Before I left, I had the opportunity to go on several home visits with the Pina Palmera team. As usual I am impressed by the persistence of the staff: searching diligently for homes hidden in remote areas with poor access and few landmarks for guidance. There is no actual address; usually one asks around for: ”would you know where Maria’s mother’s house is?” and hopes for accurate information.

The reason for visiting today is to see why the children and parents have not participated in the regular therapy sessions at Pina. It is difficult for most people to reach the therapy center: distance and money are usually the biggest impediment to access and regular participation. However, the parents may have to work, the mothers become pregnant again, the grandparents are sick or die, but worst of all the family decides that therapy is not necessary. The Pina team continually educates families about the need to continue with regular sessions, whether it is about teaching the deaf children sign language or therapy for the toddlers with developmental delays.

These discussions also enable the team to find out if the families need different kinds of help such as paperwork for school registration of the youngest child or medical assistance for a family member; many times there are issues that the Pina staff can help with.

The families of disabled children are dealing with significant stress and this leads to frequent conflicts between family members.Today, a long talk with the father and grandparents of a young boy with developmental issues helped plan a strategy for hyperactivity and frustration outbursts.

Luckily Sofia’s youngest daughter steals the show and helps break the ice – everyone wants to play with the chubby, smiling baby and soon the discussion flows smoothly into child care issues and parents share their concerns wit more ease.

After a long and very hot day on the road, our small group returns home tired but happy with its accomplishments – all 4 families targeted today have been found, visited and encouraged to take another step in the long, difficult journey towards health and better quality of life.

Perhaps the team will have to return one more time, perhaps the parents will resume their trips to Pina – who knows?  One thing is certain though: the team is not ready to give up and every child’s health and education is worth fighting for.As usual, I am impressed and humbled by their efforts and have  a deeper understanding about the effort required to provide support and access to health care  when environment and infrastructure are so unfriendly.

I have now come to the endpoint of my travels – Zipolite and the hard working team of Pina Palmera. The community visits are running at full steam even though the recent change to the Daylight Savings Time (a few days ago in Mexico) has confused most of the attendants. People come in groups, some thinking it is 10 am others opt for 11 am – almost everyone lives without a clock or a watch and they run the day based on the amount of daylight, not on some convention of hours and minutes. Nevertheless, it is full house again: parents, relatives, children with various disabilities. Lessons for the deaf with Miriam, games and discussions with Mariana and the physical therapy corner with Sofia.  I am able to help a bit and am trying to befriend a little indigenous boy with spina bifida while also trying to teach his mother how to help him improve his balance.

Pina teaches acceptance of the disabled but I must say acceptance works both ways: I am surprised to see how fast the little one becomes engage in play with me – a foreign face that first made him cry and hide in mother’s lap.

This year the Canadian occupational therapy students are again present in full force. The 2 students form Ottawa have managed to  transform an old baby stroller into a much needed wheelchair for 7year old Pablo. Handling the uneven Mexican terrain is no simple matter and most wheelchairs fall apart fast.

Not only are wheelchairs impossible to purchase by most families, they are bulky and too fragile for this environment. However, this innovative version will allow the mother a bit of freedom – not an easy task to carry around a 7year old! – and enable Pablo to explore his surroundings with better posture and more independence.

Back in the noisy dusty city where the loudspeakers on the propane selling truck competes with the one on the water selling truck and they all compete with the  never-sleeping knife sharpeners, scrap iron collectors, fruit selling trucks but most of all  with the tamale vendors – who would not want to buy tamales at 1 am?

A short visit to Hijos de la Luna (children of the Moon) informs me that the 45 children are all in good health. There is only one baby (6 months old), about 10 under the age of 6, but Coco seems to have it all in good order, as usual. As soon as I come I am handed the baby with the express request to feed him while we have our chat. Trying to juggle baby, spoon and carrot mash, I ask her about the general state of things – kids are happy and even though for a newcomer the environment is very chaotic I can see they are all sitting down for dinner in an orderly fashion, each bringing his spoon and cup to the table.  The older ones bring their own plates form the kitchen while the little ones are bring served by a volunteer.  Coco and I have a few minutes to chat before the food is devoured and calls for cookies arise from everywhere. I pass a carrot-smeared baby to another volunteer and proceed to dispense cookies as the rules dictate, to those who have emptied the plate and are sitting nicely in their chairs. Hard not to break the rules with all those smiling faces and reaching hands!

The visit at the Procasa Hogar del Nino (the home for boys) was very brief since al the boys had gone for a day of religious events due to the ongoing Easter celebrations. Religious processions are flooding the city streets and the churches have free lunches for the poor and the orphans. The priest in charge of the boy’s home has also promised a week at the beach for children from 3 orphanages but unfortunately the bus destined to take tem has collapsed a few days ago and is beyond repair.  Rosa Alba, the administrator and myself have an upsetting day, trying to find other ways to transport 60 children to their only vacation and for some the only outing they ever experience. Eventually our legwork pays off:  we find a willing company that is also offering a reasonable price for 2 smaller buses that will fit children, caregivers and luggage. Our happiness lasts 2 hours – the priest in his wisdom decides it is after all too much trouble and why would he accept the support of a donation when they can do with whatever they have? Rosa Alba is speechless. I choose to keep my mouth shut and focus on my rising blood pressure. Happy Easter everyone!

The previous story about the abandoned elderly of Tonala continues – as does our support of them. Apart from the monthly food packages, we are looking for ways to make their lives a bit easier and more dignified. Karen has been tirelessly working at finding additional support and has enlisted the help of a university student to create a short promotional video for a fundraiser.

The interviews with the elderly are eye opening – they talk about their life before receiving any help and it is a story of depression and hopelessness. Not only does the monthly food package allow them to eat better and save a little of their meagre pension, but the activities run weekly in the rented space that Karen has secured, add a new dimension to their life. They now smile and chat and have a sense of belonging, of human connection. The activities represent a reason to walk daily and interact with the world that until recently was hostile and full of peril. No one is kind to these people or treats them with respect. Until recently they were discarded and abused.

Having a place to come and play games, laugh, share a joke is unbelievable – as one woman told us “I have worked since I was a little girl, then I got married. We lived far from the village, on a hill; I never knew what it meant to play”. Another man said: “I used to only think about death. Now I am laughing again” – he ends, with a huge, happy, toothless smile!

On my visit I could not do much beyond talk about some of their many health care issues and offer basic preventative suggestions and education. All have high blood pressure, some have diabetes and the food package can only be tailored so much to help with their health issues. Osteoporosis and arthritis are deforming and disabling their joints. Health care comes in the form of a weekly (at best) visit from a doctor: he arrives at the village’s health clinic, writes prescriptions and shrugs his shoulders. There should be free medication available but there is none.  To pay for the prescription requires at least 10% of the monthly income…which most are not receiving due to some obscure administrative issues that no one can explain, let alone resolve.

All I can do is offer some anti-inflammatory creams, demonstrate basic exercises, and suggest simple joint care methods.  I know they are happy for the attention and some remember things I have said last year, much to my surprise. We share hugs and best wishes, the human connection they are so deprived of. If only it would last, if only it would change their life a little…..