Monday, February 21, 2011

Feeding the 5000...or maybe just entertaining a hundred

On our 3-day clinic expedition, I packed my scrub pockets full of balloons and stickers for the kids as usual. As a last minute thought, I threw in a few extra handfuls of balloons into my bag. Usually I only give out to kids coming through as patients to avoid the mobs. On our last clinic, though, out in the furthest village of Polo, I felt more the remoteness and little chance the children have to see much out of their village.

About halfway through the clinic, my group was taking forever on a family. Since only one person can question at a time with only one translator in our group, James and I moved on to the other 2 kids in the family. We had fun playing with them while checking them out, listening to their lungs, making a big show of breathing deep so they would imitate, looking down their throats and in their ears. Really they were a healthy bunch, but since they never have access to medical care out there, every family in their entirety were coming in to be looked at with some rather bogus symptoms or just a couple family members actually sick. All of the kids definitely needed worm medicine. We got the funniest descriptions from moms of the different sizes and colors of worms coming out in their kids' diarrhea, mouths, and noses. One mom even said her boy had moths coming out! We exchanged some dubious looks at that one.

With the current family, James and I gradually gained the kids' trust and they began to show us all their little cuts and bruises. After finding a fungal infection on the boy's foot and prescribing some Clotrimazole cream for him, I finally pulled out some stickers to keep the kids entertained while their parents were being checked. Before I knew it, the girl had run off and brought back friend after friend for stickers too. With a group of 6 girls gathered around me, I tried to talk a bit with them in limited Spanish and Miskito. Soon they were all shyly repeating "hello" and "how are you" in English as I taught them. Wanting to keep the learning going, I grabbed a balloon out of my pocket and tried to get them to say "balloon". It was fun and soon each of the girls wanted their own balloon with a face drawn on it.

You can't go very long handing out colorful balloons without kids noticing. Soon I had a crowd around me of kids, big & small, watching the production and hoping for one. It was crowding out the clinic so I grabbed my bag and sharpie and headed outside. The mob grew, and I began to wonder if this was a good idea or not. There was no way I would have enough balloons for them all. So I tried to make the best of the experience, making a show out of it by making exaggerated faces while blowing the balloons, taking the time to draw a specific face on each one, and making the older kids pronounce "balloon" before they could have one. All the parents began forming a ring behind to watch and caught on that I was drawing specific faces. So they all started guessing which kid I was drawing next from the hair style, etc. Great fun. Sometimes I'd get a dud balloon that just didn't want to expand. I'd blow and blow, until all the moms would start yelling Ai! No! She's going to blow all her air out and die!

I kept on, kid after kid, and really began to worry about running out with all the kids so eager to have one. I never looked into my bag, just stuck my hand in and rummaged around until feeling another balloon. Over and over I did that, praying each time, "Please God, give me another one." It went much longer than I expected until finally, the dreaded moment where all I could feel was my headlamp, knife, and other supplies at the bottom of the bag. No balloon. My spirits plummeted. Looking up, there were still 10 kids I could count who hadn't gotten anything. Reaching in my scrub pocket, I found half a sticker page and started handing those out. That was quickly gone and I was at a loss for a moment before I realized that the sticker page outline had little clouds printed on it. I started tearing those out like little stickers, feeling rather apologetic for giving such a measly gift compared to balloons, but the kids were grinning still, just happy to be included. Got down to the last cloud, looked around and spotted one last little boy, shyly standing back. I beckoned him forward and planted the last that I had on his sweaty hand. The perfect amount. There's nothing like perfection to tell you that God was a part of it in our non-perfect world.

Friday, February 18, 2011


On one of our past project days, Becky, Jeff, and I volunteered to go search out all the wells in the village here in Francia. So after breakfast we headed out into the first quadrant of the village walking on little trails between stilted houses. When we found a well, we'd ask the villagers around about it, noting anything broken, possible new well heads to be built, quality and depth of water, etc. I'd mark it in the GPS and then we'd trek off in search of another one.

It was great to have the chance to see deep into the village. The people are rather shy, sitting back in their houses waiting for us to acknowledge or greet them. Very unlike the boldness in Africa where everyone runs up to shake your hand and kids crowd around to follow everywhere. We ended up covering over 3/4 of the village by lunchtime, much more than expected. And that includes all the visits with people Becky knew. She was a student missionary here the same year I was in Africa and was getting the chance to greet some long, lost friends. One of the first wells was with a man with heart problems who actually stayed a year in the states for extensive heart surgery. He was barely able to stand up and greet us as he is constantly weak from the blood pressure problems and siezures he has. Later on we ran into Armando, one of the head elders of the church. He has taught himself English very well, so is always our translator when we talk up front. He invited us up on his porch to chat for a bit, noting that he needed some bleach for his well too. Also ran into a man who was so excited to see Becky. She helped deliver his wife's baby 3 years ago, so they dragged the chubby little boy out to see her. He promptly screamed and went running for his mom at the sight of us.

