Wrap up week

I think Chelsea put it well when she told me that I should appreciate my time in Honduras because soon I will be wishing I were traveling somewhere exotic. I made a valiant attempt during my final week, but I’m not sure how well I did. I started out the week alternating between small panic attacks and bouts of homesickness. It’s debatable whether or not I’m typically high strung, but nothing sets me on edge like the possibility of deeply disappointing others. I’m not sure that came out right… let me give an example. 

This week, I fretted that I would not have enough toothbrushes and toothpaste for children whose teeth are rotting out. I had already told the communities the dates that I would come back with toothbrushes, toothpaste, and fluoride. They were counting on me. When I arrived in their community without enough toothbrushes they were going to look up at me with their big brown eyes as a single tear dripped down their smudged cheek, pleading with me to save them from a life time of edentulousness. In reality, I did run out of toothbrushes, but no one cried, and the fluoride varnish (which, for the record, has nothing to do with my survey) will probably do much more to prevent cavities than toothbrushes, as half the kids that own toothbrushes here told me they forgot to use them on survey day. At the conclusion of this week, I can say that the biannual fluoride program, which may or may not continue without my presence, is off and running.

My other panic inducing issue is how to dispose of FB. The short version of the drama is that Gloria and I decided that it would be best to sell it through the guy I bought it from. The guy who sold me the bike knowing it couldn’t be in my name because I don’t have an RTN or license number. They guy who let me drive around without a “Permiso para andar sin placas” (a permit to drive without license plates) for a month until la policia stopped Baltazar. The story, as Baltazar told it, was that they police threatened to take the bike, but he dropped the name of his uncle, the policeman, and told them about the work we were doing in the communities, so they let him off with a 500 Lempira fine ($25). The guy who told me that someone would pay 32,000 Lempira for the bike. Then he told me 15,000 (It cost 50,000 a month and a half ago), and when I protested it went back up to 32,000. 

So why sell it through this obviously shady character? Simply put: it still doesn’t have license plates, isn’t in my name, and isn’t worth as much in Tegu. After a series of daily phone calls, it appears that someone wants to buy it, but they won’t have the money until the Thursday after I leave. I went to the shop to talk to him and looked at his face as he was telling me about this potential buyer. I sincerely doubt that the guy is going to show up on Thursday with the money. This man is full of shit. He had that look in his eyes. In any case, I will be in the US, and at this point I am just happy that I never have to see FB again. Hopefully someone buys it eventually. Lesson learned.

Before the saga of FB comes to a close, I will relate our last hurrah. I was out in the communities for 7 days straight without going back to La Esperanza this week. On Sunday morning, Baltazar and I went out to the last community, his hometown. I’ll admit that I may have squandered the opportunity to do about 20 more surveys, but I already have about 500, and I was concerned about how the already muddy roads would treat us once the coming storm let loose. We got back on the bike around 11 to head back to Las Mercedes. As we took off I noticed that the gas tank only had one tick mark. Nooooooo. We usually refilled every 5 days, so I guess it made sense. Baltazar assured me that we could make the trip. I secretly wondered if part of his confidence stemmed from not wanting to go back to La Esperanza without the permit to drive without plates, but I really, really, really, just wanted to go back to the clinic and pack, so I went with it.

I have mentioned before that the communities are in a mountainous region. The road between communities rolls up and down these mountains. Logically, half of the time you are going down the mountain. At the top of a hill, Baltazar cut the engine and FB coasted several miles. I was impressed to find that FB, the oversized bicycle, actually moved along about as fast as usual without gasoline. Why had we not been doing this the whole time? We could have used half the gasoline. I tucked this trick away in my memory - surely it will come in handy some day when I'm a doctor working in a developing country. We made it back to Las Mercedes with the last tick mark on the gage intact, and I found that I really didn’t care what happened to the bike after that. I would, of course, feel slightly sorry for Baltazar if he ran out of gas, but he’s used to getting along without the motorcycle. For all I cared he could leave the bike on the side of the road and catch a ride with the next papas truck.

At the end of the week, teeth were varnished, surveys were completed, and I will soon be restored to my blissful life of independence as a satisfied owner of a Honda Civic.

my one hideous picture of the unhappy couple. Fitting. 

Sexto grado and the run of the bulls

June 17, 2011

There is only so much you can say about teeth. I have now done close to 550 surveys. It’s definitely time to wrap this up. Mostly I spend the day making a valiant effort to look excited and engaged as I talk to child #437 about how many confites they eat per day, but every once in a while something funny happens. I was asking a 12-year-old boy what grade he was in a few days ago. I have always found it precarious that the word “sixth” in Spanish is “sexto.” Poor kid told me he was in “sexo” grade. Yup, sex grade. In front of his mom and everyone. He was a young twelve, I mean, he still had innocence about him, and he blushed furiously. Everyone had a good laugh and I told him how I had recently asked a girl how many “anos” (anuses) of kindergarten she had attended. That’s another precarious word, and that girl had already been annoyingly giggly.

Friday did not include any such moments of hilarity. It was also another day that I cursed my trusting nature that believed the woman who told me I didn’t need a mud tire on the front wheel of my motorcycle. Halfway between San Nicolas and San Antonio Baltazar asked me to walk. This happens from time to time, so I wasn’t concerned until Baltazar stopped and parked the bike about 50 yards later. I knew we weren’t at the school yet. As I walked toward him, slightly confused, I totally wiped out. The rocks under me just slid away. I wasn’t confused anymore. We walked the next mile, straight up, in the mud.

I already told my only good survey story, so let’s skip to the ride later that day to La Esperanza. I had packed my weekend bag and we were riding at a moderate pace to try to outrun the afternoon storm. Up ahead, a bull was grazing by the side of the road. Around here, you control your cows by tying ropes around their horns. If you want to park your cow somewhere so it can graze, you tie the other end of this rope around a tree. This rope can also be used to take your cow for a walk. I assume it doesn’t work quite the same as walking a dog, but it kind of looks like that. The best was a man walking a cow that was easily three times his weight. I could almost hear him telling it to sit and stay. Picture the exact opposite of the flamboyant men with toy sized dogs on Katy Trail.

