I hear him before I see him, even over Guatemalan banana vendors insisting diez por cinco quetzales, diez por cinco. I hear him moan and fall down the cement steps of the cantina: an indigenous young man in tattered jeans, with dusty black hair, and bloody gashes on his face and forearms. A curious crowd gathers around the spectacle. He rises from the ground bracing a wall. Women jump back and gasp, the girls giggle. He sways and collides with a pyramid of citrus; limes roll down the street.

I think to myself: He needs help. He is bleeding. I can hire a mototaxi to take us to the local clinic and hope it is open and there are staff. As the man approaches, the crowd steps back, leaving me in the open. I turn to search their faces for a confidant but find only smirks amused with the gringa.

Suddenly I am grabbed from behind in a stronghold. Muscular arms squeeze my body until I can hardly breathe or move. Then I smell liquor, and I see the blood on his arms, blood now smeared on my sweater and skin. He uses my body to support his own weight. I lift my eyes to the crowd to plead for help: some sneer, others are uneasy. I am on my own. My legs quiver.

Then all at once, he releases me, stumbles back, and staggers down the street. I catch my breath, still trembling, and look down at my sweater. I am covered in his blood: it stains my skin, so now I am obligated. But I do not follow him, and I do not move. He disappears into the crowded market.

I wander home past more cantinas, past men lying unconscious near broken glass bottles. I plan to soak my sweater in cold water to remove the blood, and for this I feel ashamed. But when I tell my friend the story, and she remarks perhaps I learned my lesson to not try to help the drunk people. I reply: on the contrary.




Fear closes your heart and mind. Fear makes your life smaller. Fear cannot bring you peace or love or happiness or wellbeing. Fear only brings more fear, and violence. So then why oh why must this world fear people who have simply been born in violent places? Why must this world fear and not love them? And by them, you know I actually mean ourselves. We are all the same. Why must we fear and not love ourselves?


by warsan shire

no one leaves home unless
home is the mouth of a shark.
you only run for the border
when you see the whole city running as well.

your neighbours running faster than you,
breath bloody in their throats
the boy you went to school with
who kissed you dizzy behind the old tin factory
is holding a gun bigger than his body,
you only leave home 
when home won’t let you stay.

no one would leave home unless home chases you,
fire under feet,
 hot blood in your belly.
it’s not something you ever thought about doing,
until the blade burnt threats into
your neck
and even then you carried the anthem under
your breath
only tearing up your passport in airport toilets
sobbing as each mouthful of paper
made it clear that you wouldn’t be going back.

you have to understand,
no one puts their children in a boat
unless the water is safer than the land.
no one burns their palms
under trains
beneath carriages
no one spends days and nights in the stomach of a truck
feeding on newspaper unless the miles travelled
means something more than the journey
no one crawls under fences
no one wants to be beaten

no one chooses refugee camps
or strip searches where your
body is left aching
or prison,
because prison is safer
than a city of fire
and one prison guard
in the night
is better than a truckload
of men who look like your father
no one could take it
no one could stomach it
no one skin would be tough enough

go home blacks
dirty immigrants
asylum seekers
sucking our country dry
niggers with their hands out
they smell strange
messed up their country and now they want
to mess ours up
how do the words
the dirty looks
roll off your backs
maybe because the blow is softer
than a limb torn off

or the words are more tender
than fourteen men between
your legs
or the insults are easier
to swallow
than rubble
than bone
than your child body
in pieces.
i want to go home,
but home is the mouth of a shark
home is the barrel of the gun
and no one would leave home
unless home chased you to the shore
unless home told you
to quicken your legs
leave your clothes behind
crawl through the desert
wade through the oceans
be hungry
forget pride
your survival is more important

no one leaves home until home is a sweaty voice in your ear
run away from me now
i don’t know what i’ve become
but i know that anywhere
is safer than here.


In the autumn the town where I live was preparing for an annual fair. I am sorry to admit that I feel great aversions towards fairs—such crowds and noises, and such a mess really. One day I walked to market and passed the center of town where a group of men were putting together a ferris wheel, and others were constructing awnings from wooden poles and metal sheets. Wooden tables already lined the streets stocked with small plastic bags of cookies, candies, and other confections.

I am always amazed at how quickly and diligently people will mobilize to prepare for their celebrations in a place where health clinics and hospitals only seldom have medicines, where education is poor and costly, and where families can go days without water before their town government intervenes. In my mind, I balk at how much these celebrations cost, adamant that it is irresponsible to waste precious resources on a fair, sapping resources that should go to healthcare, education, other more virtuous causes.

