Medical care here or in the US

As some of you may know, I have prostate cancer and will soon be undergoing chemotherapy.

Before anyone asks, I'll be getting the treatments here in Honduras.

Several times people I know as well as the doctors have asked me about going to the US for treatment. Usually, the question was breached by asking me if I have medical insurance in the US. I answer that I don’t have medical insurance in the US since I am in the US at most a few weeks a year. 

I don’t expect to just fly to the US and get medical care. I am seeking medical care here since this is my home.

In a sense, this is a way to share with my neighbors, though I do have many privileges and advantages that they don’t have.

First of all, I do have the economic resources to have high quality treatment here – I get Social Security payments and a tiny pension (from teaching at Iowa State University); I also have a decent amount set aside in an IRA (Individual Retirement Account). In addition, several persons have offered financial assistance. 

 But I recall that most of my neighbors would not be able to get this type of care in a private clinic and would have to depend on the public hospitals or do some serious fundraising. How many times I have seen people collecting money, even stopping cars on the roads, to try to help someone with major medical expenses.

But to just get up and fly off for medical care doesn’t seem right. I want to be here among the people I know and love.

One relative on learning of my illness sent me an urgent message, telling me to come home. But this is my home. I didn’t respond to her in this way, respecting her real concern for me. But it’s what I think and feel. 

And I am at peace with this decision. Of course, I may change my mind in the middle of the chemotherapies. But now I am at peace and want to stay here – where my heart is.

I hope and pray that this experience may open me deeper to the needs of mys sisters and brothers here.

Fractured limbs and fractured lives - malnutrition and poverty

My ministry isn't often filled with surprises. There are training sessions with catechists, meetings with the parish social ministry, talks at training sessions for missionary and delegates of the Word, assisting at Masses and preaching, visits to remote villages on Sundays for Celebrations of the Word with Communion, visits with youth in various towns, and visits to the sick. 

My life is also not filled with too many surprises - except for car repairs and now some dental work.

But once in a while there is a situation that touches and, sometimes, troubles me. Often they reveal the fractured lives of the people. 

A few weeks ago, Padre German noted a serious health situation in a family in a remote village in the parish. Two of the children had recently had a fracture. Two others had fractures in the past. In addition, the family had little to eat. He asked me to visit.

I knew the couple because I had done the final interview with them before their church marriage. I had also arranged some financial aid for the medical costs of the earlier fractures.

I went after a meeting in a nearby village. As I approached, in the midst of barking dogs, I was greeted by the mother of the family. I also saw the fifteen year old boy who had a fracture in his leg, due to an injury during a soccer game. The other boys, ages twelve, nine, and four were also there, as well as a five-month old girl. I found out that two of the boys had had two fractures at different times. 

The father, in search of work, was trying to enter the US.

We talked and I asked her about their diet. In particular, I asked if the children were drinking milk or eating cheese. No – it was too expensive for them.

I contacted a friend from a medical group that visits the area and explained the problem. She asked me to have a doctor friend go and evaluate the situation, so that they could bring what is  needed when they arrive in early June.

We went last Friday. The young doctor briefly examined the boys and measured their height and weight. As we had expected, malnutrition is a major contributing factor. To make things more complicated, the father is stuck on the Mexican-US border and has no way to cross – no money to pay anyone and, as I have heard from other sources, people are waiting extremely long times to even try to get a legal hearing.

I wonder how many other children in our parish are suffering serious malnutrition – which is exacerbated by the extreme poverty, in the face of higher food and utility prices, few opportunities for work that pay decently, little or no medicine in the public health centers, and more.

I find myself sad, perplexed, and wondering what can be done.

I talked with someone from the community yesterday and asked if there was someone who made cheese in their village. There is - but how could this family buy even some several times a month?

We will arrange for the whole family to get to one of the sites where the medical brigade will be. But in the long term? How can we accompany the people in their struggle to lead decent lives?

The problem is in large part due to the system that enriches some and leaves many impoverished, a system that is beset by massive corruption, militarism, and more. Systemic change is needed, as well as some cultural, social, and personal habits that impede real development.

I pray we can begin - and find ways so that people can live with dignity and initiative. God help us - and help us to come together to do this.

Gratefully bathed in prayer

Yesterday was stressful. I got up early and went to get lab tests, in preparation for a medical check-up. I also took my car to Santa Rosa to check the suspension system; these roads really wreck the shocks and other parts of the car. Not too much damage – a belt and two parts. Only about $20.