But I digress. This cow had spotted some delicious looking grass across the road from where his rope was tethered creating a trip line for us. We stopped the bike. The bull looked at us and tossed his horns menacingly. I thought of Pamplona. I think in Pamplona you run away from the bulls. Instead, Baltazar revved the engine with his red helmet flashing in the afternoon sun and started herding the bull out of the way with the bike. The bull obeyed. I waited for it to give us an indignant kick as we skirted past, but it didn’t. I’m not going to try that on my own.

Driving me crazy (excuse the pun)

June 14, 2011 etc.

Leaving Dallas after the wedding was difficult. With a solid week of teeth followed by figuring out the best way to dispose of FB looming in front of me, I would much rather look forward the future. Two months of family (writing a thesis), friends (writing a thesis), and the best city in the world (Austin) (writing a thesis) sounds soooo much more appealing.

I left Dallas on Monday and had an overnight layover in Houston. I booked that flight in a haze of end of semester panic, but it worked out well because I got to spend the night hanging out with Liz Sladecek, my former roommate from college and a truly fabulous lady. She indulged my paranoia about getting to the airport absurdly early, and we left the house at 6am. As a sign of gratitude, I bought us both some Starbucks on the way. This was fortuitous. As I got out my credit card to pay for our white chocolate mochas I discovered that my debit card was missing. My stomach dropped to my knees, and I started frantically searching my purse. I knew it was gone. I never use my debit card in the US, and I had noticed in the airport that my cards were sliding precariously out of my wallet from time to time. Unfortunately, that debit card was my only source of money in Honduras.

There are many reasons Liz is amazing. One of the lesser reasons is that she, without blinking, loaned me a couple hundred dollars to finish my trip. There was an ATM in the same parking lot as the Starbucks. I boarded my plane later that morning with my debit card canceled and an uncomfortable amount of cash in hand. I suppose that could have been worse.

When I got to Honduras, Tim and Gloria picked me up. They offered to let me stay at their house for the night, and I accepted. In Tegu, I can almost pretend I’m still in the US. We went to their office where I had reliable wifi for the entire afternoon. Then we went out to a track where they exercise every day. I ran a few miles on the track and no one looked at me like I was crazy for exercising (in the mountains this is literally a foreign concept – only the mission team does it).

In the morning, I discovered that the game plan was for me to wait in front of the house for the bus to come. I had taken the bus to their doorstep on the way in to Tegu, but somehow it seemed a bit more daunting to flag down the correct bus in the middle of a highway with two giant and fully loaded suitcases. Luisa and I dragged my suitcases across the highway and waited. Several buses passed. Eventually one to La Esperanza was among them. It flew past without stopping. I was starting to sweat this idea. It’s official. I cannot handle not having my own, reliable transportation. It drives me crazy. My stomach started tying itself in knots and stubbornly refused to listen to my pep talk about how life would go on if I didn’t make it to Las Mercedes that day. After an hour and a half of vigilantly keeping my eyes peeled for my last chance to leave that day, we managed to flag down the right bus.

The ride was uneventful, and I arrived at exactly the time I had told my ride I would be there. I called her when I pulled into the bus station, and she told me she was leaving to come get me (ya vengo). She works 3 blocks from the station. After an hour of baking in the sun during the hottest part of the day, she finally showed up. I’m grateful for the ride – the bus to the communities is a couple miles from the bus to La Esperanza, and the unpaved roads would have been rough with two suitcases and a backpack – but I kind of wish I would have known I had time to find shade and some water.

When I finally made it to Las Mercedes I tumbled into my hammock and tried to psych myself up for one last week and a half of dental surveys.

If you ran the big hill...

June 6, 2011

One last day of survey’s before a long break. Driving to Belén on a motorcycle is perilous. I had decided the week before that I would just walk. The last time we had tried to get there by motorcycle I had ended up walking half the way anyhow so that Baltazar could navigate the worst bits of road with less likelihood of falling over. Belén is in the same direction that most people on the mission trip would go running in the mornings. A little less than a mile out there is a fairly treacherous hill with a river at the bottom. This river now flows over the road since the rainy season started. Here’s a pic for the mission trip veterans. 

It is the same river that we hiked to with the kids on one of the last days. On the other side of the river the road begins to climb upwards, twisting and turning. I know I only ever ran to about the first twist in the road before deciding that it was time to turn around. I was already running at a snails pace and my muscles were burning. Brett mentioned that he had gone considerably farther looking for the top of the hill. He admitted that eventually he turned around just before a curve and tried to convince himself that the hill probably peaked just around that curve. Well Brett, this super sweet pink house is more or less at the top. 

It took me 45 minutes to an hour to walk there, and it’s in Belén. Basically that whole road is up hill.

 Given that it was my last day before a vacation, of course it was the longest day I’ve had so far. Parents and kids just kept coming. By the end of the day I had been there for 9 hours and surveyed about 60 kids. My current preliminary count is about 440 surveys. It sounds so much worse when I say it out loud (or type it... whatever). That's too many teeth. Good for the thesis though. 

Around 4pm they brought me a fried dough thing with potatoes in side – delicious. At 4:30 Baltazar showed up. I have no idea why he came. I know he meant well, but it was a bit annoying. He ignored the fact that I told him multiple times not to come. Apparently he drove all the way to Las Mercedes in the morning (20-30 km), found that I was gone and drove home. Then through some other chain of events that I couldn’t really decipher he decided to drive back again in the afternoon to pick me up. That’s at least 80 km of wasted gasoline, and, like I said, the road to Belén sucks. The first time we drove on it I thought to myself, “If we are going to have an accident it will be on this road.” Don’t worry, mom, I ended up walking half of it again. It is time to go home for a bit. 

A little team spirit for Aggies and Devils

June 5, 2011

I slept in today (until 7), had a leisurely breakfast, and watched the kids play soccer in their Sunday clothes before mass. They wandered over to see what I was up to, so I practiced some English with them and taught them to say “Gig’em, Aggies!” and “Go, Blue Devils!”

The only time I’ve really been to mass here was with the medical mission. It was weird because it was the least mass-like mass I’ve ever been to. Today, however, was a totally normal mass (without communion – they rarely have communion due to lack of priests). I think they must have been doing something special for the mission trip visitors last time.

