Mercer On Mission

2015 Blog

Thursday-Week 1: Emma

Today, my worst fear about participating in Mercer on Mission was realized in full force. We awoke at 5am on Thursday morning to embark on the two-hour drive to El Pedrero, a tiny town nestled deep in the mountains of the Agalta Valley. Upon arrival, everyone was a little tired and jostled from the pothole-filled ride. Assigned to interpret for Carson for the day, we began setting up in a back room. We didn’t have too much trouble with our first few patients—they were children who all presented with similar, flu-like symptoms, and we had a good flow going. However, after our first few successes, we both faced stumbling blocks. For me, it was with interpretation; two middle-aged women presented, both who talked very rapidly and had very few teeth left, which caused them to slur. Despite my attempts to differentiate one word from the next, I eventually had to acknowledge that I was missing the majority of their dialogue and didn’t want to jeopardize their treatment by missing crucial symptoms. Hence, I had to fetch Dr. Pino to interpret for me.

Carson also appeared somewhat frustrated after these first two cases—one woman was a severe alcoholic with a bad liver disease, and although we gave her a couple months worth of medication, we knew that she would be unable to pay for more once she ran out. The woman was grateful, but left disappointed. Next, we saw a woman who had a hole in her aortic valve and needed a replacement. She was only 49, had 9 children, and said there was absolutely no way she could afford the surgery, or even the bus ride to Tegucigalpa for that matter. She had already been to the ranch twice and received the same diagnosis and advice, but she had to come to us with the hope that “the Americans” could do more for her. Sadly, we could not.

After these two encounters, both Carson and I felt somewhat defeated. And then came our next patient: a 30-year-old pregnant woman who was dressed sloppily, smelled a little rancid, and appeared very self-conscious. Right from the get-go, we could tell that this would be a challenge for both of us. When she spoke, the woman slurred her words and talked rapidly, making translation difficult for me. She was also very indirect and far from forthcoming with us. When we asked her how far along she was in her pregnancy, she said only one month, which clearly was not the case. Carson believed her to be at least 4-5 months pregnant. When we pressed her for more information regarding her pregnancy, she became very bashful and looked away, giggling nervously. I interpreted this aversion to the topic of pregnancy as cultural stigma, so we moved on to the seemingly benign topic of her swollen feet. However, we got the same tepid response, and Carson left the room to speak with Dr. Shelley, leaving me alone with our patient. I attempted to make casual conversation with her—I asked about how long she had been waiting outside, how far she lived from the clinic, and about her family. My first two questions were met with a blank stare, but the inquiry into her family got her going—I found that she had a husband and two children. She then began talking faster and faster, and a fearful expression spread across her face. She asked me a question that I didn’t understand, and I attempted to redirect the conversation. She looked confused and withdrew into herself. This interaction reminded me of my vast limitations as an interpreter, and left me with an overwhelming feeling of self-doubt.

        Carson returned with Dr. Pino, but the woman immediately shut herself off and refused to answer his questions.  He was then called to another room. Carson also left the room, and I was again left with the woman. This time she commenced babbling even faster at me, and I was taking nothing away from her panicky soliloquy. Frustrated by my inability to understand her, I called Dr. Pino back in, at which point she promptly stopped talking.

        After over half an hour of this confusion, Dr. Hernandez, her normal doctor at the clinic, popped his head around the door to inform us that she had a severe mental handicap, and usually her sister accompanied her everywhere to avoid such situations. A wave of both relief and deep sadness hit me in that moment—relief that my inadequacies and inexperience as an interpreter weren’t what had resulted in this difficult interaction, and sadness at seeing this woman in such a state. In the States, this woman could have a decent life, with psychiatric therapy and a group home. Here, she was forced to bear children that she could not properly care for, and they would also be subjected to a life of hardship and stigmatization as a result.

In our two weeks in Honduras, we have seen immense suffering, but what keeps us going is the persistence of hope. This woman has no hope. No program exists that will help manage her illness, and the stigma surrounding mental handicaps in her rural village will endure, degrading the quality and meaning of her life and relationships. Her inability to hope for a brighter future sets her apart from the rest of her community. Diabetes, infection, and even life-threatening wounds can be cured, and faith in a better, happier, and more prosperous future survives in these instances. But mental handicap is a curse that no medicine can treat in such a remote location.

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