HBI’s Medical Director, Dr. Robert Gehringer, just returned from a month-plus long trip all around Perú. Traveling with our colleague, Srta. Lidia Ruiz, Dr. Bob made his way through a number of trains, planes and automobiles. Check out the following brief excerpt from his travel diary:
So after a 5-6 year hiatus, I’m finally back in Iquitos in the Amazon, the world’s largest city absent road or rail access. In this city of 400,000 it’s amazing to recognize that almost everything, from the concrete and steel I-beams to plastic waste baskets and beverage straws, all arrived by boat, generally up the Amazon from Brasil. Stepping off the plane a wall of humidity greets you. Last night while on the malecón sipping a cold Cusqueña after a light rain shower the relative humidity was actually 99% according to my weather app, air almost water. With the enthusiastic support of Rosana Chumbe, the new regional decana of obstetras (midwives), we’re trying to resurrect their pandemic challenged inactive newborn resuscitation training program.
We rode into the city in a mototaxi, the first of multiple excursions. There must be thousands in Iquitos. Small underpowered motorcycle in front that widens to form a bench seat over the two back wheels. They haul everything and actually are a pretty cheap and efficient way to get around. Open air with a roof for the rain in this always warm place, weaving in and out of traffic and shooting through intersections as long as the red light had only recently turned. I much prefer them to taxis.
Sunday evening on the malecón, the walkway along the broad Río Itaya adjacent to downtown, all was alive with activity. Pandemic masking seems a bit more lax here than in other Peruvian cities, though quadruple anywhere in the midwest. Families out for the evening, street food, vendors of balloons, jewelry, candy, street performers, tarot card readers, whatever. I love the energy. The flip side is that poverty is still omnipresent with no shortage of folks asking for a little money and looking like the need it. Iquitos didn’t seem as creepy as in past visits: no long beckoning looks from ladies of the night, and fewer old gringos (who unfortunately look like me) hanging out to sample the local sex trade. As the distinctive aroma of marijuana occasionally drifted by and regatón pounded away in the background, Lidia, my HBI colleague and my computer and online training expert, and I enjoyed dinner under a large table umbrella at El Mesón, a couple small lizards nervous on the adjacent wall. Our classic food from the jungle included cecina, cured pork with a bacon taste and none of the fat. Tacachos, balls of mashed cooked plantain with bits of crispy pork, spices, etc. Lagarto, local cayman, like a McNugget (yes, tastes like chicken). Chonta, ribbons of palm heart, like very long thin fettuccini. And yuca, manioc root cut and cooked like french fries, punctuated with a delicious hotsauce of cocona, a tropical fruit. All enjoyed with a second cold Cusqueña, the bottle sweating in the heat, as was I. Not in Kansas, Dorothy.
Lidy always wants to practice her English and me my Spanish. I’m in Perú, afterall. It seems that whenever I’m with my bilingual Peruvian friends, the conversation turns to the commonality of food and the idiosyncracies of Spanish and English, so we covered both, flip-flopping languages, then indulged in shared observations of the idiosyncracies of our coworkers and today’s workshop students.
After unusually smooth travel to 9 cities, we arrived at the airport today two hours early to find that we hadn’t been notified of a schedule change and our flight had just departed. Rebooked for late tonight, ergh, we salvaged the day with lunch at a unique restaurant floating in the middle of the Río Itaya. More cecina and chonta plus paiche, a huge freshwater fish from the Amazon, all in a sweet maracuya sauce, with camu camu juice to quench the thirst. It’s tough to find camu camu at the Menasha Piggly Wiggly supermarket. So, Iquitos revisited, 2022.
Random Perú Observations . . . .
About and hour into my flight from Lima to Atlanta after a month in Perú traveling among 9 different cities to resuscitate, post-pandemic (hopefully the worst of it), the Regional College of Midwives training programs. It generally went well though predictably a few trainers have dropped out and there has definitely been some learning loss since early 2020 as they hadn’t been able gather in groups to do any workshops. Two steps forward, one back. My wonderful HBI colleague, Lidia Ruiz, and I hopscotched by air, bus, and car through Lima, Arequipa, Huánuco, Tumbes, Piura, Chimbote, Cusco, Cajamarca and finally Iquitos and back to Lima, covering the coastal desert, the Andes, and the Amazon. A few random impressions along the way.In Lima, the work was mostly to reaffirm our 8th year of connection with the national College of Midwives as well as to establish new planned relationships with the national College of Nurses, the Peruvian Society of Pediatrics, the National Childrens Hospital, and the Universidad Sete Septiane with its several campuses around the country.
