Day Five: Listening

by Noah Stansbury

A cacophony of voices fills the community center where we’ve set up shop for the week: patients, staff, volunteers, a screaming child or two or three. I’m at one end of the room chipping away at a backlog of prescriptions while my (equally amateur) comrades in pharmacology try to figure out how to convert an antibiotic from a solid to a liquid, so I’m writing variations on the same medication instructions in broken Spanish over and over: Tome 3 pastillas 2 veces al dia come comida. Aplique la crema a la zona afectada lo necesario para el picazone. Expolve una pastilla y mezcle el polve con comida. I don’t know how long I’ve been working on this one order of drugs, creams, and multivitamins for a family of four. It could have been five minutes or an hour, but between the heat and the noise and the humidity and what is probably a mild case of dehydration, my focus is so narrow that counting out exactly 84 pills is the only thing I’ve ever known. It’s 90 degrees in Honduras and I am losing my mind.

For those of you playing along at home, we are in the early weeks of what has been called the endless green season after Pentecost, when nothing significant seems to happen in the church’s calendar for months on end. This is to say we are nowhere near Advent, that period of time before Christmas (a darker, colder part of the year that I’m quite partial to, especially now) when we remember how to look for Christ’s arrival both in the manger and in the manifestation of God’s dream for humanity. I like to say that Advent is my favorite season because I’m inherently expectant, and as I was preparing to come to Honduras, I found myself thinking about how I might look for God during this week, albeit without fully knowing what I was getting into. As we’ve moved through the days, I’ve had a few moments between ‘scripts to sit back and take it all in: the doctors and nurses from Philadelphia speaking to their patients through interpreters, the local staff and volunteers who are helping us by registering patients and counting medications and bringing us food and other things I’m sure I don’t know about, and (Lord knows) the hundreds of Hondurans who are here seeking real, corporal, incarnate relief. There’s a robust tradition in this region of the world of God having a preferential option for the poor, and a cursory reading of scripture is shot through with God lifting up the lowly and casting down the mighty. I had hoped that an intensive week of ministering among the rural poor might show me something that I’ve taught myself to ignore in the urban poverty of Philadelphia. In spite of all the opportunities for God to say, “Hey, over here,” I have to be honest: there haven’t been any earth-shifting revelations. This isn’t to say God isn’t speaking. I’m probably just not listening well.

I’ve struggled a lot this week with what exactly I’m doing, and I know I’m not alone. The people we are in mutual service with are in actual need of the help we can offer, and my part in that is no less important just because I don’t have medical training or speak Spanish (though David, our 14-year-old farmacia helper, certainly is patient with me). But when I think about the lives of poverty these people are going back to, my own nation’s troubled history with the politics of this place, and the fact that I’m leaving it all behind in a few days, it’s easy to spiral out into wondering what the point is. It's a dark place where intentionally or not I make myself responsible for saving the world; anyone, even Jesus, must buckle under such a burden, and in this environment the responsibilty is crushing me. It feels like a copout to face that I'm not going to solve Honduras in this room behind this table and to name that my ability to be here is wrought with complications. Even if it's not very satisfying, in that admission I'm given the grace of liberation from having to save the world, which isn't my job anyway. The task at hand is to get my brothers and sisters their damn medicine - shut up and go do the work. That's grace for you sometimes: you don't have to like it.

After the last prescription is filled, I tidy my table, two square feet of the reign of God in action, I hope. The late afternoon light is streaming through the doorway at the far end of the room onto the rude concrete floor, and there’s a quiet buzz as the team puts their stations to bed for the night and begin to check in with each other. Someone is gently whistling “Come Thou Fount of Every Blessing,” and I have to smile. David asks me if he’ll see me tomorrow, and I do my best to assure him he will. Later the team will exchange their stories from the day, and we’ll enjoy God’s creation along the shore. It’s 90 degrees in Honduras, and I’m still listening.

Day Four: Loving People, Together

by Addie Peyronnin

"For L is Love. God in every language." (Jubilate Agno (1759-1763, "B Fragment"), Christopher Smart)

My first clue should have been, if I'd noticed it, the behavior of my seatmate on the flight to San Pedro Sula. But when she offered me her open bag of potato chips--seemingly without a thought of my airport-dirtied hands, the unknown level of my wellness or sickness, or whether I might be a hesitant germaphobe (can you see the direction in which my American thoughts ran?)--my only reaction was, "Me? A stranger? Do you mean it?" She didn't speak English, and I don't speak Spanish, but we had at least one thing in common: we both love chips.

