The balcony of the warehouse where I reside faces a swamp. As I drink my coffee in the morning, the roar of incoming airplanes at the airport on my left funnels hundreds of tourists to Bocas del Toro. On the right lies a mangrove swamp where the indigenous community of La Solucion teeters atop houses and shops built on stilts over a few feet of brackish seawater, precariously clinging to access to clean water, if not electricity.
Tourist maps of Bocas del Toro leave this area unlabeled as a swampy region; yet 250 families of the island’s local population reside within this community. The paved main road that leads to the airport narrows into rocks and gravel as it turnsinto the main road of La Solucion, which branches into rickety wooden walkways and eventually dead-ends into the swamp.
Over the past week, I had the pleasure of meeting Carla1, a type II diabetic who lives in La Solucion and taught me how to fry and eat green bananas, consequently improving my culinary capabilities during residence on the Southern Wind. After visiting her house twice daily with insulin and wound care for her diabetic ulcers (as a result of poorly managed diabetes and lack of resources, Carla is missing five toes and half of two fingers) and watching our doctors instruct her daughter in managing Carla’s diabetes, I became confident in her ability to change her lifestyle. Perhaps earlier healthcare intervention could have saved a few of her toes, or lowered her high blood sugars, but Carla’s lack of seguro, or health insurance, along with the expensive price of the insulin she needs, mean that health has been denied to her based on her inability to pay.
Carla cannot even store the insulin with which Floating Doctors regularly provide her because she has no electricity or refrigerator, nor can she afford to replace her leaky roof because she is too sick to work. She lives with her husband, children, and grandchildren, in a shack around the same size, or smaller, than an average hotel room in Bocas del Toro. I will dare argue that most visitors to Bocas del Toro do not even know that places like La Solucion exist, much less that the province of Bocas is the poorest in the region with the largest indigenous population of all Panama, nor that the majority of the local population lives in communities like La Solucion. The region’s prosperity remains within a two-mile strip surrounding the beach, excluding much of the local population, which has been forced into the swamp by the construction of the airport.
Few, if any, visitors choose to see this side of Bocas del Toro. It is all too easy to ignore uncomfortable realities. After all, wherein lies the difference between Carla and my aunt, who is exactly the same age, also has Type II diabetes, and was also born and raised in a developing country, yet she has never lost toes or fingers to diabetes and has always been able to control her blood sugar. The two were born into different income levels with different levels of access to opportunity. How does one bridge this gap between Carla and my aunt, between La Solucion and Bocas del Toro, or in the United States, between the inner-city and the upper-class suburbs? Lines of division run along race, class, and religion, determining opportunities and consequently health, education, and quality of life.
Personal relationships with others allow us to break the boundaries of our world and step into the world of another, experiencing life from their point of view and accompanying them in their struggles and joys. It is too easy to create barriers—based on race, religion, country of origin, or income level—which cut us off from relationships, causing one to forget that there really is little difference between Carla and myself, or between the family vacationing on Bocas, and the family living in La Solucion. Here at Floating Doctors, we form relationships with communities based upon a sincere nearness to each other that breaks down these so-called boundaries and teaches one to share themselves. These relationships tell me that there is absolutely no reason why Carla should not have the same access to medical care and consequently the same freedom to choose her way of life as does my aunt. Our work here enables the voices of those who are often forgotten, overlooked, or trampled by those in power by ensuring their access to appropriate and effective healthcare.
1 Name and identifying details changed to protect privacy.