It started right before Christmas 2010. Dr. Ann Messer was sitting in her home in West Lake Hills reading Oprah's O Magazine when she learned about Roadmonkey, a company that blends adventure tourism with service projects.
Right then Messer decided that instead of buying her children gifts they didn't need, she and her family would take a Roadmonkey trip to Nicaragua in 2011. Of course, Roadmonkey wasn't really set up with children in mind, but Messer decided to bring Reed, 17, Madeleine, 15, and Ben, 12, to work on a clean water project while exploring the jungles there.
Then the trip organizers found out that Messer and her husband, Tim Hines, were both doctors. The 13-day trip changed. They went deep into the mountains to communities where people would line up patiently to wait to see a doctor. Most of the problems she saw were things that vitamins or other simple medications could solve. "The reason for their illnesses was they had no medicine and no one to tell them how to use it," she says.
At every village they found people who were proud to show them their community. By night, they slept on the cement floor of a local school and went to bed early without any electricity to guide them. By day, they treated communities with 300 people lined up to see them. "It was a community event," she says.
"The kids didn't fuss at all, no complaining, no whining," she says. It was a stark difference from what her own kids experience at home. It made a lasting impact on her family, she says. "My kids still talk about that," she says.
It also had a lasting impact on Messer, 59. She realized that it wasn't enough to come to a village with medicine. A real impact could be made if she could teach the local community how to treat their health problems. "I loved it," she says. "I left with this idea that this is an addressable problem. There is something I can do here."
The Austin doctor created a nonprofit organization, One Good Turn, which Tito's Vodka recently chose as one of three organizations it featured in February as part of its Love, Tito's initiative that supports nonprofit organizations.
One Good Turn goes into underserved communities, using connections to nongovernmental organizations. After doing research into that community, Messer and volunteers who come with her bring the medications, vitamins and medical supplies the community is lacking, and, more importantly, Messer identifies members of the community she can teach how to treat that community's common ailments. This way the knowledge, the One Good Turn, develops into many good turns after Messer flies home to Austin.
"It's not an in and out clinic by any means," says Annie Albrecht, who worked with Messer in 2016 in Kenya while Albrecht was volunteering with Austin-based Well Aware. "She's aware that to improve the health of the community, it's an ongoing process."
One Good Turn's focus is on a pathway toward independence for the community. "You want to be able for them to be self-sustaining," Albrecht says.
While she brings as many medical supplies as she can, she also purchases as much as she can there to help the local economy and create a partnership.
Messer has worked in Peru, Haiti, Costa Rica, Kenya, Uganda, Cambodia, Jordan and on the Texas-Mexico border. At each place, she uses a translator as needed, but she also does research into what medical descriptive words that community uses. A medicine like Tylenol is not known as acetaminophen everywhere; instead it's called paracetamol. Where we might say, "I have constipation," they might say, "I have gastritis."
Ryan and Lori Patterson, who were also with Messer in Kenya for the Well Aware project, appreciate the way Messer remains calm. At one village, Patterson says he was "running around like a drill sergeant. She pulled me aside and said, 'I understand that you are trying to move things forward, but this is a chaotic situation and you need to stay very calm.'"
A very sick man from a rival tribe was brought in. He had a high, high fever from malaria that needed to be brought down, but, as this was going on, the clinic was surrounded by a mob of people. His people were yelling for her to fix him. People from the other tribe were angry he was there.
"She very calmly figured out how to bring his fever down," Ryan Patterson says.
She bathed him with rubbing alcohol to rapidly cool him. A clinician there, who was a member of the opposing tribe, offered to put in an IV. It was a huge gesture of respect, she says.
"Her level of compassion is not something you get from other doctors," Ryan Patterson says. "She's really inspiring to me."
"She's a good person, too," Lori Patterson says.
Wherever she goes, Messer does take precautions, always carrying her own bag of saline solution and IV tubing and medications in case she gets sick. She's also been known to pack up and leave if she doesn't feel safe.
She also does research into local customs and traditions to not offend. In most cultures, it's important for her to get a female and a male translator because women won't talk to men. Also, while she's employing a translator, she's teaching them important skills to bring back to their community and have a source of income for themselves.
In Cambodia, she's learned that a doctor is a person of importance to the village, but he might not have had any medical training before he was named the doctor of the community. He might not be receptive to receiving information from a woman doctor from the U.S. Instead, she looks around and often trains the nurse with new techniques. Then, once the nurse is trained, she suggests to the doctor that they need to test the nurse and he should watch to make sure she's doing it right. As she tests the nurse and talks through what she is doing, she is training the doctor.
She tells them, "I'm not here to tell them what to do," she says. She's just there to help.
In one community in Kenya, she figured out that the eye disease that they shared was being spread by a towel that they were all using to dry their hands and faces with at the local well. Lori Patterson remembers she told them, "This towel is dirty. Let the sun dry your face." "She saved them from being blind," Lori Patterson says.
