The Nicaragua Adventure

The River Trip and Beyond

2009-03-25T20:47:00.000-07:00

Thu, Feb 26: IRR - and I! - leave Francia for our trip up the Rio Coco (Coconut River) to take clinics into villages that have never had medical care before. We leave early so as to arrive in Waspam early enough to take our boat all the way to Krin Krin, our first stop - but the boat isn´t there. By some mix-up in communication, it is actually hauling lumber on the river today. We have to wait till tomorrow for a boat. We spend the night on the open floor in the city´s community center.

Fri, Feb 27: We spend all day in our boat. Literally. We leave early and don´t get to Krin Krin till almost dark. We´re starving. We set up camp and eat a small supper. The guys set up their tents in the clinic, and we girls set up in the Pastor´s house, and on his porch, too. We´re very cramped for space.

Sat, Feb 28: We go to church in the morning and have clinic in the afternoon in the nearby school. Patients come and come and come . . . we stay open until after dark and still can´t see them all.

Sun, Mar 1: And we do clinic again in Krin Krin today, all day.

Mon, Mar 2 or Tue Mar 3 (I´m a little off on my dates): We take the boat to Krisnak, a little village up the Waspuk, a tributary of the Rio Coco. We set up camp in the old Catholic church building - by old, I mean that there´s light coming through between every board in the walls, and you can see the sheep and pigs below you through the floor. Tarantulas also come up through the cracks, and cochroaches. We hold a clinic in the afternoon.

Wed, Mar 4: Instead of starting clinic first thing this morning, we take a break first, and head up river a little ways to a waterfall. It´s a gorgeous double cascade, one after the other, with a deep pool in between that´s perfect for jumping into and bathing. There´s even a small trickle coming down that forms a perfect shower head. We´ve been bathing in the river every day (despite the threat of alligators), but this is better than anything else yet.

We run clinic in the afternoon.

Thu, Mar 5: Only a few of us head to the waterfall this morning. The group is starting to fall sick - there´s been a cold going around, and now a stomach bug has started. Even those who aren´t throwing up are tired.

We go to a village at the mouth of our tributary, named Waspuk, like the tributary. The people are so happy to see us, especially the children. They crowd around us, jumping excitedly whenever we take out our cameras. We take loads of pictures, just for the pleasure of showing them themselves. Clinic today includes a small tumor removal that I get to help with - I inject the lidocaine before the procedure. Very exciting.

Fri, Mar 6: We do clinic for a few patients in Krisnak in the morning. Except a few turns into a lot, and we don´t leave until almost noon. No matter, our boat ride back is only supposed to take 4 hours, or 6 . . . 8 hours later we finally hit Waspam. Those of us who are sick are completely miserable. I am at least not throwing up, but I am getting a sore throat.

Rusty does not meet us at the dock. We despair, assuming he got tired of waiting and left for Francia without us. We start making plans to spend the night, when the deuce rolls up. That un-naturally loud engine is the sweetest sound in the world.

Sat, Mar 7: We recover.

Sun, Mar 8: Packing day.

Mon, Mar 9: We take IRR to Puerto Cabezas and say goodbye.

Tue, Mar 10 - Thu, Mar 12: We get ready for Union´s nursing group to arrive. I spend a lot of time resting, since I now have a stomach bug on top of my sore throat.

Fri, Mar 13: The Frontier Nursing class from Union College arrives on this night.

Sat, Mar 14: We go to church in the morning, then the group hikes out to the Rio Wawa again in the afternoon. I stay home and rest.

Sun, Mar 15: We organize the supplies Union brought with them, and open the clinic for Francia in the afternoon. I assist Gina Foster, the OB/GYN nurse practitioner, with translating. I translate to Spanish, and Amelia, the local midwife, translates to Miskito for the patients. It´s awkward, but it works.

Mon, Mar 16: Union´s first clinic in Tasba Pain!

Tue, Mar 17: Clinic in Esperanza. I´m helping Gina again when a girl comes in to be seen who´s actually in labor. She´s only 15 years old, so Gina decides to take her to Francia Sirpi for the birth, because we have more resources there. I assist Gina and Amelia all afternoon with translating and helping the girl through labor. In the evening, she starts pushing, but it takes a long time, partly because it´s her first birth, partly because she´s worked up emotionally. Her mom is in another village and we have no way to contact her. The poor girl keeps crying for her mom and saying how tired she is - she doesn´t think she can do it. But she can, and she does, to a little girl, which they name . . . Katie. Seriously. It was Amelia´s idea. I´m very honored, but I kind of feel bad for the kid. Imagine growing up with a name no one in your village can pronounce.

