Monthly Archives: November 2012

Hello, we’re from a far off land and we’re going to show you how to build a fire.

Ma sa’a ch’ool

From the moment we entered the house and were introduced she stood steadfast behind her fire table. It was immediately obvious that this was her spot in the home. Her feet firmly planted on that small spot of dirt floor. Behind her on the walls in that corner were a couple small shelves, and bowls, pans and a few unremarkable utensils all hung within easy reach. She began to build a fire. Or, more accurately, to build up a fire as the embers are probably never really cold here.

The fire table was a simple affair about two feet high and four feet square. Made of rough wood, the six inch tall sides held the bed of dirt that the fire was built on. There were three rocks spaced casually in a triangle against which she leaned sticks of firewood, pots, or ears of roasting corn. Aside from the rocks there was no apparatus, no grate or racks or tools or machined parts, and it was obvious by her spare movements that she was expert in this space with her bare hands and needed none.

She hardly moved a foot in either direction as she watched us begin to work in the opposite corner of the room preparing the space for her new stove. I could feel her anxiety in the air and caught her stealing sideways glances at the new device. How could this possibly do what her dirt table and rocks and her life of fire building skills could do?

As the new stove rose up from the ground as just concrete blocks and then more functional parts and finally a simple but coherent construction that looked like a stove, her fire grew larger and smokier. I was certain that she would have an easier time adapting to it if we had at least placed the new stove in the same spot in the room as her tradition cooking fire – her place of power from which she watched over the comings and goings of the family and others in the home. Literally, her place in the world.

And by the way, now I’m going to cut a hole in your roof.

We were fortunate that it did not rain hard while we were there working in the houses. It rained only once, lightly at first and hard only after we had gone back down to the school at day’s end. For a people who are born and live their entire life under a corrugated tin roof, I can’t image what it must look like to have a stranger come in and suddenly cut a hole in your roof. Living in a tropical climate in a small room with a dirt floor, a leaky roof would be a well-known hazard to avoid.

Depending on who was wielding the tool – anything from a butcher knife and a hammer to a pair of tin snips – the holes were either well shaped ovals with little extra space to be filled by caulking, or gaping gashes requiring generous amounts of caulk to fill. At the end of each installation I wondered how this might be done a little better. But I also marveled at the simplicity of it all and hoped it was a net improvement. We always ended with a prayer, their thanks for giving our time and effort and money to help them, and a fire in the new stove. There was no doubt they were grateful. I’m just not sure they knew exactly what for. Time will tell and the benefits to the children and everyone in the home of ventilating the smoke are without question.

MTI says they plan to monitor the adoption rate and use of the stoves, including maintenance, and I am interested in following up to see what they determine. I think there is room for improvement. But that may only be the rational, square, plumb and level perspective on building techniques where I’m coming from. When I allow myself to stop thinking about it and just feel the experience, what a blessing I have received!

OT Millsap


Community. Gratitude. Courage.

Reflection from Alex Jackson, chief operating officer, St. Vincent.

I recently participated in an eight day Mission trip to Guatemala with Medical Teams International. A little like the Sisters of Providence in 1856, we traveled to a far-away place with a different language, culture, and traditions. Despite some differences, I found a lot in common – love of family, laughter, joy, appreciation of nature, and the enjoyment from a spontaneous game of soccer with children. I was profoundly blessed by the opportunity to serve with and in the rural mountain community of Chitepey, home to 400 people. This community was underserved – no running water or electricity, limited access to health care, high rates of malnutrition, as well as acute respiratory illness caused by the way food is prepared in their homes – open-pit fires. Our team installed 35 stoves in homes. These stoves not only reduced the smoke, they also are safer and better for the environment since they require one quarter the amount of firewood.

I learned a lot from the people of Chitepey, much of which is applicable to our work at Providence St. Vincent as we transform our models of care to provide high quality, safe care and compassionate service at a lower cost for Oregonians. I offer the following as reflections on my Mission trip.

· Community. I was touched by the overwhelming sense of community. A community is only as strong as its most vulnerable. I saw how this village cared for each other by always keeping an open door to ensure everyone’s basic needs were met, including housing. It reminds me that here at Providence, we have more work to strengthen the community within our hospital ministry – doing this will help us better serve our patients who rely on us on the best and most difficult days.

· Gratitude. The people of Chitapey were so present in the moment and seemed to always focus on what they have, instead of what they want or need. They expressed gratitude in a very meaningful way – by saying thank you from their hearts. At Providence, we are blessed with many resources – an inspiring Mission, a compelling vision, and terrific people of Providence who give of themselves each day. I believe we have all the resources we need to be successful, but we will have to allocate our resources differently to be successful in the new models of health care that emerge from the national legislation. We also need to make sure to say thank you in a meaningful way to each other, patients, physicians, and our families.

· Courage. I was humbled by the courage of the people of Chitepey – to welcome us graciously to their community, but also open their front doors as well as their hearts and minds to us. Even more, I applaud the courage it took to accept a stove into their home. The stove represents an entirely different way of cooking that they have used for many generations! A community leader said that these stoves will not only help them cook and improve health, but they will also change the way they think. As people of Providence, we need to continue to have the courage to open our minds to new ideas, practices, and ways of doing things that are consistent with our triple aim vision – provide national best quality, compassionate service to patients/families all while reducing the cost of care.

We are the ones who are being called to change and improve our health care system. We have all that we need to be successful – a strong Mission that calls us to serve.