Panama 2018: Minga Not Doing Well

Minga is experiencing leg pain severe enough to keep her from walking. I Googled the symptom, and found that it is very common among dialysis patients — etiology unknown, treatment unclear. Hot packs. There are some drug options. A walker might help.  Oddly enough, I don’t recall seeing very many older people in Panama, either the city or rural areas, using walkers, not the way we do here where older people are numerous. But walkers have to be available. Good ones with a seat cost around $125 in the U.S., but I’m sure in Panama they charge much more.

It’s not clear to me, even after talking with Minga, whether the pain is intermittent or present most of the time. But if Minga can’t walk, it’s a real problem. She has to walk to get to and from her dialysis. She also has to walk to keep her bodily systems functioning. Her decline, if she becomes sedentary, will be quick.

Minga wept on the phone, saying that I am like her mother and that all she has to give me in return is her love and her blessings. The words, and her tears, just about undid me.

Panama 2018: Jari’s Two Little Ones

Jari is Minga’s granddaughter, #2 of Ita’s four Jaris: Janelys, Jarelys, Jarinelys and Jarineilys. Yes, the last two have essentially the same name, slightly different spelling. Jari #3 is called Jarin, and Jari #4 is Neilys.

Jari’s partner and the father of both of her children is Joel — he works for a computer company, and is the youth pastor at the church where Jari’s family goes. That’s how he and she met.

We used to call Jari “party girl”, because she has such a bubbly, exuberant personality — and here she is the very competent mother of two small children. She and Joel bought their own home just on the other side of the Bridge of the Americas, in LaChorrera — more than an hour from where she grew up in Filipio on the other side of the airport. Her mother Ita, Jarin and Neilys still live there, as does elder sister Janelys and her two little boys, Christian and Sebastian.

Jari was studying canal zone management at the University of Panama, but I believe has taken a hiatus to care for her children.

Purely by happenstance, she was at Minga’s ten years ago when I first returned to Panama — she was about 12. She vividly remembers that day, as do I.

Here are her two little ones, Britney and Joelito. Joelito is 2 1/2, and Britney is five or six months old. You can see Jari’s sparkling personality in this pic, yes?

Panama 2018: Talking with Minga

I was able to have a long chat with Minga on Friday. Ana was home with her, and daughter Teri as well. Minga doesn’t quite get how to hold a cell phone a bit away from her face so I was looking at her forehead or hair or an ear most of the time, but it was a wonderful catch up conversation and visit.

She wants everyone to know she is grateful for all of your prayers and concern, and that on September 24 it will be one year that she is on dialysis. She said she feels pretty good, much better than last year when she was brought to the hospital near death. She sends all of you her love.

Minga is a very social person, as I knew from watching her in the village. She sort of “holds court” on her narrow front concrete patio, where she sits and makes herself available to the neighbors going by and to family who pop in to visit. She chats with the lady selling lottery tickets, the junk man going past collecting old metal, the fish truck driver selling fresh catch, the guy on a bicycle balancing a big stand of bananas on his back, the mothers and grandmothers walking their small children to and from school. Her grandchildren and great grandchildren zoom into the yard on old bikes, or on foot, and zoom back out again.

Minga has now created community with the dialysis patients and their families who come to the public hospital for that 10am Tuesday, Thursday, Saturday slot. It isn’t an easy, convivial environment. People are strung out along a very long, narrow hallway on hard plastic chairs. Many of the actual patients arrive not feeling well; they have a hard time walking up to stand in line when it’s time to go into the dialysis suite. There is no coffee shop, so they aren’t able to bond over a cup of coffee or a meal. But Minga goes up and down the long line of chairs, checking in on people. And they come to her. The nurses and orderlies, who seemed rather formidable and unfriendly when I was with her last year, have come to know her and she says they welcome her warmly when it is her time to go in.

Minga eagerly awaits my January visit; she says it gives her something to look forward to. She doesn’t have women friends to talk over aging with, and she doesn’t read like I do. But she’s figured out the basics all by herself: be social, get exercise — walking to and from the bus and up the stairs to Ana’s apartment make that happen naturally — and have things to anticipate that give meaning to life.

I continue to be amazed at her tranquility and grace.

Panama 2018: Minga

Ana tried to call while she and Minga were awaiting dialysis. I was out and didn’t receive the call. Hopefully we’ll connect in the next few days. I recognize where Minga is sitting: on one of the hard plastic chairs that line the long narrow hallway where patients and family members wait their turn.

I think Minga looks generally well, although her face looks a bit puffy. The port through which she is receiving dialysis is lower down on her chest, not so bothersome as when it was higher. I won’t know anything about her spirits until we talk, but once we have I’ll let you know.

Conscious Aging: Acceptance

A friend recently asked me how Minga is doing. I responded that she seems up and down physically, but remarkably consistent in the grace and acceptance she shows relative to living with dialysis.

Acceptance isn’t a word that I embrace willingly, and after the brief conversation about Minga I thought about it more. Minga’s desperate poverty has not offered her many choices in life. The practical effect is that she is long versed in the spiritual discipline of acceptance. She is fiercely proud of those instances where she did have a choice. While the U.S army base was open just outside the village of Rio Hato — during my Peace Corps years and until 1990 — young girls would gain a few dollars by satisfying the sexual needs of the randy 18 year old enlisted men who came to village bars to drink. Minga never did that, a fact she will tell you proudly, even when she struggled to put food in the mouths of her nine growing children and had practically no other ways to earn income.

