Muestra tu Bondad: La mano que da, recibe

La mano que da, recibe (The hand that gives, receives).

An intentional look back at my year at Padre Damien House in Ecuador, and some thoughts about leaving the country and the transition back home.

''Leprosy work is not merely medical relief; it is transforming frustration of life into joy of dedication, personal ambition into selfless service'' –Mahatma Gandhi

Sr. Annie Credidio wasn't supposed to start a hospital. The nun with the Brooklyn attitude came to Ecuador over 20 years ago to be a kindergarten teacher. A friend invited her to mass one day at the leprosy wing of the hospital of infectious diseases in Guayaquil. What she found broke her heart. There were cockroaches in the food, inconsistent wound care for the patients' chronic ulcers, and mice running around—who at night would get into the patients' rooms and chew away at their toes. In short, inhumane conditions. She felt God calling her there and knew she needed to do something. With no experience whatsoever, she dove right in...

Flash forward 20 years. That leprosy wing is now Padre Damien House, a House of Hospitality and home to around 40 in-house patients and several hundred more outpatients. What Sr. Annie has been working for in these past 20+ years has been for a humane life for her patients; in essence, a place they can call home, that ''oasis, the little cell of joy and peace in a harried world'', as Dorothy Day would put it. I arrived at Damien last year both intrigued and curious to learn more about leprosy (now called Hansen's Disease), a disease dating back to Biblical times. I've spent the last year at Damien on weekday mornings from 8:30am to 1pm. What I've found this year goes far beyond what any textbook could teach me about Hansen's. I can honestly say that I've found a family, ready to open their hands and hearts to a strange gringo with a severely-lacking Spanish vocabulary. I found a place where conversations meant more than big projects, where presence meant more than status, and where Gandhi's ''joy of dedication'' could be lived out. As Sr. Annie reminds volunteers, we're choosing to cast our lot for a year, to walk with the patients in their pains and struggles, and to step into a world that many have forgotten.

Don Leon grew up like many young men in the campo (rural) part of Ecuador, working in the rice and fruit fields with water up to his knees. Roughly 95% of the world's population is not susceptible to Hansen's, but Leon was part of that small percentage that, due to differing immune responses, could contract the infectious bacteria. It takes several months of prolonged contact with someone who carries the bacteria to contract Hansen's, and can take years to show the initial symptoms of skin blotches and decreased sensation in the extremities. However, for most workers in the campo, leaving your work (that makes just enough to support your family) to take a bus several hours to a big-city hospital just isn't an option. As the bacteria progresses, it seeks out and attacks the cooler parts of your body—the eyes, nose cartilage, earlobes, and peripheral nerves in the arms and legs. Over time, the swelling causes the peripheral nerves to become trapped, and when oxygen can't flow freely, the peripheral nerves in the arms and legs slowly die and the patient loses sensation in the their hands and feet. The most dangerous effect of this loss of sensation is the loss of pain sensation. One patient we did nerve testing for came in with a cut on her finger she received while cooking—the cut was all the way through to the bone but she didn't feel a thing; she only knew it was there when she saw the blood rushing out. Without this pain sensation, repetitive stress on the hands and feet can lead to ulcers and eventually infection and bone resorption. Don Leon is one of the oldest residents at Damien, and lived through the horrid conditions before Sr. Annie arrived. His lack of pain sensation in his feet meant that he didn't wake up when mice would chew on his toes at night, only knowing what happened when he saw his sheets covered in blood in the morning. Leon's ulcers on his leg were so severely infected that he had to have the same leg amputated twice—first below, then above the knee.

However, the good news is, just like Leon, all the patients are either cured of Hansen's or finishing up treatment. Hansen's is completely curable through a 3-drug treatment provided by the World Health Organization. If treatment is started early enough, no lasting effects will remain. The several former patients of Damien House who are now full-time employees at the foundation, with spouses and kids, are living examples of this. For patients like Leon, and others who couldn't start treatment until after significant nerve damage, daily wound care is needed to wash the ulcers and keep them infection-free. One of my most powerful experiences at Damien has been assisting in wound care, washing ulcers that in many cases leave no skin on the feet. I had the opportunity to clean the wounds of Fortunato, one of the most jovial patients, on Holy Thursday this year, and it was a joy for me thinking about Jesus washing his disciples feet on that same day so many years ago. Even with the difficulty of daily wound care, both Fortunato and Leon don't drop the smiles from their faces; something I'll remember long after my time at Damien.

Even without one leg, Leon hasn't seemed to have lost a step. I've joked with him about having a wheelchair race around the hospital, but have put it off all year because I know very well that he would beat me. It wasn't until the last several months that I grew closer to Leon and began to spend a lot of time with him. But it all started when I asked if he could teach me the art of hammock-making. This guy can churn out a custom-made, Ecuadorian-colored hammock made of fishing twine (strongest material—these hammocks are guaranteed for life) in no more than 3 days. I needed about 3 months. But those 3 months I spent learning to weave my hammock were days I will not forget. I'd ask him just about every day if he'd found his amputated leg yet, which would send his high-pitched whistle of a laugh roaring through the men's section. He'd usually retaliate with a question like ''What were you doing in the kitchen yesterday you vago? (translation: lazy person). You should have been working on your hammock, not stuffing your face with patacones''. All the guys in the men's section seemed to take an interest in me weaving the hammock, coming to watch us work and joke about how I'd finish in two years. I felt proud when Leon invited me to accompany him to Mi Comisariato (a grocery store) across the street from Damien House a few weeks before our last day to buy a few essentials. I wheeled him across the street, popping wheelies at his command, much to the dismay of concerned on-lookers. Once inside, I found an Iron-Man halloween mask and proceeded to wear it through the store as we bought some oil, sugar, and eggs. We must have made quite a pair—a gringo with an Iron-Man mask and a one-legged Ecuadorian laughing up and down the aisles. Last week, at our despedida (going away party), Leon presented me with a hammock he had made with the colors of the Guayaquil flag (blue and white) to go along with the one I had weaved. An incredibly kind act from a selfless and joy-filled man. To my hamacka profesor, thank you...I will not forget those fun days!

