08 November 2005
by Michael Moore
A homeless boy sits on a chair among debris and ruined houses near Choluteca in southern Honduras November 26, 1998. Three weeks after Hurricane Mitch hit the country, thousands of people remain homeless and in need of basic aid like medicine, drinking water and food. (Photo by Desmond Boylan/Reuters)Missoula, Montana, USA:
Missoula Medical Aid was born in a hurricane.
The volunteer group came together in late 1998 after Hurricane Mitch roared through the Gulf of Mexico and hammered Honduras. Sparked by a conversation at Nightingale Nursing, a group of nurses, doctors and translators came together, found a town and an aid organization that needed help and headed south.
“That first trip was really all about disaster relief,” said David Cates, the group's executive director. “But that really started our connection with Honduras, and it's a place we've become very committed to.”
Seven years have passed since the hurricane. Another team from Missoula Medical Aid has just returned from Honduras. The team - MMA's 18th in Honduras - spent its time in small communities around La Esperanza, in the high mountains of western Honduras. The team's list of accomplishments is impressive, but it also highlights the change in the group's mission.
“We started out as disaster relief, but it's much more about long-term health and development now,” Cates said. “We're involved in a lot more programs now, and we're able to do much better work now because we have a history in the country and a history with a good organization, Save the Children.”
Save the Children is an international aid group that works in more than 100 countries. The group has been very active in Central America, and MMA forged an alliance with the organization during the aftermath of Hurricane Mitch.
“We've been fortunate to hook up with them, because they really have a handle on what's needed in the country,” Cates said. “They handle so much of the logistical stuff, so when we get there, we can just get to work.”
One of the difficulties of doing volunteer work in a foreign country is getting a handle on the best course of action. Where can volunteers help most?
With their medical expertise, the general direction of the group's efforts is pretty obvious. Still, there are pitfalls.
“What can happen is that the skill level of your volunteers might not get matched up with the needs,” Cates said. “What you don't want to do is have surgeons handing out ibuprofens to people with headaches.”
But if the list of accomplishments of the most recent team to travel to Honduras is any indication, Missoula Medical Aid is now making very good use of its time.
That team did general health exams on more than 1,800 people, mostly in makeshift clinics set up in rural schoolhouses. Doctors wrote 35 referrals for patients who need to see specialists in area hospitals. More importantly, MMA and Save the Children set up a fund to help pay expenses for those patients.
“One of the problems in these rural communities is that we go in there, find people with problems that really need to be treated in hospitals, then they can't get to the hospitals,” Cates said. “Most of these people don't have the money to get down the road, let alone get to a hospital. That's frustrating.”
The most recent team also did 94 gynecological exams and pap smears, and gave out thousands of vitamins and mineral pills, most of which were contributed by Nutritional Laboratories in Missoula. Doctors and nurses also continued one of the group's newest initiatives: getting fluoride treatments into the schools.
“It turns out that fluoride is really cheap, so now we've got a program that provides fluoride for a thousand kids for a whole year,” Cates said.
During its forays into the rural villages of Honduras, the volunteers from MMA have seen more than their share of health problems that plague the Third World. In particular, they've seen the chronic health problems that stem from cooking inside on wood fires and using agricultural chemicals without any protection.
“I've really just grown to hate the companies that sell poor people these products and do nothing to make sure they're used safely,” Cates said. “We see long-term problems for so many farmers.”
Many in the rural mountain communities cook over an open fire burning inside the house. The smoke has nowhere to go, and breathing it often leads to chronic respiratory problems.
“For children, we often see the problem as pneumonia,” Cates said.
Like many problems in the Third World, just a little bit of help goes a long way. So as part of the group's “Healthy Homes and Farms” program, MMA is supplying materials for 10 families to construct simple chimneys to funnel smoke from cooking fires out of homes. Like everything else MMA does, the chimneys are being bought with donated money.
“It's so cheap and the benefits can be so important,” Cates said.
It's initiatives like the fluoride and chimney programs that have really impressed on Cates the value of money in places like Honduras.
“What we wrestle with all the time is the amount of money we spend on airplane tickets to get our people down there,” he said. “Sometimes, you just think sending the money would be better, but then you see the work our people do and realize that both are very important.”
Still, when $1,000 buys fluoride for a year for hordes of schoolchildren, the benefit equation is one that Cates must continually roll about in his head. But he and MMA still keep coming down on the side of going to Honduras.
“What we've really done in some places is created an opportunity for Hondurans to make a change,” Cates said. “Sometimes it helps to have someone outside giving a new perspective. But we're careful to make sure we work within their traditions and realities. A change we make probably won't last, but if the people are part of it, then it's got a much better chance.”
For Cates, Missoula Medical Aid doesn't just help Hondurans. It also helps Missoula, by offering us a deeper glimpse into another part of the world, and by offering people a chance to put their money or their time to good use.
“It's important for Americans to have a broader perspective,” he said. “It's important to know that how we live here is not how most people live.”
Sometimes, Cates said, people ask him whether he finds his trips into Third World isolation and poverty depressing. His answer is always the same - certainly not.
“It's so many things - sad, joyous, troubling, full of life,” he said. “But it's not depressing. It's life. This is how the world lives. They're not depressing. They're living and laughing and loving and trying to get by. We're just there for a little while to see if we can make things better. That's not depressing, not at all.”