It seems we’ve been able to establish a bit of program and organizational credibility, as each of these potential Peruvian partners is moving forward at different stages toward a formal relationship with HBI. The Spanish saying is “Al dicho al hecho, hay un trecho.” Literally translated, “From said to done, there’s a trench.” We’ll see where it goes.Fresh wonderful seafood! It’s said that some housewives will refuse to buy a fish in the market if it isn’t still gasping. I can’t get enough of it, from great sushi and sashimi last night in Lima, ceviche in Callao on La Punta, to mahariscos in Tumbes. Mahariscos was new to me, cooked mashed plaintains with a variety of seafood mixed in, especially shrimp, spiked with a tasty salsa ahi (spicy). I’m a fan.
On Sunday afternoon in Piura, the older waiter brought us two whole fish, freshly caught, and we chose between a mero and some kind of sole. We picked mero and he then fileted half and served us ceviche and then roasted the rest of the fish for our entree, appointed like a piece of art. Buenazo! All this thanks to the abundance of the cold Humboldt Current flowing north along the coast.Added to 11 flights, our land travel was limited to the coast from Tumbes to Piura to Chimbote to Lima. The first leg was an easy 6 hour daytime bus ride to Piura. I now veto any suggestion of overnight buses, as I’ve had more than enough of those. Piura is a fairly large city, almost always hot and sunny, la Ciudad del Sol. In 1516 it was Spain’s first city in South America thanks to Pizarro and his band of invaders. However, well before the Europeans imposed themselves, there were sophisticated cultures here with ruins dating to 3000 BC, contemporary with the cultures in Mesopotemia, the Nile Valley, the Yangtze Valley, and Meso America.
We stayed at the Hotel Los Portales, a classic old hotel at the corner of the Plaza de Armas, the original building constructed as a hospital in 1678, then converted to a hotel in 1912 with a “new” addition in 1943. My corner room, overlooking the Plaza had tall windows, 15 foot ceilings, beautiful wood floors, and 8-9 foot doorways, not to mention a very comfortable bed. The bar, Marquéz, is my favorite in all Perú. Lovely wood paneling, old black-and-white photos, comfortable soft chairs, and barmen who were real pros. They make a great Capitán (like a Manhattan with Pisco). We hosted the midwife trainers there after our two days of work together. They were a fun and baudy bunch as with the second round the laughing conversation tumbled to dildos and little bottles of aphrodisiac scents, neither in my experience. I think it’s because the midwives spend so much time working somewhere below the waist.
The next day in a private car, Montalvo took us south for 9 hours to Chimbote. Montalvo was a quiet 30-something guy who drove predictably but rapidly, topping out a few times at 92 mph, but at least on straight divided highway. On the two lane roads we weaved in and out, often passing in spite of an oncoming motorcycle or mototaxi. The unwritten rule and expectation is that the smaller vehicle will slide to the side when confronted. Hopefully, everyone gets the memo. The coastal desert was stark, often just sand and rocks to our left and the ocean on the right. Further south large agribusiness farms were green and irrigated with everything from asparagus to rice to grapes and avocado trees. The small cities and little towns along the way tended to lean to the ocean, often a fleet of small 30 to 60 foot commercial fishing boats anchored in a bay, nets and rigging at the ready. The towns had a certain unkept sameness, so many dusty buildings, rough red brick with sentinels of rebar extending skyward from the roof in hopes of better days, another floor to be built when funds allowed.
Currently, Perú’s vaccination rate far exceeds the US and COVID prevalence is blessedly low. Though masking is still almost universal, even outdoors, they’re beginning to lighten up. Fist bumps to handshakes to cheek touches and hugs. Hooray!!Happily home later today, and planning no thoughts of newborn resuscitation for a while.
