oligophilia

The Age of Information

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Will Durant became widely known for his early books, especially The Story of Philosophy.*  My copy is from 1933, the 15th printing. A yelloeing newspaper clipping is inside; it is an interview with the Durants in 1963 by Jim Bishop, and  includes a brief account of their 1913 marriage: Ariel  was 15 years old; Will, her tutor, was 25; yet they obtained approval to marry. She rollerskated to the courthouse; a ring she wore ever after was donated by an attendant; the marriage lasted 68 years until their deaths two weeks apart. Ariel was a collaborator in all of the Durant’s subsequent books, and co-authored the later ones; their commitment and devotion is palpable in the dedication of  Story of Philosoply which reads:

To My Wife

Grow strong, my comrade… that you may stand

Unshaken when I fall; that I may know

the shattered fragments of my song will come

at last to finer melody in you;

that I may tell my heart that you begin

where passing I leave off, and fathom more.

The same features of Durant’s book that made it popular were offensive to many formal historians: it is clearly written, and contains opinion, commentary, and humor. In other words, it was written to be read. understood, and enjoyed. As I open up my old copy again, the preface pages seem relevant to us in the 21st century; “Science teaches us how to heal and how to kill; it reduces the death rate retail, then kills us wholesale in war.” .They argue that only wisdom, as revealed through  “desire coordinated in the light of experience, ( philosophy)   can tell us when to heal and when to kill.” I will suggest that the world-wide chaos all around us in this new century is only another chapter in  an imagined Story of Creation: There is no author other than humanity:

Book One, The Age of Agriculture is unfinished. It begins with the creation of farming and husbandry, which promote stable communities at the expense of hunter-gathering. Stable communities lead to social order, and in time, to science, art, land ownership, geometry, mathematics, commerce, architecture, rule of law. The chapter now being written in an increasingly urban 21st century is titled,   Malthus, Speak.

Book Two, The age of Information,  is also unfinished. Its dominant theme is that to create easy access to information can lead to chaos, which in turn, creates change in human behavior. How ironic and circular it is that humankind creates that which creates change in humanity!  The chapter on the Biblical Genesis suggests that too much knowledge– information– is too much power; and power is something humans do not manage well.  When the forbidden fruit of the Tree of Knowledge is eaten, God becomes enraged and expels Adam and Eve from Eden. Now  we billions of tiny fleshy gods suffer from knowledge: Infomania, or infodynia.

The chapter on the creation of the Printing Press was about  the time when printed information became available to the entire world, information  formerly accessible only to Church, Wealth and Monarchy (one and the same). The result is a still evolving revolution in various degrees, and weakening of the three-in-one powers. Only Wealth seems still healthy; yet for how long? Perhaps we shall see. Many grotesquely wealthy people are divesting through charity already, aware that their life is finite, and wealth is anathematic when hundreds of millions of people, whose voices, unheard light years distant, are now loud and clear on Social Media.

The chapter on information  is still being written but, Ready or not, Social Media is here now, vital and alive, making books, magazines, and TV Old Media;  still of interest but mainly in retrospect.  We might have noticed the change when Talk Radio heralded new media, but was  less interactive. Social Media, in countries where not suppressed, is egalitarian,  and remains in the hands of the limitless number of individuals whose collective voice is very loud even though each one by itself is– pipsqueak–  unless it goes ‘viral’. That Info-genie, is out of the bottle; it’s body is made up of various aspects of the internet, browsers, email, skype etc.;   social media is its mind and voice,  where live information is instantly available to almost anyone, anywhere. Any image, any idea,  can spread in minutes around the globe.  Any single voice can be heard. Meanwhile traditional top down sources of information shrivel , snivel, and fail: newspapers shrink to the size of circulars, sirviving  on snippets of local news, and remunerative misleading medical or  cure-all ads. Information offered on TV remains stale, dull, repetitive, and uniform; talking heads  are entertainers on the order of professional wrestlers or football players, but less entertaining; some are serial sexual predators, violent scofflaws and drug users, yet they  foppishly foist political views on viewers who turn to free media, social media.  However we  face a  tsunami of information which creates chaos, both internal and societal. We are unable to evaluate, filter and sort it all. And until we are able to live wisely, and adapt, or create new ways of dealing with all this information, we are likely to remain factionalized, frustrated, fragile, and furious.

The Durant position is that people gnerally  lack wisdom, which they see as the realm of philosophy. They decry epistemology, as an analytic approach or scientification of philosophy. The introductory paragraph  in The Story of Philosophy, titled To the Reader suggests that:

‘epistemology has kidnapped modern philosophy’.

‘the knowledge-process … (is) the business of science,

‘philosophy (is) interpretation of … experience rather than (its) analytic description’

‘Analysis belongs to science, and gives us knowledge, while

‘philosophy must provide a synthesis… wisdom.’

The four and a half page extended  introduction expands on these assertions.  “… to seize the value and perspective of passing things, and …pull ourselves up out of the maelstrom of daily circumstance we need to know that …Science is analytical description, ( while) philosophy is synthetic interpretation. The philosopher ‘tries to put together that great universe-watch that science has taken apart”.  The Durants claim that if we break philosophy down like scientists, into– logic: ideal method in thought; esthetics: ideal form; ethics: ideal conduct; Politics: ideal organization; and Metaphysics: ultimate reality, “ it becomes dismembered, loses its beauty and joy. That is found by studying philosophers. We have had the same experiences they had but we did not suck those experiences dry of their secret and subtle meanings. So let us listen, ready to forgive errors, and eager to learn.” So maybe this is a good time to hear the philosophers speak to us through a book that is clear, short, enjoyable, and perhaps can make us a bit more wise.

*The Story of Philosophy, 412 pp, focuses on the West, and excludes Asia. But the first volume of their 12 volume History of Civilization is devoted to Eastern Philosophy and History. Caution: 1150 pp. Both are free PDF on-line. But not without cost: that of mostly shutting down Critter, Glitter, Fritter, and to some extent, email, Siri and Browser. Enjoy!

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A History and Memoir of Salud

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This is a history and memoir about the Salud Concept of communty medical clinics, and its impact on the the Salud Clinic in Broderick California,  which opened on May 21, 1971, and still operates on its 46th anniversary in May 2017. Details and time line are taken from public documents, board minutes, and personal records. I dedicate this history to the Board of Directors; to the community that gave rise to the clinic; to the Broderick Christian Center which encouraged and nourished the seminal ideas of the Salud Model, and the building of the of the clinic itself; to the entire staff, but in particular to Salud Community Health Workers and Family Nurse Practioners.

In October 1968 Central Broderick was an older unincorporated town like West Sacramento, the adjacent relatively prosperous port and residential community of West Sacramento,  and Bryte, the smallest town, home to many East European immigrants, notably those from Russia and the Ukraine. Collectively the towns were known as West Sacramento or East Yolo. Older streets are still lined with one and three quarter story buildings, like those seen in central Sacramento; the lower level rises only seven feet above ground. They had been built that way in expectation of frequent flooding common many years before.  As flood control became more effective these low-ceiling spaces began to be used for living or storage.1

With the completion of the cross country Lincoln Highway in 1916, travel boomed.  The auto court was the way people settled for the night. Many large tree shaded lots were later converted into trailer parks, and in Broderick, some were filled with clusters of ten by ten wooden shanties, without indoor plumbing,  rented to single men. Despite attempts to condemn them, these shanties, sometimes owned by politically powerful people,  survived until incorporation of the city in 1988 2.

