Deborah Proctor, MD, FACG, on
Founding a Non-Profit Organization

by Jill Gaidos, MD, FACG

Dr. Deborah Proctor & Dr. Jill Gaidos

I met Dr. Deborah Proctor at a GI conference in 2015 and remembered her excitement when she talked about her non-profit organization, Honduras Children’s Project. In researching for my talk on “Other Career Options” for the ACG Bridging the Leadership Gap in GI conference, I reached out to Dr. Proctor to find out more about the process of establishing a non-profit organization.

Jill Gaidos (JG): For those who don’t know you, you are a Professor of Medicine and Director of the Inflammatory Bowel Disease Program at Yale University. I don’t want to focus on that. I want to focus on your involvement with your volunteer work. Can you tell me how you got involved with volunteer work in Honduras?

Deborah Proctor (DP): When my husband and I first got married in 1991, we went to hear a talk in an Episcopal church. A minister came, raising money for an orphanage in a city in Honduras—the capital, Tegucigalpa. So, he really touched our hearts; we didn’t have any children at the time. We started sending some money down there to sponsor a child; it was $50 a month. About once or twice a year we would get a letter back from one of the kids at the orphanage. You know, a chatty letter saying what they were doing, going to school, and things like that. So, my interest was always kind of piqued in Honduras. We loved to travel and go places, but we have always had a connection to Honduras. Fast forward 15 years, to 2005. By that time, we had two boys of our own and we had moved from North Carolina to Yale, here at New Haven. I had met a lawyer who had underlying Von Willebrand disease and had developed hepatitis C and cirrhosis. His liver doctor asked me to do a colonoscopy on him and I did. I took off three tiny little polyps, Jill, and the guy bled for three weeks in the hospital.

JG: Oh no!

DP: It was one of these nightmares. This was back in 2005, so Endoclips were just coming out. His wife and his brother were dentists; since he was in the hospital for an extended period of time, they would come in to visit him. They were all local here in Connecticut. We got to chatting, we just all hit it off, even though I had this complication with this guy. We were just chatting about different stuff and the woman dentist said, “I go to Honduras every year for dental missionary work. Would you like to come sometime?” And I said, “Sure! I would love to come.” This was in February of 2005, and by October 2005, we are on a plane heading down to Honduras. Not to the place where the orphanage was in Tegucigalpa but on the other side of the country, to San Pedro Sula and El Progreso. I also convinced three medical students to come with me, we had a bunch of nurses, and I was the “Medical Team Leader”. I had never done this before. I didn’t speak any Spanish. So, we get down there, we get everything all set up, we are sitting down on Sunday night eating dinner. I have never had a panic attack before, but I basically had an anxiety attack. I went to her and said, “Mary, I can’t do this. I just can’t do this, and I want to go home.” And she sat me down and she said, “Debbie, you can go home if you want to, but if you stay here, just do the best that you can.” And that, 15 years ago, always rings in my head. I might not do as well as somebody else, but I can do the best that I can do. I strive to just do the best that I can. I am a big believer in just showing up; just show up and move along. I ended up staying, no surprise there. We ended up seeing like 1,100 patients in five days, which was an unbelievable zip-in-and-zip-out kind of thing, and it was the best experience that I’ve had in my whole entire life. It was with CURE International. So, the next year, I went again in October and that time I took my older son who, at the time, was 12. He came back and he said, “This is the most amazing trip I have ever been on.” We had so much fun together. And, two years later, I kept telling my husband, “Please come, please come. You’ll have a wonderful time.” He’s not a medical person, but he’s very handy.

I might not do as well as somebody else, but I can do the best that I can do. I strive to just do the best that I can. I am a big believer in just showing up; just show up and move along.

