There is no such thing as work without challenges. The more significant, demanding, and harder the work – the more the challenges. That doesn’t mean it’s time to give up or roll over with defeat. Instead, it is an opportunity to dig in and work harder.
This push and pull, give and take, up and down, is especially evident when working with families and children who have lived through the experiences of generational poverty, traumatic stress, and social isolation. The following story is about the power of resilience and one little girl’s journey to healing.
Standing in Daisy’s home was overwhelming. The stench was powerful. Dirty clothes hung from a makeshift line in the middle of the one-room hut. There was no running water, no bathroom, and no electricity. Instead – a dirt floor, a single bed, and a small table covered with discarded papers and empty medication containers.
We first met Daisy (not her real name) in 2013. Her story is about extreme poverty, family violence, and social isolation. Daisy suffers from uncontrolled epilepsy. She literally seizes every day. Her mother told us that she often seized for up to an hour. The uncontrolled and prolonged seizures left Daisy mentally altered and suffering from several complications. Daisy, as we quickly determined, was in a critical situation. She was at risk of dying with her subsequent seizure. Late in 2013, we arranged a comprehensive care coordination plan for Daisy. Unfortunately, after a few weeks of care coordination – we lost contact with Daisy and her family. It was heartbreaking.
Apparently, Daisy and her family moved. Her father got into a physical altercation with the foreman at the mine where he worked and was fired. The family moved to the small town where Daisy’s father grew up. The city, a remote mountain community, offered minimal resources. Daisy’s mother quickly left. She moved in with a new man. He did not want Daisy. Daisy ended up on the streets.
It took almost ten months to reconnect with Daisy. Trip after trip to the high mountain town continually led us to dead ends. Finally, our outreach worker (Charito) connected with Daisy’s grandparents. Finding Daisy abandoned on the streets, her grandparents took her in, and she lived in their dirt floor home. She has not been on any medications for months, and her seizure disorder was uncontrolled. At six years old, Daisy was seizing up to five times daily.
Her grandparents took her to the local health post, but the nurse in charge referred them to a larger city, two hours bus drive away. They have yet to follow up on his referrals. Fearful that the cost of having Daisy seen would be more than they could afford on their meager income as farmers – they turned to traditional healers. Now, Daisy is getting worse, and her family doesn’t know what to do.
Our plan was simple . . . and entirely complicated. We needed to link Daisy into care through the Peruvian government programs. To do this, she needed a formal transfer of care from the clinic in her hometown to the Hospital for Children in Lima. This was a challenging task. Daisy’s father and grandparents were scared. They were scared of the unknown. They were afraid of going to the big city of Lima, where their style of dress, form of Spanish, and general way of living make it pronounced that they are from the mountains – and, thereby, a lower socioeconomic class.
Our next step was firmly based on advocacy. Charito traveled back to Daisy’s home. She took the family to the health post to complete the necessary paperwork and then loaded everyone into a bus for the 2-hour trip to Caraz. In Caraz, Charito helped advocate for the family by transferring Daisy’s care to the Hospital for Children in Lima. The challenge, all the advocacy, and planning needed to happen in the next two weeks – or the original transfer of care will expire, and the process would need to start over. In addition to the logistical challenges – every day Daisy continued to seize, she was losing more and more brain function, and she was more and more vulnerable to death.
After months of advocacy and support, Daisy was finally seen by a pediatric neurologist in Lima. Her medication was dialed in, and her seizures were controlled. The family moved in with an uncle in Callao to be closer to Lima and the Children’s Hospital. We lost contact we Daisy. However, the last time we saw her and the family – she was walking, starting to talk, and receiving comprehensive care at the Children’s Hospital. She was reclaiming the life she deserved.
Daisy’s resilience taught us that we needed to be resilient. We are thankful for the life of Daisy and her resilience.
From bad to . . . An update from Perú
/0 Comments/in Blog /by Wayne CentroneA summer workshop on communication for the boys at the Casa Girasoles Urubamba.
We have heard from many of our HBI stakeholders. Thank you for your concern.
Many of you have asked how things are going “on the ground” with the Casa Girasoles and our staff with the ongoing protests and political challenges in Perú. Well, here is a brief update:
All of our staff are safe and well. The protests have directly impacted some of our staff’s families, but no one has been hurt. The children in the Casa Girasoles programs are all equally safe and well. It is summer vacation in Perú, so the kids have been hanging around the homes and staying out of street protests.
