Traveling with Feed the Children

Feed The Children’s – Guatemala headquarters are marked by a modest plaque set to the right of an ironclad gate.  The forbidding eight foot walls are crowned with a concertina wire slinky.  Bits of razors dart ominously through the Bougainvillea.   This is in Zone 5 – an increasingly dicey area of the capital.

Altagracia Hernandez, the Country Coordinator, says that the seven person crew has to move – not just for safety but to accommodate their expansion into new territories.   But, there is no time for that in the First Quarter.  Only the accountant stays behind at the Office – everyone else is out giving away hundreds of backpacks; enrolling new communities and preparing school principals and teachers to distribute their share of the 40,000 pairs of TOMS shoes.  And, after that there is the Rice give away and this means the posse will be taking some serious “Road Trips.”

It is impossible to get the” friction of distance” built into Guatemala’s ruthless topology from a map.  and, distance is quite deceptive when the highway is nasty.  For example, the threeFTC centers in Palencia are in the District of Guatemala City and they appear to be   closest but they they are really a few hours away.  Heading North; towards Solola and Quiche points also takes about three to four hours but you are gliding along the Pan American Highway.  The most distant area, Chujul, is practically to the Mexican boarder, in the Ixil Triangle. It is so many hours of driving that it requires an overnight stay.

Absolutely, the roads after Palencia are the worst — the pavement degrades continuously about an hour out of the Office.  Even in dry season, it took us forever to get to the nearest destination.  The “good news” is that it is still dusty and the crew can hump donations in via SUVs and rented trucks.  But, soon enough, it will get muddy and navigating the extreme inclines in all territories will require much more efficient vehicles. 

Meanwhile, back at the office, there is no time to consider which zone might require less vigilance until the shoes are landed, warehoused, inventoried, packed and delivered.  Did I mention the Rice just pulled into port yesterday???

Google Map show the breadth of FTC's Guatemala Operations
Google Map show the breadth of FTC’s Guatemala Operations

Got Water Czar?

Yet, there seems to be no official urgency to reallocate the increasingly scarce resource, nor are there any specific plans to slow excess water consumption. Worse, there is no budget to do the obvious, like seeking out and plugging leaks and/or determining where to build containers to harvest rain water in the wet season.

“[W-22] Water insecurity has various aspects. At its most basic level, drought can threaten the lives and the livelihoods of people. Although cases of people literally dying of thirst are, thankfully, rare, there are more frequent cases of famine caused by the loss of peoples’ livelihoods, namely their cattle, their crops and common property resources they depend on. At one stage removed is the insecurity of important economic sectors dependent on water, such as irrigated agriculture, power, industry, or tourism. There is also the insecurity posed to the environment from water shortages, for instance, the loss of rare or beautiful habitats and the death of wildlife. Finally, the loss of water security can be costly and inconvenient to users who have built their lifestyles, households and working environment around ample water use.” Managing Water Scarcity for Water Security – Prepared for FAO by J.T. Winpenny

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In a blaring two page spread Prensa Libre covered the news of Guatemala’s pending water shortage. The article was long on dire facts and short on solutions; it stated that regional policy makers are not aligned and that scientists remain unresolved about how to (legally and actually) alleviate Central America’s acute water stress. The lack of leadership in this situation is particularly distressing since it appears that high water insecurity will be very damaging to the several indigenous Districts that we follow.

Here, in Guatemala, where many farmers grow coffee and bananas for export, United Nation’s Food and Agriculture Organization (UN-FAO) and NGOs have taken steps to improve local food production by funding and promoting community gardens and greenhouses. However, neither the UN-FAO nor the various NGO’s that implemented these necessary improvements have the staff or the political standing to see their initiatives though the coming disaster. (The UN-FAO report cited above is almost four years old.)
The causes of the drought are myriad and the climate change ones are the most hotly contested.  But, sustainability experts tell us that agriculture takes massive amounts of water (sometimes as much as 80% of what’s available) and that a shortage of it at the “wrong time” in the growing cycle will definitely downgrade the yields on the family gardens average 2.5 acre plots.  Yet, there seems to be no official urgency to reallocate the increasingly scarce resource, nor are there any specific plans to slow excess water consumption. Worse, there is no budget to do the obvious, like seeking out and plugging leaks and/or determining where to build containers to harvest rain water in the wet season. (Some communities like Patanatic have received a few RotoPlast drums intended for storing water for their gardens. Yet, more than half the families there still need some kind of water receptacles to keep their fragile seedlings alive.)   There are welded plastic containment pools that might be more cost effective than the Rotoplasts and as useful but the question arises about how does the water get equitably distributed when these are public and best installed in high flat places?

