Paul and Laura Manship, Author at Shoulder to Shoulder, Inc.

February 16, 2017August 4, 2023

Bringing About Health

Like most people, I know very little about medicine and the intricacies of my physiology. I probably should know a lot more. I’ve certainly been sick or injured enough times during the course of my life, and often dependent on the services of medical professionals. They always tell me what’s wrong with me, the diagnosis, how they intend to fix me, and the treatment. But I hardly listen. Maybe it’s because I’m afraid of my own fragility or mortality, but I’d rather just trust that they know what to do – close my eyes, take the medicine, and hope for the best. What’s most important to me is that doctors and medical professionals have a specialized knowledge of what makes me tick, and that they can treat me with unparalleled competence. I can then consider them gods, always able to fix me no matter how ill or broken I might present. Of course, this is a rather naïve way to approach that which is most important to me — my health and well-being.

Shawn Riser Taylor, Dr. Emily Harrison, Dr. Wayne Hale, and Dr. Simon Tanksley

We are privileged to see a lot of medical professionals who come to this tiny part of the world to practice medicine. I am always impressed by the wealth of knowledge they carry with them. They know all about biology and science, and they know how to perform exact interventions that make sick people well. This is of incredible value, and the people living here on the Frontera, without regular access to such expert knowledge and intervention, are eternally grateful. Perhaps they, like me, would want to think of these visiting, medical professionals as gods. Clearly, they should be honored and respected for their dedication and service, but there is something much more basic about health and well-being than knowledge and expertise. The really good, medical professionals understand these basic principles, shun the temptation to be godlike, and embrace the dynamic relationships that make individuals and communities healthy.

The Brown / Wingate mission to the small community of Guachipilincito has invested in these dynamic relationships over many years of service to realize a system of sustainable health and well-being. They were here again recently at the clinic they built and maintain at Guachipilincito. Dr. Harrison and a well-seasoned, professional team with dentistry, pharmacology, and students provided direct care, offering effective interventions. As impressive and important as this direct care is, the health initiative of Brown / Wingate happens beyond this direct care. At an earlier visit to Guachipilincito, they polled families at home visits, asking them what they thought could be done to make their community healthier. They said they wanted to come together in a social context and learn about how to be healthy. So on this trip, Brown / Wingate offered a health fair at their clinic. People who had never come to the clinic or seen a doctor, mostly men from the community, showed up. The medical staff screened for chronic diseases and found two individuals who were suffering with diabetes and didn’t know it. They are now receiving treatment and training to manage their disease. The community learned about health relative to nutrition, the extremely dangerous amounts of sugar present in soda, candy, and snacks that are unfortunately so readily available and cheap on the Frontera. The teenagers from the community offered a hilarious skit on maternal health and birth. Music, good food, stimulating conversation, and a rich sense of friendship guided the evening. Perhaps the visiting, medical professionals lost some of their god-like character in the evening’s festivities, but sustainable health and well-being within this community was certainly advanced.

Brown / Wingate’s “health fair” is happening in so many ways at Guachipilincito apart from those times when they visit and offer direct care. A feeding and nutritional program is ongoing, supported and run by nurse Lesby who lives in Guachipilincito and regularly buys and distributes fresh healthy food to families in need. Dr. Dan Harris came a week early to Guachipilincito to be invested in the life of the community. Dr. Simon Tanksley has remained in Guachipilincito and will be there for three months. He will treat individuals while he is there, but he will also learn from them. He will discern with them the best means of creating and maintaining health for individuals and the community at large. Meanwhile, Brown / Wingate will consider how they can deepen their commitment and service to this isolated and resource challenged area of our world.
The road to Guachipilincito from the neighboring town of Concepción is easily one of the roughest, most challenging in all of Honduras. It is a distance of less than ten kilometers, but it takes over forty-five minutes to arrive there in a four-wheel vehicle. You can almost arrive there walking quicker than in a vehicle. The people living there are desperately poor. It is a place where it is easy to become a god. Though that temptation is great, being a god is as unfulfilling as it is ineffective. Being a friend is so much more challenging, and ultimately so much more healthy.

Perhaps then, health is not solely about specific, expert interventions from people otherwise unconnected to their patients. Perhaps it’s about listening. Perhaps it’s about investment in committed relationships. Perhaps it’s about partnering with individuals and communities. Perhaps it’s about the recognition of the inherent dignity and sanctity of shared human experience. Perhaps health and well-being is everyone’s responsibility, not just those of the gods who happen upon a moment of crisis, illness, or injury. The Brown / Wingate brigade travels to Guachipilincito across the challenging terrain. Because they are committed to the ongoing journey of reaching the people there, they can claim that they are assisting in the creation of sustainable systems of health and well-being.

