Friday, May 11, 2012

Good Friends and Good-byes

 All my girls who have been in the Hogar Estrellas de Belen with me over the last 16 months. We had a very fun goodbye party together. The tias cooked my favorite meal for dinner, then we indulged in soda and ice cream before watching a slideshow of the photos I took of the girls over the last year.

 I ate a lot of good food during my last week on the Ranch. This was the meal served to me for my goodbye party with the clinic staff.
 The beautiful going away cake that Jen made for me... with real frosting and all.

 My gift from the clinic, a key rack with the honduras flag, map, coins and symbol.

 The internal and external clinic staff from NPH Honduras.

 One little cutie... Evelin at a big celebration in honor of the boys section.

Traditional country game... the boys trying to climb a greased pole that has a $25 prize at the top. It was quite a challenge and also very entertaining.

This last week was a long process of saying good-bye to my Honduranfriends, fellow volunteers, employees with whom I had worked, and thechildren that I have come to love over the past 16 months. Volunteersluckily receive their entire last week on the Ranch free of work toallow for quality time with the kids, goodbye parties, a trip toimmigration to cancel our residency, and packing. Much to my surpriseI was able to hold it together very well, up until the end with finalhugs to my Hogar girls.

I left the Ranch on Sunday for 3 ½ weeks of travel before returning tothe States. It is difficult for me to process that my time with NPH isactually over, and that I am not just on vacation for a few weeks andthen returning. Every one of my kids when I said good-bye asked me“when will you be back?” and the most painful part of that was that Ididn’t know how to answer them. If they meant returning permanently,the answer would sadly be never. And even though I have hopes to visitNPH again within the year, and see how the kids have grown, even thatis uncertain. I hate to give them a promise that I can’t keep, so thebest answer that I could come up with was “I don’t know…”

At mass during my last day on the Ranch, I was called to the frontduring announcements and presented with a beautiful wood carved plaqueas a thank you for my service. This is a moment that passes for alloutgoing volunteers, and one I have thought about occasionally over mypast 1 ½ years at NPH. But when it actually came to be my turn,standing up there in front of all the kids who had challenged me andtaught me so much during my time in Honduras, I had no idea how toproperly convey my feelings. These kids see so many caregivers,volunteers, and visitors come in and out of their lives every few daysto years. It amazes me that they can still so willingly open theirhearts to give and receive the love with someone like me. I wanted totruly thank them for making me feel so welcome in their home and theopportunities that I was able to have. When else would I have had theexperiences of fighting fires, learning Spanish, experiencing anotherculture, delivering babies in a pick-up truck, eating innards soup, orde-liceing children.

Many people who don’t understand this place or what it has done for mesay “what a sacrifice for you to have given up your job, family, andhome to come to Honduras.” Instead, I see it as a great privilege. Itis not very many people who have the freedom and security to put theirlife on hold without worries and go on an adventure for that length oftime. As happens with many volunteers, despite how hard I worked withmy nursing role and the kids, I still feel as though I received muchmore than what I gave. I now have a wonderful experience that hastaught me so much about what is truly important in life.

I think it will be take me a while after I return back to the statesand settle down a little to truly process this experience and evaluatehow it has changed me and in what ways it will continue to affect mylife. As for now, I am going to enjoy my travels. I have 4 days leftin Nicaragua, and from there I will make my way north for the next 3weeks, through El Salvador, Guatemala, and Belize, finally returningback to the USA on May 30th.

Sunday, April 22, 2012

The Final Countdown!

With the start of April, came Semana Santa or Holy Week, thus beginning 7 days of religious celebration and vacation. That first weekend, my friend Jared Brandell arrived for a quick three day visit to see what the Ranch was all about after finishing a church trip in Guatemala. The Palm Sunday procession was a fun event with the kids as we waved our authentic palms in the air and sang celebratory songs. Simultaneously there was a forest fire passing through, so some of the older boys missed mass to go put out the brush flames. Jared was a good sport as I dragged him along to go camping with about 150 girls and women. After a 5 hour drive to the south coast, we arrived at the beach. It was a nice location for the girls to relax and swim in a sheltered bay with very little waves, especially since many do not know how to swim. For many of the girls, it was their very first time ever seeing the ocean, and it felt special to share that day with them. There was definitely no shortage of inflatable whales, dolphins, and rafts, as the kids floated about in the warm water. The only downside was that a girl would occasionally come out of the water screaming with a leg welted up from a jellyfish tentacle floating by. After experimenting with a couple of different suggestions (and turning down the urine technique) such as dabbing vinegar over the wound, we found that a numbing spray that I happened to have in the first aid kit seemed to provide the quickest relief.