And the whilrwind continues . . . wayne centrone
/0 Comments/in Blog /by Wayne CentroneWe’re back in Lima. Our original plan of conducting an in-person Center of Excellence retreat with the staff at the Casa Girasoles in Ica got thwarted by a transportation strike. As such, we pivoted and shifted our schedule to conduct the retreat on Sunday and then race back to Lima on Sunday night to avoid the strike.
This afternoon we head to Cusco and then on to the Casa Girasoles in the Sacred Valley. We will holding a retreat with the staff all day tomorrow – and then heading off on our separate ways to travel back to the U.S. or move to another program and project here in Perú.
The main focus of this trip has been the completion of our phase I of the Center of Excellence research study. Along with our partners from the University of Connecticut School of Social Work and Thomas Jefferson University School of Nursing – we are collaborating with the NGO Paths of Hope and Universidad Catolica Santa Maria (Arequipa, Perú) to more fully understand what it means to develop a toolkit of training materials and resources for service providers working in residential child-welfare services. This is a five year study that has really only just started.
We are learning so much! I looking forward to sharing more details and photos from our retreat in Urubamba.
Going at 100 KPH – wayne centrone
/0 Comments/in Blog /by Wayne CentroneWow. What a whirlwind of a trip – and it has only just started.
I arrived in Lima on Tuesday morning and we have already signed a historic agreement with the College of Nurses of Perú to help establish at newborn resuscitation train-the-trainer program. We also re-signed our longstanding agreement with the College of Midwives of Perú and are well on our way to making great inroads in establishing a credentialing system for newborn trainers.
This morning we jumped in the van and drove the 4-plus hours to Ica to visit the Casa Girasoles and plan for a “Gravel Adventure” camp in November. On top of all of the activities described above, we have our research colleagues from Thomas Jefferson University School of Nursing and the University of Connecticut joining us in Ica on Sunday to provide a face-to-face retreat for the Center of Excellence project. Then on Tuesday we will all fly to the Casa Girasoles in Urubamba.
Oh my goodness, so much is going on. I can’t wait to post more updates. Thanks for all your support.
Wilfredo – wayne centrone
/0 Comments/in Blog /by Wayne CentroneWilfredo (not his real name) must have been four or five when he came to live with us at the Casa Girasoles. The thing I remember about him the most was his deep eyes. He had the eyes of a person 40-years his senior.
Wilfredo had seen a lot in his years. Growing up in extreme poverty, he and his four siblings had only ever known hunger. Wilfredo’s father was absent at best and abusive when he turned up at their squatter home after binge drinking. Even at the tender age of 5, Wilfredo spent much of his time on the streets alone.
When he came to live with us, he was referred by the local police department – as they found him hanging out at the market late one night. When they asked him where he lived, he said he didn’t have anywhere to live.
A case was immediately opened to determine the details of little Wilfredo’s life. The social worker visited his father and mother. Spoke with neighbors. She even interviewed his siblings. The court decided Wilfredo was better off living in the Casa Girasoles. He settled into his new home nicely.
Those eyes made it hard to forget the trauma that existed deep inside the little boy. One day his father came to visit. He was drunk. He made a big fuss and threatened the staff if they would not allow him to take Wilfredo home with him. The police were called, and they ushered him away without much fanfare. A few months later, his father returned. This time he had a court order that allowed him to regain custody of Wilfredo.
The day he left was hard on everyone. The staff wanted to do everything they could to protect little Wilfredo. I could feel his pain. I remember receiving a picture from the Director of the Casa Girasoles. It was his eyes.
We lost touch with Wilfredo for a couple of years. The social worker would visit the family, but they had moved. No one seemed to be able to keep track of them.
Then one day, the police found Wilfredo on the streets. A shopkeeper reported him and mentioned that he had seen the boy sleeping on the streets near his business for a few weeks. Our staff saw a news story on social media and immediately recognized Wilfredo. Our Director called child protective services and arranged for Wilfredo to be brought back to the Casa Girasoles.
He is back in our care. We are working closely with him to find a space for healing. It is hard. The trauma of his early childhood, along with the retraumatization of moving between his home and a residential facility and then back to his house and then back to a residential facility, is a lot. It is going to take some time.
