30 June 2010

A Doosy Of a Day, Even For Honduras

Sometimes I am just floored by the days I have here. They never cease to amaze me. Today had more twists and turns than the main road here. I will to my best to re-tell.

Standard morning. Up about 630, having set the coffee maker to have my joe ready when I wake up. There are few things finer. This morning was a local coffee, grown and roasted by an Oregon ExPat named Bob who owns to my knowledge the only microbrewery in Honduras. I sat down with my coffee and wrote down in my little book what I did yesterday and wrote a couple of emails to friends before heading down to breakfast. Last week we had 25 high schoolers plus 15-20 regular people who work and eat here. These days, it is quiet with no brigades and many people out of the clinic for various reasons. Our cook María is super contenta with only having to cook for 8 people. This also means plenty of freshly squeezed OJ for everyone. Me gusta.

I sat down to my desk to attack some emails and wait to see what the day would bring. Around 8 or 9am I get a phone call from Mo, our stateside brigade coordinator who has just arrived last night to Honduras with a few others and along with her son Brett (who works here too) they are doing some traveling around Honduras in a rental car. They are a little turned around and need directions...with the limited knowledge of the city that I have, I navigated them through the streets of San Pedro Sula. Actual excerpt from our conversation:

Mo: We're driving towards a mountain.
Me: Does the mountain say Coca Cola on it?
Mo: (after asking around in the car) Yes.
Me. Ok perfect, turn left. There will be a Popeye's Chicken on your right and then after a while a Hilton Hotel. Turn right. This is where Brett and I had to bribe the cops, he will remember it.

So that was fun, and I actually thought that would be as interesting as my day got. Wrong.

Not long after I got off the phone with Mo, the power went out. Kerri Kruse is the latest addition to our gringo team down here, an MPH from Jersey/UNC who is running our nutrition program. I ask if she's familiar with starting the generator. She says no and decides to come along to learn. We shut down the computer servers and make sure all the air conditioners are off. Then it's down to the generator, check the oil and fire her up. The machine rumbles as it comes alive. While we're doing this, a truck full of people in the back zooms up the driveway. I don't think much of it, it's not uncommon for emergencies to arrive like this.

However this one was quite interesting. Turns out some guys had been working on building a house. This guy was standing on a roof handling some re-bar, which he brought too close to a high-voltage electrical line and got seriously zapped, lighting his clothes on fire and throwing him from the roof. Now here is where it really gets potentially interesting: It was during this exact moment when the power had gone out. Initially I thought that he was for sure the cause of it, but just then got a call from some people in our site 16 miles up the road, and their power was out as well. So without understanding quite what happened or knowing the exact physics of it, it seems as if WHILE this guy was being electrocuted, the power went out, potentially saving his life! The jury is still out on whether he cause it or not, but I find it somewhat (but not completely) that this one guy at the end of the electrical line could have caused the entire power outage.

Our docs treated him and sent him in the ambulance to La Esperanza, a bumpy, hot 3-hour ride to the next big hospital. While I was downstairs I ran into Flori, our accounting assistant. She had some problems with salaries that we needed to figure out. So I spent the next 2 hours or so reviewing checks and spreadsheets to find the errors and get things cleared up. Normally this would not be my job but Nelson the accountant is on vacation so there I was. Just as we were finishing up, I get a call from Don Tino, my head driver. He is on his way back from La Esperanza, having left the night before to take a different emergency. He is calling because the ambulance driver (his son, also named Tino) has run into some problems. This is the driver that has taken the burn victim in the ambulance. From what I understood from Tino, some bolts had fallen out of the gearbox of the ambulance. This did not sound good.

So Big Tino met Little Tino on the road and swapped out the patient from the ambulance to the pick-up truck that Big Tino had been driving on his way back. Little Tino then continued with the burn victim to La Esperanza and Big Tino headed to a nearby town to try and repair it.

I finished up with Flori and accounting and then had a meeting with Alexis, one of our newer employees. We have yet to really clearly define Alexis' role, so up until now his job has been "ok Ben, what do you want me to do next." Which neither he or I like but we are trying to make do. We were just sitting down to start planning the wiring plan for our newest clinic, which we will be working on at the end of July. Again the phone rings. It's Mo again, calling from the road. Seems as though while Brett was driving on the way to Copán Ruins, a tire fell off the rental truck. As they were riding along, they all of the sudden saw a tire rolling away from their car...which then ran into a passing cyclist. I couldn't make that up.

