For the Reading

Tracy Kidder's story on Paul Farmer grabbed my interest and got me hooked on anthropology in reference to poverty and disease. Some other books that address health and human rights in an interesting way. . .

Mountains Beyond Mountains, Tracy Kidder

Pathologies of Power: Health, Human Rights, and The New War on the Poor, Paul Farmer

Infections and Inequalities: The Modern Plagues, Paul Farmer

The Bottom Billion: Why the Poorest Countries are Failing and What Can Be Done About It, Paul Collier

Where there is no Doctor: A Village Healthcare Handbook, by David Werner
(this one deals with health on the field with limited medical resources, a fly-by-the-seat-of-your-pants guide.)

Herbal Medicine in GC

To what level does herbal medicine play in the healthcare of Guadalupe Carney? Throughout the surveying, one name, Maria Suela Mejilla, came up repeatedly. Maria, one of the last traditional healers in the village, chronicles information passed down from respected healers and runs her own business making herbal medicine in the form of capsules, tonics, elixirs, and tinctures. I decided to pay a visit.

A half hour later I arrive at her hut, an outlier in the 450-family
community of Guadalupe Carney. Her distance affords her an expansive backyard that quickly turns into jungle. Herbs, weeds, vines, Maria strolls and plucks up plants with the same familiarity I shop in the produce section of Fred Meyers. Quebra pedra, Absinthe, hoja de aire. . . For a moment I’m lost in the luxury of a backyard pharmacy.(pictured to the left, Hoja de Aire, ground and made into a paste as a chest rub for asthma.)

Beyond making medicine, Maria teaches classes on practical health topics. One of the many resources she uses in her work is Where there is no Doctor the ultimate survival medical guide covering everything from delivering a baby in the middle of nowhere, to flow charts determining the cause of diarrhea.

The surprising part? “Not many people use this kind of traditional medicine anymore,” Maria shrugs. “Chemical medications are cheaper because of socialized medicine. People find that chemical meds bring quicker recovery, and we find that less and less of the village come to a traditional healer for treatment.” It seems that even the removed community of GC is not immune to the instant-gratification complex that characterizes this age.

At first it seemed counterintuitive that a village nestled in nature can't afford natural medicine, but then it makes sense, because in a way, the "natural" lifestyle in Portland is more expensive. In the same city bottled water became this symbol of healthy hyperindividualism, an "ipod for your kidneys", herbalized medicine had grown madly in popularity, everywhere in the Northwest community. And 38% of American adults use complementary and alternative medicine, including acupuncture, herbal medicine, vitamin therapy, and biofeedback. Irony that herbals fall low on the priority list for GC? Maybe. . .

In the Garden

A few plants common to the region, and their uses:

Quebrapiedra or “stone-breaker”

Used primarily to treat kidney stones, or renal calculi. Villagers use this superfood by steeping the leaves and making a tea of it.

Ajejo or absinthe wormwood

Used in herbal medicine to treats fevers, cramps, stomachache and

also used to expel parasitic worms (they use for malaria). Also serves as an antispasmotic and antiseptic. The oil is used to improve circulation. Best known in its liquor form by the same name.

Noni: A super-antioxidant that boosts immunity and energy levels, fights high cholesterol and diseases like cancer and gastritis. Used to make juices, tinctures, and tonics. (to the right; immature noni fruit)

Meet the Missionaries

The sewing school, a micro-enterprise started by Diane Karper. Diane works with the ladies in the village to develop their skills into marketable products which are sold in a local co-op.

One of the highlights of this trip was meeting Scott and Diane Karper ( listen to a segment about their work on NPR) , missionaries who've dedicated their lives to working with the people of Guadalupe Carney teaching them animal healthcare and earning income. I was really impressed with Diane's emphasis on implementing sustainable change. Scott, by educating farmers on animal care, helped turn the village's struggling population of sickly cows to a healthy 1400 and a thriving milk and cheese industry thats been a primary source of income to Guadalupe Carney. Diane works with the village women developing crafts which they then sell to earn money for food and other necessities.

a different normal

"Across all barriers of land and language, wealth and poverty, knowledge, ignorance, we are sill one, created from the same dust, subject to the same laws and destined for the same end. With this compassion you can say, "In the expression of the oppressed I recognize my own face and in the hands of the oppressed I recognize my own hands, which speak of powerlessness and helplessness. Their flesh is my flesh, their blood is my blood, their pain is my pain, and their smile is my smile. Their is nothing in me that they would find strange and there is nothing in them that I would not recognize. In my heart, I know their yearning for love, and down to my entrails I can feel their cruelty. In another's eyes I see my plea for forgiveness and in a hardened from I see my refusal. When someone murders I know that I too could have done that, and when someone gives birth, I know I am capable of that as well. In the depths of my being, I have met my fellow being for whom nothing is strange , neither love ,nor hate, nor life, nor death."

