Summer 2004

Each year seems different now. This brigade left Oklahoma City June 29 on Continental Airlines to Houston. In Houston we added Thad Shook, John Brennan, and Sarah Brennan. We had variety in age as well. Bailey Stephenson is a senior in high school and thus became our youngest brigadista so far. Martin Tremwell from Fort Smith, Arkansas is also a student. He was born in Esteli, Nicaragua but did not live there long. Experience varied from first time to quite experienced.

Our hotel arrangements were also new. The hotel for this brigade was Posadita de Bolonia. It was quiet and very pleasant. The staff worked hard to meet each of our requests. We have been fortunate on all brigades to have comfortable sleeping arrangements. Managua is a large city, so transportation is an important consideration. Carolina chooses hotels that are convenient for restaurants and traveling to other destinations. They are also very safe. We were settled in early enough to go for dinner and still have a good night’s rest.

Early the next morning we proceeded to a pharmaceutical house to obtain the medications that we thought we would need. We were planning on going to the mountains, so it was essential to obtain adequate supplies. After we loaded up on medication we went to La Esperanza. This women’s prison has become part of each brigade. We set up clinic with a large area for pill counting and allocation. We treated 180 patients in La Esperanza. Our previous records were available, so some continuity was possible. Most of the prisoners have the same common illnesses as women on the outside. Parasites, urinary tract infections, and esophageal reflux disease are the predominant encounters. However, there is an added problem here. The women are very depressed. Most of them have children who were left in the care of family members when the prisoner was incarcerated. They worry about their children and feel guilty because of their role in this separation. The combination of worry plus guilt creates depression. At times this depression requires therapy. The antidepressant medications we provide offer a lot of relief on a temporary basis. After treating 180 patients, we were ready for a cold shower and dinner.

Early the next morning we left Managua for the northern mountains. We arrived in Jinotega in time for lunch then worked with three local doctors to treat 260 patients. This volume of patient encounters creates quite a strain on the pharmacy. The directions are printed in Spanish in advance of the trip. The pills are put in Ziploc bags, and the labels of directions must still be read to the patients to assure understanding. The pharmacy crew is phenomenal. Sarah’s knowledge of Spanish and John’s counseling improves the medication delivery system to an amazing degree. Kathy’s cool demeanor and ability to organize assures a smooth flow. We were pleased to have Kayna to manage questions regarding drugs.

The next morning we proceeded still further north to Laberinto. This small community is in a coffee growing area. It is a planned, cooperative community with well tended coffee plants and fruit trees. The beauty of the area is staggering. We drove around a large lake to get to this region. The trees are magnificent, and the air is fresh. After setting up the pharmacy we treated 380 people. Parasites and malnutrition were common as well as various infections. There were lots of people who complained of rheumatism, backaches, and muscle aches. The pharmacy was even more astounding in their ability to manage chaos. Thad is the ultimate in working stability. He sets up a place and just keeps on counting. The young (Bailey and Martin) collaborated with Mary, Mindy, and Kathy to keep the waiting lines under some semblance of control. Each patient leaves the clinic with several medications and the hope of some relief. Our medication bags were a lot lighter after this day’s operation.

After a good night’s sleep in Jinotega, we headed back toward Managua. But Octavio had arranged for us to treat a small group of people in Chaguitillo. Arranging the area for good clinic management required a lot of effort. This late start created some challenges but we were able to treat 283 patients here. There had been no doctor here for a long time, so the reception far exceeded predictions. All sorts of illnesses were noted here and much of our medicine was dispensed before we finished. The women of the community went to special efforts to prepare a lunch for us. The fried chicken was out of this world good. In spite of the hard work, there is not weight loss on this trip.

Back in Managua at a very late hour, we bought several pizzas and ate in the hotel lounge. It had been an extremely busy and eventful series so far. The trip was one-half over.

We observed the Fourth of July with our own holiday. We slept late and then went shopping. After improving the economy of Masaya by buying lots of goodies, we drove to the Pacific Ocean to a beautiful beach. We had a delightful lunch in an ocean front café. The big swimmers hit the water with glee while others bought trinkets from charming children who never cease to amaze. They vary in age from 5 to 12 and can trade your socks off. The trinkets are sea shell creations. There are necklaces, bracelets, and paper weights of many varieties. The children price them but then negotiate package deals faster than we can keep up. The operation is actually well organized, because they will run off somewhere and return with other pieces as soon as they get a sale.

The beach at Pochomil is nice with long stretches of sand and sloping entries. At times the waves are powerful, but swimming is possible here.

Horse rides are also popular along the beach front. The ponies are small but quite sturdy.

Monday we stayed in Managua to hold a clinic on a spot of land projecting into Lake Managua. It is a peninsula with a rounded projection creating an island-like feel. We had a good place for a clinic in the middle of the area. We were treated to a rain that was not unlike the downpours we experience at home. The patients were so anxious to be seen that they never got out of their lines during the downpour. Xiloa accounted for 271 patients. The rain kept things cool, and we were able to keep our pills safe and dry. We had one more clinic day, and our supplies were getting low. Many of our medications were now gone.

Acahualinca needs a new language for adequate description. The city dump is the home for this extremely poor segment of society. The children walk through the dump throughout the day in search of anything of value. The statement that one man’s trash is another man’s treasure takes on new meanings here. Plastic bags are carefully extricated from the filth, washed and hung to dry so that they can be used again. Empty plastic bottles are collected, washed, and used again. In this setting we set up a clinic.

The regular workers in this neighborhood strive to improve the health and education so that the children may one day have a better life. There are several things that are staggering in this environment. The first is the smell. It is beyond nauseating and pretty much beyond description. The second thing is the vastness of the environment. As we drove around to get to the area, it did not seem so bad, but after we drove inside, the area seemed to stretch on forever. As far as the eye could see, there were trucks, tractors, and people working through the garbage. The third thing of awe was the smiles on the faces of the children. In spite of the hardship and privation, the families demonstrated love and resilience. The illnesses were mostly parasites and other infections. Upper respiratory infections predominated among the 180 people who received treatment that day. We were each humbled by this experience.

Needless to say, we were able to find time for shopping. It is interesting to observe shopping preferences among the volunteers on these missions. There are many varieties of bargains. One of the most popular items is a hammock. These hammocks are everywhere and are priced low enough to have serious value. Articles for desks and walls are also popular. Shirts, tee shirts, and leather items are also purchased by some. The prices are low enough for each person to make a bargain purchase.

Rocking chairs have been the choice for several of us. It is usually okay to check a rocking chair as a second piece of luggage for the return home. They are easily assembled after we get home and are very good values. Quality is variable by price. There are also several sizes. I usually buy a guayabera in different colors. They are very comfortable.

The group was good. Everyone seemed to enjoy the brigade, and the people in Nicaragua were profuse in their stated thanks. There will be more.