Ciriboya
by Catherine Camp
I laid down for a brief nap after arriving in Ciriboya, a seaside village on the Miskito coast of Honduras, lulled to sleep by the sound of a man outside the window, sharpening a machete to trim the grass around our temporary lodging. Soothing…no traffic, no machine noise. We were staying in about the best Ciriboya has to offer: a recently completed three-bedroom house, which includes a shower in the indoor bathroom, but no electricity and so no hot water. The house has been built with money sent home from the U.S., a bit at a time, building a retirement house for an immigrant worker.
My husband Bill had arranged this trip so we could participate in a large Saturday celebration to formally open the hospital in Ciriboya: the first health center to be built with and for, and staffed by, the Garifuna people who live along this coast. Our party included John Garamendi, the lieutenant governor of California and his wife, Patti, and Bill and I. Bill is the head of one of the parties to a 3- or 4-part effort that culminated in the completion of this health center, and the first stage of a health system.

The first part of the effort is the California labor movement. Bill is the head of the labor council in the 6-county area that is the greater Sacramento area. He has brought his considerable Southern charm and political blarney to bear on the task of finding the resources to build a clinic in rural Honduras. From cash donations, to medicine approaching its expiration date, to used solar panels being replaced by the local public utility, to second-hand Spanish-language school books, to a barely-used four-wheel-drive pickup truck, he has relentlessly rounded up the resources to build this health center, and delivered them along with twice-yearly visits to develop the relationships and strengthen the resolve to build the clinic. His own motivations are diverse: he’s a compulsive organizer and has been since the civil rights movement of the 1960’s; he’s committed to a public and widely available public health system; and he’s always fascinated by complex and multi-faceted political mixtures like this one.

And why Honduras? It’s a bit of a family affair. Bill’s brother Tom began holding clinics on this coast, as part of a religious mission effort involving Methodists from throughout the southern U.S. On our first visits, these mission trips involved bringing a dozen or more folks, together with medicine and several medical professionals, and holding large public clinics in villages with no consistent medical access: lots of worm medicine, antibiotics for infections, occasional stitches and other minor repairs, and diagnosis of even more serious conditions. Some trips included dentists and eye doctors as well, and services were free to any who could come to the clinic. Tom is clear that the point of a mission trip is saving his own soul, not proselytizing others’ souls, but bibles and prayer were a regular part of these trips, including Bill’s first trip with his brother.

Tom was unable to come for the opening of the Ciriboya health center, but his own organization, the Alabama/Honduras Medical Education Network (AHMEN) represents the second part of this collaborative. AHMEN was ably represented by Larry, the AHMEN supply chief. Larry is an Alabama guy, a widower, with some kind of difficult history written in his face, who came to this coast and found a mission and a people he loves. He lives in La Ceiba, a comparatively small city that is the supply center for this coast, and manages the warehouse of donations for AHMEN trips. He loves the people of Honduras, and the tasks of helping arrange the transport, feeding, lodging and support for groups of U.S. folk to come to provide help.

Two years ago, Cuba and Cuban politics were added to this mix of Garifuna people, California labor lefties, and Southern Methodist missionaries. Fidel Castro’s ELAM (in English, the School of Latin American Medicine) has reached into native communities throughout the Caribbean, Central America, and South America, offering a completely free medical education to local young people. In return, students make a commitment to return to their home communities and provide medical care. One of the first graduates, Luther Castillo Harry, is a Garifuna from the Ciriboya region, affianced to Wendy Perez, another Garifuna doctor, who comes from Limon, the center for AHMEN medical missions. During a visit to Limon, where Tom and Bill were both providing care, Luther knocked on the door in the middle of the night, bringing an accident victim to the clinic where he heard some American Emergency Room doctors were available. He stayed to attend the clinics over the next few days, watching and learning.

Luther has graduated now, and has returned to this coast to provide medical care. While recognizing the importance of the American medical offerings, he is committed to developing a public health system in these Garifuna communities, and to building a health care institution that honors and reflects the unique Garifuna culture. Since his own graduation, an additional half-dozen Garifuna young people have graduated from medical school in Havana, bringing skills and a commitment to health services along this coast. There is little in the way of material support for these young doctors, and the communities themselves are poor. But it feels as though a health system is possible, and that the Ciriboya health center is a tangible commitment to its development.

And so we have the California labor movement, the Alabama Methodist mission movement, and Cuba’s commitment to a legacy of health care in the poorest parts of the Americas, gathered together in an unlikely partnership with the Garifuna people of the Miskito coast. Who are these Garifuna?

About 1635, two Dutch slave ships foundered in a storm off the island of St. Vincent in the eastern Caribbean. The liberated Africans found an island where, one hundred forty years before, fierce Caribe warriors from more southerly lands conquered, and killed the men, of the native Arawak tribe. There resulted a culture with a language that distinguished between words used by women and young children (Arawak-based), and those used by men (Caribe-based). The West African immigrants inter-married, and for roughly one hundred sixty years St. Vincent had a reputation as a sanctuary for runaway slaves, similar to Guyana, Brazil, and the Seminole lands of interior Florida. After the American Revolution, Britain sent soldiers to this part of the world (better that then deal with a large number of unemployed warriors, as Iraq is today discovering), and St. Vincent was taken over. The residents, a mixture of West African, Arawak and Caribe, with language and customs that even today reflect all three cultures, were deported en masse to an island where 2/3 died of starvation; then re-deported to the bay islands off the coast of Honduras. Spanish Honduras, nervous about the war-like British, welcomed the Garifuna with their fierce and independent reputation, and the Garifuna spread along the east coast of Central America, from Belize to Nicaragua. They have been fisherman, and today many of the migrant men work in shipping and warehouse industries. They have retained their language and, although many have a strong Catholic or Protestant tradition, burial and celebration customs reflect West African, Caribe and Arawak roots, along with a distinctive drumming and dancing style. With the decline of the fisheries off the coast, and because of what they regard as a government actively unwilling to support this culture, the Garifuna are largely very poor. What money and resources there are often come from those distant, migrant workers, sending back remittances from work elsewhere in the Americas, especially the U.S.

