We have long realized the most effective mechanism we have in our portfolio of activities to truly change the lives of the people we are called to serve, is training the health services providers who care for their needs.
Training is a big part of our work. We train midwives in life saving resuscitation, firefighters in pre-hospital emergency life support, and healthcare professionals in evidence-based, person-centered practices.
This past week we were fortunate to have Dr. Jessica Hitchcock join our team to provide trainings to child service providers at a number of different orphanages and homes in a truly remarkable methodology. The methodology is called The Circle of Security, and it helps parents and care providers build healthy attachments with children, youth and young adults.
Over the past week, Dr. Jessica trained the staff of a government run orphanage, care providers at One for Others Hope House, the Ines Project Health Ambassadors and team, and the staff of the Ica Casa Girasoles. Watching Dr. Jessica interact with the staff and help to open their eyes to a new way of approaching some of the biggest challenges in working with children was remarkable. She is a master trainer and a gifted intellect. But more than her skills as a infant, child, adolescent and adult psychiatrist - Dr. Jessica is a kind, compassionate, humble person . . . and this approach is so powerfully healing.
So, this past week we trained staff at a number of child welfare programs. We hope the trainings have provided the staff with new insights and a set of actionable skills. But, more than anything else - I know they have been genuinely impacted because of the amazing approach of Dr. Jessica. True healing happens in relationships - and she built relationship with everyone she met.
Thank you Jessica.
Having completed three days of training in Andahuaylas, I returned to Ayacucho, this time via private car that stopped at my direction. We negotiated a couple inches of wet snow over a high pass, as my aggressive Peruvian driver was suddenly overcome with caution. The good news was no motion sickness. The previous night the trainers and I had celebrated our successful program launch at a local bar, drinking hot cinnamon/clove tea with shots of pisco to mix in. I quit the pisco after three rounds and just sipped tea, but the decano bought a fourth round and then the waiter appeared with a fifth, on the house recognition of our patronage. It was an effective vehicle for bonding.
So, Ayacucho, a moderate size historic city in the south central mountains that seems to have improved greatly since my last visit 8 years ago. It’s the capital of one of Peru’s poorest and most rural states with greater than average newborn and maternal mortality. Some say an infusion of narco-traffic money has been a major contributor to the improvements. People have lived in this valley for at least 15,000 years, the Wari culture, followed by the Chanka, Nazca, and Inca, and finally Pizarro and the Spanish with their European diseases, violence, and oppression that decimated the indigenous population. The Spanish have been working off their guilt ever since.
The Plaza de Armas has the obligatory old cathedral on one side and the rest are lovely two story, classic tile roof colonial buildings with covered portales style sidewalks, all stone columns and arches and second floor verandas above, surrounding a wonderfully bustling public space. My hotel was on the Plaza with two foot thick stone walls throughout, a great place to ride out an earthquake but not so good for cell phone reception. There’s a delightful restaurant upstairs where I enjoyed decent coffee and breakfast in the morning sun on the veranda and a great view of the Plaza and mountains beyond.
In the center of the Plaza is a large statue memorializing General Antonio José de Sucre, on horseback, brandishing his sword. Sucre was born in Venezuela and joined Simón Bolívar’s army of liberation early on. In 1824 he lead Peruvian independence fighters in defeating the Spanish in a field beyond the pueblo of Quinoa, within sight of Ayacucho, in what would be the last significant conflict in the quest for independence through all of South America. Full circle for the Spanish as Perú was also their first colony on the continent. The city’s ancient name was Huamanga, rechristened by Bolívar in the Quechua language, Ayacucho. Some optimists claim Aya Kuchu should be translated “spirit corner,” in recognition of the city’s 33 colonial churches, one for each year of Jesus’ life. Others, perhaps pessimists, would translate to “death corner,” commemorating the Battle of Quinoa.
More recently, Ayacucho was the epicenter of Perú’s internal war of the 1980’s, catalyzed by academics at Ayacucho’s 341 year old Universidad Nacional San Cristóbal de Huamanga, and lead by Abimael Guzmán, a philosophy professor turned Maoist leader of the Sendero Luminoso guerrilla movement. The Truth and Reconciliation Commission estimates that the decade long war resulted in over 70,000 deaths, mostly poor indigenous rural people caught between the violence of the guerrillas and that of the police and military. The violence also greatly accelerated the growth of Peruvian cities as desperate people sought refuge and protection. It was a dark time in Perú. Guzmán, an Arequipan, now resides in a maximum security prison in Callao, Lima.
