The sun is already awake by five o’clock in the morning in Central America, rising to its place above the smooth green hills and amongst the clear blue skies. All that could be heard this early in the morning is a buzzing sound coming from a native insect whose harmony resembled that of one long note slowly being dragged on a violin. This unpleasant sound seemed endless, until the violin stopped playing and all is silent once more. The brigadiers earn a few more minutes of desired sleep until the time on the snooze button is up, and once again the native bug thought it would be appropriate to play its lonely part in the orchestra. Day one of the brigade has finally begun.
Several hours earlier, a group consisting of twenty-four sleepy college students, one doctor, and two nurses, arms full of heavy luggage drowsily walk out of the terminal gate of Toncontin International Airport in Tegucigalpa. It was a Saturday, June 14, 2008. Coming from the Los Angeles International Airport (LAX), these students from the University of California, Irvine traveled six hours from Southern California to Honduras, making their way to San Salvador, then San Pedro, and finally Tegucigalpa. These students are on a mission with the Global Medical Brigades at UCI, spending seven days and six nights in a developing country to help bring basic necessities to those in need.
The Global Brigades is a nonprofit student-led organization that started in 2003 with a group of students from Marquette University who traveled with their church on a medical brigade as a response to Hurricane Mitch that hit Central America in 1998. There are now around 120 university chapters across the world to accomplish the mission of the Global Brigades, Incorporated to empower the community through a sustained effort. Within the Global Brigades, Inc. there are various divisions that cover two aspects: health and development. Medical, Water, Public Health, and Dental Brigades are involved with the health sciences part of the brigade, and they travel to Honduras. Meanwhile, Business, Law, Environmental, Architecture, Professional, Dance, and Microfinance consist of the developmental brigades, and they go to Panama. The University of California, Irvine currently has a club for six of these divisions and the Global Brigades Executive Board at UCI is in the process of adding two more.
Driving through the rural lands of Honduras, from the airport the brigadiers from UC Irvine are taken to a place called Rapaco ranch, where they will be staying for the week while on this Global Brigades mission. The students are greeted by an endless dirt road, which will lead them up a hill to a mansion in the middle of nowhere in Honduras. Strolling through the corridors of Rapaco ranch, the brigadiers find numerous hammocks, a basketball court, bunk beds, and much more; it’s nothing at all like they expected.
While hiking up the hill, following the trail of dirt that would eventually take the brigadiers to Rapaco ranch, the students of UC Irvine cannot believe that they are finally here in Central America. They have made it through a rough academic year of planning fundraisers, getting donations, persuading professionals in the field to come on the trip, collecting supplies, booking flights, and carrying out any other pre-departure items. Each division of the Global Brigades has their own to-do list in preparation of the brigade they will be going on, whether it be during winter break, spring break, or summer. The Global Medical Brigades needs to raise around $2,000 to buy all of the medications and vaccinations for the clinic. Meanwhile, the Global Dental Brigades must give presentations to different dental offices to obtain their professional dentists and ask for toothbrushes, toothpaste, and floss. The Global Public Health Brigades have to plan their health education workshops to teach the locals about basic hygienic practices. And the Global Environmental Brigades must coordinate with their partners in Panama to come up with an environmental project that benefits the country.
Regardless of everything else that must be done, fundraising contributes as a huge factor for the brigadiers. Because the Global Brigades is a non-profit organization that is student-led, it is the students that must come up with the money to not only go on the brigade, but also to obtain the supplies needed for the brigade. Disha Donga (a third year Neurobiology major and President for the Global Environmental Brigades) states, “If you’re interested in volunteering, you have to take the money out of your own pocket or do fundraising and help in those aspects to reduce the costs.” At the weekly club meetings, each of the Global Brigades plan numerous fundraising events both on and off campus, whether it be at Gina’s Pizza or one of the restaurants at the Student Center, in order to raise money and awareness for their own brigade.
Having never been on a brigade before, Disha is in her first year of being President for the Global Environmental Brigades, which just started during fall quarter. She has been getting advice from the President of GEB at UC San Diego. “He would always tell me that it’s the best experience, that they’re going to be so appreciative and welcoming of you because they know that you’re there to help… He would tell me that there are going to be times where you’re really frustrated and say ‘Oh my god, why is this so hard?’ but it’s really nice in the end.”