I guess that is the hardest part for me. The time. I just keep thinking that things could have been different. Wilfredo is back in a safe, loving, healthy environment. But what about the thousands of children who are not. What about the families on the edge of poverty, mental illness, or addiction – families most vulnerable to losing a child to abandonment. What about them? Knowing that things can and must be better for vulnerable children and families is what drives us. Looking into Wilfredo’s eyes reminds me that we still have a lot of work.
Travels in Perú with Dr. Gehringer
/0 Comments/in Blog /by Wayne CentroneHBI’s Medical Director, Dr. Robert Gehringer, just returned from a month-plus long trip all around Perú. Traveling with our colleague, Srta. Lidia Ruiz, Dr. Bob made his way through a number of trains, planes and automobiles. Check out the following brief excerpt from his travel diary:
So after a 5-6 year hiatus, I’m finally back in Iquitos in the Amazon, the world’s largest city absent road or rail access. In this city of 400,000 it’s amazing to recognize that almost everything, from the concrete and steel I-beams to plastic waste baskets and beverage straws, all arrived by boat, generally up the Amazon from Brasil. Stepping off the plane a wall of humidity greets you. Last night while on the malecón sipping a cold Cusqueña after a light rain shower the relative humidity was actually 99% according to my weather app, air almost water. With the enthusiastic support of Rosana Chumbe, the new regional decana of obstetras (midwives), we’re trying to resurrect their pandemic challenged inactive newborn resuscitation training program.
We rode into the city in a mototaxi, the first of multiple excursions. There must be thousands in Iquitos. Small underpowered motorcycle in front that widens to form a bench seat over the two back wheels. They haul everything and actually are a pretty cheap and efficient way to get around. Open air with a roof for the rain in this always warm place, weaving in and out of traffic and shooting through intersections as long as the red light had only recently turned. I much prefer them to taxis.
Sunday evening on the malecón, the walkway along the broad Río Itaya adjacent to downtown, all was alive with activity. Pandemic masking seems a bit more lax here than in other Peruvian cities, though quadruple anywhere in the midwest. Families out for the evening, street food, vendors of balloons, jewelry, candy, street performers, tarot card readers, whatever. I love the energy. The flip side is that poverty is still omnipresent with no shortage of folks asking for a little money and looking like the need it. Iquitos didn’t seem as creepy as in past visits: no long beckoning looks from ladies of the night, and fewer old gringos (who unfortunately look like me) hanging out to sample the local sex trade. As the distinctive aroma of marijuana occasionally drifted by and regatón pounded away in the background, Lidia, my HBI colleague and my computer and online training expert, and I enjoyed dinner under a large table umbrella at El Mesón, a couple small lizards nervous on the adjacent wall. Our classic food from the jungle included cecina, cured pork with a bacon taste and none of the fat. Tacachos, balls of mashed cooked plantain with bits of crispy pork, spices, etc. Lagarto, local cayman, like a McNugget (yes, tastes like chicken). Chonta, ribbons of palm heart, like very long thin fettuccini. And yuca, manioc root cut and cooked like french fries, punctuated with a delicious hotsauce of cocona, a tropical fruit. All enjoyed with a second cold Cusqueña, the bottle sweating in the heat, as was I. Not in Kansas, Dorothy.
Lidy always wants to practice her English and me my Spanish. I’m in Perú, afterall. It seems that whenever I’m with my bilingual Peruvian friends, the conversation turns to the commonality of food and the idiosyncracies of Spanish and English, so we covered both, flip-flopping languages, then indulged in shared observations of the idiosyncracies of our coworkers and today’s workshop students.
After unusually smooth travel to 9 cities, we arrived at the airport today two hours early to find that we hadn’t been notified of a schedule change and our flight had just departed. Rebooked for late tonight, ergh, we salvaged the day with lunch at a unique restaurant floating in the middle of the Río Itaya. More cecina and chonta plus paiche, a huge freshwater fish from the Amazon, all in a sweet maracuya sauce, with camu camu juice to quench the thirst. It’s tough to find camu camu at the Menasha Piggly Wiggly supermarket. So, Iquitos revisited, 2022.
Random Perú Observations . . . .