The government has announced a plan to reopen all the blocked highways in the country with “firmness and in compliance with the law.” Congress is meeting to decide the constitutionality of moving the elections forward to December 2023. President Dina Boluarte continues to hold fast to her position. She has called on Congress to determine the legality of advancing the elections and clearing the way for reforms.
What does all of this mean for the protests and social unrest raging around the country? No one knows.
In the Sacred Valley at the Casa Girasoles Urubamba, road closures have meant an area shortage of gas, propane, and many basic foodstuffs. In Ica, the city has been almost completely cut off from commerce, with the Pan-American Highway suffering from blockades for over a month. Food prices have doubled over the protests in both locations, and budgets have been considerably impacted. We are working on a long-term plan to warehouse food and supplies. Our focus is making sure the children are taken care of and safe.
Nationwide, the situation is going from bad to worse. Reports from Arequipa demonstrate a drastic reduction in tourism – with only 1 out of every ten hotel beds occupied. According to the Lima Chamber of Commerce, over 1 million formally employed workers risk losing their jobs. This an alarming statistic when one considers that more than 70% of the workforce in Perú employed in the informal sector of the economy.
We will keep you posted as more information is available. Please keep all the people of Perú in your thoughts, prayers, meditations, and considerations.
Perhaps now, more than ever – we could use your support. Please consider donating the work of our Casa Girasoles. Thanks.
Keeping an Eye on all the Pieces – wayne centrone
/0 Comments/in Blog /by Wayne CentroneThe funny thing about any article that proclaims to have “real” insight is that it is ultimately a subjective opinion. If you ask ten Peruvians what they think is the underlying force, angst, issue, or challenge behind the current situation, you will get 11 different reasons. On top of the diverse range of opinions, the responses will more than likely contradict one another. No one agrees.
The challenges facing Perú are deeply complex. They are even more complicated depending on where you approach or view the issues. Rural vs. urban. Wealthy vs. poor. Formal education trained vs. apprenticeship formed. It is the classic parable of the blind men and the elephant. Everyone has a different opinion of what they are touching and feeling based on where they interact with the elephant. The discrepancy of view isn’t based on inaccurate information, as much as it is focused on a vantage point and perspective.
In “real” terms – the crisis in Perú is disproportionately impacting the poorest members of the country. With nearly one out of every three people living in poverty, and with the rural areas of the country representing a much higher percentage of the overall poverty experience, the road blockades, supply chain disruptions, and impact on the service economy are pushing people living on the edge . . . over the edge.
However, we choose to view the current situation in Perú. Whatever mechanism we use to discern the complexity, one thing is unquestionable . . . lives are being disrupted, and futures are getting sabotaged. We remain committed to championing children and the communities that care for them in Perú. We will continue tour dedication to envisioning a world where every child has access to health, hope, home, and purpose.
Please keep the people of Perú in your thoughts, prayers, meditations, and offerings. Thanks for all the ongoing generosity and support. Stay connected.
Protests in Perú – An Update
/0 Comments/in Blog /by Wayne CentroneYesterday hundreds (perhaps thousands) of protestors from around the country converged on Lima. The marchers’ self-described intent was to “Take Lima.” The protestors took to the streets in the downtown area, setting fire to a historic building and leaving five families homeless and another 14 families unable to reenter their homes due to smoke damage.
Throughout the day-long marches – the city of Lima came to a standstill, with police and protestors clashing in several neighborhoods, including the predominant tourist area of Miraflores. As a result of the clashes – 38 people were injured, and one fatality was reported.
Throughout the country – from Madre de Dios to Cusco to Arequipa, clashes between protestors and police have resulted in tremendous property damage and over 50 casualties and hundreds of injuries since the demonstrations started in December. At this time, the demonstrators remain committed to their demands: Resignation of the current president, the closing of Congress, the release of former President Castillo and Constituent Assembly, and early elections. However, nearly all of their requests are difficult and, more accurately, impossible for the government to comply fully.
