Spring 2005

First things are always challenging. This group from OCU was the first official college function. Dr. Barbara McCain was advising about or efforts and stated that she would like to have her students address the problems that have occurred as we work among the poor of Nicaragua. We put together a syllabus and eventually had it approved by the curriculum committee. The students elected to try this course. The idea for a semester hour’s course is that they would put on paper a business proposal. This business proposal must bring together the people of Mina Limon, the healthcare workers who are currently involved, the health department, and the funding agencies.

We left Oklahoma City March 12 and returned March 19. There was significant apprehension about logistics. The problems began at the onset. There were originally 15, but we could only get 13 places. There were three non-student participants. Medications were packed and were within airline guidelines. Four of our members were not USA citizens. In Houston one of them was delayed in obtaining clearance and almost missed the flight. However, He was able to get  aboard at the very last minute, so the first step worked out okay.

Sunday was a day for learning about Managua and Nicaragua. We drove around the area and stopped at parqueo Tiscapa. Most of the students chose to try an aerial cable ride over Laguna Tiscapa. The thrill of flying freely over the lagoons was enjoyed thoroughly. It is a little like hang gliding and a little like a roller coaster. We stayed at La Posada de Maria La Gorda and had dinner at Mirador Tiscapa. Mirador Tiscapa is popular with a good dance floor and live music. The music is mostly salsa with some meringue and rumba thrown in to quiet the crowd. The food is very good and service is okay considering the size of our table.

Sunday noon we had a working lunch with medical school professors. One of them speaks English well and seemed eager to work with us. He liked the ideas we presented and said he would encourage and assist medical students to work with us. The students must do one year of community service as a part of their school before their degree is granted. They would thus live in the community and work in our clinic under the supervision of local doctors.

The other doctor at our lunch was very apprehensive about us and was fearful that we were trying to push ourselves over them. When I assured him that we only wanted to do what the people of Mina Limon requested, he softened and went along with our ideas. He had been unaware of our mission and goals.

Most of the doctors are on the government payroll for some part of their income. This work may be in local health centers offering service to the poor of that community. We were able to convince them that our goals were to work with them and act as a supplement to their patients. By focusing on factors of wellness and prevention we will enhance the effectiveness of the health centers rather than compete with them.

Monday we loaded the vehicles and moved to Leon. The Colonial Hotel is very Spanish and very beautiful. We went to the local Minister of Health office and met with doctors and social workers to discuss our project and proposal. We heard lots of data about the people of Mina Limon and Leon in a broader area context. There were several things to note as we consider a business plan. Some of the data were hard to grasp because of variant methods of recording and extracting these data elements. Much of the data are dominated by the extreme poverty of the pueblo. The median age is 15. Death rates from childbirth and early life are quite high. Most of the deaths are due to infection. There are about 9000 people in the pueblo. Only about 40% are literate, but the schools work hard to improve literacy. Health education is below standards.

Tuesday we went to Mina Limon. The heat and dust are very oppressive. The rocky road is slow. Upon arrival at the clinic, the horde of waiting patients was astounding. After we pushed 100 or so people aside, we set up the pharmacy. The brigade members worked very hard and established a system for dispensing that was effective and efficient. We use Ziploc bags for the medications and place an instructional label on each bag. Even though the literacy rate is low, it is better to use typed instructions than to count completely upon their memory. The clinic has two separate areas. The patients check in and wait in one area and consult with physicians in the other area.

For three days we treated illnesses such as parasites and urinary tract infections at a dizzying pace. The first day we treated 130 people. The second day a second physician joined us, so we were able to treat 240. The third day was a monster. We treated 318 people and ran out of several of our key medications. Almost 700 patients were covered in this process. During these sessions we each learned a lot. Each night in Leon we recounted the experiences of the day as we enjoyed delightful food and each other’s company.

Thursday night we had dinner in an Italian restaurant that included a benefit concert by Carlos Mejia Godoy. His guitarist was ill and was hospitalized, so a benefit was arranged to obtain funding for his hospital expenses. The act was opened by Salvador Cardenal. When Carlos put on his portion of the concert the entire audience joined in to be a large part of the show. They sang along, cheered, clapped their hands, and stomped their feet in accompaniment to the heavy rhythms and the enticing melodies created by these incredible musicians.

The primary purpose of this brigade was to fulfill a requirement for credit at Oklahoma City University. The goal would be to understand the health care needs of an isolated community and then to draw up a business plan that would provide sustainable processes for covering basic needs. The students were guided in this effort by Dr. Barbara McCain, a professor in the Meinder's School of Business at OCU. She ably orchestrated the fact finding and idea developing aspects of this endeavor. The interviews were thorough. The students asked pertinent questions and took voluminous notes. The time in Mina Limon included visiting pharmacies and schools as well as talking to patients of all ages and community leaders.

The students who were involved selected this class for diverse reasons. Many were just curious about another country. Many wanted a fun spring break. Some were curious and wanted to do something that was different. The diversity made for a group that bonded well and accomplished a lot as part of the process. They also had fun. Only time will measure the full impact of their education and career choices. Hopefully, their business plan will be accepted and will become a model for future communities who need to establish a basic health care system.

We were honored and pleased to have Mario Delgado accompany us as Translator in Chief and Minister to Nicaragua. Since he had extensive knowledge of folk ways, opportunities, and barriers, he proved invaluable in keeping us together and assuring good communication among all of the people involved. Mario’s calm demeanor and certain ability to negotiate were most welcome and deeply appreciated.

The students in this brigade demonstrated a thorough approach to a serious problem. Their intelligence and careful study of existing problems points to a successful future. Their concern for the people whom we served offers hope for better choices as these people face a future that is uncertain. Perhaps we can improve their opportunities for management of the challenges faced in their day to day existence.