Remarks

I have received quite a few requests for a copy of some brief remarks I recently made at an awards ceremony. I have decided to make this document available on the HBI Blogspot. Please see below.

Thank you -

“I come to you in the name of . . .”
By Wayne Centrone

Thank you. It is a real honor and pleasure to be here tonight.

All too often it is easy to get caught up in the busy-ness of life. The “To Do” lists and the endless array of errands and “got to get dones.” They fill our daily routines to the point that we are lost in a mindless routine. I know this all too well.

Perhaps the best way I have found to re-center, re-focus myself through this “forest and tree” interplay - is with the stories of my patients. Stories that punctuate a human spirit and a heartbreaking level of trauma and tragedy.

Please do not get me wrong, I can get just as myopic as any other physician – relegating a patient to a set of laboratory data points or all too often narrowing them into a diagnosis – AND, when I can remember that they have a story that sits behind the “curtain” of our clinical interactions – I can really tap into the soul of the work that we are doing.

Our Outreach program is a kaleidoscope of stories. Each with a bit of tragedy, a sliver of triumph, and a significant amount of hope. Hope that comes through relationships. Hope that comes through compassionate caring. And hope that comes from just being with another human being during their darkest times and most difficult challenges.

In Latin America when a person makes a presentation, accepts an award, or is showered with accolades – they will often say . . . “I come to you in the name of – “signifying the collaboration that often seeds any activity.

Well, I come to you tonight in name of the “shadow people” of our metropolitan area. People who have for so long been without a voice. People who slip below the radar screens of our lives. People who often live their lives in a somewhat hopeless desperation. I come to you tonight to give them voice. To let you know that they are not alone. To insist that their lives do matter.

And most of all, I come to you tonight in the name of hope – a hope that is grounded in the belief that we (working together with our collective talents, skills, and compassions) can ensure that no one (no human being, no child of God) will ever be forced to suffer in silence. No one will be plagued by the desperate fear that comes from feeling cast out or forgotten by society.

I want to leave you with one challenge. A simple challenge, that is anything but easy. A challenge that asks you to push your personal boundaries. A challenge to consider one thing (one act, one contribution, one event) that you can take on each week. Maybe this is seeing a pro-bono patient (for the providers in the room), maybe this is volunteering to precept/mentor the next generation of health care professionals and social justice leaders, or maybe it is just remembering that many people in our communities are riddled with the burdens of mental illness, substance addiction, and economic injustice.

My challenge may seem simple – but my challenge comes with a hidden agenda. For you see, I truly believe that giving is more about receiving than an act or service. I truly believe that when we allow ourselves to move outside of the day-to-day comforts of our lives we learn more about ourselves than we could have ever imagined. You see I believe that the best way to change the world for people living on the streets or suffering in extreme poverty is through changing the way we view this world. Believing that we are connected. Recognizing that we are dependent. Understanding that we are united.

Tonight - I come to you in the name of the sex workers of our communities who live in fear and suffer from the ravages of abuse and addiction, I come to you in the name of the Latino Day Laborers who struggle to navigate a world so foreign to their own, I come to you in the name of the homeless young adult who is searching for answers in their life and struggling with an addiction to heroin and an abusive relationship. But most of all - I come to you in the name of hope. Hope that we can, and will change the lives of these beautiful and important people – through our collective, compassionate efforts.

Thank you for this marvelous recognition and thank you for all your wonderful work.

Alto Cayma Community Assessment

Photo: Interviewing a client

Photo: A survey collection event

Photo: Nursing students go the extra yard for their education

Photo: Protection from the sun

CARE Research Study

The CARE study is going great. The UNC-Wilmington team has been steadily collecting the data sets and we are well on our way to meeting our goal cohort of 500 completed surveys.

Stay tuned to the HBI Blogspot for updates - and, thank you for all your support!

Can't we do more?

I have had a really unique opportunity. I just got back from Peru – quickly unpacked my bags, went to clinic for a day, and then took off for a trip to Pebble Beach, California.

