I feel incredibly blessed to do the work we are doing. I am continually reminded what a great privilege it is to be in the lives of the people we serve. There are, however, days when the challenges and difficulties feel really heavy.
This has been a particularly challenging week for our team. Here are a couple short stories that speak to the dedication and commitment of our amazing team -
Tres Hermanos: We have three brothers who have lived in our home in the city of Ica for a number of years. The brothers - I will protect their identities and not share names - desperately want to build a life that includes school and work. For the past few years, they’ve been in a holding pattern - awaiting a signature from their mother to move forward with their lives. All we have for the mother is a nickname. She lives in sprawling squatter community of over a million people in the city of Lima called San Juan de Lurigancho. She works as a prostitute and sleeps in different places each night. We desperately need her to sign the birth certificates for the children, in order to get them formal entitlements. She refuses to sign the documents. She is afraid that signing means the children will be sent back to her (even though the boys have not lived with her for over 10 years; and, she has 7 children all living in homes like Casa Girasoles). Her life is so chaotic and fractured. She is paralyzed with fear. Our social worker had to walk street to street in the last neighborhood the boys remember living to find her. When she finally found the boys mother, she was drug affected and fearful of the implications of the criminal charges (she has a number of denuncias - similar to warrants). She refused to sign the paperwork. Not to be deterred, the team is already working on a plan to spend the night in one of the staffs car to be in the area where the mother lives. They won't give up. This, I am certain.
Sr. Roberto: This past January we were helping a partner NGO with an outreach project in a rural mountain community in the Sacred Valley. One day, while wandering around the community with a professor from a university, a women approached and asked if we would go with her to see her husband. She, speaking in Quechua, wanted someone to help her husband "get out of bed." Thankfully a number of team members on the project spoke Quechua. So I grab my medical bag, a nursing student and a Quechua speaking guide and we hiked the almost hour to the family home. There, lying on a bed in a cramped, dirt floor room was Sr. Roberto (not his real name). Through a convoluted conversation in Spanish and Quechua, and a review of a number of documents from various hospital visits and clinic appointments, it was determined that Sr. Roberto was suffering from ALS (amyotrophic lateral sclerosis). Worst of all, he and his family were completely unaware of the diagnosis, prognosis or next steps.
He pleaded with me to help him get to a neurologist. I assured him I would do everything I could. I left money with the family for food and clothing and promised to return the next day. That night I put together a referral letter and a plan of supportive and palliative care. We decided the best course of action was to advocate for Sr. Roberto by getting him seen at the regional hospital in Cusco - a complicated process that would involve visiting the local health post in a community about 15 kilometers from their house. With no money, no mechanism for transportation and only a modest level of Spanish language skills - we knew we had to be the advocacy for Sr. Roberto. What followed was a complex set of arrangements, a hospital system that refused to see him and a lot more questions than answers.
Fast forward to this week and our team was back in the Sacred Valley to visit our Casa Girasoles home. We decided to revisit with Sr. Roberto. We were told his brother had taken him to a private hospital. After almost a full day visiting a number of hospitals and clinics, we finally got a phone number for Sr. Roberto's brother. He was not in a clinic or hospital - but at his brother home. We packed into a car and made our way to the family home. Inside a small, dimly lite room that was primarily designed to store farming supplies, was Sr. Roberto. His condition has greatly deteriorated. Through a complicated and very emotional conversation we talked about the diagnosis, prognosis and next steps. We talked options for care. We talked about what Sr. Roberto most wants. He told us he wanted to go home. He knows, however, that his single room home - without running water, a concrete floor or hygienic areas - is not a great place He wants to know his children, he and his young wife have three, one girl only 7 years old, have a future. He wants to die at home. We talked for a long time. We laughed and cried together. We decided we would build a plan. And, well the HBI team - in partnership with our colleagues from the Minneapolis-based NGO Andean Community Partners, are going to do whatever it takes to help Sr. Roberto to find the dignity and support he deserves.
This week has been tough. One thing is clear - we won't give up. There is too much at stake. The one thing we have in abundance is our dedication. I am so proud of our team!