East Yolo was a short distance in miles, but over  50 years distant in time, from Yolo County administrative centers in Woodland, where county services and low cost medical care were  available at the Yolo General Hospital. Across the Sacramento River were the State Capitol, and the the Sacramento County Hospital, but medical care was not readily available there to uninsured Yolo county residents. There were two  West Sacramento  pysicians in private practice. Many people survived in an economic and political backwater even though Yolo County maintained a Dept of  Public Health office and a sheriff’s substation in Broderick.  There seems to have been a self effacing humility; the I Street Bridge is still named  for a Sacramento alphabet street,   and the area of West Sacramento,  sounds like an appendige to a cross river county.

I arrived in 1959,  and was the only Spanish speaking physician in the county until  eight years later our office took on a bright new partner, Brooks Smith.   We become the first physicians for the Family Nurse Practitioner  ( FNP) program at U C Davis; we hope that FNPs will work in small clinics and towns under the supervision of a licensed physician who need not be physically always on site.  The Salud Model concept develops after Herbert Bauer, former Yolo County Director of Public Health gives me a long list of places where migrant workers live seasonally.3  That leads to a series of small free night clinics for migrant workers in rural Yolo County. The first is at Madison; it’s still there on highway 16 just before getting to Esparto, hardly noticeable to people en route to Casche Creek Casino.

A pre-medical student Paul Hom, will would later become the Director of Public Health for Sacramento County, is also a lawyer. He creates  a non profit corporation, The Salud Health Foundation, in order to help build and operate the several migrant farm worker clinics. These have the support of many  local volunteer physicians. That name, Salud,  is  familiar to Spanish speakers because it means ‘health’ as well as ‘Drink up!” Some non Spanish speakers in Broderick, later rhyme it with ‘mud’, which rather nicely describes the drinking water in Broderick at that time… so bracksh that some people bring their own when working to build the clinic  there. 4

The Foundation first helps the ” U C Davis Amigos”, a group of students, to build a clinic building at the Madison camp. Later, people from Chico, Woodland, and small rural Yolo County towns, like Yolo and Esparto, request assistance to develop clinics. I  am able to explain the Salud Concept of community clinics, and the process; but projects require more than ideas. or words. They require commitment, and action; I can advise, but not commit or act on them all.

In a short time there are two  more bare bulb Migrant Health Worker weekly evening clinics; my favorite is at a large operation on the El Macero Ranch, south  of El Macero. A two story building holds a large bunk house for up to 100 men upstairs; below is a big dining room and kitchen. There are family units adjacent.  Meals are delicious, ample,  and authentic. After clinics I always chow down and schmooze with the cook.

Men who immigrate for farm work one way or another, are gererally economic  pioneers, admirable adventurers, like those of the Gold Rush… at least as I see them.  They are generally healthy enough to invade illegally, work, live on  very little, and send money home. When I was young I interpreted for them during the WWII Bracero program;  much later, often live with them during  my own summertime migration from Minnesota to work in the N Calif almond industry.  In time that  pays for my college. We are thereore generically, and animically, brothers,  even though I work for myself,  while they do mostly for relatives. Many stay on indefintely, some spending a lifetime alone and estranged from the family they support.

A friend in Woodland was an elderly peg  legged cook at a small restaurant where I often ate lunch. He had lost a leg in a  Texas farm accident at age 18. One day he told me his daughter, a judge in Leon, Mexico,   was flying in to the local airport; could I take him to meet her? Of course; we picked her up from her private plane and went to lunch.  But the enconter was quite ugly, confronttional and difficult. She made clear he was an uneducated old man; and worse,  a victim of the abusive capitalist Yanquis who stole half of Mexico, and abused and oppressed Mexicans.  He made clear that whatever she had achieved resulted from his work here, which he was grateful, for and proud of. He loved the this ncountry and the people.  End of visit. I took her back to her plane, and him to his work. Such personal stories  are not rare.

Of course there were also women and children in migrant worker camps,  in  families who move with the crops, mainly people who live in other  parts of  the US. The children in particular often had health problems: anemia; parasitosis; malnutrition related to diet where the hallmark is a mouthful of stubby decayed yellow teeth; silent tuberculosis; inadequate immunization for childhood diseases; chronic otitis. The beauty of those conditions is that all are easily diagnosed and treated. The Yolo County Health Department and the County Hospital were very helpful. 5

In a few years the UC Davis School of Medicine appears on the Davis campus. The migrant clinics are interesting and appealing, with superb medical and community support; they address the needs of farm workers, an important ethnic community. Very alertly, the school of medicine asks for help to  submit a several million dollar  Federal Grant application and it is  approved, with UCD administrative  responsibility for the project. Unfortunately two complications quickly impact the project:

First, by the time the University obtains control,   technology has already changed Yolo County agriculture amazingly rapidly and radically. Seasonal migrant workers have  been replaced by chemicals and machines; they are no longer needed, at least not here. Second, the medical school mismanages the program, perhaps because their main challenge, and burden, is to build a new school from scratch, rather than provide migrant care. They lose the grant.

However the project is large, and significant from a human and political standpoint. There is a need for  basic rural health care in small towns, the  same situation that Salud  conceptt addresses; and there is a desire to support Spanish speakers in education and in health. So the migrant project is salvaged, becoming Regional Rural Health, RRH,  generally along the lines of the Salud Model with the addition of  bilingual education, a popular idea of the time.  RRH, managed by a Spanish speaking Board of Directors,  would establish bilingual rural primary schools and offer health care to local people of all sorts.  Salud Clinic, meanwhile, proceeded at Broderick with the strong support of the Christian Center and the Broderick-Bryte Neighborhood Council.

Paul Gutierrez and John Siden introduce me to Broderick. Paul was disillusioned with the politics of the Economic Opportunity Council; although he told me nothing of the details, apparently the feeling was mutual. He wanted to open a food service for the poorer residents in the area and call it Paul’s Kitchen, and to organize the community to develop a health care facility. He and Jess Perez had gathered some 4000 signatures in support of a clinic. John was director of the Broderick Christian Center, and expressed similar hopes regarding health care. The Center hosted a series of meetings where  the focus was a health facility. It remained the planning, meeting, and eating place while the clinic was built. Without that support the clinic would not have been built. I was invited to discuss the Salud concept with emphasis on local control, and  ownership, by a Board of Directors. The council decided to adopt a comprehensive plan for the Salud East Yolo Medical Facility.