JG: (Laughs)

DP: He said, “What would I do if I went down there?” I said, “What do you mean what would you do? You would do anything! You would carry garbage, you check people in, you line people up.” So, I finally convinced him to come the fourth time I went, and he came with our younger son that time. He actually was the most popular person in the whole group because he kept the generators running, he kept the lights on, he strung the lights up. When we would go out, we would go out to these very small towns and we would bring all of our supplies with us. We had the dental chair. We had a dental arm and a medical arm. We had our medications. If there was some wound stuff, we would bring that. We would bring IV things with us. We would see somewhere between 1,100; 1,200; 1,500 patients in a week. I did that for a number of years. So, probably around 2008 or 2009, my kids started saying, “I want to go with you again.” But they didn’t want to go in October because they didn’t want to miss school. In the meantime, we had met up with an orphanage called COPPROME in El Progreso, which is an acronym for the comité al progreseno para la protección al menor. We had met up with this woman called Sister Teresita (Gonzalez) who ran the orphanage. She is the face of COPPROME. She basically gets the kids to come. She, honestly and truthfully, is the Mother Teresa of Honduras. She has actually gotten a huge award for all of the work she has done with the children in Honduras. She is one of those people that, I tell everybody, I just want to hang out with her because I feel better when I am hanging out with her. She is truly an angel. My friend Mary also falls into that category. I have told my kids, “If you want to do drugs, hang out with people who do drugs. If you want to do better than that, hang out with people who are better and smarter than you, because they will bring you up to their level.” These two women bring everyone up to their level, they are just absolutely amazing. We decided to go in the summer and thought we could do some work in the orphanage, get to know the kids. So, we would go down a couple of summers in a row and really had a lot of fun. We got to know them; there are about 50 kids in the orphanage 365 days out of the year, 24/7. We started meeting some of the kids coming in and some of the kids who had been there for a while. Basically, we just fell in love with them. They are amazingly good kids. About a third of them have no known family members and about two-thirds have known family members, but they are just too poor to take care of them; they are on the streets.

JG: At this point, are you and your family fluent in Spanish?

DP: Getting there. My two kids took Spanish in junior high and high school and they are both fluent in Spanish. I tell people I’m at about a fifth-grade level at this point. I can speak pretty good Spanish but I’m continuing to try to learn it. I had done the things with CURE International, but then I started realizing that what I really enjoy is the people interaction and knowing the people, knowing their names, and knowing who each of them are. And I wasn’t getting that when we were going down there and basically doing these one-and-done visits. The numbers sound amazing—1,100; 1,200; 1,500 people we would see—but it would be so fast, just as fast as you could possibly do. But, am I really helping these people? With there only being so many hours in a day, and only so many trips you can make down to Honduras, I decided to spend more of my time focusing on COPPROME.

I might not do as well as somebody else, but I can do the best that I can do. I strive to just do the best that I can. I am a big believer in just showing up; just show up and move along.

At that point, my kids said, “Let’s start a non-profit because then we can actually raise some money; let’s get these kids educated because, if you really want these kids to rise out of poverty, then they need to be educated.” So, they started the non-profit, Honduras Children’s Project in 2011. We started with a series of fundraisers and then focused down to three fundraisers. We have a spaghetti dinner in the spring, we have a golf tournament in the fall, and at the local fair in Connecticut, we have a stand and we sell chocolate-covered bacon. We actually make a fair amount of money doing that. The mission of the non-profit is to educate the children of COPPROME. It’s a very narrow mission and we did that specifically. We now have about a $50,000 annual budget. I pretty much run it. My kids still help; they are still interested. My younger son, we made a trip together and went down to Honduras in July for two weeks. I’m actually going in a couple of weeks to graduations. Let me back up for a second—After about a year of this, we started hiring people. Our model is to—I’m actually going to write a book about this at some point, Jill, because I think this is a very subtle point that other people miss when they go and try to help in other countries, they try to impose their own standards on the other people in a very paternalistic standpoint, and we see time and time again, that doesn’t work. I just provide the money and the support. We hire only Hondurans, and I let the administration at the orphanage do the hiring, and we just provide them with the tools, the CME equivalent. Three of our teachers are now taking English classes so they can learn to speak English better. So, we started off hiring teachers. The kids go to school in the morning. Some of them go to private school, but the majority go to public school, from seven in the morning until noon. They come back at 12:30 or 1:00 and have lunch, and then they are ready for the rest of the afternoon. The problem was, in Honduras, they have 40 kids in a class, that’s the law. Particularly with first, second, and third graders, how can somebody possibly teach 40 children in a class? Then they would come home, and they would have nobody. Do you have kids, Jill?

JG: I do, I have two.

