Yet Another 24 Hours of Uncertainty

I will be staying at home yet again tomorrow as the curfew has been extended until 6:00 pm Wednesday evening. The Secretary of the Exterior for the current Honduran government gave a press conference this evening explaining the de facto's position regarding the current political crisis and presence of Mel Zelaya at the Brazilian embassy. Let's hope they can lift the curfews soon. We depend on vendors to come into our area nearly daily to deliver fresh fruits and veggies, milk and basic grains. There has been no violence in our area, but people work with very little cash so there is a great need to work every day. Many go to the little corner stores on a daily basis to purchase the food they will need for the day. I had to laugh today, despite the curfew, the moto-taxi's were making a killing running errands for everyone. People were afraid to use their cars and trucks, but apparently when you live in the rural areas...walking, bicycles and moto-taxis are fair game as long as there are no military or police in sight. Fortunately for us, there was peace in our little corner of Honduras. Tonight I had quite a number of neighbor kids playing in my yard. It was comforting to see all of the parents sit around and watch their kids play while chatting about today's events. If I had been able to take a picture, you would never guess this country was in such turmoil. Let's hope things get better as soon as possible and that personal agendas and aspirations are put aside for the good of all. Thanks again for all of your prayers and words of support. They are very much appreciated.

Mario Catarino Hospital Near Collapse

I left for San Pedro Sula this afternoon to run errands. While I was in town, a pediatrician friend of mine called to talk to me about a mutual patient he has been seeing. I told him I was close and would stop by his office to talk. I thought it a better alternative than driving in busy city traffic and talking on the cell phone at the same time :)

Allan Caraccioli is an amazing pediatrician. I owe him my children's lives in fact. He pulled both Juan and Jessica through when everyone else thought all hope was lost. Whenever I have a critically ill child, he's the one I run to for help. He is in charge of the neonatal ICU at the large public hospital in San Pedro Sula along with running a very busy private practice of his own. He's one of the elite, very gifted, best in the business specialists who believes in sharing his gifts with the very poorest of Honduras. Whenever I have a sick child from the mountain that needs more extensive evaluation or treatment than we can provide, he is always there to help. He refuses to charge me for his services but instead prefers that I bake pumpkin bread with extra pecans for payment in kind. He has been a good friend and mentor here in Honduras for many years.

Perhaps you can understand why it was particularly disturbing to me to see my friend look really tired and worried. During the course of our conversation, Allan told me the public hospital in San Pedro Sula where he works is near collapse. The medications and supplies have been depleted. Because of the political situation, its consequences with regard to international monetary aid and the economic crisis in Honduras, there are not enough public funds to provide medical services for the ever growing population of desperately poor people who look to governmental health care for treatment. He went on to say that even some of the most basic medications such as ampicillin are running out. With great sadness in his eyes, he confessed that depression looms over him each day as patients die because of lack of adequate resources. At one point last week he said he had to stop himself in mid-stride to remember that it isn't his fault that patients die. They aren't dying because of his lack of expertise...they are dying because there is nothing left to use to treat them.

I want for you to know how grateful I am that the Fellow Man clinic nearly always has what is needed to take care of sick and hurting people. Perhaps you will never know how often you come to mind when just the right medication is found on the shelf to really help someone. My heart aches for the suffering of the poor, but it does not despair because I have my faith in a God greater than the now and I have you who have so selflessly sacrificed to assure I am never alone in this place. Thank you all for your kindnesses. If it isn't too much to ask, keep Dr. Allan in your prayers. The hospital and the poor need for him to be there. I would ask that God give him the strength he needs to continue on in the face of what surely seems like futility.

My Brother's Keeper - continued

He stood at my gate, a mere shadow of a man. Yovanny, a man I have known for more than ten years was waiting to catch me as I left the house on Monday morning for work. He apologized for disturbing me at home, but wanted for me to know his wife had been convulsing since the early morning. He didn't know why. Cruz, my right hand man, had the mission's vehicle, so I called for a moto-taxi. From the few details Yovanny was able to provide about his wife's condition, the situation worried me.


Yovanny and his wife Carmen have always lived in abject poverty. From time to time, the mission has provided food assistance for their family. About a year ago, the family moved to Pinalejo because Yovanny was offered a job at a poultry farm. Instead of finding a better life, the family has suffered an even more profound poverty than that of mountain life.
When I arrived at the house, I was shocked by what I saw. Carmen, Yovanny's wife was lying motionless on the only twin bed this family of seven owned. She had just suffered another convulsion and was not responding. She was pale and had very dark circles under her eyes. In fact, all of the children seemed to be severely malnourished and in poor health. They were thin, very pasty in color and also had dark circles under their eyes. I asked Yovanny if they had been eating. He confessed, as he stared at the floor, they had all gone without food for the last three days.

