A country without care jumps at the chance to see the doctor

The doctor is in at Angelitos Felices

I’ve known for a while now that accessing medical care was a challenge for the majority of Hondurans who have to rely on the public system. But it wasn’t until I put in a couple of days as an ad-hoc translator for a U.S. doctor in the villages this week that I fully understood that medical care is as good as non-existent for a whole lot of people.

The doctor was part of a faith-based group out of Illinois and Tennessee who were here to build fuel-efficient stoves in three villages around Copan. She hadn’t planned on seeing patients, but word got out fast that there was a doctor among the group and she graciously agreed to see a few people.

And they jumped at the chance. On Monday and Tuesday we were in Guarumal, Cabanas, a village of 15 families, and at least nine of those families were in the lineup within 10 minutes of the doctor pulling up a chair on the patio outside a resident’s house. I suspect the other six families would have been there, too, if they’d heard the news that an impromptu clinic was on.

They arrived with all the problems that any family bumps into in the course of a life: fevered little children sick with a seasonal virus; bad coughs; yeast infections; stomach pain; acid reflux; foot fungus; bad teeth; lumps and bumps and itchy rashes that they’d had for years in some cases.

But unlike a typical North American family, these ones rarely got care for their illnesses and injuries. Even if they were able to find the $5 fee to see the doctor at the public clinic, the nearest clinic was a long, hard 10 or 15 miles away and many of them didn’t have transport. Nor did they have money for any necessary lab tests to confirm what ailed them, or for medications. Not that they could count on the scarce public health clinics in this area to even be open when they showed up, or have the medications they needed.

The pharmacies in Honduras are loaded with all the modern medications, and virtually all are available without a prescription. But until a doctor gives you a diagnosis and the name of a drug that might help, none of that means a thing. I wouldn’t like to think how many people end up using the wrong medication for an ailment, simply because they don’t know which one to ask for.

High-sugar diets, poor oral hygiene and no dental care
is a recipe for pain and problems for impoverished
Honduran children.

So while the people in Guarumal were grateful that the visiting doctor sometimes pulled a free bottle of painkillers or antibiotics out of her magic bag, they were equally appreciative just to have her write down the name of the medication they needed.  Money is one hurdle, but knowing what drug to buy is an additional barrier.

The good doctor let me lure her to the Angelitos Felices foster home as well, where 25 or so kids pass their days in unsanitary, damp conditions in which they share towels, clothes, bedding, shoes and therefore all the diseases and infections that spread that way. I’d cautioned her that the kids might be shy about being examined, but in fact most of them really seemed to like the personal attention, not to mention the chance to get a band-aid (or two or three) on their many cuts and scrapes.

I came home with a list of suggested medications for all the kids with ailments, with an asterisk by the ones who need treatment most urgently. That included a two-year-old and a four-year-old who both have severe staph infections on their scalps, a nine-year-old suffering from a monstrous tooth ache from the worst of his many cavities, and a 14-year-old with a urinary tract infection. (Wish I could have done something for the asthmatic little boy we met in Guarumal, who was so obviously struggling for every breath.)

The doctor says just about every child in Angelitos has a chronic fungal infection on their feet, and some have it on their faces and scalps. So I bought a big tube of anti-fungal cream at the pharmacy this morning and am going back for two more when the next shipment arrives from San Pedro next week. Clearing the fungus out of that place sounds like an impossible task, but even a month or two without cracked, achy feet should be a relief for those kids.

Spare a thought for them next time you’re grumbling about the wait at the walk-in clinic or the lineup at the pharmacy. The people here would be ecstatic if that was as big as the problems got. 

On a mission to help a mission

My boss Merlin Fuentes demonstrates a  miniature
version of a fuel-efficient fogon at the Feria Ambiental