The HBI team is safe. Our Casa Girasoles programs continue to run smoothly, and all the boys and staff are safe and well. The most immediate impact of the protests has been the skyrocketing prices. The cost of most foodstuffs has doubled over the past month. The escalating cost of many goods and services has stretched our budget. Adding to the challenge, road blockades on the PanAmerican Highway north of Ica and to and from the Sacred Valley have made it very challenging for staff to travel.
The government has reported that over $150 million U.S. dollars have been lost in agricultural exports and that “90% of small farmers’ production was spoiled due to the latest road blockades.” Protestors have re-damaged the rail tracks connecting the Sacred Valley of Cusco with Machu Picchu – potentially further disrupting tourism for weeks to come.
What happens next and how the political and social turmoil ends are anyone’s guess. One thing is pretty straightforward – the longer the protests go on – the more long-term impact they will have on the people of Perú. We will keep you posted on all updates.
Thank you for your continued support and all your ongoing concern.
Good is good, and we can do more – wayne centrone
/0 Comments/in Blog /by Wayne CentroneMiguel is registered to race in the Rally Tortoritas on 18 February
Beneficence is the act of doing good through charitable kindness or gifts. Beneficence is a central component of medical practice and critical to caring for others. More is needed.
Miguel (not his real name) is an incredibly talented cyclist. He is always the ride leader for the Girasoles Sanos Team. Miguel is brilliant, kind, and blessed with a balance of keen intellect and profound emotional intelligence. He is an amazing young man, and he has unlimited potential. He dreams of one day becoming an engineer.
Miguel comes from a biological family marked by violence, neglect, and substance abuse. He came to live at the Casa Girasoles after spending time in a state-run orphanage and living on the streets. Miguel has had contact with his family throughout his time in the child welfare system. The pain of knowing his family could not take care of him – and having frequent contact with them, has been very hard on him.
At 18, Miguel is ready to leave the Casa Girasoles Program. His family has been contacting him more and more. They want him to come and live at their home in Lima. They want him to work and support their aging mother. This is a typical scenario. At the time of emancipation from child-welfare services, families like Miguel’s seek to reunite with their sons – often not to heal wounds or build new relationships. Time and time again, the young men who exit orphanages, state-run homes or residential care facilities find themselves living as indentured servants . . . caught in a dysfunctional web as their futures become hostage to the same trauma that trapped them in their childhood.
Perú is going through a tremendous time of challenge. The social and political unrest is quickly pushing the country into an economic spiral. The events that led to the current situation are not unprecedented. In fact, the struggles of Perú are deep seated and multifactorial. One thing is, however, ever present – people living in the experience of extreme poverty are disproportionately impacted in times of economic, political, and social upheaval. Families like Miguel’s, who were previously teetering on the edge – are now falling into the abyss.
Miguel has gained so much from his time at the Casa Girasoles. He is, however, facing a future with many challenges. We can change that. We can be the bridge!
Now, more than ever – your support is helping us to build futures. Thank you.
Rippling Waves – wayne centrone
/0 Comments/in Blog /by Wayne CentroneRoad closures and blockades around Perú.
Yesterday the Congress of Perú passed a confidence vote in the new government. The Congressional vote granted the vote of confidence to the ministerial cabinet headed by Alberto Otárola. This seemingly insignificant act of Congress has already brought wide spread demonstrations and increased agitation amongst the protestors.
Whatever hope there was for a peaceful resolution to the political and social unrest that began after the inauguration of President Dina Boluarte in December following the failed coup d’état of former President Pedro Castillo, have left 46 deaths. Around the country protestors have taken to the streets – blocking roads and marching in solidarity. The police and military have been in hours long standoff with a group of protestors attempting to take control of the Cusco airport. Differing groups of protestors have erupted into violent clashes with one another in the Puerto Maldonado. The media in Perú are now referring to the social and political unrest as Perú en crisis.
The people suffering the most are those that have long-lived in extreme poverty. The Peruvian Ministry of Economy estimates the impact from the protests to exceed S/.300 million so far this year. Some of the poorest regions in the country are also areas with the most protests and the greatest disruption to their economies.
What happens next is impossible to know. One thing is clear, the situation has gone from bad to worse. Please keep Perú and the Peruvian people in your thoughts.
The Calm Before the Storm
/0 Comments/in Blog /by Wayne CentroneOur plans to visit the Casa Girasoles homes in Ica and Urubamba did not come to fruition. The transportation strike (more accurately referred to as strikes – as they occur with little in the way of central organizing) have made it very challenging to travel outside the main cities.