In that moment, Carmen opened her eyes. They were wide with fear. She was staring at me and yet did not seem to see me. She screamed that animals were hunting her and were going to carry her off. She did not know who we were, where she was or what was happening to her. As far as I knew Carmen had never been an epileptic. A million diagnosis were running through my head. I could not imagine what could be causing the seizures. None the less, this woman was obviously very ill. The only solution was to take her to a hospital in San Pedro Sula.

But, before I could even put her in the car, Carmen began to seize again. The seizures were unlike anything I had ever seen before. She flung her head back violently. Her jaw clamped shut and she stopped breathing for a time. At the end of her seizure an almost animal-like cry came from the depth of her being. I remember thinking at the time that it was no wonder the people of biblical times thought those who suffered seizures were possessed. No sooner did one seizure stop, only a few minutes later another began. The only thing left to do was to make a run for the hospital.

Cruz and I loaded Carmen into the car. I stopped by the Center for Public health to ask for some inject able medication to stop the seizures long enough to make it to the hospital. Poor Cruz had to play both co-pilot and nurse as the medication was administered little by little to avoid further complications. Thankfully, the medication did the trick. The seizures stopped and Carmen rested comfortably in her husband's lap.

Making the decision as to where to go was not simple. I knew the doctors at the public hospital were likely to ask for a CT scan. The problem would be that the public hospital does not have a tomography unit. It would literally do me no good to take this patient to the public hospital without a CT scan and corresponding report. So, with the Fellow Man International credit card in hand, I decided to take Carmen to the Hospital del Valle. The management of this very prestigious hospital has been generous to our efforts on behalf of the poor in the past...perhaps they would be willing to give a discount on this occasion as well.

When we arrived at the hospital, I already had my speech ready for the doctor on call in the emergency room. I would explain to him that I needed a variety of tests for the patient so that she could be transferred to the public hospital. Thankfully, it was a physician with whom I had already worked before. He told me to bring her in, that he would help me get the needed tests while at the same time try to stabilize the patient. The nurses there are very friendly. One said, "I guess you are the village keeper". I silently thought to myself, "I wish I weren't some days".

About that time Carmen began to seize again. I was glad to have more witnesses to these strange seizures. The ER doctor quickly placed additional medication in Carmen's IV to stop the seizures once again. He too had a perplexed look on his face. Once all of the information was given to the emergency room staff, I stepped out into the waiting room. I was relieved that Carmen's care was now in the hands of someone more qualified than myself. It's always a relief to get to the city.

About half an hour later, the ER nurse appeared in the waiting room. Carmen had been taken to the medical tower for an electroencephalogram, but that test had to be paid in cash as it was not part of the hospital's services. I walked over to the medical tower. When I entered the neurology center where the test was to be performed there was a huge sign that said, "1,800.00 lempiras is due in cash before the patient enters the testing area...no checks or credit cards accepted". I didn't have $100.00 in cash in my purse, so I begged for time from the receptionist. She agreed she would take the patient back for testing as long as I promised to go to the bank immediately to withdraw the necessary cash for the test. I thanked her for the favor and ran out the door to go find some cash. I wondered what a patient would do at night in the case of emergency. Where would a person find large amounts of cash at night when the banks are closed. Thankfully, the bank was open for business. It only took about thirty minutes for me to obtain the necessary funds in cash and return to the testing center to pay for the electroencephalogram. "Whew," I thought. One more hurdle had been jumped toward helping this woman.

Carmen was immediately taken to the CT scanner for her next test. Once again, I was sitting in the waiting room watching television and hoping for a diagnosis that would be treatable. About an hour later, the nurse told me that the test results were ready and that the neurologist had come to examine Carmen. I was allowed to enter the room to speak with the doctor. The neurologist was a kind man who seemed to be very thorough and kind. He spoke with the family, asked lots of questions and performed an exhaustive physical exam. After about an hour I would guess, he turned to me and asked if I had any idea what this woman's problem might be. I confessed I had no idea but had hope he would know. He showed me the EEG and the CT scan. Everything was normal. Her blood work was also normal. Now, I was even more confused than before.

"This woman is suffering from psychogenic non-epileptic seizures," he said. I could hardly believe what he was saying. I had seen women before who had "fits" or "spells" due to severe emotional stress, but this woman's condition was far different from anything I had ever seen. Certainly, her symptoms as far as I could tell were very real.

(To read more about this disorder click here http://www.epilepsy.com/articles/ar_1112967056)

This kindly, experienced neurologist explained that these "seizures" can be very difficult to diagnose and are often very tough to treat because they have a psychological origin most likely due to extreme emotional stress and trauma. He gently described the condition to Carmen and her husband in a very non-judgemental way. He encouraged them to talk about about the things in their lives that could be causing that kind of severe stress. He listened to their answers with a compassion and intensity that left no doubt in any one's mind about his commitment to his healing profession.

