Sole of the Matter

Shoes.  I love shoes but I have come to truly appreciate shoes since being here.  They are not as much a fashion statement as they are a protective item and tool for the environment.  Instead of my favorite shoes being based on shape, color or heel height, my favorite shoes here are ones that are stable, breathe well and can be rinsed off in the river when really muddy and still worn the next morning.  The shoes available here are not well-made and mainly rubber flip-flop and "crocs" styles that are not very durable.  One of the most frequent requests from our clinic staff when one of the volunteers are going to the States, is a pair of tennis shoes.

Girls in the village of Corazon

In the U.S. we are so used to wearing shoes that we don't think about what it would be like to not wear shoes on a daily basis.  The government list shoes as part of the school uniform but children are not allowed to be turned away from school because they do not have them. Out in the villages shoes are definitely not a rule.  The men put on their rubber boots to go work in the fields but many of the women and children go barefoot around the village.  It is actually much more difficult to walk through the mud in cheap rubber flip-flops than barefooted.  We encourage people to wear shoes not only to protect their feet but to decrease the chance of getting intestinal worms (not all worms are contracted by eating affected food, some burrow into the soles of the feet to then migrate).  The chickens and pigs roam freely through the village and there was a study in the Toledo district that showed that at any given time, sixty-six percent of the population is infected with worms.

School children in the village of Santa Teresa

I have definitely thought about shoes since I have been here but as I did home visits with our physical therapist, Annette, I realized how they can truly make a difference.  Santos Norales is a 28 year old man who had a significant brain injury (with unclear details) after working in the heat.  He had a subsequent craniotomy and still has part of skull embedded in his abdominal wall.  He now has memory problems and spastic hemiparesis.  At this time he spends most of his time in bed and has become very depressed.  Annette has been working with him to increase his ambulation but it requires a very stiff AFO (ankle-foot orthotic) on his left ankle, and a lot of help.  He needs a supportive pair of shoes with easy entry and closure so that he and his family can get them on him with the AFO.  The only pair of shoes that his family has found for him here that might give him some support are sandals that are too small (his toes hang through at the end and he and his family are not able to get them on with the AFO).  Something so easily obtained in the U.S. but unavailable here would allow him to get out of his room, out to the front of the house and enjoy life more.