I want to vote in Perú. Last week, Sunday, was a special national congressional election. Always Sundays, which seems much more reasonable than our workday Tuesdays. With high level corruption rampant, politics are more of a mess here right now than in the U.S., if that’s possible. The entire congress had been dissolved a few months ago and everyone was up for election. Voting is required in Perú and the alternative is a modest fine, though those my age and older are excused if they wish, dottering as we are.
We discovered that our 4th floor Arequipa corner apartment on the edge of old Yanahuara was immediately across from a polling place in a school, and while sipping my coffee at 7:30 in the morning I noticed a young woman, dressed in army camo fatigues and carrying an automatic weapon. She had placed herself near the school entrance, as large ballot like signs were hung and polling workers began to show up. Looked very official if not threatening. Simultaneously, in counterpoint, two ice cream vendors arrived with bright yellow push carts sprouting large umbrellas. Subsequently, two blocks were cordoned off as police redirected inconvenienced motorists at each end.
Voters straggled in, more, and more, and more until the two blocks were full of at least a couple hundred people, kids, families, everyone. The ice cream vendor count had swelled to seven and there was music from somewhere and a lady with her grill stoked up selling roasted potatoes and anticuchos, marinated beef heart medallions on skewers. At the other end another enterprising woman, Manuelita, laddled her adobo from a big pot, a classic Arequipean Sunday morning dish featuring a rich spicey chili like broth with chunks of pork and onions. One of my favorites.
A party ensued, clearly way more fun than my polling place at the Jefferson School gymnasium in Menasha, with somber citizens waiting quietly in line to consider the least offensive of uninspiring candidates. I vote YES for adobo!
I really like Father Richard Rohr. His wisdom is so profound.
Father Rohr speaks eloquently about the concept of stumbling over the stumble stone. In his book Falling Upward: A Spirituality for the Two Halves of Life, he talks about the importance of stumbling stones as metaphors to help connect with purpose and meaning. He talks about the power of “stumbling downward” in order to move upward. Father Rohr describes the stumbling stone as a “rock that can bring you down into a larger freedom from your small self.” Rohr is calling us all to a transformation. A transformation that will bring us to a place of deeper life work. I feel like HBI is at a place of great growth – and the stumbling stone is deeper understanding of the true impact of our work.
We started Health Bridges to create an organization whose mission is to help build connections. Our focus is bridge building. We build models of care delivery - to act as guide posts for others to use to foster better health. In some instances, this has meant identifying and securing financial resources. In other instances, supporting our partners through training and subject matter expertise. And, in even others – we’ve been a collaborator to walk alongside our colleagues in the work they do.
All of our efforts have been predicated on the belief that the best way to make a difference in the world is through deep collaboration. I believe this wholeheartedly. And, for HBI this has meant a focus less about “doing” in our work and more about supporting the doing of our partners.
The other day an HBI staff sent me a link to a blog post. The post, written by an evangelical missionary in Cambodia had a big impact on me. In very eloquent terms, the author discussed the conundrum that exists when people want to “change the world” – but aren’t fully mindful to the impact of their efforts. He talked about the secondary effects of flying halfway around the world to deliver direct services in developing countries, without addressing the need for training in-country professionals to do the same work you are doing in your outreach efforts. He talked about the seductive allure of “doing stuff” and the need to strategically consider how our “doing” can actually have a greater impact when it is linked to local initiatives and in-country organizations. Most of all – the article was a wake-up call for me to reconsider how we support and collaborate with our in-country partners.
While I agree with the author, I am left feeling there’s another way to think about the challenge. To borrow from Richard Rohr again - we need to break from dualistic thinking or the notion that there is any one right or wrong approach to anything. Rather, Rohr points to the enormous “both-and” opportunities that exist all around us. This leads me to the belief that there is another way to think about our role in international development: Yes, we must be focused on preparing and advancing local capacity. This means training and supporting the next generation of change agents. It means looking to local leadership over international consultants. It means partnerships. It means investing in relationship development.
Time and time again the element that makes programs and projects most successful is not technical expertise or sophisticated staffing, or even money (as strange as that may sound). The secret ingredient that makes international projects most successful is relationships. Deeply developed, mutually respected relationships. And the act of cultivating and nurturing such relationships takes a great deal of investment . . . and a fair amount of strategic “doing.”
His Holiness the Dali Lama once said, “Learn and obey the rules very well so you will know how to break them properly.” There are no rules for the work HBI does. Certainly, there are best practices and years of research to support certain interventions over others; but the simple fact is – there is no one way for relationship development and social justice work.