Along with this extremely bad news about water, Central America’s coffee fungus is causing a local state of emergency that threatens to devastate some families around Solola’s Lake Atitlan particularly in the small fincas near San Antonio Chacaya. But, while the coffee “Rust” can be burnt away and some plantations could be restored over the next three or four years, without action,the drought will continue to slam the region and hurt the poorest.  Clearly, the region and, most certainly, the country needs an expert to step in and be given the power to regulate and conserve water.

Jesuit Medical Mission 2012 – The Supporting Posse

Dallas Jesuit Medical Mission
2012 The Kids
2011 Support Posse
2011 The Kids

The Jesuit Medical Mission fielded a support team of ten including four health practitioners from Baylor, three people from the high school’s science and one from the language faculty; and, most delightfully … my friend Kevin Garcia and his daughter, Olivia, who help translate. The posse saddled up in support of six young men from Dallas’ Jesuit College Prep high school. Everybody ponied up part of their spring break in order to manifest this rare, hands-on clinical experience. Altogether they would produce a labor of love that fulfills on one of the purposes of the Jesuit Medical Mission: to provide service.

— This time, almost three hundred Mayan agricultural workers from the highlands of Guatemala benefited.

The whole school (along with interested alumni like Kevin) supports the Medical Society by accumulating hundreds of pounds of medicines for distribution on the annual trip. And, the two pediatricians, GP and social worker from Baylor are specifically selected for their willingness to teach the kids. The massive expedition is coordinated by the Medical Society’s six-gun-tottin’, troubleshootin’ director, Jan Jones. The Mission’s in-country partners handle all logistics for clearing medicines and getting the doctors permission to practice in Central America. Two local non-government organizations, Vivamos Mejor and Hospitalito Atitlan did the administration and secured the remote site for the prep school. The latter on-goingly raises funds for Pastor Pedro’s clinic – fifteen km outside of Santiago Atitlan.

Pastor Pedro had expected that, of his fifteen hundred patients, eight hundred would be at the clinic. Fortunately, this was too bad to be true. But the crowds were so thin on the first morning that the situation needed remediation. So, Erica Walker, JMM’s Spanish teacher and I set off to spread the word through the village. She schmoosed the cops and charmed truck drivers hauling people into to Santiago. Sure enough, she drummed up enough business to keep the students and doctors busy for the next few days. Meanwhile Jan Jones and Ben Kirby anchored the pharmacy and Physics teacher, Max Von Schlehenried took over translating in triage. Things were running so smoothly when Kevin Garcia arrived that he could see that no need for his translating. So he kept busy fixing the plumbing.

The days ran into a blur and, thankfully, there were no emergency moments. But, there was an unusual situation: It is quite rare to see Mayan children without a Mom nearby and there were several scruffy boys tearing around. As they clustered to ask for more goodies, Dr. Rhonda Walton noticed one child with a gash over his ear. She asked him how it happened and became alarmed by his reticence. She had fully expected him to tell her some adventure story and when he did not, she began to wonder how the wound (perhaps from a machete) was inflicted. She dressed it with some misgiving and determined to bring the incident up with Dr. Carlos Flores of Vivamos Mejor when he came to the farewell dinner. Dr. Flores acknowledged the fine line of Good Samaritans and said that he would not have treated the child without a parent present.

It was during that final debriefing that Doctor Walton would voice everyone’s concerns on how to make the Mission’s impacts go beyond the examining room. In this context, she would address the uncertainty of doctors making diagnoses under unfamiliar conditions and without the confirmation of lab tests. Her comments highlight the necessity of pre-briefings (perhaps questionnaires?) that would pre-form visitor’s expectations and guide in the selection of medicines. In her impassioned way, the pediatrician would air the frustrations that come up for doctors when they can’t be sure that patients will take advice or follow-up on necessary treatment.

“Five days doesn’t mean much. Education in skin hygiene, diet and nutrition lasts so much longer. We are not just bringing vitamins – we are here to learn, too…”
(The doctor continued using birth control as her example.)
“We do not know the local mores and no one knows our philosophy or our hearts. But, I have a position on birth control. So, the patient gets to hear that and get the pills, too.”

Doctor Yolanda Brady offered that she saw pills in the cases at the clinic and one of the students countered that that wasn’t proof that Pastor Pedro dispensed them

Looking into the long term, Jan Jones wants to see the Medical Mission create an association with their local patients. As if in response, Dr. Flores gave the group sturdy picture book produced by Vivamos Mejor for new mothers. Clearly, other trainings and picture books would help the community incorporate more healthy behaviors.

