Wednesday, August 3, 2011


Now that I have access to reliable, high-speed internet, I have gone back through the blog and inserted pictures from my travels. Small changes may continue to occur, such as the fixing of grammatical or spelling errors or the addition of more photos and links as they become available from others who were on the trip. Thank you for reading.


Tuesday, August 2, 2011

The End (July 31)

At breakfast in the morning, I met an interesting man named Wes who was with a group at our hotel called Blue Line Ministries International, a small American organization working with the police, military, and politicians in efforts to eliminate corruption from Honduras. “It’s a goal that seems impossible and unreachable. We want to completely turn the country around,” he said. Apparently, the police and military have quite limited training and even more limited access to counseling services, despite routinely facing extremely difficult situations. The organization also combats child trafficking in the region, and is currently on a ten-day trip to work in a few Honduran orphanages. “Our leader, Ken, who to me will always be Pastor Ken, is the kind of person who can see people and get them to open up. Of course, there is resistance everywhere along the way. He frequently receives death threats, and the places where he stays are often attacked and broken into,” he added.

We finished the conference in the morning with the remaining student presentations and then prepared to leave. During our shuttle to the airport, however, a cargo cable broke on the top of the van and one of the soft bags, containing a computer, fell off onto the highway. Luckily, the car behind us was able to stop without running over the bag, and we were able to retrieve it.

At the airport, I said my final good-byes to many people with earlier flights (mine was the latest), but Roger and his sister came to visit us one last time before we left. They gave me a nice Honduras t-shirt and a personalized keychain with my name on it as parting gifts. Suddenly, however, we were kicked out of the check-in line we had been waiting in for well over an hour, because the computer system was down. “Welcome to Honduras,” Roger said, annoyed.

Now waiting until 2:30pm to check-in, the few of us with late flights, including Dr. Malkin, went to get lunch with Roger and his sister before they went back home. Finally, the time for our flight came, and quite by chance I was sitting next to Leah, who had worked in Roatan.

On the second flight, which departed from San Salvador, I was seated beside a woman named Cora and her 10-year-old daughter Clara who were Canadians. We had a very interesting conversation, and after discussing things such as from what and where we were returning home, she asked about where I went to school. “Oh, yes. Ronald Reagan?” she replied, “I know all about him. We learn about American history in Canadian school.” “Well, we don’t learn Canadian history in America,” I responded. She laughed, “That’s because there’s nothing to learn. Really, not much goes on. Canadians are content to be followers while the U.S. leads. But, at the same time, we can go anywhere in the world with our Canadian flags and everyone loves us. You can’t do that.”

Cora’s own story was also interesting. “I’m a single mother, but when I had my child, I decided that it didn’t have to mean I would stop traveling. So every summer, we go somewhere in the world. Clara here is a little world traveler; we just spent three weeks in South America and the Amazon. I started out small at first, but I worked hard and am now what you might call a successful corporate banker. We might be opening up some branches near where you live.”

On the third flight, from Guatemala City to Chicago, I was again seated by Cora and Clara, but this time in a different row. We were in the same plane as well, but had to remove ourselves and our baggage from the plane for a security check and drug search. In the aisle across from me was an interesting person named Ian, who works with the Institute in Basic Life Principles in Chicago. While the ministry was hosting seminars in Chicago to teach about the spiritual, physical, and economic effects of emphasizing family and moral values in a society and culture, some Peruvian leaders who attended the conference were so impressed that they invited the group down to Peru for five days to meet with government officials.

A woman in front of us turned around and said, unconvincingly, “I’m sorry. Your conversation is louder than my headphones,” expecting us to stop talking. Of course, she was actually just uncomfortable with the content of our conversation, as we were not at all loud and she did not even wear headphones during the flight.

Finally arriving in the States was a bizarre feeling. Waiting in line for customs and immigration, a cheesy welcome video played, with stereotypically American images. The film of steel mills, people fishing, wild horses and buffalo, the Rocky Mountains, and a few skylines climaxed with the Statue of Liberty and a faded American flag waving in the background. Of course, I ecstatically drank in the propaganda with my mouth gaping open. At nearly 3:00am, my family awaited on the other side of the doors with a sign reading ‘KLINE’. I was not yet in my house, but I was finally home! Later, I felt foolish for asking in response to my thirstiness, “So, does the hotel have drinking water?” “Uh, yes,” Paul said.

