“Push! Push! Push!” I said to the fatigued woman in labor before me. We were in a delivery suite at the University of Arkansas for Medical Sciences in Little Rock, and I was a third year medical student. It was 1988.
“Push! Push! Push!” I repeated a bit louder. This was our first baby: she had never been pregnant, and it was the first time that I had ever attended to a woman in labor, “Push! Push! Push!” I said in an ever-louder voice and with a greater sense of urgency.
Suddenly, the supervising resident physician came into the room and said to me, “Scott, your patient is pregnant – not deaf!” I laughed and then probably turned red. I was caught up in the excitement of the impending birth, and I thought that somehow the force of my voice would help to bring it about. Was I naive? My presence at that moment and my voice were all I had to offer. I was doing what I could. And while I may not have been with this mother for most of the pregnancy, I was at her side during a crucial time – the birthing process. In the end, my presence and my voice may have made a difference: after more effort and much pain, mom gave birth to a healthy baby.
The woman in labor did most of the work that day. She was supported by a competent medical team though. And it was prepared for any emergency. I was a junior member of that team – inexperienced and always under supervision. But my proximity to the patient during the birthing process gave me a unique perspective on the situation. So it will be as I closely follow the birth and development of the Camillian Task Force during the next 7 months. During this time I will minister as a priest and a physician in Honduras, El Salvador, the Philippines, France, Kenya and Uganda. And if the situation permits, I will respond to any man-made or natural catastrophe that occurs. As the animator and organizer of the CTF I hope to pave the way for collaborative efforts, particularly with the local church in areas that have been affected by catastrophes. I am only a junior member of the Camillian team, but my travels will afford me a unique perspective on the “birthing process” of the CTF. The woman in labor that I attended to as a medical student gave birth to a healthy baby. I hope that my presence and my voice as a Camillian physician and priest will produce a similar result for the CTF.
I began my ministry as the CTF animator and organizer by participating in a collaborative medical-pastoral mission in Honduras, a country that has been affected by numerous natural catastrophes: earthquakes, hurricanes and landslides. From January 5-11, 2004 physicians, nurses, medical students, physical therapists, pharmacists, translators and logistics personnel – 25 in all – from Global Medical Relief (GMR), the Camillian Task Force (CTF) and Sociedad de Amigos (SAM) went to 5 locations outside of Tegucigalpa, Honduras. A total of 6 different doctors helped: Three of them were present at all 5 locations: Dr. Chris Drayna, Dr. Lise Taylor and yours truly, Dr. Scott Binet, OSCam. Dr. Drayna, an internist from Milwaukee, Wisconsin, was the senior physician of the group. He went on GMR’s first mission to Honduras in March 2003 and was thus a reassuring presence for Dr. Lise Taylor and me. From Baton Rouge, Lise is a med-peds resident at the Medical College of Wisconsin in Milwaukee. She brought much zeal and a very pleasant disposition to the team, not to mention a medical acumen bolstered by her recent formation. I am a Family Physician by training. Prior to the brigades I was doing volunteer work as a physician at two medical clinics in Milwaukee. During the mission, we three doctors from the States were joined by Dr. Daniel, a physician from Cuba doing public service in Honduras and working with Sociedad de Amigos; Dr. Jose Samra, the chief of the emergency room at the major public hospital in Tegucigalpa; one other Cuban doctor working for Sociedad. These three Spanish-speaking physicians were a source of moral support for us gringo doctors and often a good source of help with difficult cases that needed to be referred. The physicians were supported by triage personnel, pharmacists, translators for those physicians who didn’t speak Spanish, and several interested students who were present during the consultations both to learn and to help fill prescriptions at the pharmacy.
The first brigade took place on January 6 in El Coyolito, Honduras, a small town in the mountains about 1 ½ hours outside of Tegucigalpa. There we served people whose medical needs were great and resources few. The team learned much that first day. At first the physicians had to deal with an inordinate number of complaints for each patient: “triage” made a laundry list of each patient’s complaints rather than screening them to determine if they could be treated by a nonphysician. This problem would take some time to rectify. Similarly, the group had to make some personnel adjustments to insure that we would have enough Spanish-speaking people instructing the patients about taking medications. And some of the latter ran out rather quickly while others remained untouched. The first day was a learning process for me as well. I had to familiarize myself with the more than 100 different types of medications in the pharmacy and become comfortable speaking medical Spanish – Honduran style.