Wed, Mar 18: The deuce goes to Kapri again! Rusty tries to take it all the way into the village again! And gets stuck again! I´m so glad I stayed home on this day. They actually did make it all the way in, but got stuck again on the way out, on the same steep hill as last time. They had to hike out to Miguel Bikan again, but this time, Jeremy was there with the second deuce to meet them. They didn´t all get back until 3am, tho.

Thu, Mar 19: Rest day.

Fri, Mar 20: Last mobile clinic in Tikamp.

Sat, Mar 21: The nursing students leave. :( Now I´m even more homesick, because I had my friends here for a while, and now they´re gone. But, only one more month and I´ll be home.

Sun, Mar 22: Dr. Rafael Lacayo, a local doc, Janet, Amelia, and Ruth´s mother, who´s a nurse, go with us on a small mobile clinic to Wisconsin. Union had planned on hitting Wisconsin, but had to miss because of the truck getting stuck.

Mon, Mar 23 and Tue, Mar 24: Rest and clean-up from the groups.

Wed, Mar 25: Come to Port - and here I am. And tired. Aren´t you proud of me for staying up so late to tell you what I´ve been doing? ;)

I love and miss you all, and I´ll be home soon! May 3, Lord willing and the crick don´t rise. Pray for our last month to be productive and happy.

A very muddy tale

2009-03-25T19:14:00.000-07:00

Well, I´ve been absent from my blog for almost two months now, and I´m almost afraid to try to catch you all up to speed on everything that´s happened since. But I can try, at least a little bit.

Wed, Feb 11: I go with Rusty and Jenny on the deuce to Port to pick up supplies for the groups coming in.

Thur, Feb 12: I go with Rusty and Jeremy on two deuces (yes, we have two that work now). We head to Leymus to pick up IRR (International Rescue and Relief from Union College), who are supposed to be crossing the river around noon there to leave Honduras and enter Nicaragua. We wait by the river all afternoon, from 1pm on. Finally after dark, at 6:30 we leave to spend the night in nearby Waspam. We check email there to see if they sent us anything, but no. We sleep in a sparsely furnishing hotel of questionable cleanliness. The barrel of water that I am supposed to use to clean myself has mosquito larvae in it. I entertain serious questions about whether this ¨shower¨ is worth it.

Fri, Feb 13: We go back to Leymus and get IRR. Apparently they reached the river about 20 minutes after we left. Oops. :P We load up and head back to Francia Sirpi.

Sat, Feb 14: Valentine´s Day! We take IRR to church. Then in the afternoon, we hike to the Wawa river. It takes about an hour through the jungle. It´s still muddy, but not nearly as bad as the first time I hiked it last August. And the rapids are totally worth it - cold and fast and fun. After showering, we spend the evening eating candy hearts and giving each other back rubs. :)

Sun, Feb 15: IRR sits in lecture, and Jenny, Mindy, and I get to organize their pharmacy! Apparently all the hours we spent organizing our clinic´s pharmacy were meant to prepare us for something. :) We get faster every time we do it.

Mon, Feb 16: IRR´s first mobile clinic in Tasba Pain. Some of the students treat a little baby with bad pneumonia. Everyone´s worried about it - Dr. Duehrssen especially thinks it needs to go to the hospital. We´ll send someone back tomorrow to check on him.

Tue, Feb 17: Mobile clinic in Kwiwi Tingni. We get back late, and then Mrs. Brown comes up on the hill to tell us that her daughter, Dexli, who´s almost ready to have a baby, is having pains. Several of us head down to check on her, but it turns out she is not having contractions, but pain in the area of her liver, maybe gallstones. By the time we figure that out and get her pain medicine, it´s past midnight.

Wed, Feb 18: Break from clinics. I go with Rusty, Mindy, and Jeremy to Port to buy groceries. We leave at 4am or some such ungodly hour so we can pick up the baby and his family from Tasba Pain and get them out to the main road where they can catch a bus to Waspam. We also send Dexli to Waspam. We get back from our grocery trip around 10pm, very tired.