As one of the few participants in this mission trip with neither medical experience nor Spanish, I am a member of our (self-)vaunted pharmaceutical team--The Farmacia--which office is perched at the stage end of our Community Center clinic. From my vantage point on this stage, during lulls in pill-counting, I am so lucky to be able to look out over all the activity happening just slightly below me. I can see the check-in/triage desk, the medical consultations in the middle of the room, and (most importantly for this blog entry) the two waiting areas: one where our patients wait to see a doctor, and the other where they wait to receive medications and procedural counseling.  

Nothing about this trip has surprised or taught me more than than the total togetherness I see among the people I see waiting. Whole families come together--several generations--to see us. They sit, together, in our waiting area, along with other large families, single people, old people, children; friends, neighbors, family, strangers. Volunteers from the local Episcopal parish mop the floors under our feet, talk to our waiting patients, and assist with moving our waiting patients from zone to zone. The fact of the scene from the Farmacia Stage is: people, lots of them, all together, no one a stranger from another. I've been amazed by the ability and patience that these patients have to wait, together, talking, not talking, holding babies, watching babies, letting crying babies just be, watching doctors, watching procedures. Boundaries are few: one of the most wonderful things I've seen from my stage is children watching their parents as they talk with doctors, listening and focusing on the conversation, laughing with their brothers and sisters at funny or embarrassing parts. Children wander in and out of other families' consultations--so do neighborhood dogs, for that matter, every once in awhile--and adults sitting next to one another in the waiting area listen just as much to their neighbors' pill instructions as they do to their own. Babies are not shushed in parents' embarrassment (why be embarrassed? they're babies!), children entertain themselves happily playing with latex glove balloons or clapping games, and bodies are just bodies, worth talking about and caring for. 

In my Center City Philadelphia life, I become too used to the privilege (is it always, I wonder while I'm here in Honduras?) of my privacy. At home, I complain about my small apartment and my inability to host parties--here, I think, how lucky I am to have 650 square feet ALL to myself, or to share with whomever I want to invite over to share them! At home, I go to work, where I sit quietly in an office; then I might go quietly to a loud exercise class, where I am one among many; and no matter what I do in the evenings I always return quietly to a nice, quiet home, with a nice, quiet, happy dog, and a nice, quiet show on Netflix to entertain me. But here, I think: how lucky I am to have my family and family of friends, and why can't we be together all the time, talking, not talking, holding babies, watching babies, sharing space?

I may be making our time here seem idyllic and rosy relationship-ed, and it is that, sometimes, especially if Larger Life Lessons are seeking out one lowly pill-counter. I realize how fortunate I am in my independence, financial and spatial, and I will be so thankful for it when I return home on Saturday. In the meantime, I have learned so much about togetherness. Togetherness is one of the many things I love about my life at Saint Mark's, and it is a thing I've learned from my life at Saint Mark's, but its magnification here gives me much to bring back to my life of friendships and blessings in Philadelphia. 

Day Three: Illumination

by P.J. Prest

Lord - set our souls ablaze with the light of your love, that it may illuminate for us the path to righteousness, and be onto others a beacon of hope. 

In the the heart of Philadelphia is the oldest hospital in the nation.  Pennsylvania Hospital is a national treasure, and chief among its gems is the original operating theatre.  It is at the top of the building, and as one climbs up the old staircase you can't help but feel a sense of majesty.  The operating table could be confused with an altar - square and substantial, in the center of the room. The viewing pews are circular, expanding upward; at the top is the glass cupola, which allows for sunlight to enter as if a spotlight illuminating the patient and doctors.

In the outskirts of the Honduran village of Cuyamelito there is a small community center.  Cinder blocks and a tin roof provide for shelter, yet a four foot gap - supported with iron bars - between the ceiling and the roof allow for natural light to enter.  There is no sense of majesty, and there is no natural spotlight.  Two tired light bulbs hang from the ceiling nearly useless, a crude reminder of where we presently serve.   

When you rely on natural light you have to adapt; mission trips are very good at teaching adaptation.  Today a storm came upon us in the middle of the afternoon.  The sky darkened, and the rain was thunderous on the tin roof.  We could barely hear each other, and the two lights proved as useless as we imagined.  And of course this happened during the worst possible time - an uncontrolled diabetic had an abscess in his hand and was in the midst of having it surgically drained; another diabetic needed a large amount of intravenous fluids in order to control her dangerously high glucose; the pharmacy was desperately trying to dispense medications safely; children ran in for shelter, their youthful chatter adding to the chaos.  

