Generally, the times that I am conscious at 3:00 AM are unintentional. But last week Laura and I stood outside our home at 3:30 PM to be picked up by a Shoulder to Shoulder driver in his pick-up. We wanted to see first-hand some of the more demanding work our Equipos de Atención Primaria (EAP) (Primary Care Teams) accomplish. We wrestle into the extended cab to join the driver, the health promoter, the lab technician, and the dentist. On the way we pick up the doctor bringing to seven the number squeezed into the vehicle. We turn off the main highway, such as it is, and head down. A good forty-five minutes later along this single-lane, rutted, wooded road we meet its end. It’s 5:10 AM, still dark, and we’ll be footing it for the next two hours toward our destination, the health center in the small community of Delicias (translation – “Delights”).
Why?, you ask. Once every two months one of these EAP health teams visits Delicias. This insures health care for the residents of this community and its four surrounding communities. As we travel, the residents in those communities who need health care also travel, sometimes three hours or more to visit the clinic in operation. There are no roads out here, only well worn paths through mountain passes. Out of the truck, the six of us shine our flashlights to the ground to secure our footholds as we continue down the extension of what had been the road. Fifteen minutes later we reach a river bed, the first small descent accomplished, and we’re pleased dawn has broken and we can see where we are walking. From here we go up, then follow the edge of a ravine descending more slowly, then up sharply for a good hour to reach the summit, and finally down again to the small complex. The path is mostly a wide one, well traveled, a main thoroughfare where we meet many men and a few families traveling in the opposite direction. The vistas are outstanding, looking down into valleys, out onto mountain ranges, with the undersides of clouds circling mountaintops to greet the sunrise. The travel is not so much treacherous as it is exhausting, but the freshness of the experience energizes us. Without warning, out from the thickness of the forest, we arrive at Delicias.
The clinic looks exactly like every other Honduran government designed clinic. The school here was falling apart. They tore it down to build a new one with aid from Germany. The make shift school, roofs suspending over bamboo poles, is set up in the back yard of the clinic. The newer school, just above the clinic, will be large enough to accommodate the 150 students, its construction to be completed in May. There is also a small church, presenting as Catholic, but perhaps doubling for any number of other denominations and providing space for secular meetings. A family has a home where supplies and snacks are stored and sold, and meals cooked at the outdoor kitchen. It’s surreal, this little oasis of civilization so singularly distant from the rest of the world. A well and pump provide water, but only within this small development. There’s no electricity, save for the generator the construction team operates. The dentist, young, newly hired, transplanted from the city, and assigned here after her graduation from university, questions why anybody would choose to live here. Good question really, but no one chooses to live here. They inherit it, bequeathed as it were, from one generation’s poverty to the next. Walking in and out is hard enough, leaving is virtually impossible.
The kids arrive for the morning session. There are only two teachers now. Four more will come for the afternoon session and stay for the week in a room they use in the clinic. The dentist gives instruction to the kids on brushing and dental hygiene. She’ll give a check up to each one individual. She can’t fill cavities out here, too expensive, but in two months when next she comes, the kids will get a fluoride treatment. The pregnant women’s club arrives. They, along with individuals seeing the doctor and even the construction workers, get health talks on Chikungunya (similar to Dengue), tuberculosis, and other public health concerns. They call all this a health fair and there is a sense of celebration. It’s a reason to gather, to meet up with friends, a special event. By 1:00 PM, the dentist and the lab technician are finished with their work. The doctor will probably be seeing patients until three. But Laura and I, the dentist, and the technician decide to start our walk back. We’ll walk leisurely and the doctor and health promoter, leaving later, can catch up so we’ll all meet the pick-up at the same time.
Laura and I will only make this walk once; the doctor, dentist, and lab technician once every two months; and the health promoter once every two weeks. Some of the people who live here probably never leave, but they’re all accustomed to the hiking. It’s their routine and they don’t think about it as anything special. The materials for the school, how do you think they got there? On the backs of the residents. We’re told that the men carried three to five cinderblocks at a time, the women one or two. We are indeed walking leisurely, the sun beating down, and the dentist, the youngest among us, stops every few hundred yards to rest in the shade. Persons are passing us in both directions, carrying one-hundred pound sacks of corn meal, or beans, or cement. We have to move off the side of the path when a man balances and guides a 30 foot roll of sheet metal roofing for the school. Then two familiar women come up behind us. They were with us at the clinic, participants of the pregnant women’s club, now going home. It’s not so much that they’re making better time than us. It’s not so much that they don’t even seem to perspire. The thing that just seems unfathomable is that they’re wearing flip-flops. One tells us she’s eight months along, and all I can do is pray.
Finally, we make the river. All that’s left is the last rise to where the path turns back into a road. It was dark when we were last here, casting our flashlight beams to our feet. Now I realize that the entire hill is deforested. A small slip, a tumble, and a roll, and it would have been an unobstructed fall 200 feet into the river bed. Silly me, I thought we started out in the dark to make better time and to avoid the heat. We come up on the road, slightly wider, much less gutted. Though they left a good hour and a quarter after us, the health promoter and doctor join us within twenty minutes. Another fifteen and our truck arrives to take us home.
The long ride home gives me time to reflect. I am happy to have had the experience. It’s so beautiful, romantic even, to live so connected to the rhythm of nature. I now know what it means to visit the Delights, but I will certainly never know what it means to live there.
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