Getting to Blue Creek takes about an hour's ride in "the Mobile", a sturdy vehicle with rows of seats along both sides, seven of us in back with three boxes of charts, our backpacks and water bottles. Two Belizian nurses in their white uniforms, four students from England and the U.S., and me.
When we arrive we find the water level identical to yesterday. Hmmm. Although Rudy is the one who knows what should be done, I am the doctor, which astonishingly imparts to me presumed knowledge and insight for which I am unprepared. Rudy and I look seriously over the river. I wade across, feel the strong tug around my ankles, and shake my head that it's a bad idea to cross in the Mobile. Let's eat, I suggest, which is welcome news for everyone.
After a simple meal the water level is unchanged. I recall that a little girl came by clinic yesterday breathing too hard and too quickly. Rudy knows her. Their house is nearby and on our side of the creek, so my next pronouncement is that we can at least make a home visit. And maybe check on her sister, Maria, as she requested yesterday. "Is Maria sick?" I asked her patiently. "She can't walk." I look to Rudy, who quietly says Maria has Down's Syndrome, "not that I'm a medical person or anything." Understand here that Rudy is a man with much responsibility. He led teams that built many of the paved roads in the Toledo District of Belize a few years ago. Now he is the main driver for the mobile clinics--not an easy task on the rock-infested red clay roads which remain unpaved. Roads that toss and turn, are often more mud than road after a rain, and that not infrequently contain bridges that flood. He is serious about his responsibility to be sure everyone (and the precious vehicles that carry them) arrives safely. But he doesn't want to go beyond his expertise. Of course he knows what he sees, and knows that we are both aware of his wisdom and good judgment.
Off to the little girl's house we walk, less than five minutes away. When we arrive we see three wooden buildings. The little girl, whose name I learn is Donecia, asks us to wait until her mom can come before we visit. She and her younger brother use their bare hands to dust off two rough wooden benches for us to sit in the shade, a welcome offering as the sun climbs.
We don't have long to wait. Mom comes, I watch Donecia's breathing long enough to see that she's at least no worse than yesterday, and leave one of the capable PA students getting her story and exam. Would mom like me to see Maria? We are sitting outside the main house.
"Yes, please," says mom. "This is where Maria stays." She indicates a square structure with a sort-of-roof, which looks like a large doghouse, maybe 12 feet square, with steps leading to the inside. It's made of deteriorating wood, weathered gray. I get a funny queasy feeling in my stomach.
Mom opens the door and I see Maria. She is thirteen, dark shiny black hair pulled into a high ponytail. She has facial features typical for someone with Down's. She sits alone on the wooden floor, both feet inturned by a deformity she was born with. Her blue nylon shorts are wet with her own urine--in fact, mom wants me to check an itchy rash she feels is from the Pampers Maria must wear at night. She smiles, sort of, and jerkily catches my hand as I am checking the rash. She makes noises but cannot speak--has never been able to speak. Mom scolds sharply at her when I want to check her leg and she rolls over onto it so I cannot, but no more sharply than any mom to a small child who isn't cooperating because she doesn't want to be poked around on.
I admit that I'm shaken by this child. It takes only a moment to glance around this tiny empty room. There are windows cut high in the north and south walls, which allow light and ventilation since the door is normally shut. The only thing besides Maria is a string hammock. The walls are all the same rotting-wood color as the floor and the ceiling. There are no happy pictures on the wall, no music player, no toys. Just Maria, alone, scooting around on the gray board floor, her useless legs and feet crossed in front of her. How can they bear to keep her here? How...sad. How very sad.
We discuss how mom can care for the itchy rash, and I ask her to come over to clinic later to pick up medicine for Donecia's asthma. Clinic is slow initially, so I sit with Maria's mom to be sure she understands how to use the inhaler. It isn't long before I hear more about their family. Her husband, who worked for a company of some sort, fell off a high ladder two years ago, and "has never been the same." He can do some farming but not "hard work" such as carrying Maria. She is brought back to the house for meals and to sleep next to mom at night. She has seizures, you know, and they are always concerned she will hurt herself. That explains the empty room and the closed door on her little house. Mom lifts her into a sort of chair to bathe her from a bucket, and to carry her back to the playhouse each day. She hopes someone can come help replace parts of Maria's playhouse where the floorboards have become rotten. Mom has to wash the floor often, and over time the boards have become rough, tearing Maria's clothes and skin as she scoots around.
I spend the ride back from clinic in a distracted fog, feeling irritated with a culture that doesn't--can't--provide support for these children and their families, irritated that poverty has consequences. It's impossible not to wonder if this would be Maria's fate if, like my children, she had the great luck to be born in the United States, where deliveries are safe, where children get therapy and surgery, where families are supported in their stark need. I try to imagine if this mom and I lived each other's lives: she getting a great education and growing up showered with resources and options; me having neither and scratching out survival each day for my children.
When I am finally back and the mobile is unpacked I go home. I look at each of my children for a moment with a stranger's gaze, wondering how they are seen by eyes that don't love them. I see the miracle that allows them to speak, walk, and miracle of miracles: LAUGH!! The miracle that allows them to be whole, when a simple gene hiccup could have left them with feet that won't work, a brain that will never process speech or singing, hands that will never draw pictures or do anything with glitter glue.
The wonder is not that things occasionally go awry as people are conceived, develop, and are born. The wonder is that the complexity of a human going from two half-cells into a fully developed body and person ever goes right. Every single one of the mitotic divisions resulting in our trillions of cells can glitch. But usually they do not. It's so easy to forget the astounding truth that each of us is a miracle, even when we don't get life quite right.
Deep in my heart I feel Maria's need calling to me, asking for a few moments of my abundant life. Being here, I guess, is a beginning.