August 2009 Mission Trip -- Long Version
August 2-15, 2009
NY/HELP Honduras, an ecumenical project of the New York Conference of the United Church of Christ (UCC), has been working with the people of the indigenous communities around La Laguna de Mataderos, in the rural mountains near Yoro, Honduras, since 1989. Projects include a health clinic, staffed full time by a local nurse and periodically with New York doctors and nurses; agricultural programs, carried out in cooperation with Sustainable Harvest International; water and latrine projects; economic development projects; and most recently, construction of a new Centro Educativo Básico (Middle School) in the nearby community of Mataderos. This was done in cooperation with the local community, which provided much labor, and the Education Department of Yoro, which is providing teachers for the 7th to 9th grades.
Planning for the August 2009 mission trip to La Laguna, Honduras, began last winter, and at one time we thought there might be a dozen people going from New York. But various events occurred, and we ended up with four coming from New York: Nancy Savoy, a women's health nurse practitioner from Buffalo, who has attended the Cleveland Heights Christian Church and the Riverside-Salem UCC on Grand Island; Eileen Brittain, a Spanish teacher who translates for migrant workers (sometimes in Gordon's medical office in Arcade!) for the Finger Lakes Migrant Health Care Project, from the Pioneer Christian Fellowship in Arcade; Hanna Zetterstrand-Robinson, a pre-med student from Geneseo State College; and Dr Gordon Comstock, a family doctor from the Arcade UCC Congregational church, who was making his 19th trip to Honduras.
Nancy's son Andrew Savoy-Burke is currently a Peace Corps Volunteer in Camasca, in southern Honduras near El Salvador, working on water and sanitation projects. He and three of his friends were able to take time to come and work in the La Laguna area. Two other water & sanitation volunteers, Randy Harrington from Washington state, who is stationed in near-by Yoro, and Emelina Choi from Los Gatos, California, stationed in El Negrito (between Yoro and San Pedro Sula), also worked with our group. The three of them surveyed four village water systems, met with the local water boards, and made recommendations for maintenance and needed improvements. The fourth volunteer, Gail Norton from Fairbanks, Alaska, is working in Protected Areas Management in Ocotepegue in southwest Honduras. She is interested in going to medical school, and along with Eileen, spent a lot of time translating for Nancy and Gordon. When they were not otherwise occupied, the PCVs helped out in the clinic and pharmacy, freeing our nurse Mirtila Garcia to work with the medical providers.
The trip started somewhat inauspiciously when Gordon discovered he had dropped his passport on the plane from Buffalo to Atlanta. He went back all the way to the other side of the airport, and there, a nice lady asked if she could help him. He replied he was looking for his passport; whereupon she showed him one in her hand and asked, "Is this it?"!! Unfortunately, he was not able to get back to the far gate in time to catch the plane to Honduras. However, his sister Martha, who lives in Atlanta, came and took him in for the night.
The next day, Monday, Gordon was met in San Pedro Sula by Selvin Puerto from Sustainable Harvest Honduras (who seems to be in charge of "baby-sitting gringos"). We caught the bus up to La Habana, about 20 miles short of Yoro, where a bull-dozed road climbs up the mountain to La Laguna. The road is relatively good as far as Mataderos, but the last mile to La Laguna is in terrible shape.
Eileen, Nancy and Hanna went on to Honduras on the Sunday plane as scheduled. Eileen had the Spanish skills to get everyone through Immigration. They were met at the airport by our coordinator in Honduras, Yovany Munguía, who took them safely to the hotel in Yoro, where they spent the night. The next day they visited the "Boarding House" (where some students stay while attending high school in town) and the local hospital, then shopped for supplies. They had a problem buying foodstuffs, since Gordon had the shopping list with him. But they succeeded quite well.
In Yoro, they were met by Nancy's son Andrew Savoy-Burke, who is a Peace Corps Volunteer stationed in Camasca in southern Honduras. He brought along three of his Peace Corps friends: Randy Harrington of Washington State, who is stationed in Yoro; Emelina Choi of Los Gatos, California, who is working in El Negrito, located along the road between San Pedro Sula to Yoro; and Gail Norton of Fairbanks, Alaska, who works in Ocotepegue in the extreme southwest of Honduras. Andy, Randy, and Emelina are all in the water and sanitation program of the Peace Corps; Gail is in the Protected Areas Management program, but was with us as she plans to apply to medical school next year.
Andy, Randy, and Emelina surveyed the water systems in four local villages during the first week. Mataderos, which has a new system, was in good shape; El Paraiso had a jury-rigged system that seemed to work quite well; La Kiloma's system was almost defunct; and La Laguna's system needs major work. (We could tell that: there was not enough pressure in the system to get all the way up to the clinic faucet during this trip; so we had to walk down to Adilid's house to get water.) The PCVs met with the water boards of these communities, and gave them their recommendations; Randy is available to assist them if they wish.