Then, as if by divine intervention the neurologist turned to me and said, "I am not going to charge you for my services". I explained that I had not called him out of his private practice expecting a gift. He said, "I have a heart too you know and I want to contribute". I was speechless. It would be a lie if I said I wasn't becoming worried about the medical bill by that time. I was so grateful for his generosity, I simply didn't have the words. He wrote down several prescriptions. He explained that we could perform more testing, but that it would be expensive and most likely reveal the same diagnosis. He then gave me his private clinic's address and his personal phone number. He said I could call upon him if ever I needed his services. Suddenly, this very bad day was turning into a pretty darn good day.

He released Carmen from the hospital, but I still needed to take the FMIF credit card to the cashier's box to pay for the hospital's services. The ER nurse who had been helping me said she was told the hospital was going to reduce its fees for this patient. With the CT scan, emergency room services, medications and blood work, the bill came to slightly over $300.00. It was significantly less than I had expected to say the least. Once again, such unexpected kindness left me speechless.

Soon, we were on the road to Pinalejo. What an emotional roller coaster! Before I could take Carmen home, there was still the problem of feeding the family that had to be addressed. How could we expect for her to recover from her depression and anxiety if the sources of those factors were not eliminated or at least reduced. At the very least, Fellow Man could provide some basic foodstuffs for the family. Beans, rice, corn, sugar, milk and a few other groceries were purchased on the way home to get things started. As I laid Carmen down in the rickety, old twin bed I wondered if we could do more. I feel in my heart, we have to do more.

If you would like to see a video of this family's living situation, click here http://www.youtube.com/watch?v=usPxpTlGcT4

Carmen has since confessed to me that she can not bear to see her children continue to suffer. The family needs much in the way of financial support to bring them out of this utterly desperate circumstance. These are the things that the family needs along with the cost of each item to bring some hope back into their lives.

4 beds at $50.00/ea

linens, sheets, blankets, pillows, towels $150.00

a pair of shoes for each member of the family $10.00/ea

cooking pots and pans as well as a few plates, cups and silverware $40.00

cleaning supplies, broom and mop $20.00

food support for the next three months $75.00/month or $225.00
medication support for the next three months to treat Carmen's illness $50.00/month

Total needed is: $855.00

Normally, I don't like to ask for specific family living support because it can be dependency based and not helpful for the long term. However, this family's situation is so dire that it just breaks my heart. I like what Bryan Sirchio says about being open to seeing what must break the heart of God. Perhaps this is one of those times.

If this situation should move your heart you can click here to donate.

http://www.fellowmaninternational.org/donate.html

*Please make sure you designate your gift for the Zelaya family.

My Brother's Keeper?

Today was one of those days...the kind where I need to just come home, play with my kids and forget about what happened. However, the silent desperation of this woman's eyes is even more disturbing in person. I'm almost afraid to turn out the lights because I fear today's experience may have permanently burned her image into my brain and perhaps even into the back of my eyelids.

Today's story will have to wait until tomorrow. For now, I would just ask for your prayers for Carmen Zelaya and her family.

Living Between Two Realities

Most days, this is my reality. I work, just as I had most wanted to, with some of the poorest people living in Honduras. Life in the mountains can be both a living hell as well as heaven on earth. It would be tempting to find this remote area quaint, filled with a living history of how things "once" were. Recently, a representative from UNICEF declared that Honduras' most vulnerable were indigenous, illiterate women with large families...in essence, the majority of the people we deal with every day at the Fellow Man Project. For most women, the day is filled with things to do. There is corn to be ground for tortillas, wood to be cut for the fire, clothes to be washed by hand and children to be raised. But even with all of these things to do, life seems less complicated than that of these women's urban counterparts. Certainly, to live without the luxury of electricity has its drawbacks and yet, I almost envy the families who sit in the peace and quiet of the darkness of this mountain at night, sharing their thoughts to the rhythm of swinging hammocks.

I have struggled and worried and wrung my hands over the recent political events in Honduras. I couldn't help but wonder as I watched this woman disappear into the mist, how aware she might or might not be that her country is in crisis. I wondered if it really mattered. The only news most people receive in this area is that via radio and because of their proximity to the Guatemalan border it is generally not Honduran news. How concerned could the people here be about democratic order or the threat of Hugo Chavez to stability in the area? Do they understand the meaning of Capitalism, Socialism or Chavism for that matter? I doubt it very much. I would argue the monsters these people face are much more personal and well known. Hunger, illness, illiteracy and desperation, I would guess, concern these people more than any political ideology.