October 6, 1970 Council Meeting: The Salud East Yolo Board forms, and draws up  organizational papers. East Yolo lawyer William Dedman acts as consultant to the board.  They continue to meet regularly at the Christian Center. Emilio Lopez,  (Human Rights Commission) is elected president of the Board of Directors. Pete Villarreal takes the job of fund raising. Carlos Salinas ( Washington Unified School District) chairs the Building Committee;  John Pagett is  sub chair for Carpentry, with French Francis.  Ray Gutierrez, (Bryte Council) electrical, and grounds.  Lillian Newton PHN, Publicity Chair; Janette Vaughn, East Yolo Youth Council; and Carlene Sharples, Welfare Worker, Legal Chair. For many years Lillian has been tireless in promoting dental health for E Yolo children.

November 22, 1970 Escrow closes on  the building in Broderick. It is condemned and the lower floor reeks  of rat offal, but it has some unique assets besides rats: 1)  it comes with a second lot to the East that could be a community garden. 2)   the main structure is solid; 3) there is a wedge of vacant land in front of the building that could be used for off street  parking, and might be acquired from the State, as it has no other useful purpose. 3) a complete  second floor apartment is in good condition.

The condemned house is brazenly named the Salud East Yolo Medical Facility, with plans to open in 1971. Mike Kolar, UCD student who had been a driving force in the building of the Madison Migrant Camp addtion, had graduated and is hired part time as part of his conscientious objector deferral from the military draft. The Salud Health Foundation assists in raising funds, with much community support. They have many pages of donors mainly in amounts less than $20.00.

November 28, 1970  There is a sudden flurry of interest from  Yolo County. Captaine Thompson [County Director of Mental Health Services, whose spouse becames a County Supervisor] organizes  a meeting of dignitaries with the Salud Board. It does not go well; I note some quotes from my personal  record:

Dan Kelly, Administrator, Woodland Memorial Hospital (read Woodland Clinic)

“You are naïve.”

Glenn Snodgrass: UCD Medical School:

” UCD Med School is fully committed and unable to help.”

Emilio Lopez: Board President Salud E Yolo Medical Clinic

“The trouble with outsiders is you go home to your cushy life and remain ignorant of our local reality.”

French Francis: Salud Board Member and favorite professional curmudgeon:

“We don’t need any help. Or want it.”

January 4, 1971 Every weekend volunteers work at the building. We have lunch at the Broderick Christian Center. Adolph (Tiny) DiGiulio is a 300 lb genius who organizes the meals. Rumor has it that he solicits food like day old bread and slightly outdated vegetables and meat from known but safe sources. Whatever the truth, the three course meals with beverage are simple, tasty and ample; they usually cost Salud about $20 for 20 people, including but not limited to:

Alex Creighton,

Lloyd Newhall,

Emilio Lopez

Felix Mejia

Jessie and Alberto Rodriguez

Fred, and Robert Loofbourow

Carlos Salinas

French Francis

John Pina, and

Chuck OHara and others from Johnny’s Time Out Bar

Members of the Jay Cees

It is awkward for me to list these names, because I’m certain there are many missing. For example, I recall Steve, a UCD student, but can’t remember his last name. I apologize to those volunteers, with only the excuse it’s more than 45 years since I saw you last. Mike Kolar, worked with many local people during the week to meet the complicated code requirements of a commercial building including lab, and lead shielded X-ray.  The Second floor is used  for meetings and training of clinic staff.

We always are short of funds of course. Arguably,  that shortage is a cost of freedom or independence. There are many inventive activities that we, and I, are involved in over the next two years; some are contracts for services, others things that the board accomplishes; anything that allows us to complete the building, and later  will support operations. These include:

A contract with Yolo County Compensatory Education to do 200 child exams.

Auctions conducted by the Board

Consultation with EOC to organize, train and supervise staff for Senior Citizen Screening Clinics, coordinated by EOC director David Pollard in Auburn, Forest Hill, and environs.

Contract with the Sacramento Concilio New Careers Project providing Health Workers with the option to go to Sacramento Community College with half time support.

Consultation and testimony regarding pesticide legislation ( Petris SB432)

Family Planning clinics in Yolo county and at Salud.

On the recommendation of Dr. Helen Kleviscus, a volunteer in the Yolo County Migrant Clinics, we apply for, and the Board of Directors agrees to participate in, a drug trial for Abbot Labs. This would  now be called a phase III investigation, and while it is not so well compensated as similar trials today it is very helpful, providing volunteer subjects with a physical and lab workup. Many have never had that experience before.

Broderick was ground zero for the diabetogenic and atherogenic diet, the alcohol stricken family and individual, the tobacco toxic lung, kidney, and heart. The environment was often dismal, or harmful; like the water previously noted; I felt that the soul, the ethic, and the driving force of a community clinic lives only within the community itself. The physical manifestation of that soul can be reflected in a  Board of Directors, and  by their operation of the clinic, involving people in the community. 

Therefore I write a grant proposal   for A Community Health Worker ( CHW) Training Program for submission to the Yolo County American Cancer Society, where I had previously served on the board. The grant application is predicated on the idea that the development of cancer is generally a many year  process– like many other chronic health problems– greatly affected by life style and environmental conditions.

There is a time-honored principle of  Public health: No law, or fine, or regulation is very effective in changing harmful personal behavior; what is effective is when people  conclude themselves  that a  beneficial behavior is in their interest. The corollary is that nothing can be so effective to improve health  as involving people who are a part of the community itself.  Emilio Lopez and I present  the proposal to train CHWs, and it is approved. We are forever admiring and  thankful for the Cancer Society sprit, and intelligent foresight;   oterwise I don’t think the CHW project would ever have been completed.

We would train local people to  both work in the clinic  and learn about the main factors affecting health in the community.7 Community Health Workers,  and later, FNPs become the most effective and unique  feature of the Clinic.

May 21, 1971 Opening of Salud Clinc with participation in the ‘Rub out Rubella Campaign.

Herbert Sabin, volunteers as clinic nurse. He is a dedicated worker, always There, decisive, authoritative, dressed in his white uniform. He is capable and experienced in Xrays.  On the other hand he is a take charge guy,  often dramatic, who likes to Intervene in a way  that makes me uncomfortable. I am a more conservative minimalist who likes to keep in mind how our citizens suck up pills as if there were never any side effects; and feels that Beg Pharma and Big Tech seed  TV and the ‘news’ with misleading true lies.  Observe that today’s  medical consensus is all to often tormorrow’s medical sin. As it turns out the board later has to negotiate about a child with a temporary patch of subcutaneous fat loss after Herbert gives a steroid injection without consultation. It was a minor self limiting complication, but at the time, looked ugly.

September 1971: Interview and selection of CHW trainees.

Victoria Odem

Ray Rubio

Carmen Shelley

Geraldine Hernandez

Raquel Carmona  left for nursing school was replaced by Anna Sankey

Mary Romo

A felon, who violated parole was replaced by Joan Schauberger

March 1, 1972 Dick Noble, MD, is hired as part time physician, but leaves abruptly in September without giving notice other than writing Pig on his desk.  He had never objected and never said why he was so intemperate or outraged. Maybe we couldn’t pay him enough;  or What? It was not as if he worked for free! Ouch.

July 1972 Data on 600 Senior Citizen Screenings8: ( % approximate)

50%  abnormalities of vision, Blood pressure*, hearing.