Towards lunch time, we happened across the house of a newborn baby that we'd seen a couple days earlier. The parents had brought the baby to Dr. Caldera because she was sick with fever and not breast feeding at 10 days old. He check the baby out and was concerned that she was developing some lower lung pneumonia. So seeing the baby, Becky asked if we could check her out. We climbed up on the porch and were happy to see that she looked much more hydrated but still had a fairly high fever. She was taking the antibiotics ok, so after some suggestions on how to keep her fever down, we left.

The next day, we decided to go check on her again after talking to Dr. Caldera. He was still concerned because he'd asked the parents to bring her back to the clinic right away to get checked, but they never had. So at lunch time, Becky, Jeff, and I headed back out to the house. I came prepared this time with balloons after seeing all the kids the day before. So while Becky checked out the baby, I blew up balloon after balloon and drew faces on them for all the kids in the family. This visit we were surprised to find 3 young babies on the porch and it took a bit to sort out which was the sick one. The other two were twins that belonged to a sister. Becky said the baby was doing better, fever down and breastfeeding. So we headed home feeling good that she was improving.

The weekend came and on Sunday, Brittany and I got called out on a house call with Dr. Caldera to check on an older lady with bad heart and blood pressure problems who was having trouble sleeping. Dr. Caldera is such a great teacher, explaining everything step-by-step and letting us do every part of the assessment with him. The lady, Olga, had a very irregular heartbeat and through Dr. Caldera's careful teaching we narrowed it down to the exact heart valve that was causing it. She also had too high blood pressure so we decided to get some meds at the clinic for her. Noticing that we were close to the little baby's house, I asked Dr. Caldera if he wanted to check her and he readily agreed. So I led them over to the house, but we were disappointed to find the parents and baby gone for the day. Questioning the family, we heard that the baby was not doing well. Dr. Caldera said it was very bad that they hadn't come to the clinic again and that they should come immediately once they returned. The family brought out the twins to be checked instead because both seemed to be coming down sick as well. One of them especially could barely cry and both their lungs sounded like the beginning of bronchitis. With promises to return with meds, and instructions to send the newborn with us, we headed back to the clinic.

The rest of Sunday went rather smoothly until that evening when Dr. Caldera was called to go check on the newborn who had finally been brought to the clinic. The new on-call team, Justin and Rebecca, went down with him. I was studying on the porch in a hammock when the 4-wheeler suddenly roared up and Dr. Caldera went running into his house. Soon he ran out with the news that he was taking the baby to the hospital in Waspam, and took off on the 4-wheeler again. Justin appeared soon after since there was only room for Rebecca to go. He said the baby was barely breathing when they got to her. While trying to study, I kept thinking about her, wondering how she could have taken such a bad turn since we'd seen her just 3 days before. I was also trying to imagine them driving all the way to Waspam on the little 4-wheeler since the truck was gone. It might be faster going around all the potholes, but very exposed and difficult to fit them all on and keep the IV in that little 14-day old baby.

A couple hours later Rebecca walked in teary-eyed with the words, "she died halfway there" and then walked out. Justin and I took a few minutes to say "that's too bad" and "they should have brought her in earlier." Then we looked at each other and Justin said, "are we really un-feeling people?" After seeing Rebecca's anguish, our quick "wish it would have turned out better" seemed short and not enough. We've both already seen so much death, though, during our times in Africa that this just seemed like another one. Justin said that as soon as he saw the baby, he had no hope that it would make it to Waspam. We talked for awhile about how to balance expecting and being ok with death while also believing in the power of God to heal. We finally came to the simple conclusion that we would at least wish and pray to feel the same that God would feel over the death of that baby. I think God feels anguish over the suffering that happened and the loss the family will feel, but also joy and excitement over the knowledge that death isn't the end of this story.

Wednesday, February 16, 2011


Celebrated with banana bread, a candle, & friends.

Saw over 100 patients in the village of Miguel Biken on Tuesday.

Worked Men's/General Pathology with Dr. Peterson & saw the results of lives full of hard labor and surgery cases to refer to Waspam.

Cut and popped some kind of parasite and larva out of Alex's foot.

Pitched tents around the clinic for the night.

Saw a huge scorpion on Jeremy's pack.

Got to call on the satellite phone for a few minutes for my birthday!

Woke up early on Wednesday to grab our backpacks & meds and hike 2 hours through the jungle to the village of Kapri.

Mud, mud, and more mud.

Set up clinic in Kapri in the little catholic church.

Worked Women's with Dr. Caldera and saw many pregnant women and STIs.

