Wandering Bob

An update from Dr. Bob Gehringer, HBI's peripatetic Medical Director:

"Hello Everyone,

It's been a while since there has been a Peruvian epistle from me, so Thanksgiving seems a good time. The Peruvian calendar is replete with holidays, but El Dia de la Accion de Gracias, Thanksgiving, isn't among them. I've been in Peru almost a month this time, and this week in Ica (check the map), where I've been kept rather busy with multiple neonatal resuscitation workshops. So far this week, I've done six workshops for a total of 117 medical professionals of various sorts, with two more tomorrow. I just spoke to Natalie and all is well, though I'd rather be enjoying Thanksgiving with some of you at home. At least the Packers won again.

So, yesterday.... I went to Pisco, a small city near the ocean, to the hospital to do a training, and had a delicious ceviche lunch with the director. Late afternoon, I was picked up at my small downtown Ica hotel to be transported with all my gear a little over two hours south to Nazca by a guy named Gustavo Montoya Lopez, a chunky, gregarious, middle-age Peruvian. We headed south on the Pan American highway out of Ica through a wide irrigated valley about equally divided between vineyards and cotton fields and punctuated by smaller plots of aspargus, artichokes, and corn. The Pan American is really the only north-south highway of any consequence in Peru, mostly a busy two lane road with a variety of vehicles, especially inter-city double deck buses and long haul trucks.

The first half hour was through the valley with the sun setting behind the first ridge of the coastal range of the Andes a few miles to the west. Sunsets happen more quickly here than in my more familiar northern latitudes and the clouds went rapidly from cotton candy pink to a deep mauve before fading into night sky. We rolled south climbing a bit to a plateau of rocky desert moonscape devoid of vegetation, over and around some modest mountains, and finally into Nazca.

OK, now for the best part. Gustavo picks me up in a wonderful, beat-up, bright red, 1975 Dodge Cornett. This thing is so big you could land small planes on the hood. In the crowded Ica city traffic it's a joke, but out on the highway we cruise through all the small towns. Cruise is definitely the correct verb, as it's a true land yacht. The acceleration wasn't great, but when Gustavo stepped on it, the sound was magnificent. A full throated roar, akin to a turboprop just before take off. The radio going full blast, windows down, and me channeling Jack Kerouac. All we needed was a bottle of Pisco to pass back and forth (no, no Pisco).

Anyway, it was a memorable trip and Gustavo asked me to call him next time so he could bring me over to his nearby hometown of Palpa to spend the day eating and drinking. I hear he sings and plays a pretty good guitar, so let me know if anyone's interested.

One last thing, our organization, Health Bridges International is doing two runs, each 50 kilometers through the slums and nicer neighborhoods of Lima and Arequipa early in December to highlight the contrasts and need for change. Please check the websites, www.hbint.org and www.iamthebridge.org and consider making a pledge, all of which will be used to support our partner organizations that work in impoverished communities in Peru."

A Tear in the Fabric of Humanity

"A tear in the fabric of humanity," I heard this expression the other day in the context of the HIV epidemic. The scientist referencing the quote (I am not certain to whom to originally ascribe the origins of the phrase) was proposing that HIV was the result of a convergence of a number of social, economic, medical and geographic issues. He was saying that the "tear" in the fabric that blankets all of humanity was a function of the multiplicity of these issues contributing to the enormous impact (scientists estimate that there will be 60-million world-wide cases of HIV by the end of the decade) that is HIV and AIDS. In essence, he was saying that HIV and AIDS have become a dividing element in our collective humanity.

There has been another devastating convergence of issues that has led to a "tear in the fabric of humanity." This tear has been around economic parity. The enormous distance that has grown in the world between socioeconomic segments of societies has been prominent in the media over the past 6-weeks. From the political protests in Northern Africa to the Occupy movements in major cities around the globe, people are taking to the streets to voice their frustrations.

We too are taking to the streets. Our "Bridging the Divide" event in Peru is designed to draw attention to the needs of under-served and marginalized communities. We are also seek to generate and encourage greater active participation in sourcing solutions. We are running 100 kilometers to bring a singular message that is "we can all build bridges" to connect resources with needs.

Peru is in a unique position. The economy of Peru is growing at record rates. There are more people with more resources than ever before. There is a great opportunity to build a network of "bridges" that will support the delivery of services and supports to the segment of the population that has been "torn" from the fabric of society. There is a great opportunity to level the playing field and assure that all Peruvians have access to their basic life needs.

We are running 100 kilometers in December to make a difference. We are asking others to come along with us in the movement to Bridge the Divide.

