Author: Paul and Laura Manship

Most of my life I’ve kind of hung around at the same altitude, give or take about 1000 feet. I suspect that is mostly the case for anyone living in the US. Our elevations don’t vary tremendously from day to day or hour to hour. That is not the case here in Honduras where everywhere you look there is the remnant of another volcano standing in your path. Almost every Saturday morning I wake up at 1624 feet in Concepción. I get on a packed bus with thirty some other people, at least as many backpacks, and sometimes a chicken or two and begin to climb. About one hour and forty-five minutes later, having traveled along 34 miles of road a total distance of 22 miles, I find myself in La Esperanza at 5577 feet. It’s colder and clearer, the air much thinner, and the whole world seems changed. On Monday morning, I do the reverse, shedding layers of clothing on the way down. Everything changes in the rapidity of ascents and descents.

Rapid changes in elevation is what best seems to describe Maine-Dartmouth’s experience on their recent medical brigade to Colomoncagua, Intibucá. It’s safe to say they started out at or about sea level in Maine. Because of the irregularity of flights from Maine to Boston to Tegucigalpa, their odyssey lasted almost two full days, and, by the time they caught up to us in La Esperanza, they were exhausted. Flying in and out of the heavens, they were diverted from their final destination in Tegucigalpa to return to almost sea level at San Pedro Sula. Back in the air quickly thank God, they arrived at Tegucigalpa, 3248 feet, where Shoulder to Shoulder was waiting for them. Up and down a few dozen times more in an escort van, they finally got to the highest city in Honduras, La Esperanza at 5577 feet. Oddly, the weather they experienced, the damp and penetrating cold, might have reminded them of the late April weather of Maine that they had just left behind. There only for one night, their elevation changed drastically again, falling about four-thousand feet to arrive in Concepción. After a brief bathroom break and tour of our main clinic in Concepción, they winded back up another mountain pass to finally settle in Colomoncagua at 2576 feet. Talk about a roller coaster.

Laura and I usually spend a good deal of time with brigades on their way in and their way out. We hear about their expectations on going in and share in their reflections as they leave. We might get a half day with them at their work site, but we’re busy taking pictures and they’re busy seeing patients. We did see Maine-Dartmouth on their way in. But we wouldn’t be available on their way out as we were already committed to important meetings. Because we would miss them on their way out, we decided to spend the weekend with them in Colomoncagua. We were so pleased that we got such a close up view of their rich experience.

The varied elevations, their varied experiences, and their varied characters and personalities weaved and waved in and out of their time together. But without diversity, harmony cannot be achieved. José was born and raised in El Salvador, a literal rock’s toss away from where we were, but Barbara had never been on a medical mission trip and spoke no Spanish. But their voices blended in a theme of service and compassion. We witnessed them working among the simple townspeople at the San Marcos clinic. They had come from so far away, had traversed high peaks and low valleys, and yet they all seemed as if they belonged. Laura and I felt privileged to be part of this concerto of care.

The next day was yet an entirely different experience.   It was Sunday, it was May Day, it was Nancy’s birthday, and it was certainly time for fun. After a great breakfast and a visit to the local market where hand crafted leather belts, woven shoulder bags, and other local goods were purchased, we headed out to see the beauty pristinely hidden within nature. The waterfall dominates the natural amphitheater where the stone walls rise majestically above us. One further elevation to consider and explore. I watched them all under the curtain of the water’s fall. They surrendered to the experience of the moment, defined and enhanced by it, elevated to great heights and plunged to great depths. It is all so very enriching.

Over the last couple of months Shoulder to Shoulder has a lot to be proud about in terms of the quality of medical services that we have provided to an isolated, and often neglected, people. We do this regularly, of course, by the contractual agreement we maintain with Honduras and the International Development Bank, providing ongoing care to over 65,000 persons on a daily basis. Still, that care is conditioned by the scarcity of resources. Our brigade teams from universities and other organizations augment that care by way of their generosity and commitment. Through February and March we have had nine brigades, and their efforts are best described as herculean. The overused adjective is awesome, though according to our experiences over the last two months, this adjective is clearly appropriate. Our first ever surgical brigade provided relief and healing to persons who had absolutely no hope for any attention to their discomfort and pain. Brown University partnered with Wingate University, School of Pharmacy to provide a level of care and treatment to the small village of Guachipilincito unparalleled in even the most developed areas of Honduras. Cleveland Clinic, Christ Church and pharmacy students from the University of Michigan literally changed the makeup of the small community of Camasca by arriving 34 strong, a sustained force for healing and wellbeing. Even mentioning these brigades, I do a disservice to the others who were equally impressive in their singular commitment to service in justice. I feel exceptionally privileged to witness all of this, and mostly I stand with my jaw agape knowing that I possess neither the skill nor the stamina to accomplish such awesome results.

Becoming so impressed by incredible undertakings, achieved with such professional talent and skill, it is easy to miss a more subtle offering of compassionate service. The University of Minnesota, School of Nursing, under the leadership of Dr. Marti Kubik, recently visited Santa Lucia and the surrounding small communities of that municipality. Like the other brigades, they too offered professional service and care of exceptional quality that impresses and astounds. The School of Nursing plans their service with great attention to the needs of the ongoing medical interventions that Shoulder to Shoulder will continue to offer once they have left. It is a very well thought out brigade, and very much meets with our mission and philosophy of providing sustainable, quality health care. Laura and I met up with them on their last day in Santa Lucia. They were offering trainings to health care volunteers who live in some of the remotest areas of our territories.

These volunteers are perhaps some of the most uncelebrated individuals within our health care system. They do not have job descriptions. They receive no compensation. They are provided very little by the way of training. They are placed very low on our organization structure. What they do have are hearts of compassion to be present to those suffering within their communities. On this day they were filled with gratitude as the nursing students recognized the importance of their presence and commitment. They had a workshop on nutrition and how to maintain healthy habits of living. They learned how to transfer persons having become physically challenged and dependent. They learned about end of life care. Watching this, I could almost physically note the aura of gratitude present among these humble, sincere volunteers. The integrity of their service met with the recognition from the nursing brigade of the value of their service. Whereas the particulars of what they learned in the trainings will most certainly benefit the persons they return to in their communities, the appreciation of who they are and what they do is the pearl of incalculable value.

Certainly we should all be impressed with the awesome undertakings of skilled professionals over the course of these last months. The quantifiable results of such herculean efforts should be celebrated in full voice. But let us not forget that things need not be extraordinary in order to be recognized and appreciated. Some middle-aged woman is sitting in an adobe hut with her neighbor who is in her last moments of life. She has few skills save for those that are born of a compassionate heart. Her presence and attention to her dying neighbor honors the value of her neighbor’s life and her own. The nursing brigade from the University of Minnesota is also honored and appreciated in the sacred exchange.