Oh, what a week it has been - freshly back from a fast holiday in Las Vegas with a couple  of my daughters, now plunged into a week of acting as a kind of tour co-ordinator to a group of 15 Americans who have come to Copan on a mission to help my organization build fuel-efficient  stoves.
And just to add to the over-stimulation, it's election day in Honduras today. People have already started streaming into local schools and other polling stations to participate in what is essentially the primaries for the 2013 election.
Rumour has it that things get interesting on days like today, when political opinions tend to heat up. Cuso Honduras actually told us volunteers to stay indoors today and stock up on emergency rations, advice that the locals got quite a kick out of when I told them. At any rate, my American friends are counting on me to lead them on a tour of the Mayan ruins and later the foster home where I help out, so shutting myself in the house isn't an option.
It's pretty amusing to be called into service as a Copan tour guide and a translator, neither of which I'm remotely qualified for. Happily, a genuine tour guide who's quite fluent in English has already attached himself to the group, wisely seeing an opportunity to be of service in all kinds of ways. But I suspect the group and I will still have a lot of hanging-out time  in the  week to come, and now the bonding experience of going through our first Honduran elections together.
Hosting missions from the U.S. and elsewhere is one of the goals of the Honduran non-profit I work for, the Comision de Accion Social Menonita (CASM). Faith-based groups from various denominations do a significant amount of project work in the country, coming down for a week or so to build schools, take on a water project, construct chicken coops or tackle whatever else needs doing.
This particular group is more eclectic than most, coming from four states and having family ties, old friendships and a parish preacher in common. So there's a mom-and-daughter pair, three siblings from another family, two parents with their two kids, a couple cousins. Some have done several missions before while others are trying it for the first time; one fellow is on his first-ever trip outside the U.S.
Starting at 8 a.m. tomorrow, they'll be spending five days in the countryside around Copan building about 40 wood cooking stoves in the homes of subsistence farmers. The group raised $2,000 to cover the costs of the stoves - fogones, as they're known here - and soon they'll be mixing cement and stacking bricks in homes in Guaramal, Mirasol and Libertad, three of the many, many struggling little villages around this region.
My organization has built about 350 stoves like these ones over the last three years. Everybody loves them. They burn 45 per cent less firewood, have chimneys to vent smoke out of the house, are insulated with ash so nobody gets burned, and have big cooking surfaces that can easily accommodate all those tortillas that are a constant of the Honduran diet.
But while the stoves cost a  scant $40-$60 each to build, that's still a lot of money here. The only way farmers get the stoves is if CASM has development money from somewhere to do a project. Or if a good-hearted mission group from outside of the country raises money among their friends and heads on down to Honduras for a working holiday.
Pictures to follow.  And now I'm off to the ruins, on a beautiful day in the midst of the drizzly season that I think must be some kind of karmic reward for good people who come all this way to make life a little easier for a few Honduran families.

Give this poor country a break

This is the first time I've lived anywhere other than Canada, let alone in a country with such a ferocious reputation for violence that my friends and family are regularly checking in with concerned voices as to whether everything’s fine down here. 

Nothing to worry about, I tell them. And I mean that. Despite the endlessly bleak news about Honduras and a truly formidable murder rate, this country has in fact been a very pleasant place to live these past 10 months. The place needs work, absolutely, but this seemingly global need to portray the country as a random killing zone is both cruelly inaccurate and damaging to the people who live here. 

A worried friend back home recently asked me about this comment from the latest newsletter of Médecins Sans Frontières/Doctors Without Borders. In Honduras, “violence is the main strategy for solving any problem, whether it’s related to drugs or not,” said MSF spokesman Javier Rio Navarro.

I don't know about you, but that kind of statement conjures in my mind visions of dangerous men everywhere, daggers clenched between their teeth and assault rifles at the ready should there be a need to gun down random strangers. It conjures up a country that is inherently violent, where the norms of civilized society have broken down and no one is safe anymore.

I have tried to square that image of Honduras with my daily experiences here, in which I walk back and forth to work and meet nothing but friendly people also walking to wherever their day-to-day routine is taking them in the moment: To the market to sell tortillas; to their child's school; to the field where they're moving the cows; to their construction job. It doesn't square.

I've even walked the wild streets of Tegucigalpa. And while the city has yet to win me over, nobody my partner and I have come across in our visits there has been looking to do two gringos harm.

Nor were they shooting at each other, having fights, robbing passing strangers, or otherwise wreaking havoc on the social order. They were going about their business. That’s what human beings tend to do most wherever they are in the world, even in the middle of a full-on war.

I've yet to see a problem solved with hand-wringing. But that and a challenging reform of the Honduras police force – badly needed, but not a solution  all on its own -   are pretty much all that’s going on. As far as I can tell, no work is underway to get underneath the scary statistics and figure out who is really at risk and what can be done about it. Simply piling on more headlines to scare off even more of the tourists certainly isn’t any help. 