Thu, Feb 19: Back to clinics again! Today we go to Kapri, a town down the road past Miguel Bikan. But I´m using the term ¨road¨ very loosely. It has huge mud puddles at the bottom of each hill, and after a while it cease to be a road for vehicles and turns into a footpath for horses and muddy humans. Rusty says he got the truck all the way to Kapri last year, so he can do it again this year. But it´s been rainier this year . . . Rusty tries to take the deuce through one too many mud puddles, and it gets stuck. Very stuck. The men of IRR start trying to pull it out while Rusty jumps on the motorcycle to go back to Francia and get the other truck. The problem is, the second truck has no brakes. It gets stuck too, without doing the first truck any good.

Meanwhile, we girls have hiked a small amount of medicines into Kapri and are setting up a limited clinic. Some of the guys join us, and we go until early afternoon. We hike back to the two deuces - by now they are both unstuck. But it´s rained while we´ve been in clinic, and we still have several steep hills to go up. Here ensues the great battle with the mud. Our pack of IRR guys gets the trucks up one hill, two hills - but not three. The third hill is much too steep. But we don´t realize that until we´ve tried for two hours or so. First all the guys push at the back. Then we load all the girls onto the truck for extra weight to create traction, and all the guys push again. The tires spin mud up into their faces, and many of them are soon coated. (I promise to post the picture of Jeremy after I get back - he was the best monster.) Then all the girls jump up and down in unison while the guys push, again to create more traction. It helps, but not enough, and we decide the danger of us falling off the truck is greater than the benefits. So all the girls go in front of the truck and pull with the chain while the guys continue to push. We still only make it to halfway up the hill.

So when it gets dark, we start walking, and Jeremy and Ryan Veness take off faster than us. They get to Miguel Bikan first and borrow bikes so they can get back to Francia and ask Mike Halverson to come get us on his truck. We get to Miguel Bikan a little later and settle down to wait for Mike to come. We bunk down on the wood floors of a church. After a while, it gets cold, and, prepared IRR souls that we are, we have metal matches, so we build a fire outside. Cow poop covers the ground all around us, but we try to avoid it when we lie next to our fire. Between the fire and the Space blankets, everyone manages to get warm, some inside the church, some out. And we sleep. Mike never comes.

Fri, Feb 20: We wake up at dawn and start walking. None of us have eaten since, at best, late afternoon yesterday. None of us have water left. We don´t talk much - walking takes a lot of concentration right now. When we´re getting close to Francia, Clint Hanley, another local missionary, comes along with his pick-up truck and takes some of us the rest of the way in to Francia. He explains that Mike didn´t come last night because one of the axles on his truck was broken. When we´re finally home, food and water have never been so sweet before.

Sat, Feb 21: We rest our beaten bodies.

Sun, Feb 22: Mobile clinic in Esperanza.

Mon, Feb 23: Off day.

Tue, Feb 24: We go back to Kapri, scene of the disaster. Wiser this time, we stop the truck in Miguel Bikan and hike in. We split our group in Kapri, and half of us go into Polo, a village even further back. We make it back to Francia on the same day. :)

Wed, Feb 25: We pack for the river trip.

You´ll notice the above account of the truck getting stuck in mud is different in some details from the story Union College´s Clocktower published about the event. The date, for instance, is incorrect in the CT, as is the statement that we were back in mobile clinics the next day. (No way did we want to do that). Just thought I´d set the record straight...

Surfing and Other Vacation Activities

2009-02-03T19:22:00.000-08:00

Yes, I did surf, and yes, it was fun - and much easier than I expected. I stood up on my first attempt, and on my fourth try I stayed up all the way in to shore. I really enjoyed it - I could see myself getting into it as a hobby - and then the sad truth looked me in the face and told me, ¨You live in Nebraska.¨ :(

We stayed Tuesday night in San Juan del Sur, then took the bus back to Managua Wednesday morning to start the next part of our adventure - the journey to Corn Island. And what a journey it was! Wednesday night at 10pm we left on an overnight bus to Rama, which arrived at 4:30am, giving us just enough time to lug all of our bags down to the docks and board the Captain D., a small ship which left at 5am. We floated down the Rama River toward the Carribean coast, then out onto the sea. The river part of the trip wasn´t so bad, but the sea was rolling high that day. We found out later that the Captain said that the sea was the roughest it had been in his experience making that voyage. Jeremy and Mindy got drenched with waves splashing onto the deck, Bridget and Ruth threw up, and I crashed onto the deck when the bench I was lying on flipped over.