The Conference (July 30)

At the hotel in La Ceiba, we woke up well before 5:00am to ensure a spot on the private bus to San Pedro Sula and then to Tegucigalpa. Although more expensive, using the private bus company is much safer than the public busses, involving many security precautions. To begin, a passport for foreigners or national I.D. for Hondurans is necessary to purchase a ticket. Also, luggage is checked-in and can only be retrieved with the proper tags at the destination to protect against theft. Then, we as well as our hand baggage are meticulously searched for weapons before being allowed to board. Finally, a photo is taken of each passenger and is likely run against a database, an act that greatly discourages anyone with a criminal record or outstanding warrants from ever trying to get on the bus. The busses are direct, making no stops, further lowering the risk of assault or criminal infiltration. Our tickets for the ten-hour ride were $25, about twice the cost of public busses.

All of this may seem a bit silly, except that bus violence in Honduras is a real threat—and common. Since Tegucigalpa is the capital city, many tourists, loaded with all of their luggage, go there at the end of their journeys to fly out from the international airport. The early morning busses are even more likely to be filled with tourists, making them especially enticing targets for some of the most dangerous street gangs in the world. For instance, a little over a week ago in Trujillo, a small coastal town of 30,000 people, a 5:00am bus leaving for Tegucigalpa was hijacked by robbers. The bus driver initially ignored the demands of the gunmen, who wanted him to stop the bus so that they could load everyone’s luggage (and wallets and purses) onto another vehicle. Gunmen responded by shooting and killing the driver of the moving bus, and they then turned their weapons on the passengers, killing and wounding many more, including a young child. The dead and wounded were rushed to the hospital in Trujillo, where they were seen by Anjuli and Mindy, an EWH team working at that hospital. Though the danger may seem spread over the size of the country, a per capita relation may bring some perspective. Honduras is home to 8 million people, which is roughly the number of people living in the Chicago metropolitan area. Did Chicago have a fatal bus hijacking last week?

Finally arriving in Tegucigalpa early in the afternoon, the first thing I noticed was the temperate climate. At a high elevation in the mountains, the city enjoys cool weather, though every major rainstorm triggers dangerous mudslides and rockslides on the mountain slopes.

The conference was opened by Cathy Heck, one of the founding members of EWH. “We’re very thankful for the work you all have done this summer and hope that in some way you will keep in touch with us and continue to be involved. We know that all of you are going to do great things, and you are our program’s best ambassadors.”

Her openning was followed by Dr. Malkin, who gave the following address:

“Right now, all of your are in stage five of culture shock, the exciting period when you first begin to reenter what you consider to be normal life: running water, hot showers, people speaking English. The bad news is, this stage doesn’t last long, lasting only to about the point that you pull into your driveway with your mom. ‘Wow!’ you exclaim, ‘The toilet here flushes!’ ‘Yeah, that’s nice’ your family replies. They can’t understand what it’s like for you to be back, and you’ll want to keep telling stories about your experiences long after people no longer care to hear them, which can be very discouraging. This is the sixth typical stage of culture shock.

"So I want to start the conference with two short stories to help you focus now and to get through the difficult times that are coming. I just came here from Guatemala, where EWH does work with a high school program for kids who want to pursue careers in neonatal medicine. I was also there last year, where I met a young girl with jaundice who was born premature. Of course, this can be treated quite easily with biliruben lights, which intensely shine a particular frequency of light at the baby’s yellowed skin, breaking up the toxic substances into components that can be safely handled by the body. Today, that little girl would have been a year and four months old. But she’s not—she died. She died because no one had fixed the problem with bili lights, so there was no way to treat her.

