On a hot afternoon in Olanchito, Honduras, I walked back on the dusty streets from the edge of town after my last home visit for the day. I loved my SST service assignment teaching adults in a banana plantation town how to read and write. I would visit their homes several times a week for an hour or two of tutoring in Spanish.

One of the families had four students: Senora Alvarado and her three oldest daughters. The visit would last the entire afternoon, and I treasured our time together. Senora Alvarado lived in a very small, one-room cabin with her 13 children. We always had our lessons on one of the benches outside the house, as all the space inside was taken up with hammocks and cots. I had never been invited inside, but I could see those hammocks through the cotton curtain that covered the doorway.

Her cooking fire was outside, and every day she would prepare strong coffee for me from freshly roasted beans. It seemed that coffee beans and bananas were all they could afford. It didn’t occur to me until much later while in medical school that the explanation for the blond hair and protruding belly of her youngest child was malnutrition.