Bridging the Divide - Lima Press Conference

We have the Lima Press Conference set for the Bridging the Divide run. On Monday, December 05 at 11:30 a.m. PERU (EST in the U.S.) we will hold a press conference in the venerable Congressional Hall of the Republic. Need-less-to-say, this is a very big deal.

HBI is proud to be part of the movement that is slowly taking hold through the I am the Bridge project. We are really excited to see what comes next. Who knows how "viral" this movement can become with a little press and a lot of hard kilometers (a hundred hard kilometers that is).

Ines: A Bridge to Somewhere

Photo: A recent picture of Ines - a far cry from earlier photos

The following is a story that originally appeared in a letter that HBI sent to our donor base along with "year-end" receipts. The story is particularly timely with regard to our Bridging the Divide campaign.

A few years back HBI was working in a community providing medical and social outreach. The community, a desperately poor area of dirt streets and clay brick homes, sits on the edge of one of the largest urban slums in Latin America. An area so poor that it actually rests “outside” of a completely impoverished slum.

At the time that I met Ines she was only two-and-a-half years old, yet she had suffered more than most people will in their entire lives. She lived with her mother and sister in a small "house" in the community of Via El Salvador - actually they will tell you that they live in Via El Salvador, but they really live in a small squatter area above the formal slum. When I first met Ines, she had never walked on her own. She did not speak. She could not go anywhere without her mother.

You see, Ines has a horribly disfiguring condition that causes her skin to fall off in sheets. Her entire body, with the exception of her head was covered in blisters, scabs and open sores. The condition, a rare diagnosis known as Epidermolysis Bullosa (EB) has only four known cases in the whole country of Peru. Her diagnosis is so advanced that she even has blisters on the soles of her feet and under her little finger nails. When I first met Ines she was constantly in pain.

I met Ines on the last day of a week-long outreach campaign – just as we prepared to end our work. She is a beautiful young girl with deep chocolate brown eyes and a soft smile. After spending almost an hour with the mother and daughter, taking pictures, making copies of the medical records she brought - we said goodbye. I felt haunted by the experience, for I wondered what I could possible do. I felt a little bit hopeless for the plight of the mother and daughter. Then, almost before I packed my bags to leave, they came back. She - Ines – came back to the clinic to kiss me goodbye. It was almost too much. It was a crushing moment. A moment when I realized the importance of our work.

HBI’s initial work with Ines included helping to secure a monthly stipend for the family. Money that went to pour a concrete floor on their dirt floor home. Money that helped to pay for monthly visits with a dermatologist who we connected with the Dystrophic Epidermolysis Bullosa Research Association of America to advance her knowledge about caring for Ines. Money that went to help Ines go to school and her mother to learn a trade to advance the economic situation of the family. Finally, we realized the most important thing we could do to help Ines was to “build bridges” of support for her and her family. As such, some of the monthly stipend went to pay the salary of a care advocate. The advocate helps to link Ines to care and support. We did all of this with a monthly stipend of $150.

Since we initially started working with Ines, our program has grown to include care, advocacy and support for a number of medically fragile children. Thanks to your generous support, the “Ines Project,” working in close partnership with the Anglican Church of Peru, has grown into a collaborative effort that is assuring care and advocacy for some of the poorest children with the most advanced medical needs in Peru.

Ines and the thousands of children who suffer through extreme poverty with medically complex conditions need our help. The depth of support that is needed can not be matched with a small program like the one that we have created through HBI. The depth of support needed requires the development of many "bridges of support." Bridges built by Peruvians for Peruvians. Our hope is that the Bridging the Divide events can call greater attention to the numerous opportunities that people have to build the bridges that will assure every child has the support they need to live a life filled with health, hope and happiness.

Video Updates and Training

We are really upping the ante on our promotional approach to the Bridging the Divide events. In fact, today our ace volunteer designer (Sr. Hugo Corzo) put together a number of really great "I am the Bridge" videos. Check out the videos on the I am the Bridge blog and on HBI's YouTube Channel.

In addition to run promotion, we are also pushing our run training. Today, in a 40 degree rainy fall day in the Pacific Northwest, we ran almost 10-miles and discussed our plans to assure we are all on the same page for the event. We continue to collect a number of Peruvian runners in the events. They, a group of politicians, business community leaders, and social change agents, will join us for various distances throughout the Lima and Arequipa events.

To keep our stakeholders connected to the events, we will be airing video updates throughout the run, posting pictures and making sure that everyone can follow our progress on the event website.

Preparations for the Run

Photo: The HBI team and members of the Peruvian Congress in support of the run

We are in full preparation mode. The "Bridging the Divide" runs are almost here and we have a full docket of planning before we take our first running steps.