The next day I dropped Jared off at the airport and simultaneously picked my parents up for yet another visit to Honduras. I took some vacation days and we spent two nights at the giant Lake Yojoa, exploring the nature around us and relaxing at an American run brewery/hotel. Just in time for the peak of the Semana Santa celebrations, we arrived to the historic capital and colonial city of Comayagua. In addition to exploring the historical cathedrals, we took part in some processions, watched some theatrical renditions of Jesus’ last days, and soaked in the community feeling amidst us. The most incredible sight to see, and the reason for us being there on those specific two days was the construction of the ‘alfombras’ or carpets. Starting before midnight on Thursday, and working all through the wee hours of Friday morning, various different groups of towns people use sawdust, both plain and colored, to construct beautiful pieces of art that appear to be like ‘carpets’ lining the streets all throughout the central part of town. In the morning the town swells to the brim with Hondurans traveling from all over to come see the beautiful art before the sawdust tapestries get trampled in the later hours of the morning as the processions and Stations of the Cross pass through. This event was the most impressive display of Honduran culture and tradition that I have witnessed in all my year here.

We came back to the Ranch in time to participate in our own sunrise mass on Easter morning. Before my parents left that day, we did a little Easter egg hunt with the girls in my hogar. Instead of hiding all the candy stuffed plastic eggs (in the interest of time) we rolled them out on the floor and all the girls had to find the nine eggs with their specific number on it. It was super cute to watch them crawling around on the floor, investigating the eggs and calling out numbers to help each other find their respective treats. And to share a little bit of my own childhood traditions with them. After my parents left it was back to work as I had a big couple weeks of activities and a medical brigade ahead of me.

The weeks prior to Easter, I had been intensely planning a Health Fair for both the elementary school and middle school to help raise awareness for different wellness issues and also allow the kids to have some fun while learning about the importance of their health. When the big day came, 13 people from our health-team turned out to help run the 8 different stations that the kids would rotate through. The themes ranged in everything from nutrition, hand washing, self-control, disability awareness, why say no to drugs, how to avoid getting sick with Dengue, colds or parasites, personal hygiene, and dental hygiene. Each station was very interactive with games and activities so that the kids could have fun while learning. Our doctor dressed up as a clown to teach about drugs, the kids got to put glitter on their hands to simulate the passing of germs, or wear blurry glasses to help understand their peers with disabilities. It was an exhausting day teaching the subjects from morning until late afternoon as the kids rotated around the stations in small groups, but hopefully very effective. I hope that this trend of health education can be continued for the kids after I am gone.

Shortly after, it was brought to my attention that one of our ‘abuelos’ from the grandparent house had been in the hospital for almost a week after getting very sick during a visit to his extended family over the holiday. He had been diagnosed with a heart block and urgently needed a pacemaker to be installed to allow him to ever be able to leave the hospital or do any sort of activity again. The pacemaker was $520 and the leads another $350, an amount that neither his extended family, nor NPH in our current financial situation could come up with. In a desperate plea for help, I turned to all of you who have been so supportive of me during my time here in Honduras. I was overwhelmed by the rapid response of donations that we received when I checked my email the next morning, a mere 14 hours after I sent my original message. Thanks to all of you, Don Santiago is happily back home here on the ranch and quickly on his way to a full recovery, where I’m sure I will soon see him out watering the plants in front of his home as I pass by on my way to and from my work.

