Rolling along...

I made it through the week!! Well, that is kind of dramatic, but I am riding a wave of relief…Last Sunday, as I mentioned, the promoters came to Rio Sucio for a week of courses and learning. Since I have been here with Alan and Julie, I have known that I needed to organize and teach a course in child development. I knew when I accepted this job that I would have to teach, but to do it in June caught me a little by surprise, well…scared me to death. The longer I was here it always seemed to be a cloud on the horizon. I felt that it was a bench-mark of sorts. But I had time to organize and prepare I had helpful people around to ask questions. Today we finished the week. I spent much time reading and studying in Spanish, writing out what I needed to say, learning vocabulary, and thinking up logical class flow. I was pleasantly surprised. I know the promoters learned something from the course, but they were really patient with me and my Spanish. I had a great, enthusiastic group. Here is a photo of us on the last day. I am the one that looks kind of anemic, and also who feels like the weight of the world has been lifted off his shoulders. I know my teaching and language will get better …

Yahoo!!

We head out for more community visits the middle of this coming week. Tomorrow is reserved for laundry, cleaning the house and trying to relax a bit, but those days never seem to go as planned. And we have to get ready to move, as we are changing homes before we set out to the campo…

I began that note nearly 2 weeks ago…time flies …we have moved into a bigger space, and we just got back from a fantastic trip up a smaller river basin. We visited 3 communities. Ismael organized us and had his hands full driving the boat. Susana, John and I worked on the medical end of things. It was a great trip. Smooth. As the river was known to wind through trees and be generally difficult to navigate, we used a smaller boat and a smaller motor to make the trip more manageable. It was still pretty tight. The river was thankfully slow during that portion of our week.

As the first promoter we visited is fairly new, this was the first visit of our group to the community. We arrived at the river’s end to find that the community was another 20 minutes by foot…we quickly prioritized the medical equipment and went hiking through the mud.

We left the remainder sealed in plastic bins under a thick plastic tarp and palm leaves. The rest of the visit went well. The meeting with the community reinforced the job the promoter had been doing. We organized to see patients the following day. We normally bring staple food for someone to cook for us while we are working. Usually we eat some combination of plaintain bananas, rice, a root vegetable (yucca, carrot, potato, onion) and some protein (bean, lentil)…This is a photo of us going to dinner our first night there.

Clinic the next day was busy, but with three physicians, completely manageable. With one promoter we were able to show her anything interesting we found. That way she could learn from the three of us fairly simultaneously. We finished clinic a little early and walked through the jungle to see the rest of the community and go for a swim in a wonderful river. The next morning we packed and left very early in the morning as we had a 5-6 hour trip ahead of us to reach the next community. Back down the winding river…we saw tons of bird species, monkeys, fish…

That is a quick view into a normal community visit. Each community is unique with different issues. I feel lucky to be able to work as closely with the promoters as I do.

I am still healthy, but check out these feet!! I swear I couldn’t feel the flies that did this at all.

There as been a small debate in the house, but those in the know say the fly that does this could have laid some eggs inside of me, soon to hatch into larvae…that was over a week ago, I used some medicine and my feet have almost returned to normal. I still have the little dark dots as the blood-thinner that the fly uses caused a small amount of bleeding under the skin, which takes longer to heal...the swelling is completely gone…mom, I am fine.

We have just returned to Apartadó. Alan will be teaching a course next week and is getting ready for that. I need to plan my next course which will start in September. I also am anxious to catch up on people and news from home.

Please take care…
Brian

I have been feeling like I need to write something recently, but I hadn’t quite figured out a topic until one found me…we ate an early dinner tonight, and as the humidity and ants are doing a number on the lap-top I’ve been using, I took a walk down to the clinic to use a different computer and to get some studying done…

I received a great email from an old friend this week…we haven’t been in contact for years…she had been catching up by reading my blog posts…she thought that as I keep mentioning clergy in my stories that I must be doing a religious mission…that made me realize that I haven’t really described my work to everyone…I better set that straight, huh??

I also better straighten out the fact that despite photographic evidence to the contrary, I am still young on the inside. I have shaved since this photo and all is well.