When the PCVs were not out in the field, they assisted in the clinic and the pharmacy, which was a great help. They also helped translate at meetings with the tribal council. Gail, who has an interest in primary care, spent the week translating for Nancy and Gordon, alternating with Eileen. She did an excellent job of medical translation for us, and we missed her when she had to go back to Ocotepegue. After Gail left, Eileen translated for Nancy, and Gordon used his newly-upgraded skills to go it alone.
The major focus of this NY/HELP mission trip was the medical clinic. Attendance started out slowly (it seems that our arrival was not well publicized), but gradually the clinic got busier. Nancy and Gordon saw 200 patients during the 7 days the clinic was open. There was the usual range of acute illnesses, from ear wax to respiratory illness, gastritis, diarrhea, intestinal parasites, and arthritis. Many of these are preventable by better housing, stoves with chimneys to get the smoke out of the houses, clean water, and particularly better sanitation (of which a latrine for every family is a vital part!). We saw several patients with chronic seizure disorders, who needed their daily medicine (easy to get in the US, but very difficult for the families in these rural mountains). There were several patients with long-term disabilities, including rheumatoid arthritis. We saw Yovany Ramirez, who lost his eye during our visit in July 2008; he now has an artificial eye (but needed financial support to go back to the eye clinic in Tegucigalpa for follow-up care). The only "surgery" we had to do on this trip was to lance a boil on a young woman. She was frightened at first, but was reassured by Eileen and Nancy, and admitted it felt better after it was over!
We discovered a problem with the Pap tests done by the February 2009 group. It seems that the proper paperwork did not accompany those Pap tests, and so they just sat at the La Habana health clinic. Nancy and Eileen were able to retrieve the slides, and with Mirtila's help, generated the necessary information for most of them. (Some tests Nancy just repeated..) Hopefully, these Pap tests will now be sent on to the lab for interpretation. Nancy and Mirtila also developed a Pap test log to help keep track of the tests, and to be sure each woman got the results.
We made several major commitment to assist patients that need to see specialists in the city. A commitment to pay for prostate surgery was confirmed during this trip. Yovany Ramirez has to go back to the eye clinic in Tegucigalpa for follow up. His son with cerebral palsy needs to go to the therapy clinic in San Pedro Sula. (A wheelchair in Agua Blanca might need fixing, too.) Several patients need hernia repairs. There is now a charge for surgery, and expenses for food and family living expenses while the patient is in the hospital. We will need over $1000 to pay all these expenses; otherwise, these procedures won't get done in this very poor and un-powered population.
In addition, Adilid needs major adjustments to his new artificial leg. Adilid had lost his leg 15 years ago from a machete wound. His old artificial leg was worn out, and a new prosthetic leg was made for him by a prosthetic specialist in Buffalo. We thought it fit well last July 2009, but now it appears that the leg socket is too big, and needs to be redone. Adilid says it can be done by the "Teleton" in San Pedro Sula for 1500 lempiras (about US $80) plus some travel expenses. This might be the best way to be sure he gets fitted properly.
Saturday evening we met with representatives of the Tribal Council: President Lauro (Laurito) Martinez, Secretary Vairon Sosa,, and Cacique (Tribal Chief) Eufemio Cárcamo. The NY/HELP group was assisted by our Peace Corps contingent; Emelina was particularly helpful in translating for the meeting. Randy and Andy discussed the problems with the water systems and offered technical assistance. We thanked the community for providing "watchemen" (the guards) who ensured our security at night. We discussed the possibility of re-roofing the clinic, asked the council to remove the dead tree which is threatening to topple over onto the clinic, and discussed the poor school attendance. There is a significant cost to going to middle school - about $70 per student per year for uniforms and school supplies. NY/HELP also granted 1000 Lempiras to the Tribal Council to send four members to a 2-day educational training program in Yoro.
Sunday we had a fun event: the inauguration of the new Centro Educativo Básico (Middle School) in the nearby community of Mataderos. This middle school was built with funds provided by NY/HELP (a large proportion generously donated by the Eastside Congregational UCC in Binghamton, NY) in cooperation with the local community, which provided labor, and the Education Department of Yoro, which is providing teachers for the 7th to 9th grades. Up until now, the six local primary schools only went up to the 6th grade; if a child wanted to continue his or her education, they had to go to school in the "county seat" of Yoro, some 20 miles (and 4 hours travel) away. For many years, NY/HELP (in cooperation with another group, Honduras HOPE) provided a "boarding house" in Yoro where these students could stay under the watchful eyes of the house parents, a retired pastor, José Feliciano, and his wife Petronida.. However, only about 3 to 6 students a year could be accommodated in the house, so over the past three years, a new local middle school was built in Mataderos, so more children can now attend grades 7 to 9.
