Notes from Honduras I

Feb 08 2009 Published by under Medical Musings, Notes from Honduras

In 1999, during my intern year, Hurricane Mitch struck Central America. As stated below, I wanted to become involved. The program director of my residency was kind enough to view this as a worthwhile educational experience. This is my diary from the trip.
The idea to go to Honduras came about in a way that may or may not be unusual. I have no way to judge, never having done it before. I had of course heard of the disaster of Hurricane Mitch. As I listened every day on the radio, I thought about all of the potential deaths that could be avoided by simple medical care. One day on NPR they were interviewing the Episcopal Bishop in Honduras. He was asked what he tells the faithful about what happened. Paraphrasing, "It is OK to be angry with God," he replied, then tearfully, "I am angry with God, but I know that things must come out for the best. It must. The people suffer so much, so many have been lost. I am so angry with God, but I know we can move on and continue life and faith."
I am not a man of faith, but to hear a man of such deep faith in so much pain, to hear him try to explain to the faithful why they must repeat the trial of Job, this affected me very deeply. The idea came to me the same way as the idea to go to medical school. It was something I wanted to do and I would make it happen.
As it turns out, it is not easy to put together something like this. Support is not the problem. Everyone wants to support missions such as this. But to take raw enthusiasm and puzzle out how to create something useful, this is the challenge. I called the Honduran consulate, the major aid organizations, finally my rabbi. Among other things, he gave me the name of a Vincentian friar at DePaul with connections to some of the Catholic aid organizations. He in turn gave me the name of Dr. Don Mehan of the Catholic Medical Association. Dr. Mehan runs a surgical program in Honduras but had converted his infrastructure for medical disaster relief. With an infrastructure already in place, I knew I had the number for the right person. Rabbi Gordon informed me that funding was unlikely to be a problem, so I recruited a team and we went.
To Honduras
My team assembled itself. Ty G. and Jeremy S., residents in Internal Medicine at Northwestern, and Kim Marie M., an all-around nurse from Marengo, IL, who had heard about the trip from her sister, a member of my congregation. We met at O'Hare's international check-in at 4 am on December 6. The flight was uneventful until the landing. Kim Marie, who had been to Honduras before, described in detail the landing we would experience in Tegucigalpa ("Teguz"). Her memory was very accurate. Approaching the airport the plane descended sharply, banked steeply with the wingtip visible barely 80 feet above the ground. We slipped between the mountains sideways and dropped immediately to the runway, braking violently. Despite her warning, I walked out of the plane and into the heat already covered in a cold sweat.
We stepped out of the plane onto the tarmac and walked into the shack that serves as the arrival area in Teguz. The air was mild, dry, and clear with a nice view of the small mountains that we had just slipped though. We were met at the airport by Monsignor Muldoon, the bright-faced and boisterous Bishop of Olancho, and his crew from the Caritas organization. They whisked us and a group from Boston through customs and immigration and loaded us into pickup trucks for the ride to Juticalpa, capital of Olancho, the largest department in Honduras. The younger of us were instructed to ride in the back of the trucks with our supplies so that in the crowded, poor streets of this partially devastated city we would not have anything stolen.
We were driven down to the river district to view the extent of destruction in this 300 year old mining town. The city's crowded streets looked reasonably normal until we approached the river. Beginning about a half a kilometer before the river is the mud. It had been about a month since the Hurricane and the mud had hardened into the same local cement that we would see children making into cinder blocks a few days later. Pompeii must have looked somewhat like this, had anyone survived to see it. Buildings and cars, and probably people, were entombed in the hard, red cement. In some places, cars and houses formed grotesque chimeras, permanently joined in unnatural-looking ways. Uprooted trees rested against half destroyed buildings. I was impressed by the destruction, but this could also have passed for any decaying warehouse district in the US. In the nearly deserted flood path, the human element was missing.
We crossed the river and rode up to a bluff above it to get a better look at the extent of the horror. From our vantage point the Bishop showed us the kilometer-wide swath the river had cut through the city at two in the morning. Buildings were sheared in half, cars piled against anything harder than them. It must have been terrifying. I pictured families crowded into small apartments, awakened by the roar of mud, having heard rumors passed from door to door about the rising river, not believing that this time it would mean their lives.
Descending into the city again, we passed down toward the river, the crowds growing as we neared one of the few remaining intact bridges. At its base was an ancient church whose foundation was severely eroded, with a car rudely molded to its medieval-appearing walls. And here, the human element. People were crossing the bridge slowly on foot and by car, tired-looking young women with baskets of food on their heads, young men with machetes carrying torn pieces of metal for salvage. As we inched onto the remaining causeway, the river slowly passed under us, its red surface visibly teeming with insects. Many pedestrians held cloths over their faces. My first rather unfortunate instinct was to inhale deeply. The smell of sewage and death was overwhelming. My camping and travel experience had taught me that a bandana is always useful, so I took one from my back pocket and brought it to my nose and mouth, inhaling the sweet scent of laundry detergent, wondering if the pedestrians saw me as a weak gringo arriving to document, perhaps exploit, their misfortune. On the other side of the river the water line was visible on the shops and homes, and the power lines were caked with detritus of the flood, but shopkeepers set out carts before ruined store fronts and the business of daily life continued.
Next: to Juticalpa...

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