Yesterday concluded another Orthopedic surgical brigade at our on-site surgery center, the fourth one that I have participated with since my time at NPH began. This one was slightly more exhausting as it not only consisted of the typical orthopedic specialty, but also the specialties of Ear-Nose-Throat, Gynecology, and General Surgery. I often started my day around 5am and worked until almost 7 or 8pm when I would come home for dinner and promptly disappear again into my room to go to bed. Jennifer, my partner volunteer nurse, and I helped run consult clinics for these specialties to screen patients for surgery. Several of our own NPH kids were able to get much needed tonsillectomies or ear surgeries. During the 8 days of the brigade the team saw 700 consults and did almost 100 surgeries and minor procedures. When there were no consults, I assisted in the admission room preparing patients for surgery and when there was down time would occasionally peak in on some surgeries to see some interesting things. One of my highlights was scrubbing in on a surgery where an older man had a large cyst in his scrotum, the size of a softball. I got to assist holding instruments and eventually pop the fluid-filled sack as 400ml of fluid rushed out. I then helped to stitch the incision in his abdomen closed, another first for me! Needless to say, I’m sure he felt much better after the surgery!

The final countdown has begun, but not necessarily in the exciting sense of the term. In 14 days, my time at NPH will come to an end, at least for now. I feel that my work here as a nurse has reached a good closing point and I look forward to the new chapter of nursing that lays ahead of me while attending the University of Minnesota in the fall (yes, it’s finally official now). However, saying goodbye to the kids and my hogar never really does get easier, no matter how long you stay. So with that said, I will just have to make the absolute most out of my next two weeks here while wrapping up the loose ends of my job and enjoying every moment with the girls.
Palm Sunday Processions to the church.
Exploring the burn zone, hours after a brush fire burned hundreds of acres of Ranch property.
At the playa with the girls of Talita Kumi.
Ricardo, he and his twin are our youngest kids here, and both just completed their first birthday.
Kids trying out some  blurry vision to learn about disability awareness during the elementary school healthfair that I coordinated.
Our Ranch doctor, Mario Ramos, dressed up as a clown to teach kids the importance of saying 'no' to drugs.
Jennifer and Rebecca, two nurses teaching kids about the importance of handwashing.
Caroline and Ricardo, this photo taken the day before he and 13 other kids came down with chickenpox.
Lago de Yajoa with my parents during Holy Week.
Bird nests hanging from the tips of branches. Nature's amazing!
Exploring the waterfall, Pulapanzak.

My dad and I infront of the cathedral in Comayagua.
Preparing for the Stations of the Cross in Comayagua on Good Friday.
With two volunteers, Kate & Lydia, seeing the hundreds of 'alfombras' lining the streets of Comayagua.

Watching the processions pass by on Good Friday.
Robed assistants carrying the floats depicting Jesus' march with the cross.

Sunday, March 25, 2012

Real Life Honduras

The first two weeks of this month I participated in back to back medical brigades. I, along with three other NPH volunteers, was invited to serve as a translator and accompany a group of American doctors and dentists to an area called Montana de la Flor (Flower Mountain). We ventured hours and hours into the mountains along rugged dirt roads and across river beds to arrive at this extremely remote area where the people remain primarily indigenous and stricken with poverty. The brigade was comprised of about 70 people from the US military, Honduran military, a medical mission group of American dentists and doctors, a group of students from the South Dakota State University, a few Honduras doctors, and us translators. It was a very odd ensemble to say the least, and a lot of different people who thought they were in charge. But in the end, we were all there for the same purpose, to help people in need. I have to admit, I stopped and staired as much as the Honduran children did, when the military arrived in their convoy of humvys and began to unload. So we got to work… setting up base camp in the town community center and school, clinic by day and dormitories by night. The US military provided triage and talks on health and wellness education, the American doctors held general consults, the dentists pulled hundreds of teeth a day, and the students from SDSU did nutrition assessments both for the women and children who came to clinic and out in the field.

I worked mostly as a translator for the Nutrition and Food Access study that was being carried out by SDSU in collaboration with the Honduran ‘Ministry of Health.’ Every day teams of two students, a doctor, a US military personnel, a Honduran guard, and a translator would be sent out to find homes in the mountains that contained a randomly selected ‘index child’ to conduct the study on. The first day, our local guide was actually the chief of the village. The group hiked 1 ½ hours into uninhabited mountains, lugging scales, laboratory equipment, and personal gear to find a few clustered homes nestled into the hillside. The goal was to find a mother and child between 6 months and 5 years of age to participate in the study. In the homes we visited we would survey the family on food security and other family history data. Then collect data such as height, weight, arm girth, a physical assessment by the physician, and blood samples from the mother and baby to test for nutrition level and mineral levels such as Zinc, iron, Vit C, and Vit A. Those found to be anemic were then treated with iron and those underweight with a dietary supplement called plumpy-nut.