Meanwhile, in the other reality of Honduras, there were massive marches yesterday against Hugo Chavez, the president of Venezuela. The event was coordinated with many other countries in protest of the spread of Chavez' political agenda. Some have alleged Chavez is attempting to unify Latin America in what has been deemed a return of the Cold War era for this hemisphere. It is estimated that thirty thousand people marched in Tegucigalpa alone. And while all of these people, dressed in white in the name of peace marched for what they would consider an important, pressing issue...life in the mountain and all of the struggles that life represents...went on as usual.

Got Eggs?

This sign in San Pedro Sula was just too good to keep to myself. With the coup now entering into its third month, a country divided over its leaders and the threat of further international intervention to restore democratic order, someone in Honduras still has a sense of humor. It would seem to me, as this tiny, poor Central American country tries to defend itself again the private interests of the various countries who would use Honduras to their advantage, this billboard has some ring of truth to it. It reads, "In Honduras we have neither oil nor dollars, but we do have EGGS". I'll leave it to your imagination what you might think the eggs symbolize.

Contribution to Humanity?

It's hard to step away from patient care when it's what really makes my heart sing. Last Friday, Dr. Marvin had an unusual problem he was unable to resolve. A small child had pushed a red bean into her nose. The bean was now well beyond reach, blocking off one side of the child's nose and causing considerable discomfort. Dr. Madrid was performing surgeries on Friday as well. He suggested putting the child under anesthesia to retrieve the bean. The mother was very poor and from a neighboring village. Traveling to San Pedro Sula was not a viable option because of extreme economic difficulties.
Once, I had a child who had a grain of corn stuck in his nose. I had fashioned a small suction device from a catheter, managing to pull the kernel out with the help of a little surgical aspirator. I asked the doctors if I could try to remove the bean in the same way. Neither had any objections. At first, the bean was barely visible so threading the catheter so far into the child's nose was painful for her. None the less, with the help of a little anesthetic spray and suction, the bean readily came into view. After a few tries, the catheter finally latched on to the bean and out it popped...much to everyone's relief. I was glad to see that little girl smile as her "bean saga" came to an end. Although sucking a bean out of a child's nose is hardly the romantic idea I had of missionary life...every drop in the bucket that helps to fill the poor with hope instead of dispair is well worth the effort.

Learning How to Live, Not Just Exist

If there is one thing I want for my employees to learn, it's that life really is worth living...not just surviving! Too many people in Honduras are forced to just exist because of many factors beyond their control. Hondurans, I think, by their very nature are a humble, passive people. I have often observed they are reluctant to take risks. And why should they? After all, risk taking in Honduras could cause a person to loose their life! None the less, today I decided to live a little myself. Dr. Marvin Pineda, the clinic's doctor is a motorcycle enthusiast. I asked him if he would take me up to the clinic this morning on his motorcycle. He laughed a little bit surprised that his boss wanted to try her luck out on the dirt roads of this Honduran mountain in western Santa Barbara. The trip was amazing. I had forgotten how wonderful the rainforest smells and how beautiful the birds songs are. Always in such a hurry to get to work, I too had forgotten to live.

As the employees giggled and chucked, I couldn't help but notice even perhaps a glimmer of envy in the nurses eyes as I pulled into the project on the back of Marvin's bike. God forbid that this lost "Dorothy" from Kansas break the rules for being the ever prim and proper example of femininity. When I am gone from this place, and my nurses are all grandmothers who tell their grandchildren about the crazy gringa with whom they worked so many years ago, I hope they will remember me not only for my quirks, but as a woman who taught them that life, most certainly is a ride to be enjoyed! Blessings, Lisa

Gunshots are just a part of life in this remote mountain. Sometimes, it is an accident, but most of the time it's due to crime. Once in a while, it's even due to vengence. In a place where there is no police presence, people often take the law into their own hands. On Friday, a fifty-something woman came to the clinic after having been shot in the right thigh the night before on her way home from church. She couldn't or wouldn't give very many details about the accident. For whatever reason, she seemed to be frightened.

Thankfully, the bullet did not touch any important structures. It only did a small amount of soft tissue damage, finally coming to rest just below the skin's surface. It was relatively easy to remove the bullet, then the wound was thoroughly cleaned and damaged tissue removed.



After that, a drain was placed and the entry wound was closed. This quiet woman from the mountain smiled after it was all over and promised to return on Monday to take out the drain and check for any signs of infection.


She returned as promised today. the drain was removed. The wound is healing nicely. The woman's only request was a before picture of her leg with the gunshot wound so that she could show her pastor the lengths she is willing to go, to be present at church. Nothing like living in the wild, wild west ... of Honduras that is!