I was prepared for most of what I encountered that first day in Coyolito: respiratory, parasitic and skin infections; headaches; coughs; rashes; foot problems; high blood pressure, stomach pain, musculoskeletal pain, dysmenorrhea, scabies, and prenatal care, etc. The circumstances and my lack of training limited me somewhat though. For example, two of my first three patients were pregnant, and the diagnostic resources at hand were suboptimal. What did I do? I talked to the women about prenatal care, determined the gestational age of the children and assessed their status, discussed the signs of labor and indicators of a possible problem, examined the women and then gave them prenatal vitamins. And because these mothers lived far from any labor and delivery services and to my knowledge there weren’t any midwives in town, I reminded them of the importance of prearranging for transportation to the hospital. In the end, I did what I could. I would have felt more comfortable with the care that I provided, however, if I had an ultrasound of the baby and could order certain tests. Indeed, we physicians could do very little about some conditions that we diagnosed, e.g. dental problems and cataracts. We could only refer these patients to professionals in Tegucigalpa and hope that they would go.
The GMR-CTF-Sociedad team members served the medical needs of hundreds if not thousands of poor sick during 5 brigades over 6 days. After El Coyolito, we went to Los Limones, El Zarzal, Las Guaras and Nueva Esperanza – all located within the Department of El Paraíso. We followed the same routine for each of the brigades: the night before a brigade the team selected and organized the medications and supplies for the next day, processed in writing and through discussion the brigade just finished, celebrated mass in the Nuevo Paraíso chapel (in English or Spanish), and socialized; the morning of a brigade we ate breakfast, loaded medications and supplies onto the vehicles, received our assignments for that day, traveled to the site, set up, provided medical and nursing care for the patients, and then returned to Nuevo Paraíso. With each successive brigade the team became more efficient and the medical care we provided was that much better.
Both the team and the people we served benefited much from this collaborative GMR-CTF-Sociedad de Amigos medical-pastoral mission. The people received medical care, supplies and, when necessary, a referral. We also tried to impress upon them the importance of taking care of their health through proper hygiene and preventive measures. And with our visits these towns in rural Honduras became a part of the network of people that would be served in the future by medical brigades: there are at least 6 groups from the United States and Canada that organize annual medical missions to Honduras. On an interpersonal level, the people we served experienced the good will of their fellow Hondurans and of us Americans. This benefit is less tangible but no less significant.
The team members also benefited from the mission. We became more sensitized to the unfulfilled healthcare needs of the Honduran people, which are primarily a result of poor access to care, a lack of services, and difficulties in obtaining medications because of their relatively high cost and low availability. The team saw how the people live, and we witnessed their poverty. This was eye-opening for many, and it made us much more conscious of how we often take our own healthcare system for granted. We were exposed to situations that stretched our medical skills and made us better healthcare providers. And students entering the healthcare profession learned much from working with already trained physicians and pharmacists.
The mission was also an opportunity for having some fun and for making new friends. One Honduran team member told me that she was very surprised at how genuinely friendly and compassionate the Americans were towards the poor Hondurans they were serving: she expected the opposite. For my part, I experienced the Hondurans on the team as very welcoming and similarly dedicated to serving the healthcare needs of the poor sick. We also learned about ourselves and our capacity for service, empathy, and compassion. Finally, we grew individually and as a group through working together and sharing our experiences both orally and in writing. Not everything went as I would have liked though.
I am disappointed that we did not celebrate mass in the towns where we served the sick. I did not push the issue during the mission because celebrating mass in the towns was not a previously agreed upon part of the routine of each brigade. And several of the team members were not Catholic. I did preside at mass each evening in Nuevo Paraíso though. In the future I would like those participating in a Task Force mission to have the opportunity to worship with the people that they serve. I am also disappointed that I was not able to follow the progress of any of the patients that I took care of. Continuity of care is a part of Family Practice that I enjoy.