Altogether we spent 13 hours on the Captain D. By the time we got to Corn Island on Thursday night, we were exhausted. But it was worth it - we rented a little house on the island and spent the most relaxing week we´ve had since we´ve been in Nicaragua. We had television, air-conditioning, a refrigerator, real mattresses - and, the real point, beautiful beaches a short walk away. We spent time with the islanders - a man named Sparky invited us to his house Saturday afternoon for a traditional meal called rondown. It´s made of fish, breadfruit, yucca, plantain, and flour-and-water balls all cooked together in a big pot under leaves. He served it to us with beans and rice cooked with grated coconut, and gave us whole coconuts to drink and eat too. The whole meal was extremely delicious. Then that afternoon we went out to the beach with Sparky´s kids and played in the sun and water.

My one regret about Corn Island is that I came down with a bad headcold Friday night and kept it the whole time I was there. It prevented me from scuba diving and snorkeling with everyone else. But I still had fun - played on the beach, went to a baseball game, went out to eat with friends, got sun-burned . . .

We came back to Managua last Thursday - the same trip in reverse, except the sea was a little calmer. Also, we took a small ponga up the river instead of the bigger ship. Then we took the long bus ride from Rama back to Managua, where we spent the weekend. We all went to a SuperBowl party at the home of one of Payton Zimmerman´s teachers from the Nicaragua Christian Academy. (What a game!) And then Monday at noon we hopped on the 24-hour bus that would take us across the country back to Puerto Cabezas. I don´t know when I´ve been more miserable in my life. The roads are not paved most of the way, and it was nearly impossible to sleep. My shoulder is bruised from banging into the wall of the bus so many times. But here we are, in Port once more. We´ll take the bus back home to Francia in the morning.

Time to prepare for groups to come in and do mobile clinics! Our last three months should be busy. Keep us in your prayers, that we can stay motivated and accomplish much in our remaining time.

San Juan del Sur

2009-01-19T18:35:00.000-08:00

So we flew out of Puerto Cabezas into Managua last Friday and found ourselves in the civilized world once more! Everything amazed us - the cars whizzing by outside the airport, the fast food available in the airport, billboards, shopping malls, movie theaters . . . after living in the jungle for five months, we have forgotten that such things exist. When we first came to Nicaragua, Managua seemed small and run-down to us. Now, all it takes is a real mattress in our hotel room to make us feel like aristocrats. (By real, I mean about 6 in. tall with springs inside, as opposed to the cloth-covered sheets of foam we sleep on in Francia.)

In Managua we stayed in Covanic, the Adventist school that we stayed at when we first arrived five months ago. On Sunday we took a day trip to Masaya, a city a short distance south of Managua (or perhaps a sort of suburb). In the morning we visited the Masaya volcano. We drove up to a parking lot near the top. From there we could see down into the crater. The smoke rising from its depths obscured the lava I assume lay in the bottom. We walked up some stairs to a viewing station where we could see more of the area around the crater. A few hawks were wheeling around the volcano´s mouth, soaring through the smoke. Swallows swept by me, too. I wondered how they could live in the sulfur fumes.

We hiked up a hill on the other side of the volcano to get a bird´s eye view of the whole area, including a beautiful lake. Then we left for the famous Masaya market, where you can buy everything a tourist could ever want, including frog-skin purses with the frog´s head still on and highly indecent coffee mugs portraying the feminine figure. We much prefered the mugs with the ceramic cochroach in the bottom - they reminded us of what it´s like to live at home in Francia Sirpi.

Today (Monday) we headed to Costa Rica to get our visas renewed. It was a boring day - we spent most of it standing in lines. We only stayed in Costa Rica long enough to eat lunch. :) Nicaragua requires foreigners who hold tourist visas to leave the country every six months. After three days, you are free to re-enter and apply for a new visa. We didn´t want to spend three days in Costa Rica, so we just spent about an hour and came back. Nobody seemed to mind, so we assume the three day rule isn´t that important.

On the way back towards Managua from the Costan Rican border, we turned off on the San Juan del Sur road. We found an inexpensive but nice (real mattresses!) hotel with a breath-taking view of the ocean, then headed out to the beach just in time for sunset. I´ll post pìctures when possible. Just a short description for now - the beach is on a little bay and there are craggy hills on the edges for the sun to set behind. The clouds made the sky a fiery pink-red color. The waves crested on the shore in perfect little rolls. And the sand was fine and soft - extremely nice to dive onto. Also nice to wrestle your friend down onto, which we did repeatedly.