November 28, 2016August 4, 2023

Visiting

The first challenge for the University of Wyoming medical and service team that recently came and visited the small community of Agua Salada (translated “Salt Water” – really interesting since you would need to cross all of El Salvador to find saltwater) is getting them there. The 22 participants (20 women and 2 men) plus six translators packed into the bus in La Esperanza to begin their trek. It’s all downhill, not very far really, but taking over two hours. Even though the highway is being rebuilt and paved, you cannot travel fast along the treacherous curves. This is called the “highway,” and at first everyone laughs at that term until they experience driving on what is not the highway. We arrive at the nice, modern-looking, clinic in Concepción. Everyone piles off the bus. They think they’ve arrived and there are expressions of relief. Their expressions droop, however, when they realize their bags are being packed into the beds of pick-up trucks. The bus won’t go where you are going. You’re not there yet!

The luggage is delivered first with as many people as can fit into the cabs of the trucks. An hour later, the trucks return and they get packed up with people: seven or eight in the beds and four or five into the cabs. I’m driving one. For safety’s sake I tell those in the bed to sit down or hold on. They laugh at me and I crack a knowing smile. We turn off the ‘highway’ to begin the three to five mile per hour crawl to Aqua Salada. Over the ruts and rocks the truck launches them off their feet or bounces them off their behinds. I hear their screams and hoopla. Someone from the backseat of the cab says they want to be in the bed when we return next week. It’s better than the best amusement park ride. We come to the river. Someone from the bed yells out, “Where’s the bridge?” just as I enter into the water with the truck. The water is a little high for the dry season. “This is awesome!”

We arrive at the Agua Salada clinic facility. They grab their suitcases and gear. Most definitely exhausted, their minds racing with all the newness they are taking in, they now need to set up their tents and sleeping bags. The clinic is really nice, well designed, but not really equipped for over thirty people. They will be tripping over one another all week. This makes boot camp look like a five-star luxury hotel. But, they are well received by the people living in this forsaken and forgotten territory. What the team will put up with for a week is nothing as compared to what the people who live here endure every day.
But, that’s why they’ve come. The Agua Salada residents and those from the surrounding small villages are always enthusiastic and grateful for the arrival of Wyoming. Most wouldn’t be able to find the state on a US map, but they well know the hearts and souls of those who have journeyed to visit them. There is a sense of celebration among the community that finds varied expressions during the week. Over five-hundred persons will visit the clinic. Many will see Larry the dentist who has been coming since before the clinic was built. Linda, a nurse practitioner now retired from the University, leading the team, knows everyone. Indeed she’s watched many grow up. They’ll have a special luncheon for the parteras (midwives), and all week long the children will be playing soccer with the gringos. It feels like the circus has come to town. I take that back. It’s more like a homecoming. It is a time for catching up, a time to become reacquainted, and a time to really enjoy a very special, perhaps even sacred, friendship. Laura and I will meet up with them at the school scholarship festivities.

We take going to school for granted in the US. But for the people in Aqua Salada and the surrounding area, even the small costs associated with public school – backpacks, notebooks, uniforms, shoes (yes shoes), and other materials – can be overwhelming for a family without any income. Wyoming has responded well to the need, setting up a scholarship program to fund these families. It’s not blind charity. It’s a covenant where the students and the families commit to community service and the maintenance of good grades. This makes the relationship an honest one — one in which the travelers from Wyoming and the residents of Agua Salada find mutual respect and commitment. This program is for the children attending what is referred to as ciclo comun – seventh, eighth, and ninth grade. Very few will go beyond those grades because it is just too difficult for the families. They would have to travel to one of the municipalities to go to High School and earn a degree. The transportation cost is prohibitive. Wyoming is now also responding to this need as well. It is a larger commitment on the part of Wyoming, but one they are pleased to be able to make. The most promising students, the ones who have a burning desire to be educated, will now be able to live their dream and receive a high school education. They will become honored in their families and their communities, and Wyoming will have a legacy of noble value.

All the scholarship students, their families, and the team from Wyoming gathered in the church for the ceremonies. Records were turned in, contracts were signed, and the scholarships administered. Some of the students spoke of the incredible gift of education and expressed their gratitude to Wyoming for the trust that had been given to them. I watched an older man’s hand sign his commitment for his granddaughter. His hand was shaking, but his smile was one of profound dignity. I thought I saw a small tear in his eye as he placed an “X” on the signature line. Perhaps he had missed the opportunity to read and write, but his granddaughter would not.