Peering out of the bus window on the day of the first brigade that summer, Nazreena Abulkalam (a fourth year Public Health Sciences major and Co-President for Global Public Health Brigades) takes in the Honduran environment. An hour has passed by already since they left the beautiful ranch of Rapaco where they are staying at, and the brigadiers are still on their way to set up a clinic in a small village nearby. Nazreena could feel the bumpy roads underneath her seat, the tires picking up pieces of the earth. Rocky dirt roads occupy the land and go on for miles; there are automobiles blowing out thick clouds of smog, and houses with only a sheet of flat metal or aluminum as a rooftop occupying the streets. There are no highways and no skyscrapers in sight. This scenery is way different than what the students saw at Rapaco ranch just an hour ago, and even more different than what they are used to seeing in Orange County.
Finally arriving at the village, the brigadiers lug their suitcases full of medicine, vitamins, and medical supplies into the school, as the long line of Hondurans wait anxiously for the free clinic to open. The group of students on the medical brigade separate into four stations: intake, triage, consultation, and pharmacy. The local people make their way through the different stations, first arriving at the intake station where they have to fill out a patient information sheet, including their name/nombre, date/fecha, age/edad, sex/sexo, and community/comunidad. Next is the triage station, where patients tell the nurses their symptoms and students take their blood pressure, temperature, weight, and glucose tests. The next room is for consultation, in which patients go see the doctor who will consult, diagnose, and prescribe medication to the patient, while the students shadow the doctors. The pharmacy is last, where the prescriptions are filled and medications given out. There is also a dental station set up nearby, where students from the Global Dental Brigades work. Starting at seven in the morning and not getting back until five in the afternoon, the brigadiers literally work out of their suitcases to help the people of Central America.
“El estómago” is the Spanish term for stomach; however it refers to the actual organ and not the body part. On the first medical brigade she went on, Nazreena served as a Spanish translator. Always having her mini Spanish dictionary at hand, she remembers asking the patients to repeat multiple times what they were saying, and thought that the hardest part was translating what the doctor said into the correct medical terms. “It’s crazy cause you know in each country they have their different dialect so they had different words for like stomach that I never knew about so it was really helpful having the Honduran staff there… because when people would say, ‘My stomach hurts,’ I couldn’t figure out what the word stomach was.” Nazreena laughs at the memory. Sourav Roy (a fourth year Biological Sciences major and President of the Global Medical Brigades) remembers being made fun of his Spanish: “We give it like a bad, terrible accent.”
Next to the triage station is a room claimed to be the consultation station, where the doctor has just diagnosed a Honduran man as having a “dead foot.” Puss was seeping out and the blood was building up, resulting in the swollen foot that the doctor’s eyes lingered on. The man had an infection in his toe that he left there for months due to walking long distances, since many of the villages in Honduras are high up in the mountains and it is rare to see a car on the roads unlike here in America. The man would need to go to a local hospital to have this dead foot cut off. That was the only prescription the doctor could give at the time, as the brigadiers only had medication with them and no sterile equipment. “We’re kind of like a free clinic, we’re nonprofit so we do these things for free, and so that’s why people come to us rather than go to the hospital when they actually really need to go to the hospital,” says a frustrated Nazreena. “It was really sad because how are we supposed to treat it? We don’t have the surgical means to do so. So all we did was refer to him to an actual hospital but it’s difficult because a lot of these families don’t have money to pay for that kind of treatment.”
In the room next to the intake station, the nurse stared at the girl before her, as the young girl broke down in tears in the free clinic thinking about all of the times her father sexually abused her. This is the first time the girl ever told anyone of these incidences of sexual abuse.
After waiting in line for the consultation station, a young boy took his place and sat in front of the doctor, both of them staring into the eyes of the other stranger. A black pupil with a brown iris around it and white surrounding the outer portion of the eye reflected in the other’s eyes, except for the young boy the doctor noticed a little squiggly black line growing towards his pupil. The seven-year-old boy was recently bit by a parasite indigenous to Honduras, and one of the parasites ended up in his eye. The squiggly black line that resided in the white part of his eye looked like a worm and was protruding out of the boy’s eye. If the parasite were to reach his retina, the child would go blind and become a victim of river blindness. Because the clinic didn’t have the surgical means to deal with this case, they had to refer the family to a hospital. “So I don’t know what happened to him, and every time I think about our Honduras trip, I always think about that kid because I wonder what happened to him… Did we really help or did we just kind of like throw him to someone else?” Nazreena continues to ponder more than a year later.