I am working for the Pastoral Social for the Dioceses of Apartado in Colombia. This is the social arm of the Catholic Church dioceses which includes the area where I am living. We work exclusively in this regard. But I didn’t find them on my own. The support for the volunteers is provided by Concern America (situated in California and Chicago); which is a non-profit, non-religious, and non-governmental group. That is why the majority of our local contacts are church-related, but our work is not. Our work benefits the church as we improve the medical care in their jurisdiction and they help us with transportation, and occasional space for working and lodging. THAT is why I needed to ring the bell and wait for a priest to answer the door.

If what I am doing has an official title it would be a teacher and advocate for health promoters. The idea of educating local people to act as medical care-givers in a community far-removed from official medical services is not new. As I mentioned before, Susana is working with the same model in Guatemala and Juan is in Mexico. It has been proven effective all over the world. My colleague Alan created the program locally just over 5 years ago. The program has grown slowly, but steadily. He has his wife Julie and his close friend from Riosucio, Ismael, doing a massive amount of work concerning logistics and transportation; but he has done the majority of the medical portion single-handedly. I can’t fathom how much work it has taken. Now there are roughly 3 levels of health promoters, living in nearly 30 communities along the Atrato River and its tributaries in Northern Colombia. As I am so new to the project, the best thing I can do is learn Spanish as quickly as possible and start teaching medicine to the promoters.

Our primary goal is education. The promoters leave their homes for weeks on end to come to Riosucio to learn from us. If Alan is alone here he spends a week teaching a specific course to a specific level, but as we have 3 others physicians here presently, all the promoters have been convening here for three different courses…the last series included the gastro-intestinal system for the first level, advanced suture and trauma for the second level and eye diseases and treatment for the 3rd level. As we had a larger group in Riosucio than we could fit into our small classroom, we used the 3 separate classrooms across the river. They have adequate space, but no electricity or bathrooms...yep... Here we are crossing to the other side for morning lessons. The classrooms are the small group of buildings in the background.

Here is Alan teaching IV access. I needed two tries to find Alan´s vein, the promotors, on the other hand, did great! All the other classroom photos from the week have a pig dissection or pig suturing...I figured I would leave those out...

ummm...sorry about the tease, but this photo kept crashing the computer...I´ll send this post without it...

That was about 3 weeks ago. All the promoters will arrive back in Riosucio next Sunday, June 15th. The first level will learn the respiratory system, the second will be wowed while they absorb growth, development, immunizations, and illnesses of childhood, the most experienced group will learn neurology and auto-immune illnesses. Here is a picture of Susan at our kitchen table working on a game illustrating the life cycle of different worms.

(Alan and Julie have spent a long time fixing up their home. It is a really nice place to stay. The kitchen is in the background, the three bedrooms are along the wall on the left. On my last visit, we lived downstairs as this upstairs’ floor had burned down.)

Each course adds to the promotors´ knowledge as they go back to their village and practice. They are volunteers and are busy. They have families to care for, food to grow and harvest, and other jobs to complete. As much as I admire how much Alan has accomplished, I am completely impressed by the work and dedication of the promoters. The amount of experience with classrooms and structured learning varies. A challenge for me will be structuring a course that is practical and helpful. I have been planning this course steadily and have enjoyed coming up with games and activities to make the concepts more real, understandable, and hopefully more memorable. I am scared stiff. I think I have a knack for teaching, and I am certainly comfortable with the subject matter. The scary part centers on teaching pediatrics with my present 4 year-old Spanish vocabulary. I hope I am exaggerating. I also hope no one was wondering how that is different than me teaching pediatrics in English.

Besides structured coursework, we also complete visits to the communities. I love this even more than the teaching, primarily because it combines teaching and medicine with traveling and camping. We work hard in the communities, but for me the reward is meeting people and seeing places that I would have no opportunity to encounter other-wise.

As I mentioned, the towns are along small river valleys, accessible only by boat or by foot. In each of the communities that I have visited we have been put up in an open-walled platform with a roof. We set up our camping mattresses, our mosquito nets and we are good to go.

