Familiarity Breeds…

Aesop is credited with the first use of the idiom ‘familiarity breeds contempt’ as the moral in the fable The Fox and the Lion. This past week I pondered that adage as each morning I drove out to the small village of Guachipilincito to pick up a few of the Brown / Wingate residents and students and transport them to our clinic and our health center in Concepción. The drive is only about seven kilometers either way, and yet it takes over one-half hour out and in. It is not exactly a road as one normally considers a road. The jagged ledge designed to puncture tires, gaping holes, loose gravel, and boulders to be circled about, demand maintaining the vehicle in first gear and four wheel drive for the entire trip. Beyond that, there is the frustrating, anxiety creating long pauses behind herds of cattle or the inability of two vehicles passing in opposite directions. By the end of the week, I knew that Aesop had got it right: my familiarity of the road only heightened my loathing of the trip.
Brown built the clinic in Guachipilincito and has been coming to the secluded village for years. Wingate School of Pharmacy has partnered with them in more recent years. Though for many of the students and residents, their present brigade is their first experience of the town and its residents, for the leaders and the institutions, Guachipilincito is familiar territory. The townsfolk know them and appreciate their visits. Here, familiarity has not bred contempt, but rather something truly amazing that defies a simple explanation.

Breakfast at Guachipilincito
Breakfast at Guachipilincito

Familiarity here seems to have bred a sense of mutual respect and a profound sense of commitment in service. While medical treatment within the local community is the ostensible purpose of the service trip, the team is deeply invested in the wellbeing of the local residents and the larger population. The highly motivated Brown / Wingate team is assessing and treating all the children and adults in the community, offering dental services, feeding children under age 5 years through their nutrition program, and taking a census to discern service needs. Beyond the local community, Brown / Wingate is engaging the wider community. Students, residents, doctors, and other medical professionals are visiting the main clinic and health center in Concepción, working side by side with our Honduran medical staff, professionally sharing and developing more effective, meaningful models of care. At home visits, at the clinic delivering babies, in emergency situations, students and residents see what medical care entails, and Honduran professionals benefit from the knowledge and experience of seasoned and accomplished medical professionals.
In consult with mother and child
In consult with mother and child

A very special aspect of this brigade has been the presence of child psychiatrist, Dr. Horacio Hojman. Originally from Argentina, Dr. Hojman now practices in Rhode Island and Massachusetts. His treatment of Honduran children and adolescents with psychological challenges was ground breaking, as mental illness is not readily discussed in this area of Honduras. Beyond this, he has been offering professional workshops for medical personnel and teachers such that children will find help and support on a continual basis. We certainly hope that this will be only the first of many visits from Dr. Hojman.
Dr Hojman / Professional sharing
Dr Hojman / Professional sharing

Brown / Wingate has committed to three weeks in February for this brigade. Many participants have already left after the first week, yet much more is still planned for the weeks ahead. Another professional sharing day is scheduled and other meaningful work. What marvelous things they have already accomplished in their ardent commitment to a relationship with a small, isolated community in the backwoods of Honduras. The road to get there is challenging, grueling really, but they have not grown contemptuous from the familiarity of the journey. Instead they have recognized that familiarity, coupled with a committed relationship of service, breeds the dawning of hope.
 

Article by: Paul Manship and Angela McCaskill
Photographs courtesy of Paul Manship and Angela McCaskill

Respect Yields Healthy Living

Laura and I do not depend on stocking up on food and household supplies in Concepción.  There is a market on Saturdays in Concepción where we can find some of what we need.  The items are always more expensive, and it is not always clear just how fresh the fruits and vegetables are.  The pulperias (Mom and Pop supply stores) may, or may not have fruits and vegetables during the week, but they certainly don’t look very appetizing by Wednesday or Thursday.  Other supplies’ availability is at best a crap shoot and the quality is questionable.  It is just hard to get anything down to the Frontera.  We’re simply too far away.  On one occasion we were looking for a small chain and padlock to secure a cabinet where we store a laptop at the clinic.  I imagine that on Family Fued, the survey answers to the question, “Items found at a hardware store,” would likely include a chain and a padlock.  Still, at the two retail places purporting to be hardware stores, we couldn’t find either.  We ended up getting them in La Esperanza, where we end up buying almost all of our supplies.