Early in the afternoon, Regino worked some magic on the solar batteries and informed me that I could charge my iPad. I spent the rest of the afternoon reading (all of my fun books are on my iPad).

Changing filters and Why I haven't been posting

June 4, 2011

When Baltazar picked me up on Saturday morning, he said Gloria had called and was coming to Las Mercedes with a church group. If I wanted to go back to Tegu with them today, I could. I had time to go to El Cacao as planned and then I could go back to Las Mercedes to pack. I would only miss one day of surveys. Sounded good to me, and then I could get both of my suitcases back to the states to bring back supplies.

Back in LM, one of the men from the church group helped me change out the water filters, which were green with algae. Just in case some one some day wants to do this again: just twisted the filter containers hard (lefty loosey). I'll leave the spare filters in the cabinet. There are two types and only the boxes (not the actual filters) are labeled so be careful as they look identical. Unfortunately, the solar panels still aren’t working well, so I the UV filter won’t work, but the other two will.

The group also discovered that the sink in the bathroom I don’t use pours water on the floor. I fixed part of the problem with the screwdriver on the leatherman multitool that Penny gave me (Thanks, Penny!) but the other problem is that they used some really flimsy plastic accordion piping to connect the sink to the PVC drainpipe. This had cracked in several places. I’ll try some duct tape, but it probably needs to be replaced. The sink in the kitchen started out with duct tape on the pipes, so now we have a matching set.

After lunch with the church group, I told Regino I wasn’t going to Belén. He looked a little upset but recovered quickly. Regino never looks upset, so I decided to stay. I just sent my suitcases with Gloria since I’m staying with her on Tuesday. The consequences were that I inadvertently gave up internet and electricity earlier than planned. **This eventually led to me not posting for two weeks as I was having way too much fun in Dallas to get caught up on blogging** . On the plus side, I get to go to mass with the community and do one more day of surveys. Not a big deal. I prefer to keep Regino happy. 

A reflection on living without electricity:

As I mentally prepared myself for life without electricity, I expected a week of silence – no music, no audio books. Instead, I really noticed for the first time that nature is absolutely not silent. Constant hum of crickets chirping, bird calls, cows mooing, chickens clucking or crowing, wind rattling and howling, streams rushing, rain roaring. Yes, rain roars on a tin roof. Two nights this week I felt like I was living under Niagara Falls as I tried to drift off to sleep. Periodically, children laugh, cry, or callout. Motorcycles wax and wane as they pass. Mine has a lower growl than most, so I know when Baltazar is coming. That and the motorcycle stops out front. Trucks filled with papas and people rumble past occasionally. Tarps blow in the wind and the metal roof pops and groans.

Instead of unwinding to music or audiobooks, I daydream. It took some practice at first to daydream when I’m not trying to study. I’ve relived memories of favorite places, loved ones I’ve lost, best friends, family vacations, phases of life.

Occasionally deeper thoughts occur to me. I can’t remember the first time I became aware that, as an American, I live in luxury. However, as I swayed in my hammock, forced by my circumstances into prolonged reflection, I am now blown away by the contrast. To be clear, the contrast is not “My life is good. Theirs is bad.” They live in a beautiful mountainside forest with bananas and pineapples in their backyard. They have grown up in the sort of close-knit community that most Americans will never experience. The mechanic who helped me complained that when he lived in the US he had to work all the time. He and Baltazar agreed that here you work when you want to. (Although I don’t think the women would agree with that statement). I don’t think they believed me when I arrived and told them that I had slept 4 hours in 3 nights. I can’t even begin to count the number of nights I’ve worked straight through without sleep. No. It’s not “My life is good. Their life is bad.”

The things that blow my mind are more specific: Not knowing what the internet is, for example. My life revolves around it. I called my mom today to pay a bill on-line, and I don’t even have electricity right now. Without internet, I brought completely the wrong motorcycle. I usually thoroughly vet all major purchases. I buy most non-grocery items on-line. I got through med school googling, and I couldn’t write a paper without the journals I cite from the internet. When I realized the kids don’t know what the internet is, I couldn’t explain it succinctly in English or Spanish. The kids only have limited access to books, can count the number of times they have watched TV or used a phone, and have never really used a computer. How would you describe it? I think I would have to draw pictures.

The limited access to books is another thing that blows my mind, and it’s not a rural thing. They don’t sell them here. One woman recommended I go to Tegu or another town two hours away to find books for the kids. So much of the world they will never hear about or see. Thoughts, ideas, philosophies, and beauty that they may never experience or learn to create.

It’s not the latrines, wood stoves, stick houses, contaminated water, or lack of electricity that surprised or shook me. I saw those coming and have ideas on how to fix them. If you give a person clean water or a toilet, anyone can use those things. Unfortunately, it seems to me that after a window, the likelihood of absorbing or embracing these other concepts and experiences would diminish as you grow up. Maybe it’s not all that different from home. I guess many American kids don’t like to read, but to never have the option of buying a book or going to the library…  Where’s the Carnegie of Latin America?

** Post wedding addition**

A friend of Nicole's who is a librarian suggested something like this (here's the New York Times take on it) to me at Nicole's reception:

Yes. Biblioburro = Win.

Pics of what I do all day and a couple life lessons

June 2, 2011

Lesson #568:

If you walk into your outdoor shower and find yourself standing in 2 inches of soapy rainwater, you can, in fact, use your flip-flop as a plunger to unclog the drain.

On a more serious note, Lesson #583:

If you are going to a developing country to do surveys, bring paper copies, even if you are intending to use your computer. Fortunately, in a fit of what I thought was over-preparedness, I printed 300 copies of my survey and brought them with me.

Today I used about 25 of them and I assume I’ll use another 40-50 tomorrow. If I hadn’t brought those blessed little pieces of paper, I would have more or less lost this week of work as well. We went to San Nicolas today, talked with all of the teachers, and surveyed over 40 kids. That makes about 100 surveys in 3 days. Not bad J. They fed us a huge lunch and literally told me that their door is always open to me. Good to know that translates directly.

I know you're dying to see what a day in the community looks like for me, so here are some pics.