"The second story is also from Guatemala. With the high school program, we visited a clinic in a small village to work and observe some childbirths. Traumatizing to the students was watching a birth which not only was a stillbirth, but which was soon followed by the death of the mother from hemorrhaging. Now, let me ask you, why did she die? Hemorrhaging is the number one cause of childbirth mortality in mothers, and the hemorrhaging itself is usually caused by elevated blood pressure. Early in the pregnancy, when warning signs of future hemorrhaging are detected, the mother can be treated preventatively with a good chance of success, though the treatment cannot be given to mothers who are not at high risk for hemorrhage. But, like so many other clinics throughout Guatemala, this one did not have even a single working blood-pressure cuff. If you can’t diagnose, you can’t treat.

"Now, the tragedy here is not what I want you to take from these stories. Instead, think about the difference you’ve made. I’ve already talked to many groups who repaired bili lights, and that repair is going to save thousands—literally, thousands—of infants. Also, I’ve already spoken to many of you who have repaired blood-pressure cuffs, each of which can prevent the deaths of dozens of women. Remember that when you start having trouble adjusting to home.”

We had many student presentations at this point in the conference, including PowerPoint presentations, videos, scrapbooks, and our posters. This was an exciting opportunity to learn about the experiences of the other groups, and although each group had vastly differing experiences, we were quite able to relate to one another in them. Memorably, one group was almost electrocuted, but luckily only melted their screwdriver instead. Another group, despite following safety precautions, was the victim of faulty wiring, which shorted out and caused a brilliant, sparky explosion “like the Fourth of July”, as the Hondurans said. The electrical current and heat involved were so great that the switch which initiated the ongoing issue of fiery sparks had actually now been melted into the “ON” position. The group then had to scramble for a way to cut power to the shorted circuit.

Other speakers included a man from Mozambique who was representing an international health federation closely allied with the United Nations and the World Health Organization. He expressed great admiration for what EWH was doing and shared with us about the work of his organization. Another speaker presented about a program nearly identical to EWH, but started a few years ago by a student responding to needs he identified by traveling, without any specific plans, to the developing world and working with great success in hospitals there. Now, the two programs are considering joining forces for greater effectiveness. The final speaker of the evening founded and runs a private biomedical engineering school in Honduras, which has just matriculated its first four alumni who are now working in various private companies. He considers the EWH BMET training program, which offers technician training at a very low price, to be a complementary, rather than competitive program, since technicians can perform preventative maintenance and simple repairs, while the engineers perform more specialized tasks.

Roger, Maritza’s nephew, returned that evening from Olanchito to his house in Tegucigalpa, and he came to visit us at the hotel and got to meet the other Summer Institute participants. After a few hours of talking and looking at the city from the roof of the hotel, I slept in Honduras for the last time.

La Montaña Pacura (July 29)

We woke up at 5:00am this morning to hike the 1200 meter mountain overlooking Olanchito. Most of the people in the homestay thought we were crazy for attempting this, since our bus for La Ceiba left at 2:30pm that afternoon and we did not have a guide (instead, Roger, having completed the climb once before, would lead us).

As we set out, one problem soon became evident: we did not have a sufficient supply of water. I had anticipated needing three or four liters of water for myself during the journey (I sweat a lot), while the others could get by on one or two. However, the gallon jug we had bought the night before “to refill our bottles” was understood by Tom to mean, “used to fill our bottles before we left,” while I understood it to mean, “refill our bottles during the hike.” The gallon had been left at the homestay. No stores were open this early in the morning for us to buy water, so I continued with only one liter.

During our walk toward the base of the mountain, we passed a heavily agricultural area of town, with cows, goats, and sheep on and along the road in various places. “This is the old city,” Roger said. “Olanchito was founded here in the early 1500s, and the old church is the only thing left now.” The new church, in contrast, was built in the early 1900s, along with the new central park and much of the city.

Finally reaching the base of the mountain, we had to cross a rocky mountain stream. Having removed my shoes, I eventually decided that letting my pants get wet was not much of a concern, considering how much I was sweating already. From the other side, we resumed the hike on a horse-trail.

Eventually we reached the half-way point, a grove of banana trees, and I began to feel something strange under my right foot. While we rested, I found that one of my hiking shoes had, in fact, broken through across the bottom, allowing rocks, sticks, etc., to protrude through to my foot. So for three-quarters of our travels, I had only one fully functional shoe.