10% fasting blood sugar diagnostic of Diabetes*

5% anemia

3% abnormal intraocular pressure.

* These abnormalities are based on old criteria. Today some % would be much higher because criteria have tightened.

September 25 1972 A proposal to the California Community College system to develop a career ladder for CHW training and progression, beginning with a program to train and certify CHWs is rejected

January 6, 1973 . The Salud CHW Training Manual, in which the beautiful artwork is done by Sandra Tiller, is adapted for use by George Kent for the Chico State Satellite Closed TV training projects. 9

February, 1973 The clinic continues to be busy, seeing nearly 50 patients daily. Yet Salud has not become self sustaining. We all realize that the ambitious and arguably arrogant attempt to provide medical services without accepting government funds will not succeed unless I continue to subsidize the operation at about $2000 monthly  or become the government myself. That makes me slightly sympathize with Congress; but only for an instant can I sympathize with people who  live high,  and exempt themselves from laws and regs they lay on the rest of us.  But my physical, emotional, and personal resources are drained. I am divorced, and my contribution to that personl loss is having pretty much abandonded my wife and children in favor of Farm Workers, Broderick and even, I suppose, to my own fading idealism, which might be viewed as ambition.

‘Revenue Sharing’ has been started by the Regan government, and I reluctantly apply for funds. I know, as does the board, it is a pact with the devil. But.. Who Else?

May 1973 Two years after the opening of Salud our  Federal Revenue Sharing Grant receives preliminary approval. Yet the devil is here: the Yolo County Board of Supervisors must agree. They reason that it is wrong to add a third ( and relatively independent)  entity  in the county to provide care for indigent  East Yolo people. Their approval requires that 1) the entire operation be turned over to the Yolo General Hospital or to the Yolo County Public Health Department; our choice! 10 2) that the Board remain only as an advisory body. 3) that the County acquire the clinic for what I originally paid for the building, without consideration for what the community or anyone else invested. We smell brimstone and sulfur, but agree, providing:

1) We are assured the CHWs individually and as a role model be kept as employees with full benefits. 2) The advisory status of the board be documented.  After discussion the Salud Board elects to go with the Health Department, under the direction of Otis Cobb. If I or the Board had more determined, if we knew our true strength, one of us might have refused; in view of the nature of politics, the County very likely would  have back tracked.  But I ,for one, was whipped, not sure whether I was Faust or Don Quijote.

After a brief time the original Salud clinic Street is abandoned by the Health Department and moved to a building nearby. Our cherished little medical office with lab and X-ray will be put to other uses; maybe.  The littered lot remains as it was, though perhaps the county improved the clinic building; they acquire the parking area in front, something we were not able to do. In the next few years I occasionally visit when Salud is in an old school near the I Street Bridge. It operates reasonably well, and health workers are included.  Yet there is a sense the sprit is dead despite  devoted and inspired efforts of the physicians, nurses, FNPs, and CHWs who seem unable to move the Public Health behemoth into the arena of Primary care. Maybe that is inevitable, because it  that kind of service never has been the Health Department’s primary job.

To quote John Siden:

” Although Salud was subsumed under the health dept in the early 1970’s, soon thereafter all the county’s health functions were administratively reorganized and the clinic became a branch of Yolo General Hospital’s outpatient clinic…  It acquired a little more of a look of a traditional clinic, but in fact it was always the ugly step sister as far as the hospital was concerned.  But it had a dedicated and devoted staff, from the health workers through the MDs.

“The (original) organizing effort was so powerful that to this day the rather meek and mild Salud Advisory Board that lives on in county ordinance is listened to by local politicians far in excess of its present strength. …The forces (of) … the early 70s were still at work when the county set out to replace its facilities in WS in the early 90s… ( including) a new ( and far more luxurious ) Salud … (W)hen the hospital was closed in 1991 the clinic operations were taken over by Davis Community Clinic (now Communicare).”

Salud has come full circle, arriving at its beginning as a community clinic. Nonetheless, the new owners are absentees, and distant; they are not familiar with the local reality; they have far larger and more significant concerns, even though Salud remains the most active, profitable, and productive of their several clinics, like an ugly stepsister who is otherwise admired by the polyglot and multicultural  community for her CHWs and FNPs, and the constant, consistent, and  persistent devotion of David Katz, the chief Salud physician, who has a long history and awareness of the Salud Model and concept.

After Salud is suibsumed into the county government,  the RRH, stepchild of the Migrant Health project survives, but barely. I still have a soft spot in the brain for them, and agree to become medical director. They build a Dixon clinic and rent space in Esparto, and Courtland.  For a couple of years I try to breathe life into those operations, but fail miserably.   The millions of Federal dollars fade away. I leave but am still unwilling to let go of my own illusions, and  then agree to become medical director for a Federal project attempting to create an HMO for  Sacramento, where CHWs and FNPs are key providers. But again, the Federal DNA is fatal, and after a number of million dollars, the patient dies.  Yet,  I am  cured, at least superficially,  give up the private practice of Community Health. I devote my  next 25 years to Emergency Medicine,  to my family, and to traditional medicine

The most significant personal events of these past nearly fifty years have been:  First, 41 years with my fierce and stubborn  but tolerant wife and children; Second,  25 years in Emergency Medicine, the last 20 at Kaiser PMG. I think  often of Salud, vaguely aware of the changes over the years.

For a while after retirement I volunteered at Salud; it was rewarding to care fpr the same  patients we saw early on. Salud,  nominally,  has come full circle, arriving at its beginning as a community clinic. Nonetheless, the new owners are absentees; they are not familiar with the local reality,  the people, the history of Salud, or the concept. It seems they have far larger and more significant concerns to attend to, though Salud remains the most active, profitable, and productive of their several clinics–  a weird stepsister who survives and is adored by locals for polyglot and multicultural CHWs,  for FNPs, and  for the persistent effort of David Katz, who has a long history, devotion, and awareness of the Salud Model and concept.

Recently I spoke with Katz, and found the clinic name on line is name is now Communicare Health Center. Yet there is much unchanged–The CHWs and FNPs remain the body and soul of the operation, providing interpretation not only of language and culture, but of spirit, and community,  through vital connections that would never otherwise exist.  The heart of Salud remains the Board of Directors; it beats only quietly in the background, but it is alive.

To my family,  my love, sincere admiration and gratitude for patiently or at least kindly tolerating my excesses; and to  you all at Salud , for preserving, and further developing that which we began to create so long ago.   Because of you May 21, 2017 was the 46th anniversary of the opening of the Salud Clinic.

Bravo; Brava!

 

1 See three articles in the March 2004 History issue of Sierra Sacramento Valley Medicine pp 5-20. Trappers came down from Oregon finding only the Sutter Buttes sticking up out of an inland fresh water sea; they brought malaria with them which decimated the native population. Cholera came up the river and decimated Sacramentans. In the 1850 flood of Sacramento, Dr Morse, whose office was on the second floor, floated dead bodies in the water below, until they could be moved. That was a very bad year!