Made ramen noodles for dinner over a fire outside.

Pitched a tent for the night with a circle of curious onlookers.

Listened to crazy massive pig fights all night.


Packed up in the morning, left personal stuff at the church and carried all the meds & clinic supplies to the village of Polo like porters in a line through the jungle.

More mud including some massive 3 ft deep holes with slick little logs to tiptoe across on.

Clinic all day in Polo, seeing practically every person in the villaage, family by family.

Thought we'd have to turn patients away to leave in time, but decided to just stick it out & chance hiking out in the dark.

Worked pediatrics with German med-student David, treating tons of worms, parasites, sinus infections, bronchitis, and UTIs.

Flew through tons of Albendazole, Mebendazole, Metronidazole, Amoxy, Doxy, and Cotrimoxazole.

Saw first case of intense Leishmaniasis, also known as Mtn. Leprosy, on a 14 yr-old girl.

Gave out every balloon & sticker I had with me to the crowds of kids.

Finally packed up to leave and hoofed it back to Kapri through all the mud pits again.

Grabbed our backpacks and after an intense pouring of rain, headed out on the long jungle trek back, slogging through the trails.

Darkness came and we got to hike by the light of the moon and stars, listening to the jungle come alive at night.

Arrived in Miguel Biken and finally met up with the truck for the long drive back to Francia Sirpi, our village.

Truck's headlights were fairly nonexistent so a couple guys had to ride on the hood, shining their headlamps on the road.

Listened to Tyler's farm stories and all the guys' battle wound stories all the way back.

Finally home with a big meal Mrs. Brown had prepared for us!

What an expedition!

Monday, February 7, 2011


If you were told there was a major bus accident with many injuries and had 30 seconds to grab whatever you needed, what would you grab? And that includes not knowing how far away it is or how long you will be gone.

Today we went to the Adventist church here in Francia Sirpi. I think we tripled the amount of people there. Everything was spoken in Spanish and Miskito, so David sat behind us during the sermon to translate into English. After church we walked back up to the mission to eat lunch. Some were still down at the church when word came in that there was a large bus accident down the road a ways with many people hurt including some church members returning to Francia.

So I was sitting on the porch when Ryan ran up and asked if I wanted to go.

“Go where?” I asked, having not heard anything.

“There's an emergency. Go grab your water and jump in the truck.”

So I ran up to our cabin, pulled on some scrub pants, and quickly grabbed anything around me that looked stethoscope, a few granola bars, sunscreen, headlamp, and jacket in case we stayed after dark. I ran out to fill up my water bottle but we ran out of water after only filling it halfway. I jumped into the back of the truck along with the 3 other students, the SM girl here, our leader Jeff, Dr. Peterson, and a German nurse doing a rotation for medical school out here. We took off and I heard the news that they thought a bus on its way to Francia had rolled. Everyone was speculating on how many injuries that could mean, how to respond, who to leave at the site while transporting patients, etc. I just sat down in the back and got comfortable for as possible for a long ride on the bumpy road, remembering all the miscommunication that usually happened with emergencies in Africa.

We drove through the village on our way out and stopped to talk to the church members about the accident. Within a few minutes, the German nurse, David, started mumbling excitedly in German and finally in English, “Why aren't we going?! Why are they wasting time talking!” As the trip continued, he was continually fidgeting and exclaiming, “How far is it? Are we ever going to get there?!

The SM girl, Brittany, and I kept responding with, “It's ok. There is no rushing it, and there's no reason to be worried so much about it until we get there and see the situation.” In my mind I was already wondering if maybe it was just a car or truck instead of a big bus coming all the way out to the village. Brittany started getting very concerned that there was only one other person along besides her that spoke Spanish well. I kept trying to reassure her too that we would be fine with our basic Spanish and hand gestures. Anyway, it turned into a long bumpy ride where I felt like I was constantly saying, “relax, we'll figure it out when we get there.” Looking back on it now, I wonder where I became so laid back. I can certainly have my times of wanting to have everything planned out and analyzed. And how can I say, “don't worry” when I'm a huge worrier at times. I think it's something to do with the “overseas mode” coming back to me. Letting things slide along as they come, not getting anxious about things we don't even know.

About a half hour down the road we stopped a moto driver heading the other direction. He surprisingly told us that he hadn't seen anything on the road on the way in. No accident, no large amounts of people, no bus. So we decided to head back to the village until hearing more. David immediately got anxious again, poor guy, so worried that we might just be leaving people out there to die. But we couldn't just drive out blindly, wandering around with not even a confirmed report. They had probably already all been transported to the hospital in Waspam if it had happened. As Brittany and I agreed on that and about waiting back at the village, he looked at us like we were ogres or something. I wonder if I'm too calloused already from past experiences. I returned to the mission without much of a later thought on what might have happened, knowing we might never know. All the students were sitting around in their scrubs, prepared for patients when we arrived and there was a bit of a collective disappointment when they heard the news. No, we aren't crazy EMTs always wanting people to be hurt, we just want to be there when it happens so that we can help!

