Day four of Ciriboya UNAH nurse/med student brigade

Please donate to support our brigade and the First Garífuna Hospital in Ciriboya.

In the morning we went back to the hospital, and once again it was packed. Turns out people in the region had heard about the brigade, and figured it was a perfect time to visit the hospital. So they went back to work again, attending to patients. I went back to work too, stealing a corner from Nora the Cuban lab tech whose warmth and humor made me feel right at home (and little Omer took my camera from me again, leaving me many photos I wouldn't have taken, like this one).

The students, meanwhile, were listening to one of several lectures that Dr. Margarito Lino would give that day. They had requested them (and certificates of attendance) because outside classes fill some sort of requirement for their degree. Dr. Margarito is a captivating speaker, and had their full attention every time I went out to take pictures and check on the group.

It's been interesting negotiating issues around education here, and the negotiation process itself has been quite educational. Honduran students, like students in just about any money-based education system, are conditioned to see the rewards of education as being (in the short term) grades, degrees and certificates, and (in the long term) social status and wealth. There's also the inherent teacher-student hierarchy created by the capitalist classroom that is impossible for even an anarchist professor to truly overcome. Some brave tenured folk insist on not giving grades, and some universities and other schools have even discouraged the use of grades as policy (I was privileged enough to attend such places for high school and college), but it's very hard to challenge the paradigm within the structure.

As such, it defines every part of my relationship with my (former) students. I am not sure if that is why my (nursing) students insist on calling me Doctora whereas the med students (who never were actually my students) call me Adrienne. (Why they call me Adrienne instead of Adriana like everyone else here in Honduras?). It could also be a question of social class; medicine is a degree that is mostly restricted to the wealthy in Honduras, because all of the materials required are too expensive for the average Honduran to afford. That is one of the many reasons why the majority of Garífuna med students are studying in Cuba on scholarship instead. Anyway, all of this is a prelude to a short anecdote.

In getting the students to think about the importance of learning at least the very basics of the Garífuna language on the previous morning, I had joked that I was going to give a quiz later in the week. When I said it, they seemed to take me seriously; I chuckled to myself as they all whipped out their notebooks at that moment and started practicing. This morning (day four) I greeted my former students in Garífuna as they arrived for breakfast. A couple of them stumbled over the response, and I made the same dumb joke again with faux sternness. You better practice—you'll fail the exam! A few seconds later, it dawned on one of them. "Wait a second!" she said triumphantly. "You don't get to grade us anymore. We don't have to learn anything!"

At that point, Mirna, who had been standing by making our delicious breakfast, lit into them in a friendly, but very firm way. If you want to and work in solidarity with Garífuna people, you'd better start learning the language, she told them. This isn't about grades—it's about respect for people's culture, and the quality of the care you will be able to give as nurses. And if you don't respect your patients, they won't respect you. My student, chastised but seemingly grateful as well, smiled and said "I take it back. You are absolutely right. Guiti binafi."

After lunch I walked back over to the hospital. Ciriboya, like everywhere else in Honduras, still has a bunch of fading political posters up from last November's elections, which were stolen by the ultra-right-wing National Party candidate by widespread fraud and a thoroughly corrupt, coup-installed electoral-monitoring structure. And like just about everywhere else in Honduras, from what local people tell me and from the number of campaign posters on people's home (only a partial indication, but a fairly good one in this case given that the National Party spent many times what the other parties could on campaign propaganda) the LIBRE party had far more grassroots support here.

Dr. Margarito gave another lecture in the afternoon that required a participatory intestinal tract. Luckily the whiteboard had an eraser. The final product had quite a bit of detail, and the students were fully engaged.

After Margarito's second lecture, Dr. Marilyn led a theater workshop. I wandered in while the students were preparing their play, and one of them said to me excitedly "Doctor, we're doing the same play we did in your class!" But the product was so much better than what my students, limited by the 50-minute session, had been able to achieve (I should have given them the whole week!).

In these photos, the family members argue with a busy, indifferent nurse at a public hospital to try to get a doctor to take a look at their ailing father. The doctor then ran through, ignoring the nurse who shouted "Doctor!" to the raucous laughter of the audience. Funny because true. There were scenes in which the doctor tells the son of the increasingly ill patient that he could get surgery if they were willing to pay an exorbitant amount of money ("but isn't this a public hospital?" "You know how things are. And, the hospital doesn't have the right equipment- we'll have to take him to my private clinic") and other scenes in which they visit a private hospital and get treated with great kindness and assurances that all the treatment they need is available there, only to be quoted an even more exorbitant, totally inaccessible fee. The acting was quite good, in the overly dramatic telenovela style that gets the best comedic response. Even the tragicomic death scene had the audience in stitches (again, funny because true). I got the feeling that of all the exercises so far, this was the one that most clearly demonstrated to the students (who were already amenable to the analysis, to be sure) why a public-but-not-universal (still-money-driven) system is bound to fail, as is a private for-profit (or "non-profit" for that matter) model.

The other team, apparently having lost some sort of challenge, had to dance punta.

Dr. Marilyn then gave a training on the APS (primary health care) family health histories they would be filling out the following day in their visits to different local communities.

After dinner, they decided to have a bonfire on the beach. I was coming down with a cold, so I sat it out, but these photos made their way back to me. The students seemed to think the pictures were somehow risqué (although they seem like a perfectly innocent good time to me), and got all giggly when I told them I had the evidence. One said "don't publish any of him," pointing to another. "He has a girlfriend!" But they also all wanted copies for their Facebook pages.