My life has been very different, at least as an adult. If I read something whose viewpoint I don’t accept, I look for other sources. If I get a bad table, or a poorly prepared entree, or a garment returned from the dry cleaner that is damaged, I insist on an adjustment. If I wonder about a medical recommendation, I get a second opinion. If I don’t like the quote for a new car, I make a counter. Acceptance for me is an “if” not a “must”.

That said, I do greatly admire Minga’s attitude toward her dialysis, which has changed her life in every respect. She always said she would never live in the city; she is now living in the city 5 days out of 7. She always said she didn’t want to live tethered to a machine; she is now living tethered to a machine. She loves her home, her neighbors, the flow of village life. Now she is living with her daughter Ana in a city apartment, rather isolating. Minga is glad to have the welcome and the support. But it still has to be hard for her not to be the center of her own home with extended family popping in and out all day to visit.

Aging has something to do with becoming more practiced at acceptance, I suspect. My choices are limited, somewhat, by energy levels, by a reduced tolerance for commotion, by less steady balance — even though I work at it — which makes it a bad idea for me to climb up on a ladder to change batteries in the high ceiling smoke alarms. Ben and Sara came over last night to help.

I will have to get better at acceptance, and not have a knee-jerk resistance to the word. In this Minga is my role model, which I will tell her the next time we are together.

Panama 2018: Britney

Baby Britney is Minga’s great-grandbaby. Britney’s mother is Jarelys — one of Ita’s four Jaris. Britney’s dad is Joel, and big brother is Joelito. Looks like the baby is thriving, and I am eager to meet her in January 2019. 🙂

Climate Change: Bad for the Panama Canal

Panama is a small country, with few natural advantages other than location. Panama has a robust banking and finance industry, but other than that, what keeps the country afloat is revenue from the Panama Canal.

According to the Washington Post’s Energy 202, the daily newsletter about energy-related issues, the Venta Maersk, a Danish container ship, is about to attempt to sail through the Northern Sea Route. Enough ice has melted, apparently more or less permanently, to make the passage possible from July to October.

This is good news for the profitability of shipping companies. The news is very bad for the global climate, for the Panama Canal and for Egypt’s Suez Canal.

Wealthy Panamanians, like the wealthy anywhere, will likely be largely untouched. But the poor, the people I visit in the city and the village, Minga’s large extended family, will see their lives get harder and harder.

Panama 2018: Death of Tio David

Those of you who’ve been to Panama with me in recent years know David Bustavino, who sometimes serves as our driver. He’s Lily’s cousin on her father’s side. David’s father, Tio David, is Lily’s uncle, her father’s brother.

Tio David has died, after many years receiving dialysis. He lives in Rio Hato, and as soon as she got word Lily asked for and received permission from her employer to go. Even at her level, chief pharmacist for a large Arrocha store, Lily’s employment schedule is tightly regulated. Time off is not granted easily. Even if she misses work because of illness, she has to present a doctor’s note in order to get paid for the time she is absent. But in this case, permission was readily given — although I’m not sure if she will be paid for the shifts that she misses.

Honoring family obligations is a fundamental part of Panamanian culture, even as life is changing in other ways.

Tiio David will be washed, dressed, and laid out in his home. Family will be by his side. Many from the village will come by to express condolences. No later than 24 hours from the moment of death, because bodies are not embalmed, there will be a funeral mass. In most cases, the coffin is then carried on the shoulders of pallbearers the four miles to the cemetery out on the highway, followed by the mourners. Occasionally, someone has small pickup with a bed larger enough for the simple wooden casket, and the casket is driven slowly, with mourners walking behind.

Lily’s father is ill with Parkinson’s, and I imagine the death of his brother will hit him very hard. David is a devoted son, and he will worry about his mother living alone in the village when he and his family live in the city. For Minga, who has made a new community of dialysis patients both in the village and in the hospital where she receives treatment, the loss of one of them must come as a harbinger of their own fate.

I conveyed to Lily that all of us who know David send our condolences and our prayers. She will pass those along to David, and it will matter to him that we note his father’s death and that we care.

Panama 2018: Update on Minga

Lily sent word yesterday that Minga’s port has been moved — not sure if this is a second adjustment from the original site, or whether a single intervention long talked about has finally happened. Apparently the procedure was hard on Minga, and the dialysis that happened the next day did not go well.

After some rest and rehydration and a day or two interval between one dialysis and the next, Minga perked up a bit and is feeling stronger. The chronic stress of being in dialysis is no better, and realistically, will never be better. But she is managing, and continuing to have some quality of life. Ana and Raoul and Miley seem happy to have her in their home. Minga is content to be there too, and the apartment building is much closer to the hospital than when Minga was living in Filipio with daughter Ita. Getting to and from dialysis is shorter and easier — one bus, not three.

Clearly Minga is not giving up yet. I have high hopes for seeing her in January 2019, although I’ll go sooner if she takes a downward turn.

Panama 2018: Baby Axel

Axel, son of Luis and Lynette and Gloria’s fourth grandbaby, is now two months old. He looks healthy and thriving.

You’d never know it was 85 degrees there. I imagine it’s been raining. When it rains, they all think it’s freezing — even if the rain is accompanied by the usual hot temperatures, which it always is.  Their feeling chilly has something to do with cold vapors released by falling rain, they tell me. I’ve been there during rainy months, and for me,  rain just makes it all the more sticky and humid. You wouldn’t get a knit cap on me for all the money in the world. But even the adults wear wool caps, and jackets, when it rains.