Rancho Santa Fe y La Vida en Honduras

May Surgeries

2009-06-15T21:16:00.008-05:00

From May 21 to 28, the Daly group was here for what would be the final surgical brigade during my time in Honduras. Their goal was to expand upon the successful inaugural operations that took place in March. To do this, a number of projects needed to be completed, foremost of which were installing a backup generator in the event of a power outage and installing a water filtration system for the autoclave.

The generator and filtration system, along with many medical supplies, were to arrive two weeks before the Daly group came with technicians to install the equipment. With unsurprising Honduran reliability, the container was delayed at customs in Puerto Cortes by a broken computer system, and its ETA was completely unknown. However, to unload the generator inside the container, we needed to rent a mobile crane mounted on a flatbed truck and have it at the ranch when the container arrived. At this stage that I actually benefited by Hondurans’ aversion to schedules. I could not tell the rental company when we needed the truck, but they were content to wait until we called. When the container finally showed up on our doorstep a week late and without warning, we called the company, and they arrived within about a half an hour.

Everything came intact and was unloaded without a hitch. We even succeeded in enlarging the generator house to accommodate a larger than anticipated generator in the span of a week, no small feat for the ranch construction workers. I regret not having a camera handy to document the proceedings, especially the generator being lifted by the crane, which was impressive. Everything was in place for Dr. Daly and his team of technicians.

Dave Helgeson and Keith Hines installed the generator, Brad Weaver put together the water filtration system, and Becky Hines RN organized all the medical supplies. The generator was equipped with an automatic transfer switch to maintain a nearly constant power supply, keeping anesthesia machines and other life saving equipment running during surgery. The four orthopedic surgeons were now able to operate.

After screening patients in the external clinic, the surgeons selected a number of feasible operations. At final count, twelve operations were performed during two full days of surgery, ten orthopedic cases done by the U.S. surgeons and two elective, general procedures that Dr. Cerna completed on Pequeños. The Pequeños had needed their respective surgeries for some time. Of note was the most complicated procedure, removal of dead bone from a middle-aged woman’s wrist that had become infected after being operated upon by public hospital doctors. After taking out an unexpectedly large amount of dead tissue, she will need further surgery in August or November to finally correct the problem. None of the 10 patients from the community paid a cent for the operations they received.

All in all the week was a success, in large part because, with the invaluable help of Dave, Keith, and Brad, the final major components were installed to equip the building for function on a full scale. With these pieces in place, the Daly’s are ready to scale up operations in August to treat more needy persons. It was great to see a wide array of talented individuals give their time and work together to make large strides for the surgery center and the health of our community here.

Weblinks

2009-05-17T18:41:00.003-05:00

Hello Readers. Just wanted to direct the attention of those interested to a few pages about the Surgery Center and my work as a volunteer. There is now a website for the Holy Family Surgery Center, http://holyfamilysurgerycenter.org/. It has news updates and some short biographies and testimonials from people involved with the project. The short piece I have written about my volunteer experience is basically the same one that is posted on the NPH International website: http://www.nph.org/ (put your cursor over "volunteers" on the left and click on "testimonials").

Not much else to report: I am gearing up for a visit this week by Dr. Daly's family and a slew of other visitors, including three other orthopedic surgeons, nurses, students, and experts who will help with some equipment installation at the SC. A container of supplies including a 100kW backup generator, water softener system, and seemingly endless boxes of medical supplies arrived last friday, and the goal this week is for the mechanics and technicians arriving with Daly to install these items to be able to operate again early next week. We will be having an all-day clinic Saturday to triage for possible procedures should everything be in place. Will keep you posted...

Forest Fires, Camping, Easter

2009-04-19T19:37:00.020-05:00

Here it is HOT. The activities of the past weeks have all been within an environment of blazing heat, dust, and the smell of burning. For the torrents of rain that Honduras receives in the months of June through September, it sure settles the score with absolutely no precipitation for most of March, April, and May. I think all the volunteers are experiencing various degrees of insanity.

The dry season brings frequent fires, which on the Ranch’s largely undeveloped 2000 acres can quickly become unruly. Mostly the older boys track down and put out blazes, some with a crazed, fanatical exuberance, but depending on the severity everyone can be involved, including soldiers from the nearby military base in La Venta. My first encounter with fires was of special personal significance as my house almost burned down. When the flames jumped over the dirt road and onto the grass not 50 yards from where I live, I renewed my efforts to keep back the burning onslaught with green branches, some water, whatever my roommate and I could find. With extra help we eventually won the battle, and our house in the Hortaliza survived. In other forest fire news, an unrelated blaze later in the week came within about 10 feet of the surgery center, almost destroying my entire year’s worth of work. We’ll see what May brings.

The ranch celebrated Holy Week with much fanfare, highlighted by separate camping trips for the boys and girls. Along with other Buen Pastor volunteers I accompanied the boys over Palm Sunday weekend to Rio Grande, where we spent two days camped in tents outside an old school building without running water. We went swimming in the nearby river, made campfires, and the kids took a break from their strictly regimented schedule. Some made their own little tents with sticks, trees, and blankets and slept under the stars. In the afternoon on Saturday, the volunteers and Tio’s took on a group of townsfolk in a pickup soccer game, noteworthy because nobody died from heat exhaustion as we ran around in million degree weather, while smoke from nearby uncontrolled blazes burned our lungs. But overall camping was one of the best times I’ve had with the kids.