Of interest, I asked Baltazar why kids here don’t smile when I smile at them. Really, I just expect all random strangers to want to smile at me when I smile at them. That's the only time they don't smile. Once we get to know each other they warm up. He told me it’s the culture and that only kids who grow up watching tv smile so liberally.

Spanish words of the day:

Hermita: church. They know the word iglesia, but they always call their church an hermita.

1peso = 1 Lempira. No, they aren’t the same, but the kids here say they bought 1 peso of candy and it’s the same as buying one Lempira of candy (the Honduran monetary unit.)

Politely saying, "4th graders are taller than you."

June 1, 2011

Way more successful survey day. Fifty surveys and seven hours later, I pity the fool who does this for a living. Does anyone do this for a living? Maybe only grad students are so lucky. Around lunchtime, the teacher gave us juice and cookies. It was very sweet of him, but I felt a little guilty lecturing the kids on sweets with my mouth full of cookie. I’m really glad the last two kids had particularly precious huge brown eyes, because it took a lot of self control to patiently teach them to brush the fish’s teeth.

Back at the clinic, someone had come to check on the solar panels again and decided some parts don't work anymore (I can't even begin to be mores specific. I know nothing about solar panels). They told Regino that we have to pay to replace the parts… that are under warranty. Apparently I have mostly embraced the lack of electricity because I was more or less indifferent. Unfortunately, I only had three hours left on the iPad, so half of San Nicolas and all of Rio Grande will be on paper. I think I’m faster with paper, but it’s going to make things slower when I get home – 6 of 1, half dozen of the other. I’m just glad to be getting the survey done.

Words for the day:

Chaparritos: very short people (like the people in my community). I was assured that this is not a derogatory term…

Plancones: tall people (like a plank)

Fornido: Big boned (I didn’t get a direct translation on this, the man I was talking to described his daughter with this word and mimed muscles. He sort of suggested in a polite way that she was larger, so I decided this means big boned)

May 31, 2011

Another day of almost doing work. No parents came to the school in Las Crucitas despite our forewarning, and the teachers didn’t seem that into it. We found some younger kids at home with their mothers and surveyed them. Luckily, a community health volunteer who works in Las Crucitas and San Antonio came by. He told me the next month’s vaccination/weighing dates for the communities and said he would tell the moms to bring all their kids to be surveyed. Hope springs eternal.

I split the rest of the day between reading NMS Peds, Clinical Micro Made Ridiculously Simple, and a biostats primer. The nerd that I am, I was a fun afternoon. It was the first time I really let myself try to imagine what it will be like to be a pediatrician. Way back in first year, I had a conversation with a third year about primary care vs. emergency peds. He told me I would miss the long-term patient-doctor relationship. I told him I wouldn’t. Now that I’m three years wiser, I think he was right. My mind wandered to community health interventions. Things have changed since first year. 

Day of rest

May 29, 2011

Yesterday was a bit of a low. With concerns about bad roads, no electricity, and issues with paper work for the bike, I was kind of freaking out. Going to sleep to the sound of rain last night did not seem to bode well. I word vomited my concerns into an email to Aly and tried to go to sleep.

When I woke up, I had a note from Aly. It reminded me that God’s taking care of me, so I shouldn’t worry about the roads. And she told me to offer it up. Bahahaha. Did anyone else’s mom always tell them that at the most annoying times? It was perfect.

I walked myself to mass and tried to offer it up. I know I’ve said this before, but one of my favorite things about mass is that it always feels like home no matter where you are. I know some people don’t love the formality and tradition of the Catholic Church, but let’s talk about incense for a sec. Mass involves the senses: the beauty of the art and architecture, the sound of the music and scripture, receiving the Eucharist, the smell of the incense. Some smells become tightly entwined into our memories so that when we smell them, the places and events they were associated with come flooding back. With the smell of the incense, memories of home parishes washed over me. Knowing the Eucharist was in the tabernacle made me feel God’s presence. I let my concerns slip away and spent the hour and a half mass letting good memories and peace wash over me.

After mass I relaxed at the hotel room until eleven when Baltazar came to pick me up. When I walked out to the bike the sun was shining. I hadn’t realized how long it had been since we last had a sunny day. It was beautiful. A small patch of brilliant blue sky and sunshine followed us to El Cacao. I soaked it up and spent the ride thinking of the mountains of blessings in my life and being thankful for them. The road was dry and as good as it ever is. When I got to El Cacao, Baltazar pointed me in the direction the church and wandered off to play soccer. There was no one there, so I enjoyed the scenery and took a couple pictures. 

Only about 10 kids ended up showing up. It was, of course, not awesome for the survey, but I actually had time to talk to the kids and parents, so the day was more enjoyable. The last kid had some form of MR. He was about ten and kept blowing kisses. Precious. I made my way back to Teresa and Baltazar’s house without any idea what to do with the rest of my day. I talked to their dad and asked if it would be ok if I just wandered around to houses. As I finished up with the second house Teresa arrived. She whipped things into shape, and I had a line of five or ten more kids to round out the day. We made plans for me to come back the following Saturday, and I’m feeling hopeful that next time the community will actually know that I’m coming.

COW BATH!

Survey-wise it was not that successful of a day, but life-wise it was exactly what I needed: slow paced, beautiful, and complete with human interaction. There were two places on the way back to LE that I wished I could stop and take a picture. In this part of Honduras any story could start with, “As we came up over the hill…” So that’s where these scenes took place. We came up over the hill, and I could see out across a small valley with a lake at the bottom. The hill across the lake was brilliantly backlit by a pale blue sky with patches of cotton-ball clouds. The hill itself was a lush green (one good effect of the rainy season), and on top of the hill three or four trees stood individually silhouetted in sharp contrast. It was breath taking. Around another hill, a farm spread out in the shadow of a thundercloud capped mountain. The violent gray blue of the cloud contrasted the rainbow of greens in the patchwork quilt of crops that spread over the farm. The patches were cut into rectangles by stands of sugar cane swaying nervously in the pre-storm wind. It was alive, and I could fell my sense of adventure returning. 