Back across the bumpy road and the river the service team would travel. In another day they would be thousands of miles away, comfortable in soft beds, their privacy secured. It will be a long time, however, before they forget their experience among the people of Agua Salada. The people of Agua Salada will, of course, never forget. They will be ready to welcome them back when they return.

October 16, 2016August 4, 2023

Fun and Fulfilling

Over the course of twenty-six years, thousands of individuals and hundreds of professional and academic associations have shouldered the mission of improving the quality of life on the Frontera by visiting Honduras on service trips. They have paved the way for the ongoing provision of quality health care and established the infrastructure to support that ongoing care. Through dedication and commitment, through the sharing of expertise and knowledge, these associations and individuals have uprooted the embedded poverty that denied people basic health care and planted systems of sustainable empowerment. People live longer, healthier, more productive and fulfilling lives in strong communities. These individuals and groups will continue to visit and support and grow this sustainable system of quality health care delivery. Shoulder to Shoulder will support their dedication, commitment, and service.
Shoulder to Shoulder has become an expert in receiving medical professionals and students, sending them out to treat the people, and coordinating that service in relationship to our ongoing heath care service delivery. We’ve done it for so long, it’s become second nature. However, we are yet inexperienced when it comes to receiving and utilizing groups coming specifically to assist us in our evolving mission of education.

Laura and I nervously awaited the arrival of Genesee Valley Presbytery who came to visit us in Camasca. Though they came as a service group, they had no medical expertise and had no intention of providing health care. They came to exclusively work at our bilingual school. Laura and I know how to manage medical teams. Also, the medical teams have an inherent focus on their service in providing health care. But what would this group do, and how would we organize their efforts? In part it was a construction brigade to establish a rain water collection system at the school. In part it was a school brigade where they would offer games and exercises with the children. In part it was a resource brigade to stock and organize the shelves of our library. Their focus was disparate as were their personalities. In speaking to them on their first night in Honduras, I realized they were all different individuals and no one principle gave them a coherent organization. Some were here because they liked construction, some because they enjoyed singing and celebrating with the kids, and still others wanted to catalogue books. How would I do this? How would I herd these cats? My anxiety rose.

It was needless anxiety. I soon realized that there was indeed a common organizing principle to their service mission. It wasn’t a professional principle, though it was clear that the contractors, engineers, musicians, and teachers knew their stuff. It wasn’t so much a drive to realize specific objectives, though they accomplished incredible things. The organizing principle was much more profound than this. They all shared a generous spirit, a willingness to serve no matter what need was encountered, a singular respect for the people they met, and a driving desire to come to know in a meaningful way the children of our school and the people of Camasca. This was what we might call charm and grace. They had loads of it, and in six days they found a place of welcome in the hearts of our children and the people of Camasca.
I could simply focus here on what they accomplished because it impressed me beyond my expectations. They built a quality water collection system in about two days, making me scramble to find additional construction projects to keep them busy. They added six hundred books to our library, and organized a eclectic mess into an efficient store of knowledge and literature. They enlivened and enriched our students with song and spirit each morning. They visited other area schools, gifting them with their presence as well as with books and clothes. This success would certainly have been sufficient, but there was more.

They did it all and had tremendous fun doing it.

“Papa Grande,” aka Adam, played his guitar, sang his songs, and corralled the smiles of our children.
“Gopher,” aka Tony, busied himself in digging holes.
Andy was forever ready with the right tool for the job.
Jeff, the still, but deep waters, was always ready to help.
Bill drew up plans and designs.
Chris may have found a new vocation as a librarian coding books and stacking shelves.
Whitney mastered the troops.
Lori provided for all needs from a bottomless purse.
Jan articulated the sacred privilege of reading.
And as all this business went on, we found time to barb one another with groaning puns. Pat provided the ultimate symbol for this in carrying “Donkey Hotey” back to the states.
We followed Dan’s challenge to us all by “super-sizing” our generosity and realizing the super-sized response in the appreciative embrace of the people of Camasca.

What wondrous things Shoulder to Shoulder has achieved over the course of twenty-five years in the dedication and commitment of professional service teams. True enough. I am certain that just as we have established a sustainable system of quality health care because of the generous service of medical mission teams, so too we will establish quality, sustainable education on the Frontera as we develop relationships with groups and individuals to shoulder this mission. It is always so impressive to see what we have built and accomplished. It is, however, so much more impressive when we find meaningful connections that bind us to the best of who we are. This is grace.