The rest of the week revolved around masses and religious celebrations of increasing duration and complexity. This culminated in a midday Saturday Stations of the Cross Bataan Death March, after which the shirtless Pequeño fixed to a cross and acting as Jesus really did look like he was dying. But the kicker was a 4am “Sunrise Mass” on Easter Sunday, where we assembled for a candlelight procession into the church and lengthy celebration during which it gradually became morning and various children gradually dosed back off to sleep. The church actually looked pretty cool, but whether it was worth a 330AM wakeup call could be debated. All in all, the planning and choreography of all the week’s events was rather spectacular. The ministry team, headed by three energetic, Honduran laymen, each of whom enthusiastically strums a poorly tuned guitar while singing with varying ability during the mass, was in top form. I don’t think they slept the whole week.

In any case, the Ranch has now returned to some degree of normalcy, weather aside, and its back to business as usual. This past weekend was the semi-annual volunteer retreat, a very relaxing time at Lago de Yajoa. My work is progressing unremarkably, as we look to a May visit by Dr. Daly, and I’ve began thinking a bit about my fast approaching August departure. Until next time…

The kids were all pretty exhausted on the bus ride back from camping. Also a view of the river where we swam.

Inaugurating the Holy Family Surgery Center

2009-03-22T16:23:00.013-06:00

The customary overdue Hello, and an update on the recent events at the Surgery Center. Though progress has often inched along, both during my time here and in the 5-year history of the project, March 6-11 we crossed a milestone of sorts, blessing and inaugurating the new Holy Family Surgery Center as “complete” and performing the first surgeries with U.S. medical personnel. It was the fruition of years of hard work and dedication on the part of St. Paul orthopedic surgeon Dr. Peter Daly, his wife Lulu and family, NPH International Director of Family Services Reinhart Koehler, and a sea of other invaluable colleagues, benefactors, Ranch employees, and friends of NPH.

Dr. Daly and colleague Dr. Mike Forseth performed the first surgeries on two patients who came to the external clinic looking for medical assistance in the weeks leading up to their visit. One patient, an elderly woman, was in serious need of help. Last November, she fell out of a tree and broke both wrists (why a woman in her sixties was climbing a tree to cut wood in the first place is a question we did not get into, and likely would’ve led to a larger discussion on Honduran cultural norms and living conditions). The public hospital in Tegus, her only form of assistance, asked for somewhere in the neighborhood of US$10,000 to operate on her. She hasn’t seen that kind of money in all the years of her life, so she walked away untreated and continued to care for her children as best as she could despite her comprimised condition.

On triaging this woman and other candidates at the beginning of the week, hand surgeon Dr. Forseth determined that hers was a case that, while complicated, they could reasonably undertake. Along with the other patient (needing a minor cyst removal in her hand, lingering from a previously botched attempt at a health center in nearby Talanga) the two became the Surgery Center’s first patients to receive US trained surgical care.

The surgeries were successful, and both women expressed gratitude and dignified satisfaction with the care they received. A humbling and rather striking sentiment I realized was the pride and joy felt by the community that such a center has been constructed for them. The goal is to make the center of U.S. quality, and this is a level of care far and beyond what these people have experienced. It really does affect one’s psyche when the quality of the facilities and services available to you are in poor condition and third rate. For these Hondurans to be told that they deserve (and will receive) sound care in clean facilities uplifts their dignity and sense of worth, and it is an additional benefit that really can’t be quantified. To see the surprised smiles of these two patients as they received careful attention from dedicated providers, who listened to and answered their questions, was a terrific thing to behold. Thinking of the many future patients that are soon to come, it certainly solidified my faith in the project.

All in all the week was a success, and I think everyone involved left with a feeling of satisfaction and gratitude, including the patients. For now, we will continue to treat patients once weekly at the surgery center for minor procedures (with Dr. Cerna from Tegucigalpa), progress with details in building construction, and gather more patients as we look forward to a May visit by the Daly group, with goals of augmenting the services provided and numbers of patients treated at that time.

The medical team that came with the Daly's.

My 15 seconds of fame scrubbed in and sitting at the surgical table.

Please Donate to Nuestros Pequeños Hermanos and the Catholic Medical Mission Board

2009-02-15T20:17:00.003-06:00

Ok, this is it – my one-time, simple request to readers to support the very good work happening at NPH. To recap, NPH is a non-profit, Catholic organization supporting thousands of orphaned and abandoned children in 9 countries across Latin America. These children are blessed with a stable, loving home that gives them food, clothing, shelter, health care, and opportunities in higher education and vocational training to better their futures and break the cycles of poverty, abuse, and neglect that they have experienced. The children also benefit from the work international volunteers, who give specialized skill sets to expand and enrich the services supporting the children. These areas include teaching, care giving, health, and physical and occupational therapy. The Honduras branch alone is the family for over 500 current Pequeños. NPH also reaches out to the local community with nearly free health care services to needy Hondurans in our community. My work as a clinic assistant is a part of this effort.

In my particular volunteer work as a clinic assistant, I have been blessed to have the sponsorship of the Catholic Medical Mission Board. CMMB is a non-profit that sponsors and places volunteer health care workers all over the world who dedicate themselves to improving third world health care. CMMB has financially supported my year of volunteer service, with airfare and health insurance, so I could come to NPH Honduras, support the clinics here, and work at the Surgery Center that provides direly needed surgical services for the poor at a token of the cost.

Please support these necessary efforts to lift up our brothers and sisters living in poverty in Latin America. As my grandma Treacy would tell me, you can give time, talent, or treasure, and all are important. NPH cannot function without the continued support of its sponsors, and it is all the more evident during this time of economic crises. Our home has laid off care givers, teachers, and the entire psychology department, just to name a few, in anticipation of a 30-40 percent drop in funding. While these are hard times for everyone, this definitely includes non-profits. If you are able to give, your contribution really will make a difference in the lives of these children. I know firsthand. Please give, and you’ll feel good about doing it!

