Parasitology and Paradise

Trip Start May 12, 2009
Trip End Sep 29, 2009

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Saturday, August 1, 2009

     ŋComo estamos? How is everyone doing? When I am in Denver again, it will be sweet. I look forward to being home.
    I have been on the road three months, and expect to travel for two months more. Time is finite- and that is why it is valuable. In three months I have accepted a lot of new definitions of "normal": It is normal to have mosquitoes swarm around me although I am indoors, it is normal to eat rotten bananas. It is normal to have taxi drivers shout to me as I walk down the street. Normal, to spend no more than three dollars on a restaurant meal and douse it with hot sauce. Normal, to hear howler monkeys and use a banana leaf as a plate.
    In two more months, I think I will be back in Denver. A first-world city, with light rail, busses, and traffic jams. Credit cards, cell phones, English spoken everywhere. Strip malls, universities, retailers. I confess, sometimes I just donīt want to go there.
    Yet it is my home, and this is my country. In two months, I believe I will be back in the daily grind. I take with me... my time as a witness. I think the truest sense of travel may be to stand as a witness to other ways of life. To observe, bear testimony to. To experience without prejudgements.
     Then what? To synthesize something new.
      I have had the opportunity to stay with the director of a local mercy medical clinic for the past few days. The clinic serves impoverished villagers about 2 hours outside of San Pedro Sula, Honduras. S.P.S. is the second largest city in Honduras, a bustling working class suburbia. In the village, families survive on 15,000 Lempiras (US$790) a year. This is income solely from the sale of corn, coffee, or potatoes that they farm.
    I saw worms being cut out of a childīs head. The product of Bot fly infestation (Yes! Jules, this is what you told me about!), there were large worms living in cysts under the childīs skin.
- - Be aware, this is descriptive. If you have a weak stomach, you might want to skip this.
++However, if you thought anatomy and physiology was a fascinating subject, then you can watch a Bot fly extraction here:

    The lumps were large, red, warm, and tender, sitting just above the skull. When the worms moved, the spines in the larvae would dig into the tender tissue, causing pain to the boy, Pedro. The operation was pretty straight-forward: to cut the worms out with a scalpel, then wash with liberal amounts of iodine and alcohol, followed by sutures.
    This was done with minimal anesthetic. This would be done under sedation in the US, but it was done here with three people straddling and immobilizing the boy. He cried bloody murder.
    There was a lot of blood. Blood, and clear fluids gushing from the cysts. It was indeed sickening, and I respect the determination of the team to work under such stressful circumstances. His mother was beside herself with worry- and also beside the team, almost in the way. It was disgusting when they pulled out the plump white worms with black spines.
    It is difficult work. At Clinica Dios Con Nosotros (God With Us), they help how they can. Most days this means asthma medicine, a cholesterol check, and setting a broken bone. Some days it means social work, finding a home for a newly orphaned child after AIDS takes his last remaining relative. San Pedro Sula bears the unfortunate title of being the VIH-SIDA/ HIV-AIDS capital of Central America.
    The clinic receives donations from abroad. The Rotary Club of Holland pays their overhead and they receive donations of drugs from a wide variety of pubic and private interests. It is interesting that Clinica Dios Con Nosotros receives essentially no support from any Honduran entity. They get occasional nominal in-kind donations from vendors in the community who have heard about the work they do.
      Imagine rationing antiretrovirals (ARVīs) to persons diagnosed with an infection that is 100% lethal.
    Imagine doing this with no oversight. Imagine being 29, with no formal medical training, with this responsibility. Well, if you imagine that your name is George, then this is reality.
    When possible, he tries to get drugs to people with children, younger than 40, and with no complicating health conditions (and therefore the best chance at long-term survival).
    This is reality. This is how most of the world lives. Three billion people live on less than two dollars a day, according to figures endorsed by UNICEF and the UN.
    But back to Pedro. As they stitched the incisions on Pedroīs head back together, he was faint with pain and exhaustion. I was a bit faint too, if you must know. They sent him home with some penicillin to guard against infections, and a B12 injection.
    Vitamin B12 is the fix-all here. They are aware of the dangers of overuse of antibiotics. When someone presents at the clinic with phantom pain and they suspect they simply want drugs to sell, they offer a B12 injection instead. That usually helps with phantom pain, and other issues as well...
   This is Honduras. The home of Georgeīs family, my hosts, is also Honduras. It very comfortable, with an in-home stereo system playing contemporary Christian rock. They have a pet chihuahua they treat like a child. They use American Eagle cologne and chat on cell phones with custom ring tones. This internet connection is reliable, and "mom" served me a sprawling typical Honduran breakfast.
      First, I ate cornflakes. I thought I was done. Then she presented me with a plate of frijoles licuado con queso blanco, and asked if I would like sweet cream with that. I obliged and added a spoonful of rich sweet cream. When I was almost done with the beans, she added platanos frito (fried plaintain wafers). When the platanos were almost gone, there was an avocado wedge appearing on my plate. Also, she asked, would I like juice with that? Jamaica (pronounced H'mike-uh) is a mellow red tea/juice, and it went well with my breakfast. When I had almost cleared my plate, "mom" had coffee ready as well (Honduran cafe: half milk, half coffee). ĄIncredible!
    Their family structure is illustrative of several common social trends here. Betty is 55 and lives here with 3 of her four children, ages 24 to 29. The fourth child is studying medicine in Valencia, Spain. Her husband left her over 15 years ago when he went to the US and was never heard from again. They think he is in Florida... All the children live at home because they are unmarried, it is as simple as that. It would be unusual for an unmarried person to seek their own house unless they had the misfortune to find employment too far away from home to live with the family.
The two children living at home are employed as elementary school teachers. Fabiola teaches in a private school, with only 25 1st graders. Jose teaches in public school, with a class of 57 3rd graders to control. Fifty seven! Often, he says, he teaches while children cry or hit each other. He simply canīt teach on top of controlling the classroom. I have shared their story with their permission because it is very representative of many Honduran homes.
  This is Honduras. Last night, I went to a mall near the Hilton with George and his friends. There was a Lacoste, GAP, The Body Shop... I was agog. Just, stunned and distracted by this paradoxical shopping mall that looked like the Cherry Creek mall in Denver just switched to Spanish and every blond person skipped work for the day. For the Israelis, I would say it could pass for the Azreili Center.
   This is Honduras. A relatively comfortable country, but blanketed with inequalities.
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