The machetes were not quite as necessary for brush-cutting as we had been led to believe, but only because the trail we were taking had already been cut recently by others. In a few places, however, we needed the machetes to cut away obstacles. Shortly after the halfway point, we came to an impasse for horses where the trail became nearly vertical, in the form of climbable steps of spaces filled with dirt between tree roots. At the top of this stretch, however, evidence of horse traffic resumed, implying that alternate routes existed.

So far, the hike had been through dense tropical forest, muggy, buggy, and shrubby. At a certain point, however, this microclimate came to an abrupt end, replaced by an evergreen forest with very little underbrush. The air was now cool, clear, dry, and breezy with few bugs. Tom and I especially enjoyed this comfortable environment by imagining ourselves back home in the States again, while Roger could certainly enjoy the pleasant weather and sunlight.

Nearing the summit, a golden eagle that probably nested nearby flew closely overhead while filling the mountains with its calls.

At the peak, we stopped to enjoy the incredible view of the city in the valley below.

Being short on time, we traveled much more quickly during our descent from the summit, though in my opinion going down a mountain is more difficult than going up one. Controlling our speed and trying not to fall was very difficult, and besides this, I was quite dehydrated with my shoe quite broken. Several times I stopped to wring out my shirt, from which easily more than a liter of sweat dripped to the ground. Not only my legs, but also my arms, became incredibly shaky from the lack of water, and my stability in balance waned greatly as a result. The trails were extremely rocky with most of the rocks between baseball- and basketball-size, making each step precarious and painful without adequate shoes. Often, our previous steps would dislodge rounded rocks, which would then roll underneath or in front of our feet as we walked, a great hazard to our balance. Also, many of these rocks would simply start rolling as we stepped on them. But this was our only trail.

Finally reaching the city, I quickly regained strength and stability in my muscles after drinking substantial fluids, including water from a bag rather than a bottle (this is a cheaper way to buy water). At the homestay, I took a cold shower, ate lunch, and packed hastily until we left the house for the bus station with Maritza. Rather than boarding the bus, however, Maritza told the bus to wait for us to return and then drove us around on a quick farewell tour of the city, buying us each an Olanchito key chain.

Now on the bus to La Ceiba, we were shocked to be leaving the city we had come to call home for a month.

Last Day at the Hospital (July 28)

On our way to the hospital, a horse in the road appeared to be confused, trying to eat something on the pavement which was not there. Tom managed to snap a few good photos of cars braking or going around the horse, since each time the animal began to leave the road, it turned around and went back toward the road’s center. Just before reaching the hospital, we saw Yosser approaching on his bike, and he stopped to talk to us. When he learned that we were not being paid for any of our work, he was quite surprised.

While still talking to Yosser, we saw Jairo working on the roof, and he motioned for us to join him there. We then said our final goodbye to Yosser and went to work. Climbing onto the roof, we searched all around but could not find Jairo. After climbing back down, we asked other maintenance staff where Jairo was, but were told that he was still on the roof. Now back on the roof again ourselves, Esau, the oxygen tank manager, came to talk to us and take pictures. We then left the roof the usual way, by jumping off onto the giant water tank.

When we finally found Jairo, he took us down town in his truck to buy a cake for our going away party. First, however, we stopped by a local shop, where the hospital bought us Olanchito t-shirts. Next to the cake shop, we happened to see Maritza, who was helping us to plan our upcoming trip to Tegucigalpa. From Olanchito to Tegucigalpa is only a four to five hour drive through the department of Olancho. However, absolutely no busses travel on this convenient route because of the high frequency of murder, robbery, and bus hijacking. For a ride to Tegucigalpa, we must travel from Olanchito to La Ceiba (2-3 hours), La Ceiba to San Pedro Sula (3-4 hours), and finally from San Pedro Sula to Tegucigalpa (6-7 hours). Maritza called the hospital administration for us to see if we could have transportation through Olancho, but the hospital refused because of how dangerous the route was, and offered to drive us to La Ceiba. “That’s alright,” we said, “we can just take the bus.”

