without hesitation to reveal an oval shaped collection of hard, greyish blisters.  Beneath the blisters was an area of tissue that was red, firm, and hot to the touch.  Further examination showed an elevated heart rate, low grade fever, and adventitious breath sounds to the right lobes.  This woman was clearly suffering from an infection of some type and was in dire need of antibiotics as well as further medical evaluation.

Her determination to remain at home to complete her tasks was as admirable as it was concerning.  The elderly in the village particularly, but not exclusively, adhere to an unrelenting work ethic that is difficult to interrupt even in times that warrant pause.  The elderly woman and her husband were home alone with responsibilities beyond their capabilities, a finding not uncommon in the villages.
Miss Lorna, happy as always to help out
We also took time to visit at home a young boy who days ago had lost a brief scuffle with an unsheathed machete left laying in the tall grass at his family’s farm.  This shy fellow had just returned from the hospital where he received over a dozen stitches to properly close the wound.   
walking to the outskirts of town with my crew of nurses

sutured leg after machete laceration

We found him recovering quietly with a book inside a hut at the far end of the village.  Theresa, Hilaria, and myself playfully inspected the wound changing out the dressings while making sure to keep the mood relaxed and supportive.  It was a unique opportunity for the three of us to work together as a health care team.  Theresa finished the visit by performing a general medical examination allowing a few of the other children to make their own discoveries using her stethoscope. 
Theresa completes a home visit
In the end, it was decided that Theresa would return each day to inspect the wound and eventually remove the sutures.  I would first build her a medical kit as she had no supplies of her own to use.  My hope was that doing so would generate some long lost motivation.  Theresa had been attending to healthcare matters in the village since the early eighties and had recently been struggling to find interest in the work.  My hope is that a touch up on her skills along with additional equipment and support would renew he interest in the job.  There are some things that can not be forced no matter the purity of intent nor method of pursuit.   The invitation was delivered, and we would simply have to wait to know if it would be accepted.

Theresa at emergency childbirth training

Wednesday, March 7, 2012

Journals From Belize 2-5-12 evening

Journals From Belize:
2-5-12 evening

Tonight as I attempt to settle down to rest I find that writing is my only haven from a situation that feels stifling at best.  Despite promises of being put up in a guest house, I have arrived to find that I will be residing my entire stay as a home visitor with a family here in the village.  I have graciously been offered my own “bed” and the family seems kind thus far.  Still, there are seven of us dormed here in one room that includes bedrooms, kitchen, washroom, and chicken coop.  The children, though sweet and excitable, are all sick with cough and fever.  Hygiene appears poor at best.  I am thinking that if I make it out of here with my health and sanity intact it will be a miracle.  

chicken foraging in the house
I have work to do here and this situation feels inhibitory.  How am I to focus my efforts on improving the quality of health here if I am battling to preserve my own.  The chickens come and go throughout the house as they please.  I have seen little in the way of hand washing and the kids are constantly sneezing and coughing into their hands.  It feels as though every time I move I am bumping into someone or knocking something over.  There is little room to manage the abundance of gear that I have along with me and every time I set something down I think about washing it. 
humble abode
What a shift in events this is.  There are so many unknowns at this point, so many variables and questions to be answered.  The family I am staying with is closely related to the organizer of the home visits here, and I am a bit suspicious of that connection.  My family appears much less well off than many of the others I have visited here in Toledo district. 

Belize or Tennessee?
 I can’t help but to be wary that my arrival here may be viewed more as an economic opportunity than as a cultural one.  These factors in combination with barriers of culture and language combine to present a very uncertain and vulnerable existence here.  I am entirely alone in this place.  I have no cell phone with which to contact our organizers.  There is no internet, community politics are entirely unknown, and I have been placed well outside my comfort zone.  Welcome to expedition medicine.  

The Boyz:  Steven, Orlando, Alejandro and Ronaldo

I suppose these are the types of conditions that I have come here to experience.  Were the situation clear, the conditions ideal, there would be no challenge in coming here.  These are the factors I must remind myself of as I attempt to find comfort in this new place.

looking down at Aguacate Village from the house

Journals From Belize 2-5-12 morning

Journals From Belize:
2-5-12  morning

Today we woke before the dawn to Howler Monkeys and mist.  It will be a quick camp this morning as we will hurry off to the more rural villages.  I will be making may way to Aguacate a fairly large village an hour or so south and west from Laguna.   

ready to deploy
Yesterday I learned that I will be travelling alone as my would be companion Anna has been called to stay with a family member that has fallen ill.  I will miss having Anna there as she is an extremely giving and gifted Health Worker.   