We arrived in Arequipa yesterday afternoon, and the first sign that things were different was the significant presence of the military at the airport on the tarmac. As we exited the airport, we met an even more impressive brigade of police with riot shields lining the roadway entering.
The official communique of the government announced 17 more deaths from the protests. Clashes between police and protestors have escalated in the Puno area, with the city of Juliaca becoming a hotbed of conflict.
The rising death toll comes amid growing protests calling for President Dina Boluarte to resign, Congress to be dissolved, and former President Castillo to be freed from jail. A vote is scheduled for today in Congress. The vote will decide the future of the current administration. Suppose Congress moves forward with a no-confidence vote and amends the constitution to allow early elections. In that case, it seems unclear whether these concessions will appease the protestors.
Last night we shared a pizza in a small restaurant near the Plaza de Armas. A large group of rather boisterous protestors filled the streets and marched in solidarity for peace. The vote in Congress may decide if the protests move in a more peaceful direction or turn an otherwise challenging situation upside down. We will see. Stay tuned.
An update from Perú – wayne centrone
/0 Comments/in Blog /by Wayne CentroneRush hour on the streets of Lima.
Happy 2023!
I arrived in Lima a couple of hours ago. Leaving the airport in the taxi, I expected to see a large police and military presence on the road. I expected to see visible signs of unrest. Instead, I found an eery calm.
International news outlets have talked about the widespread civil unrest around Perú – with the most significant confrontations occurring in Arequipa, Ayacucho, Apurimac, Cusco, Moquegua, Madre de Dios, and Puno. More than 25 people have died, and hundreds have been injured. There was a lot of speculation about what the city would be like now that the protesters have regrouped and taken to the streets in the new year.
The main instrument of the protestors are paros – or strikes. With the transportation strike being the most effective. It is working. The city is on holiday. I just went for a run, and the customarily congested streets of the city are all but mellow. It feels that way, at least.
Many businesses are closed without workers to attend to customers and manage shops. Tourism is all but on-hold, and the feeling is that of the visitor-less pandemic. Livelihoods are being upended. The protests will have devastating impact on the 70+% of the Peruvian population working in the informal sector and struggling from the effects of the pandemic.
What does all of this mean? In many ways, the current social and political situation in Perú points to significant change. Change in the old guard. Change in the status quo. Change in politics as usual.
I am still determining where this change will lead. It is too early to say. One thing seems clear . . . change is coming. We will keep you posted.
A Month of Thanks – Day 31: New Beginnings
/0 Comments/in Blog /by Wayne CentroneMarco (not his real name) was ten years old when he realized he could no longer care for his little brother. At four years old, his little brother was more than he could handle.
For as long as Marco could recall, he was the sole parent of his little brother. Taking care of him was like taking care of his son. And, for most of that time – Marco knew what to do. Now, at four years old – his little brother was more than he could handle. Marco didn’t know what to do.
A kind neighbor had always been there for Marco and his brother. She would feed them when his mother would leave for long periods and not provide any money for food. She would check in on them, ensuring they were safe and warm in the cold rainy months. One day this kind neighbor noticed something very different – and she went to the local judiciary to file a report of child endangerment.
That was when Marco and his little brother came to live at the Casa Girasoles. From the very first day – Marco talked about how much he wanted to go home. Marco spoke about how his desire to be with his mother. He knew of her “sickness” and the changes that would happen when she was drinking – but he also knew she was their mother and wanted more than anything else to know her love.
One day Marco ran away. A few hours quickly turned into a whole day – with no word of his whereabouts. The police found Marco at his mother’s home (a small four-wall hut with a dirt floor and an open-pit fire). She was drunk and rambling about letting him stay or go or whatever he wanted to do. Marco cried with the police and pleaded with our staff to let him stay with his mother. He hoped this time things could be different. He longed for a new beginning with his mother.
Each day offers an opportunity for new beginnings. But what about when it doesn’t? We must develop the kinds of programs and projects that work with the total needs of the children we serve. We must build models of care led by the voices and experiences of children like Marco. We must do more than respond to a challenge or problem – we must create new beginnings. This is the work of Health Bridges.