Here’s my take on who’s really at risk here, based on my reading of the news and the many stories I’ve heard from Hondurans:

• Anyone associated with the illegal drug industry, where assassination is used to kill off the competition, wreak vengeance, and “send a message” through the murder of family members, loved ones and acquaintances of a narco-traficante on the wrong side of somebody’s list.
• Poor people who live in the poorest barrios and ride the cheapest buses, which are regularly held up by robbers and gang members who either want to steal what they can in the moment or extort the driver and passengers with a “war tax.”
• Poor business owners who are extorted by gangs just for trying to make a living in the roughest areas of the big cities where law and order simply don’t exist.
• Campesinos fighting in the heated Bajo Aguan land dispute.
• Hondurans engaged in Hatfield-and-McCoy style vendettas over real and perceived wrongs of the past, in which one violent act begets another and another for potentially years.
• People who get fingered by acquaintances as a known killer, robber or otherwise bad person, and thus become candidates for the kind of street justice that can happen in a country with a troubled police history and a largely ineffective justice system.
• The unfortunate innocents who occasionally find themselves in the wrong place at the wrong time when one of the above-mentioned groups engages in violence and kills them by accident.

That’s a lot of people, for sure. But except for the last category, it’s not a random collection. It still means Honduras has some big problems to get a handle on, but it doesn’t mean that the whole country is a dangerous wasteland that only dare devils and the uninformed would ever spend time in.

That image does such a disservice to the vast majority of pleasant, peaceful, deeply religious Hondurans. It does the country genuine harm by scaring off the aid programs, investors and travellers that are so vital to a brighter future for Honduras.

Don’t believe everything you read. Good people live here, and they need more from the world than condemnation and fear-mongering.

The more things change...

Cuso International brought me to Honduras to do communications work for a Honduran non-profit organization, a job that is both strikingly similar and completely different to communications work in Victoria.

On the one hand, communications is ultimately about finding effective ways to talk to the people you need to talk to, whether you’re in Honduras, Canada, East Timor or Uzbekistan.  But in Canada that largely means focusing your efforts on those with money or influence, whereas in Honduras the whole game changes because the country doesn’t have a responsive government or much of a culture of philanthropy.

One thing that is identical, however, is proposal-writing. That might not be in the job description when you take a communications position, but trust me, you’ll end up doing it sooner or later if you’re working with non-profits. I’m well familiar with that soul-destroying process after seven years of working with Canadian non-profits, and now have enough proposals under my belt here in Honduras to report with confidence that it’s an equally miserable task here.

Non-profit organizations have to submit proposals constantly to try to sustain their funding. They’re essentially sales pitches shaped around some undertaking that a particular funder has in mind. At its essence the practice is like bidding for a building contract, except that non-profits are mostly working on less tangible things, like better societies.

 If you’re smart, you spend a lot of time reading what the funder says in the proposal call before you begin writing, so you can better match your pitch to the things they’re identifying as important.

They all have their areas of interests – youth, women, animals, disease reduction, a thousand themes. But there’s also a kind of flavour-of-the-month practice that’s very common. Whatever subject is globally “in” - human trafficking, literacy, protecting kids from gangs, crystal meth – tends to be a  theme across many different funders, at least until the next new thing comes along.

In Honduras, the big themes right now are around reducing the risks that communities face due to climate change, helping people to be better farmers and stewards of the environment, and developing more active, engaged citizens aware of their rights. My organization is working on all those fronts, as are many of the other non-profits here in the country dependent on international funding.

All noble pursuits, of course.  But none are short-term undertakings. Adapting to climate change in some cases in Honduras will mean convincing people who have farmed the land for centuries to look for new kinds of work. You can’t stop Honduras’s rather horrifying rate of deforestation until you do something about the almost five million people living in poverty who cut down trees because they need the wood to cook with and the space to grow corn. You can’t exercise your rights in a country where government just does what it wants.

Change takes time, yet the bulk of project funding is for a year or two. And while the current themes are important areas to focus on, many other equally important needs are neglected due to the big funders all shopping for the same kinds of projects.

You get tangled in all of that pretty quickly when you’re writing a proposal, in Honduras or anywhere. You know what the real needs are, but you face either having to find a way to squeeze them into the shape of the funding or give up on trying to address them. You know that a project will in fact take a generation to be fully realized, yet you’re writing like you’re going to make it happen in a year.