Donations to NPH can be through Friends of the Orphans, the non-profit fundraising organization for NPH in the U.S. http://www.friendsoftheorphans.org/s/769/start.aspx. You can also choose to continually support a particular child, and exchange letters, photos, and communication with him or her.

If you would like learn more about the Catholic Medical Mission Board, please visit http://www.cmmb.org/. I have also set up a special page to help finance the support I receive, which can be viewed at http://support.cmmb.org/site/TR/Events/General?px=1109422&pg=fund&fr_id=1010. Thank you very, very much for your support.

Long Overdue Update: Christmas, David, Work

2009-02-07T13:34:00.015-06:00

I'd bet that the countless loyal followers out there (if there are any left) are all but certain the blog has retired to greener pastures, but on a chilly February Sunday in Honduras I've managed to zap some life back in it. With so much to report, I’ll limit myself to give a hasty run-down of as much as I can remember from the last 7, 8 weeks (cringe)…

Well, Christmas was nice (a belated Merry Christmas to all and a Happy New Year). All the volunteers took a two week break from work and watched over the kids while the employees vacationed over the holidays with their families. It was something of a one-species Zoo. On Christmas eve and New Year’s we made gigantic bonfires, the kind of which could easily start a forest fire, for which the Discipulos Hogar, Finn, and I had to cut and haul about two dozen trees from the forest in which we live. Not fun. The kids roasted marshmallows as close as they dared, until the falling ash made such endeavors doubly dangerous and amidst their complaints we pushed them back for their own safety. No one was burned.

On Christmas day, all the kids went walked to various nearby villages to give away some of their clothes to residents. It was really quite heartwarming. Above are pictures in La Venta, a small town just up the highway. In the first, some Pequenos have stopped to bring clothing to the red house.

After two weeks of Christmas/babysitting chaos, my fellow volunteers and I were ready for a break. I was fortunate to then have the visit of my brother David from Jan 3 – 17. We spent a week on the Ranch and I did my best to show him around and give him the full experience. He weeded in the Hortaliza, swam at the dam, watched Dr. Cerna operate, and played with the kids during vacation courses. Then we escaped to travel Guatemala, which was a terrific time. We hit up a plethora of touristy but breathtaking sites, highlighted by a large clear lake nestled between three volcanoes, hiking an active volcano, and seeing the Mayan ruins in Copan. It was especially amazing to see multitudes of indigenous Guatemalans speaking their various local, indecipherable tongues as they conducted business in crowded marketplaces, wearing colorful woven cloths traditional of their still-vibrant native culture. The NPH Guatemala home also welcomed us for a night and showed us around their complex. It was a great week.

After seeing David head back to the U.S. to find a job, I’ve been focusing on work. Currently we are making final preparations to try to organize a surgical brigade from the States sometime this spring. My most important tasks are to install an automatic transfer system to turn our backup generator in the inevitable situation of a power outage during surgery, and get our license from the Honduran Ministry of Health. This is a tedious process involving applications, building plans, environment codes, and inspections. We also have the usual mix of nagging, minor construction projects (closet shelving, curtains, door installations, floor sealing, and other facile tasks made more difficult by a lack of dedicated, qualified workers).

That about wraps up the basics, for brevity I’ll leave it at that and spare more boring details. One last thing of note is that we are in the transition time for the January volunteers. We have six more here from the U.S., Spain, and Germany, and we are losing the old group (about 10, including my buddy Finn). Next weekend we will say goodbye to this incredible group of people, who will go their separate ways to travel Central America before heading back to the States, Spain, and Germany. They will be missed.

Soon to come will be information about how readers can donate to NPH and the Catholic Medical Mission Board. Stay tuned

Casa Emmanuel, and Pablo Goes Dark

2008-12-16T20:53:00.013-06:00

One of the ranch’s small joys is Casa Emmanuel and its residents. Casa Emmanuel is the hogar for boys with disabilities on the Ranch. There is a home for girls called Casa Maria Reina. About 15 boys and girls with more profound conditions live in a special N.P.H. house in Tegucigalpa, Casa de Angeles.

Seven boys live in Casa Emmanuel, ranging from roughly 10 to 25 years: Omar, Carlos Perez, Luiz, Pablo, Joel, Carlos Joel, and Brian.

Omar is the oldest. He wears ear plugs, stoops a bit, and walks around with great vigor and alertness. His favorite greeting is when you hug and lift him up off the ground, and his appetite is voracious. This picture is of Omar in his Olympiades costume (more to come later about Olympiades).

Carlos Perez (right), Omar’s slightly younger brother, is sort of the father figure of the gang. He can be seen shouting orders to the others (indistinguishable to my untrained ear) if they are out of line before misa or skimping on their daily chores in the kitchen. Frankly, he has an opinion on most everything.

Next is Luiz, probably the quietest of the bunch, very soft-mannered. Pablo is autistic, he wears Plexiglas thick glasses and is typically rocking back and forth and rubbing his fingers together to music only he can hear. He likes to do his own thing.

Joel (19, left) is nearly always sporting some degree of a drooly smile on his face. On greeting you he offers a handshake and a hearty laugh, before inevitably trying to reach into your pockets to look for food or any kind of toy.

