The Blessings of Service: Lessons from Guatemala

The Blessings of Service: Lessons from Guatemala April 4, 2014

Service opens the world to us. That, anyway, is what I have experienced in Guatemala where for the past 17 years I have joined a team of eye surgeons about every other year to work in a remote hospital in the highlands among people who are among some of the most underserved by modern healthcare in our hemisphere. I have no medical expertise, although I grew up wanting to become a doctor, but I do have Spanish language abilities that have allowed me to be of service as an interpreter and as an assistant in the clinic. I am indebted to my best friend and freshman roommate, Andy Sorenson, and his family who have been coming here for decades as now a three-generation family of eye surgeons and who first began inviting me many years ago. Andy came as a young boy and now brings his children, as do I.

Bob Sorenson does surgery with his daughter, Becca Janik, while being assisted by Deanne Heinrichs.

The Hospital de la Familia, where we work, is located in the southwest corner of the country, just a few miles east of the Pacific Ocean and not far from the Mexican border near Chiapas in a small town called Nuevo Progreso. The area was once dominated by large landowners who ran coffee plantations but has since fallen into a more diversified but still struggling economy. About a third of our patients come from Mexico. You can read about the hospital here. The hospital was built due to the efforts of an American businessman, Jack Younger, and his friend, the priest Padre Cayetano Bertoldo Meda who almost forty years ago collaborated on the construction of the hospital that is now run by Catholic nuns and funded by a combination of ecclesiastical support, private donations, government funds (from both the U.S. and Guatemalan governments), and the extraordinary donations of time, money, and equipment from many teams of doctors who come every few months to loan their services, including general internists, cosmetic surgeons, eye surgeons, and others, all of whom are united by a desire to relieve suffering in the world. It is an unusual but thriving partnership that has resulted in benefits to thousands of the very poor in this part of the world. Those who come here will tell you that is some of the most important and best work they will ever do.

In our case, we look at anywhere from 50-100 patients a day, people of all ages and of all levels of illness, and we end up operating on about somewhere between 15-25 of those people each day. Others are sent away with medication or in search of another specialist. We see stories that inspire and stories that will break your heart. We see children born with cataracts, elderly with simultaneous conditions of cataracts and glaucoma, men with serious injuries to their eyes while at work, young mothers who see the doctor with their own eye problems while we attend also to their ailing children, people who learn that their eyes are only a symptom of a larger problem, such as cancer. And more frequently, as a sign of the growing impact of the hospital’s work, we see patients returning for prescriptions and check ups. One thing to remember is that when the general health of the population is weak, so too are their eyes. In other words, their eyes may be only one of the many problems they face. And because of the differences in access to health care and in individual economic means, their problems, by the time they see us, are usually much more advanced than doctors will find in the United States. Just this week, for example, we had to turn away a young mother of 27 who went suddenly blind seven months ago due to neovascular glaucoma, a condition that, had she been able to get treatment earlier, could have been slowed down in its effects but that instead left her totally and irreversibly blind. She went away in tears, to face live blind and alone with her five year old daughter. However, we also saw a young man who punctured his eye in a accident working as a butcher only four days before our team had arrived and we just happened to have one of the best surgeons in the country to make the kind of repair he needed. Had it happened any time earlier or had the team been much different, he might not have recovered sight in his eye.

The lucky patient with his doctor, Andy Sorenson

The vast majority of cases with cataracts are able to enjoy the dramatic results that come from an artificial implant of a lens that restores sight to an ailing eye. Those are the most joyous cases, especially when they remove their eye patch the next morning after surgery when, perhaps for the first time in decades, they can see. Glaucoma patients cannot recover the sight they have lost, but they can get surgery to prevent further loss of sight. What is especially remarkable and the most moving aspect of the whole experience is to witness the dignity of these good people, most of whom are Mayan and who know suffering intimately. They are unimaginably patient and humble but incredibly resourceful, hopeful, and persistent. And for the most part, they are surrounded by loving and concerned family members with whom they have traveled, in some cases as many as 6 hours, to arrive at the hospital across uncertain, unpaved, and winding roads in the middle of the night. They are in the land of their ancestors, they retain their traditions, and they have made adaptations to modernity without losing their essence.

I have always felt that learning Spanish as a young LDS missionary in Venezuela some thirty years ago now has been one of the greatest blessings of my life. And I cut my teeth in Venezuela talking to people about their most personal struggles and questions. While my vocabulary took many years to grow, it was initially a language learned in the context of love and service. I have almost never passed much time, wherever I have lived, without my Spanish affording some new opportunity to assist and serve. Knowing Spanish has stretched me into feeling compassion for people in circumstances far different from my own, and it has enabled me to see the world from radically different perspectives. The paradox of this is that what gave me this gift was the fateful decision to put my trust in God and allow him to send me wherever he needed me as a missionary. In other words, if it hadn’t been for my somewhat simple belief that the world is one, that it is small enough for me to reach across it and serve meaningfully, I would never have discovered just how big, diverse, and plural the world is. The truth is that one learns more about the world and about people from service than most anything one can gain from books, from touristic or academic travel, or from the classroom. I have often reflected on the paradox that you can’t really learn unless you are willing to risk the desire to change the world. Only then will you be in a position to be truly changed yourself. That is not to excuse zealots who impose their worldview on the world without an ounce of humility or self-correction. It is merely to suggest that humility is the friend of service, not the reason to shy away from it.

Besides, as I have learned in my experiences here in Guatemala, service is multi-faceted, and it takes many people to make a tangible difference. Not only has the institution of the hospital outlived governments, economic downturns, and other uncertainties, but it functions and provides its services to people because of many, many hands: nuns, nurses, staff, surgical technicians, surgeons, translators, not to mention those who have worked over generations to develop the technology upon which this miraculous work depends, all of whom do what they do because of the instruction of teachers and other institutions equally blessed by the collaboration of many over generations. While it is perhaps understandable why we sometimes experience a collective depression over our human capacity for evil, civilization provides ample evidence that over much time and with many hands, we are frequently capable of remarkable good.

These teams of doctors provide what good fortune they can to those who need it, but one quickly learns that there is only so much that can be accomplished. Every time I have come, I have seen reminders that despite the advances of the health of the community, there are many who are still too remote from modern healthcare to receive even its minimal benefits. I also understand that even our best efforts and our best technology cannot stop humanity from suffering the challenges of physical existence. This is sometimes very hard to accept, especially in the face of innocent suffering.

Two reasons for hope have stuck with me in the face of possible despair, and both have to do with the Sermon on the Mount’s great teaching that our weaknesses are also our strengths. First, the human body is a fragile thing. Physical existence is full of risk. This has helped me to understand that poor health, though tragic and sad, is more the norm than the aberration. We can then understand that the true miracle is that we are ever healthy at all, that we have been granted the rare chance to be alive and to experience joy. Second, because of that risk and our fragility, we will want to serve but we will also consequently discover our inadequacies. compassionate service is vital to our humanity. Similar to what we understand from acts of worship, aesthetic experiences, or from learning, service teaches us of a broader reality beyond our own. We discover that there are as many worlds as there are people, each one with its unique story, unique joys and unique pains. I believe in a God who, rather than taking care of everything for us, feels what we feel, mourns with us, weeps with us, and rejoices with us. And I believe he gives us powers of love beyond our natural capacity. I have seen it and felt it many times over: we are never better nor more beautiful than when we serve with love and sincere feeling for others, even or especially when our efforts are imperfect. With that love, which we learn from and share with a suffering God, we build a bridge across our many differences and discover that we are united by our belonging in the same family as children of the same God.


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