As Paul Jacquay approaches the parishioner's house where the makeshift medical clinic will be held, he feels encouraged. The pockmarked road in the Paraguay village of Luque had twisted and turned through neighborhoods that screamed of poverty, yet now, peering through the dust on the windshield, he spots a small knot of people waiting on the back porch.
"Looks like someone's waiting to see the doctor," he says. "The pastor must have gotten the word out."
Carrying his portable examination table under one arm and a box of supplies under the other, the white-bearded, 58-year-old physician's assistant nods to those waiting as he introduces himself to the woman who has offered her home for the two-hour clinic.
But his initial enthusiasm about the number of waiting patients quickly wanes. The group on this sticky, 90-degree, February afternoon turns out to be two mothers and their children, most of whom couldn't be left home alone while the sick ones see the doctor.
Local church support Jacquay and his wife, Marianne, a rural, public school teacher, have uprooted from Big Timber, Mont., so he could work as a volunteer medical missionary for two years through Misión de Amistad (Friendship Mission). The mission, founded in 1953, has had a long-time "partner church" relationship with Global Ministries, a common ministry of the UCC and the Christian Church (Disciples of Christ).
Both Paul and Marianne had participated in mission trips to Paraguay through First Congregational UCC in Big Timber, Mont. So when they were looking for an opportunity to serve overseas, "it was the support of the church in Big Timber – and the pastor, the Rev. Larry Pray – that really pushed us this way," Paul explains.
"The Big Timber church is like our family. They have sent us care packages and have had ongoing communication, just as if they were our parents," he says. So with a small stipend from Global Ministries and the income from Marianne's private school teaching job in Asuncion, the capital, the couple has lived in Paraguay since January 2006.
'A strong spiritual calling'
At first Paul Jacquay had no specific plan as to how he would practice medicine, "just a strong spiritual calling combined with the ease of how things fell into place," he says.
But soon he needed to refine his plans in order to gain financial support from Global Ministries and political support from the local medical establishment in Paraguay.
What emerged was Project Maestra. In Spanish, maestra means teacher, an appropriate title since the project functions on two levels, both diagnostic and educational. It also is an acronym for the group's full name.
"We want to let people learn that their health is important," says Rosalina Paciello de Cabrera, Friendship Mission's executive director. "If a patient comes in with a small problem, we want to fix it. But we also want to educate them about health issues."
"We want to have an ongoing relationship with the patients," she says. "We want to take time to develop their trust and to establish a climate of professionalism."
'Up rocks like a monkey'
Friendship Mission serves the people of Paraguay in many ways, including classes for women, therapeutic support, workshops on domestic violence, concerts, recreational activities, children's programs, school support, a health clinic with more than a dozen medical specialties, and a nursing school.
One afternoon, carrying bottled water against the heat and humidity, and swathed with Deet to ward off mosquitoes carrying dengue-fever, currently at epidemic proportions in Paraguay, Jacquay visits two different rural hospitals near Asuncion. There he hears success stories of recent nursing school graduates.
At the hospital in La Colmena, 21-year-old Maria Griselda Benitez, only one month on the job, has spent the past 24 hours on call in an ambulance. Despite her inexperience, this has included transporting two dying patients to Asuncion.
Nancy Caballera, 21, spent the morning with an experienced nurse, vaccinating indigenous (Indian) patients in a remote area.
"I climbed up a mountain, up stairs, up a ladder and up rocks like a monkey," she says. "This was my first time to do it, but I'll do it every two months."
For Lorena Gomez, 22, the work is harder than she expected, she says, since there is not enough equipment and nurses have to make do with what's available.
But, she is asked, did the training at the nursing school prepare you adequately to do this work? "¡Si!" she answers promptly with a smile.
Goal getting closer
While Friendship Mission's history and these success stories inspire Jacquay, his own progress in getting his small clinics established has been very frustrating. His first problem was the language barrier.
"It would have been really nice to be fluent in Spanish when we arrived," he says. "It was six months before I was even fluent enough to work with a doctor to write up the proposal."
Another problem is learning to work with a frustrating (to him) Paraguayan custom: People say "yes" to anything, rather than turn you down, he says, but then don't follow through.
Nevertheless, Jacquay is learning from these experiences and getting closer to his goal of one clinic a day. Two recent developments give him hope.
First, the government is making available two former clinic buildings, now deserted, for Project Maestra's use, and even provides a community nurse to service the community with inoculations, etc., in between Jacquay's weekly visits.
Second, a U.S. organization that wants to send medications to Paraguay has put Friendship Mission on its list.
With this encouragement, Jacquay is applying for a third year.
"We've been working on the medical needs, and now we're really close to starting the classes and workshops, especially on diabetes and hypertension," he says. "It's going to take at least another year to get these established, so they can be sustained after we leave. That's really our goal."
The Rev. W. Evan Golder is editor emeritus of United Church News. He visited Friendship Mission in Asuncion, Paraguay, earlier this year.