Subirana Clinic, Subirana, Yoro, Honduras.
Yesterday Don and I participated in a medical brigade that traveled to a small clinic in an indigenous community Subirana. The clinic was originated by North American Missionary Dr. Joyce Baker and built mostly with funds from a United Church of Christ church in Connecticut, Greenwich Congregational Church. No, this brigade was not from the United States or Canada. This brigade of 4 doctors was from San Pedro Sula, Honduras, three hours away. It was completely organized by the local community and the Evangelical and Reformed Church of Honduras.
Our participation was observation, encouragement and an occasional cheer of support. The doctors and pharmacist assistants (aka doctor’s wives) served 200 patients with various ailments including asthma, rash, pre-natal exams, fever, stomach ailments and chikungunya virus. The pharmacy was well stocked with common remedies such as pain relief, salves and various anti-biotics. Some of the medications were donated and some were purchased by the church.
OK, so the amazing thing is not that this brigade was organized and funded completely through local efforts. The amazing thing is that many North Americans think that that’s amazing. Let me explain. Honduras is overrun with people who want to help. Of course, Don and I are two of those people and that irony is not lost on me. However, the problem comes in when trying to understand what is helpful and what is not. Most aid organizations want to give “stuff,” often their worn out items. The thinking goes like this; This item is old and I need a new one. I can’t sell it because no one would want it. But I could send it to some needy soul in a developing nation. They have nothing and this item has lots of useful months left, so they won’t mind my old, worn out item. Since I am donating the item, and cost of shipping, the least they can do is buy the parts necessary to fix it.
Replacement parts are impossible to order or pay for, so often the item sits idle or breaks down often. Developing nations someday will be overrun with storage rooms full of old donated hulks that receiving organizations don’t dare dispose of for fear of offending their donor. Besides, there are no sanitary landfills, so where would it go? My suggestion is, the next time you get the urge to donate an item that is nearing the end of its life cycle, consider buying a new item and donating that. Afte rall, if you can afford a new item, you can afford the repair parts for the old item and the gift would be so much more useful.
So back to the clinic. Hondurans are intelligent, capable people with a heart of improving their communities. Money is extremely limited, but much can be done with little. They are experts at negotiation and improvisation.
Sick little boy waiting to see the doctor. In the background, Don found a friend. An engineering student studying in the U.S.
So, how can caring people make a difference?
1. Start by recognizing the capabilities of the population you want to serve. Listen to the presenting problem from the local perspective and ask for ideas and solutions. You may be surprised at the answer.
2. Try to resist proposing solutions until you fully understand all the local challenges. Get to know the culture you are working with.
3. Have confidence in the people you are working with. Jean-Claude Shanda Tonme, a lawyer and journalist from Camaroon, said of the Live Aid Concert, “they still believe us to be children that they must save” with “their willingness to propose solutions on our behalf.” Try to put yourself in the place of the people you want to serve.
4. In general, helping systems such as schools, churches and communities, is more beneficial than helping individuals. Giving money to individuals can create dependence, bitterness, helplessness and isolation from their community and family.
5. Ask yourself, how is this project sustainable in the long term? If I died tomorrow, does this project have an exit strategy? Sometimes your project is a one time gift; tools for a vocational school, for example. However, if you are involved in building a church or school, does the local community have the ability to pay the taxes, the electricity, the salaries?
People getting registered for the clinic. Each adult paid $1. The dog was free.
6. Ask yourself, do they want this project? I have seen donors ask, “You need a new well at this school, right?” Try asking, “If I had $20,000 to give to this school, how would you spend it?” I have seen many well funded, well intentioned projects ripen on the vine because the local people are unfamiliar with it or do not see the benefit. There was a group that came to Honduras after Hurricane Mitch to rebuild homes. They built hundreds of identical, 500 square foot block homes, all in a straight row on a plot of donated land far from a city. Far from jobs, far from commerce and transportation. The houses were never used. The attraction of a house was not enough to lure people away from their communities.
7. Ask yourself, who benefits from my donation? And then honestly listen for the answer. Is there a benefit for the donor in the terms of a tax write off, disposal of unwanted items, fame, recognition, guilt-reduction?
8. Borrow something from the medical profession. First, do no harm. Analyze similar projects before yours and look for unintended consequences. There are always unintended and often unpredicted consequences. But are the consequences tolerable or avoidable?
Dra. Andrea Bustillo-Acosta
The clinic will be open for brigades once a month. The brigades are volunteer doctors and medical students from Honduras. The church partners with the Honduras Medical School and other NGO’s working locally. There is a possibility to partner with Cuba, Europe and the United States for other medical personnel, brigades and specialty services. Your participation would be more than welcome! Don and I found that the most helpful thing we could do was to get out of the way and try not to look surprised. Our look was of admiration.