DP: So, you know, half of what kids learn is what you teach them at home. You go over their homework with them, you go over their projects with them. These kids didn’t have anyone to do that with them. So, we provided somebody to help them with that. We put extra teachers into the public school, so they keep going to the public school, and they have a curriculum that they go by. Then, the kids come home, and we have teachers onsite at the orphanage. So, they would come back and have four hours of instruction in the afternoon with the teachers. So, we have 10 staff members. Six of them are full-time and four of them work 20 hours per week. We have several kids who have graduated up and they wanted to go to college. So, we will pay for their college, but they have to work 20 hours at COPPROME on a weekly basis.

JG: That’s a great idea.

DP: It didn’t go over so well in the beginning. The first girl we did this with was a teenage girl and you would think I was torturing her or something.

JG: (laughs)

DP: “Ugh, I don’t want to do this. So-and-so doesn’t have to do this.” Her friend, who was also from the orphanage, was also going to college and had another sponsor from another organization who was paying for everything. Well, sadly, that girl ended up getting pregnant and she had to drop out of school. My girl, who I insisted on coming back to COPPROME, is now two years into her schooling and is doing great. I tell them they have to come back. Imagine that you are 18 years old, very pretty, and do not have a parent to tell you what to do and what not to do. It’s sort of a recipe for disaster.

JG: Exactly! That’s true.

DP: Socially, economically, getting up in time, everything. So, by coming back to COPPROME, this was the closest thing to family that these kids would ever know. They have these women, mostly women, who have their best interest, their eyes on you. “What were you doing last night? How is your homework coming? Why did you get a five on your math exam?” And, they are on them all the time, which, in my opinion, is a good thing. So, we have a series of these kids that we support, and they come back, and they work with the kids. The whole mentoring/mentee thing. I tell them, “Look, you have a job now. When you finish college, you are going to be able to say that you had a job, you have work experience and all the things that go with that.” So, that is where we are right now. The school year was from February to November. I’m going down in the beginning of December because we have four kids who are graduating from various levels of school. One of the girls who is graduating from high school is going to go to medical school. In Honduras, you start medical school when you are 18. So, we are really excited about that. We are going to continue to support her.

So, that is kind of my story. I don’t take any salary from the non-profit. This is not an alternative career.

JG: It absolutely helps with work-life balance when you have another focus, another purpose. It feels like extra work, but when you are getting something out of it, then it’s not work anymore. This is contributing to your life, and your children’s lives, and all of the lives of these kids in Honduras.

DP: It gives me a tremendous amount of pleasure, above and beyond any monetary amount I could get out of it. I also think it makes me a more empathetic person and I can understand. The other thing, the indirect benefit, was when I was 50; I decided I really needed to learn how to speak Spanish. So, I started taking Spanish lessons. I do anything I can—I look at Spanish TV, I listen to Spanish music, I read Spanish books, I talk to my friends in Spanish, I do anything I can to improve my Spanish. What it did—Jill, as you go through menopause, you have trouble with word-finding and you forget things. All women complain about this. In the beginning, I had a very limited vocabulary. So, when I wanted to say something, I had to go through my head, “Well, I don’t know how to say that word,” so then I would have to redo the sentence in my head and come up with some words that I knew in Spanish. So, by constantly doing that, I had far less trouble with word-finding than any of my friends who were going through the same issues that I was. I think that’s kind of cool. It’s a totally separate part of your brain that you’re working. Everybody talks about how to keep your brain going. Honestly, I love what I do, inflammatory bowel disease and procedures, but I do it so often and I’ve done so many of them that it doesn’t really exercise your brain anymore. It’s a rote thing that you do. Every once in a while, a very unusual patient comes along, but they are few and far between for me these days.

It gives me a tremendous amount of pleasure, above and beyond any monetary amount I could get out of it. I also think it makes me a more empathetic person and I can understand.

JG: Going back, you said it was your sons’ idea to start the non-profit in 2011. How old where they then?

DP: They were 16 and 14 at the time. I was the treasurer at the time because, to form a non-profit, you have to first get the IRS to agree to it and then you get the state to agree to it. The IRS and the state of Connecticut, neither of them ask you how old you are when you are forming a business because basically, you are forming a business. I think that goes to age discrimination; there are laws that the federal government can’t ask you how old you are. But, when we went to the bank to open an account so we could put money into this, the bank cares how old you are.

JG: (Laughing) That’s true.