The large majority of the towns do not have electricity, and water for washing and other things is provided by the river. We spend these visits with the local promoter talking about town needs: water sanitation, mosquito prevention, creation of latrines, and vaccination. We also see ill people in the community. This is very different from the clinic at home. As our priority is the education of the promoter, we see all patients with the promoter. What we teach depends on the promoter’s level. With an early promoter we might work on history-taking, examination, or obtaining vital signs, while with another we might talk about the sequellae of diabetes mellitus or the specifics of treating emergent hypertension. The promoters improve steadily and it is great to watch and be a part of the progress, not only for the promoter as a person and care-giver, but for the community. It is our goal that eventually some promoters will become teachers and form the foundation of a solid, sustainable medical care system for this remote part of the world.

That is what we are doing in a nut-shell. I am so proud to be doing this. It seems completely worth-while. I realize that my 2 months of work here pales compared to the years and even decades of experience of my 3 current colleagues. It feels strange even to sound like I am doing anything more than just starting to help out. I am humbled.

Thinking of you…hoping all is well...
bg

I made it!!!

Hello!

This is WAY overdue…my apologies…we just got back from a 8-day trip working with some of the health promoters in their communities. I will write about my work and the trip in the next few days…the note below is something I began writing ages ago, but never sent. I am pushed for time tonight to finish this and get to the computer with internet access before it closes. Please excuse any mistakes…AND...the line is super slow here...so I am not sure I can include any photos...

It is Wednesday night; May 21…we have been in Riosucio for 5-6 days. Our trip from Apartadó was blissfully uneventful. Despite waiting for a few hours for our boat to leave, nothing unanticipated happened: nothing broke down; we didn’t run out of fuel, the crossing of the Gulf of Urabá to the Rio Atrato was as calm as it has ever been.

It feels great to be back in Riosucio. Its energy and people make it unique. I am now staying in the home of Alan and Julie, both colleagues in this project. I lived with them during my last visit here. John and Susan are here working as well; they are visiting from Mexico and Guatemala (during their vacation). I have mentioned them earlier, and I am glad there are here. We are sharing a 3 bedroom apartment. Gregory, the 2 year old, has many friends in town that play on the partially enclosed (completely safe) balcony. Despite what sounds like a crowded situation, living is easy; I enjoy my days and the company.

Realizing that I have only just returned and knowing that my views will change and undoubtedly become more accurate, I wanted to describe Riosucio as I am seeing it again with fresh eyes.

Riosucio has a pulse all its own. Currently it is raining and after 9 o’clock. Without straining I can hear the rain falling on our tin roof, a group of men smacking dominoes on the playing table across the street, the amplified speakers playing vallanato music a few houses away. This morning different speakers began playing religious music before 5 a.m. Then when I was drinking coffee on our balcony at 6:45ish a large man walked down the street verbally berating the owner of the early morning music. The ironic part is that it happens every morning.

People live very closely here, not just in location. 11,000 people living next to a river which frequently floods. There is a cell-phone tower and fairly consistent electricity, but water is a commodity. The river is used by the majority for bathing, washing laundry, using the bathroom, and even drinking. This photo doesn´t quite do it justice, but here you go. The closet-looking things on the rafts (balsas) in the photo are used for privacy for the toilet, there is also a woman washing something on the balsa nearest the camera.

It is more accurate to say drinking water is a commodity. The seasons are just changing, we are moving from the dry summer to the rainy fall/winter. It does rain daily and the river is slowly rising. Right now, there is 1-2 blocks of solid ground/mud next to the river, and the remainder of the depth of the town is under water.

People are anticipating that what is left will be submerged in the next few weeks. The walkways to reach homes and to go shopping are planks balanced above the water. Before the angry gentlemen walked under the balcony this morning, I saw a woman, with her hair in curlers, wrapped in a towel, with her recently-cleaned laundry and dishes in her arms walking on planks from the river back to her home.