So now, as I consider who HBI is in the next phase of our growth and maturation, I am reminded that stumbling over the stumbling stone is an opportunity to truly grow. I am drawn to really consider how we can use our resources to the betterment of the in-country partners we support and trust. And I am re-reminded that sometimes the “doing” of our service is more about supporting others to do and walking alongside them as they request.
Thank you for your continued support of HBI.
Beauty is all around us.
Its striking how often that beauty goes unrecognized.
The other day I was running in Lima. I ran up a long ramp that exits from the beach and ascends 200 meters to the ridge above the coast. The vast majority of the time I am on that run course, I see very few people. In the summer months, January through April, there tend to be more runners and walkers – as vacations abound.
That day, a father and his son were running together. The boy, not more than 8 years old, was trudging alongside his father with a look of pained exhaustion. The father, for his part, had an equally uncomfortable look of frustration.
I caught eyes with the father. I gave him a thumbs up. I said, “Wow, this is excellent. So cool.” His demeanor instantly shifted. He reciprocated my gesture and ran on.
Seeing the father and son on a run. Engaging with the father. It was beautiful. Little things like this give me great reason to pause and re-remember – the most important things in life come from relationship. From connection.
Our work, it’s connecting work. This past couple of weeks we’ve had a group of students from St. Olaf College. We’ve spent time helping them gain an experience through our unique practice of global public health – through the practice of connection. They’ve been immersed in the community of Alto Cayma. They’ve spent time with our partners. They’ve participated in our some of our project work. Whatever they did, we hope they will walk away from their experience with us having a better understanding of the beauty that exists when we invite ourselves to be in connection, in relationship, with others. We hope their time with Health Bridges gave them an opportunity to engage and experience the beauty that exists all around us.
We are in the beautiful Sacred Valley of Cusco working with the NGO Andean Community Partners and St. Olaf College. For the past few years, we’ve been invited to support ACP and St. Olaf on a project they have facilitated in the community of Huilloc. They've been working in the community for almost two decades; however, in 2017 they made the incredibly important decision to really shift-gears and move toward more sustainable models of services. This is where HBI has come in. They've asked us to be consultants to their work, helping to identify ways they can work more sustainably with the community. This is our third year in such a role. It is a very humbling experience. I learn so much every time I am here. Perhaps the greatest lesson is one of humility.
I continue to be reminded that communities are their own best change agents. Every day they live with challenges and constraints. Every day they are faced with finding creative solutions to address or overcome their challenges. It is only through cultural humility and attentive listening that we can best support them to build their own desired futures. This connecting of the dots work, it’s all about humility. It’s all about seeing things through a shared vision. It’s about stepping out of the role of an expert and into the role of a learner.
Yesterday, after a full day of outreach – I decided to run the 12 kilometers back to the hotel. The run, one I have done many times, is one of the most beautiful runs I have ever taken. The landscape is breathtaking. There are trails everywhere. And, if you know the trails – you can run from the community of Huilloc (at almost 12,000 FASL) to Ollantaytambo in a little over 2 hours, all on trails. However, the trails are tricky and hard to navigate. Such was the case for my run yesterday. I started out with the goal of running on the trails the whole way. About an hour into the run I was lost. I found myself on a trial that dead-ended into a field. With no-where to go but back down the trail, I clamored my way to the next trail I could see. The problem – this trail required that I cross a river . . . and, I could not find a bridge or passage any-where.
Serendipitously, I ran into a little girl playing in a field. I asked her how I could cross the river. She replied, with as bewildered look, “on the bridge.” Much to my dismay, I could not find a bridge. I looked everywhere. I once again asked her where is the bridge. Looking a little frustrated at my ineptness, she said she would take me to the bridge. She then led me the 100 meters to the bridge and said, “here is the bridge - exactly where I told you.”
Well, this bridge was really nothing more than a few logs strapped together. I guess I wasn't looking for the right bridge. In this work, the work of global health or community support – I am forever reminded that I need to change the way I see things. I need to re-adjust my vantage point to see the opportunities through a different perspective.
There are bridges all around us . . . they just look a little different depending upon what you are accustom to seeing . . . and how you allow yourself to see the world around you.
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.