Monday, September 24, 2012

Dust Storms

For me, last week was rough. Every gust of wind seems to raise a dust cloud, and already with a cold, I was an easy victim for laryngitis, flu symptoms, and so forth. I was not able to teach my part of our classes so Lynn talked more than usual. However, early in the week I met with two representatives of pastoral care for penitentiaries at the Archbishop's Office. I am still trying to complete certificates of participation for the inmates in our English courses at Abra. With the certificates, Lynn and I hope they qualify for some reduction of their sentences. I also asked about the inmate with HIV who was refused treatment at a local hospital.  From our discussion I understood the following about the inmate's dilemma:
·      Doctors are obligated to treat patients, including those that are HIV-positive;
·      The inmate was initially treated and advised that he should first wait to see if his broken bone would set satisfactorily after being repositioned and splinted;
·      He returned to the hospital the following day and requested the operation to set the bone using metal screws and a plate;
·      Pending this operation, he was admitted to the hospital and placed in a ward for [HIV?]-infected patients;
·      In Bolivia it is the patient's responsibility to purchase in advance the materials that will be used in the operation, and apparently the patient was aware of this;
·      At the scheduled time for the operation the patient did not have the necessary materials ready, for which the operation did not proceed.
·      The doctor did not refuse to treat the patient because the patient was HIV-positive.

I have no reason to doubt this version of events, in which case the Abra protesters' support for their fellow inmate misrepresented the doctor's reasons for acting as he did. In one newspaper account Celima Torricoa, the Government Secretary for Human Development, said that the incident would be investigated thoroughly. From those findings I hope to verify that the doctor did not refuse to provide treatment and the inmate was not refused treatment because he happened to be HIV-positive.

I regret having left a false impression for a week but the combination of my illness and our having lost internet access during all of that time (just restored an hour ago) made it difficult until now to post an update. 

Monday, September 17, 2012

Tranquility

Sometimes when I go to Abra to teach my English language classes at the carcel I stop at the tienda across the road for a drink of water and to chat. Usually the tienda is open and someone is around.  Today it was S, the owner of the tienda. This was also laundry day. S sat on a rock in the shade as she doubled down on a pair of denims. Her shoulders and triceps sent the sudsy water hissing over the edge of the tub between her legs.1  Probably the jeans were her husband's.  He sometimes works inside the carcel, making repairs, chatting in the commissary with some of the men. S and I exchanged greetings, remarked on the increasing mid-afternoon heat as spring advanced.  This heat felt comfortable to me--like I was absorbing needed energy rather than losing it. However, it was intense, and a brief time in the direct sun makes me feel like I'm about to ignite.  The locals say Bolivia is directly beneath a hole in the ozone layer at this time of year, and it certainly feels hot enough for me to believe it.  I glanced around the surrounding yard and saw dogs and puppies, a cat chasing a butterfly, baby chicks peeping one after the other as a rooster chased after a fleeing hen, and ducks sucking muddy water from a puddle, raising their bills skyward with each bill-full as though guzzling champagne.

Although Lynn and I see more dark clouds travelling east to west these days, September is still in the dry season.2 When the winds buffet the orangey-red dust whirls up to mark the movement. The dust settles over everything--the cactus blades, the flowering scrub brush. This blending-with-the-terrain quality contrasts with the way the people (well, not all people, and I count myself in this latter group) can walk along impervious to dust and perspiration.  E--S's 5-year-old granddaughter--was that way, looking prim and clean, a princess of the yard. We wished each other good afternoon, and she asked where I was going. I always enjoy her questions because she seems both friendly and demanding, and I owed her a reply because I was after all trespassing in her yard.

It would have been a pleasant afternoon just to talk with S and E--a welcome contrast to the women and children I meet begging on the streets in the city--but I had a class to teach, and I planned also to ask if the men inside were interested in playing a soccer match against the student friars I teach at the convent in the city. It could be an interesting experience for both groups.