After a week of house visits and surveys, almost all the situations were the same. Most of the homes were made of mud walls with a dirt floor, no electricity, gathered water from the river, 5-6 children per family, mother nor father had never attended school, nor even knew how to sign their own name. Most families constantly worried about food supply or ran out, children were eating just one type of food every day if available, sometimes going all day without anything to eat, and going to bed hungry. Even after having traveled to many parts of the world and living in Honduras for over a year, this was some of the worst poverty I had ever seen. The first home that we visited that week was the worst, consisting of 4 poles holding up a roof of leaves with three tarps forming the walls. The only furniture in the house was a couple of tiny beds made of sticks stacked together and a few rags thrown on top. The 5 children walked around in tattered clothes, unkempt, caked in dirt head to toe, bellies distended from malnutrition. The mother stood by a pot of corn kernals cooking over a few logs of wood. Since her husband was away she did not consent to all of the study, but we were able to leave them with some soap, toothbrushes, clothing items and iron supplements.

It was an interesting dichotomy to visit this area, where because of their isolation they have managed to maintain their indigenous heritage and continue to pass down their culture and traditions such as their language ‘Tolpan.’ However the lack of influence from the outside world has also hindered their advancement in basic things such as electricity, water access, sanitation and cultivation of a value for education.

The day after I returned to the Ranch began another brigade held at NPH that I and another volunteer, Kate, helped to coordinate. Seven visiting doctors from Spain offered specialties of Gynecology, Pediatrics, and Family medicine. We offered consults for three days in the external clinic on the Ranch and the last day traveled to two very underserved and difficult to access communities. At both areas we held consults in the school house and pieced together a make-shift clinic and pharmacy. We were swamped by women and children seeking out medical services and treatment. But over the week, a lot of good was done seeing 120-150 patients per day. 

Last weekend, the kids put on a talent show. While most talent shows I grew up watching consisted of a majority of singing numbers, here at NPH the kids much prefer to show off their dancing skills. I have always been impressed by how well the kids can dance here, and in a variety of different styles. I could name off any style of dance to a school-age child and they would most likely be able to dance the correct steps (Bachata, Merangue, Salsa, Punta, Ranchero, even Rock&Roll and Disco). A group of the youngest girls showed off their talents with a hula-hoop, some even able to do dance steps while twirling the hoop around their waist. The girls in my hogar self-choreographed a dance to an entire song on their own, with 12 of them actually getting up the courage to perform it.

Today I returned back to the Ranch from a quick weekend trip to visit an area called Santa Barbara. After about 6 months of attempted planning, I and my two favorite caregivers for the girls in Hogar, Carmen and Lizeth, were finally able to make this trip a reality. Lizeth and I traveled about 5 hours north-east to visit the home of Carmen and her family. She lives in a modest house out in the country with her husband, two young children, 15 dairy cows, 4 dogs, 2 pigs, a handful of chickens, and a rabbit. It was a great weekend, both to relax and get away, and also to learn what it is like to be a homemaker in Honduras. There was time for some fun as well as we got to spend the afternoon playing in a river, followed by a hot springs in the evening that curiously spouted out of a pipe on the side of the highway.