About and hour into my flight from Lima to Atlanta after a month in Perú traveling among 9 different cities to resuscitate, post-pandemic (hopefully the worst of it), the Regional College of Midwives training programs. It generally went well though predictably a few trainers have dropped out and there has definitely been some learning loss since early 2020 as they hadn’t been able gather in groups to do any workshops. Two steps forward, one back. My wonderful HBI colleague, Lidia Ruiz, and I hopscotched by air, bus, and car through Lima, Arequipa, Huánuco, Tumbes, Piura, Chimbote, Cusco, Cajamarca and finally Iquitos and back to Lima, covering the coastal desert, the Andes, and the Amazon. A few random impressions along the way.In Lima, the work was mostly to reaffirm our 8th year of connection with the national College of Midwives as well as to establish new planned relationships with the national College of Nurses, the Peruvian Society of Pediatrics, the National Childrens Hospital, and the Universidad Sete Septiane with its several campuses around the country.
It seems we’ve been able to establish a bit of program and organizational credibility, as each of these potential Peruvian partners is moving forward at different stages toward a formal relationship with HBI. The Spanish saying is “Al dicho al hecho, hay un trecho.” Literally translated, “From said to done, there’s a trench.” We’ll see where it goes.Fresh wonderful seafood! It’s said that some housewives will refuse to buy a fish in the market if it isn’t still gasping. I can’t get enough of it, from great sushi and sashimi last night in Lima, ceviche in Callao on La Punta, to mahariscos in Tumbes. Mahariscos was new to me, cooked mashed plaintains with a variety of seafood mixed in, especially shrimp, spiked with a tasty salsa ahi (spicy). I’m a fan.
On Sunday afternoon in Piura, the older waiter brought us two whole fish, freshly caught, and we chose between a mero and some kind of sole. We picked mero and he then fileted half and served us ceviche and then roasted the rest of the fish for our entree, appointed like a piece of art. Buenazo! All this thanks to the abundance of the cold Humboldt Current flowing north along the coast.Added to 11 flights, our land travel was limited to the coast from Tumbes to Piura to Chimbote to Lima. The first leg was an easy 6 hour daytime bus ride to Piura. I now veto any suggestion of overnight buses, as I’ve had more than enough of those. Piura is a fairly large city, almost always hot and sunny, la Ciudad del Sol. In 1516 it was Spain’s first city in South America thanks to Pizarro and his band of invaders. However, well before the Europeans imposed themselves, there were sophisticated cultures here with ruins dating to 3000 BC, contemporary with the cultures in Mesopotemia, the Nile Valley, the Yangtze Valley, and Meso America.
We stayed at the Hotel Los Portales, a classic old hotel at the corner of the Plaza de Armas, the original building constructed as a hospital in 1678, then converted to a hotel in 1912 with a “new” addition in 1943. My corner room, overlooking the Plaza had tall windows, 15 foot ceilings, beautiful wood floors, and 8-9 foot doorways, not to mention a very comfortable bed. The bar, Marquéz, is my favorite in all Perú. Lovely wood paneling, old black-and-white photos, comfortable soft chairs, and barmen who were real pros. They make a great Capitán (like a Manhattan with Pisco). We hosted the midwife trainers there after our two days of work together. They were a fun and baudy bunch as with the second round the laughing conversation tumbled to dildos and little bottles of aphrodisiac scents, neither in my experience. I think it’s because the midwives spend so much time working somewhere below the waist.
The next day in a private car, Montalvo took us south for 9 hours to Chimbote. Montalvo was a quiet 30-something guy who drove predictably but rapidly, topping out a few times at 92 mph, but at least on straight divided highway. On the two lane roads we weaved in and out, often passing in spite of an oncoming motorcycle or mototaxi. The unwritten rule and expectation is that the smaller vehicle will slide to the side when confronted. Hopefully, everyone gets the memo. The coastal desert was stark, often just sand and rocks to our left and the ocean on the right. Further south large agribusiness farms were green and irrigated with everything from asparagus to rice to grapes and avocado trees. The small cities and little towns along the way tended to lean to the ocean, often a fleet of small 30 to 60 foot commercial fishing boats anchored in a bay, nets and rigging at the ready. The towns had a certain unkept sameness, so many dusty buildings, rough red brick with sentinels of rebar extending skyward from the roof in hopes of better days, another floor to be built when funds allowed.
Currently, Perú’s vaccination rate far exceeds the US and COVID prevalence is blessedly low. Though masking is still almost universal, even outdoors, they’re beginning to lighten up. Fist bumps to handshakes to cheek touches and hugs. Hooray!!Happily home later today, and planning no thoughts of newborn resuscitation for a while.