So I passed through the checkpoint at the outer gate, having my belongings inspected, receiving a pat-down search and then the stamp of approval.  That was always the longest delay in entering.  The inner gate was always easy to pass.  However, as I passed through the gate at the chain link fence something seemed different.

Rather than the usual few men lounging and chatting just inside the final gate, men began pouring through the doorway of the first main building, the one that houses the wood-burning crafts shop, the call center, the education office, and the library. They scattered through the yard surrounding the inner gate, and just as quickly as they found places to stand, more poured out of the building to crowd around the others, some running up the stairwell to take positions along the bannisters or ascending to the flat rooftop to line the low wall facing the main outer wall.  Soon I was surrounded by a good portion of the 500 plus inmates, all with serious looks on their faces.

From a few of them I heard "Hola, Profe," which made me feel better, and R tried to sell me one of his over-priced chocolate treats on a stick, as he always does3, so I didn't feel entirely weird. Today I had more appetite for news than chocolate, so I asked J, one of our students, what was happening. Then it happened.

One shirtless inmate jumped up on a rock,  faced us, and started shouting. All the other men started shouting back in unison, and the whole yard was thundering with righteous indignation. I had the general idea, but J leaned close enough to shout in my ear, "protesta."

And the man on the rock shouted, "Que queremos?"
And the men throughout the yard shouted, "Salud!"
And the man on the rock shouted, "Cuando lo queremos?"
And the men throughout the yard shouted, "Ahora!"

Solidarity seemed better than just standing by, so soon I was shouting "Salud!" and "Ahora!" on cue and in unison with the others. The chanting continued for about fifteen minutes or more.  Suddenly the main gate swung open, and the commandant stepped through. Off to one side I noticed that a cameraman from one of the local television stations was taking video of the protest. I wondered what was going to happen next. As the commandant passed through the wire fence, I saw that he was smiling.  He entered alone and began chatting with the men. It looked as though everything was going to be all right.  He seemed to be assuring everyone that their complaint had been heard and that it would also be presented on television and in the newspaper.

And, of course, at just this moment the gate opened, the waves of men parted, and Lynn entered like Venus on the half shell, mouthing from across the way so I could read her lips, "What-the-hell?"4

Soon the men in the yard began to drift away, back to their activities.  I passed through the building and up the stairs to the library. Soon the students began to arrive. Amid talk of count and non-count nouns I also learned from the men that they had protested because an incident the previous day. During a soccer match one of the men had fractured a tibia. When he was taken to a local hospital for treatment, the emergency physician on duty refused to care for him. This seemed outrageous, and I thought of the blues singer Bessie Smith who bled to death after a Memphis hospital refused to treat her because she was black. How great could the prejudice against the inmates be?

Later during the class we reminded the men that the friars were interested in a soccer match.  All that was needed was a date that would work for both groups. We finished the class and Lynn and I went our own way.

When I read the story about the protest in the newspaper the following day I learned that the doctor had refused to care for the man with the fractured leg bone because the man was or was suspected of being HIV-positive.

I empathize with both the doctor and the protesting inmates. From my work at the Santa Vera Cruz hospice I see the wasting effects of AIDS in otherwise healthy young men.  No one would want to risk contracting that. I do not know the extent of precautions taken by Bolivian hospitals to protect doctors and staff against HIV, but I will ask. Maybe some of the doctors feel that currently their best defense is to refuse treatment.  I do not know the extent of HIV infection among the prison population, but I will ask. I imagine that under the circumstances some of the young friars might also hesitate to play a full-tilt soccer match against the inmates. The Bolivian government also has a roll5 to play in mandating both treatment policy and guidelines for precautions--both at prisons and hospitals--to reduce risk.
                                                                
__________
1S washed with such a rhythm that had she been at the oars of a skiff we would have crossed the valley in no time.
2The climate offers two options--mud or dust.
3Some say this is how he supports his drug habit, but I still sometimes buy one.
4Beats-me! I replied. We always do our lip reading in English. I tried to convince her that this was a surprise celebration for her arrival, but she wasn't having it.
5Well, okay, I meant role to play, but it was late when I wrote this, and I was getting cross signals for croissants.