The rest of the week

And we were off. El Rosario on Thursday, El Cacao on Friday, Rio Grande on Saturday. About 70 surveys in the three days I think. Slowly but steadily I will win this race. I didn’t really know anyone in Rio Grande, but I had stopped at the school on the way to El Cacao and told the children that I would return the next day to survey their teeth. My heart sank as we pulled up Saturday morning. Three small clumps of people were sitting in various patches of shade out in front of the school. Very few people, no open buildings. I fought of the impulse to turn back for La Esperanza and walked up to the only adult I could see. After explaining who I am and what I’m doing (which flowed easily given the number of times that I’ve read out the consent form), the mom told me they were waiting for me and that she could get someone to open the church. I gave my self a pep talk and settled down on a log with a couple of kids. While we waited I started interviewing one of them. It turned out he was thirteen (too old for the survey), but it only takes about 30 seconds to look at a kid’s teeth. That’s all they really want any way, so I looked at his teeth and pulled out the stuffed fish with dentures. The kid was still acting shy, but I could tell he dug the fish. Smiles grew as I told him to show me how to brush.

Mom came back with the keys, and I used the walk to the church to continue my mental pep talk. It actually turned out all right. People steadily trickled in all day, and it was kind of nice to not have a giant line waiting. Around two, I managed to finish up. I know I didn’t survey anywhere near all of the children, but at least today I know I surveyed the ones who cared.

Here’s an interesting bit of information: these communities are orders of magnitude larger than Las Mercedes. Didn’t see that coming. At this point I’m just surveying as many kids as I can find, sorry Dr. What’s Your Face who taught me sampling strategy. Hopefully it works out, but I only have a couple weeks, and I’m doing the best I can. I could write a book of what they didn’t teach me before I left for field research. I think I’ll start now in list form.

1. If you’re going to make a major purchase, buy what the locals buy. Let’s, hypothetically, say you want to buy a vehicle. You notice that everyone in your neighborhood drives a monster truck or a dirt bike. You should buy a monster truck or dirt bike. FB is neither. I’ll elucidate the consequences of this below. 

2. If you are going to survey children, start by getting the list of school kids from all of the communities you are going to. If a list exists in this neighborhood, it will exist in the one you are going to. Even if you also want to survey children younger than school age, start with the school list so you can get an idea of how many kids you are working with. I was totally blindsided by how large most of these communities are.

3. Find a contact person for each community, and give them a list of exactly what you need before you get there. It has been incredibly difficult to convey that I want to see all the kids, even if they don’t have cavities. Why would a doctor need to see a kid that isn’t sick? They also don’t understand why a parent must be present.

I’m sure more things will come to mind as eventually. In the mean time, let’s talk about dirt bikes. The garden-variety Las Mercedes motorcycle (look back at Jaime's bike) is high off the ground so it doesn’t bottom out on the “road.” They have several inches between the fenders and the tires and they have tires for off roading (with thick spikey treads for better traction in mud). When I bought FB, they tried to change out the smooth city tires for the off roading tires. They ended up changing out the back tire, but the fender on the front wheel was too close to the tire, so the new tire wouldn’t fit. I (literally) asked them what the consequences would be of not having an off roading tire on the front wheel. They hemmed and hawed, so I asked if I would be ok if they didn’t change out the front tire. They told me yes, but looking back, there was very little eye contact in that moment. Today (Saturday) I found out why.

Like I said, we finished up in Rio Grande around two. Baltazar and Teresa had taken a few trips between El Cacao (where they live) and Rio Grande over the course of the day. El Cacao is between Rio Grande and La Esperanza, where I am spending the night. The roads had worsened with the days rain, and Baltazar wanted to try a different route. It was the one with pretty valley Gustavo had shown me. That road had seemed much better, so I was all for it. We got about half way between Rio Grande and La Esperanza when Baltazar pulled the bike over. We had been crawling along for several minutes and I had noticed that the road seemed slick under the wheels. I wasn’t sure what was up at first. Baltazar had me walk for a bit, and then I saw it. The front tire was no longer moving. The low fender and grooveless tire were completely defeated by impacted mud. Apparently there is a Honduran song called Mala Suerte (Bad luck). Baltazar started singing it as we looked for a stick to try to clean out the fender. We cleaned. We rolled the bike two feet. We cleaned. We rolled the bike two feet. 

Baltazar scrapes the mud off. Yes that's sun shine... it just never stays around long enough.

This went on for about a quarter mile. I wished I were with and old friend rather than a dude I hardly knew who didn’t really find the situation to be funny. It was so ridiculous it had to be funny. Visions of hitchhiking back to LE and just leaving FB on the side of the road floated through my mind.

Eventually we got to some better … mud… It was all mud, but the rocks were bigger and didn’t clog the fender. As we resumed our journey back to LE, I realized that my relationship with this bike is something like a bad boyfriend. Hear me out. Some women date men who are convenient. They are available, seem interested, kind of attractive, and, hey, what if no one else comes around. I’ve always prided myself on being slightly pickier than that, but apparently not when it comes to motorcycles. It’s like I went on vacation and picked up the first bike I met. It was available, sort of sexy (although if I had met the bike back in the states I wouldn’t have looked twice at it), and hey, what if I couldn’t find another one. The first time I went by the shop it seemed great. It was going to solve all of my problems: I could go anywhere I wanted, on my own schedule, through the tropic forest with the wind in my hair. Then I got the bike home and realized it was kind of fat, beats me up, never wants to work, and gives up when the road gets hard. Unfortunately, I’ve invested a lot in this bike. I’m sticking with it for the sake of the survey. On the bright side, the break up will be quick and painless. I leave for home (where my sweet little civic awaits me), and the bike stays here. On that note: Happy one-month anniversary in Honduras to me. Exactly one month to go. Please let Mala Suerte not be my theme song for the next month.

St. Columbanus of Bobbio (best name ever), patron saint of motorcyclists, Pray for us (thanks Jamie!)

Spanish words for the day:

Lodo: mud

Liso: slick

Hondurans love Bob Marley

May 25, 2011

Guess what the rainy season does for a solar panel... Nothing. Most importantly, it does not charge it. On Wednesday, as I tentatively rejoiced in the FB’s full recovery, the solar panel battery began to beep. The only thing worse than the incessant beeping was when the beeping flat-lined, and the battery shut off. I struggled with the manual for a while turning things off and on at random. Regino poked his head into the battery room, and I explained that the battery wasn’t working. He looked completely unsurprised and said Spanish the equivalent of, “Yeah, we haven’t had any sun.”