The Jesuit Medical Mission with its playful students and dedicated posse was entirely welcomed by a sweet and needy community. They most certainly lived up to their motto homines pro aliis.

Jesuit Medical Mission – 2012 Part 1 The Kids

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Dallas Jesuit Medical Mission 2012 – The Kids

Dallas Jesuit Medical Mission
2012 Support Posse
2011 Support Posse
2011 The Kids

High school kids from Jesuit Medical Mission tentatively blinked out of two mini-vans about sundown last Wednesday night and it had taken them a real long day to get to Lake Atitlan from Dallas, Texas.

First, two tall Asian kids with short cropped hair and devilish smiles uncrumpled and, stood side by side before introducing themselves. I heard someone stage whisper that Tim Nguyen and Kevin Kim would try to confuse us by switching names. Next out, were two taciturn guys: Manoj Jacob and John Euart; their carefully chosen moments and words would prove as interesting as they were rare. Then, John Simion, a veteran of last year’s trip, swooped me high into the air and put me down in front of the serious looking Chris Steiner – this year’s designated el Oso. (You know, the chest thumping bear.) At last, Olivia Garcia, wedged her way through the guys to give me a hug. Last year, she had accompanied her dad as a “translator” but the doctors very purposely engaged her, too. (It is an open secret that some folks want to see her study medicine. And, she can wait to decide that until (at least) after high school..)

Alas, their first hours would be absorbed with logistics as we changed from the unacceptable hotel into better quarters. It was after eight when we finally sat down to supper at one of the Santiago Atitlan’s three restaurants. We would begin everyday there before traveling twenty minutes out of town, beyond the coffee and banana fields to the village of Chacaya. The town of 1,500 is announced by it’s memorial map. The large sign that shows churches, fields, evacuation routes and is variously graced by depictions. Along with flying Quetzals and pretty quipils lay three women in their own blood under an armored tank. The students were curious about this grizzly scene. I told them that the Civil War had been settled less than a generation ago and that many of their older patients may have seen the violence.

A few steps away was Pastor Pedro’s clinic where his son greeted us in a crisp shirt. Diego, is about fourteen and he would be stationed at the pharmacy to translate the doctor’s instructions into Tzutuil, the local Mayan dialect for the next few days. The students unloaded the ten fifty pound duffels and began to set up. Within a half an hour, medicines were in alphabetical order in plastic bags lining the twelve foot square building, the doctors were sufficiently settled into their rooms, the tent (that would be used for triage) popped up suddenly and after that the students began to sit down with their first patients.

All morning, the dirt field between the clinic and pharmacy filled with feral little boys wanting to play or to get sweets, toys and cash. At lunchtime, the students divided themselves and teamed with the youngsters for a pick-up game on the court behind the clinic. sitting on the concrete bleachers, we cheered for everybody while balancing our plates with grilled chicken and local vegetables.

At dinners, the students were funny and exceptional bright conversationalists. John Euart spoke with some sophistication about neuroplasticity. He had already read the most recent works on turning strokes and OCD around. Kevin Kim, who shared this interest would get the word that he had been accepted into the University of Chicago (home of the recently demolished and eponymous Dreyfus Research Labs.) The two “business guys,” Chris and Tim, were hatching clever models for opening their practices.
“Have a van pick up and deliver senior patients.”
“Build a one-stop complex with out-patient surgical suites, dental care, emergency room, etc.”

Aside from his kindly tent-side manner, everybody was impressed with Manoj’s alarmingly skillful bargaining.

Someone quickly made up this fictitious scene:
“Merchant : 300.
Manoj : ZERO
Merchant : 200.
Manoj : Okay. 30.”

One of the most effective offerings was a giant bag of toothbrushes and toothpaste. After handing this stuff out to the waiting hands in minutes Olivia and John presented dental training. There is no way to calculate how many teeth were saved by teaching kids why and how to brush..

The good/bad news was that patient load was not as heavy as last year. However, the doctors appreciated the additional time that they could take with patients and the students. At one point, John Simion said that he was glad that the crowds were thinner.

“The hardest thing, last year, was closing the gate on the people we could not see.”

In three days, the students would see a little less than three hundred patients presenting asthma, allergies, diarrhea, malnutrition, rashes, depression, anxiety and exhaustion and one case each of TB and CP. When I asked what was the best part of the trip, they answered that they enjoyed the team energy and most especially they loved the smiles and thanks that came from their giving this service.

Jesuit Medical Mission 2012 – The Supporting Posse

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