2 One generations is often very different from the next, each unaware of the values and physical reality of the other. These buildings were structurally and hygienically marginal, but rents were $75, the equivalent of about $200 now. Yet they compared favorably to neglected motels, public housing, and rest homes, precisely because they offered a certain freedom, an independence, a dignity, in the way the people  interacted with one another and the surrounding community. The renters were from an age past, with their own set of truths and values. Single, usually older men, could be called bums. But they were a driving force in building Salud, and active on the Board.

3 I have a 1966 list of 117 migrant camps in Yolo County alone. Some 10,000 workers were required yearly from March to September. With the help of the Yolo County Health Dept, County Hospital, and Medical Society, we established four night clinics with follow-up at the Yolo General Hospital. Later the UC Davis School of Medicine opened and became involved. However within a very few years agricultural practices changed so radically that the camps are nearly all gone, and migrants generally seek work elsewhere. The migrant clinics became obsolete.

4 For a perceptive study on the East Yolo and the development of Salud, including the water problems, see Donna Fazackerley’s ‘The Politics of Health Care in East Yolo‘, which she submitted as a Senior Project for the UCDavis Department of Applied Behavioral Sciences in June 1973. Donna moved to Broderick and lived there for three months in preparing for her report. I also have somewhere a 4 page history of Salud, author unknown. It relates the development of the facility and includes a nine point exposition of the Salud concept for Community Clinics. It ends with the notation “Salud- Power to the People, 1972.”

5 We had to send stool samples to be examied for parasites, and of course the parents collected the samples, and took them to the hospital lab. I had once a wonderful letter from a lab technician where he colorfully described how he would arrive at work to face a clutter of bottles and cans, filled to the brim with stools. He hoped we would teach migrants how better to collect save the specimens.

6 There were many more. Among them Alfred Biles, Chuck Snodgrass, Ray Pines, Paul Gutierrez, David Ingberg, Alex Creighton, Gary Oschner, Tiny Di Julio, and Fran Molina were sub committee members, some on more than one committee. Fred Adams, Harold Hocker, Lloyd Newhall and Len Ortiz( plumbing), These were the people who sustained Salud in the difficult times ahead.

7 The training course held five afternoons weekly for 6 months, and was relatively intensive. Though the Salud CHW Training Manual was adapted by other programs, and went trough several revisions, I have only the templates for the first two sections and the Table of contents, for the original version. ( I am missing section 3.) Although local community colleges declined to offer a course or a career ladder for CHWs, it has been done elsewhere.

8 An El Dorado OEO project for Senior Citizens where CHWs performed most of the screening, and abnormalities were referred to local physicians.

9 I later was hired as physician and developer of a CHW training project for a federally funded HMO project in Sacramento. However it lacked community support and control, relying solely on very generous ( millionary) federal funding requiring a huge federal burden of oversight. It died almost as quickly as the money disappeared.

10 See: The Politics of Health Care in East Yolo. The problems and deliberations of the Board are presented with sympathy and accuracy by the author.

Letter 10: American Syncretism

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Feb 6 – Mar 25 2015 Brazil and Chile

In the USA we are familiar with syncretism of the Northern Hemisphere, especially in what we call The West, meaning Greece, Rome, and Europe. We speak of the Melting Pot especially in that regard. Yet The Americas, meaning the continents of our hemisphere, also share the unique mestizo heritage of our indigenous and European past.   Syncretism often reflects change, hopefully progress. But it can send a message; in several American countries,  Mexico, for example, El Día de la Raza  – or racial day- is celebrated on October 12,  which is Columbus day in North America. But there it is devoted to the mestizo or mixed race.  Syncretism can be seen everywhere.  In the Americas, especially in North and South America there are some curious inversions, geographical, linguistic, and cultural:

In the South, Daylight savings is ‘Spring back, Fall forward’; and Winter lives in the Deep South not the Far North. Santa spends Christmas in South America though he and his reindeer sweat in Summer heat. The global map below is a way of looking at the same world from another viewpoint.

In the Americas we share some holidays that sometimes seem out of place; the indigenous altiplano peoples love dance, song, and colorful costumes and in Puno, on the shores of Lake Titicaca, Halloween is celebrated with wild abandon: jack o’lanterns, witches, trick or treats; the next day is a traditional  Día De Los Muertos, or day of the dead, with feasting and ceremony held at a local cemetery, more strictly a Spanish American religious  holiday.

In Cuzco Cathedral there is a beautiful painting of the Last Supper by an Inca artist – of the  people who actually built the cathedral with stones originally carved by their ancestors, from structures torn down by the hands of the conquered at the command of the conquerors. The Cuzco painting features not wine, but chicha, a purple fermented corn drink. The meal is cui– roast guinea pig. There are corn based dishes the table. Judas clutches his gold in the lower right hand corner wearing the curiously browned face of Pizarro who looks directly out at the viewer, as does Christ. It is a syncretic symphony.

Where the Valley of the Inca meets Lake Titicaca, small groups of Uros live on their floating reed islands; I first was there 40 years ago, when they were isolated, impoverished, fearful, sickly and short lived. The children attend a floating totora reed island public school. They have solar electric panels,  with connections to the world, and have become quite worldly, taking visitors on guided tours in 30 foot long reed boats, welcoming them onto their islands, greeting them with multilingual songs, and coaxing visitors into conversations, story telling and singing. They invite visitors into their reed homes, explain the raising of guinea pigs and birds for meat, speak about potable water and waste disposal, and recycling systems. They welcome overnight visitors. The change from 1975  is almost inconceivable, until one takes into account syncretic development.

The oldest painting in a Sao Paulo museum, was done by a French artist who had never been there; all his native subjects wear white skin and French faces, a curious syncretic error. In North America Spanish and native place names are everywhere, among those of classical Greece, Rome, and Europe. Yet while we myopically worry, pander, and focus on the forever fratricidal Mideast and Europe, we become ever more American—North and South. Ordinary Americans are by most measures relatively apolitical, hardworking, and productive. That is a priceless advantage in a chaotic world; we try to preserve American syncretism, and reject Mideast bad tempered tribal misogynist and vindictive jealous gods who urge us to destroy one another in- of course- His name.

I am writing this at the home of a rancher in the Lake District of Chile. Even in this, the 4th year of drought, his farm is green because of the unique climactic conditions where mountain and sea air clash. He has set up a small hydro-power plant purchased in– of all places–Redding, CA. His home is modern, with automated radiant heating, showers– no tubs, no bidets. It is electronically world connected, but preserves a fancy old wood-burning kitchen stove that conveys a feeling of simpler times past. Even in summer, the old stove is lighted and used for cooking; it is ecologically sound for this region, operating on modest amounts of renewable fuel. It is a perfect syncretism of North, South, old and new.

Language itself a verbal and cultural living recording of syncretism;  indo-european group winds its way across the globe- from Sanskrit to English. Spanish and English in particular are melting pots of Indo-European languages,  rich with related words, ideas, literature.  In the Americas there is constant ebb and flow of language fostered by our proximity and shared past and present. 

