Traveling
Bright and early we arise to a breakfast of sweetbreads, fruit, juice and coffee. Once everyone has completed their morning routine, we load everything on the two buses. Totes of medicine strapped down on the top and luggage on the inside, we head out at 6:00 for a 2.5 hour ride to Sebaco .
According to these roadside signs, they have apparently put this road right through the middle of a giant herpatarium. This looks more like a food chain to me. Can these creatures actually all live in the same place? And by the way, what the heck is that first thing? It looks like a fat little german shepherd puppy.
Sebaco is in the Matagalpa region which is mountainous with few (read: “one”) good roads. The direct route from Leon to Sebaco is so bad our drivers have elected to go almost to Managua, and then pick up the better road. (here’s a map.)
Every mile or so of every road in Nicaragua contains at least one tire repair shop. “Shop” may be misleading. Often it is just a kiosk or shed with no machinery other than a compressor. The tire is removed and replaced by hand – even large truck tires. Outside every one of these shops is a large tire, painted white, perhaps mounted on a post, on the building or just sitting inside another tire by the road, with the word “vulcanizacion” painted on it in a circle.
Of this I am certain; the chemical action of vulcanization does not take place in these little sheds. No one seems to know why they don’t just write “reparacion” or “reparación del neumático” (tire repair). Anyway, everyone knows what they are and we needed one after about 2 hours of driving – a flat.
We back up 30 yards to a repair shop, everyone gets out and they go to work. The little shop is right next door to a small fruit stand manned by two sleepy gentlemen. One had on a t-shirt stretched tightly over his generous belly which read “My Next Husband Will Be Normal”. I don’t care who you are…that’s funny.
Back on the road, it’s not long before we pull up to the church in Sebaco where we will set up the clinic. There is an orderly crowd out front, people smiling and greeting us as we load in medicines, supplies and equipment. It doesn’t take long and we are seeing our first patients.
Eso Es Justo Cómo Rodamos (That’s Just How We Roll)
The church is one large room, very clean with shiny ceramic tile floors, concrete block walls and a tin roof. The exam rooms are divided out with colorful sheets and tablecloths. There are iron bars in intricate designs over each window and the doors. Outside the back door is an outhouse and a garden that runs the length of the building.
As people approach the building there is a table set up for registration. Workers from our host church write down name, age, weight, complaints, etc., on a sheet of paper that will follow them all the way through the clinic. The doctors will use it to write in the prescription, make referrals to physical therapy or the eye clinic and any follow up notes. After registration, people are directed next door to wait for the triage nurse and hear the gospel message while they are waiting.
Next, the patient enters the building and the triage nurse, Jeannie Guerin, takes blood pressure and pulse. By the end of the week Jeanie will have seen every patient in the clinics. She speaks no Spanish, but she thoroughly entertains everyone as they wait. She performed this critical component 100% by herself the entire week.
Next stop is the doctor. Cindy Lewis, Janie Witten, Arlene Dupont and Mariella Sanchez (a Nicaraguan doctor). All have done this before, know what to expect, know what we have in the pharmacy, and start work immediately.
Everything we do in the clinic is designed to serve the doctors. We try to make sure they have everything they need. People ask all the time what they could do on a medical team. We need probably 4 helpers to every doctor or nurse to run the clinic efficiently. Registration, triage, pharmacy, traffic directors, evangelists, people to run errands, pack and unpack. There is more than enough work for everyone.
After the exam, the doctor will write a prescription and may refer a patient to one of our other areas. We are fortunate to have on this trip an optometrist and 2 physical therapists.
Scott Denison, our optometrist, is seeing patients in the front of the building on the stage. He tests eyes with the help of Herman, his interpreter. From there, the patient will step over to Ryan Denison (Scott’s son) and his friend Jessica Anderson who look at the prescription and try to match it up with a pair of glasses which have already been labeled. Scott has brought over 300 pairs of glasses and when packing at the house, he found another 200 or so pairs left by a group from a previous mission trip.
If the referral is for physical therapy, the patient will see Donna Cole and Amanda Fife who have set up their clinic near the entry to the doctor’s area. Donna owns “Healing Hands Physical Therapy” and Amanda is an employee. On the drive in, we passed a man selling “mattresses”. They are so thin, I would almost call them mattress pads. Anyway, Donna purchased a couple for her treatment area so patients do not have to lie on the floor directly while being treated.
After the referrals, the next and last stop is the pharmacy. There is an enormous amount of work that goes into the distribution of these medicines. Once they arrive in Louisville, we get together, unpack them, combine them into as few bottles or boxes as possible discarding any extraneous packaging, and then divide them into totes, distributing them by weight. Once in Nicaragua, we divide them up by type, then in the clinic, we package them for prescriptions. As the pharmacy workers get the prescriptions, they fill out the instruction labels, then an interpreter gives verbal instructions to the patient.
David Hashman and Jim Lyon start out packaging medicines while Stacey Stewart and Rex Brace fill prescriptions. When they are ready, Susan Strange (who speaks Spanish very well) gives instructions to the patients along with the package of medicines.
The whole operation looks like an American diner in the 50’s. The cacophony and activity level all around require some extra effort to be heard when a prescription is ready. As if Rex needed any additional encouragement to be loud, he came up with what is now our standard “your order is ready” notification; “ORDER UP!”. Even the Nicaraguans, having not a clue as to the meaning or context of this expression, can be heard yelling “AUDERU!”. I watched Rex try to explain it to one of them one day. After about 20 minutes he gave up claiming success, but the next time, Julio still said “AUDERU!”.
