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.