It shouldn’t have to be this hard . . . or should it? wayne centrone
/0 Comments/in Blog /by Wayne CentroneEvery couple of weeks or so, I receive a call from a loyal supporter. He calls to chat about the work of HBI – and to encourage me. Let’s call him Jim, as he has not permitted me to use his real name.
Jim is a super nice guy. He always tells me what a great job HBI is doing and how much he enjoys supporting our efforts and watching our progress. The other day on our call, he said that it just seems like things are “too hard” and that they “shouldn’t be so hard.” Jim’s right – things sure as heck are hard . . . but I am not sure they are supposed to be anything other than challenging.
One of the parts about not-for-profit work that makes it so hard is that we rely on soft funding – donations, grants, foundations, to keep our work going. We don’t make a product to sell. We don’t have a direct service we can market. We are selling and marketing our efforts to address some of the biggest challenges on the planet—things like homelessness, hunger, climate change, and child welfare.
Sure, several NGOs meld fundraising with “for-profit” activities, selling merchandise, spinning a portion of program activities into the pay-for-services realm, and even shopping their technical assistance and consulting services. These are great alternative revenue streams for not-for-profits . . . and HBI has tried its hat at a few of them. The problem, if our work is focused on addressing the most underserved populations and creatively engaging the most marginalized of issues – we can’t also be accountable to the brass ring of profit.
I guess what I am saying is this . . . this is hard work, and it’s supposed to be. There is nothing easy about managing an almost million-dollar budget – with donations or widget sales. HBI is in a unique funding cycle at this time. It’s one of the phases that every not-for-profit goes through. We are cash strapped. For HBI, this cash-strapped scenario means we have a pipeline of money we have predicted will come in throughout the year – grants, foundations, events, and private donors – and the money hasn’t arrived yet.
So this leads me to a request – if you are considering donating to HBI, now is the time. We will make it through this phase – we always do. It’s a real privilege to be on this journey with all of you. It is, however, a time when the work of running a not-for-profit feels extra hard. Thank you, as always, for all your trust and confidence in our work.
Resilience: One day at a time – wayne centrone
/0 Comments/in Blog /by Wayne CentroneResilience.
We talk about resilience a lot in the work of HBI. It is the foundation of our efforts with the boys living in the Casa Girasoles program. It is a critical part of our advocacy and support for the families in the Ines Project.
But what does resilience mean? I learned firsthand over the past couple of weeks. My family experienced a very untimely and unexpected death, as many of you know. It has been challenging. Thank you for your thoughtful messages and kindness.
The impact of this experience – is not something that will magically go away. The healing will take time. It will take healing relationships and meaningful connections. It needs space. It needs a place to find support.
Recovery requires intentionality and purpose. This is what I am learning about resilience – it is not something that happens to a person as much as a process that unfolds with other people.
This same commitment to space and place is what makes our work with children who have experienced abandonment and homelessness communities who have lived through trauma and marginalization not something we can measure in days or weeks. We need to commit to the long-term and build deep, supportive relationships.
Our Center of Excellence project is working to chart a path for training staff working with children living in orphanages, group homes, and residential care facilities to build resilience. Over the past year, we have partnered with the NGO Paths of Hope and Thomas Jefferson University (Philadelphia, PA, USA) and La Catolica Santa Maria Universidad (Arequipa, Perú. When we started the project – a five-year research study – I naively expected to have a curriculum planned and ready to roll out within a year. Oh my goodness, was I wrong?
Instead, we are finding that training staff in core concepts and skills is just a tiny part of helping to build a culture of resilience. Our biggest challenge is enhancing a culture, an environment, and a community to be pathways to resilience. Now, as we bring the first year of our five-year research to a close, I realize that our actual work is about connection . . . and this is not something that can be rushed or pushed into a small box.
This thing that we call resilience – is about space and place, and it is about people connecting with people. That’s profoundly healing.
Thank you for all your warm wishes and support. We are in this together.
Sorting Through
/0 Comments/in Blog /by Wayne CentroneI arrived in Lima this morning. Bright and early. Nothing compares to a redeye. Arghh.