My opportunity, aside from learning how to juggle back-to-back packing experiences (I have quite a few more back-to-back trips planned for the spring), is that I find myself staying in a real luxury resort. The “opportunity” that I define from this experience is that just one week ago I was staying in one of the poorest communities in Latin America - an area where families often live on less money for one month that it costs to stay in a place like this for one night.

I am very humbled by this experience. Don’t get me wrong, I do not fault places like this, nor do I in anyway intend to point the finger at the upper socioeconomic elements of our society; rather, what is most compelling to me is the vast gap that exists between the “have” and “have not” populations of this world. This trip allows me to directly juxtapose my two experiences and to draw immediate (and very tangible) comparisons in my mind.

I don’t think that advocating for a sweeping dismal of places like this resort, or demanding that we stop purchasing luxury items – that sort of thinking is illogical and does not make any sense - is a good idea. If people stopped staying in wealthy resorts like this place many people would lose their jobs. If people stopped spending their money on luxury purchases – the economies of the world would trickle even further into a bottomless hole. Rather, what is most immediate to my mind while I am having this luxurious experience is the need for moderation. The need for a living on a little less - so that others can live at all.

What if we all decided that we could live on just a little less? What if we decided that we could cut our vacations back by one day? What if we decided that we would donate the monies from this moderation exercise to organizations that are working for social equality and economic fairness?

I spoke to one of the housecleaning staff last night. She was telling me that business is very brisk at this time. She was telling me that she is happy that people are staying in her resort – because it means she has a job. She said that she was very happy to have a job at this time in our economic "crisis."

I would not advocate that we make such sweeping changes to our lifestyles such that she no longer has a job. Rather, I wonder when the last time she had a vacation was. I wonder if she could even afford to stay in “her” resort for one night.

is a well established fact (UN Development Data, 2005) that the THREE richest people in the world control more wealth than all 600 MILLION people in the world’s poorest countries. Can’t we do a lot more with just a little bit less personal consumption?

I once had a person ask me, “Why should I give money to your organization and not give my money directly to the people who need it?” That is an excellent question. My reply was something like this . . . if you are one of the three wealthiest people in the world, then great – please give away; because the amount of money that you can afford to donate will make lasting changes for this generation and future generations. However, if you are not going to give the sort of financial capital that will structurally change the way that people live, provide educational opportunities for future generations to fight the vicious cycles of poverty, develop better healthcare delivery and utilization mechanisms, and increase the earning potential of the 600 million people living in poverty – then please give your money to groups and organizations that work to build sustainable bridges of advocacy and care delivery. Please contribute to organizations that work to create structural changes.”

We can, and must, build a future that eliminates desperate poverty – and the only way to do this is the change the structures that lead to such disparity in the first place. I am challenged to determine ways that I can live on less in my life – so that many more people can have an opportunity to live. Please join me in considering ways that you can live more life on less money.

Thank you for your continued support of HBI.

"Being" vs. "Doing" - The Gringo Dilemma

Yesterday I did something very unique. Something I hardly ever do – whether or not I am in Peru or the U.S.

Yesterday, I sat in a park and watched people. Okay – truthfully, it is not that simple. In all honesty I was waiting for a meeting that was suppose to take place at 2:30pm in a part of Lima that I do not normally go. As it turned out, my colleague never showed up. As such, I got to spend a delightful hour watching people go about their lives.

I was in the burgeoning middle class neighborhood of Magdalena; a Lima neighborhood situated on the coast just next to the popular tourist spots of Miraflores and San Isidro. The breeze was light, the sun was bright and the temperature delightful - the perfect summer day in Latin America.

Yesterday, for a couple of short minutes, I saw Peru not as a project to develop or as a program to facilitate – but as a place where I truly feel at home, a place that is deeply seated in my heart. Grandfathers and grandmothers, business men and business women, mothers and fathers, children and adolescents – everyone was just living their lives. It was amazing to stop, even for just an hour, to really observe the flow of life for the average Peruvian.