This collaborative GMR-CTF-Sociedad mission was a good next step in the “birthing process” of the CTF. Gail Johnson and I accomplished much, and our ministry together contributed significantly to promoting the Task Force. Participating in the brigades allowed Gail to confirm her desire to be involved in missionary work – both as a participant and through fundraising. She will continue to play an important role in the development of the CTF in the States. As the animator and organizer of the CTF, I had the opportunity to serve the sick as a physician and to witness to my faith as a priest through the celebration of mass, counseling people, frank discussion of the Faith with Catholics and non-Catholics alike, and the telling of my vocation story. The latter was an important part of my ministry because many of the members of the team were young and still discerning their own vocations. The mission was also quite edifying from an organizational, fundraising, personnel and logistics standpoint: I was a part of the planning and execution from the beginning. And given that the mission was in a country with a history of natural catastrophes, most recently Hurricane Mitch in 1998, I was able to learn much from the Hondurans. I spent a significant amount of time with Sister Maria Rosa Leggol and Mae Valenzuela, the founder of Sociedad and its coordinator of development respectively. Sister is a mainstay of the Church in Tegucigalpa. In the event of another natural catastrophe in Honduras, I am sure that she and Mae – along with the ordinary of the Archdiocese of Tegucigalpa – would help the CTF to carry out its mission there.
The “birthing process” of the CTF has begun in earnest. I am very close to it as the animator and organizer of the Task Force, and through my presence and my voice I am doing what I can to help. If the Task Force is going to develop further we are all going to have to “push” together. It will take much planning, hard work, cooperation with others, and resources – people, supplies and money. Most importantly, it will take a commitment on the part of the Order and the larger Camillian Family to make the CTF directives of the 1995 and subsequent General Chapters a reality. As I minister in El Salvador, the Philippines, Italy, France, Kenya and Uganda, the CTF will benefit from my unique perspective in many ways.
In El Salvador I will meet with Monsignor Richard Antall, the director of Catholic Charities in the Archdiocese of San Salvador. I intend to tell him about the CTF, to learn more about both the healthcare system there and the response of the Archdiocese to the 3 earthquakes in El Salvador in 2001. I will inquire about how the CTF might collaborate in the future with the Archdiocese in the event of another natural catastrophe. In the Philippines I will participate in a 12-day collaborative CTF-Rizal McCarthur Foundation medical-pastoral mission with 40 other healthcare providers and helpers – primary care physicians, surgeons, nurses and anesthesiologists. Most of the members of the group will be Philippinos who now live in the US. Reverend Dr. James Roa, OSCam will join us on the mission. James is a cardiologist and the initiator of the recently established rapid response team of the Young Camillian Association in the Philippine Province. After this collaborative mission I will stay in the Philippines for approximately 2 months during which I plan to work as a physician in the emergency room at Philippine General Hospital, the largest and busiest tertiary care facility providing indigent care in Manila. I will reside at the Camillian community in Makati City where I will also help as a priest at La Paz Parish. I also plan to make contact with the local church and the leaders of the Camillians in the Philippines, a country that has been subject to numerous natural catastrophes – volcanoes, earthquakes, monsoons, landslides, floods, etc. In April I will go to Rome for one week to meet with the other members of the Central Commission of the CTF. Among the items on our agenda will be the financing of the CTF, further developing its website and assessing the response of the larger Camillian Family to Father Antonio Menegon’s recent appeal for their help with the CTF. While in Rome I also hope to meet with Father Loci, the director of Salute e Sviluppo. I want to see if the CTF and this organization can collaborate. At Easter I will go to Lourdes, France with three members of the larger Camillian Family. Together with members of the American Special Children’s Pilgrimage Group we will serve the medical and pastoral needs of numerous handicapped children and adolescents. While in France I also hope to meet with other members of the Camillian Family. After Lourdes I plan to head to Kenya and Uganda to further promote the CTF, to do ministry and to get some medical formation.
Despite appearances, this schedule is actually somewhat flexible: if a man-made or natural catastrophe occurs either after we have completed the collaborative mission in the Philippines or while I am in Africa, I intend to respond. I have to be prepared and available to do just that given the nature of the CTF: an ensemble of religious and lay people who are prepared to respond on short notice to emergency situations. I hope that wherever I am my presence and my voice will make a difference. Let us all push! push! push! A healthy baby is on the way.
Scott F. Binet MD, OSCam
Animator and Organizer
Camillian Task Force
February 22, 2004
Feast of the Chair of Saint Peter
Address any suggestions or comments to Scott at SFBRome2@hotmail.com
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