Late last night, as I prepared to depart from Atlanta, I received a message from one of the HBI staff. They said, “There are protests, and they are turning violent. The president just declared a ‘State of Emergency.’ I am not sure anyone can pick you up at the airport.”
I was uncertain what I would find when I arrived in Lima. And, as I disembarked from the plane this morning, my first clue that things were not just business-as-usual was the emptiness of the airport. There was practically no one.
As I exited the terminal, I met an eeriness. There were no taxis anywhere, and the crowd of drivers, family members, friends, and tour operators was dramatically reduced. I found a driver who said he would take him in his private car to Magdalena. The drive took a fraction of its usual time, as the streets were practically empty.
All afternoon I have been listening to the sound of sirens and honking horns. On my afternoon run, I was one of only a handful of people out. It felt otherworldly.
Tonight – as I sit in the HBI office, I can hear pots clanking as protests continue around the city. Some of these protests have grown violent. Others, like the march this afternoon in San Isidro, included hundreds of middle-aged Limeños demanding change.
This unsettled sentiment in Perú has been simmering for months. Perhaps for decades. It is a convergence phenomenon. What started as protests over the rising inequality of the economy and post-pandemic economic recovery, has morphed into a full blown call for a complete change in the presidential administration. As gas prices keep rising and inflation far outpaces income – people are becoming desperate. Desperate for change.
It is hard to balance the race to find a new normal that most of the world is experiencing as we emerge from the long tunnel of the pandemic against the ongoing challenges of developing and middle-income parts of the globe. For many years, people in developing nations have been promised a better life. Politician after politician has promised much and delivered very little. This is especially true in Perú.
The protests are an outward sign of profound angst and unsettledness. As the country faces monthly inflation not seen in over two decades, and a slow re-start of the economy has yet to impact the lives of the vast majority of Peruvians living and working in the informal sector – people are fed up. Can you blame them?
It is hard to sort through everything that is going on. I am not sure what the next week will look like. One thing is for sure – there is a lot of sorting going on in the world – and that is especially true in Perú.
Transitions – wayne centrone
/0 Comments/in Blog /by Wayne CentroneWe just got back from vacation. Our trip to Cabo San Lucas was a reverse “staycation.” We did not go anywhere – no restaurants, no trips to the beach, no excursions, just pool time, daily walks, and lots of family time. We spent our entire week in México at a rental house. It was awesome.
One of my jobs on the trip was to keep the pool floats blown up. Every time I had one float finished, it seemed like another would require more air. This went on all week.
In all my inflating of rubber floats, I recognized a pattern. The initial phase of inflation is challenging. There is a lot of resistance and pushing air into the float requires loads of energy. However, there comes the point where things ease up when the air flows with less struggle, and the impact of all my huffing and puffing becomes more visible. Then, I would reach a final phase – let’s call it the last 10% – and the process would get arduous again. I mean, really demanding. Almost to the point, I wanted to give up. However, the last 10% of the effort made the pool float work. The final bit of air made a raft my wife could float on versus sink.
I noticed something in this endeavor. Aside from the satisfaction of accomplishing something tangible, there was a pattern metaphoric for our work with HBI.
The initial stages of our efforts are challenging. There is a degree of uncertainty as to whether or not we can accomplish our goals. Then, as we settle into the project’s work or the program’s tasks, things lighten up – they get easier. Finally, there is a push – a sort of last effort – and this is often the most challenging.
For over 25 years, we have worked in Perú’s child welfare sector through critical partnerships with academic institutions, subject matter experts, hospitals, youth ambassadors, and government agencies in the country. Over many years, our focus shifted from delivering services to training and assisting many organizations working on child abandonment, homelessness, and child welfare services. This shift required a different input of energy.
This phase in our organizational development is a bit scary and exciting. We are at a new stage, and it requires a renewed effort. As we venture forward, we are focused on helping to construct the systems and structures of care that can genuinely change child welfare. Shifting our focus to systems development – Centers of Excellence – does not mean we are less attentive to the needs of the women and children we serve. No, we are even more concerned about their needs and now find ourselves wrestling with the structures that will be sustainable.