Then, since I had bought new tires on Friday, I took the car to a different shop to balance the wheels and get the car aligned. Well, there was more to be done, partly because of some worn out parts, partly because the alignment resulted in some damage. I dropped the truck off about 12:30; it was finished at 5:45 pm. Several parts had to be replaced, to the tune of about $185.

After I dropped the truck off, I went to the doctor’s office for my regular three month check up. I was there until about 4 PM, waiting. But that was not the worst. My chlorestol and triglycerides had gone through the roof! My doctor listened to my heart and had this worried look on her face. She recommended that I get up early and have an electrocardiogram the next morning. There was something goofy about my heart rhythm.

Last night, after a long and rather stressful day, I wrote a short note on Facebook, asking for prayers.

More than 75 comments, most with a word of prayer and concern. More than 135 “liked” the post.

I feel myself bathed in prayer. Such love and care from others, even from as far away as Brazil and the Philippines. I feel the presence of God’s loving care from these people – and from many others.

A few weeks ago, Gloria Steinem is reported to have said:

“gratitude never radicalized anyone”

I beg to disagree.

Gratitude has opened my heart – not once, but innumerable times.

Gratitude is the recognition that all is gift and that God and others provide this.That doesn’t mean that gratitude is tied to good fortune, to money, to success.

I clearly remember my months in El Salvador in 1992, helping in the parish of Suchitoto. I spent much of the week in the farthest part of the parish, staying in the house of Esteban and Rosa Elbia, and the six or eight children still at home.

It was a poor house, fashioned out of the stalls of a former cattle shed. Esteban and other families had moved into this former hacienda a few months before the end of the Salvadoran civil war.

Yet almost every morning, when I woke up in my hammock in the house of the Clavel family, my first thought was “Gracias” – thanks!

Here I was in a poor community, without water, with minimal food (and with too much salt in the beans), with streams of rainwater entering the house and flowing under my hammock. But I felt gratitude.

Partly is was gratitude for being able to share in the lives of these people, to see their faith, their resilience, their commitment to God and to a new El Salvador. Most of the people were sympathetic to the Salvadoran guerrillas. Several were former guerillas and a few, like Esteban, had been catechists who had escaped death threats and death attempts.

But here I was among them, helping train catechists, visiting communities to see how the faith life was being nurtured, swimming in a nearby stream with the kids, occasionally helping with the work – including a few days helping build the trench for a water line.

Gratitude was my reaction.

And here too I find myself grateful. It’s central to my experience, visiting the communities, training catechists and working in other areas of faith formation, accompanying a new association of small coffee growers, assisting at Mass and at other sacraments, bringing Communion to the sick.

But it is also my reaction when I encounter people who care for the elderly and the sick – including a young man who cared for his aunt who just died and still cares for his grandmother; when I talk with one of the Communion ministers who walks hours to get to meetings and to share the Eucharist in other communities; when I listen to the struggles as well as the successes of people.

Gratitude is central for me as it was for Dorothy Day who wrote in From Union Square to Rome:

Gratitude brought me into the Church and that gratitude grows, and the first word my heart will utter when I face God is 'Thanks.'

It is central to the recent experience of Robert George. Though I do not hold many of his views, he reflected how he was flooded with so many messages of prayer and concern when he was hospitalized. 

“My reaction to all of those was pure, unadulterated, overwhelming gratitude – gratitude to God, not only for my survival, but for the good people, who, moved by their devotion to Him, offered their prayers for me. And gratitude to the, Boundless gratitude to them.”  

“Because of their prayers and God’s goodness, I now understand every day as a gift.”“So don’t tell me that gratitude never radicalized someone. Every morning when I brush my teeth and look at the guy in the mirror, I see someone who was radicalized by gratitude.”

All is gift.

As Gustavo Gutiérrez puts it in We Drink from Our Own Wells: The Spiritual Journey of a People  (p. 110):

The experience of gratuitousness is the space of encounter with the Lord. Unless we understand the meaning of gratuitousness, there will be no contemplative dimension in our life. Contemplation is not a state of paralysis but of radical self-giving… In the final analysis, to believe in God means to live out our life as a gift from God and to look upon everything that happens in it as a manifestation of this gift.

It is because of the centrality of gratefulness and the need to see how God continues to fill us with gifts, the first step of the Ignatian examen is asking for God’s grace. In gratitude, we recall the good things that God has done for us during the day.

In a world wrought with divisiveness, violence, suffering, and pain, perhaps gratitude is the most important lesson we can learn.