It had been an exciting day, so I decided I would write about it on paper, as my computer hadn’t charged after the previous night’s use. I would be posting what I wrote that night, but I intelligently left the journal in Las Mercedes thinking, “My computer will be charged. I won’t need to write in this.” So here we go from memory.

Baltazar’s friend, Jaime, drove out to Las Mercedes Wednesday morning. I learned where the carburetor and the “regulator of the accelerator” are (I assume there is a better English word for this but I don’t know it). With the regulator of the accelerator adjusted, FB fired up and reliably stayed … lit? What’s the English word… eh… you get the picture. 

Jaime holding the carburetor and rocking out to Bob Marley. (Note Jamie's bike behind FB. Come back to that for the next post)

From there we moved on to the problem of the gas leak. Jaime took the carburetor apart and showed me the floaty things and abuja (I have no idea how to translate that but it looks like a thick pin and works like a valve). The gas comes into the carburetor, and the floaty things rise. When the gas gets to a certain level the abuja, which is attached to the floaty things, closes the valve (at least that’s what I got out of the conversation). Apparently the abuja wasn’t closing and gas would just continue flowing in until it came out the manguera (literally “hose,” but this one lets air in). Jaime tried adjusting things for about half an hour before deciding it would be best to just drive back to La Esperanza and replace the abuja. When we got to La Esperanza FB wasn’t leaking gas any more! But you never know with FB so we looked around for a new abuja anyway.

This inadvertently led to a shouting match with the lady I bought the bike from. She had lots of complaints about how I had dealt with the multitude of problems I’ve been having with the bike (it’s under warranty), and Baltazar doesn’t seem to trust her (probably because she was willing to sell me the bike in the first place J). In the end, I tried to smooth things over, and we decided to just head back to Las Mercedes, as FB appeared to be cured anyway.

I was so pumped that I was actually going to get to do my survey the next day that I really wasn’t that upset about the electricity and am willing to overlook the fact that I am putting entirely too much trust in the lady that sold me this bike.

PS. The “La Gringa’s Blogicito” link is awesome. It has everything you ever wanted to know about what’s up in Honduras, particularly if you were lost about what I said about the OEA (OAS in English I think) and the coup.

Spanish words for the day (this one’s for you Charlotte):

“Que pedo?” Honduran for “how are you?” alternately: “What’s the problem?” (I’m not sure I’m gutsy enough to use this since I know pedo means fart, but I was assured it’s what they say…)

Word of the Day: Casi (almost)

May 24, 2011 

Teresa told me her brother, Baltazar, would arrive between 7 and 8 to take me out to El Rosario. I had been able to start the motorcycle easily when I got back on Monday, so I had high hopes that I would finally make some headway on my survey. Eight came and went. At nine I texted Teresa but knew she wouldn’t have phone signal until the afternoon. At nine fifteen I nervously contemplated driving the bike again myself. I promised myself that if he didn’t show up by 10, I would head out on my own. I started a Harry Potter movie to keep my nerves calm and awaited the moment of truth. Thankfully he appeared around 9:30. Poor guy had walked all the way from Rio Grande. Must have taken him a few hours.

We hoped on the bike. He started it up and we went about 5 feet. He shifted gears, and the bike died. I present to you Baltazar (on the bike), Regino (the other guy), and Fat Bastard:

Yes. That is what I have named my bike. Not G rated I realized, but it fits. What was wrong with FB this time? Well, we held down the choke and pressed the starter button as instructed by the shop guy (This had worked yesterday). The engine turned over feebly the first few times and then the battery buzzed with no engine turn over. Dead battery? No problem. You can kick start this bike. Now Baltazar is not as short as most of the people around here, but he might be my height. To get enough leverage, the guy put down the kickstand, balanced on the pedals and started kick starting the bike. Badass, Baltazar. Several minutes later he was sweating and frustrated, while FB pulled his classic move and started pouring gasoline out the side. I rolled my eyes and told Baltazar that FB does this all the time, and the shop guy told me it was normal (although I suspect he is wrong/full of shit).

For the millionth time I was told that I should have brought someone with me to buy the bike. Thank you, Captain Obvious. Don’t worry, my sense of humiliation has been severely punishing me since I spotted this mistake, but again, the pleasure of meeting you and your helpful advice has come too late. Let me clarify that I didn’t say it quite like that, and I am sincerely grateful for all the help Baltazar gave me today. He called a friend who is a mechanic to get him to visit my sick bike. We had to wait until one to see if the guy could come. By one ‘o’clock, in true tropical style, the usual mild afternoon hurricane was in full force. His friend couldn’t come until the morning. As Baltazar brought the bike back in side he tried it one more time. This time the battery light was on. He called his friend back to say it was for sure the battery. I’m sure everyone knows this, but, as it was news to me, guess what? You can start a standard vehicle with a dead battery by rolling it down the hill and starting it while in motion!

 Let me remind you that I live in a village. This is how we get a fat ass motorcycle up a hill in a village:

At one point there were so many boys helping that they tumbled over each other and couldn’t find enough bits of motorcycle for them to all hold on to. Regino would give Baltazar a push and the bike would start rolling.

Are you still wondering why the word of the day is Casi? It’s because we rolled that thing down the hill at least 30 times, and 10% of the time the bike started. All the rest of the time we looked encouragingly at each other and said, “Casi! Casi!” You may have spotted that 10% of 30 is 3. Shouldn’t that have been enough? You have forgotten the name of my bike. That’s not how FB rolls. Each time the bike started, Baltazar would patiently rev the engine for about five minutes trying to recharge the battery. The kids thought the heat blowing out the tail pipe was awesome:

Then the bike would die again despite Baltazar’s careful attention. After the death, the battery would buzz rather than start the engine, and FB would stubbornly pour his little gasoline tears out the side. I passed out a round of lollipops to my pit crew somewhere near the middle of this process. Since girls don’t push bikes around here, I led a clean up crew with the little girls. After making sure everyone put their lollipop rappers in the trash bag, the girls and I wandered around picking up all of the other trash littering our runway. Baltazar finally decided that the engine didn’t sound right when once it started and that the quantity of gas pouring out the side could not possible be normal. The word carburetor was tossed out, and now his friend is coming in the morning. I gave him money to hitch a ride back home. Thank you, God for people like Baltazar. Tomorrow I will do surveys. I can feel it.