So then I began a whirlwind of calls that included the car rental company and a few other people. I got Mo and Brett in touch with who they needed to talk to, knowing they'd have to wait a while before another rental car could be sent where they were. Kind of stinks they had to miss out on a day of vacation basically. They were upbeat about it though, saying that their day was "Ruined."

I sat down to a lunch of Fried Rice with Doris and Kayla, a nurse and doctor who just started working for us a few weeks ago. They gave me their olives which I was very happy about. I headed back upstairs for my afternoon siesta, about 20 minutes long. I then sat back down with Alexis to try and working on the wiring plan when I get a call from Don Tino, my driver. He tells me he's coming upstairs to see me. I knew something was up because Don Tino never comes up to my office.

Turns out I completely misunderstood Tino when he told me what was wrong with the ambulance. Not only that, what he thought was wrong with the ambulance was not actually the problem, it was actually a much bigger problem. So what I have been referring to as an "ambulance" this whole time is an early 2000s Dodge Ram pick-up outfitted with a camper-like fiberglass box on the back to carry patients. It has a stretcher in there, a place for an oxygen tank, a place for an IV, etc. It also has no air conditioning and very little ventilation, so it makes for a pretty hellish ride on an awful road. This fiberglass box is extremely heavy and like every other thing on earth, was not designed to withstand what the roads of Honduras had in store for it. Over time, the top-heavy box (which is attached to the bed of the truck) had pitched and yawed back and forth so much, that the ENTIRE BED had broken off from the frame of the truck. So try to picture it in your head. This big huge box is attached the truckbed. BUT, when you move the push on the bed, lifting it up from the suspension, the whole body does not move, just the bed and the box. The tire stays exactly where it was, showing no stress that it is being pushed on.

In order to fix this, the first step is to remove the box from the bed. This would require some honduran ingenuity the likes of which even I had never seen before. Using rope, pipes, 2x4s, a car jack, some plywood, a barrel and an ancient patient stretcher and a lot of pushing and shoving, we managed to get this thing out of the bed and safely supported on the stretcher and barrel. Here are the steps we followed:

Step 1: inside the ambulance box are a few release pins...fairly straightforward, remove them
Step 2: Using the tire jack, raise the back end of the box from the bed of the truck
Step 3: Run honduran rope over the ceiling perlines (like joists) and suspend the box from the ceiling and remove jack. Trust honduran structural engineering.
Step 4: Plan on using barrel to "roll" the box out of the bed onto the ground
Step 5: Place metal pipe in bed between box and bed to facilitate movement
Step 6: With two people pushing and lifting on the front of the box, drive forward very slowly, allowing the box to slide out a bit at a time
Step 7: Realize that the barrel method is not going to work. Reach for the closest next best thing, an ancient stretcher, slide it under the front end of the box, and use the barrel upright and plank to hold up the back.
Step 8: Lower the rear end of the box off of the rope and onto the barrel, move rope to hold up front end of the box using the same hanging method
Step 9: completely remove truck, leaving the back of the box supported on the barrel/plank and the front hanging by the rope
Step 10: Raise ancient stretcher up using the raise handles that work due to some miracle, raising it up to meet the box and take the load off of the ceiling and the rope.

Words cannot begin to capture the ridiculousness of this process. It was truly unbelievable. Here is a picture of the rest of the team:
Left to Right: Don Tino, Don Nato the guard, Alexis

And here's a photo of the final product. Priceless.



Throughout this entire day, the power had not come back on. The bad news was that we were out of fuel for the generator and I was pretty sure it wasn't going to last much longer. Literally at that moment, the low rumble of the generator stopped and the fans stopped spinning. Don Tino had hardly finished tying off the hanging ambulance box when I sent him to bring some diesel from his house to lend us. He promptly headed out and was back in a jiffy. We loaded it up and bled the lines like a good mechanic does when the fuel runs out and we were back in business. The power finally came back on around 8pm tonight, so at least I don't have to worry about finding more fuel.

Never a dull moment around here.

