It would not be easy to forget Sister Lucía, the frail little nun whom I met in a strange and terrible place, the Manicomio de San Lazaro in Quito, Ecuador.
A Dostoevsky or at least a Dickens would be needed to do justice to the place. Bedlam Hospital in 18th-century London may be more famous, but it could have been no more terrifying than the government mental hospital for Ecuador. At the edge of Quito’s seamy red light district, it rises in baroque splendor, for the building originally served in the colonial period as the novitiate of the Society of Jesus. There is a towering chapel, far bigger than most churches, and grand stairways and numerous patios. The walls are thick and indestructible. But behind all the monumental architecture and the huge stone walls were hidden great pain, anguish and much sadness.
The enormous dusty paintings of early Jesuits that still hung above the stairways looked down on an elderly nun who moved painfully up the stairs and down the long cold corridors. There was no heat in the building; and since Quito is high in the Andes, the stone floors and walls are always cold and often damp. It was no surprise that Sister Lucía had contracted arthritis after 40 years of work in this place. The buildings are set against a mountainside, and to go from the office and central patio to the patio of the children requires climbing five or six long flights of stairs. Sister Lucía had been climbing those stairs for 40 years.
She left her native Colombia to begin work in Ecuador. For all those years she cared for the poor patients at San Lazaro, a woman of joy and peace in this world of disorder and madness. She was one of the 20 members of the Daughters of Charity of St. Vincent de Paul whom the government kept on as cheap labor to care for almost 800 patients. They were truly the pobrecitos, as Sister Lucía called them, “the poor little ones,” for the government allowed the Sisters only about 8 cents per day for the care of each patient. From this must come medicine, clothes and food. Even in Ecuador, where the cost of living is obviously very low by U.S. standards, this will not buy a patient more than some bread and rice and soup. Even a small piece of meat is a rare delicacy. When the government found itself in financial problems, the first to feel the economic pinch were the mentally ill, whose allotment fell to as little as four cents per day. Sister Lucía’s greatest pain did not come from her arthritis, the cold, the hard work or the grim surroundings. It was caused by the constant frustration of not being able to do more for her “poor little ones,” especially the children.
Many of the nurses who are trained in Ecuador leave the country to find better paying jobs elsewhere. And in any case, there is no program in psychiatric nursing that could provide the trained personnel needed at the Manicomio. Some good medical doctors are available in Quito, but could a psychiatrist or a clinical psychologist be found? Those trained in the United States or Europe seem to lose all desire to return to their fatherland, with its lower standard of living and primitive working conditions.
So men and boys suffering from all types of mental illness wandered aimlessly through the patio and ran under the cloisters, shouting and laughing. The “professor” shuffled up to recite long and elaborate odes in eloquent Spanish, in honor of anyone who happened to come by. A boy, barely covered by his tattered pants and ragged shirt, sobbed in a corner. A middle-aged fellow swayed in a weird dance in time to his own private music. Suddenly a gaunt little man dashed out from behind a pillar. He ran about screaming and cursing. His brown body showed through the holes in his pants; his shirt without buttons flapped about his tubercular chest. The others ignored his threats and hardly looked at him. A young man of about 20 sat on the cold stone floor and stared ahead of him at some personal vision. He never moved; he never spoke. His eyes were dark and empty.
From the cells for the more violent patients came the stench of urine and excrement. Through the peepholes in the heavy doors a man or woman could be seen huddled on a bit of straw in the semi-darkness of a cell. Many of these wretched patients, moaning or shouting in their agonies, would have benefited from the latest medicines. They would no longer have to be kept in confinement in an ancient and unhealthy dungeon. But in the Manicomio, who could buy such drugs, and who could prescribe and administer them?
The hospital pharmacy was neat and clean, but it was more of a pharmaceutical museum with its antique jars of herbs and specifics, its old mortars and pestles, than an efficient dispensary for today.
Sister Lucía organized a few women, wives of workers at the American embassy, who took an interest in the senile women patients. It came as a surprise to walk through the long bare dormitory, crowded with ancianas into the smaller ward where these few women had been working. Things had been painted and rearranged. There are some colorful curtains and prints on the wall. The brighter atmosphere seemed to be reflected in the old ladies, who were proud of their ward and alert to show off its treasures.
The Daughters of Charity, Sister Lucía’s religious congregation, do not take vows for life. St. Vincent de Paul insisted that they renew their promise to serve the poor each year. Therefore every year Sister had to consider again what she was doing and decide if she wanted to continue doing it. Each year she was quite free to leave the Manicomio and do something far easier. But she stayed.
She received no plaque or memorial, no testimonial dinner to honor her service, no praise for her life dedicated to the most abandoned of God’s children. It seemed enough that they loved her. And she loved them. When Sister Lucía appeared, they ran toward her laughing and dancing. She would embrace them and kiss them and bless them. She was a nurse, a companion, an advocate, a loving mother. She was a woman who cared.