And yet the darkness did not ruin us.  Headlights were produced. iPhone cameras appeared, and otoscopes were used liberally.  And yet most brilliant of all was the inner radiance of our team members - their tireless work providing all the necessary illumination in order to bring our message of hope to the people of Honduras.  And they shone!  It was a privilege to be a part of and witness this team as we came together to serve those who desperately need it.  

Today we treated nearly 130 patients.  We are tired, and inspired...and we can't wait for tomorrow.

Day Two

by Sean Mullen

Yesterday I had the great privilege of saying Mass for the local church here.  I was not expecting to be called on in this way, but there were two deacons and no priest available, so they asked me to, when I allowed that I might be able to make my way through the Mass in broken Spanish.  A very patient congregation put up with my horrendous pronunciation, balanced, I hope, by a prayerful attitude.

Toda , our first full day running the clinic, we saw nearly 120 patients, and worked out our system of  treatment.  We are so glad to have with us again this time, young students from St. John's Episcopal School in Puerto Cortes, serving as interpreters.  They are hard working, smart, and indispensable!

So many of the people we see - children and adults - suffer primarily from poverty and the many hard realities that come with it, including a substantial measure of ill health.  Treating poverty sometimes looks entirely mundane.  We dispense a lot of Tylenol, Aspirin, TUMS, Vitamins, etc to deal with every day maladies.  But today our doctors also treated a young infant with a very dangerous birth defect, a woman with uncontrolled diabetes, and a family who traveled six hours partly by boat, to reach our clinic.

Tomorrow we will return to the single-room clinic, and we expect to see a significant number of patients again.  We are trying to be careful to avoid the mosquitoes.  The daily downpours of rain don't interfere with our work much.  The heat and humidity are pretty constant.  We are grateful for all who support us, and for one another. 

The Gospel reading on Sunday here in Honduras included the last line of Matthew 10, which I think was omitted in the reading used at Saint Mark's, and probably elsewhere.  Jesus says, "whoever gives to one of these little ones even a cup of cold water because he is a disciple, truly, I say to you, he shall not lose his reward."  In my few words to the local congregation, I highlighted these words, and I tried to say to them ( I hope I did!) that i believe we have been called to provide a cup of cold water to each other.  They have made sure we have water to drink, and we are bringing what we hope is another kind of water to them - the water of care and healing.  There is always irony on a mission trip like this when we realize that we are being cared for, even as we try to care for those who have so much less than we do, and so much less than they need.

Arrival: Day One!

by Ken Pearlstein

The road to Cuyamelito, Honduras is unpaved and narrow.  Vines grow, some unkept, others radiant with tropical flowers. There are mausoleums along the road. Today is Sunday and the graves are well-visited. Ana Reid, our local guide, tells us that this road, a mere seven kilometers from the Guatemalan border servers as a clandestine route for those headed north. For now, the road is quiet. Our coaster van is kicking dust and the locals barely notice. 

Outside the Iglesia de la Natividad de la Bendita Virgen Maria, however, there is an expectant crowd unhampered by the relentless, morning sun. The missionaries are coming, and with the hospitality that scripture has taught this community, the locals greet us warmly.   

The church is made of cinderblock. The roof, tin. The pews are of rude wood.  The music is from an ill-tuned electric guitar and a hand-held keyboard fueled by a deacon blowing through an air pipe. The words of mass: the same. In the sweltering heat a rooster crows and a priest from  Philadelphia transforms bread and wine and sweat and song into a transformative, mystical moment. Those who've traveled here before remember why we're here, and so we begins. 

Dr. PJ Prest, trauma surgeon, is here. 

Dr. Maura Pearlstein, trauma surgeon, is here.  

Dr. Michelle Moreschi, intensivist, is here. 

Dr. Janet Hines, infectious disease specialist is here. 

Dr. Danica Zold, resident of emergency medicine is here. 

Dr. Anum Siddiqui, resident of family medicine is here. 

PA Abigail Helms, pediatric specialist is here. 

Anesthetist Ken Pearlstein is here. 

Nurse practitioner, Claire McConnel is here. 

Nurse educator, Suzanne Casey is here. 

Nurse Bonnie Dettore is here. 

Spanish professor, Matthew Fischetti is here. 

Addie Peyronin, vestry member of Saint Mark's is here. 

Noah Stansbury, verger of Saint Mark's is here. 

Father Sean Mullen, rector of Saint Mark's is here. 

This is the team from Saint Mark's Church Philadelphia.  Day one. Our clinic is set in the local community center yards from the church, a rude square structure transformed into a place of healing. The team is resting. The air could not stand one more pound of barometric pressure, and the sky has opened up a torrent of rain as we sleep.