Anna training with Breaux

The last minute cancelation is a change in momentum but not a significant setback to the mission at large.  I am thankful that Anna has chosen to be with family.  Even with service work, your family must come first.  I am confident that our time in Aguacate will be productive.  Being alone in the village will allow me to focus and move freely.  I am anxious to get started! 

heading to Aguacate

Journals from Belize: 2-4-12 afternoon

Journals From Belize:
2-4-12 afternoon

I felt invigorated and was buzzing with enthusiasm after returning from our brief re-supply in Punta Gorda (PG).  At first I was hesitant to return to the busyness of the “big city”.  I had settled well into “Belize Time” and was enjoying a much more moderate pace.  Although it is less than 20 miles from Laguna Village, PG is worlds away culturally.  As a costal city it has a festive Caribbean character.  However, it possesses a culmination of not so charming qualities as well.  


roadside store

 The narrow streets are ridden with potholes, and lined with vehicles that look unfit for travel.  Garbage can be found in the ocean, along the streets, and in the yards of many of the homes. Tucked discretely behind the colorful houses and businesses on the main routes are unpainted concrete block dwellings surrounded by chain link fences.  Driving past these places reminded me how much more desperate a poor city is than a poor rural community.  The simplicity of village life can be alluring at times.  I would never want to be poor in a city.  

run down bus (PUP is a predominant political party)

PG Ambulance (at repair shop on blocks)

Jono enjoys a hard earned treat
 In PG we stop briefly, and rather chaotically, to buy rain boots, use the internet, and indulge in processed food.  The mission feels successful and rejuvenating which is more than I had hoped or expected.  I have before returned to town on re-supply only to become tragically polluted by consumerism.  The insatiability of man can easily distract from the tranquil focus of a backcountry mission.  This, however, is not the case in PG.  We manage to slip in and out without event, quickly returning to organize our dispatch to the villages.

Western Caribbean
Upon return to Laguna preparations quickly get underway.  Behind me in the T.E.A. guest house I can hear muffled chatter as cash is counted and dispersed.  One by one the each group is called in to be briefed on the logistics of their mission.  Once in the villages we will be largely on our own.  However, our training and preparations in Laguna will aid us in supporting the Community Health Workers in each of the the rural villages once we arrive.  Our training has been general, knowing well that each group will face remarkably different challenges.  Knowing this, I find myself getting antsy.  I am excited and I am ready to leave Laguna and get to work in Aguacate.

off to the village   photo: Ryan Bannan

Sunday, March 4, 2012

Journals from Belize: 2-3-12 afternoon

Journals from Belize:
2-3-12 afternoon
Our meeting with Andreas did not go as well as I had hoped.  He was in bed when we arrived and claimed to be ill with fever.  His prescription of anti-biotic on the table next to his hammock somewhat legitimized his claim.  However, there was a hint of mellow drama as he squirmed nervously during our visit with him.  So he is out for sure on today's training and questionable for tomorrow’s health check as well.  This is a hiccough for certain, but not worth stressing much over.  This is the nature of expeditions.  Things rarely, if ever, go off as planned.  Resources and contacts frequently fall through or must be re-arranged.  This too will soon get sorted out. 
Sorting supplies for the villages
Anna, Anne & Breaux
Chad and Breaux helping Andreas
Back at the clinic Carlos and Anna are working through medical treatment scenarios with the rest of the MedicForce volunteers.  Afterwards I find a quiet moment to talk to Carlos about his trainings with the Toledo Ministry of Health and page through the binder they have given to him.
Carlos and Jono
Health checks at the clinic
Sign at Laguna Health Post
In addition to useful heath information, the notebook contains his many certifications, of which, I can tell he is proud.  When I make mention of them he quickly disappears into the T.E.A hut and returns to show off multiple I.D. badges with his name and photo on them issued by the Ministry of Health.  Carlos is fully invested in his role despite the fact that he receives little in terms of compensation.  Welcome to public health and education. 
Laguna Village
 Somehow between training and dinner we find time to hike to the ridge that reaches several hundred feet above Laguna Village.  We dub the event “Jono’s Discount Jungle Tours”, and head up single file like a group of leaf cutter ants…only less dangerous and not whatsoever adept at jungle travel. 
Hiking to the ridge
 Half way up Carlos stops and points abruptly yet calmly, “Don’t touch that plant there.  Those ants bite very hard.” He informs.  I heed his warning and pass by gingerly careful not to slip on the steep and muddied jungle floor. 
Termite mound
 We are also very cautious of the “Bastard Tree”, a vine like plant possessing spiny thorns that could make any a porcupine jealous.  We are almost to the top when from the rear of the line I can hear Jono declare, in his token British accent “OK folks, this is a bit sketchy up here.  This is at your own risk.”  Classic.  Topping out requires just a few careful climbing moves over rock that is rough like coral raised form the ocean floor and dried in the hot Belizean sun. 
 High above the village, the view is almost too much to take in.  To the west we can see past a lake into the mountains beyond.  For the first time we are able to view the valley we have been inhabiting for the past week.  It is a beautiful sprawling mass of palm and citrus interrupted only by a broken shelf which vaguely represents the Guatemalan border.  The sun is setting and the ridge is lit up by a shower of flashbulbs.  Behind us ridges converge forming a jungle chasm too deep to capture by film or photo.  The talk is of Jaguar and Howler Monkey. 
Bryan & Breaux with Jono and The Crew
Prior to our descent my mind wanders off to an earlier conversation.  The problems of humanity seem so unsolvable.  We search for a life that is sustainable, but do we really know what that would look like?  How do you find something, where do you begin to look when you don’t quite know WHAT it actually is?  This is why we are here.  This is the riddle we are attempting to solve.  For me the answer is as simple as it is complex…you look everywhere, and you never stop.