And so, these unlikely partners came together in this year of 2007 to celebrate the building of a health center in Ciriboya, perhaps the first of a coastal system of Garifuna health care. And what a celebration it was. Although some television is available here, through the expensive use of generators in a handful of houses, this is a community without the short, electronically-fed attention span of the U.S. And the ceremony was planned and directed by Luther Harry, Garifuna but influenced by the Fidel Castro and Hugo Chavez style of political theatre. Saturday morning we all participated in a five hour ceremony to celebrate the opening. Chairs were available: members of our group spent the previous afternoon driving up and down the terrible dirt roads to gather the plastic chairs of every church and school for dozens of miles in every direction. And the First Garifuna Planned and Managed Hospital was a Big Deal. Garifuna leaders came from communities as far away as Belize. One of the few Garifuna legislators came from Tegucigalpa, the capitol. The mayor of the county came, along with a cultural ambassador representing the President of Honduras. The Cuban ambassador to Honduras came. And everyone spoke: Bill, John Garamendi, the Honduran legislator, the mayor, the Cuban ambassador, a descendant of the only Garifuna doctor ever to graduate from the medical school in Tegucigalpa, and all of the Cuban-trained doctors now ready to staff this clinic/hospital and extend its reach along the coast. And a couple hundred people listened, clapped and paid attention for the full five hours.

In between the speeches were intervals of drumming and dancing, a Garifuna tradition, with the men drumming and the women dancing. There are strong matriarchal elements to the Garifuna culture, and the women dancers, groups of them from surrounding communities, danced and sang, with a style of line dancing that is by turns aggressive, solemn, flirtatious or celebratory, often calling out for better drumming or teasing the men. And virtually every local speaker began and ended with how important this event was for the strength and solidity of the Garifuna culture, as well as the health of its children and families. Throughout this celebration there was a political element: those bureaucrats in Tegucigalpa, who control the federal resources for everything from roads to hospitals, and the Hispanic doctors who decide who and where Honduran doctors will practice, better listen up. We brought together on this day the resources of the labor movement in California, the lieutenant governor (the highest-ranking official to travel to Honduras in a very long time), the church resources of the southern U.S., and the might of resurgent nationalism fueled by Cuba and Venezuela. Who knows what is possible with our combined passion and commitment?

And it is important work. The most important outcome of these labors, of course, will be on the health of the children and adults in these Garifuna communities. a significant number of the children here die before their fifth birthday, with worms and malnutrition and bad water taking a huge toll. And malnutrition is a newly abundant risk, as the sea-based resources that have been a traditional foundation of Garifuna nutrition become more scarce due to commercial over-fishing in the Caribbean. And AIDS is a problem, as it is in virtually every culture where the men go afar to earn the money to keep families afloat. Women have chronic and early back problems, because they haul increasingly scarce firewood from the hills and jungles for cooking. For many of those Alabama volunteers, and others who come to help, the commitment to others, especially those in poverty, is truly soul-saving. For the Cubans, the Ciriboya experience represents a public success in their effort to extend the legacy of improved health care beyond Cuba itself. The best place for a black child to be born anywhere in the world is Cuba, measured by infant mortality. Ciriboya represents the possibility that that success can be extended to Garifuna communities. And for the California labor movement, this effort offers a small but significant opportunity to build alliances between working people in this globalized economy, and to demonstrate that widely available health care, affordable to the poorest community, is not a costly, unattainable goal.

And at the end of the day, it was all about the people. Why was the lieutenant governor willing to come along on this adventure? Opulent junketing this was not. The drive to Ciriboya alone, several hours on a road that involves driving through a couple of rivers where the water comes up nearly to the door handles, potholes and crevasses on the road that are spine-jarring, and one landslide area where shoveling dirt into the canyon to make the road wide enough for our 4-wheel-drive was involved. But John and his wife Patti spent the early months of their marriage in a village in Ethiopia in the Peace Corps. Patti’s response to our lodging in Ciriboya was, ‘Oh good, no electricity, there will be candles.’ Both John and Patti have done international development work in their subsequent careers, and their interest in the Garifuna is personal and direct. Beyond that, the extensive coverage of this unique collaborative of interests was big news in the Hispanic news arena following our visit. And that can’t hurt any of the participants politically.

Beyond Bill, the California labor movement was represented by Bud, a sheet metal worker, single, a craftsman caring for his aging father. He has found a passion as road manager for these trips, assuring that the sturdy vehicles to get us there are rented, the houses in the village for us to stay identified, the individuals in the village who will host and cook for visitors as a part of the partnership to build a health system found, and the food and water purchased. (The food, by the way, was excellent, stews and plantain and rice and freshly caught fish.) Perhaps his comment as we left sums up a part of his commitment: ‘It’s hard not to fall in love with a place where a dozen kids greet you when you arrive, calling ‘Bud, Bud, Bud.’

And the larger Garifuna community is represented by Jesus, a young Garifuna woman who now lives in Sacramento, going to school and raising her son Isaac. She is an understudy to Bud, providing road manager services as a way to build her home community and to return there frequently. The most remarkable part of her history is her arrival in the U.S….she walked. She walked the entire way. And after she arrived, she worked through the system to legalize her residency, to support herself, and to go to college.

It’s hard to tell who is doing the giving here….and perhaps that is the magic. We’re all giving, but what we are receiving is a remarkable human, political and spiritual partnership.