While everything in our Americas North, South, or Central, is not ideal, or without troubles and unsolved problems, by comparison we are far more civil than much of the world, avoiding America wars. To young Americans everywhere I suggest this: Don’t just look East or West: Look North and South. The Americas are your home, our home; savor them, save them, cherish them, share them. As the saying goes, if everywhere is your home, Where is your home. While you should not reject the East and the West but your true syncretic  home and your wider American family is here, and now.

Pixelated People

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Images appear

every day and night;

I look but do not see

the pixelated sight

 

of flesh that vegetates

in bombed out homes,

and the calcined white

of a million femur bones,

 

Smoke choked yellow skies,

 sunlight without shade,

moonlight without solace,

and gods that are manmade.

 

Silent pixel children

whose huge sad eyes

and thin husk of skin

never  feel the feet of flies;

 

Resigned young women

waiting to be resold

shriveled brittle elders

 empty, silent, cold;

 

Pixel justice  is revealed

to every sex and age

according to the canons

of fear and hate and rage

 

By talking pixel heads

selling stale ‘Breaking News’,

beer, and sex and drugs,

and biased, specious views.

 

And yet — despite true lies

or images that decieve,

I  listen, look,and hope;

but rarely can believe.

Book Review: The Log from the Sea of Cortez

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With the Dec 7 1941 attack of Pearl Harbor, my father immediately volunteered with the Naval Sea Bees hoping to build airfields, and bases. Yet he was a geologist and mining engineer at a large remote Cascade range copper mine in Holden Washington.  Since copper was essential to the war effort he was rejected by the Navy, and quickly transferred to the Santo Domingo copper mine in the Municipality of Aquiles Serdán, Chihuahua, Mexico, to help develop it and other nearby copper mines. He was 33 and I was 9. We lived in those particular parallel worlds of father and son. I understood nothing of the Great War or mining, but everything a boy can know about the demanding and transient childhood culture of boys in remote little mining towns. He understood blasting hard rock a mile or more underground, and analyzing diamond drill cores to make 3D maps of mineral deposits. I understood  one had to carry a stick to make it to school unscathed until he could transform himself into a local peer.

In that March and April of 1942 of the log, we lived about three hundred miles to the West, of where John Steinbeck and Ed Ricketts, were in their own parallel world with a crew of three, aboard a boat on the Sea of Cortez. They were collecting littoral sea shore specimens at each low tide,  and afterward sorting and preserving the specimens, and collaborating on a journal while joyfully consuming 2500 bottles of Corona beer. They knew not of the crush of  day to day events of WWII, nor did their close Monterrey friends know of  their days and nights on The Sea of Cortez… sea cucumbers, limpets, rays, swordfish, Gulf of California life forms including the local human  inhabitants.

While my former Holden childhood friends shot down  imagined Zeros, my new friends and I shot down Gringo warplanes. In the Cascades of Washington, WWII raged. In Chihuahua wounds from loss of the northern 1/3 of Mexico’s territory still wept. Each world was unaware of the other. That has generally been the way of humanity, at least until recent decades when people are progressively more heavily bombarded with the sounds and sights of suffering people in other contemporaneous worlds, thanks to technology. It remains to be seen if that assault of ugly information will lead to more  mutual understanding, or will dull our sense of common humanity. So far the outcome is in great doubt, as if we are the generations of chaos suggested by Moisés Naím in The End of Power,   another book review on this blog. 

But The Log from the Sea of Cortez. ISBN978-0-14-019744-1 is the subject of this review. The cover names only John Steinbeck, and yet the content, and interplay of writing styles, clearly supports the two old friends claim that they both wrote it. They make that claim in a brief introduction as well as in the text; there is a rough map of the route; there is a Glossary of Terms- mostly devoted to taxonomy and ecology. But on first opening the book The Appendix drew my attention. It is a long eulogy to Ricketts written in Steinbeck’s, sharp, often moving and often humorous, unhurried rich prose on the life and death of his friend and co-author.

That long eulogy is in contrast to the many sections of the log with taxonomic names and descriptions, and pithy commentary about ecology, the nature of collecting specimens, the importance of life’s diverse forms; and life’s natural purpose – or better said- non purposeful, non teleological nature. There are many dense little essays on the ecology, the one-ness, of living and non living matter, and the interrelation of individual animals to the collection of all those individuals that make up and entirely different animal; there are crisp philosophical discussions on the nature and fate of life. The log is clearly a joint effort by two great writers who became one, in separate but contemporaneous world of the 1941 Sea of Cortez.

A brief introduction sets forth the authors’ vision: “We take a tiny colony of soft corals from a rock in a little water world… Fifty miles away the Japanese shrimp boats are dredging with overlapping scoops …destroying the ecological balance of the whole region. … Thousands of miles away the great bombs are falling and the stars are not moved thereby. None of it is important or all of it is.” But the following 221 pages of log entries make clear the authors believe that both are true: none and all.

The pages are encrusted with zoological terms, sticking like limpets to the pages. There is a glossary of terms —from Aboral ( upper surface of a starfish brittle star, sea urchin.), Amphipod, (paired legs of beach hoppers, sand fleas, shrimp-like crustaceans..), Atokous ( sexually immature forms of certain polychaet worms) … to zooid (individual members of a colony or compound organism having a more or less independent life of its own.

The Log is chronological. It begins by detailing the process of finding a suitable boat, The Western Flyer–a 70-some foot long well maintained and well built trawler; finding and getting aboard scientific equipment and supplies, six weeks food stores, and introducing the reader to the characters crew, including an outboard engine that has its own troublesome personality. It becomes immediately evident these writer/explorers are not simply adventurers, but a team of zoologist ecologist and gifted writer.

By March 11, at page 25, after a days-long raucous celebration and farewell, they cast off. The log speaks of writers classically educated in history and literature and science, in the mold of lovers of knowledge: Philosophers. The Captain, Tony, is a solid sailor, a careful hard bitten technician. Tex is the engine man whose very bones are parts of a diesel engine; Tiny and Sparky are old friends, ‘bad boys’ become bad men, rough sailors, whose perceptions and salacious comments are–to everyone’s delight– in sharp contrast with those of the toney writers. Page 18 begins a seven point/paragraph introduction to the remaining crew member, an outboard engine called The Sea Cow, who always promises to propel their skiff, but always refuses, or quits when it causes the greatest problem. They row. Except for the captain and Sea Cow they all share a great affiliation with 2500 bottles of Corona beer.

This log is informative, entertaining, and thought provoking. The fame of the authors makes it especially notable and relevant to those familiar with the Monterrey area and history. It is doubly enjoyable to me because in the same days and nights described in the log, I lived nearby in my own very different parallel world, one that is in another sense the same world. Goodreads offers many quotes and have note-booked many of Steinbeck’s beautiful portraits of people, seascapes, places, children, towns, officials, and natives; and many pithy Ricketts short essays on the nature of nature, of ecology, of relationships among living beings. But if one doesn’t read both Steinbeck and Ricketts in their log habitat, they seem to me lifeless as a diaphanous pellucid sea creature in a specimen jar, where color and motion and even structure are lost. To enjoy that one must simply… Jump into the Log!