Each phase of our organizational development included many lessons and learnings. The most critical is the need to continuously involve community stakeholders and representatives in all our work. Having strong community-based partners helps shape projects and programs that meet local needs and ensures a sustainability plan. This is the last 10% of our efforts – and it is challenging. It is the phase of our work that requires constant attention and effective communication. It is the last push of energy that makes everything worth it.
Check out our 2021 Year in Review – we are super excited to share all the amazing work you helped us do! Thank you for all your continued support.
Farewell to a True Hero – wayne centrone
/0 Comments/in Blog /by Wayne CentroneLast night, I got back to my hotel room and quickly scrolled through my emails. One of the subject lines caught my eye, “A sad goodbye to Paul Farmer.” What, I thought . . . Dr. Paul Farmer? The physician and anthropologist who I have admired for nearly two decades. How could he be dead?
It turns out to be true. At only 62 years old, Farmer died in his sleep on Monday at his home in Rwanda. What a tragic loss.
Farmer was a true hero of global health. From his deep commitment to academic, evidence-based pursuits to his overwhelming devotion to underserved communities – Farmer was the modern-day architect of global health. He was also a hero for me.
I was a third-year resident and eagerly trying to build the momentum that would eventually become Health Bridges. A friend said they read a book they thought I would like. They said the book reminded them a lot of me. I must have read Tracey Kidder’s Mountains Beyond Mountains three times before finally putting the book down. I was enthralled . . . and a bit envious. In Kidder’s book, I found a hero and mentor.
I never met Paul Farmer, although HBI has gone on to work with Partner’s in Health, the NGO he co-founded, in Perú on more than one occasion. Although we have moved beyond the delivery of direct healthcare services as the focus of our NGO, so much of Farmer’s work and methods have greatly influenced HBI.
The world lost a real champion for change yesterday – and many of us in global health lost a true hero. Thank you, Paul Farmer for your inspiration, integrity, and commitment. Rest in peace.
Beauty – wayne centrone
/0 Comments/in Blog /by Wayne CentroneI’m a big fan of the late Irish poet and philosopher John O’Donohue.
O’Donohue writes with such depth and clarity that his work is timeless. I recently read some of his poems, and I found his words to be critical in the current world challenges.
The essence of life is beauty. Not the type of beauty that can only be found in culture or aesthetics, but the beauty found in depth. A deep understanding of complexity transforms this type of beauty. O’Donohue is quoted as saying, “If our style of looking become[s] beautiful, then beauty will become visible and shine forth for us.” This statement resonates strongly inside of me. I feel so fortunate to be called into communion with so much beauty regularly. I am blessed to be enriched by the deep beauty of an almost 30-year marriage and the immeasurable power of a healthy and happy child – but more than that, I am enriched through service and commitment.
There is nothing easy about the work we do with HBI. So much of what we do is about continuously showing up in the lives of others. It is about commitment and connection. This is true beauty.
I am back in Lima. I arrived a couple of days ago. I am joined on this trip by two important supporters of HBI’s work. This afternoon we took them out to some of the most impoverished communities in Lima to visit with families in our Ines Project. We will call one of the families, the Alvaro’s – and they live at the top of a long flight of stairs high on a hill. Their home is a mishmash of discarded wood and poured concrete – the fruits of years of saving and a multitude of informal jobs. The government deems them ineligible for assistance because they have a poured concrete floor.
Juan, not his real name, is enrolled in the Ines Project. At 12 years old, he has a constellation of congenital, developmental, and physical challenges. Juan’s brother, who lived with similar challenges and was also enrolled in the Ines Project, recently died from complications associated with his condition.
Juan lives in a wheelchair, and the concrete floor is a true blessing for the family. Whenever Juan has a medical appointment – which is often – Sra. Alvaro must carry him on her back down and back-up the long flight of stairs. She performs this activity many times a week. She does it with such love and dedication. She is the pure embodiment of beauty.
While visiting the Alvaro family, I took a picture. In the photo, Señora Alvaro is looking over her dear son with the eyes of love. The depth of her gaze speaks volumes. This is true beauty.
The poet John O’Donohue would be able to memorialize the moment in more eloquent prose. I will end this post with his rich teachings – wow, talk about beautiful.
“May the nourishment of the earth be yours,
may the clarity of light be yours,
may the fluency of the ocean be yours,
may the protection of the ancestors be yours.”
— John O’Donohue.