El Medico Cubano

Warren Johnson, MD

As I sit on the sweltering back porch of the clinic, my own sweat blinds me while I struggle with a bullet in a buttock. I can’t wipe the salty water away with both hands in the sterile gloves I am wearing. The porch is the only clean location where there is sufficient light for a surgical procedure. My hands are struggling, probing several inches deep through several layers of muscle into Adrien’s adolescent thigh, fishing for the bullet that I can feel with my long-handled hemostats, but I can’t see the target. I shoo chickens away from under my feet. We don’t evict the chickens from the clinic compound because they love to eat the biting flies and ants that I cannot swat away with my sweaty, sterile-gloved hands. Seven people standing nearby wince at the clicking sound the surgical instrument makes against the bullet. It makes me a little nervous to have this audience, but Adrien had invited them all, glad to have his neighbors witness the surgery being performed by “El Medico Cubano”--“The Cuban Doctor” (my local nickname) in the afternoon heat of Southern Honduras. Besides, this surgery is the only entertainment in town today.

I was known in the clinic as “El Medico Cubano,” a doctor with the American medical relief group, Cape CARES (https://capecares.org). Each year, Cape CARES brings dentists, doctors, and educators to a few small communities in the jungles of southern Honduras. Our four brigades per year last one week each, bringing 20 volunteers from across the United States. We work on young smiles, old teeth, aching bodies, and rarely, bullet wounds. Each clinic is located in an open-sided brick building, standing tall amidst humble adobe houses. For decades we had no electricity and no running water, but things are better now.

Cape CARES began in 1991 to fill the gaps created by Honduras’s struggling healthcare system, and those left after the end of emergency disaster relief initiatives. Cape CARES’s humanitarian work has no political or religious agenda. In the two communities where we run clinics, dental care has evolved from just extractions to restoration and prevention. Medical care has grown from first aid and acute disease care to ongoing primary care, well-child care, and health maintenance.

Adrien had high hopes of making a new and better life in Honduras’s capitol city of Tegucigalpa. He is good-looking, well spoken, and literate in his native Spanish. He is also a good soccer player. Sadly, there is no work for him in the small village of San Marcos, and no level ground on which to play soccer. The only professional job that existed in San Marcos— rope-making--was already taken by Adrien’s older brother. The historic industry of making rope from fibrous local plants was crushed under the weight of plastic fibers and cheaper Asian labor. Adrien’s only two options were to swing a machete all day in sugar cane fields, or go to work in a factory in the city where he had been shot twice in the back for his bus fare. A third option would be for Adrien to make the trip from southern Honduras, through Guatemala, to the wealthy countries of Mexico or the U.S. Even the poorest urban neighborhoods in the U.S. and Mexico are safe and opulent by Honduran standards.

In 2014--the year when I removed that bullet--I was the only Black man to have come with Cape CARES to San Marcos, a community populated by brown-skinned Mayan people who did not immediately understand that this black man was American. Honduras is also home to the Garufina people; those coal black-skinned descendants of enslaved Africans who were stranded by sixteenth-century shipwrecks on the Caribbean coast. But poor and uneducated Garufina rarely venture into southern Honduras where Cape CARES clinics operate. Years ago, the Cuban government sent health professionals throughout Honduras to help the rural underserved. Some were blackskinned. Thus, the San Marcos community assumed I was Cuban and so was born my alter ego, “El Medico Cubano.” It was on my second trip to San Marcos that I realized how some Hondurans truly did not believe that “El Medico Cubano” was one of the North American “Fat pink ones.” They would whisper to me in Spanish, “We like The Fat pink Ones, but they don’t understand us.” It was said with such tenderness, meant as endearment, not as insult. They told me things like, “They dress funny.” “They have strange ideas of money and land.” “They offer to buy things that we would have given for free.”

Dawn breaks in San Marcos with roosters crowing and dogs barking. At first light, shoeless children walk livestock from bare clay yard to green pasture. They run home, bathe, and dress in white shirts for school before they climb the narrow foot path to basic schoolrooms. School breaks at midday and, if the teachers are not on strike, they will have an afternoon school session before herding the cattle back to the yard. Life will go on like this from first grade to sixth grade. At that time the boys are old enough and strong enough to get jobs cutting sugar cane or harvesting melons. Some will go to work in one of the major cities: Tegucigalpa or San Pedro Sula. We employ a few local people during our brigades, and they gain a few non-agriculture job skills.

Adrien is still in San Marcos. His teeth and body are in good repair because of Cape CARES dentists and doctors. He still has that second bullet deep in his buttock. When I last talked to Adrien, he was no longer contemplating a trip to the U.S. Working for Cape CARES for one week twice a year, he acquired some employment skills. He no longer calls me “El Medico Cubano.” I am one of the Americans now--tall and fat, just not pink. +

Warren Johnson, MD is a family physician in Colorado has volunteered with Cape CARES for 25 years.