Josef Wolf Burwell, PA-C
Origin Story: Every living thing has its unique history, and Peacework Medical is a dynamic, living creature. It goes through growth spurts, fallow times, and it can be moody. But Peacework Medical has always, ultimately, found its way nurtured by its village: the volunteers.
The way this all began, and changed not just my life but the lives and health of tens of thousands of patients and volunteers over two decades, was with a simple proposal.
I was in Na Trang, Viet Nam in January 2000 with the Executive Director of Peacework International, Steve Darr. Peacework International (now known as simply Peacework) is a non profit based in Blacksburg, VA. I had known Steve from spending years at VA Tech, where I completed graduate school in the 1980’s.
Along with a group he had assembled, we were doing cultural and social projects with the veterans of the U.S. war in that naturally stunning beachfront location. But as often happens when people assemble, there were minor illness and accidents. As a PA, I was spontaneously compelled to treat these. I would dash to the local pharmacy in town and return with what was needed for treatment.
After a few episodes, I asked Steve if he thought I could travel with his teams in the future as a medical volunteer. With little hesitation, he responded that I could, instead, convene and take entire medical teams to where there was need. And there was need almost everywhere.
And this, my friends, is why Peacework Medical and Peacework are two different names, but inextricable linked by the same 501(c) 3 EIN. We are, in fact, the same organization separated across the U.S. continent physically, Blacksburg and Phoenix, while serving the globe collectively with very different humanitarian missions.
Our First Project: I spent the next year planning, organizing, and getting the most adventurous of my friends and colleagues on board. Honduras was still devastated from its protracted recovery from Hurricane Mitch. So, I went there for a reconnaissance trip. I traveled around in an aged Toyota Corolla with a Mennonite pastor at the wheel to potential places for Peacework Medical to launch. I’m still in awe at what a Corolla with nothing but front wheel drive and a skilled driver can do on roads with missing bridges and rock slides. I do not travel well by car.
He introduced me to many places and people, but it was a string of tiny villages, held captive against the San Francisco River by steep mountains, that impressed me deeply. Nearly every family had suffered drownings during Mitch, and all been victimized by mudslides to sink them well below their baseline poverty. Villagers walked as if in a daze, many wearing the same clothes as the days of the flooding. Hogs, the few that were left, were emaciated, with their ribs and hip bones poking through their skin. The government clinic had been abandoned, and it had a thick layer of dried mud covering the floor of its four rooms. This was a perfect site for us.
Nine trusting, hearty individuals joined me in March 2001 for the inaugural Peacework Medical project in northern Honduras. These were my ER colleagues from Maryvale Hospital ER, as well as other ERs around Phoenix. It was funded by an anonymous $1500 donation for medications that we would distribute: primary care basics with an emphasis on antibiotics, plus every child was given anti-helmintics for worms. We camped in a school there, which had outhouses. The outhouses had a hybrid spider/scorpion with watchful eyes. We called him “Snuffy”, and no one was bold enough to take a swing because he looked like a jumper. Showers were rigged with water flowing from the nearby river. Oh, and Snuffy’s family. Local ladies cooked our meals. If you have never had fresh thrown hot tortillas when you’re truly hungry…
On the second day of clinic, seeing 300 patients per day, we delivered a healthy baby boy. It was also, metaphorically, our entry into the world. To our North American surprise, but no one else’s, the new mom climbed onto a burro within 45 minutes post partum and trotted back into the mountains, her husband smiling broadly at the reins. I extended the metaphor to not rest on our laurels, but the real work was just beginning.
Moving On: After 8 years of projects in these 22 villages in northern Honduras, that area we had grown so attached to had stabilized. Village leaders had better access to regional governmental resources. It was time for Peacework Medical to find other needs, adventures and projects.
A project in southern Honduras was started, and Jeff and Shelley Vaughn took this on with great success for many years. They not only brought first rate primary care to an area when many were fearful of even traveling to Tegucigalpa, but they also created a legion of humanitarians in eastern Arizona.
Jeffrey R. Vaughn: We lost Jeff to cancer in 2018 at age 47. I knew Jeff since 1996, from the first moment I clocked in as an AZ PA. He was my very first rural paramedic; one that was expertly well qualified, and spoiled me with his intelligence, wit, and a unique ability to make me look good as a clinician. He was my orientation counselor to all things that was eastern, remote, austere Arizona. Rattlesnake bites. Crushed by horse. Toxic copper mining synthesis leaks (for which we had cyanide kits). Scorpion stings. Sand rail mishap. He was also a gourmet cook, but his EMS pager would go off and others would be left to complete the complex meal. That’s what it feels like happened with him gone.