Sunday, February 6, 2011


This post is coming from my own hands on the internet. Exciting to be on for a little bit. We are at Clint & Marilyn's house a couple hours from our village. Clint is a pilot out here and they have quite the nice house and compound out here. Can't write much, but we are able to get some emails out through the ham radio now in Francia so I will keep trying to send a few blogs. Mobile clinics have been great and this next week we will be doing an epic 3-day trip doing clinics at 3 different villages. So driving to Miguel Beacon on Tuesday, walking to Kapri on Wednesday, walking to Polo on Thursday, and then walking/driving back to Francia that night if possible.

Hope you all are well and happy :) I've been sick with something for 2 weeks now which just lately has been diagnosed by the doctor as either strep throat, mono, or some other virus. Not fun. My tonsils are so covered in white right now, they look like 2 cotton balls in the back of my throat.

Love you all,

Saturday, February 5, 2011

The Tarantula/Cockroach Dance

With the tropical weather, I've been pushing myself to drink massive amounts of water. But with that comes many trips to the outhouse...including at night. I have learned to be prepared for those nighttime jaunts both physically and mentally. As the air cools considerably in the evening, apparently all the tarantulas are attracted to the warm little outhouse sitting out there in the field.

So when the need is too great to ignore, I creak out of my cot, grab my trusty headlamp and slide my way precariously on the mud trail to the outhouse. First comes the outside inspection where I walk around the building and check for potential intrudors. Usually there's a big hairy tarantula or two hanging out on the walls. I mentally file away their locations and expected amount of time they would take to reach an entry point. Then I slowly open the door and start scanning from the top down because having a tarantula jump down on me is more disturbing than one along the ground in reach to step on if needed. Last time I arrived at the outhouse, I found 6 furry bodies with 12 beady eyes flashing back at me.The problem is that they don't conveniently congregate in one spot. While staking out their own private real estate, it makes four directions for me to monitor.

The other creature I keep an eye out for are the cockroaches. It might be disgusting to mention, but there are hundreds of cockroaches hanging out in all the glory down the hole. But when few humans are frequenting the building and nighttime arises, the bravest of the cockroaches come scurrying out of the hole to explore the surroundings.

Thus begins the dance. It is quite a workout to be squatting up over the hole, constantly turning my head to check on all the tarantulas who freeze in the light, and then be jumping my feet up and down to dodge the myriad of cockroaches going crazy as the light shines on them trying to run back to the hole. It's like practicing Capoiera, the Brazilian fight dance that Jeremy is teaching us. I guess the positive part of the experience is the extent to which it exhausts me to go back to bed.

Tuesday, February 1, 2011

DAY 4 - January 21, 2011

In Nicaragua for the 4th day and it feels so great to be hearing the generator running in the background at the mission. My mind has been constantly comparing this place to the other places I've been, especially Haiti and Africa. Justin and I were just discussing today as we walked through the village, how the standard of living here seems much better than where we've seen in Africa despite being the lowest in Central America. Almost every house has a tin roof, they have pumps on the top of wells, and so many animals running around. All the houses are built up on stilts to keep away from bugs, although right now I'm sitting in the dark writing with my headlamp on, and there isn't a single bug flying in my eyes! Sonya, Liz, and Hans – you know what I'm talking about. Working night shifts at the hospital in Africa, and being attacked by all the bugs attracted to our lights as we gave out medications. And I mean bugs up the nose, in the ears, down the scrub shirt, and in the morning we'd clear an entire layer of dead bugs off the desks in the wards. Here in Nicaragua the air is so clear at night!

And everything else seems to compare that way with Africa looking more extreme in every aspect. We went to the market in Puerto Cabeza to buy food and hardly got a few side looks. No mobs of kids touching us or people laughing at every word. There is an abundance of all types of food here. The outhouses have a cement block with a toilet seat on it to sit on. I actually miss the holes in the ground in Africa because it seems more sanitary than sitting on the nasty seat. So I've been climbing up on top and squatting over the hole. Haha! I never thought I'd miss that from Africa.

But I do wonder about this desire I have for things to be hard like in Tchad. Maybe because that experience pushed me so much in every way, making me grow in ways I didn't even know I could. And now I'm wishing for that again. I want experiences to happen even if it's hard. I'm sure it will come and then I'll be wondering what I was wishing for! The first few days here have just been so lax and laid back. I should probably cherish them. And I'm sure I'll be finding experiences unique to Nicaragua like the 3 tarantulas we've chased out of the girl's cabin already!