Politics May Be Your Friend, Doctor


One-on-One Personal Influence

Little did we realize that at that time and in that situation we were in the process of cutting new policy between the countries. The Hondurans were under the mandate from their master in professional matters, F.O.M., Fernando Ortiz Monasterio, for them to coincide their position of plastic and reconstructive surgery with that of Mexico; and they had been told the professional position was, “Send them home; we are able in Mexico and Central America and to a certain extent in some South American countries to take care of ourselves. We should well do that and this is the new order of things starting now and from now on.” Yet here in front of them were six eager eyes and three faces bearing gifts of skill and knowledge, and the Hondurans also had personal human priorities and instincts which were commanding them to do the right thing for their countrymen. We also had another type of power over them because we were people and were face-to-face. I knew that. The personal bond that all six of us had formed with each other in that first thirty minutes of the meeting had amazingly already formed the group into a union, a sort of team of six people with a single task of “doing the right thing.“[1]

The secretary of state/aide-de-camp to the president of the country said (diplomatically of course), “Yes. A good idea you have there, but we have a program like that already. We already have American plastic and reconstructive surgery help here. Dr. Gil Snyder of Miami has come to our national women’s and children’s hospital right across the street and has done four cases this year and two cases last year in urology, congenital anomalies of the penis, hypospadius. Thank you, but we won’t need your gracious help.”

The army colonel responded, “This is very good. We have a border dispute along our frontier with Nicaragua. You could help us win the hearts and minds of the Mosquito Indians living there by setting up a medical program of cleft lip and palate, etc., for them.”

The minister of health had another idea. “We have Snyder here; he will do our clefts, which are not numerous in this area. But I have a good friend in the northern city of San Pedro Sula, a city where they do business in this country. Here in Tegucigalpa we do politics; in La Ceiba they dance; and San Pedro Sula is a port and a factory city where they have plenty of cleft lip patients. Why not do your program there at the old Leonardo Martinez traditional hospital?”

We said, “Yes!” He picked up the phone immediately and called Dr. Rene Bendaña, who said, “Yes, send them up!” The minister then called a taxi and sent us to the airport.

We arrived in San Pedro Sula at 11:30 in the morning and looked for the very experienced 85-year-old Dr. Bendaña, dean of the surgeons in San Pedro Sula. He was not at the hospital, so we took a cab from there to his private home. The maid told us that he had gone away to his farm in the country. Medicine is like a trampoline. At one moment you’re high in the air and at the next you’re very low. This was a low point.

We went back to the 90-year-old hospital and looked it over. It looked twice as old and was in disrepair. However, we saw no rats or dog shit, and there we found nirvana. Our career-long goal was before us! There were sixty children, many in mothers’ laps, sitting on long benches while being reviewed by Bendaña’s girlfriend, Maria, the hospital social worker and most efficient humanitarian you could imagine, who had their medical records in hand. Ecstasy descended upon us.

We asked immediately for a translator and began triage. “Babies with unrepaired cleft lips first. Then four-year-old unrepaired palates. We will need tongue blades please, and we all must wash our hands after every case, please.” The blue background cloth for the camera was in our backpack. We had missed personal contact with Bendaña or his equivalent, but his surrogate, Maria, a social scientist was the miracle he had provided us.

We worked hard, buoyed up by their Pepsis, much sweeter than Coke (we were in sugar cane country and Pepsi had the good stuff). This was banana country also, and until 5:30 we each had a few Pepsis and a few bananas. Then we packed up our photos and records galore. (Many of these records gave us clues for our associated cleft research: advanced paternal age and parental contact with agricultural chemicals might be factors.)

What a day!

Then we naturally went to the Guanacaste[2] Bar at the Gran Sula Hotel. There amidst all sorts of European, Japanese, and American business folk we had “couple beer,” Nacional brand, which was specially manufactured for the banana workers. Nacional had been given a high alcohol content because the very popular Aguardiente rum was gone from the local market in an effort, we were told, to reduce the incidence of “Collins syndrome.” [3] The Honduran sitting next to Phil Collins (no relation) at the bar said in Spanish, “I have reported 2500 cases of Collins. I named it Collins syndrome in my report to the society in Managua. It is endemic here, and it acts as if it were a contagious disease.”

An American Learning from an Honduran
An Honduran Teaching an American

Another interesting person associated with this project was David Ohlwihler “Yes, I have experience with a cleft lip and palate repair program that failed,” said Ohlwihler, one of the American pilots for TACA Airlines. He was had become so concerned with the high incidence of clefts that he entered medical school at an advanced age and became a plastic surgeon. “I know why that foundation failed. And later, if you want to do these cases, I know how to be your political guide and keep you safe from the detractors.” [4]

Luis Bueso Arias (a pediatric surgeon whom we taught in the process of the project to do the best cleft lip and palate repairs), taught us in return the little sayings, the local jokes, how to have fun, and the value of the social acts—dancing and reveling with all those people who participated in the program, from janitor to prince, in the restaurant high up the mountain at the end of the main street of San Pedro Sula.

We soon had new friends in the business community because we stayed in their homes.[5] We were soon shielded from the jealousy (selosa) of the doctors, jealous even though the surgery was 100% gratis to poor people, but afraid that somehow we would take away from their income. And that was the source of the detractors’ dissatisfaction. (As an aside, I knew that at least three percent of the patients’ fathers wore a business suit, an obvious sign that this was not a “poor” person.)

You can see personal contact, aka sustainability, throughout this narrative from beginning to end.

Six months after that visit, four spies were sent on the first day of surgery (q.v. that episode). All the spies were card-carrying professional doctors who had fortunately been trained in the United States. Being a physician, one has automatic invitation to be received cordially by any other doctor in the world. But just as in the custom of the knights of old, if you do them any harm during their hospitality, they will quickly “kill” you.

[1]  Motivation. Usually at a meeting in Central America, the individuals give first priority to (1) how they can personally obtain wealth or advantage for their family, their primary unit. However, our presence and demeanor as straightforward, humble people with something to offer, changed their usual game plan–they decided that approach would be bleak. Now their unverbalized agenda was to consider our motivation. (2) They asked themselves, What is their palanca (leverage)? How are these capitalists from America going, as usual, to take advantage of us? (3) But in their conversation, then marked off in their minds, they asked themselves, Do they desire information? Are they from the CIA? Are they government agents? (4) Then, Are they missionaries, motivated to proselytize and convert us? (5) Finally, Are they socialists or cultists perhaps? (6)  But apparently they all decided, “None of the above. These Americans are possibly naïve; possibly even psychotic.” I think the conclusion of their evaluation, by power of personal contact, was that it was obvious that we were crazy Americans, out of our boxes as usual, but were making straight talk. They decided, “Let’s see if we can gain from them for our country and deal earnestly with them.”

[2]  Guanacaste is a local forest hardwood tree.

[3]  Collins Company of England is the manufacturer of the 44” machetes used for cutting the 4-5” diameter banana trunks in one swoop. In fierce discussions, the left side of a face might also be cut, and sometimes hands were cut off at the wrist.

[4]  (footnote to be written)

[5]  Including the English people in the tobacco industry compound, the banana executives at United Fruit’s ruling class homes, the honey farmer, the physician who owned the coffee company, etc.

 

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