Today is the final posting in our Month of Thanks campaign. We appreciate all the messages and well-wishes we have received over the past 31 days. Please stay connected to our work – and #BetheBridge
A Month of Thanks – Day 30: Resilience
/0 Comments/in Blog /by Wayne CentroneThis push and pull, give and take, up and down, is especially evident when working with families and children who have lived through the experiences of generational poverty, traumatic stress, and social isolation. The following story is about the power of resilience and one little girl’s journey to healing.
Standing in Daisy’s home was overwhelming. The stench was powerful. Dirty clothes hung from a makeshift line in the middle of the one-room hut. There was no running water, no bathroom, and no electricity. Instead – a dirt floor, a single bed, and a small table covered with discarded papers and empty medication containers.
We first met Daisy (not her real name) in 2013. Her story is about extreme poverty, family violence, and social isolation. Daisy suffers from uncontrolled epilepsy. She literally seizes every day. Her mother told us that she often seized for up to an hour. The uncontrolled and prolonged seizures left Daisy mentally altered and suffering from several complications. Daisy, as we quickly determined, was in a critical situation. She was at risk of dying with her subsequent seizure. Late in 2013, we arranged a comprehensive care coordination plan for Daisy. Unfortunately, after a few weeks of care coordination – we lost contact with Daisy and her family. It was heartbreaking.
Apparently, Daisy and her family moved. Her father got into a physical altercation with the foreman at the mine where he worked and was fired. The family moved to the small town where Daisy’s father grew up. The city, a remote mountain community, offered minimal resources. Daisy’s mother quickly left. She moved in with a new man. He did not want Daisy. Daisy ended up on the streets.
It took almost ten months to reconnect with Daisy. Trip after trip to the high mountain town continually led us to dead ends. Finally, our outreach worker (Charito) connected with Daisy’s grandparents. Finding Daisy abandoned on the streets, her grandparents took her in, and she lived in their dirt floor home. She has not been on any medications for months, and her seizure disorder was uncontrolled. At six years old, Daisy was seizing up to five times daily.
Her grandparents took her to the local health post, but the nurse in charge referred them to a larger city, two hours bus drive away. They have yet to follow up on his referrals. Fearful that the cost of having Daisy seen would be more than they could afford on their meager income as farmers – they turned to traditional healers. Now, Daisy is getting worse, and her family doesn’t know what to do.
Our plan was simple . . . and entirely complicated. We needed to link Daisy into care through the Peruvian government programs. To do this, she needed a formal transfer of care from the clinic in her hometown to the Hospital for Children in Lima. This was a challenging task. Daisy’s father and grandparents were scared. They were scared of the unknown. They were afraid of going to the big city of Lima, where their style of dress, form of Spanish, and general way of living make it pronounced that they are from the mountains – and, thereby, a lower socioeconomic class.
Our next step was firmly based on advocacy. Charito traveled back to Daisy’s home. She took the family to the health post to complete the necessary paperwork and then loaded everyone into a bus for the 2-hour trip to Caraz. In Caraz, Charito helped advocate for the family by transferring Daisy’s care to the Hospital for Children in Lima. The challenge, all the advocacy, and planning needed to happen in the next two weeks – or the original transfer of care will expire, and the process would need to start over. In addition to the logistical challenges – every day Daisy continued to seize, she was losing more and more brain function, and she was more and more vulnerable to death.
After months of advocacy and support, Daisy was finally seen by a pediatric neurologist in Lima. Her medication was dialed in, and her seizures were controlled. The family moved in with an uncle in Callao to be closer to Lima and the Children’s Hospital. We lost contact we Daisy. However, the last time we saw her and the family – she was walking, starting to talk, and receiving comprehensive care at the Children’s Hospital. She was reclaiming the life she deserved.
Daisy’s resilience taught us that we needed to be resilient. We are thankful for the life of Daisy and her resilience.
A Month of Thanks – Day 29: Home
/0 Comments/in Blog /by Wayne CentroneWe believe in bringing more than just food and shelter to children that were formerly homeless. We believe that we can move past treatment and toward prevention. We are committed to helping children find the lives they deserve; whole lives – filled with health, hope, home, and purpose.
We are thankful for the homes that we’ve created with the Casa Girasoles Program. Our homes are spaces of safety, places of love, and cultures of integrity and trust.
You are helping to empower children to the futures they deserve. You are bringing them home.