Carlos Joel (right) has huge ears and is perhaps the liveliest of the bunch, his growth on one side of his body is stunted from falling off a horse. Every time Carlos Joel sees me he asks when I am going to come visit them in hogar, with Carlos Perez often chiming in. They don’t need to do much to win me over. Last is Brian (no photo now), whose calm face often hints at an inner intelligence, though Dorie the volunteer in Casa Emmanuel says she’s yet to find it. Today I found him hiding under the table in Casa Emmanuel because he was upset about something. Though he arrived at the same time as Carlos he is nearly opposite, much more calm and withdrawn.

All are characterized by a stunning familiarity and exuberance with whomever they meet on the ranch. All are quick to smile except Pablo, and only because he’s off in his own world. Pablo’s independence actually led him into trouble a few weeks ago. It happened when the boys were returning across the ranch from working in the kitchen to Casa Emmanual, which they often do. Though they amble haphazardly as they interact with each other and passersby, they eventually make it to the right place. But this time, Pablo became separated and wandered off. In the afternoon Lolita, the Tia that day for Casa Emmanuel, realized he was missing. Soon a grand search was underway for Pablo, involving all the Ranch, employees, volunteers, ano familiares, even the military from the nearby base in La Venta. The extent of the search I am probably not conveying well, as I was off the ranch at the time and did not experience it firsthand. But suffice it to say that on a ranch of 2,000 acres, with hardly any fencing on the perimeter, there was plenty of space where Pablo could be hiding out. All hands were scouring the forests in the dark with flashlights, calling his name. Attempts were made at organizing the search so as to have even separation between the hunters to thoroughly cover as much ground as possible, but like anything here such efficiencies were out of the question, and in the end most did what they pleased.

The search lasted all night and through the morning, and it was not until 10 AM the next morning that Pablo was finally found, in the mountains miles from the ranch. He was found sitting in a hole, glasses intact, playing with a ball that he had been carrying with him the day before, apparently oblivious to the calamity of his situation. He had been missing 20 hours.

Needless to say Lolita, a Tia of ~20 years experience, was let go by the ranch not too long after. This was a very sad time on the Ranch. At least some questioned whether there weren’t financial motives behind the move, as the Ranch is in dire straits with the financial crisis and has let go many employees, including all of colegio (middle school). It was the third time Pablo has gone missing.

In the end, the fortunate thing was the Pablo was found and experienced no harm. There will certainly be more stories to come of Casa Emmanuel; they always find a way to keep things interesting.

Surfing in El Salvador

2008-12-07T16:19:00.010-06:00

OK, so the blog has been suffering. A lot has been going on, but no excuses – I’ve got my work cut out to get it all in. So I’ll start with something that was fun, the min-vacation Finn and I took to El Salvador, Nov. 12 – 16. Fellow volunteer Mark was going to go too but…well, you’ll see…

At 11:15am Wed. Nov. 12, I leave Tara and Annette (volunteer nurses) to finish surgery in the Quirófano with Dr. Cerna, and Finn, Mark, and I embark on the surfing trip we planned some time back. From the Ranch we take a bus to Tegus, then a taxi to the King Quality bus station. An aside about the buses. The local buses are mostly school buses, chicken buses, I guess because once in a while you see a passenger holding a live chicken wrapped in a plastic bag. The buses are cheap, crowded, loud, and slow. Personal space is nonexistent or at least understood very differently. Reggaton blares from front speakers below cursive proclamations of “God loves you” and no smoking signs, while entrepreneuring locals board frequently to sell bread, bracelets, medicine, the Word of God, anything. This particular bus was no exception.

Checking in at the desk at King Quality, Mark realizes he forgot his residency paper. This is a big oops. Now we are in scramble mode – Finn is visibly perturbed, smoking a cigarette, and I can’t help but laugh – we've got to get that paper here in 90 min or Mark can’t get on the bus, a near impossibility. So begins a mad flurry of calls, Chris my roommate running all over the ranch to the Portón, the Hortaliza, and Talleres to get the paper to the Padre, who was headed into town, and the Padre goes to meet Mark at Cerro Grande. Long story short, Mark doesn’t make it. He plans to take the early bus Thursday and meet us in San Salvador, and Finn and I depart on the KQ bus (international coach, pricey, and comfortable).

After a few hours of very scenic travel we get to the border, and now I’m in trouble. The residency paper alone isn’t good enough for me to leave the country say the immigration officers, two stout, plump Salvadoran women in neat white and black uniforms. However I’m in luck: I went back to the States in October, and by mistake, my passport has been stamped with another 90 days of uninhibited travel. The officers have a chuckle and begrudgingly let me pass. Finn already has his residency card and no problems. We continue on, crossing our fingers that Mark will make it ok.

The next morning in the capital we have time to kill before Mark is scheduled to arrive. San Salvador is cool. The city is smoggy but much greener than Tegus, with parks and boulevards lined with trees in some places. I want to go to the Centro Monsignor Romero and see where the six Jesuit priests were assassinated. Finn is an atheist and has no prior interest or knowledge, but he is a good pal and likes history so we go to the museum, aided on the way by many friendly San Salvadorans. One woman, Mari, took us on the right bus and showed us where to get off, chatting the whole time about the city, the sights and dangers, and our work. She even gave me her name, address and email and said to look her up if we ever needed anything. Unbelievable. As we get to Universidad Centroamericana, a UCA student picks up right where Mari left off, walking us into campus and pointing the way to the museum. The Salvadoran friendliness continued to amaze me throughout the weekend.

At the museum (surreal) we find out Mark is stuck at the border. Puta, no me dejaron a cruzar, he writes. Puta is right. Nothing else to do, Finn and I continue, feeling a bit sad that Mark won’t be joining us. We take a bus 1 hour to the coast, to the surf town of La Libertad, and so begin the toughest leg of the journey.