13 June 2010

The Same But Different

It's Sunday morning in Concepción. It's been raining all night, and for a good while there it was pretty torrential. All the roofs here are made of corrugated tin, so even a light rain sounds like a herd of thundering rhinoceroses (or rhinoceri for all you Hanauers out there). With a heavy downpour there is little hope of talking to anyone you may be with, so we've gotten pretty good at sign language.

Sunday mornings here are just about the most pleasant part of my life in Honduras. Our clinic here has not opened yet, so there is no hustle and bustle, no babies crying downstairs, no one telling me that the internet isn't working. The view from this back porch is immaculate; brilliant white fog burning off the mountains as the sun inches higher in the sky. It has been raining pretty steadily for about 6 weeks now, so the white of the fog contrasts nicely with the bright green of the newly refreshed plantlife that covers the nearby hills. A nice hot cup of locally grown coffee and some Avett Brothers coming through the speakers and I am about as content as can be. I remember really loving Sunday mornings in Bolivia as well...it's almost as if it's the only time anymore that I feel like is really my own. That sounds bad but I can't help but think it is true. Living in the same place I work with the people with whom I work makes it feel like every moment of the day belongs to Shoulder to Shoulder. By no fault of theirs mind you, I think it's a combination of there being so much work to get done and not too many other ways to pass my time. Throw in my "everything needs to be working properly" mentality and it adds up to a lot of time spent on Shoulder to Shoulder. Even our post-work conversations end up being about community development or how to improve this project or what would it be like if we started doing that...this creates the feel that we are indeed ALWAYS working, although we may not be sitting at our desks or distributing water filters or whatever. A good friend asked me the other day how I feel about being a "development professional." It made me chuckle a little to think of myself as a professional anything, but that has marinated a little bit and I guess even though we don't dress nice or have to commute or worry about TPS reports, we kind of are professionals. It's got me wondering whether this could be a "career" or not.

So that amongst other things is what is on my mind this lovely sunday morning. I am not sure if folks even stop by to check in on this blog anymore...with all the iphones and twitter and all that it's almost like a blog is passé, especially one that doesn't share news or opinions. Nevertheless, I want to start updating it more and hopefully develop a refreshed following. You all may start hearing more ranting and raving about work, but know that having this outlet to rant and rave perhaps keeps me a little more sane. I do have a lot of fun stuff to report on, including 2 weeks spent in Seattle, hanging out at a Honduran microbrewery and playing cornhole inside until my arm was sore. But for now I just hope you've been able to enjoy this Sunday morning porch as much as I have. Toodle-oo.

11 June 2010

Por Fin

Hello friends...so I've had these photos uploaded for a while but just now am getting around to adding commentary. I'd like to get better at updating this thing but I've been saying that pretty much since I started it so we'll see. It's not like I don't have anything to update on, I just haven't made the time. So with the hope of more frequent posts, I leave you with some photos I hope you enjoy, in no particular order.

Be well.

-This video was shot during the consult portion of one of our children's brigades with some nursing students from the University of Cincinnati. I walked in and was struck by everything going on at once...4 or 5 consults, translating, mothers waiting, kids being attended to...I think the video does a good job of showing the awesomeness of what was going on.



A group of us moving a satellite dish. The drama with satellite dishes is never-ending it seems. Believe it or not I've learned a good bit about satellite dishes while down here. I've mostly learned that I don't ever want to see another one again.


Below is a group photo from March of an awesome brigade made up of nursing and nurse practitioner students from both the University of Kansas and Montana State University. We had a LOT of fun with this group and saw over 1000 kids in the week they were here. Even better I now enjoy drinking my morning coffee from an excellent Montana State mug. Thanks guys! (what you don't see in this photo is me holding approximately 75 cameras. This is standard practice with most groups, as it seems few people grasp the digital age.)

This is the view of our clinic "campus" in Concepción. For the last 20 years our main base has been in a town called Santa Lucía, where I live. Soon the base will move to this new, more cenral location, while maintaining a strong presence in Santa Lucía as well. We inaugurated these buildings in February and will finally start seeing patients in July

A quick ten-minute hike takes you up a hill to a great 360-degree view. A group of us from the Kansas/Montana State group made the short journey and got a somewhat rare clear shot of the mountains in the distance.