I really enjoyed unassuming Ayacucho and have moved it into third place among my favorite Peruvian cities, behind only Arequipa and Cusco. More ramblings from the road to follow soon.
The HBI office is in the community of Magdalena, in the vast city of Lima. Our office sits just a couple of blocks from the ocean. It's a great location, with cool afternoon sea breeze and a pleasant smell of the ocean. I really like the area. And, it is changing. Only a few years back, this area and the neighborhood directly to the north (San Miguel) were “up-and-coming.” They provided a safe place for middle class families to raise their children. Now, the coastal communities are being overrun with condo developments. It seems every other block has a new construction project. This has brought tremendous change.
One area of San Miguel that has seen much growth and development is around Calle 16. With a direct vista to the ocean and an unobstructed access to a wide green space that runs along the cliffs above the coast, the area around Street 16 is prime for development. However, the area is marked by a large concrete structure that runs a square city block. The facility is the Maranguita Detention Center; and it is one of the most notorious juvenile prisons in Perú. The government officially refers to Maranguita as theCentro Juvenil de Diagnóstico y Rehabilitación de Lima or the Youth Center for Diagnosis and Rehabilitation of Lima. Whatever name it goes by, Maranguita has a notorious reputation for street youth. It is a place that brings shivers of fear when mentioned. And, Maranguita is a facility caught in a challenging situation.
Maranguitasits at the nexus of the change in the city of Lima and a growing recognition to the need for newer approaches to juvenile rehabilitation and justice. It is a place hindered by a history of fear, and pressed by a future of modernization. In many ways, it represents the challenges of Perú. Challenges that Perú faces as it moves further and further from their “developing nation” past and closer and closer to their modern image as a leader in Latin America and one of the top travel destinations in the world. Perú is in the midst of a number of changes – and Calle 16 is a part of this evolving new story. But it is not the only story that demonstrates the massive changes.
The changes are everywhere, but what’s most challenging to understand is the increasing difficulty many communities and people are experiencing in the face of the changes. This morning I went for a run. Most mornings I run south along the coast - today, I ran north. I’ve wanted to run to the community of La Punta (the point) for years. The challenge, to get to La Punta from our office, you need to go through a very dangerous neighborhood - La Perla District.
La Perla is a community stuck in a time warp. It reminds me of Lima 20 years ago. Broken windows and crumbling buildings are the norm. The density is a bit overwhelming - with people literally stacked on top of one another in makeshift housing projects. Certain neighborhoods in La Perla are so dangerous that while running, I was instructed by more than one person toward other routes. In fact, a woman literally stopped me while I was running and walked me for a good 5 blocks out of the neighborhood.
Yet, La Perla is only a few kilometers from the wealthy neighborhood of San Miguel. La Perla sits on the same coast and has similar views of the Pacific Ocean. And, there are no condominium projects. There are no widespread efforts to repair the crumbling sidewalks and potholed streets. Rather, the children of La Perla that live in the neighborhood of San Judas Tadeo, suffer disproportionately from malnutrition, anemia, communicable diseases. Unemployment is so much higher than the sister neighborhood of La Punta (only 2 kilometers further north along the coast). And the people who make their lives in the community of La Perla die on average 15-20 years earlier than Lima citizens living in more affluent neighborhoods.
So much is changing in Perú. And, yet, so many Peruvians are unable to feel the impacts of this economic wave of development and prosperity. One thing my morning run showed me, the work of HBI is only just beginning. HBI focuses on advancing the health of communities of need – recognizing the challenges that exist now and will exist well into the future. We know that sustainability is one of the most important – and incredibly challenging – goals of our work. And as Perú and Lima changes, pockets of disparity exist. This means our work must continue. Must grow.
This morning I went for a run. I ran through one of the wealthiest waterfront development districts in Lima and through one of the poorest. I went for a run this morning and I realized how incredibly important our work is - today . . . and well into the future.
More work with the Colegio Nacional de Obstetras del Perú training newborn resuscitation trainers in Perú. In order to get to the city of Andahuaylas in the mountainous state of Apurimac, I flew into Ayacucho. Andahuaylas has a small airport, served by a single carrier that had declared bankruptcy the previous week, so we opted not to risk a cancellation. As the crow flies between Ayacucho and Andahuaylas it's only 66 km, but traveling by car is 248 km, at least 4 hours plus through the mountains.