At another community, she realized that they all had the same eye disease and that could be solved with oral medication, but their tradition was to put drops in their eyes. She offered saline drops in addition to the medication. She says she is combining their tradition while giving them new information instead of telling them that they are doing it wrong.
What she's learned is that often her own assumptions are wrong. There are stories behind why communities do what they do, and they make sense in context. "It's fascinating," she says.
In Kenya, she trained the staff at the school she worked with how to give deworming medicine as well as vitamin A to preserve sight. She also taught them about record-keeping. "Having her train on things like that has been huge for our staff," says Tony Mauldin, executive director of Change a Life Ministry and School in Kenya.
One Good Turn harkens back to Messer's initial idea when she was studying medicine that she would work in Alaska as a bush doctor. After college at the University of Wisconsin and then study at Rush Medical College in Chicago, she studied psychiatry and internal medicine at Harvard before completing a family practice residency at Brackenridge Hospital in Austin.
She always wanted to do fieldwork, and she was one of the first doctors at the Austin Convention Center when more than 7,000 people arrived after Hurricane Katrina in 2005. She got her first taste of volunteer fieldwork and setting up a medical clinic and triage system before the city's health system took over.
While One Good Turn is a full-time gig, it doesn't exactly pay. She still works part-time for Crossover Health, which operates an on-site clinic at Apple's offices.
Funding for One Good Turn seems to always happen when she needs it, she says. She runs into people in the Austin community and tells them what she's been doing and they help fund a project.
"I'm a believer in providence," she says.
This summer in Kenya, she'll get help from the World Dream Foundation and Change a Life.
Like funding, projects also have a way of finding her. There are a lot of places that she hears need help, but she picks her projects carefully. First she does a needs assessment to see what's already being done and who she can partner with. Recently she returned from Brownsville and Matamoros to see how she could help the people waiting on the bridge to come into the U.S. She's looking for information about what the medical needs are, what other medical organizations are there and what are they doing and if a partnership with them make sense.
There have been times she's figured out she wasn't really needed. Her daughter Madeleine while in high school led 11 of her friends in rebuilding a playground in Peru after it had been washed away. When Messer arrived with her gear to set up a clinic during their time there, she realized the local women shamans did a really good job. The community was healthy and wasn't interested in what she could bring them, which was fine with her. She ended up giving exams to the American nonprofit workers there.
Messer's goal is not to return year after year, but lately she's been returning to some of the projects at their invitation to expand the work and to collect data. She wants to know if the work she did in Kenya in 2017, which included deworming more than 1,200 people and treating anemia and typhoid as well as training the staff at the school to continue deworming treatments, has had a lasting effect. Is the staff continuing to treat the community, and is the community healthier?
"How do I judge the efficacy?" she asks.
She doesn't want One Good Turn to be like some models where American doctors and nurses come a couple of times a year to run a free clinic. For her, the focus is about training local community leaders to provide future care once they have been given a culturally sensitive education.
She's also providing those health workers access to employment in their community.
"They are desperate for knowledge," she says, and they know their community and want to get rid of illnesses. And they see "what we do here in America is have a good knowledge base. If we can get that out to communities that don't have internet, that don't know about the CDC (Centers for Disease Control and Prevention), we're golden."
She believes if she can collect data, then she can apply for more grants. She can also duplicate her efforts to set up projects and train more community health workers in more places. In the next 10 years, she would like to have the data collected and a concrete model of "here's what you do to make this work."
To help with that, she hired Albrecht to be a part-time administrator to help with social media and the website. Albrecht lives in Spain and teaches English while working part-time for One Good Turn.
"Ann is really something special," Albrecht says. "How she throws her whole heart and soul into this work is really inspiring. She just has this magnetic draw to her."
One of the things Albrecht is hoping to help Messer do is focus her energies away from the administrative, marketing and communications work that she can do for her and into growing One Good Turn. "It's been a bit of a relatively recent epiphany. How do we do this? How do we expand? What does it look like for hiring employees?"
Albrecht calls Messer "an idea person. So far, it has not led her wrong once."
Messer, she says, has a combination of big ideas and big dreams, but she also gets it done. Now it's about turning those ideas into something that could be replicated in different communities. She is creating a health care handbook that could be translated into different languages and distributed. Albrecht is setting up an online forum for Messer to share health care journal articles and information with doctors and health care workers around the world. It could be training project managers to do the work in the field.
"I really hope to see her making a big impact," Albrecht says. "We're in a period of growth right now, but it's an exciting time."
Even with the help and as One Good Turn grows, Messer knows she needs to be in the field working with communities. "It feels so good to get out there," she says. "If I haven't done a (project) for a few months, I get itchy. It's weird."
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