My good pal/co-worker/roommate Alex hanging out with Tina. Tina works in the UC College of Nursing and brings lots of groups down throughout the year. Alex first got involved with Shoulder to Shoulder through one of these brigades, so in a way we have Tina to thank for that.


Playing with the same satellite dish you saw earlier. This is not a staged photo, this is my Honduran version of a blue-tooth so I could talk to Art and still use both my hands. If it's one thing the third-world teaches you it's how to make useful things with little resources available.

Students waiting at a Children's Brigade to be seen. A group of 12-20 brigade members show up to a school with the goal of doing well-child visits with all the 0-15 year olds. It's a great way to hit a lot of patients at once and utilize the skills our brigades bring down.

This is the sunrise after a very early-morning hike up a mountain in Santa Lucía. I need to do this more often, it provided some hard-to-find peace and quiet for a little while.

A group of our employees after work enjoying each other's company. All are from Santa Lucía or nearby. I just thought it was a really cool photo. From left to right: Doris, Gisela, Norma, Mercedes, Raúl

We can get pretty goofy down here sometimes. A lot may stem from us being delirious...or we're all just hilarious, who knows. While setting up the newly constructed maternity center in the clinic, we found that the first baby to be born in it was quite mature! From left to right: Edgar, Brett, Alex, Seiko, Janell

During our clinic inauguration in February, the Honduran minister of Health showed up in his chopper, covering everyone with dust. If you look closely you can pick me out in the back of the red pick-up on the left. I'm the guy with the hair.

Cheap repair of the power-steering pump hose. I took a page from the book of Bolivian engineering and wrapped the hose with some rubber (like a bike innertube) and then wrapped with some duct tape. This was in February and it's still going strong.

The porch in one of the cottages in Concepción. This is where I usually crash when I have to stay the night, there is a great cool evening breeze and you can't beat the morning view.

Inauguration day with Art and Ed Zuroweste. I look grumpy likely from not sleeping. Ed has not shaved his beard in over 30 years, it's something to shoot for.

Emerging from the helicopter dust.

This photo captures what I've come to expect as a typical day when there's a lot going on. Computer open looking at email, coffee closeby, on the phone probably talking to one of my drivers about where he's headed next, in the midst of a meeting with the excellent Dr. Emily Harrison, head of our affiliate group from Brown University. We are putting the finishing touches on an outlying clinic her group built, having raised the money all on her own. Emily bought her way into my heart with gifts that included a pound+ bag of M&Ms and a Brown University hat! It was a good day.

Ranzaganza in Honduras! Left to right: Ginger, Art, Brett, Me

Enjoying the company of some good friends on a non-school night. We are quite the dysfunctional loving family down here. From left to right: Yaniré, Edgar, Juan, Janell

The day of the inauguration there were guards that showed up with the Minister of Health. When asked if I could borrow his machine gun for a quick photo, the guard did not hesitate and had it off of his neck in no time. I'm highly confident there were no bullets. Either way, Alex makes a great security guard.

Nearby the Concepción clinic is a great little swimming hole with an excellent waterfall. There is a great jumping rock and a good place to stand to get a water-massage. If it looks like I'm on the phone, it's because I am...I'm pretty sure I was in the midst of getting a truckload of 21,000 pounds of nutrition supplement across the Guatemala border into Honduras. Just another average Sunday here at Shoulder to Shoulder.

Brett and I managed a little R&R in early March...this was our stash of goodies before we set out. The trip included fresh seafood, driving for hours through trees and across rivers up a dark jungle road, bribing police officers and also stumbling upon an excellent find: a micro-brewery run by an Oregon ex-pat. Needless to say we have visited multiple times since this discovery.

Also on said journey we saw this sweet waterfall. Please note awesome braids in my hair from the beach!

The Kansas/Montana State crew giving consults on Childrens Health brigade.

This is our new friend Alicia, a Honduran Peace Corps volunteer from Seattle. Her site is near the aforementioned micro-brewery and through a random connection we managed to meet her. Alex and I got to do some hiking with her and her dog Chelsea around easter time.



These photos only take you up through early April, and so much has happened since then. All of this seems so long ago now...it's crazy how the time flies on by...