Our last lunch at the hospital was especially good, consisting of rice, stir-fried chicken and vegetables, and fried chicken. Thus stuffed, we waited until 2:00pm for our going away party. To begin the festivities, the hospital director rose and said, “Every year, we have a going away party for the students who come to help. We are very thankful for everything that you have done, and we hope for more students next year. However, I hope that next year we can have girls!” After the laughter died down, he continued jokingly, “Yes, every year, all the men hope for girls to come, while all the women hope for boys to come.”

After the director’s speech, the rest of the administration, one-by-one, followed with speeches thanking us for our work. At this point, I began anticipating that I would have to give a speech as well. Soon, the staff began murmuring, “Which one of them is it that speaks Spanish? Make him say something.” I clumsily gave our farewell address: “First of all, thank you for your patience with our Spanish. Secondly, thank you for all of your help with our work. The people in the hospital were always very friendly to us, and we like the city of Olanchito. Our time here has been very special.”

Before leaving the hospital forever, I ran into the emergency room to talk to Dr. Allan, who had helped us with so much, being fluent in both English and Spanish. “Yeah, sorry we couldn’t get together yesterday,” he said, “The thing is, this is where the people are.” We had hoped to discuss some things about the hospital with him for our research, but he again pulled an extra-long shift because no other doctors were available. “It’s totally fine. What you’re doing is very important,” I replied. “Anyway, if you get the chance, this is our last night here, so feel free to call us if you can. But in case you’re not able to, we want to thank you for everything and all the help you’ve given us. Because of you, we were able to accomplish a lot more than we could have otherwise.”

On the way home, Tom and I stopped at a shop to buy the much-needed machetes for the hike we were planning with Roger for the next day—climbing the tallest mountain near the city. Back at home, we packed and ate our last dinner. During the dinner, Maritza asked if I could mail something for her to her daughter and son-in-law living in Texas, because mail from Honduras to the United States can easily require more than a month to arrive.

After dinner, we went to watch a movie with Roger in one of Maritza’s apartments. From the outside, I would not have guessed how well-furnished the apartments were. When we returned, I stayed up late preparing for our departure the next day. I bought two CD-Rs at a local store and burned some of my music on each for Maritza and Roger as parting gifts. While trying to sleep, however, there was suddenly a loud noise which seemed to originate from the roof. “What was that?” Tom said, waking up. I sat still and listened before getting up to lock the door. “I don’t know,” I said, “My only worry is that since this is our last night, if anyone wanted to try to steal our stuff, they would probably do it tonight. Also, the roof is the only way in here when the gates are closed.” When the dog failed to bark ballistically, however, we were able to safely assume that no robbers were present.

Friday, July 29, 2011

July 27

Sleep last night was difficult. Around midnight, the dog, Petra, began growling and barking with unprecedented urgency, running around the patio at full speed. The amount of racket was such that I wondered if there might be another dog in the yard with whom Petra was fighting. Just then, the dog—growling, yelping, and all—slammed into the window next to my bed. This startled me into sitting up, and glancing outside I saw the little protagonist: a black rat scurrying for dear life. As the noise continued, Maritza, Milania, and La Abuelita woke up and went outside, thinking there may have been a security breach. “What happened? Did you see anything?” I was asked. “There was a rat…Petra saw it,” I said. They began laughing and said, “Crazy dog,”

In the morning I began working on the blood-pressure machine calibration, connecting the pump-bulb, manometer, 500mL container, and the machine using the four-way valve Tom had fabricated from syringes on Monday. The results were discouraging, and the true values followed by the machine’s readings (mmHg) were 0:0, 50:25, 100:88, and 200:200. If the disparity between any of these measurements is greater than 3.0 mmHg, the machine needs calibration. Unfortunately, the procedure labeled “Calibration” in the manual was actually just an accuracy test, as any adjustment to the readings can only be performed by the manufacturer. I returned the machine with a note and an explanation that the blood-pressure function could not be used and that there was nothing more we could do.  

In the office of Maria, who had ridden with us from the airport at San Pedro Sula to Olanchito, I explained the letter I had prepared for CAMO and asked if she could help me prepare it for submission by the hospital director. She checked for factuality and made a couple corrections, and then printed out a copy for me to give to the director.