In an effort to not to completely waste the day, I challenged the boys to some soccer. Despite the fact that the lawn maintenance team was out in full force:

we had a pretty intense game. Then I bravely/naïvely taught the kids to use my camera. In case the last round of soccer pics wasn’t enough for you, here is some of their handy work:

Oh, and did I mention that the solar power battery at the clinic (aka: my electricity) is on the fritz. Thanks and gig’em.

An American Tourist

May 22, 2011

Mass was interesting today. In the gospel for the day, Jesus says he is “the way, the truth, and the light.” The 8am mass is a children’s mass so the priest was warning against the other paths of the world and warned the children to not get piercings because they are the way of the devil. I tried not to laugh and wondered if the woman next to me had noticed my nose ring.

When I got home from mass and grocery shopping I found Teresa waiting for me. I already mentioned her fabulous news, but beyond that it was nice to have some one to go out to lunch with. She asked me how my week was, and I asked her about her week – I know, not a big deal, but that was the first time I got more than “I cooked” as a response so it felt like a triumph. We also talked a bit about the clinics in the communities. I thought they were all the same, but I guess the clinic in Las Mercedes is actually a big deal because it is supposed to be a place where women can give birth, and there are supposed to be doctors that can handle more than primary care. I guess Rio Grande has a health center rather than a clinic, and they only handle basic primary care? I’m not sure if there is a doctor in Rio Grande or not. San Nicolas has a doctor. They do primary care and at least minor emergencies because I know they can do stitches. As I was thinking about the three clinics I noticed one of these things is not like the other. Rio Grande and San Nicolas have over a hundred families each. Las Mercedes has 20-40. Rio Grande and San Nicolas treat their water, have a store of some sort, and look at least somewhat developed. Las Mercedes not so much. Then I spotted a problem. Where would a doctor live out here? I live in what’s supposed to be the delivery room. When the clinic design was explained to me, there was no place meant to be living quarters for staff. There aren’t exactly rooms for rent around here. I suppose the doctor can drive in from La Esperanza. Hope women around here have their babies at convenient hours.

There’s also the problem of doctors adjusting to life in rural areas. This was a big topic in our Health Systems class. It’s always difficult to attract doctors to rural areas, even in the US. In Honduras they have a civil service year of medical training, so I suppose the government will just send someone whether they like it or not, but they certainly didn’t choose a location that would make it easier on the doctor. As I get to know the communities better, I’m realizing that there is a pretty big difference between rural and urban society here. The closer I get to La Esperanza (the city), the easier it is for me to relate to the people I meet. I assume it would be the same for Honduran doctors since they are generally from the cities. Peers are going to be few and far between for the doctors that are sent here. If Las Mercedes were a good location for the locals, then I’d say the doctors could just suck it up for a year, but I’m not really sure about that either. Like I said, there aren’t that many families in Las Mercedes. Maybe it was chosen as a central location? Who knows. But it’s here, and it’s a nice building.

When I got back to the hotel, I packed and made some phone calls in anticipation of leaving that afternoon. However, when Gustavo showed up he didn’t have his backpack. It turned out that we weren’t so much leaving La Esperanza as leaving the hotel. I had told him that I didn’t leave the hotel on Saturday. I didn’t leave because it was raining, but I wasn’t complaining. I come to La Esperanza because my hotel room has a door and I can use the internet. In most other aspects I prefer Las Mercedes. It’s beautiful, it’s quiet, and no one yells, “What’s up, Mami?” or “Oye, Sexy” in almost recognizable English. In any case, he was there to take me sight seeing, and I appreciated the gesture. First we went to La Gruta, the Marian grotto to Our Lady of Lourdes. 

Gustavo seemed to be under the impression that Mary had appeared at this Grotto, but it pretty clearly said “Our Lady of Lourdes,” so I doubt that. I tried to explain the story, but I get the apparitions mixed up and gave up pretty quickly. There are some worn steps up the hill behind the Grotto and we climbed them for a gorgeous panoramic view of La Esperanza. From there we headed out to a park with waterfalls. If any one wants to go there on next year’s mission trip, you just go to the grotto and take the road on the left at the bottom of the grotto steps. Follow it around the left side of the grotto hill, and it’s maybe a mile down. The small park is designed with the classic combination of beautiful scenery and odd, slightly whimsical plaster statues.

There is a clump of trees over my left shoulder. My hotel is right behind them. I'm standing right above the grotto.

sweet fish thingys

My tour guide, Gustavo. I sort of surprised him with this pic but he still managed to go all asian tourist on me. And a waterfall.

sad, one-armed, eyeless, plaster frog

happy dolphin near a waterfall. 

We hung out in the park for a while and I seized another opportunity to ask a local what he thinks of the country’s political, educational, and health situations. Gustavo seemed to feel like the Honduran people had voted for Porfirio Lobo, but he laughed and explained it was complicated when I asked about the situation with the OEA (who won’t recognize Lobo because he was put in power by a coup) **UP DATE: Since I wrote this, Lobo and Zelaya signed the Cartagena Agreement. Honduras is back in the OEA, and Zelaya is back in the country**.

When the conversation moved to education, he told me that last year the schools were only open for about 120 days of the year. The previous year they had been open for ~80, but that was the year of the coup. He blames the government-affiliated teacher’s union. I don’t know much about American unions, but I think this one is different in that it was appointed by the congress and has some legal authority. For example, it says how may days a year the teachers will work, and that the teachers get paid during strikes. Gustavo also complained about the quality of education. He certainly isn’t the first person to tell me that the curriculum isn’t very good. To be a health promoter, he went to the usual 6 years of primary school, 3 years of preparatory school, and 3 more years for a degree that starts with a B (I think it’s a generic term for an advanced degree, but I can’t pronounce it and therefore can never remember the word).