DP: And they weren’t going to let a 16- and 14-year-old open an account (laughing) just because the government said they were a business. So, that is where mom came in. We have all been doing it together. My husband, of course, he helps out too. We have a whole Board. I managed to get two of my friends to be on the Board with me. I haven’t done anything medical in, probably, five or six years at this point. When I go down there, I see the kids, I take care of the kids, anything that needs to be done. I have several physician friends in Honduras that I go and visit, and we talk, and I help them out, but I don’t go down there to do any official medical things, which is fine with me; I’m happy doing that.

JG: Sometimes you need a break from your routine.

DP: Absolutely.

JG: What are your responsibilities in your role on the Board of Directors for the Honduras Children’s Project?

DP: I run the Board. I basically am the president of the organization at this point. I run the Board, I run the three fundraisers, I deposit all the money, I send the money to Honduras on a monthly basis, which is interesting in and of itself–how to send money to another country. I fill out all the forms. I do the admissions, sales, and sales tax on a monthly basis for the state of Connecticut and annually for the IRS, the 990-N form for a non-profit. I do all the paperwork. This year, I will have made four trips to Honduras. I go somewhere between three to four times per year. So, notwithstanding those times that I go down there, I estimate somewhere between 300-400 hours annually. Probably 10 hours, 10 weeks out of the year. It’s not all lumped together. It’s two hours here, four hours on a Saturday. As you have noticed, this is something I really like to do, so I don’t really look at it as work. I guess you have to be willing and able to spend a significant amount of time, but you don’t have to spend that much time. At this point, I have done this so many times. I have done 10 spaghetti dinners, 10 golf tournaments, I have everything on my computer, I can just change the date and send the letters out again. Starting it and getting things running was quite an adventure.

JG: I have read that there are a specific number of required Board members and certain roles for the Board of Directors. How did you figure all of that out?

DP: We started with a president and a treasurer, the necessary numbers. And then we initially thought we were going to have five members and we picked them. Some were my kids’ friends because some of their friends had come down to Honduras with us and wanted to get more involved, so we put them on the Board so they could come to the meetings and get involved with the decisions. They have sort of faded with time because they have gone to college. My kids are actually graduates from college now, so they have moved on to other things, their friends have moved on to other things. So, then I started putting my friends on the Board, that would actually help out. Now I have two of my friends on the Board, so there are six of us. My other son made himself a senior consultant. That’s kind of funny.

JG: Are there any difficulties juggling your clinical workload at Yale with your trips to Honduras? Has there been any push back or difficulties with that?

DP: Yeah, there is. Because, you know, they tell you that you are only supposed to take a certain amount of time off each year and I have managed to convince people that this is more along the lines of work than it is CME or vacation. I get a little push back on that, but I am also like, “This is who I am. This is involving education and if you really want to disrupt who I feel that I am and what I do, then you can tell me I can’t go anymore. But, other than that, you can get out of my face.” To answer your question, Jill, I think it’s more along the lines of, if you want to do something outside your day job, you have to be pretty clear about what you want to do and what you are willing to give up to do that. I have to say, my bosses—my section chiefs—have actually been pretty good about it. Every once in awhile, I get a little bit of grumblings about it, but not too much. Most of the time people are pretty good about it.

If you want to do something outside your day job, you have to be pretty clear about what you want to do and what you are willing to give up to do that.

JG: That’s good to hear. I read that on one of your previous medical trips to Honduras, you performed endoscopies. Was there any special credentialing or legal requirements that you needed prior to doing that?

DP: I was kind of wondering that myself when I agreed to do it. First of all, they had the equipment where you look through the scope, as opposed to looking on the screen, definitely 25-years-ago kind of equipment, very rudimentary. I was also worried about how they were going to clean it, but they did a really good job of cleaning it. I had someone who gave some drugs. I asked for fentanyl and Versed® and they gave those drugs, so the patients were a little bit sedated. In Honduras, all I had to do was have an active medical license and evidence of malpractice [insurance] here in Connecticut, at Yale. So, I verified that with our malpractice carrier we have. No one is going to sue you in Honduras, so it was kind of a non-starter. That was pretty much all I had to do. For CURE, they pretty much took care of everything themselves. I just needed a valid license. My friend who invited me down to do the endoscopies sent my paperwork to their equivalent of the medical board in Honduras and came back and said, “you’re all set.” It’s not like coming here to the United States. If someone wanted to come here to do something, to practice medicine, that would probably be a nine-year process. They would have huge hoops to jump through. The reciprocity of that is not the same.

JG: It was great talking with you. Thank you so much for your time.