In a colectivo with three other passengers we departed Ayacucho in the late afternoon. I had the shotgun seat in front, probably undeserved gringo privilege. The highway is new, but with constant curves (I mean CUUURVES), as our driver, Percy, drove aggressively, but well. He was a twenty-something guy with a scraggly little goatee who seemed to enjoy listening to traditional criolla and altiplano music. As we ascended, the sky turned a gorgeous orange with the sun dropping behind the distant cumulus clouds at the horizon. No rain, but cloud lightening popping intermittently. Other worldly snapshots.
We rose above the tree line, finally cresting the pass at 14,000 feet, surrounded by scattered rocks and tufts of coarse dry grass, darkness taking over. With little traffic and good highway, Percy accelerated on the way down, curve after curve after curve. Two hundred meters was probably our longest straight stretch with only the next switchback curve sign to focus on in the darkness.
The next 2 hours plus into Andahuaylas was a study in acute motion sickness, semi-circular canals going crazy. My car mates just slept, uninterested in my distress. I’ll spare you the graphic blow-by-blow but in the final 2 hours of the trip I stopped 5 times as Percy wanted to keep the car clean. It brought back less than pleasant memories of the spinning teacup ride at the Douglas County fair outside of Omaha.
Next time I’m committed to flying directly.
All too often it is easy to get caught up in the busyness of life. The “To Do” lists and endless array of errands and “got to get done” tasks. They fill our days to the point we get lost in a mindless routine. I know this all too well.
Perhaps the best way I have found to re-center, re-focus myself through this “forest and tree” interplay - is with the stories of the people we have had the pleasure of working with and serving. Stories that punctuate remarkable human spirit and relentless resilience, but always seem to be rooted in a heartbreaking level of trauma and tragedy.
I can get just as narrow focused as anyone – AND, when I allow myself to remember that everyone has a story that sits behind the “curtain” of their trials, tribulations and troubles; I can really tap into the soul of the work that we are all called to do everyday.
The work of HBI and the people we serve is a kaleidoscope of stories. Each story mixes a bit of tragedy, a sliver of triumph, and a significant amount of hope. Hope that comes through relationships. Hope that comes through compassionate caring. And hope that comes from another human being during the darkest of times and most difficult of challenges.
In Latin America when a person makes a presentation, accepts an award, or is showered with accolades – they will often say . . . “I come to you in the name of . . ." – signifying the collaboration that often seeds any activity.
Well, I come to you in name of the “shadow people” of our society. People who have for so long been without a voice. People who slip below the radar screens of our lives. People who often live in a somewhat hopeless desperation. I come to you - to empower their voices. To let them know they are not alone. To insist that their lives matter.
And most of all, I come to you in the name of hope – a hope that is grounded in the belief that we (working together with our collective talents, skills, resources and passions) can ensure that no one will ever be forced to suffer in silence. No one will be plagued by the desperate fear that comes from feeling cast out or forgotten by society.
I want to leave you with one challenge. A simple challenge, that is anything but easy. A challenge that asks you to push your personal boundaries. A challenge to consider one thing (one act, one contribution, one event, one interaction) that will you will take on this week. Maybe its volunteering your time in a social outreach project. Maybe its becoming a mentor to the next generation of social justice leaders. Or maybe its just remembering that many people in our communities are riddled with the burdens of mental health challenges, substance use disorders, and economic injustices.
My challenge may seem simple – but my challenge comes with a hidden agenda. For you see, I believe giving is more about receiving than an act of service. I believe when we allow ourselves to move outside of the day-to-day comforts of our lives, we learn more about ourselves than we could have ever imagined. I believe the best way to change the world for people living on the streets or suffering in extreme poverty is through changing the way we view this world. I truly believe we are all connected, inter-dependent . . . united.
I come to you in the name of the sex workers of our communities who live in fear and suffer from the ravages of abuse and addiction. I come to you in the name of the immigrant day laborers who struggle to navigate a world so foreign to their own. I come to you in the name of the young adults suffering through the experience of homelessness and searching for answers in their lives and struggling with an addiction to heroin and an abusive relationship. But most of all - I come to you in the name of hope. Hope that we can, and will, change the lives of these beautiful and important people – through our collective, compassionate efforts.
The HBI Blog is a rotating journal from our staff. Our Blog is a series of messages from the field, insights from our work, and lessons in service.