Before I forget, I wanted to write a quick blurb on traveling to poorer countries. I am certainly not an expert, but every time I get re-acquainted with living outside the U.S., I forget the interesting subtle differences that soon become normal and lose their interest. On a resourceful level, it is true, clean water does dictate so much of our habits here. We buy our drinking water in 12 liter hard plastic jugs and fill our pitchers and glasses directly from that. We have gutters on the roof which drain rain water into a 2000 liter tank. This tank has alum in it which acts as a water clarifier (settles out the large impurities and dirt). We use this for cooking, washing dishes, and bathing. Any water that we cook with needs to be boiled as well (there are other animals that use our roof too). So it works great for coffee, tea, pasta etc. If we use the rain water for washing dishes, then we add bleach to it first. Finally bathing…to save water, we stand in a large plastic bin. We have a small bucket filled with rain water and we repeatedly dip a small bowl in the water to get wet, then to soap up and eventually to rinse. The soapy water that we stand in is then brought upstairs in buckets and used to flush the toilet (pour the water into the front bowl). I don’t want to go much further along this line…but there are a few notables…toilet seats are a rarity…more cracks and crevasses to keep clean, I guess… ...go on...I know, but when I thought of that phrase, it made me laugh, so I kept it in…The other interesting thing is that nothing non-human goes in the toilet. There are small trash cans for everything else. I guess they are much kinder to their sewer plumbing than we are at home.

I sleep under mosquito netting every night. It keeps the mosquitoes and biting bugs away, and hopefully keeps me healthy. On a neat note, when here in Riosucio, we no longer have to do laundry by hand...though it isn´t quite what you´d expect...here is a photo of me wrestling with my laundry...

Alright…I am going to run to the computer place…I hope this finds you happy and healthy…I think of home often, but all is well…

bg

Happy Mothers' Day

We woke up yesterday morning and made pancakes to celebrate moms around the world…I hope everyone had a good day…

When I sent my last note to this blog, I was really not in tip-top shape. Everything is behind me now, pun intended, and I am moving on…I feel healthy and great…I have been in Apartadó for the past week. This town is really important as it is the home of the dioceses that is sponsoring our work here. Alan, Julie and Gregory have a room on the church grounds for sleeping and storage. We use it as a place to replenish supplies and organize courses. In an interesting turn of events, I have a room in the same building as the priests for the cathedral next door. Each night, I ring the bell, and one of the priests lets me into my room. Despite living a completely responsible existence here, I still seem to feel guilty while waiting for someone to open the door.

The heat persists here…wow. Everything is damp too! What a combo. It really is not all that comfortable, but my body is getting used to it.

I thought I would keep my eyes open for the past few days and take some photos of the animals that are living on the cathedral grounds. This will be more interesting for kids than adults, I imagine. Here is a photo of our shared terrace and the ground below. It is teeming with neat critters. You can see the groups of orchid leaves on the big two trees that form the foundation for the deck, I missed the full bloom by a few weeks. That is Vincente in the background, definitely a friend, not a critter. I took the second picture at this morning’s information meeting. We were organizing class-work, planning finances…I guess Julie got some meditation in as well. This is where I drink my coffee in the morning.

What better place to start looking for great animals than the KITCHEN!! I wish I were kidding. Everyone loves the kitchen. I found this moth while we were cleaning dishes after dinner.

Here are some more house guests…



We have a huge variety of lizards around the house. We have a neat one that is really fast and not so photogenic (yet). It has a dark body and a orange head. Here…I almost got a photo of him this morning.
Looking at that one again, I really probably didn't need to share that with you.

Despite carrying my camera around for the past few days, I missed a fantastic photo opportunity on the way to lunch yesterday. We saw a tree laden with big iguanas. Big. We counted over 10. The largest probably had a body 2 feet-long with a longer tail. But I did manage to find these guys in the trees over the terrace. Not as dramatic, but sort of a neat ‘find the iguana in the photo” game. They move fairly quickly and they also fall from the canopy and hit the ground with a large “thud” before rolling over and heading back up the trunk to the leaf-laden limbs.
Despite their size, these guys aren't all that easy to find in these photos...I might have to share the real photos when I get home...

I would like to dispel any thoughts of the tranquil solitude that surrounds a cathedral. I shouldn’t generalize, but the area around this cathedral is teeming with noise. There is a great spanish word for it "bulla". The services of the church use microphones, the neighbors of the church play their music loudly and at all hours, there is a busy street nearby, and not to be out-done, squirrels, an owl, monkeys, lizards all compete for air-time. I need to share my surprise when I was strolling from my room in the priests house to our office, I walked right into this:

I had no idea that peacocks were loud. It isn’t really a beautiful noise. It sort of sounds like an angry wet cat screaming. This one flew (they fly!) to the roof opposite our meeting this morning, I took a quick video...




