Saying Sayonara to San Juan

1/28/12

So, a few things have happened since my last post. As is often the case, these projects wind up, not down towards the end and so they did, at least for the surgical and dental teams. The clinic team found there work slow down a bit with fewer people coming to the Centre Salud in San Juan than had come to the remote village clinics from the prior week. The weather was cooler, but only because of the rains, and the locals tend to stay indoors when this happens.

For the surgical team, we did more and more cases each day, everything ranging from removing extra fingers and toes from children to a steady diet of hernias. Most the hernia repair were actually on women, who tend to do a lot of manual labor. This is opposite the proportion seen back home. Of course, when a man comes in for his repair, the hernia is massive and has obviously been put up with for years - either for lack of opportunity to have it fixed, inability to stop work for recovery, or the nearly axiomatic truth that guys just don't go to the doctor until there is obviously a problem (and even then wait for someone else to notice it too). All this has meant a bit less down time for reflection and journaling/ blogging.

Our evenings likewise have been filled with social engagements unlike last week. Wednesday was a formal dinner with the mayor, the entire city council, and other government officials. Being a Japanese colony, this meant sushi, though I am still unable to get a straight answer as to what was actually in that Maki roll. Bolivia has no coastline, draws much of its water from tributaries of the oh-so-clear Amazon, and nothing about is infrastructure says "flown in daily." In Cipro do we trust. The dinner was a wonderful honor, however, and so far, my only known souvenir from the evening is my copy of the municipal ordinance read in our honor... in its entirety... in Spanish. It is nice to know that our work here is done with the cooperation and blessing of both the local government and health authorities. Francis has gone out of his way to develop such cooperative relationships and I truly get the sense that this local government cares deeply for its neediest people (across linguistic, racial, and economic lines), though it is often helpless to help them given the limited resources available to them.

The next evening, we were invited to the home of Miyuki, our 18 year old translator who worked with the clinic team on the first week and with the dental team this past week. Her mother is the local public health doctor who has worked closely with the clinic team. Her father owns a farm about 20 minutes north of San Juan which means one thing. Bugs. I literally ran a gauntlet of massive June-bugs just getting into the house - those that didn't audibly crunch under my feet managed to jump up and swarm my torso while I ducked for cover and ran inside. We were treated to an evening of hanging out, sipping coke, and admiring Miyuki's art (truly incredible paintings) until the dinner was served. Her father came in from the backyard pond with a pan of fresh caught fish - Paku and Sirubi (I am 100% sure those are spelled wrong - don't even bother googling them) which was prepared 4 or 5 different ways, including as Sashimi. (By the way, does anyone know for sure if Cipro covers the typical South American freshwater parasites? If not, please email me immediately.).

Later in the evening, we met her grandfather, who is 94 years old. He move to the area in the early 1950's from Nagasaki, just as the community was being founded. We did the math and he would have been 26 or 27 when the atomic bomb was dropped on his city. Seven or eight years later he would travel by boat to an as-yet uncleared portion of the Amazon basin where life would somehow be better and provide more opportunities. He has done well with what was given him and has a beautiful family to show for it. I can only imagine the stories that he could tell.

Amidst hernia-fest and one gallbladder (I must have removed the rest of them the last time I was here), the last couple of days were spent trying to tie up loose ends. This means making sure that appropriate follow up is arranged for some of our more concerning patients and that proper goodbyes are said and appreciation shown for those who have helped us.

Oliver's wound will still require meticulous care and occasional washing out under anesthesia. He tells me that the dressing changes hurt a little less each day, though he still cries when we do them. We share a hug and some laughs each day after we are finished. His room by now is filled with the crafts he has made with the pipe cleaners and construction paper that team members have given him - the paper chain must be at least 15 feet long. Fran still lets him borrow her iPad every now and then - he is getting good at Fruit Ninja and Angry Birds and apparently likes U2 music (but did he have to play Joshua tree the morning we said goodbye? That is just not fair to anyone hoping to maintain their composure).

The boy with appendicitis also has an open wound (quite common when the infection is so severe) as well which could take weeks to months to heal. Still, he is alive, and I am etremely grateful each day when i hear him say "hasta manana." At one point we were not sure he would even have one. He left the hospital on our last day.