So much of my time is consumed with meetings, projects and the standard “hurry up and wait” phenomena. In fact, as the “golden” thirty minute mark (Peruvians are notoriously late – and it is customary for people to arrive for meetings 30-45 minutes late) came and went and my appointment had still not shown up, I started to experience agitation – thinking to myself, “there is something more important I should be doing than just watching people walk by on this beautiful sunny day.” I felt an internal pressure to go and “do” something to fill my time.

Father Alex regularly talks about the importance of “being” vs. “doing” – and how often North Americans are consumed by the “do” at the expenses of truly experiencing the events of life. He will tell the groups that we bring down to Peru from the U.S. and Canada – “please allow you’re self to just “be” for the time you are here. Please let yourself be moved by the experience of “being” with people and witnessing their daily struggles, triumphs, dreams and desires.”

I think it is easy for people who have busy (half of my “busy-ness” is self imposed) lives to fool themselves into thinking that we do not have time for “stillness.” We are always thinking about the next item on our “To Do” lists or planning for our next event, program or project. This “busy-ness” fills our lives. At times, this busy-ness distracts me from what is really important – relationships . . . people.

Yesterday I sat in a park and watched people go about their lives –and it reminded me why I feel so committed to the work that we do. My quite time sitting on a park bench in the Plaza Magdalena reminded me why I feel so passionate about the “William’s” and “Ines’” of the world. Yesterday I fell in love with Peru all over again – just by being!

Community Assessment Survey

The University of North Carolina -Wilmington students have arrived in Peru and the real work for the survey project is about to begin.

On Monday night we conducted a three hour orientation and mock-survey practice session (very similar to the one we put together for the interpreters on Saturday). The 27 nursing students, faculty and distinguished dean of nursing were enthusiastic and ready to learn. One of the real joys of the work that we do is getting to create meaningful programs and projects with smart, young, eager health care professionals. Their excitement to fully immerse themselves in this new world of Peru is contagious.

For many of the students, this is their first trip outside of the United States. They are wide eyed and ready to catch the day by the tail. Good – because we have plenty of work in store for them. The actual survey collection will not begin until Wednesday. We have decided to conduct a convenience sampling survey and set-up data collection in football pitches or open spaces in 9 different areas in the Alto Cayma community.

Some of our data collection will be in locales close to the mission clinic and the social service operations of the church, while other data samples will be collected from newer “invasion” areas with little to no access to utilities – let alone healthcare or social services.

The primary goal of the survey is to assess healthcare utilization patterns as well as objective and subjective barriers to healthcare in a series. More specifically, the survey will gain information regarding perceived access to healthcare, awareness of area clinics and charity care resources, emergency department use, and perception of their own health, including medical, dental and mental health issues. The survey will also evaluate participants’ feelings on the medical care and treatment they are provided.

In gathering this information HBI and our collaborator the University of North Carolina Wilmington, hope to better understand the behaviors of the people living in the communities of Alto Cayma. We recognize that the data sets generated from this research project are not generalizable to broader peri-urban populations – and we feel confidant that this project is a paramount venture into creating more sound scientific examination of the lives of the people living in extreme poverty in Latin America.

Let the Games Begin

Today was the first of our orientation sessions for the participants in the CARING Survey. We had over 20 volunteer interpreters join our HBI team for 3-hours of training. We went over the survey instrument, talked about the schedule for the project and went over the interpreters responsibilities within the framework of the project.

The interpreters are fantastic. Think about it . . . they took a Saturday morning out of what little free-time they have, and came to a training session on confidentiality, privacy and informed consent. They had many great questions and a variety of great input we can use for future survey research projects.

The nursing student team from the University of North Carolina will arrive in Arequipa tomorrow (Sunday). We will hit the ground running with an all day orientation to the Mission of Alto Cayma, the specifics of the research project and some general information about Peru and the Peruvian healthcare system. Then, on Wednesday the group starts day one of data collection.

Our plan is to collect data in a variety of geographic settlements within the Alto Cayma area. We hope that the variety in data collection settings will give us a more thorough “picture” of the needs of the people living in this area. The goals behind this survey project are to better define the needs of the communities and to empirically develop interventions and projects that most appropriately address their needs.

Stay tuned to the HBI Blogspot for updates on this project and information regarding publication of the data sets from the survey.