I feel I would be very inadequate if I ever wanted to marry and run a household in Honduras. I learned many new tasks this weekend such as cow milking (very tiring by the way if you haven’t developed the right muscles in your hand and forearm), corn tortilla making, how and what to feed pigs, and how keep children and a husband happy. Carmen is able to maintain the household in a very sustainable way, in that the majority of the staple foods her family eats come from their property. The milk, cream, and cheese comes from the cows, eggs and meat from the chickens, beans are grown in the garden, not to mention the huge variety of fruit trees on their property. When it was blazing hot in the mid-day sun, Carmen said “I think some lemonade would be good right about now” and she went out into the back yard and plucked the limes off the tree. One of the things Carmen told me this weekend that had a lot of meaning was “It is possible, with some hard work, to live a comfortable and happy life on very little.”
 All packed and ready to go on the Montana de la Flor brigade, where we volunteered as medical translators.
 Hiking up the mountain to selected home sites with all of the survey gear, military personelle and students.
 Typical 1 room mud and stick home in the village of Rincon.
 The first home we visited, Maria Luisa with her five children. The boy in the middle demonstrating the typical fashion for carrying babies and toddlers in a cloth sling.
 Typical handicrafts made by the Montana de la Flor women.
 One of the little girls we surveyed, showing off her bandaided fingers after we took a blood sample to measure her nutrition status.
 One of the National Guard members teaching the local children handwashing technique in the river.
 Daytrip away from NPH, we converted a one-room school house into a make shift clinic for the brigade of Doctors from Spain.
 Deedee and I ran the admission, vital signs, and pharmacy at a few tables out front of the school.
 Jen, my fellow volunteer nurse, and I in the back of a pick-up truck on our way to the remote village of Las Pilas to attend to the medical needs of the community.
 One of our youngest (and cutest) patients.
 The little girls (ages 4-6) putting on a hula-hoop performance for the talent show.
 A day hanging out with the girls... Cathi and Carmen.
 A typical way of cooking in most Honduran households with a wood-fueled fire below a large metal plate, where pots, pans, and tortillas can be heated.
 The view of the property at Carmen's home.
 The "Pila." A normal fixture in most honduran households that serves as a water container for the daily water use of the household. The scrubing board attached serves a variety of functions such as clothes washing, dish cleaning, handwashing, and teethbrushing.
 Playing in the field with Carmen's daughter Valeria (5 years).
 Learning how to make corn-flour tortillas. First you have to make a ball and get it as even and flat as possible.
 Then you place it gently on the comal (stove surface) being careful not to let it burn.
 Learning to milk a cow, not as tedious as I thought, but definately tiring.
Enjoying the hot springs.

Sunday, March 4, 2012

For the love of Bees

Well, another busy 5½ weeks have gone by since my last blog entry, and I am trying to recall the most important highlights to share with you. As January came to a close, I tried to get the clinic in order and in tip-top shape to turn it over mid-February to Jen, our new volunteer RN. For months, I had been trying to get someone to come and remove a large bee hive that had been growing in-between the wall and the roof of the clinic, and also get someone to fix the front metal door that would jam and I had to kick open every morning. Each day when the sun came out and heated up the wall, the bees would swarm and I was always worried a patient would be stung. Well, coincidentally on the same morning that that the metal workshop teacher came to fix my door, the farm manager came to remove the beehive. While trying to scoot around the sparks flying around the clinic from the metal door being sawed off, the bees started going crazy as their hive was disturbed when the roof above the admission room and pharmacy was removed. This situation would have been okay except that I still had about 15 patients in the other building of the clinic waiting to see the doctor. By the time I came out of the pharmacy, my staff had all disappeared into the laboratory, and the patients were nowhere to be found. I went outside and realized that the metal door to the building where my patients probably were was still stuck open. I ran up to the patient building and quickly untied the door and pulled it closed. I found all the patients inside, huddled at the end of the hallway, trying to swat down the angry bees that had entered.

I spent the next 1 ½ hours holding the front door closed and watching the swarming, kamikaze bees dive-bomb the screen windows, trying to sting the patients inside. Luckily they seldom were able to find an opening to enter, but when they did, they went straight for the first thing they saw moving. Luckily only a few patients were stung, and no one was allergic. As I sat there, trapped with my 15 patients, listening to the buzzing grow louder and louder, and a little girl who had to go to the bathroom “really, really bad” for the last hour, I felt like I was reliving the movie killer bees, and couldn’t help but think “only in Honduras!” Finally the ‘bee venom’ arrived and the majority of the bees were killed, leaving a thick layer of dead bees, sawdust, and honeycomb on the floor and walls inside and out of my clinic. When the doctor finished all his consults and declared it ‘probably safe’ to finally let the patients out of captivity, I opened the door and we all ran across the clearing a safe distance from the hive, just as the doctor himself got stung.

Knowing that my patients had been delayed many hours by this ordeal, I knew I had to try to fill their prescriptions and get them on their way as soon as possible. I collected all the patient’s prescriptions and called the nurses hiding in the laboratory to tell them to be prepared to open the door, and I made a run for it. Once in the laboratory, we had to make runs down the hallway to the pharmacy which was directly under the open roof and deteriorating bee hive. After several trips back and forth with dead bees falling from above, and drugged bees buzzing around in circles, we were able to collect enough medications and materials to set up a make-shift pharmacy in the laboratory, and quickly distribute the medications. Once the bee situation was under control, we began cleaning up what looked like a war-zone in the clinic, and the metal shop professor was able to return safely and continue shaving off the door again. Needless to say, I was left with a hole in the roof of the clinic for 5 days, through rain and shine, until someone was able to come and repair it. A few minor maintenance repairs turned into quite a big event.

