Style, Substance Mark Success for Private Aid Group

By Lawrence Morahan | July 7, 2008 | 8:09 PM EDT

(Editor's Note: Senior Staff Writer Larry Morahan spent a week traveling the jungles and back roads of Central America in this profile of Friends of the Americas, a private aid organization based in the U.S. This is the second of four installments on Morahan's findings.)

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One aspect of Central America's political upheaval 20 years ago was the involvement of a growing number of public and private relief organizations trying to improve the condition of a region racked by war and poverty.

Click to enlargeMany humanitarian groups packed their bags and went home after international and local relief agencies gradually resolved the crisis caused by tens of thousands of Sandinista refugees crowding into Honduras in the mid-1980s.

But after months of working with the mostly women and children who crowded into a United Nations refugee camp outside Danli, Friends of the Americas, then a newly-minted medical and humanitarian relief organization, discovered something unexpected: it wasn't that easy to leave.

"We developed a great love for the people and for the work, so here we are, 17 years later," said Diane Jenkins, president of the Baton Rouge, La.-based group.

Over the years, the organization has grown into a $1.5 million non-profit operation, and employed more than 70 people, including doctors, nurses and teachers, mostly in Honduras.

A Hand Up, Not a Hand Out

Friends of the Americas decided early on that it would set up only by invitation in Latin America, treat anybody who needed medical assistance, regardless of their political or military allegiance, and seek to avoid the creation of a welfare mentality among the people it helped.

Soon after the Honduran refugee crisis of the 1980s, that formula for success was put to the test when elders from the Miskito Indians, a community of about 50,000 Moravian Christians living in primitive conditions in eastern Honduras, contacted officials with Friends seeking medical help for their people.

The Sandinistas frequently attacked the Miskitos, who claimed a 4,000 square mile territory on either side of the Coco River near the Caribbean coast as their sovereign homeland, trying to drive them from Nicaragua.

It was a challenge the fledgling humanitarian organization could not pass up, and the meeting with the Miskitos soon led to the establishment of a hospital at Rus Rus, a remote outpost in the jungle three miles north of the Coco River, which serves as the border between Honduras and Nicaragua.

Today the Miskitos live in relative peace in the region, and the Friends-funded hospital at Rus Rus includes an operating room, an outpatient clinic and a staff of 30, including doctors, nurses, a pharmacist and lab technicians.

The clinic also attracts medical personnel who want to do pro bono work in Latin America. Dr. Michael Sabback of Charleston, S.C. brings a 12 to 15-member volunteer surgical team every year to Rus Rus, where he stays for a week, performing 30 to 40 major surgeries at the Friends of the Americas facility.

Risky Business

Setting up in remote areas in an underdeveloped country is not without its hazards or additional costs, said Danny Smith, a senior vice president with the organization.

During a recent audit, Smith had to fly two accountants from the United States to inventory the group's facilities in Honduras, including the medical facilities at Rus Rus in La Mosquitia.

Known as the frontier land of Central America, La Mosquitia is dangerous to get to, and any flights into the region have to be taken in the morning, before the torrential afternoon rains hit. The area is also known for its poisonous snakes and unfriendly insects.

The trip to La Mosquitia with the U.S. accountants illustrated the adage that the only constant in Central America is change, Smith said.

For starters, the Honduran army called Friends and said the organization had to use a small airplane to get into the region because the army felt the helicopter Smith and his party were scheduled to fly on wasn't safe.

"Then we got a call telling us, 'sorry, that plane has just crashed, too, and you'll have to make other plans,'" reported Smith.

So Smith and his party drove eight hours through the night to La Ceiba, a town on the Caribbean coast with a small airport. Their trip was delayed for hours by an accident when two trucks collided on a narrow bridge in the dark and their cargoes were strewn across the road.

Eventually Smith's party got a flight to Puerto Lempira, where hospital Administrator Manuel Garay picked them up in one of the group's own ambulances and drove another five hours through the jungle to Rus Rus. "You have to constantly improvise," Smith said.

The Difference Between Asking and Telling

In the interest of maintaining efficiency, Friends of the Americas only sets up its medical facilities in areas where no similar facilities exist. "We don't duplicate what's already being done," Jenkins said.

During the El Salvador earthquake of 1986, for example, the group was the first on the scene with a mobile health clinic, treating anybody needing help. After two major earthquakes in El Salvador earlier this year claimed the lives of up to 5,000 people, the organization's doctors and nurses again flew to the disaster area.

Dr. Hector Zepeda, the Friends medical director in Honduras, and Dr. Marco Irias, set up a mobile clinic March 26 at Jayaque, a town outside San Salvador, along with other church and private relief organizations, and gave medical assistance to hundreds of people.

While providing important services, the group also seeks to raise the standards of care and sanitation, and the expectations of what medical service should be like. Friends also tries to secure the permission of local and government officials before its medical teams arrive.

Part of the organization's success lies in its approach to offering aid. "In various situations, we meet with the village people in advance and tell them we have certain things we can do for them and make an informal arrangement," said Jenkins. "But just to kind of bust in and say, 'here we are, the Americans, we're going to solve your problem' - I think that's the worst attitude."

Thursday: Looking Toward the Next Generation

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Read the 1st installment here