Institute for Human Promotion

March 12, 2009. The lunch menu was reduced by half today. Until now, we could choose between PBJ and tuna, with a side of Chex mix or trail mix. The special today was PBJ. In truth, lunch is little more than a short break in the clinic and research schedule, and no one complains. The day was full:  an early morning interview with the physician from the Totagalpa clinic, a chance encounter with an NGO (Institute for Human Promotion, or INPRHU) project, a lengthy interview with an INPRHU project coordinator, and a late afternoon meeting and interview with the “sub-director” of INPRHU Somoto – all this while examining and providing medicine for approximately 65 patients.

We have been interested in the work of INPRHU since we first came to Nicaragua. Hiking through the region to conduct in-home interviews, we saw signs announcing INPRHU projects and heard in interviews that INPRHU had built this house or replaced that roof, or had helped with instructions in agriculture. We met last year with an INPRHU representative, but we were less prepared and, perhaps, had not yet earned credibility with an organization that has been working in the country and district for many years. We tried every day since our arrival to arrange this meeting and with Gabi Arias’ persistence finally managed it today. The INPRHU representative expressed some concern that we’d waited so late into the week to meet with her, but apparently she believed us when we explained that we’d called every day, several times each day since Saturday. Communications are not easy, even in larger communities like Somoto (about 20 kilometers from Cuje; approximate population 10,000).

Molly Copeland (’11; 1st year) is a remarkably quick study. She has moved from triage, to pharmacy, to field research with the shortest imaginable learning curve. Unfortunately for me, she is more likely than others to actually hear my “throw-away comments” that mostly would be better left unsaid. She is quick with a rejoinder or a snappy comment and keeps all of us from taking ourselves too seriously. She was single-handedly responsible for the gourmet lunch described above.

Thirteen students, one physician, two drivers, and one professor have come together and go about our work with almost no need for discussion, negotiation, or compromise. Co-leaders Molly Blumgart, Allison Corbett, and Sarah Goldman suggest, listen, watch, and encourage, and decisions seem simply to instantiate. Sadly, Molly Blumgart’s head is attached to the rest of her body only with rubber bands, making it impossible for her to travel the mountain roads without experiencing whiplash. I watch in the rearview mirror as her head bends and sways like the branches of a weeping willow sapling in a hurricane, and my sides ache from laughing at the end of the day.

There will be profoundly mixed emotions tomorrow at this time. Almost certainly we will judge that we have acted faithfully on our intentions and that we began and ended with a close, critical, and objective examination of those intentions. We remain committed to evaluating our efforts on the basis of the best holistic appraisal of the consequences of our efforts – even if it may be some time before we have the best data to do that.

We’ll close the clinic tomorrow, and Sarah Ruth Goldman and Allison Corbett, seniors who have been with the project for three years and from its beginning, will know that they have done remarkable things – even as they struggle with their wish that it might be more. They have grown – and grown up – with the project, and they have carried on work begun by two young visionaries, Lyndsay Usry and Ben Winer. There is much to be proud of, and a keen urgency about all that remains to be done.