Set up next to the medical clinic is the dental station. From the next room, the brigadiers could hear a child crying. With puffy eyes and tears falling down his cheeks, the dentist thought that the child had been crying because he was scared of getting his tooth extracted. As the dentist used his tools to get a hold of that decayed tooth as the child continued to cry, he finally just pulled. The child was perfectly calm after that. “It’s just amazing how we could have that effect on people,” expresses Kelley Nguyen (a fourth year Biological Sciences major and President of the Global Dental Brigades). “That’s what I really liked about the dental brigades that we’re giving them an immediate solution and extracting their teeth because it’s so sensitive that it’s hurting them when they eat.”
Not only do the brigadiers of the Global Dental Brigades assist and shadow the professional dentists, but they also get training to do the work themselves. The brigadiers will actually give people anesthesia shots and do extractions, along with teeth cleaning and education workshops on proper hygiene and brushing techniques. In spite of the training that the brigadiers receive beforehand, this poses a problem for some people who believe that college students are too inexperienced and not professional enough to carry out these types of procedures the dental brigadiers do. “A lot of people think it’s unethical that we’re doing this, but the way I see it is that they really have nothing else. They’re in pain if we don’t help them so I mean… we should just help them,” Kelley says. Some people view these trips to Honduras and Panama as treating the local people as guinea pigs, letting students who aren’t properly and formally trained to experiment with clinical procedures. However, the brigadiers express that students are under the watchful eye of professional dentists who wouldn’t tell them to do anything that would be harmful to the patients.
Although the Global Public Health Brigades aren’t as hands-on with their brigade as the Global Dental Brigades, people still have a problem with Americans going into another country. There are some people who believe that with these brigades, Americans are telling the local people of Honduras and Panama how to live their lives and interfering with their business. “I’m sure the Honduran people are kind of like ‘Why are they here?’ but if that community wants us there, then we’re going to be there,” says Nazreena. “And we only work in communities that want us there because obviously why would we go if they didn’t want us there?” Many of the brigadiers express that they would not be paying so much money ($750+airfare for Honduras, and $850+airfare for Panama) out of their own pockets just to “experiment,” that there has to be a meaning behind it as well. “I know my intentions are good, like I know they are so that’s all that matters,” states Kelley.
The health and growth disparities between the United States and developing countries such as Honduras and Panama are so drastically different, and through the Global Brigades students receive an eye-opening experience. Imagine having to live on less than two dollars a day for basic necessities with no access to clean water, no medical treatment nearby, and no higher education. In Central America, the typical family income for the communities in Honduras and Panama is less than two dollars per day to spend on food, water, clothing, shelter, etc. Typical families need to survive on less than three gallons of water each day, which are infected with parasites. There are no doctors within a twenty-mile radius for these villages. The average level of education is 5th grade for the communities in Central America. “We take so many things here for granted… just like the necessities like clean water. That should be a human right that we should have access to and they don’t even have that over there… And it’s really nice to go there for like a week, one week a year to really put yourself and to experience all of that so you can really appreciate what you have,” expresses Kelley. “The people are why you’re there; they are very friendly, nice and appreciative of the free healthcare… Definitely helping these people in remote communities is life-changing,” states Sourav.
After a long day working in the free clinics at the villages, the brigadiers finally head back to Rapaco ranch, where they will repack the supplies for the next brigade and rest. Lying in the hammocks on the patio, they watch the sun set over the mountains and recap their experiences. “Even though we were all there, we all took something different from each day,” says Nazreena. As the sun begins to doze off, the various colors begin to blend in the atmosphere. The oranges and pinks and purples mix together with the blue sky. There’s a tint of gray and the green from the hills rise up to the sky and begin to merge. Once again, all is quiet at Rapaco ranch except for the sound of power generators running.
-Sourav Roy (President of the Global Medical Brigades)
-Nazreena Abulkalam (Co-President of the Global Public Health Brigades)
-Kelley Nguyen (President of the Global Dental Brigades)
-Disha Donga (President of the Global Environmental Brigades)
-Observation of weekly club meetings for all Global Brigades clubs; tried to attend a couple of meetings for each of the divisions; reconstructed scenes based on information from interviews, powerpoint slides used at meetings, and various documents obtained
-Documentation of Global Medical Brigades at UCI website with pictures and slideshow, The Global Brigades website, Global Brigades travel blog, Global Brigades on Twitter, Global Medical Brigades on YouTube, history of the Global Brigades from website, various articles about individuals who traveled with the Global Brigades organization and their experiences, Global Brigades Day information session
-Email and phone call exchanges
For more information, here is the link to one of the interviews for this article: Interview with President of Global Medical Brigades