And I have noticed that here even the poorest households may keep beautiful flower gardens—flowers, not vegetables or fruits that you can consume or sell for money, and not the flowers sold in the markets. These are flowers whose only purpose is to be beautiful, to bring joy and delight. You will visit houses made of mud bricks with dirt floors, with flies everywhere, chickens running wild, empty bleach bottles holding their only source of water, collected from a local pump or polluted creek. But neatly planted in plastic containers or old pots are roses, red hibiscus, each carefully watered and pruned daily.


As Jack Gilbert writes:
We must risk delight. We can do without pleasure,
but not delight. Not enjoyment. We must have
the stubbornness to accept our gladness in the ruthless
furnace of this world. To make injustice the only
measure of our attention is to praise the Devil…

dios en los vacíos

In my dream I was sick, so my family took me to the local hospital, but it was the weekend, so there were no doctors there. The nurses told me that they had no medicines to help me. Suddenly the Virgin de Guadalupe appeared with her hair wrapped in cloth, but she also wore white pants and a white coat, just like doctors do. She came to my bedside and said, ‘Do not be afraid, you will be cured,’ and she injected medicine into my veins.


Thoughts on God, civil society, health NGOs, and chronic and terminal illnesses shared on Global Health Hub this week.

This essay was quite tailored to its audience: those who work in ‘Global Health.’ What I really wanted to say was also that those who work with fancy NGOs should not be so haughty towards these small community churches, those that play loud music and shout every other night in a small cement block building on the corner. Sure the fancy health NGOs have beautiful websites, funding sources, biomedicine but how do they touch the hearts of those they support? Do NGO staff ever consider going to pray with the patient and her prayer group from church? How can you really understand someone until you hear their whispered and desperate prayers? This is all to say, yes I am a bleeding heart, and no maybe I do not belong in ‘Global Health’ given my inefficiency and wastefulness. But how do you make real change? How do you start revolutions? You go to where the people are and meet them there, in their cinderblock meeting places, and you learn their hymns and hear their prayers.


María Gumez, age 23
Should never have gone with him.
But he took me and entered me,
And now I carry his child,
And I hear his voice everywhere
Though he is nowhere to be found.
I cannot sleep.

The nurse told me to be happy
Like the other women,
But all I can think of
Is how I would rather step in front of a car
Than carry this baby,
Than explain this to my family.
What will they think of me?
I am alone with no job, no money.
How can I raise a child?
How can I bear my shame?

Sara Gumez, age 54
When one of my sons was nine he fell into a well
And he died. For months after, I did not sleep.
My other son died in a car accident,
And I had a daughter who died when she was four.
We do not know why.
All this,
And María, my only living child,
Wants to end her pregnancy.

This is not a cat, this is not water.
This is a child, a person who could live.
In twelve months this child could be walking.
At just age three, María helped me make tortillas
And gathered wood in the hills with her papa.

My husband is dead, my two sons are dead, my daughter is dead.
Everyone in this world dies so easily,
But we are still here.
Quiere ganas vivir.



Yesterday you sat upright on your bed, a quilt on your lap,
Your hair wet, clean, neatly braided.
Evangelical radio floated through the room.
You pressed closed your eyelids like crescent moons,
lifted your chin as you struggled to hold on
To each oxygen molecule that passed through your nose.

You gazed towards the sky, towards mountains,
As if basking in a cool breeze we could not feel,
As if bathing in a warm glow we could not feel.
What world surrounded you in these moments?
Is that where you are now?

This morning I wandered in the hills to pick wildflowers.
I sat on a stone ledge to feel a cool breeze from higher peaks.
On a white petal, a tiny brown beetle struggled to hold on to the soft surface,
To not tumble to the dirt.

I gently nudged her onto my fingertip
And held her up to the breeze,
And she flew away.




to die in life is to become life.
the wind stops skirting you
and enters. all the roses, suddenly,
are blooming in your skull.





where was she going?
that day as she darted through ancient kapok trees,
as her toes danced upon moist soil,
and dark hair swirled like wild vapor,
bare thighs glistened,
wise eyes glowed.

what was she dreaming of?
before he confined her intuitive step to his iron compass,
captured her spirits in musty jars,
infected her warm body with icy semen and smallpox
as he hissed in her ear:

on that day
her smoky trances,
star songs,
beloved minerals
became metals to smelt in the minting mold
of that worm who had slithered across the sea,
come to calibrate her wonders to his old world desire.



tiny skeleton wrapped in a blue blanket.
through his translucent skin
i see rib and thigh bones,
his muscles and fat dissolved,
and flies on his eyelashes.

old man wastes in bed,
mind quiet forevermore.
i see bones through his sun-weathered skin,
and his tail bone covered by a bed sore.
The thin body of Christ hangs on a cross above.

bodies come apart
to be recycled, but
bones sleep like stones in the earth,
and spirits in the sky for eternity.

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