Henri J.M Nouwen

I sat on my hotel bed flipping through the interview questions. "The 5 most common causes of death . . .The number of women who have died in childbirth each year. . . the number of disabled. . . incidence of malaria, tuberculosis, aids. . .the number of children less than 1 year old that die each year" seriously. Nothing like a good icebreaker. The first day was the project of just learning how to ask questions in a way that conversation could flow well. The hospitality shown was humbling, the responses. . . surprising. Almost everyone has had malaria in the village, but because of the socialized medicine most have been able to recuperate by purchasing pills from the local health clinic for 5 lempira/pill (cheap). Most suffer from p. vivax (the less harmful form) but p. falciparum, a deadly strain, is also common. And the most common cause of death. . . getting hit by a car. Flood season comes and when village roads turn to rivers, villagers are left with no choice but to use the nearby highway to go to and from school. 18 children have been killed since 2000. "They die like animals," says one father. Drivers don't even stop, due to the risk of confrontation with families (death by violence/scuffles/breakouts with is also common)

Since we wrote the grant for the project, there has been some political tension in the village. Guadalupe, once a land reform, was bought and taken over by a wealthy Honduran government commissioner in 2000. Long story short, conflict in late 2008 caused villagers to surround the commissioner's house and burn it to the ground. This didn't go down well with the commissioner, who was in another one of his houses during the protest. He blacklisted all of the village's influential leaders and council members, prohibiting them from leaving the village to get jobs at the penalty of death. 2 people tried to escape earlier in January, but were apprehended and incarcerated, awaiting execution . Diane, the missionary, got in contact with amnesty international and they got involved, delaying further action. The villagers are still imprisoned but alive. The stress from this situation has shifted the main concern of the village from the issue of drainage to the need for freedom. The presence is evident there. . .every day we stop at a barricade to get searched by battalion officers before we can enter, and must also pass the same checkpoint to exit.

The Trip Begins

Welcome to Honduras, or the depths. Columbus wasn't a fan. Not surprising after checking this week's forecast. Rain every day. True it is rainy season, but its the best time for the assessment to understand the most stress that the drainage system we want to implement will face.

So here it is. . .a really dry summary of the project. I’d give you better, but being as we're leaving in 4 hours. . .

“The community of Guadalupe Carney, Honduras is in need of a drainage system for a storm water runoff in the village. The hope is that the system will reduce the incidence of malaria and dengue fever in the community, and improve all modes of transportation within the community (walking, bikes, cars, and trucks). With proper maintenance a system could continue to benefit the community for years to come.

The site assessment will locate where the drainage problems are and develop a plan for the village. It will require a combination of structures, such as cement slabs that water flows over, culverts with headers, and box bridges. There are many streams, creeks, and run-off ditches throughout the village. When roads and walking paths are constructed, it is done during the dry season, and little thought is given to drainage. When rains come, stagnant water builds up above the roads and paths.”

The exciting part of the trip?

We know nothing.

From a goal-setting perspective, you pretty much can't screw things up. We've planned and proposed, but once we go down, all of the maps, photos, graphs, and relayed information are out, and now we get to be in the community. This trip, hopefully, is the springboard for a 4 to 5 year project.

With a differing background in public health, my interest in this trip is steered toward the community members and the health system (or lack of ). For four days we will be talking with the community and learning as much as we possibly can from what areas are most important for drainage to their understanding of disease and transmission. Bethany, Teddy, Jaci, Carla, Alex, and Patrick will be talking with villagers, and assessing and surveying the land to plan out priority areas . Engineers without Borders provides a mandatory health assessment as a guide for making sure that we are in touch with the community.I’m bringing outside questions specifically about the water and its role in the community, to submit a 250 word abstract to submit to the upcoming American Public Health Association conference in November, which this year treats the theme “Public Health and Water.” Really, the point of the survey is to understand how the community treats health. What does it mean to be healthy. Who treats the sick. Where do they think that this disease comes from and how do they work to prevent it. Who controls the water, where the system runs, where waste ends up, the average water use per family. . .these are all things we know nothing about.

Anyways, off to pack.

Hasta nos vemos :)