A few weeks ago, I had the lucky excuse of two more Graduate school interviews to make a week long trip home to the states; first spending the weekend in Minneapolis for an interview at St. Catherine’s University and simultaneously getting to see many good friends in the area, followed by 5 days in Park City with my family and an interview at the University of Utah. Highlights included a Camp reunion-potluck, being at home with my entire family, and attending a Univ. of Utah vs. Stanford gymnastics meet. I am not officially committed to any one school yet, but chances are very high I will be moving to Minnesota in September.

When I arrived back to the Ranch last week, I had 107 pairs of glasses waiting for me from our previous Ophthalmology brigade, to be fitted and distributed. Over this week, 30 NPH children received glasses, mostly for distance vision which will greatly help them improve their school work. The remaining glasses went to employees, family members, and other patients from the community. Some of the kids are so excited about their glasses, and others (mostly the girls who are more worried about fashion over functionality) are not so thrilled. My favorite patient, one of the special needs boys named Carlos, has been asking me about his glasses for the past month. Since the minute he received them, I haven’t seen him take them off once. I am hoping that the kids who are a little more apprehensive about their glasses, either for appearance or adjusting to the strong prescription will eventually come around and see the benefit of having better eyesight.

The same week our 5 volunteers left, the children’s housing sections changed as the older kids in each hogar group moved up and new younger kids moved in, a process that happens each February before the school year starts. 11 of my 19 girls moved next door to an older age-group section, and 12 adorable younger girls moved up into our hogar. Moving day was a big ordeal. When I arrived to my hogar in the evening, there was a line of  girls outside the door, each with their personal belongings wrapped up in their bed blanket. As they entered the hogar, they had to sit down on the floor with a Tia and inventory all their belongings, so that those missing important clothing items could get more from the storehouse. The evening was a chaos of cluttered floors, girls meticulously folding their clothes, and organizing their prized possessions into their locker. The new group of girls as a whole is very well behaved, a little less loud and dramatic than the older ones who moved up, and they have already started bonding well.

The hardest part of this last month was saying goodbye to my closest friend and roommate, Caro, from Austria, as she and the majority of my entering cohort finished their 13 months of service and headed back to their respective homes. Of the three volunteer cohorts I’ve watched leave, this one was by far the hardest, possibly because of the realization that I will have to go through the same process of separation and goodbyes in two months. I am realizing how much I have truly come to love the kids here, especially my hogar girls over the year. It is a love that is new to me, and that I didn’t even realize was growing inside until one day, it was just so blatantly obvious it was there. It is different than romantic love, or the love one feels for their parents and siblings, but the type of love that I can only imagine would be most closely compared to the love that a parent feels for a child, ‘unconditional love.’ It is a love that wants the absolute best in the world for the child, that loves them no matter if they do good or bad, and wants them to stay safe and protected always.
 A night in the city with Nancy, Irene, and Kristina.

 21 volunteers squeezed into a van for a day trip to the Honduras version of Child Protective Services.

 Visiting the Basilica Suyapa in honor of the patron saint of Honduras.

 Enjoying some campfire time with three sisters, Elsy, Digna, and Carmelina.

 Digna roasting marshmallows in a bamboo shoot.

 Adorable Evelin.

 The cake I made for the goodbye party of the 11 girls who moved to another hogar.

 Moving day... all the younger girls lined up outside awaiting their turn to move their things into the hogar.

 Carmen, with all of her personal belongings wrapped up in her one blanket.

 Tia Dania doing inventory of Carmelina's belongings.

 Daniela helping Carmelina organize her clothes to put in her locker.

 Josselin showing off her new locker.

 The explosion of 'things' that ensued as the girls found their place in the hogar.

 Patients waiting for a consult outside of the clinic where I formerly worked.

 Patients waiting for their consult in the hallway on diabetes club day. The same hallway I was trapped in for 1 1/2 hours during the bee episode.

Moises and Juan Carlos showing off their new glasses.