Maybe my biggest realization in El Salvador (after the cheap goodness of authentic pulpusas and honest Salvadoran amiability) was that surfing is HARD. After two full days hitting the waves I had little to show for my efforts besides a cut foot, broken board, burns on my stomach and chest, and an undiminished desire to try again. The ocean beat me up bad, so I had to be content with the smallest marks of progress. In our beach motel we met an old New Jersey man back to relive the surfing years of his youth he spent in this town years ago. He gave us some tips and pointed out that these were expert waters, so we took solace in this fact and chalked it up as a learning experience.

Saturday night we went back to dirty downtown San Salvador and Sunday bused it home on the cheaper Tika bus. The only hiccup was a huge FLMN parade we had to fight through on the way. All in all a great trip and break after a few busy weeks prior.

CMMB MVP's for Change

2008-11-18T08:16:00.003-06:00

Hi Readers,

Recently I have created a fund with the Catholic Medical Mission Board to support my volunteer work here in Honduras. If you'd like to read about the fund, the Catholic Medical Mission Board, or make a donation, please visit the following link:

http://support.cmmb.org/site/TR/Events/General?pg=fund&fr_id=1010&px=1109422

Thanks very much for your support! Below I have included the piece I wrote for the Catholic Medical Mission Board summing up the bulk of what I have been doing on the Ranch since my arrival. I include this because other than the “typical week” I related months back, I really have not described my job in any detail.

My primary responsibility on the NPH Ranch has been to manage the construction and operation of a brand new surgery center. Begun in 2004, the center is the vision of Dr. Peter Daly, an orthopedic surgeon from the U.S., and longtime NPH director Reinhart Koehler, whose goals are to provide a vehicle for bettering the health and medical care of underserved populations in this area through improved access to surgical services, which are in desperate need. My job is to communicate with project leadership to organize and execute construction tasks, as well as facilitate activities at the surgery center in construction, maintenance, and medical service provision. The center is nearly finished, having installed anesthesia gases and suction piping this past week, and we are currently planning final modifications to prepare the facility for licensure and certification by the Honduran Ministry of Health. Our leadership is also looking at long-term business and operational plans, which must cover the building’s expenses and upkeep while allowing access for poor and underserved Hondurans at prices they can afford. The center hopes to partner the expertise of U.S. and European medical brigades with Honduran care providers to exchange medical knowledge and elevate the country’s level of care while providing high-quality, affordable surgical services. Primary care for surgery center patients, including triage and follow-up, will occur at NPH’s external clinic, which is staffed by volunteer and Honduran medical staff and serves roughly 40 patients daily. Currently, the surgery center is being used once per week by a Honduran surgeon for small surgical procedures (e.g. removal of cysts, in-grown toenails, and benign tumors), and these patients are triaged at our clinic. They pay a symbolic nominal fee.

A second project of mine was to provide all needy children on the ranch with glasses. This project was begun last January by a volunteer ophthalmologist who examined almost all the children, fitted those in need with a supply of frames, and negotiated with the public hospital optometrist to make the lenses. Upon her departure in August, I finished her work by bringing the remaining children she did not examine to Tegucigalpa for eye exams, helping those who need glasses choose their frames, and taking prescriptions and frames to the optometrist. We just received our final group of glasses from the optometrist last week, so now the vast majority of children who need glasses, excepting those new to the ranch, have received them. Future work in this area would include keeping up to date with new arrivals, changing prescriptions, and repairing frames, and as we must pay for these services in Tegucigalpa this likely will be continued by other clinic staff.

My other duties include helping the Honduran surgeon to provide medical services at the surgery center. I call the patients to come for surgery, act as an assistant during the procedures, and clean up afterwards. For one weekend, I also helped the NPH International medical team to check on water filters brought to rural Olancho by a Virginian medical brigade, and I will likely help the brigade again when they return in the spring (see “La Hicaca”). Future ideas include making a public health presentation about diet, exercise, and common illnesses to children in our school during their science classes when they begin next February, and possibly working with our IT volunteer to try to implement in the clinic some rudimentary form of an electronic medical records database.

That about sums it up right now. Please consider making a contribution to the CMMB fund, or to NPH Honduras. Also coming soon will be a recap of a productive visit by Dr. Daly and his medical team that really whipped the surgery center into shape, and pictures of my surfing trip to El Salvador. Stay tuned.

As easy as kicking a drunk

2008-10-19T17:07:00.014-05:00

Foremost, my apologies for the delay between postings, this was due to a short trip back to the states. In any case, I was crazy enough to come back to Honduras, and my first blogging order of business will be to relate my adventure on the medical brigade to La Hicaca, an excursion that happened just before my U.S. vacation.

The purpose of this brigade was straightforward; we were to check on twenty some water filters given in April to residents of La Hicaca, a small village in Olancho, a northern costal territory east of La Ceiba in Honduras. These water filters were the work of Dr. Pat, a specialist in adoption medicine and third world orphanages, and affiliated with a Virginia university. He was helped by Annie, a nurse and former NPH Honduras volunteer who now works for the NPH International medical team. She has worked closely with Pat on his NPH projects, for Pat also leads a brigade of medical students from his university each summer to do health check-ups for residents of La Hicaca and smaller towns outside Olanchito, the major township in Olancho with about 40,000 residents. The brigade is hosted by the Catholic Church in Olanchito, and they helped him identify the need for potable water in La Hicaca. In this tiny village, there is no electricity or running water, and residents were suffering from diarrhea and vomiting, especially children, due to parasites and bacteria in the water. Pat and his team handed out 22 filters (basically clay pots set inside larger plastic buckets with spigots) to homes in La Hicaca with specific instructions on how to care for them. He had come back test the quality of the filtered water and see how residents were doing.