There is a family of white-faced monkeys that live here too. They are much more active in the sunshine and we haven’t had an abundance of that yet, so I am still waiting for a better photo opportunity.

It is interesting to mention that people with white skin and blonde hair are called “monos” by the people here. Mono is Spanish for monkey. This monkey’s white hair around its face and its white skin are the reason why.

And lastly for this installment…my favorite…look how cool these guys are…

They are called leaf-cutter ants. They are pretty organized. They cut big chunks from a leaf and walk with it for long distances back to their hive. They move in nearly single file. Here one has also picked up a small flower…hopefully bringing it home to its mom…wow...ending on a cheesy note...

Let the hello’s begin!

Yahoo! I am in the Bogotá airport awaiting my flight north. At the end of the day, I’ll be with my friends Alan, Julie and their 2 year old Gregory-Mateo. I can’t believe it has been over 2 years since I have seen them.

The remainder of my time in Bogotá went well. My Spanish is steadily improving. Though, I have to say, I do have moments of uncertainty. My plane is currently delayed, I can figure out that much, but as to the pertinent details, I am a little foggy. There is always room for improvement.

I spent last week seeing the sights I hadn’t seen yet. I took a trip via train and bus to Zipaquirá, which is north of Bogotá. The town is famous for its salt mines and incredibly, for a large underground cathedral carved into the ground. It is pretty amazing, though I don’t think this photo does it justice.

The following day, I went to visit the Museo de Oro (museum of gold). When the Spanish Conquistadores came here in the 1530s , they found large, organized, indigenous tribes thriving in concert with Colombia’s natural resources. This museum has a huge archive of tribal artifacts. I also got to see a great Rodin exhibit that is touring North and South America. I also had an INCREDIBLE tamale in a very old restaurant. I am still thinking about it.

Well, the plane did leave Bogotá pretty late and hence arrived at my connection city late as well. I disembarked to find I was still early for the flight I really should have missed. I guess I needn’t have worried.

I arrived to my final destination on time, which completely startled my friend Alan. Oh my…it’s hot. I completely forgot how hot and humid it is here…whoa boy. On a really neat note however, I feel great to be here. This feeling really blossomed as we were shopping for fruit on the street. This is a neat community. I still have more traveling to do before I am truly in the town where I will spend the majority of my time…but I am pleased to be getting closer.

Thank you for the comments. I have really enjoyed them!

Finally!!

Hello from Colombia! I made it and all is well.

After leaving Salt Lake City, I spent a week at home. It was a great time to unwind, see friends, and spend time with my family. It seems like saying good-bye kept getting harder, rather than easier.

I am currently in the Colombia’s capitol, Bogotá, spending 3 weeks studying and tuning up my Spanish. I am taking classes and living with a family. I am amazed by the city. It is brimming with people and completely modern, but there is still a very prominent colonial-Spanish influence here. Large buildings are right next to small tiled-roofed homes. Here is the front of the home where I am living. That is Samuel, a Golden Labrador, at the front door.

I live with Dueña Alba Luz and her 12 year-old daughter Paula. The house has four other professionals living in it. It is a great, friendly atmosphere for learning.

This past weekend, I visited the oldest portion of Bogotá, La Candelaria. Not only did I love the small streets and old homes, but I also completely enjoyed the Botero Museum. Fernando Botero is a Colombian painter who inflates his subjects, from political figures and infants to oranges and guitars, both in oil paint and sculpture. I can’t see his work and not smile.


Later that night I went dancing and started to learn salsa. Needless to say, I have my work cut out for me. Pictures do exist, but they aren’t really available at this time.

The following day my classmates and I took a trip to Chicaque Parque Natural. It is just outside of Bogotá’s sprawling city limits. It is just a little higher in altitude than Bogotá (~8000 feet), but is a forest consistently surrounded by clouds. We did some hiking, threw the Frisbee, even rode on horseback. I am helping my friend here. I am the one with the big backpack-still a Boy Scout at heart.

My goal is to update this page every few weeks. I am really a novice at this. If anyone has any tips for me, please feel free to drop a line. I am hoping blogspot allows posts. I hope this finds everyone well. As much as I miss home, I feel completely content and happy.

bg