The inauguration was a success. The keynote speaker was Señora Olinda Amaya, who was born in La Laguna but now is the principal of a high school in Colón. She spoke about the importance of education. Also present was Osmán Ramos, Director del Distrito de Educación de Yoro (the local "School Superintendent"). Gordon gave a short speech on behalf of NY/HELP (written with help from Eileen and Selvin), and we also presented the library with some Spanish-language books. The students had an exhibit of their projects, and lunch was served by the community.
Following the inaugurational festivities, the traditional soccer match occurred. El Calechal won first place (400 lempiras and a soccer ball), Mataderos was second (300 lempiras and a soccer ball), El Paraiso was third, and La Laguna fourth. A dance at the school followed (less raucous than last year's!).
Gail left with Yovany on Saturday, as she had to get back to her post in Ocotepegue in southwest Honduras. Sunday afternoon, Emelina and Randy also left to go back to work. Hanna decided she wanted to spend more time exploring history at Copán Ruinas, and went with them; Randy made sure she got to the big new bus terminal in San Pedro Sula the next day, and caught the right bus to Copán.
Gordon and Nancy continued seeing patients in the clinic for the next day and a half. Eileen worked closely with Nancy, translating for her, while Gordon got to use his newly-upgraded Spanish skills in the dorm room being used as an second exam room. The original plans were for us to go to a near-by community for a "mobile clinic", but as there were no facilities for GYN exams there, nor any pharmacy back-up, we decided to stay in the La Laguna clinic. In fact, Monday and Tuesday were the busiest clinic days of the trip.
Tuesday after lunch, Nancy, Andy and Eileen went with Selvin and Rigo, on a trek by foot down the famous path between La Habana and La Laguna. It is generally a beautiful hike, but that day there was a terrible rainstorm just after they left. Several hours after they left, word came by cell phone that they had arrived in La Habana, "safe but very wet"! Gordon stayed behind at the clinic to see a few more patients that had straggled in, and so stayed dry. The plan was for the pickup truck to come and get all our baggage (and Gordon), and the cell-phone system got the word to him that the truck had gotten to Mataderos by 3 PM. By 5 PM, it still had not made it to La Laguna, and finally the word came that we would have to hike to Mataderos to catch the truck, as the road between these two communities was impassible due to mud. Joel, one of the Sustainable Harvest technicians from La Fortuna had climbed up the back side of the mountain, along with a friend, and with the assistance of several kids, we hiked the mile to Mataderos, where the truck was waiting. Then it was only a short ride down the hill to La Habana.
Arriving safely in La Habana, we spent the night at Sustainable Harvest's new headquarters building. They have a nice bunkhouse, with electricity and running water! The next morning, we took the "directo" bus to San Pedro Sula. There Nancy and Andy caught a bus to La Esperanza and thence to Andy's home in Camasca. Nancy had a great time, seeing where her son Andy was working. Eileen and Gordon caught the fancy bus to Copán Ruinas, arriving there that afternoon. Sitting in the hotel restaurant, we saw Hanna walking by. She was staying in the "Green Apple" hostel for $5 a night. We visited the ancient Mayan ruins there; we also visited the town museum and got a guided tour. The town museum gave much more information about the history of the ruins than was available at the park itself!
Friday, August 14, we all met back at the Hotel Terraza in San Pedro Sula, and went out for a fancy meal at a local restaurant. The next day, we were off to the airport, and an (almost) uneventful trip home. (Eileen's backpack did not make it with us to Buffalo, but did come the next day.)
1) Sustainable Harvest plans to stop working in the La Laguna/Mataderos area in 2010, and instead begin a new project in Sulaco, about 45 minutes away. Yovany would like NY/HELP to participate in this project. I am not sure how much support will be available from SHI after 2010.
2) On June 28, 2009, there was a coup in Honduras. In my view, the oligarchy that runs the country got very upset with the old president, Mel Zelaya, who had done a number of things to improve the lot of the industrial workers (such as increasing the minimum wage fro $6.00 a day to $9.60 a day). BUT, he was also pushing a referendum to change the constitution. This worried many people, because Honduras has very strict term limits (4 years for the president, and no more, designed to prevent a dictatorship from developing). One of the few reasons that a new constitution would be needed would be to change this limitation. Also, Mr Zelaya was becoming very close to Hugo Chavez, the left-wing ruler of Venezuela, and this worried many upper and middle-class people. So the oligarchy sent the army to expel Mr Zelaya from the country, and then set about justifying their actions.
A significant portion of the population was upset by this action, particularly in the industrialized "manquila" areas, such as El Progreso and the suburbs of San Pedro Sula. Demonstrations were held there, as well as in the capital city of Tegucigalpa. These did not affect the area around Yoro, where we in NY/HELP have been working for 20 years. There were discussions about the political situation in the village, but so far there there seems to be no effect on the poor farmers we are working with. I was concerned that the U.S. response might include pulling the Peace Corps Volunteers out, but so far, humanitarian and non-military aid has not been stopped. If this should occur, though, that would severely affect the poorest people in Honduras.
Gordon F. Comstock, MD, October 3, 2009
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