And the corker: You do all that work – and believe me, every proposal is a lot of work – with no certainty that anything will come of it. You twist yourself into knots trying to come up with something creative that the funder will like, you draw tables and create spreadsheets and fill in the squares of yet another week-by-week work plan, and more often than not you don’t get the money anyway. (Or worse, the funder collects all the submissions and then decides not to go through with the project.)

One particularly rude practice of a few international funders here in Honduras is to issue calls for proposals with a deadline that’s less than a week away.  What do they think, that a scratchy little Honduran non-profit has people just sitting around waiting for a proposal call to fill their day? No, they’re out busting their butts trying to achieve all those other unrealistic goals they had to promise in the last proposal.

Anyway.  Perhaps the whole thing’s just a bit fresh in my mind right now, having just gone through an intense period of proposal madness this very week that involved dreaming up a year’s worth of activities on a ridiculously tight deadline with the knowledge that in all likelihood, the project will do little to solve what ails Honduras . I guess I should just treat it as a valuable cultural learning experience: In any language, in any country, proposal-writing is a total drag.

And while any money is better than nothing to a non-profit, you just can’t solve a complicated country’s problems this way.

Remembering the dead

It’s not often you’d describe a graveyard as a beehive of activity, but the cemetery here in Copan has been these past couple of days as the locals mark Dia de Los Difuntos.

Every Latin American country celebrates the Day of the Dead – or Day of the Deceased, as it’s known here – in their own way.  In Honduras it’s a time for heading down to the cemetery to do a big cleanup of your loved one’s grave. There can’t be much budget in a poor country for maintenance staff at cemeteries, so it’s a chance for family members to spruce things up while honouring the memory of the mothers, fathers, grandparents and children buried there.

The Copan cemetery is a five-minute walk from where I live, and I headed over early yesterday morning to check out the activities. Some 15 families were already hard at work. Many more would come over the course of the next two days.

Some families just needed to freshen up the flowers a little or clear out a few weeds. But others were in the midst of full-on construction projects – putting a new roof on a tomb, repainting, finishing off a monument’s ceramic trim that they hadn’t been able to afford up until now.

I was a bit apprehensive about showing up with my camera like a big, gawky tourist. I contemplated trying to sneak in a few shots, but thought that would be just plain disrespectful. So I asked people if it would be all right if I took a photo of them working. Everybody was completely fine with that – happy, even. 

 I wandered around the small cemetery for longer than I intended, feeling moved by the love and family connections that had brought everybody there.  Whether they were tending to beautifully kept mausoleums or teeny crosses hand-painted with a family member’s name, all of them were there to remember somebody who’d meant a great deal to them. Every culture does that in their own way, but something about seeing a man on his hands and knees pulling long grass away from his wife’s grave really adds to the poignancy of the act.

We tend toward a more sanitized version of remembering in Canada. My father’s ashes are in a beautifully kept cemetery in Victoria marked with a perfectly lettered memorial plaque. I know my mother was hurt that I never wanted to go to the memorial park to “visit” him when we lived in Victoria, but it never felt like he was really there.

But walking past the Copan grave of Fanny Carolina Leonor Garin, dead at the tender age of 28, watching the husband she’d left behind lovingly restoring her grave to a vivid shade of turquoise– well, I felt her there. I could feel Juan Antonio Lopez Jacinto in the scrawl of his name painted on one end of his tomb. The dead were alive again in the faces of their cheerful family members, who were busily scrubbing and sanding and reminiscing about the people buried beneath their feet.

A Canadian memorial park is much, much tidier and greener than the overgrown, dusty plot of land where Copanecos bury their dead. Our dead in Canada exist amid a kind of hushed tranquility that I associate with funeral homes and carefully managed sorrow.

But something about the sheer disorder of the Copan cemetery feels so genuine. Death is messy and sad. All the well-trimmed and verdant landscaping of a typical North American cemetery can’t change that.

It was practically like hearing people’s thoughts as I wandered through the graves in Copan.

My neighbour was there, mopping the floor of the mausoleum where the family had buried their young son after his murder. Two children sat atop their grandfather’s tomb nearby, sorting through the plastic flowers they’d brought to fancy things up. An elderly man bent near his wife’s grave, silently sharpening his machete to take another crack at the saplings pushing through the soil. Their labours seemed like such a wonderful expression of love.

May eternity find me in a similar place one day, asleep among the wild things until the people who love me return to make me real again.