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Follow up on my health

I went to Santa Rosa this morning for an electrocardiogram in the Hospital. The results indicate an irregular heart beat - asymptomatic ventricular extrasystolis (or something like that.) The doctor gave me a medicine and told me to check my blood pressure and let her know in a week. If all is going well, I will go back to her office for a check up next month.

Follow up on the Clavel family

Saturday one of the little girls I knew in the family made her final profession as a Franciscan Sister in Guatemala. Earlier this month, the youngest son was married. Sadly, Esteban did not live to see these blessed events. He died a few years ago with complications from chagas.

Esteban and Rosa Elbia, December 2010

Education alternatives and more

In many ways, the public education system here is a mess. Though there are primary schools and kindergartens in most rural villages, the teachers are often paid late – if at all. School supplies are inadequate. Some teachers’ positions are politicized; you need to belong to the correct political party in order to get a steady job.

Education beyond sixth grade is difficult to get. A study of a few years ago noted that only 33% of those who could go past sixth grade continue studying – and some don’t even go that far. In the parish of Dulce Nombre – 4 municipalities, more than 40 villages, and about 40,000 inhabitants – there are only four what we’d call middle schools; one of them has no budget to hire teachers and so the mayor’s office is paying. And in the whole parish there is only one high school.

To provide opportunities for young people a distance-learning, education by radio program has operated in the parish for years. The sisters in Dulce Nombre have run the Maestro en Casa for years and there have been a few other centers for the program. This year there are now eight centers which serve several hundred students.

At the suggestion of the previous pastor of Dulce Nombre, St. Thomas Aquinas raised money for partial scholarships for students this year. 105 students are being helped. Some of them would not have signed up to syudy if there had not been this financial support.

Today, Saturday, I decided to visit a few centers to see how things were going.

I first stopped in Dulce Nombre at the center run by the Oblates of Divine Love. Sunday there are classes for about 75 students in what we’d call middle school and high school. Saturday is for primary school classes, where the students can do two years study in one year.

Grades 5-6, Dulce Nombre Maestro en Casa class

Then I went to the new program in San Juan.

I didn’t know where the classes were being held and so I stopped by the primary school which was open. I was surprised to see two classrooms full of kids on a Saturday morning. They often have classes there on Saturday, in addition to the five weekdays, one teacher told me. That surprised and delighted me. Here were teachers willing to work more than mandated to help their students. 

Fourth to sixth grades in San Juan's primary school - with one teacher.

I finally found the Maestro en Casa program, which is small. There are classes for seventh and eighth grades. I watched as the seventh graders (which included a man in his thirties!) read about astronomy and astrology. With the teacher’s direction, they had an interesting discussion which include sharing about when one should plant certain crops. I shared the tradition to plant potatoes on Good Friday and the adult man shared how he plants beans on June 12 or 13, around the feast of St. Anthony of Padua.

Seventh grade Maestro en Casa class in San Juan

Even though the class meets only once a week in San Juan, there seems to be a lot of attention to the students, something I don’t always see here.

Afterwards I went to El Prado de la Cruz, about half an hour from San Juan. There I met the teacher in charge, who is also the village’s primary school teacher. He is – rightly – proud of the program. He has recruited eight other persons to give classes. I met three of them – one is a teacher in a nearby village, another is studying at the Teachers’ College in Santa Rosa, and the woman teaching when I arrived has a university degree in computers. His initiative in seeking others to teach really impressed me. 

Class in El Prado

After the visits, I went back to Dulce Nombre to discuss some details with the secretary. I arrived just at two couples emerged from their wedding Mass. I knew one couple, José, a catechist from El Zapote and his wife (whose name I cannot remember). I took pictures and will make copies for both couples, since there was no one there to take their wedding photos. (I'll print out copies to give them.)

José, his wife, and their padrinos

After I spoke a little with Padre German. He asked whether we can find some funding for a project to set up three small greenhouses on the parish grounds to grow tomatoes, green peppers, and some other crops. He wants to get people from the local area to take responsibility for the project which will benefit them as well as the parish. We’ll work on costs and I’ll contact  friend who has three or four large greenhouses in Intibucá where he raises a lot of tomatoes and strawberries.

I also mentioned to him my concern for the health needs of two people involved in the pastoral work of the parish. Fernando’s seventeen year old son has a spur on his foot that local doctors don’t seem to be able to treat. He walks with a cane but really wants to be able to work in the fields (as well as finish his education). Olvidio’s daughter has a displaced kneecap. Surgery to correct this would cost about $4,000, something well beyond his means.

And so as I rejoice in the great work being done in some of the Maestro en Casa centers and in the marriages, the difficulties of life – especially in terms of health – persist.