The original text of this article appeared in the Fall 2008 edition of The Global Address, a publication of The Ohio State University Office of Global Health Education. It may be found at this link: http://medicine.osu.edu/globalhealth/8843.cfm.

The main street of El Progreso, the dusty capital of Honduras’s state of Yoro, is a tribute to the remarkable permeation of Latin America with US fast-food. Pizza Hut, Popeye, and Burger King are but a few of the conspicuously gringo restaurantes that thrust neon signs against the verdant background of jungle and mountain. Jan Esker, Rein Lambrecht, Stephen Morrical and Sara Brummel, arrived with me in this decidedly un-touristy location with the mission of documenting the needs of its poorest inhabitants. Our quest took us to public and private hospitals, health centers, far flung orphanages and squatters’ villages around Progreso. Using formal surveys and conversational interviews we spent weeks piecing together the subtle shades of Latin American poverty. Now almost at the end of the experience, I was bounding along in the back of a pickup truck on an unfinished road, within easy sight of a larger than life glowing bucket of KFC. The odd contrast between Coronal Sanders and corrugated metal homes was striking and surreal. Our final survey site, Monte de Olivios, was an encampment built almost directly behind this tribute to fine southern cuisine. The village was composed of just three rows of shanties built on an embankment between two swamps. As the people came curiously out of their homes, I got the feeling that perhaps we had gotten ourselves in too deep. However, to my pleasant surprise we were soon surrounded by chatty Honduran women and learning their sad short history. As the story goes the town was originally located several kilometers away but following a foreign aid proposal to install a project in the area, the Honduran government evicted the residents and bulldozed their homes. Certainly the well intentioned folks at the foreign aid organization were appalled when they got wind of the situation, but by that time it was too late, the damage was already done and the citizens of Monte de Olivios were forced to look for shelter elsewhere. The story of Monte de Olivios is a parable of sorts in that it speaks to the dangers of assuming that we as the providers of international aid know what the people we plan to serve really need. For many of the people of Honduras life is a complex calculus of survival in which all the variables are precariously balanced and small disruptions can lead to catastrophic collapse. Doing no harm means first learning up close and personal about dimensions of this balancing act. After all, a detailed history is as indispensible to serving the health of a community as it to addressing the needs of an individual patient. This summer we had the opportunity to listen to the unique and fascinating stories of the people we hope to serve. As we look forward to returning with a medical brigade this December I trust that the foundation of knowledge and trust we built over the weeks of our investigation will help us to deliver on the promise of a true partnership with Monte de Olivios and the other communities we came to know.