November 2004

This brigade included only three persons. It was established as an elective part of medical school. Brooke Nida is a senior student who decided to use her elective time in this manner. She invited Stella Bass to accompany us and work as support staff. Traveling with three people is less complicated but loading adequate medication is challenging. We used four bags for medications. Brooke and Stella then packed their personal things together. With this technique we were able to haul sufficient medication. We even had a few bottles of pills left over on completion of the visit.

We arrived just after dark and were checked into La Posadita de Bolonia in time for a good night’s sleep. The staff of Bolonia are like close friends now. They really go out of their way to see that we are comfortable. There is a feeling of security throughout the stay. The food is okay, and the air conditioning works fairly well.

We had already arranged to have ancillary medications on hand, so we were ready to leave early the next day. We were in Mina de Limon about 11:00 and seeing patients a few minutes later. The clinic is still pretty hot but fans kept us relatively comfortable. With two doctors working we were able to give service to 280 patients the first day. I don’t remember too much because the pace was frenetic. Most of the patients had the usual panoply of complaints. Parasites, reflux esophagitis, and arthritis are essentially universal. There are also a lot of urinary tract infections. Since we provide only urgent care, the patients with diabetes and hypertension go to a local health center.

The second day at Mina Limon we only treated 120 patients, so it was slower and much more fun. We had a small amount of time to visit with the people and analyze the general health there to a better degree.

Plans were discussed in regard to completion of the clinic building. This story continues to be developed as we go along. There are two women who spend a fair amount of time trying to improve the health of this community. They both live in Leon and commute occasionally to assist in this process. There is no local group to carry on with this process between visits. One of our goals is to fully modernize the clinic and maintain continuity in some manner. Even though Mina de Limon is pretty close to both Leon and Chinandega, there is a separation because of the very poor roads. There is 55 minutes of slow, rocky, bumpy, and dusty roads after we leave the pavement. There is bus service at very low cost, but it still uses up a lot of time for clinic visits. At this time a doctor and nurse ride the bus to the clinic one day each week.

After two days in Mina Limon the hotel in Managua was welcome. We spent Friday after Thanksgiving at La Esperanza, a women’s prison in Managua. We treated 200 women at the prison and were pretty tired when we finally were back at the hotel. Saturday we loafed. Site seeing at the volcano, the shopping mall, and the military park in the hills above Managua felt really lazy but very welcome.

Sunday we headed south and went to a community that I had never seen. It is beautiful, and the people seemed different. They were older than we usually see. There were several faces over 90 and one over 100. The woman who cooked our lunch is 97.

The lunch was great. We had grilled chicken legs that were perfectly spiced and so tender that they melted in the mouth. The soup was tasty with just a few bits of chicken here and there among the vegetables of the area. Carrots, onions, beets, and squash were mixed with green bananas and cactus to make a wonderful tasting and very healthy soup.

We treated about 140 patients that day. I would like very much to return to that community and renew the wonderful atmosphere. The clinic was held in an elementary school, so the tables and chairs were quite small. We stacked two tables to achieve a reasonable working height, but the chairs were quite small.

Monday we went to Masatepe. The minister of health had requested this clinic so we were anticipating a lot of really sick children, but it did not happen. There were doctors who worked there on a regular basis. They were accompanied by two nurses who gave children’s immunizations while we were treating illnesses. The doctors went about their business as usual. When they wrote a prescription for medications that we had, we tried to fill them. One of the doctors worked about an hour then left with no word of farewell. The other one stayed three to four hours and then left.

Our last clinic day was near Masaya. We left the paved road and traveled a narrow country land until we reached a beautiful garden spot. Along the way we were treated to beautiful flowers by the roadside. Our driver identified some of them, but some are still a mystery. The colors were deep and varied. There were clusters of burnished gold, bright orange, hot pink, deep fuschia, purple, violet, and yellow. The yellow ones were most common, but the entire panoply was presented. It is hard to capture the blossoms in photograph, but we did try. One of my surprises was the poinsettias growing wild. I know they were originally discovered in this area, but so far I had not seen them growing wild. Some are 20 feet high. The bracts are smaller in size but very deep in color. The driver said they were named "Pastora" and the multi-colored bush is called "Triniteria". The tree with yellow flowers is called "Sardinia". I was not able to coorberate any of those names. Most people simply said they did not know the names.

After traveling several miles through this lush floral forest we reached a community that is pretty special. The Minister of Health sent two doctors to help us. They were wonderful and efficient. Upon completion of the patient visits, we loaded their pick-up truck with our remaining medications. They will use it wisely in their own clinics. The women of this community cooked our lunches while we treated their families. Wonderful day!