"Light Dawns in a Weary World"

This post is written by Peter Kuhnert, a Lutheran pastor and medical doctor and Guyanese colleague.    He was a leader with both the 2013 exploratory mission and the 2014 Mental Health Team which worked in Guyana for ten days in October-November.  [They have a wonderful FaceBook page, "Transforming Guyana's Mental Health System".  Peter's message serves as an excellent reflection on giving flesh to the incarnating Christian Christmas message.   

Peter bends low to listen to a girl at St. Ann's 

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Three years ago, shortly after my first ever visit to Guyana, I was contacted by John.  He asked me if I thought we might do any kind of work together in Guyana.  I told John, emphatically, that I did not think there was any opportunity to do any work in Guyana.  There was no will, no energy, no finances, and no manpower.  There was no Spirit.  I suggested perhaps we talk again in one year.

Two years ago, a dimly burning wick began to splutter to life.  Perhaps a opportunity did exist for some partnership work to strengthen and support existing mental health services in Guyana.  John was now living locally in Ayr.  I had started working at Freeport Hospital.  We had met a couple of local psychiatrists who wanted to explore international mental health care in a culturally and religiously diverse context.  Perhaps this opportunity might bridge the partnership and development work of the ELCiC with that of mental health services, for the betterment of life for the whole people of Guyana.  Perhaps.  Certainly, there was enough enthusiasm to plan a needs assessment visit and begin some relationship development.

One year ago, October 2013, Ram and Brenna and Sujay and I joined John in Guyana for a week of site visits and meetings and discernment. We were graciously received by Dr. Bhiro Harry (Georgetown) and Dr. Mayda ( New Amsterdam), and by the minister of health, Dr. Ramsarran. We saw much and heard much and clearly saw the need for a sustained mental health initiative to support good people and hard work already being done with absolutely minimal resources.  Few in-patient beds.  Few trained staff.  No budgets.  Limited medications with only variable availability.   The needs seemed overwhelming. Yet the Spirit began to blow.  The candle burned brighter.  We knew we would come back.

The past year has been a year of planning and preparation.  An excellent slide show about our 2013 trip, courtesy of Sujay and Brenna, began to peak interest in this initiative amongst the local mental health staff at Grand River hospital, Homewood health centre, and the Kitchener Downtown CHC. Who would have expected that when we called a planning meeting, in March,  for those interested in a self-funded mental health trip to Guyana in October 2014, over 40 people would attend!  And over 20 would commit to this 10 day project!

The Canadian Mental Health Team at the Farewell reception
hosted by the Minister of Health

The project itself was a huge success.  19 individuals divided into two teams, working in both Georgetown and New Amsterdam.  The number of initiatives for  this 10 day trip was astounding. The re-introduction of life-saving ECT technology to the New Amsterdam hospital.  Clinical visits to community hospitals in Linden and Suddie ( including an awesome speedboat ride across the Essequibo river).   Opportunities to teach physicians and nursing staff at both Georgetown and New Amsterdam.  Community education initiatives about mental health during each of our community tours.  Relationship building opportunities with the ministry of health, the University of Guyana medical school, and the schools of nursing in both Georgetown and New Amsterdam.

Dr Bhiro Harry continued with his
on the ground leadership for our team.

Dr. Bheri Ramsaran, the Minister of Health provided
excellent direction and support for our team.

Perhaps most impressive, has been the high level work that John has participated in, to help create a national mental health strategy for Guyana.  This is coupled with an ambitious strategy for the creation of a bilateral university partnership to bring bring post-graduate psychiatric training to Guyana.  This would be a first step to creating a national human resources strategy for mental health that might eventually include nurses, social workers, occupational therapists, and chaplains.  The wheels of future possibility have already begun to turn.

Chaplain Ram Kalap was a leader
on both the 2013 and 2014 teams.

Sujay Patel and Peter celebrate the fulfilment
of all their hard work over the last two years.

What a difference a couple of years has made!  Initially, there was no hope.  There was no kairotic time- no time for illumination and transformation.  But slowly, ever so slowly,  light has dawned.  A dimly burning wick has begun to burn brightly.  Hope is being reborn and a spirit of possibility  is beginning to take hold. What began with the question of one, " What can we do in  Guyana?" has been echoed by the voices of 19 others and the possibility of systemic change is becoming real.  Systemic change for the betterment of care for the whole

people of Guyana.

What is more Christmas?

...than bringing Joy to children.

Thanks, John, for risking asking the initial  question.  Thanks, John, for nurturing hope in your own unique manner.  You have helped open our eyes to the possible.  You have inspired us.  We are grateful.

John amazing the Cuban Psychiatrists
 with his command of Spanish.

Thanks for being a blessing. Looking forward to being your partner into the future.

Peter Kuhnert MD MDiv 

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Thanks, Peter.  I am humbled by your kind words.

PS: I have a few more themes for this blog, but I have returned from Guyana to develop my usual cough and cold. I am feeling better today.  I especially want to post the pictures and stories from the "2nd  Annual Father John's Photo Contest.'

Have a Blessed Christmas and let you light shine...

And They Are All Still Here

Can you guess the first thing Dennis did with the Students?  (Remember he is a Baptist pastor.)
Answer here: http://www.youtube.com/watch?v=-UYoh7f6BTU

Classmates Reunited

Dennis LeBlanc, an old Maryknoll College classmate and friend, arrived to join me here at Mercy last Sunday Morning.  He has already spent the week teaching in the PBL classes and doing a few hours of "Family Mapping" (Genogram) with the students' wonderfully complex Caribbean families.   There are some families with half-siblings from three different fathers and in one instance the same on the mother's side ..... And often different last names reflect the complexities.  I am often amazed to find out that students in different years and with different names are really sisters.  (The stuff you learn on FaceBook!)