The End of Power, Book Review

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The End of Power

By Moisés Naím 

From Boardrooms to Battlefields and Churches to States, Why Being In Charge Isn’t What It Used to be..

By Moisés Naím 

ISBM 978-0-465-06568-4

Perseus Books, 2013

Hardback $35, kindle $9, audio $ 35 ( + tax, & shipping)

Amazon 2015 Editors Pick

This is a book for millennials. It is an extensive and possibly seminal work, not a quick or easy read. There are eleven chapters, each consisting of about ten sections. I found it almost  impossible to summarize, so will start with some observations that may put it in context:

We live in a time of world wide societal upheaval, arguably brought about by critical developments in technology. Similar radical change has occurred in the past, as when:

  1. mobile hunter-gathering was replaced by place-bound agriculture, leading ultimately to cities, tribal warring religions, art, architecture, scientific discovery, and monarchic faith backed nation-states;
  2. The printing  press made information or knowledge,  formerly tediously recorded in  manuscripts and available only to the monastic and wealthy few, available to the many; this lead to many decades of bloody revolution- the Thirty Year War-  culminating in the overthrow of monarchic religious states, and the birth of political and individual religious freedom.
  3. A perfect storm of scientific developments like the chronograph, compass, telescope, and gunpowder, led to the ‘age of discovery’, brutal conquest, and colonial domination.
  4. A philosophic and political Enlightenment  led to the overthrow of colonial power, continuing until after WWII, and including that imposed on the British Colonies in North America. 

Today, here we go again. The limitless internet and its consequences  make accepted barriers obsolete; old lines are breached: national borders, commercial, religious and political fiefdoms  are violated.  The powerful -nations, presidents, governments, CEOs, large multinationals,  all seem weak and ineffective, causing public disillusionment, and anger. Nowhere is the old order respected, or trusted.

What are we,  Millennials who live at the beginning of this century, to do? It appears the most interesting reaction of millennial young people is to try to adapt continuously, like children of miners, diplomats, or warriors who live in alternating realities, and move over and over to into a new town, country, language, and culture.

They learn:

to adapt to new people, groups, languages, cultures,

to be astute and adept at knowing and learning about the Other,

to embrace, value, and respect one another above Self

to consider the earth, and even the universe, as home

to be family to every age, race sex or condition.

They find that:

personal liberty requires constant shedding the old and taking on the new;

nations and peoples have their own beauty, and truth, but all are transient;

each person has the right to accept, or to ignore, any religious belief or unbelief

that ‘scientific certainty’  can be useful, but is as always, suspect and transient

that doubt is the primal force of both science and religion

every age, race, sex, or condition can be both confining and liberating

Author Moisés Naím finds that those who hold power try to retain it by erecting barriers to keep challengers at bay; but now multiform insurgent forces from every remote area of the earth dismantle those barriers quickly. He calls dispersed collective power micropower. Example: personal diverse acts of both terror and commercial or scientific innovation collectively challenge civilizations.

Micropower defeats megapower in warfare because of plentiful and diverse microweapons, and the rejection of more chivalrous “rules of war” (Isis, Jihad). Yet power, once grasped, fades fast; the new power quickly becomes vulnerable and loses that edge. Maybe the process could be thought of as constructive or creative destruction.

Naím catalogs the general changes as three revolutions:

1) More: people have more and more means to overwhelm or evade control.

2) Mobility: people are not controlled by governments, borders, distance.

3) Mentality: even the most remote people are now aware of possibilities, options, needs, desires, rights.

He notes that in chaos we tend to listen to “Terrible Simplifiers”: people who offer vague, bombastic simple solutions to complex problems. He summarizes the decay of national politics (parentheses mine):

Empires to States.

Despots to Democrats.

Majorities to minorities (as the U.S.)

Parties to factions.

Capitals to regions (Pinks, Blues, rural, ranch, city )

Governments to lawyers (unjust courts, straitjacket laws/regs) Leaders to laymen (NGOs, Buffet-Slim- Gates-Bono).

Hedge funds to “hactivists” (Assange, Snowden, etc).

 

Chaos results; maybe the process could be thought of as constructive destruction.

Naím ends with suggestions to reorder the national chaos. This is the most disappointing part of the book for me, because I’d prefer a quick fix; of course. Yet that is, de facto, unlikely. The author’s suggestions are rational, but require great and gradual, likely painful, public re-orientation, and a conscious and conscientious media: No quick fix there either. He suggests:

  1. Forget about who is first or what country is up or down, who we like or fear.
  2. Reject the Terrible Simplifiers. (You know them!)
  3. Restore the power of our institutions (Well,Yeah but…)
  4. Bring back Trust ( Ditto)
  5. Strengthen political parties (?!)
  6. Increase political participation ( but maybe non voters are careless quiet patriots!)

Wow! This book is well worth some time, for at least one rational evaluation of what the next few decades could be about.*

 

In 1952 Sci Fi writer Robert Heinlein wrote a postscript to his series voluminous writing titled Stories Never Written; they were too dark. Reading those comments 62 years later  is sobering considering our in world chaos today.

Letter One Feb 6- Mar 25 Brazil and Chile

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 To Brazil

Note: These letters are Creative Nonfiction, but they accurately coincide with real events. Personal names are fictional. 

 

The first two of these letters are about a  Methodist  VIM project– Volunteers In Mission.  I  am a Methodist by virtue of family, and inclination,  who has  participated in several  VIM Missions; I find the people who do this sort of thing are unusual and outstanding in the best sense of the words.  Our two designated drivers,  Frank and Ted, two senior citizens,  can serve as examples. They neither speak Brazilian nor have ever been in the country before. Frank is  from Oregon, has never been out of the USA. He has spent his life in electronics, and is retired, now trying to develop a practical small hydrogen generator.  He has been breaking down water into  its gasses, Hydrogen and Oxygen, trying to  use only a small amount of energy to do that; and then generating power through the chemical re-fusion of the gasses, recycling recreated  water in an endless cycle. To me that  seems an impossible  perpetual energy machine, but… what do I know? Nada.  He has blown up his work-space a couple of times.The other driver- call him Ted- is an executive who made his fortune late in life at a silicon valley start-up. He’s hard working and focused. And, most importantly from my perspective, an alert and oriented, even in this place where he had never been before.  He has led several VIM projects; this is one more.

It’s  cool now, but the day promises heat and humidity. This is the second big night of Carnaval here in this small Minas Gerais town at about 3000 ft ASL. My companions went last night but I begged off, too much noise and too many people… tonight will be enough for me. I’m writing this in the still of the morning at a friend’s home, a friend, Nana, who has a fast internet connection.  She is, I’d say, a self-made woman who began to make and sell clothes, married well,  expanded to a store, and gradually accumulated a number of  pieces of  rental property. At age 90, the madrefamilias of her clan  she still is constantly thinking and planning new enterprises, alert but weak; she just had a bypass, diagnosed  as diabetic only a few months ago, is on metformin, apparently controls her blood sugar well.  To use Nana’s internet today is a great advantage for me because I work on the asilo –– a home for the elderly and handicapped–during most days, and in the evening transportation is a problem.