With these simple goals in mind, we set off, leaving from the Ranch at 5AM Friday September 26. The running joke on the nine hour marathon through Honduras to Olanchito (thru Tegucigalpa, El Progresso, Tela, La Ceiba—this was the only safe, paved road there) was about the condition in which we’d find the filters. Pat not too optimistically predicted 6 out of 22 would be in use, with the rest of the round clay pots decorating La Hicacan yards with Honduran flora. To our surprise, when we went to La Hicaca on Saturday we found quite the opposite. Residents were actually using the filters, and when we asked them how they were feeling, most reported that incidences of diarrhea and vomiting in the children had disappeared or were dramatically reduced. This was rather heartwarming. In addition, the buckets occupied places of prominence in each home, and their owners cleaned and maintained them fastidiously. We took water samples from each of the filters, and Pat resolved to bring more filters down next spring.

With these reports the trip was by and large a success, and furthermore so because I learned one of the best Hondurismos I’ve seen yet, thanks to our guide Jorge. Jorge works for the church’s radio program in Olanchito, and as he grew up in La Hicaca, he offered to take us to the village. This required navigating cow herds and crossing a swollen stream, and prompted me to describe such a drive “a piece of cake.” I asked Jorge if there was a Spanish equivalent for something really easy. Sure, he said, it’s like patear un bolo—“kicking a drunk.” Because they can’t defend themselves, he said, waving his arms in front of him. Of course…

These are pictures of some residents of La Hicaca. To the near left can be seen a red water filter bucket in the background. Most all the buckets were carefully covered in with a clean cloth like this one.

Casa Alianza

2008-09-24T17:09:00.005-05:00

Last Thursday presented a window into another non-profit organization that works with children here in Honduras. A few of my fellow volunteers and I had the opportunity to visit Casa Alianza, an institution in downtown Tegucigalpa that works with street children and their families. While they are in no way affiliated with NPH, the two organizations are in the same line of work, and sometimes children are referred to the Ranch from Casa Alianza. In fact, Laura, our volunteer visitor coordinator since January who led the trip, actually recognized there a girl from her Hogar who left NPH in March. The girl left to live with her family, but evidently she has since found her way to this halfway house of sorts. She told Laura she wants to go back to the Ranch. With such ties in mind, I thought it valuable to relay what I learned about this organization to perhaps broaden the picture some and provide a little information of what life is like for some Honduran children outside the Ranch.

Casa Alianza, started in 1987 and largely supported by a New York charity, takes children off the streets of Tegucigalpa and works with them on a near term basis to resolve problems in their lives. These are wide ranging but typically involve physical or mental abuse, drugs, sex trafficking, and gangs. Over 90% of the children suffer from some sort of abuse. The organization is best equipped to serve children ages 12 to 18, any older and they are legal adults and difficult to help, and the younger ones are typically referred to other groups who have more specialized care abilities (e.g. NPH). Even so, they treat approximately 1500-1800 kids each year, and about 160 live at the institution at any given time.

Children are at the institution of there own volition, often just showing up on Casa Alianza’s doorstep because they have heard about the place through other street kids. They also have a street team that looks around the city for new children to help, inviting them to the house after three or four positive encounters. Many of these children are troubled by gangs, and the horror stories about Honduran gangs abound. Gang members are said to drive by in cars and force youths to show them their chests—if they have tattoos from a rival gang they are shot down right on the spot. This is one of the reasons that Honduras has an unusually high homicide rate among minors, a statistic of which the government seems unaware. Children are also referred to the house from other organizations or the legal system.

The house helps children foremost by giving them food, medical care, and a safe place to live. The children can attend school nearby and return to the house afterwards. If the child is in trouble with the courts or the police, the house has lawyers on staff who work with him to resolve those issues. They also have a family services department that works with the kids’ families to help their economic development, because due to extreme need many of the children are forced by their parents to work the streets to help earn income. They also have programs that work with adolescent girls, many of whom have been involved in the sex industry.

After all they do for these troubled kids, Casa Alianza still finds that others are ignorant or unsupportive of their work. Because many of their clients have been involved with gangs, some are untrustworthy of Casa Alianza or assume that it supports gang activities. Due to this youth gang involvement, some even think it is better for these street children to die or disappear (remember governmental apathy towards adolescent homicide rate). In any case, the house continues its unheralded work, and right now they are even in the midst a fundraising campaign to renovate their building. It was an eye-opening experience, helped me put some things on the ranch into perspective, and I wanted to pass it along.

A "Typical" Week

2008-09-14T22:10:00.014-05:00

As good a place as any to start blogging about the Ranch would be to recount what is a typical week for me, at least as much as any other. Here are the day-to-day highlights of my last week, September 7th-14th:

Sunday, September 7, 2008

Volunteers have every other weekend off from work, and this weekend I am on vacation in Tela. Visiting this small north coast town with me are my two friends and fellow volunteers, Finn and Marieke. They are both from Germany; since arriving in January, Finn has been the school’s physical education teacher, and Marieke began volunteering with me in July in Padrinos. The Padrinos office coordinates communication between pequenos and their padrinos, or sponsors, the majority of whom reside in the U.S. or Europe. Marieke’s job is to translate letters that the kids write to their padrinos from Spanish into German. In the afternoons, she leads Chicas Podorosas, a program to support and educate the adolescent girls on the Ranch.