After much of the morning had passed, we began to worry as to why Julien had not yet arrived and why we were unable to contact him by phone, since he had to check out of his hotel by 1pm. Although he was alive and well when we parted ways the night before, nothing is impossible here. Asking around the hospital for “another white guy”, it became clear that he had not yet arrived. When I ran into José, who had driven Tom and I from San Pedro Sula to Olanchito the first day (a long treck), he stationed a sentinel to watch for Julien at the front door and offered us a ride to the hotel. Julien happened to be leaving just as we arrived, so we brought him to the hospital in style, that is, in an ambulance.

In the back of the ambulance with Julien

Before leaving work today, we took some pictures with Jairo in front of the hospital, scarcely able to believe that a whole month has already passed. Jairo asked a random man to come help us take the photos, but he had never taken a picture before and had some difficulty doing so. Nonetheless, we have some adequate pictures of the building where we spent so much time working.

Back home, we started and finished work on our Honduras experience poster, a file that will be printed as an actual poster for us to use in our presentation to Dr. Malkin, the Board of EWH, and various donors and other persons who will be attending the conference this weekend. 

Secondary Project (July 26)

I woke up extremely early this morning, but also very hungry. When breakfast was finally ready, I was pleased to be given two tortillas filled with sausage, egg, and cheese. After breakfast, Tom and I evaluated the amount of paperwork needing to be completed for research, and decided to spend some time at the homestay working on it. After about two of hours data entry and prep for interviews, we got a call from Jairo. “Hey, how’s it going with you guys? The carpenter is here!” he said. I asked to speak with the carpenter, but just as we began talking, the phone call ended—our phone had run out of minutes.

We scrambled out of the room and took the first taxi we saw to the hospital so as to not miss the carpenter. When we met him, he had already been informed about our project to build wall-mounted patient monitor holders, so I only needed to tell him a few specifications. The price for all of this, though, was only fifteen dollars. Before he left, I asked him to talk to the people in the laboratory, who were wanting a locker to secure their personal belongings during work.

We went to the carpenter’s house to get receipts, and then back home to work on more paperwork. At an internet pit stop before returning to the hospital for interviews in the afternoon, I got a letter from Lillian to use as a template for requesting equipment donations from CAMO (Central American Medical Outreach) for our hospital, which serves nearly 100,000 people in and around Olanchito, as well as people in the rest of the provinces of Yoro, Olancho, and Limón.

We returned home to resume paperwork (bringing our laptops along around the city is not recommended) and to tell Maritza that we didn’t need dinner since Julien would be coming. “Perfect, would you like lunch instead, then?” Already sitting at the table were two set places and a large bowl of spaghetti.

At the hospital, I interviewed Jairo, the technician, as part of our research to help EWH develop a curriculum for a biomedical engineering technician training program. The questions help EWH to know how much education and training current technicians have already received, how many hospital technicians are interested in more training, and what kinds of obstacles make attending a training program difficult (e.g. distance to classes, time away from family, etc.). Until the end of the week, I’ll be doing more research like this for EWH as the organization continues to seek out an understanding of the underlying difficulties to improved healthcare and their possible solutions.

Jairo gave us a ride home, but before dropping us off, we rode in the back of his truck to pick up his wife from another part of the city. This trip was scenic and fun, and when we jumped out right by Ramon’s juice stand, we bought some more fresh juice from him. Several cars pulling out of the nearby intersection skidded their tires, after which Ramon said, “One of my glass jugs [of juice] was broken by a little rock that a tire threw. That’s why I keep a clean area in the road.” Sure enough, although dust and pebbles were all around, Ramon had swept clean an area of the road around his stand to protect against tire-thrown debris. Before we left, he gave us some traditional Honduran bread “Caballito”, and fresh green oranges. Both were excellent.

When we returned from the hospital again, I went to work on the Spanish letter, making sure that it applied to Hospital Anibal Murillo Escobar in Olanchito. Later in the evening, Roger, Maritza’s nephew, was visiting, and he helped tremendously by meticulously proofreading the letter and making changes to formalize and professionalize it.

When we finished the letter, we had dinner with Julien, our On-the-Ground-Coordinator for EWH Summer Institute activities in Honduras this year. Tomorrow, he will be visiting the hospital to speak with the director about EWH’s impact on the hospital and what future goals we should work toward.