My flights to Sao Paulo, Brazil–  SMF HOU GRU– were uneventful. Houston was under a thick blanket of sea fog, but arrival and departure were on time. Leaving HOU I was in the janela seat- window- so only uprooted the two sleeping Brazileiros twice to walk about.  There were only a few people in the’ foreigner’ line at immigration, in the main Sao Paulo airport. My well-traveled  checked bag, hadn’t gone to  Heathrow like it did  in the past; I suppose it was disappointed.

Three people of our group should have  already arrived from Chicago. I checked for their flight;  it had landed on time. Yet they were not  at the place we were to meet, a certain  a restaurant. The only other  likely nearby place was a Pizza Hut.  ‘Informacao’ said there is NO way to page, ‘ nao ha parlantes’ –no speakers? Really? Police don’t have them?Nao. …I looked around for a prepay phone to buy, but found they could only be sold to Brazileiros–9/11 effect? There are many. For example, foreigners wanting to visit the USA can find the experience not only difficult, but sometimes administered by those who are callow and demeaning. After 9/11 the experience became more troublesome, and Brazil responded in kind. Like Argentina they decided to require  a ‘reciprocity fee’ just as we do in the USA:—$160 at the time,  and an extensive application. Hassle for Hassle.  Mordida for Mordida—as well as a convenient way to collect another tax.

I needed to find a way to the town where we were to work– in case my colleagues had  failed to make their flight.  So I checked out the omnibuses and found they leave from terminal four.  Rather than go there immediately, I waited. The last two people  in our group were to arrive from LAX  at about 1330;  and indeed, right on time, our leader appeared, call him Ted. He went directly to a little clutch of chairs nearby and the first 3 were there. But he had news. The other leader, Neli, our native Brazilian organizer, who would guide us, had missed her flight in LA. American Airlines did not wait 10 minutes needed for her and 15 others to arrive. So she would arrive at midnight. We decided to stay the night in a nearby Marriott, a quite plush and comfortable nearby Marriott.

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The next morning, Ted immediately sets to work arranging for two vans  from Hertz; not a simple task as it turns out: the phone call required about 50 min and the car pick-up another 50 minutes.  So after two hours we load up two  minivans. My van has a sliding door that won’t open but Hertzians confidently say ‘neve- mind-no-problem’ and we take off planning to follow the lead  van onto the nearby freeway. Within a few minutes our  van’s door alarm began to sound unceasingly… so we turn to  go back to Hertz.

Not so fast. There is  the central São Paulo freeway ‘system’ to consider; it allegedly is a system, but  almost impossible for a stranger to decipher. One MUST use the freeways to get from one sector of downtown  to another. Further, one can never just drive round the block without heading one-way toward some distant unknown place or world. When our van begins its beeping-complaining we are in the midst of at least 15 freeway lanes; the actual count changes due to off and on ramps, merging and sets of parallel lanes separated by cement dividers, off and on ramps, with signs with names we find meaningless; it is a traffic limbo.

Worse, if you find yourself on the set of freeways going in the wrong direction, (as we did twice), to get from that wrong way series of lanes  to the right way you must invent your own clover leaf under and around all these lanes. We finally did so, and got back to HertzHell. They give us another van after another 30 minutes and we head out again. Frank is driving the lead car guided by Neli- the native Brazilian; but she  is almost  as confused about the freeways as any American;   she grew up in her  small town  and for many years has lived in California;  in our van no one excepting me speaks any Brazilian, and I speak poorly.

We are immediately separated  at the first on ramp. In one of those incredible episodes, after wandering around for half an hour we find  a gas station to ask directions: There they are, the lead car!   Relief and  joy, we’re on our way! But I had a nagging premonition, and ask Neli to write down the sequence of towns we are expecting  to drive through.The traffic is heavy and the lead car switches constantly from one side of the stream to the other as we follow. The signs are hard to detect or understand.  Guess what! We are once more instantly separated. Despite our in our vast collective ignorance, Ted  finds what we think is the ‘actual’ freeway, according to Neli’s ’s instructions. So  we simply start the drive North dripping  with doubt.

We travel  private toll roads; they are new, beautiful, with contractual requirements for maintenance:  at the end of a couple of decades they will revert to the State and begin the inevitable process of rising tolls inefficiency and decay.  Every half hour or so there is another toll booth, usually about US$ 5 or 6.  Every hour or so we pull off the toll road to a gas station to ask the way; happily, as time goes on we start to see the names of places we expect;  it becomes clear we were on the right route. At first the very attentive and friendly gas station attendants we ask don’t even recognize our destination, but in time they re the name, and we began to see highway signs that confirm it. Celebration time again. Right?

Wrong. At the next to the last toll Candy, wants to pay the toll and finds she has left her purse in the women’s banhiero, at the last gas-direction station. It contains ALL her documents, credit cards,  and money. She is frantic. We turn around, paying tolls again as we go back. Ted, our compulsive leader, goes directly to the right gas station. I explain our problem to the cashier , who says no one had been into the locked ladies room since we left; and he is right! Candy breaks down in tears.  We resume our northward way again paying a third toll twice. No credit for recent payment!

At last we  arrive, a town of about 14,000. I have been here before  on an earlier VIM trip and know generally where to meet our contact at a church on a central rise, that can be seen from afar.  That church is the very heart of the local Carnaval celebration. We immediately find our contact,  call him Dan,  an old-timer from earlier missions here.We are Home free, like in the old childhood game, Hide and Seek:  Alli Alli Oxen Free! Right?

Wrong. Dan has more news. The lead Hurts-van broke down at a divider strip in the middle of those parallel freeways. After a frantic 15 minutes with high-speed  death passing  on either side, Neli apparently decided she would rather die crossing to a nearby hotel than from starvation or humiliation or anger. She crossed 5 freeway lanes, a low cement divider, and  3 more lanes to the hotel. She called Hurtz. They send a tow-truck, which required 40 minutes because  afternoon traffic was picking up. The driver agreed to take them to within 50 yards of the hotel. He explained that was as near as he could get in his tow rig, because the entrance is blocked… a big convention

Our colleagues dragged the luggage from their van  across the huge parking lot. ( I am very happy my big blue wheeled bag, the one that likes to go to Heathrow, survived.) Our companions told Hurtz to take a Hike, and got a ride in a taxi to the bus terminal nearby. They boarded  an elegant Marco Polo Brazil-made  bus  and finally reached our town at about 1 AM after a long but easy ride, with one change of bus; the way many normal Brazilians travel.

A week later we have complete the task proposed for  the newest section of the asilo. That is the topic of the next letter, but here are some  photos:

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HurtzHell                                                             Carved fruit at Bob’s Hamburgers (!)

 

I’ll email this now because I’m dreadfully afraid of losing it somehow…. Outside it’s still quiet. I want to take some pictures, and my companions are due back in another hour or so. Nothing will really happen with Carnaval til it is dark, and less hot and humid. That’s why it begins at Midnight and ends at dawn. The celebrants are not stupid.  Ted has vowed he is not finished with Hertz. I take him at his word.

Photo Album:

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