When I first met Jeff I was naïve enough to believe that a lot of people put service to others first, and he was just a regular guy. My world was smaller. By the time we lost him, I came to realize that few dedicate their entire lives to others, and rarely at the cost of their own comfort and pleasure. He was an exception to the norm, and in fact, he spent his entire life posing as a regular guy who was anything but that. Understated, unfailing, outrageously idealistic compassion that caused others to take his lead and fall behind him. Mentorship matters, because you do have to leave bread crumbs. He leaves a memory in me that begins in Morenci and ends with the type of sadness that makes you feel physically weakened. He leaves an incredible clinician Shelley, whose heart and courage is immeasurable. And for the people who never met him; he leaves an absence they will never know, but he would have helped them along if they needed him- anything from a good risotto recipe to a well established airway.
Other Countries: I went next door to Belize from Honduras for several teams, then briefly to Guyana, S.A. We lingered awhile in Ghana, W. Africa. We were in Cambodia for three team clinics. These were projects that were meaningful in their own way, and for different reasons, we were there only 1-3 years total each.
Haiti: On January 12, 2010, a devastating earthquake struck near the Haitian capital of Port au Prince. Thousands were immediately killed, and for a short while, the world was transfixed on the very real suffering.
But the aftermath would prove to be a health challenge beyond a metric of reasonable scale. Tens of thousands fled the overpopulated capital to the vulnerable villages. It was an epidemiological time bomb.
Peacework Medical took a team to Haiti 16 weeks after the original emergency. It was May, 2010. We purposely set up in a smaller town far from Port au Prince, and saw thousands of people who, while unhealthy, were not yet plagued with any worst case scenario of endemic or epidemic disease. Mostly we treated typical aches, pains, and anxiety.
Cholera, a water born bacterial disease that can be fatal, was first found in the villages in October 2010. I received an urgent phone call in Phoenix that “people are dying”.
Indeed they were. Cholera drains the victim of their body fluid by vomiting and diarrhea. It’s a vicious, horrible way to die. And it’s extremely contagious by touch of the expelled body fluids, especially when a person is already vulnerable from a lifetime of poor nutrition and or other untreated pathology. Individuals were dying daily, so much so that the coroner was overwhelmed and healthy men were being asked to build wooden caskets.
I went to help almost immediately; there was no time to assemble a team. Simple antibiotics would reverse the course of the disease, if given in time. An isolation tent had been constructed by Medecins Sans Frontiers, who then departed. I arrived with 5000 Doxycycline tablets. Three tablets would be sufficient to reverse the course of the disease, if a person could still swallow and not vomit.
The long term goal for Peacework Medical was three fold:
1.) health education about contact with body fluid; and 2.) clean water. 3.) build a clinic and train Haitian clinicians
1. Peacework Medical teams spent the next five years in this rural area in Haiti ostensibly providing primary care. But what we were really doing was gathering people for health education lectures about hand washing under the many circumstances that clean hands will keep you healthy
2. And importantly, we financed 30 water purification tanks in the region, constructed by local men. These tanks hold the water that come from the mountain springs, and it’s where everyone gets their daily water from – 10,000 people and 4X that many jugs of water.
3. We built a clinic through generous donations and a lot of local hard work. We sent nurses to get their advanced practitioner degrees in Cap Haitian and return to run the clinic. One actually did.
Cholera goes dormant when there is no storm activity. But Haiti gets storms; the island it shares with Dominican Republic geographically protrudes into the Atlantic ocean as well as the Caribbean, and it catches weather. When it rains hard, cholera bubbles up into the mountain streams, and these water tanks can then be shut off and purified with simple chlorine bleach.
There needed to be a physical place to receive patients, while we were there, and long after. After all, our mission in foreign countries of need was always to not just make it better, but to make it work better.
Colten Smith: This is where Colten came in. Colten had started volunteering in 2011 in Haiti, with his new paramedic skills. He was good. And a good photographer too. But remarkably, he showed passion for the region that went beyond the basic skill set. In 2014 he shepherded the construction of the clinic there while waiting for PA School to begin. He’s now our Co-Director in Arizona, and he, and we shuffle responsibilities between us as needed. AKA Colten Smith, PA-C since 2015.
Since building the tanks, there has been no incidence of cholera in the region. We could not have done this without the tremendous generosity of one single community in Winston-Salem, N.C: Brookberry Farm. They literally funded these tanks and education and teams over the years with amazing parties, led my own sister Nita Saylor and her Bridge, yoga, and church friends. Our eternal gratitude as well as the people of Ranquitte Region, Northern Haiti.
Upon departing Haiti, we turned partnership and stewardship with Haitians of the tanks to “One Hundred for Haiti”, a non profit in Seattle, WA. This non profit is directed by a former Peacework Medical volunteer who had joined us in that region, Greg Bennick.
Present: In September, 2015 we moved “home” to Phoenix. Trans Queer Pueblo, a Latinx social justice organization, described the abuses suffered by transgender women of color at the hands of ICE when in detention. This was an affront to all this Peacework Medical believes, and it offends our collective humanitarian spirit. So, we moved home to try to help. The other parts of this website explain how being in Phoenix has taken root. History is, after all, an ongoing process.
Colten at Triage, Haiti 2011
Haiti Cholera Health Education 2010
Typical home outside of Ranquitte, Haiti
Clean water near Ranquitte, Haiti