#15. Cleaning the Wound

There is a small chunk of land between Nicaragua and El Salvador that connects Honduras to the Pacific coast. In retrospect, traveling those remote mountainous roads, in June 1990 was not the best place to be for two gringos.

The UN was clearing the Nicaraguan Contra’s out of the country side; helping to stabilize the area. This small chunk of land that was Honduras was a major guns and drug smuggling route.  I was very aware of the political situation and my location. I should have been worried.

But I was in the infectious confidence of Reids connections to doing the Good work.

Reid was the in-country coordinator for our healthcare team. We were on a scouting trip to find areas that had not seen care in years. Also, areas that would also accept the help when it came. Gringos had a mixed reputation in the area.

I arrived weeks earlier to see how international work would be. I was looking for something else to do with my life. My paramedic career was fascinating, but I wanted something else. I was restless. International medical relief worked sounded promising but I wanted to see it up-close and personal. I wanted to rub my nose in it.

Reid and I drove ‘roads’ that children dressed in perfect school uniforms would laugh at us for trying to get down. We crossed bridges that sounded like they really didn’t like us. And we introduced ourselves to the village elders where we could find them. All trying to learn where we would be most useful and accepted.

As the afternoon light was stretching out the shadows, we said good by to another village elder when a young anxious couple with a baby, walked up and started talking to both Reid and the elders from the house.

Given the age of the baby, I figured they’d been married about a year. He was painfully shy, tall but stooping over to hide it and taking off his hat, putting it back on and off again. All done with the greatest of humility.  She was clearly in pain, with shocks of winces breaking her face.  She carried and nursed the baby at the same time.

I should have known that this would happen.  Arriving in Honduras, I bonded quickly with Reids’ sister-in-law Marta.

Marta was a nurse who followed her own path. She was a nurse in the way the greatest of that profession are built. Guided by spirit and unrestrained by social or government influences. She had a ‘habit’ of disappearing for days or weeks at a time. Her family at first terrified and after years, quietly resigned to her calling.

We bonded immediately. We were both outliers in our communities and we were both fine with that.

Marta traveled these to these remote spaces to care for her people.  She told me about these communities.  I should have been ready.

Kitchen, main room, and the private back-room was the typical layout. In my time in Honduras I’d never been asked into the back room; that was for family. It was intimate space and for a gringo …  it didn’t belong to me.

Stucco walls and dirt floor; the room was closed off by just a curtain and the north window – for the coolest air – and the least light. 

The next realization hit me. I was going to exam this mans’ wife in a world I didn’t understand – that’s not great territory.  These are rural conservative people.  Church has a huge influence on them.  I had not knowledge of the social boundaries. And to examine under clothing – even more concerning.

My final shock was the  infected surgical wound and large bulbous puss pockets that had formed around her navel and abdomen.  A soft stomach told me infection hadn’t moved inside.  Phew!  Unfortunately, the surgical wound meant their was a track that could take you there in a hurry. Out here, where we were, an infection of the stomach lining would likely be catastrophic and a horrifically painful way to die.

I proceeded to clean everything I could.  No anesthesia, just 4×4 bandages with betadine dumped on them; and scrubbing and scrubbing; puss pockets failing under rough gauze, spilling fetid flesh and oder down her sides.

They were face to face, taking it together just the way couples do. Squeezing a hand hard, she not moving, he feeling every motion of my work.  Neither questioning; accepting my care fully.  It must have been horribly painful. My scrubbing allowing clean angry red flesh to emerge from its grotesque tomb.

Finishing with a clean bandage and Reids translated wound care instructions, I asked them to please go back to the hospital.   The responsibility suddenly felt very heavy and not something I wanted.  I was pretty sure I had just faked my way through something that needed knowledge, experience.  I had had enough time with her wound to think of that man alone with that baby.  I wanted an out – turn the patient, the responsibility, over to someone else.

That just wasn’t going to happen.  No doctors, no nurses.  I was going to own this one and never know the outcome.

Nose, now firmly rubbed in it.

I handed them all the bandaging supplies I had – all of it received with unabashed gratitude.  Time was pushing us out of these mountains before the problems of night arrived.  I was grateful to be getting out of there. I was stinking of the sweat that comes with fear and feeling bent by the entire experience.   

A festering discomfort accompanied me during the intervening days before the Cape Cod team arrived.  Seeing that family in my minds eye; Mother, Father, Child.  I was learning quickly that life in this space was tenuous, and death could savage you quickly.  I was not at all convinced that their story was going to be uncomplicated.

Our team set up in 3 separate location over a week. We had our own drama and health scares that provided distractions. And the work was hard, hot and relentless.

Then, several days into the teams work, I was stunned to see them. Walking beside the line of patients, baby in arms, up to our makeshift clinic.  Meeting me in the shade of the back of the school building – his hat on, off, on, off – she lifted her shirt just enough to see under a marginally dirty bandage, a very clean looking wound.  Not yet healed, but healthy.

There was real beauty in that moment between us. We had no shared spoken language.  For a breath there was no shyness, or awkwardness; alone in the moment, it was just us four.  For a breath.

They never did go to the hospital.  That journey and the money would have been a big hurdle.  I like to think that at best, medicine controls 1% of the healing of the body; the rest being personal.  She may have done just fine without my mucking around, it’s a tough group of people and impossible to know.

But what is clear is how we cared for each other. I stepped through all my barriers and did my best. But they came back to me, through hours of walking, simply to answer a question that would have haunted me, truly forever.

Crossing paths with those in need; stopping, helping, doing what you can.  I understood Marta now; why she ran from the city.  The power she had in this place filled her.  She ran away from the world of the city – to be out here – where there are no doctors.

Where there is only the Good work.