Marieke, Finn, and I spent Saturday at a Garifuna village near Tela called Miami. The Garifuna are one of the many ethnic groups in Honduras. They live on the coast, trace their roots back to Caribs and Africa, and maintain much of their own culture. They are expecially known for their Punta style of dance. On Sunday, we took the five-hour bus ride back from Tela to Tegucigalpa.

Monday, September 8, 2008

My morning routine is to get up at 6:30, shower, and eat breakfast in the big kitchen. Today was average – rice mixed with beans, mantequia (creamy white, butter-like dairy product), avocado, and milk. The ranch gets milk straight from the udders of the cows on their farm; it is whole, thick, and hot.

After breakfast, I talk with Tonin from maintenance about installing a hands-free sink in the Surgery Center – we agree to do this Wednesday. At 8:00, I go to bug Talleres, the workshops, about doing work. My primary job on the Ranch, loosely described as project manager for the Quirófano (Surgery Center) being constructed here, means that I frequently need Talleres to do things. Talleres, more often than not, feels that they should not do such things, and their blatant unwillingness to work under any reasonable time constraint is largely to blame. For this we are in a perpetual struggle of opposing interests, each side using all their guile, cunning, and available tools to thwart the intentions of the other. It is a never-ending battle that I fully expect to continue my entire time here. Talleres won today’s skirmish, as Renan from Metals successfully defrayed my inquiry about working on a bathroom screen—countering that they were still waiting on parts to be delivered to the bodega—and Marcio from the woodshop avoided a confrontation about constructing doors by escaping to a meeting, promising to call me when he could stop by the Quirófano to appraise the work. Talleres 1, Quirófano nil.

Returning empty-handed, I called Reinhart to discuss some business with a sub-contractor named Fausto. Reinhart is the Director of Family Services for NPH International, almost single-handedly built the entire NPH Honduras branch beginning in the 80’s, and is my boss. He is a large-framed, balding, middle-aged German who inspires a mixture of awe, fear, and respect from his peers and subordinates. Our talk centered on getting this Fausto to begin installing anesthesia and suction gas systems in Quirófano. At 9:00 I went to meet a potential volunteer at St. Christobal, the visiter house, for a tour of the surgery center. Afterwards, it was up to the Home Correspondent’s office to speak with Patricia about Quirófano fundraising business. Mostly, this was about coordinating information about our projects and spending patterns with NPH fundraising offices in the U.S. and Europe that are working to provide funding for those projects.

1:00 is lunchtime on the Ranch, and the lateness of the meal makes for short afternoons. It is always rice, tortillas, and a steady rotation between some kind or soup or chicken. To be fair, occasionally an item such as salad, pork, or a fruit drink is offered. After lunch, I wrote an email to a contact in Tegucigalpa about buying some surgical scrubs, and called Fausto about his work. He is waiting on parts (big surprise) but promises to begin in two weeks. Vamos a ver...I call it a day, go for a run in the mountains west of the ranch, and spend dinner in my Hogar.

Tuesday and Wednesday September 9 – 10, 2008

These two rather uneventful days were distinguished only by a discouraging lack on progress on Quirófano construction and an exchange in Hogar, so for brevity I will combine them. Of note Tuesday was a particularly brutal practice I endured with the Ranch’s soccer team, involving distance running, an obstacle course, and heavy calisthenics. Wednesday, our plans to install the hands-free sink were thrown asunder when, in a commonplace occurance, the power went out. Unable to work, we patiently rescheduled for Thursday and I went up to the internal clinic. I spoke with Alma, the head of NPH’s internal and external clinics, about an ophthalmology project.

In the evening, Hogar was difficult for one of my boys. First, briefly, every volunteer is assigned to a Hogar, or “home” of about twenty-some similarly aged boys or girls, where she will eat meals and interact with the children during evenings and on weekends help with chores. My Hogar is Discipulos de Jesus, a hogar of 22 boys aged 14-16. This particular night, a skinny boy with an easy, toothy grin named Gerson was uncharacteristically down. Whether or not his disposition provoked two of his fellow roommates is impossible to say, but they began to tease him. Not in a mood for kidding, Gerson lashed back, but as the boys were stronger he could not defend himself. Deflated, his pride temporarily hurt, he put his head down on the table and covered his face and any tears with his arms. I thought about how I had likely just witnessed one occurance of many, and how quickly some have to grow up, and not believing I could say anything to make it better, I patted him on the back and gave him my apple.

Thursday, September 11, 2008

Today was a terrific Quirófano day. Ranch workers began preparation work on a new storage shed, or bodega, that at we are constructing to house Quirófano supplies. Leo from maintenance began installation of the hands-free sink. This sink is for surgeons to scrub in before beginning surgery: the water can be turned on by moving a semicircular device with the knee. Josué from maintenance and I put together some bathroom shelving for five of the six Quirófano bathrooms. An aside: Josué is an año familiar, a pequeño that is doing one of his required years of service to NPH before he can attend either high school or university. One year of service is required before NPH will support a pequeño to attend high school, and two years before university.

Later in the morning I spoke with Tom, an IT specialist who is here to volunteer along with his wife Casey, a doctor, about equipping Quirófano with internet. And I scored an important victory with Talleres when Marcio actually came down to Quirófano to take measurements for the wood doors we need built. To top it off, Juan, the ranch’s engineer who is very involved with Quirófano, told me that today he would order the epoxy I’ve been asking for for weeks in order to finish sealing the floors near the sterilizer. So all in all it was a very successful day.