We have hired a PR firm in Peru to help with the marketing and awareness around the run. Their role is to get the media at Press Conferences the day before the runs in Lima and Arequipa and to assure that there is publicity after the runs. In addition, they are setting up television interviews for Ben and I when we are in Lima before the event.

On the U.S. front, our partners at Pac/West are continuing to guide us through the deliciate nuances of "earned media." We are meeting with them tomorrow to go over the last minite details of the U.S. media campaign. We owe them a great deal. They have been really accesible and responsive to all of our questions and concerns.

This is a big venture for HBI. We are really hoping the run will draw attention to the tremendous economic disparities in Peru and help to raise awareness about our work.

Special thanks go to Dr. Daniel Bueno and Mr. Hugo Corzo for helping to make the Bridging the Divide event a reality.

Bridging the Divide

We are really busy preparing for the Bridging the Divide events in December. The runs, two 50-kilometer events, will draw attention to the great economic divide in Peru. our goal is that the runs will be a motivator to get more people involved in "being the bridge" in their own communities.

Over the next couple of weeks we will be updating the Blog, making changes to the Iamthebridge.org website and creating a number press related activities. Stay tuned to all of our "channels" for updates. And - if you are so inclined, please pledge a runner for this very worthy project.

Thanks for all of your on-going support!

Pictures from Peru - Outreach to Carabayllo

Photo: Dr. Townsend Cooper - what an amazing guy!

Photo: Our pharmacy dispensing window - eat your heart out Walgreen's

Photo: Dra. Paola and the great dental team

Photo: Ben getting the clinic up-and-running

Photo: The community - dry, dusty, and terribly poor

Everything we need, we learned from Sesame Street

Have you ever seen the Sesame Street skit in which a group of penguins attempt to order room service at the Furry Arms Hotel?

If you haven't seen the skit, or if it has been a long time since your last viewing, take three minutes to watch this really funny Muppet act at: http://www.youtube.com/watch?v=WPfaV8n3R_o

What in the world does the Furry Arms Hotel and penguins ordering room-service have to do with global health? Well, I think the skit captures one of the major problems with the way that we deliver aid and support. The aid is not connected together. Our efforts are not grouped in "sets" of complimentary services. Instead, multiple agencies, deliver multiple programs, in multiple locations with little coordination or collaboration.

Stepping back from services delivery and defining the various mechanisms we can "pool" to compliment resources (packaging our aid in more effective ways), is the key to ending world hunger and greatly decreasing extreme poverty. Just like the penguin ordering room service in the Sesame Street skit, we can't continue to look at our work in discrete elements. We have to choose to view the power of "sets" and influence of pooling our efforts.

Re-entry

Photo: Our princess in her Halloween costume.

Following our outreach trip in Peru, I hopped on a flight in Lima and flew directly to New Orleans to meet Lee and our baby Alex. The transition, moving between different geographic worlds, is nothing new to me. I have been traveling back and forth between a number of different communities (here in the U.S. and internationally) for a number of years. This re-entry, however, has been difficult for me.

The difficult part has been trying to hold the bigger picture. My challenge has been viewing the bigger goals of HBI - all the while being mindful of the issues and elements that cut across the numerous cultures and geographies of our planet.

Yesterday I went for a run. I ran down Magazine Street to the Garden District. A beautiful area with old Antebellum homes and tree lined "Southern" streets. Running back to downtown I passed an inner city school with children playing. The kids, elementary aged students, were playing typical school yard games. There were smiles, loads of laughter and a general lightness in the air.

Almost instantly I felt this jolt of awareness - what if these kids had a strong connection (a bridge) to the kids playing in a similar playground in a poor community in the city of Lima. What if they, from a very early age, had a chance to get to know the intricacies of the lives of their counterparts living on continents thousands of miles away? What if the world were connected at the level of children meeting children? Would these "bridges" be powerful enough to ground our economic, political and social forces toward a common good?

My re-entry from this latest trip has been a powerful adjustment. I have this nagging feeling that there is a more strategic role that HBI can play in helping to build more complete bridges. I am excited to think about a future that binds communities and people together at very early ages. I am hopeful that such connections can lead to vast improvements in the health and vitality of communities and populations. I am completely committed to the idea that connecting people through meaningful relationships can (and will) generate powerful levels of change!

Are you a bridge?

We are excited to have a number of fantastic supporters engaged in the HBI "Be the Bridge" for change campaign.

Check out the following video clip of a very famous Peruvian Senator and her commitment to "Be the Bridge:"