The local doctors and nurses at the Centre Salud are being very gracious to see all our patients in follow up, even housing some who still need wound care or antibiotics. Others came back to see me on Thursday or Friday for wound checks and to confirm that their groins are still supposed to hurt a bit. They are all so gracious.

On Friday, we did one last case and made our final rounds. We packed up all the surgical supplies into their suitcases and bins and loaded them onto the trucks. We ate lunch, then returned to the hotel where I took down my mosquito net, dismantled the MacGyver coffee apparatus, and weighed my bags - I am apparently bringing home as much weight in coffee beans as I took in medical supplies. We loaded the bus and made a relatively easy drive to Santa Cruz where we did our requisite souvenir shopping before having one last meal with our Bolivian team mates. We will miss them dearly. I hope to see and work with them again, however, possibly as soon as November. By the way, there are apparently Spanish words that sound similar but should not be confused at dinner: these include Salmonada (salmon) and Salmonella, Jamon (ham) and Jabon (soap), servilleta (napkin) and cerveza (beer). Please make note of this for your future travels.

Now as we are on a plane somewhere between Santa Cruz and Miami, I have time to reflect. I'll spare you most of those thoughts for now. I have divided my time in the air between reading, sleeping, prayer, and the obligatory perusal of SkyMall magazine. To bring things full-circle from my opening post, I will now list the ten things that would have been useful had we been able to order them on the way down:

10. 140x military zoom binoculars for bird-watching (there are some beautiful birds in Bolivia)

9. Litter Robot self-cleaning kitty litter box - we'll take 250 of them for the streets of San Juan

8. Sleep sound generator - the one without the barking dog setting

7. The always cool pillow

6. Digital Bark-Free Pro ultrasonic dog repellent machine.

5. Peeing Boy of Brussels statue and fountain (It belongs here, not Brussels)

4. Cheesy Friends forever jewelry - at least 25 of them

3. Green Bay Packer auto decal - NONE of the cars down here have them. so sad.

2. Heated lumbar support cushion - because everyone in Bolivia has a bad back it seems

1. Rosetta Stone software, Spanglish edition

Enough silliness. I am onto yet another page and should spare you the rest of my thoughts (but you didn't think I'd actually err of the side of brevity, did you?) They center predominantly around gratitude as they often do at such times, but not necessarily in the way one might think. Whereas I used to fly home grateful for and eagerly anticipating reunion with my creature comforts, I am now both grateful for and in spite of them. It is pretty much a cliche by now that in serving on a project such as this, one always receives more than he could ever give. Try as one might to avoid this, it is the inevitable result of service to a God who is Himself the giver of all givers, the multiplier of loaves and fishes (raw though they may be at times), and the producer of a harvest a hundred fold what was sown. I have come to embrace it, and almost to laugh when it happens. When have I ever ended a vacation with tears of joy and an overwhelming sense of gratitude for the people I have met along the way? When have I returned so much richer than when I left?

The stuff which we left and to which we now return is mere stuff, material, yet immaterial. It is that stuff which so often separates those of us who cling to it from those who might never have any of it, or at least very little. In seeking it, we so often find ourselves alone, or in very small and loathsome company. When we seek to give of it, or to relinquish it in order to give of ourselves, we learn that we are all needy. Then we find that our needs are met in ways we could not have imagined. Scripture tells us in different passages that Christ is the giver, that He is the gift, and even the unintended recipient of the gifts we might give. We have seen Him everywhere.

I have before me a customs form instructing me to list the estimated value of what I am returning home with. Were I to fill it out truthfully, it would result in much bewilderment from the customs officials and I would likely miss my connection to Chicago (not sure what denomination I would use anyways). Please do not tell them of my omission, at least not until around 8pm Central Time.

Thank you so much to all who have followed my verbose blog posts, who have prayed or supported the project, who have come with me or have sent loved ones. I am flattered by anyone who is still reading or who would entrust so much of their time, talent, and treasure to a rookie director with much still to learn. Pictures will come soon.

Ciao.