When we talked about his own job, he said the government is having trouble paying some of its health workers. That seems to be a fairly common problem here. I wouldn’t say I was surprised the government is inconsistent about paying it’s workers, but I was expecting it less in the health field because I know Honduras has a big World Bank loan for vaccinations. Vaccinations are part of his job. I wonder what salary issues will do to the success Honduras has had with its vaccination program. Vamos a ver (we’ll see).

Add these words to your vocab:

Catracho: noun or adjective. Cool/trendy person/Hondureñan

Cheque – ok. It was explained to me that the catrachos like getting their paychecks and this somehow evolved into cheque meaning ok. 

Stars realigning

After a waste of a week a surprise visit from Teresa brought me some awesome news. Teresa is from El Cacao, one of the communities I'll be visiting. She is in nursing school and works at the health center in Rio Grande. Gloria, hence forth known as my angel, has been keeping tabs on me through Teresa. I'm pretty sure it's my angel's fault that Teresa turned up at my hotel today to tell me that her brother, who knows how to drive a motorcycle, is off from work until July and would be happy to drive me around. Hallelujah! Time for some surveys!

I also stopped by the motorcycle shop to talk about my non-starting motorcycle. The shop owner told me there was only supposed to be a tiny amount of oil on the dip stick when you checked it. He also coached me that the choke needed to be pressed when starting the engine. I'll admit that I noticed that Gustavo only pressed the choke sporadically when he was trying to start the engine. My bike does look different from his. Additionally, he told me that the bike can take regular or super gasoline (although super is better). That means I didn't ruin my motorcycle some how with the wrong type of gas!! I'm not sure you can ruin an engine with the wrong type of gas, but when the bike wouldn't start I immediately started envisioning all of the ways I could have destroyed a brand new motorcycle. Cross your fingers that I just need to press the choke and my bike will return to life! And if you're lucky I'll post a pic next week.

Fútbol!

Soccer is kind of a big deal here. Here is a slide show of a game that took place outside the clinic :)

Adelante (moving forward)

May 20, 2011

I went for a run this morning to vent my frustration. Getting 45 surveys done in a week had frustrated me last week. This week I did 10. I can’t even think about it. Instead, I’ve come up with a new game plan. It hinges on the philosophies I’ve been working with since I got here: “You gotta do what you gotta do,” and “We’ll see.”

Here’s the plan: We’ll see where Gustavo goes for the next two weeks and I’ll just go with him if it’s a community on my list. It’s not ideal because I don’t know how many surveys I’ll get done while he works, but he can introduce me to the community, and I assume I’ll get more than 10 surveys done this week following this plan. The “you gotta do what you gotta do” part of the plan is that there are a few communities I can walk to in an hour on the days that Gustavo goes somewhere I don’t need to go. Regino seemed doubtful that I would want to walk so far, but it’s another one of those situations where I’m not really psyched about either option but I like one less than the other. An hour of hiking with a heavy bag on either side of 8 hours of dental exams isn’t ideal, but I want to getmy survey done so… Gustavo also said he would help me practice riding the motorcycle, so we’ll see how that goes. Maybe I can use it when I do the fluoride application or to get out to the farther communities. I’m also toying with the idea of taking a bus out to a community in the morning and just sleeping in the church that night. Then I could move on to the next community by bus in the morning. It wouldn’t be awful as long as I could figure out food and water, and I could probably get rides with Gustavo sometimes. I’m saving that option for the fluoride application weeks.

That’s more or less the plan I pulled together while sweating it out on the mountain roads. I got back to the clinic and prepared to leave for the weekend. I was pretty much packed when some kids showed up. They did the usual “stand in the doorway and stare at me” bit. This always follows the part where they walk right into my room without knocking. This makes changing and going to the bathroom trickier than it ought to be. In the end, I let them draw pictures using my pens and paper. We wrapped up their visit with a modified game of tag. In this version I was always it, and nothing but hysterical giggling happened when I caught someone. Eventually it was 8am and they had to go to school. They’re cute and I’m glad they come by, but I wish I had a door and that they would say why they are there when they arrive. “Let’s play,” or “Can we draw,” would be awesome. This is the herd of cattle that ran by as they were leaving:

Gustavo showed up a couple hours early because a meeting had been canceled, so he flipped through my Clinical Microbiology Made Ridiculously Simple while I secured my belongings from the dogs and did some last minute packing. After my Wednesday driving adventure, riding with Gustavo was fabulous. For one thing, my backpack rested on another bag and wasn’t making my shoulder blades ache. More obviously, he navigates the roads easily so it’s just less stressful to let him drive. We stopped off along the way at a Health Celebration in Rio Grande. He told me it was a party, and there were a lot of people milling around a well-decorated area. The odd thing was that no one was smiling. You hear smiling is the universal language, so it really throws me off when people return my smiles with blank stares. That’s pretty much what I got as we got off his motorcycle. We walked up to the church where a man was speaking passionately to a large crowd about men not beating their wives. Nothing screams “Fiesta!” like a good sermon on spousal abuse. We said “Hi” to Gustavo’s boss and set out again.

I joked about the lack of smiling at the party. He laughed and said it wasn’t a very good party. He went on to explain the structure of a Health Celebration, and apparently it’s much like a mullet. Up front it’s business. At the beginning of the celebration they present to the community the death rates and disease burdens. I suppose the spousal abuse sermon fits with health promotion, and it’s definitely something that needs to be discussed. After that comes the party where they sing and dance. We had just arrived during the business part of the day.

We drove on passed a continual array of beautiful scenery. At one point we were coming to the top of a hill and Gustavo told me to close my eyes. I obliged and he pulled the bike over. When I opened my eyes, we were overlooking a gorgeous valley of patchwork-quilted farmland and grazing cattle. I didn’t tell him I had seen the valley before and tried to look surprised. It really was beautiful. He explained that it is a cooperative farm owed by the people who work the land.

Again we drove on and soon reached La Esperanza. Gustavo dropped me off at Hotel Mina and told me to call if I needed anything. Bonus: I got a new room with more outlets and a desk! And the internet is working this weekend! Now maybe I can get some work done on my thesis…