Day One
The entire day was a model of efficiency. There were never more than 10 or 12 people waiting for a doctor at any time, 2 people waiting in the pharmacy and for glasses. Physical therapy was recruiting customers. The children waited patiently on their parents laps and said “gracias” when we gave them candy. We didn’t even need fans. The temperature was perfect, even a light breeze blowing through the building.
We only saw about 120 patients all day. We closed the doors at 4:00 PM and finished the last patient before 5:00. The only incident for the day was another flat when Terry Dupont tried to drive to Managua to get our other totes from the airport.
We set out traveling further north about an hour and a half and pulled into to Esteli where we had a home-cooked meal at a pastor’s home, then checked into or rooms at the “Panorama 1 y 2” hotel. “1” had been completed back in the 70’s it looked like and “2” was just barely started although the sign that said “1 and 2” was at least 15 years old. Planning? More like wishful thinking. Nobody was working on the expansion while we were there.
The hotel had a computer with internet connection in the lobby. More importantly, there was an internet cafe just a block away with international calling. We were able to call home for about $.06 a minute! Internet use was less than that! Most of us called or wrote home, bought a coca or coca light, chatted in the lobby and headed off to bed. This was shaping up like a vacation without the little umbrellas or hair braiding. But not for long.
Day Two
We arrive at the church…is this the same church??!! People are crowded out into the street. kids are pushing people and the door is guarded and locked. We have to push through the crowd to get in and prepare. There are as many people at the door right now at 8:00 AM as there were all day yesterday. The faces are not as inviting. There is a look of underlying desperation; like a fear that they may not get in.
On this day we set up 30 or 40 chairs in the waiting area and they were never empty. The line for glasses extended out the side door at times and some people actually got a little beligerent about keeping their place in line.
Here’s how crazy it was: An elderly lady was carried into the clinic by her daughter. We then carried her from place to place within the clinic; physical therapy, eye doctor and pharmacy. When it was time to go home I picked her up and carried her out (she lived nearby). As I got into the street, some 12 year old Jesse James who had seen me giving out candy, stuck his hand in my pocket and grabbed the candy from it along with about 40 cords. I don’t think he was after the money - that was just a bonus. I didn’t think I could catch them while carrying the old woman, so I gently laid….no I didn’t. I couldn’t have caught him anyway.
In this picture everyone is having a hearty laugh at my expense. Maybe the old woman was part of the scam and they will split the take later on. (It was, after all, soft candy)
The medical problems were more severe as well. The doctors treated several wounds that had become infected due to neglect with at least one close to requiring an amputation of the foot. Cindy was giving people shots in every part of the body you could imagine. I had to peek before walking in her exam room for fear of passing out while someone was getting a shot in the neck.
I had a lovely 4 hour bus ride to pick up our errant luggage in Managua with Roberto, our driver, who doesn’t speak english… I don’t speak spanish…sure was pretty scenery…both ways. You always see intersting things on the road in Nicaragua…
Anyway, we picked up 3 of the 4 lost totes. The last one is still lost to this day - someone, somewhere has a lifetime supply of laxatives and sterile syringes…that’ll come in handy.
Day Three
On Wednesday, we travel further north into the mountains, to a small border town called Somoto.
We find the church larger and perfect for a clinic of this type. Everyone has plenty of room and the patients are not all crowded into one room while waiting.
Everyone knows the drill by now and we can get up and running very quickly. There is simply not enough room here to tell of all the needs that were met, the divine appointments that were kept and how the extraordinary came to be expected.
By now it was apparent to me that everyone on this team knew they were truly on a mission - not a mission trip as we think of it in our church life, but a MISSION - a purpose and a work to be accomplished. Each person owned their peice of it and carried it out with verve and passion. The doctors stopped to pray with people, the interpreters asked medical questions on their own, even patients who spoke some english jumped in to help. The physical therapists didn’t wait for referals and began to recruit people from the waiting room to be blessed with their healing touch.
A lady came to the clinic today with one of her children; a baby. She said she was pregnant with her 4th child and that when her husband (or maybe live-in boyfriend) found out, he left her with nothing. She said they had not eaten for a few days and an examination of the baby appeared to support this. Some folks from the clinic went to the store and bought 2 weeks worth of food. Susan Strange then went with the family and the pastor to deliver the food. She found the woman’s home no bigger than a king size bed, a single thin mattress on the floor, a fire pit outside for cooking and 3 eggs in the house. The pastor will follow up with her to get some help.
Unfortunately, it is very neccessary to control access to the clinic. Once the word is out, people come from near and far for treatment, to try to get a prescription filled, for eyeglasses, etc. Church members work each day at the gate to take the vouchers previously handed out to people in the community. There is no way to see everyone and every day the doors will close with people still in line.
Day Four
Our last day for clinics. By the end of today the eyeglasses are all gone. Many medicines are depleted and everyone is willing to stay until the last patient is seen which puts us on the road back to our hotel and dinner no earlier than 7:00 PM. No one is complaining though.
After dinner, as usual, is our share time. Observations of the day, personal epiphanies, funny stories. I wish you could have heard how people were impacted by their participation in this mission and I hope you will get a chance to ask some of them.
We end our day saying goodbye to Arlene and Terry Dupont, our interpreters Yorleni, David, Herman and Oscar and to Julio. Roberto, our driver, and Jessica (the little Nicaraguan) will stay with us tomorrow for our sightseeing and shopping. Tonight we pack up and make ready to move out early - it will be a VERY long day.
At least 4 missionaries from this trip plan to return in September for a mission trip to Honduras where we will be working on a building project; either building onto an orphanage or building a basketball court at a police station for the sports ministry.
Why don’t you consider going with us? Hit the contact button at the top of the page and send me an email for more information.