A little weaving...

The master!

Unlike Leon, not all the patients are in need of daily wound care. Many choose to stay and live at Damien House because their families either cannot or will not care for them. Sr. Annie is very adamant about never turning anyone away, and there has always been a bed for anyone who needs it. The strong stigma that haunted lepers in the Bible still, to a certain extent, exists today. Without a home or support system to return to, Damien House is the only option for many in-house patients, and the patients see Annie as an angel sent from heaven. One group from the U.S. that helps Annie out considerably is appropriately named ''Annie's Angels''. Annie's Angels is a peripheral nerve surgery team that comes down to operate on Hansen's patients like Niño, one of my best friends at Damien. Niño is probably the most active 85+ year old I've ever encountered..he's always wheeling other patients to wound care or running to unload the donations truck. Everyone calls him Niño (little boy) because he's small and skinny, and he loves to joke around too. Almost every day, he'll sneak up on me while my back is turned and reach into my bag to steal whatever contents are inside, usually some bread from breakfast. I've become adept at stealing his hat off his head without him noticing. When the medical group came, I got to walk with Niño through the surgery process, hanging out with him the day before and waiting with him in pre-op before heading into surgery. Once inside the OR, the surgeons make small incisions into the arm and leg, working to widen the tunnel through which the peripheral nerves run in order to decrease the pressure on the nerves and prevent further nerve damage. The surgeries can have dramatic effects, allowing the patient to regain some sensibility and regain wider use of their hands and feet. I was lucky enough to watch the surgeries up close in the OR, talking with the doctors as they made the incisions and opened up the tunnels. It was an incredible experience with the group, but it was even more special to accompany many of the Damien House patients through the surgeries. For Niño and Leonor, another patient who had a foot surgery, it meant a lot to have us volunteers there in pre-op, the OR, and post-op when they woke up. I didn't realize just how special my time with Niño had been until our despedida, when he came out of his room crying, gave me a slip of paper with his cell phone number, and said I best be calling him because he would no longer have his ladron (robber) amigo around.

Niño(s)

I was able to work on a wide variety of things this year at Damien: wound care, peripheral nerve testing with my man Jonathan, translating for medical groups, cooking in the cocina with J-Lo and the other ladies, and maintenance work with Edgar. However, it is the hospitality and cariño (love) I received that has left such a big impact on me. And now it's time for me to return that love. Thanks to Chad Puclowski, one of the Rostro de Cristo retreat group leaders, we were able to set up a fundraising program on StayClassy, a new fundraising platform for non-profits. Our hope is that every volunteer and visitor who passes through the doors of Damien will spread the word, help raise awareness about Hansen's Disease, and raise funds to keep Damien House open for these individuals who have become like family to me. When Sr. Annie started Damien and broke off from the surrounding hospital, the foundation became completely dependent on donations and grants. One of the biggest stresses for Sr. Annie is where funding will come from; as she often states, there is usually enough money in the bank to last another 2 months. We hope that StayClassy can help eliminate this worry for her. If every visitor to Damien House agreed to support Sr. Annie's efforts through a $10 monthly donation on StayClassy, Damien House would take a huge step toward becoming self-sustainable. So, to keep my experience alive and to support my Ecuadorian family, I have created a fundraising page on StayClassy. Access it at http://www.stayclassy.org/fundraise?fcid=251769 , where you can make a one-time or recurring monthly donation. Every little bit helps!!! As Jack Johnson's All At Once campaign states, ''An individual action, multiplied by millions, creates global change.'''

So, that's a little bit of the world I experienced this year at Damien House. I'm now sitting here on the back porch by the hammock with a cup of coffee, thinking about leaving Ecuador in two days. This spot has become one of my favorites this year, my place to pray, reflect, play the guitar, and read. I feel excited to head home, but sad to leave behind such amazing people. I feel a longing for more time to spend with the people, but feel so very grateful for the time I have had. I feel like my efforts were not enough, yet I know I gave my best effort to truly ''be'' with these people. Most of all, I feel thankful—thankful for the family I've found at Damien House and the Arbolito neighborhood, thankful to have spent a year learning a different ''way'', thankful for all the friends and family who have supported me throughout this year, and thankful for being ''ruined for life'' by what I've seen and experienced this year.

My physical contribution was so very small this year; it was mostly a simple ministry of presence. However, I think this year marked the awakening of a deeper social conscious in me and a broadening world view. It has reaffirmed the truth that we are all linked together by love and support at the human level, regardless of language or class status. As I begin to try and put my year into perspective, I am constantly reminded of a quote from a book I read this year called Santiago's Children. The author writes, ''In retrospect, although I'd tried on lots of fronts, all my contributions paled in the face of so much poverty, repression, violence, and need...what had changed the most was me'' –Steve Reifenberg, Santiago's Children. Indeed, I identify strongly with his words; what has changed the most from this experience is me, and I know that my responsibility is to take the things I've learned in Ecuador and pour them out through a lifetime of service.

Thank you so very much to everyone who has supported me throughout this year, and who through generous donations, allowed me to live and love here in Ecuador for year. I can't wait to share more of this experience with you when I return home! God Bless and thank you for reading this year!

Cristobal