Filling in Holes

After saying goodbye to the promotoras (community health workers) who had participated in the Leadership Training Workshop sessions, my colleagues and I talked about the transformation we had seen. Even the most reserved, mild-mannered promotoras were projecting confidence and inner strength. I was amazed at how far they have come. And then I looked inward, and began to think about how I got to the place I am now… 

Two years ago, I had just quit my nursing job at Vanderbilt Medical Center in Tennessee to move to a small, rural town in Honduras. I would spend the next year working in a primary-care clinic, treating the most destitute Hondurans. With my stethoscope and blood pressure cuff in hand, I was ready to save the world.

Tools I used as a health care provider at a clinic in Honduras.
Tools I used as a health care provider at a clinic in Honduras.

A year ago today, I was wrapping up that year in Honduras. Here’s an excerpt from a blog I wrote on my last day in the country:

Im tired of seeing patients in the clinic with problems I cant fix…uncontrolled diabetics…painful hands twisted with arthritis from a lifetime of making tortillas and scrubbing threadbare clothes on stone sinks. Im tired of grasping at straws for diagnoses and answers…And Im tired of waking up every morning in a country full of so many problems, at every single level, that anything I do feels like less than a drop in the ocean. But. How could I be tired of patients who have become friends, who brighten my day when they walk through the door?…I could never, ever grow tired of the new friends and family I have made hereI will be forever grateful for the ways they have brought me into their culture, for the lessons they have taught me about life. It is one thing to give when you have, but I have received bags of freshly roasted coffee from families that cant even afford the medications they need, or bunches of plantains from people who are barely eating enough themselves. That kind of generosity touches my heart, almost to the point of breaking it.

Honduras had broken me and put me back together, softer and wiser than I had been a year before. And the desperate and destitute that I had come to save had, as it turned out, saved me.

But why am I talking about Honduras when I’m in Peru, 6,000 feet higher and thousands of miles away? Because without Honduras, I wouldn’t be here, and without the lessons I learned in Honduras, I couldn’t do this job. Working in Honduras in primary care, I learned a lot. I learned a lot about medicine, about people, about not-so-textbook Spanish. I also learned a lot about working in global health. I saw how helping sometimes hurts, and I learned the importance of sustainability. As I was preparing to leave Honduras, I realized that, for all the people I had treated, for all the ways I did my best to help, I was still leaving a hole. I came to the conclusion that I was done being the provider; I wanted to teach providers. Enter Sacred Valley Health.

Teaching promotoras about the effects of alcoholism on the body.
Teaching promotoras about the effects of alcoholism on the body.

Here, in Ollantaytambo, I’ve put away my stethoscope for a while. I don’t start any IVs, give any shots, or pass out any medications. Instead what I do is teach. I teach our promotoras how proper hand washing can prevent diarrhea, or how good nutrition can help the children learn more in school. I teach them danger signs to watch for in pregnant women, how to clean a cut, and how to identify early symptoms of pneumonia. There are days when it’s frustrating, and there are times when I want to dig my stethoscope out of the bottom drawer, jump in, and say, “Here, let me do it.” But when I step back and see just how hard these men and women are working to learn, how much they want to be agents of change in their communities, and I look at all the holes we are slowly filling in, I can’t help but smile and remember why I’m here.

Ana Cecilia teaching her community about the effects of alcoholism on the body.
Ana Cecilia teaching her community about the effects of alcoholism on the body.

After spending the last two years working in health care in developing countries, I see that the problems are much more complex than I had realized when I embarked on this journey. There have been times in my life when I’ve felt like I was saving the world in a week, one vitamin or anti-parasitic pill at a time. Looking back, I can see that I put a lot of Band-Aids over bullet holes. I’ve learned that lasting change can’t be built on a foundation of quick fixes.

You’ve heard the saying, “If you give a man a fish, he has food for a day; if you teach a man to fish, he has food for life.” Effecting real change is slower, more tedious, and much less glamorous than my younger self had imagined. I feel, more strongly than ever, that education and empowerment are the most important things in making someone’s life better, and the promotoras we work with prove it to me every single day.

Matilde teaching good hand-washing skills to children in Yanamayo.
Matilde teaching good hand-washing skills to children in Yanamayo.

– Written by Jenny Jordan, R.N. 

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