Making a difference

I’m standing on the edge of a dirt road on the side of a mountain with the Caribbean Sea on the horizon, watching a slight old woman walk up towards me. She is dressed in a too-big blouse and mismatched skirt, with a light worn cardigan overtop. She is wearing brown flip-flops on feet hardened and grey by decades of travelling on foot. Her feet are gnarled like her hands, her face lined and leathered by the sun. I later learn how people look far older than their years. Poverty does that. Everyone grows old too soon. Ten-year-olds are responsible for their younger siblings, 12-year-olds are sent to the fields to work, teenagers are having babies. By age 30 villagers here look a decade older. Worn out by life. But this woman is smiling. Beaming even.

There are several people, fair-skinned westerners like me, standing further down the track, alongside a row of heavy duty trucks that lumbered up steep and winding roads, carrying medical supplies, clothing and food to el Mirador, the first of six remote villages that we will visit over the next seven days. This woman has come to see the doctor and dentist. She has come because there are few other options for her.

Honduras is one of the poorest countries in the Americas, with more than half of the population living under the poverty line. Reports show a significant shortage of health care professionals, with only 5.7 physicians and 13.2 nurses for every 10,000 Honduras residents (compared to 22 physicians in Canada), with a concentration in urban areas, leaving remote villagers on their own. Low government health-care spending of only US$241 per capita further exacerbates the problem, leaving clinics and hospitals chronically short on supplies. To fill the gap, volunteer medical brigades from so-called developed countries travel to places such as Honduras to provide free medical and dental care.

I’m part of a mismatched team of health care professionals – a cardiologist, ultrasound technician, ER doctor, pharmacologist, pharmacist, registered nurse practitioner, a dozen nurses and nursing students, plus two Honduran doctors and a dentist – travelling along the coast for 12 days in February, going where other brigades don’t go. I’m ostensibly there to document the work of the team to try to understand the impact these brigades have on vulnerable populations. That was my role when I left Canada. What I didn’t realize was how involved I’d become, how taken, “captured” even, I’d be by this work.

I watch the woman take slow and careful steps up the hill towards me. Each time she passes by one of the brigaders, she stops, touches them and says, “Gracias, gracias.” When she comes to me she starts to say thank you, but then takes my hands and kisses me. Her gratitude is humbling and overwhelming. I watch her continue along the track towards the two-story community centre built out of rebar, wood and cement where we will be setting up our makeshift clinic. Although it’s still morning, I feel my skin starting to prickle with the heat of the day. The breeze smells green, like the tropical plants in a greenhouse, my breath soupy. My senses are assaulted by the intensity of colours, sights, sounds in this foreign land over 5,000 kilometres away from my home. And yet it is here I feel my life returning. I turn and follow her.

* * *

The villagers who visit the clinic that day are wearing their Sunday best – party dresses for some of the girls, skirts and blouses for the women. I’m told to look past this; first appearances can be deceiving. Dressing well is a sign of respect, a way of expressing gratitude. I’m told to take a closer look – at the state of their shoes (if they’re wearing shoes), their nails, the condition of their skin, their hair, their teeth. A person’s smile says a lot. The day I worked with the dentist he extracted 35 teeth that were rotten, blackened with decay.

Before I came to Honduras I was ambivalent as to how brigades actually make a difference. Does it make sense for foreigners to parachute into a region, provide care and then leave again? There’s no consistency of care, no follow up. And I wondered if brigades simply reinforced the idea of the great western saviour. But here, now, faced with people in need — hungry children with bloated bellies riddled with parasites, a young boy with a deep machete wound festering on his leg, a 15-year-old girl pregnant with her first, but most likely not her last, child, a woman dying of malaria – these questions seem immaterial. These people feel forgotten by their government. Are forgotten.

Midway through the brigade I have a conversation with a writer friend back home. He lived overseas for almost a decade, worked as a freelance journalist, photographer and then later as an editor. He’s spent time as a traveller, an explorer. I trust he understands the intoxication — the addiction – of this work, capturing others’ stories as a means to understand my place in the world. My wanderlust.

When he asks me how the trip is going, I find myself tripping over my words. There is simply too much to tell, let alone process.

“Are you aware of your choice of pronoun?” he asks.

“What do you mean?”

“You’re saying ‘we’ instead of ‘they.’”

I admit to losing my objectivity, becoming part of the team rather than strictly reporting on it. But it seemed the best way to tell the story, to understand. I made this trip personal.

I think of the 17-year-old girl who came to the clinic with her family, spoke to the nurse practitioner in secret about how to prevent an unwanted pregnancy. That girl left with a 12-month supply of contraceptives. We gave her a year of her life. We made a difference to her.

UPDATE MARCH 24, 2015: Please read my follow-up post where I admit to contributing to the very narrative I’m trying to get away from — that of the great “western saviour.”