Dennis with the First Year Students at Mercy.  

So your father was living with one of your mother's
ex-partner's spouses when you were born and
your mother was married  to his stepbrother ..... ?

Bibi getting some mapping pointers on her family influences.

Continuity and Change

I have known Dennis for almost 50 years.  When we began our friendship we were both going to be missionaries; however, life intervened, we left the seminary, AND we both got married and changed brands (he is a Baptist) and both pursued counseling for most of our ministries ..... surprisingly similar paths.  We have kept in contact in various ways and varying times/ degrees of closeness.

Last year, Dennis visited us before we moved from Nova Scotia.  (And a "small world" note:  his father's family came to North America and lived in South West Nova... so Dennis was related to half of Pubnico.  This was a new discovery for his own family map.)  One aspect of the people in Pubnico that I sometimes envied was that they knew their friends (and enemies!) and their families for all their lives.  When I look at my life, there are so very few constants; in some ways I have been a different person in different contexts with seemingly limited connections between the selves.  There were times where I wondered if the remembered "who" back then still existed in the present.

It is good to have Dennis here so we can both lie about the past to reflect the "who" we are now .....   And two old guys have variable memories.  I sometimes have no recall of what Dennis remembers -- and vice versa.   Even if some of the tales are embellished just a little, they are comforting remembered continuities.

“And what is a friend? More than a father, more than a brother:  a traveling companion; with him, you can conquer the impossible, even if you must lose it later. Friendship marks a life even more deeply than love. Love risks degenerating into obsession;  friendship is never anything but sharing. It is to a friend that you communicate the awakening of a desire, the birth of a vision or a terror, the anguish of seeing the sun disappear or of finding that order and justice are no more. That’s what you can talk about with a friend."                                                                                                        Gates of the Forest,  Elie Wiesel

No Sooner Had Dennis Settled ..... 

..... than the Canadian Exploration Team arrived.   Over a year ago, Peter Kuhnert  (a Medical Doctor and Lutheran Pastor) contacted me to see what I knew about psychiatry in Guyana. I freely admitted that my understanding of Psychiatry there was limited to drinking with my friend, a Guyanese Psychiatrist, Bhiro Harry.  Well, in spite of my lack of credentials Peter and I have stayed in contact and this year he and another doctor from Freeport Hospital in Kitchener, Sujay Patel (a psychiatrist) began to explore their dream of doing something in Guyana.  We were joined by Ram Kalap (Chaplain at Homewood, in Guelph) and Brenna Patel (a teacher) to design an exploratory trip that might lead to a more sustained involvement in Guyana and specifically Mental Health.

Dr. Harry touring the Georgetown Public Hospital with the Team

Bhiro, Ram, Peter, Sujay, Brenna, Dennis in Bhiro's office

 They arrived at 4 AM on Thursday Morning and by 11 they were meeting with the President of the Lutheran Church in Guyana and brainstorming ideas of how the churches might participate in the developing project.   (The Eastern Synod, specifically Bishop Michael Pryse of the Canadian Lutherans, awarded a small grant to get this project off the ground.)  In the afternoon Dennis and I joined them in Dr. Bhiro Harry's office at the Georgetown Public Hospital to chat about his work and the possibilities for their involvement.  Later, we had a tour of the psychiatric beds and some other parts of the hospital before going out for a good meal at the Dutch Bottle.  And to bed early, as we had a 6:30 am departure time to join Bhiro in his psychiatry clinic across the Essequibo River in Suddie.

An early dinner at the Dutch Bottle

A Travelling We Did Go
Bright and early we were headed West to get over the bridge before both lanes of traffic switched and only came East into Georgetown for a couple of hours ..... and we made it  along the West Coast of the Demerara to Parika and onto a speedboat to cross a really wide river .....  On the other side we were back into taxis and on to Suddie Hospital where we had a second meal since leaving and before working.  (The Guyanese love to eat!)

The speedboats at Sparendaam, Essequibo Coast

Breakfast One

Beach at Suddie

Ram and Dennis on the Atlantic shore

The Conquering Canadians arrive at the Atlantic

Working Psychiatrists

Bhiro gets to the Suddie Clinic once a month and there are always 60 to 100 patients waiting to be seen... One person had been sitting there since 5:30.   We all got introduced to the patients and families and were given offices for anyone who wanted to see any of us.  However, mostly, the people were there for prescription management, so Peter, Sujay, Bhiro and Carmen (Bhiro's Cuban associate) saw the bulk of the  patients while the rest of us helped out where we could.   It took some time, but in the end all were seen.

And an added Bonus

One of our taxi drivers Romo, on the Essequibo Coast, told us that his family was having a celebration Puja of thanksgiving and invited us back to their home to partake of the foods in a seven-curry feast.  It was a lovely home with fruit trees and flowers.  They wanted to share their thanks for God's blessings with everyone.  And we even got back across the Demerara before the lanes were closed to westbound traffic.

Everyone finished the Day with a Banks

The stress of being a psychiatrist was too much

And who lets a friend drink alone?

It was a week filled with memories of old friends and the potential for new happenings...   Thanks for coming with us.      

John