Checking out Nutritional Information
Checking out Nutritional Information

Still, there is one thing here that is as ubiquitous as geckos.  Snacks:  sugar, salt, caffeine, synthetically contrived carbohydrates, and that orangey, sticky substance that stains your fingers and pretends to be cheese.  Every pulperia stocks a plethora of these processed, plastic-packaged, brilliantly marketed, nutritionally challenged, faux food products.  Coke, Pepsi, sports drinks, energy drinks, chips of every texture, flavor, and color, line the shelves.  The evidence of their abundant presence is not confined to the pulperias.  Their non-biodegradable containers litter roads, walkways, hills, and homes, even scattered along the pathways to the most remote villages.  We have no landfills here, no recycling to speak off, and no understanding of how this stuff so completely debases life.  It pollutes our bodies when it’s consumed, our land when it is discarded, our air when it is burned, and our community pride when it invades and conquers all viable development.  It thrives here, much like weeds in an untended garden, and like weeds, chokes life and leeches the nutrients from the environment.
According to a Nielsen report, snack sales in Latin America ($30 billion) increased by 9% from 2013 to 2014 (http://www.nielsen.com/us/en/press-room/2014/global-snack-food-sales-reach-374-billion-annually.html, 9/30/2014).  If obesity presents an epidemic crisis in the US, it’s right around the corner here.  Diabetes, hypertension, cardiovascular disease, and other chronic, debilitating diseases follow behind the wholesalers’ snack vans that seem to have no problem reaching the Frontera.  We’re in the middle of a drought.  Water is as precious as gold here, but carbonated beverages flow with ease.  María Antoinette’s prescient remark echoes across the hills of Southern Intibucá, “Let them eat cake.”
Minnesota Debunking the Snack Industry
Minnesota Debunking the Snack Industry

Marti Kubik, PhD, RN, and Karin Larson, RN from the University of Minnesota, understand this incipient danger.  They prepared their students, studying for their Masters in Nursing, to speak sensitively and authoritatively about it to the people they would meet in Santa Lucia on their recent brigade.  They spoke at the elementary and high schools and at the clinics, arming their audience with knowledge.  Knowledge is the only effective defense against the snack purveyors’ reliance on the lure of immediate, self-gratification:  “It tastes good, and it curbs my hunger.”  One student’s passion came from a personal empathy; having managed diabetes, this student spoke from the heart.
Laura and I met up with the brigade on Thursday.  They were traveling to the small clinic in the village of Santa Teresa about an hour and a half’s winding drive along a typical mountain road.  The schedule purported they would be giving a workshop to a small group of women in the pregnancy club.  Upon arrival, however, the men and women present were clearly not anticipating the arrival of a child.  It was the chronic disease club.  Dr. Kubik took it in stride, reminding her students that flexibility is a necessary talent.  Serendipitously, the students quickly readied themselves to present on the dangers of the snack culture.
Dancing Our Way to Healthy Living
Dancing Our Way to Healthy Living

Their presentation was as exceptionally flawless as it was engaging, and certainly no one would have known that they had come expecting to present on an entirely different subject.  They first recognized how packed the room was, and thus had the sensitivity to present in teams of pairs rather than en masse.   This sense of sensitivity and respect set the tone.  Then someone showed a coke bottle, asking the audience to guess at how many teaspoons of sugar it contained.  “Two, three, maybe four.”  A sixteen ounce bottle typically contains eleven teaspoons of sugar.  “Ugh, that’s disgusting!” as the participant fills the bottle with sugar.  How does it even dissolve?  Then, someone else presents a stack of empty bags of chips.  We call them churros here, an innocuous, innocent word that draws up an image of a cute, panda bear.  Someone reads the nutritional information.  The first thing to notice is that in this tiny little bag containing less than a handful of crunchy things, the packaging claims there are three servings.  Three servings cost five lempira (about $.23).  Ralph Nader would have a field day debating the lack of truth in advertising.  Then, they read the ingredients:  the unpronounceable chemical compounds with fats, sugars, and salt.  Everyone is laughing at the expense of the producers of poison.  The curtain has been drawn back and the wizard is seen for who he truly is.
After the debunking, the discussions move to self care.  Exercises bring the group to their feet and we’re all dancing and laughing.  Then, before we dismiss the chronic disease club, everyone gets an individual check-up with blood pressures read and lungs and hearts listened to.  A couple of feet are checked as foot care is critical for diabetics.  Dr. Kubik is examining one woman.  She proudly professes how faithful she is to her hygiene.  Dr. Kubik exclaims, “I’ve never seen such well cared for feet!  I would like to take you to the United States and present you as a model patient to the patients I see there.”  True enough, most people want to be healthy.
Beautiful Feet
Beautiful Feet

It’s unfortunate that the force of consumerism blinds its benefactors to basic human dignity.  There are other voices, though.  These are the voices that respect human dignity.  Thank you Minnesota for making it down to the Frontera.