Friday, September 12, 2008

Today marked the Ranch’s celebration of the Honduran National Day of Independence, a holiday every 15th of September. During the morning the entire ranch participated in a big parade that went from the army base in the nearby village of La Venta all the way back to the Ranch. Many of the children, especially the younger ones, dressed up in costumes and outfits, and there was a percussion band and baton twirlers. A few people watched from the sparsely populated town, but mostly it was employees and volunteers from the Ranch who cheered on the kids. Soldiers directed traffic as the children proceeded down one-half of the highway on which the Ranch and La Venta are situated. A squad of troops from the army base brought up the rear of the parade, and later they performed in a presentation at the school.

During the afternoon, Christiana and I met at the external clinic to help a few new pequeños choose eyeglasses. Christiana is an ophthalmologist from Germany who spent about six months giving eye exams to all the children on the ranch, fitting frames for those who needed them, and taking the frames and prescriptions to an optometrist in Tegucigalpa to make glasses. After vacationing for about six weeks she was back on the ranch for only a few days before she went home to Germany, and we wanted to use this opportunity to use her skills for a few new girls. Unfortunately, we could not find the key to open the room where her stuff was stored. In a confoundingly unsensible move, the clinic gave their only copy to the workers who are finishing construction of the consult rooms that contin the opthalmology supplies. It is not a huge deal, but it means we will have to pay for these services in Tegucigalpa for these children at a later date.

Saturday, September 13, 2008

This weekend was my turn to work, so I was at my hogar before 9:00 to eat breakfast and help with chores before going to the school for the day’s activities. Today was different because the children were to going to play in the morning and do their chores on Sunday instead. There were a few boys’ soccer teams from nearby villages that came to compete on the field at the school, and all the other children hung out and played games into the afternoon. At 1:30 lunch came in uniform red coolers, whose insides are permanently tinged by the contents they hold three times a day. Coolers are the method of choice for transporting the food from the kitchen to the kids, whether that be at hogar, talleres, or the school. Today's lunch was rico: spicy chicken, rice, and cabbage-tomato salad, topped off with pinapple refresco. There were a few free hours afterwards before mass began at the church at 5pm. During mass, there was a very relevant skit about stealing that incorporated a gospel message about the golden rule. Girls sit on the left and boys on the right to minimize mischief. After mass it was dinner in Hogar (eggs, tortillas, avocado, cheese, tea) before the boys fastidiously brushed their teeth, gelled and spiked their hair, put on nice clothes, and went to meet the girls at the Talleres auditorium for a concert. After I said my goodnights and snuck out the back, the week’s work over, I could still hear the echoes of a very average garage band as I made my way through the ranch and back to the volunteer house. Sunday I am off work and rest.

Bienvenidos a Honduras

2008-08-31T17:46:00.003-05:00

This blog is about Honduras and a Ranch called Rancho Santa Fe, 36 km outside Tegucigalpa, where I am living and working for a year. Beginning the blog two months into my time here was probably the second worst thing I could do (the first being never starting one), for already I can see it will be an organizational nightmare of events, people, places, pictures, and whatever else comes up. But I will try to start out with the basics of the story, and we will see where it takes us. A few items of business: the blog is organized thematically, and though the most recent post will appear at the top of the page, all posts are listed in chronological order on the left side. I would encourage readers to add their comments, questions, and general feedback; it will greatly help me to improve the site and to direct me with future postings. Enjoy

Background and Introduction:

In the beginning there was Padre Wasson, and Padre Wasson created Nuestros Pequeños Hermanos (Our Little Brothers and Sisters). Even the littlest pequeña can tell you this, for she has heard it since the day she arrived. Wasson started each of the nine NPH orphanages across Latin America, from Mexico to Bolivia, beginning in the 1950s in Mexico City. The oft-recited story goes that Wasson was presented by the police an orphan who had stolen from Wasson’s church. When Wasson offered to adopt the boy into his home, the following day they brought him a half-dozen more orphans from the jail. So began the first NPH home. The ontology is important because the generosity of William Wasson is one of Rancho Santa Fe’s biggest themes, and much of the Ranch’s philosophy keeps the late founder in mind. For example, Casa Suyapa Tias (caregivers for the youngest children, anywhere from toddlers to eight or nine years) can be heard lecturing their charges on the virtues of Wasson and how this knowledge should inform their behavior, while they wait impatiently for dinner. Wasson founded the Honduras branch of NPH in the mid-1980s, and it currently serves 550 children.

The big picture of NPH Honduras, similar to all nine homes, is this: the orphanage takes children, often siblings, out of desperate situations, brings them to the ranch, and raises them more or less until adulthood. As they grow up, the institution has various mechanisms in place to prepare each child as best as possible to break the cycle of poverty and neglect. For example, Rancho Santa Fe has a school that all children (except for the developmentally disabled) attend, giving them the equivalent of about a primary school education. Those with the aptitude and desire can continue their education through high school and university levels, interspersed with required years of service to the ranch. The Ranch also has a system of Talleres, or Workshops, designed to give every child a trade to support themselves in the outside world. There are numerous other NPH departments and programs dedicated to the children, including an Ex-Pequeños office, Social and Family Services, Psychology, Health Clinics, just to name a few.

It is a big place, in both institutional and physical terms, with more than 200 employees and around 30 volunteers working on a mountainous, 2,000+ acre piece of land. This is large enough for stray horses to find their way from nearby farms onto the ranch and make their home here for weeks, converting lots of foliage into smelly sidewalk obstacles (for this, the ranch charges the horses’ owners before they can have them back). It’s large enough to attract forest fires during the dry months of March and April, when the entire Ranch must put down what they’re doing and run to protect the property from encroaching blazes. Because of its size, among other more important reasons, Rancho Santa Fe is in many ways its own little world, and like any other, takes time to get a grasp of. As I learn about the way things work here and in Honduras as a whole, I will pass it on.