After months of work and stress, this was the perfect evening. Having worship with my friends that I love as a second family, sitting on the beach in an almost perfect world . . . how much more can I ask in life?

Tomorrow I may learn how to surf! The beaches of San Juan del Sur are famous surfing locations, and we can rent boards and get lessons. We´ll see how it goes. ;)

Bush Medicine

2009-01-16T06:32:00.000-08:00

Some days here in Nicaragua medical care seems fairly straight-forward. We see patients at the MINSA clinic and diagnose ear infections, respiratory infections, stomach bugs, and parasites and treat them with antibiotics and antiparasitics. It´s just like a family care practice in the States, except for the parasites. :)

But some days we have emergency transports to the hospital. We turn the back of our truck into an ambulance by laying a mattress down, and we drive two hours on a dirt road, bouncing all the way because we don´t have shocks, and using the transmission to slow the truck down, because we don´t have brakes. In the States, the same distance would take perhaps half an hour, because the road would be paved. Also in the States, I would have a fully equipped ambulance so I could actually care for my patient on the way to the hospital.

On Tuesday, January 6, we took a patient to the hospital who was having convulsions of some sort. Mindy said they didn´t look like seizure convulsions to her, but they certainly looked bad, whatever they were. The young woman would start thrashing around agressively, obviously not in control of her body. Her fists were clenched so tightly her nails were digging into her palms, and she was screaming in obvious pain and terror. Her eyes looked strangely glazed over. The only thing we could do for her was hold her down to keep her from hurting herself.

We got her to the hospital, carried her in, and laid her on a bed in the emergency ward. She was still convulsing violently - three or four people had to stand next to her bed and hold her at all times to keep her from falling on the floor. A doctor came in with an injection to calm the convulsions. But all of a sudden, the girl´s mother started saying no. She refused to let the doctors touch her daughter and said that she wanted to take her to a sukia (witch doctor) instead. I was listening to this conversation in Miskito, and couldn´t understand what was happening. All I could gather was that the mother was saying something about the doctors at the hospital not speaking Miskito. Which is true - that particular hospital is staffed solely by doctors from Cuba, which is one of the things that makes it a good hospital. But in this case, it apparently contributed to the mother´s distrust of the hospital.

I tried to ask the other friends and family of the patient what was happening, in Spanish. One young man told me that the mother wanted a witch doctor, but he used the Spanish word for it, which I didn´t recognize. Suddenly the people picked up the mattress and carried it outside. not knowing what else to do, I stayed with my patient and helped. While we were carrying her, Janet told Jenny what was going on, and she told me, so I finally knew that they were taking her to a sukia.

They loaded her onto a pickup truck in the street outside the hospital. She was still screaming and convulsing, and I felt desparate to get her help - real help, not whatever dubious ¨care¨ the sukia would provide. But how to communicate? I didn´t think the mother spoke Spanish, and I couldn´t say what I wanted to in Miskito. I started trying to convince the friends and family, in broken Spanish. But I was talking to the wrong people, and I was too late. The mother had decided, out of her fear and ignorance, that her daughter would be better off with the sukia than in the hospital. The truck left before I had barely started making my case.

The next week, on January 12, I met another case that tested my limits. Sunday night around 8pm, a woman in Santa Clara walked under her house. From what I could gather, she was chasing a chicken. All the houses here are built on ¨stilts,¨ so you can get under them easily. While she was down there, a beam fell from the underside of her house and struck her. They came to our mission the next morning to ask for medical transportation.

When I got to the patient´s house in Santa Clara, she was lying on the floor moaning with pain. They showed me the places on her left side and abdomen that were hurting her, and then they rolled her over and showed me her back. She nearly screamed when they moved her. There was a lump near her spine halfway down her back, where I assume the beam had hit her. Just the gentle pressure of my hand touching there hurt her badly.

All the medical training in my head said I needed to keep the patient´s back straight, because it might be broken. In the States, that would involve strapping her to a back board, chalking her head, and packaging her in a Stokes basket for transport. Here, of course, I have none of that equipment. So I had to get creative.

In my own quaint mixture of Spanish and Miskito, I told the family her back had to be straight, and asked them to get a piece of wood. They came back with a 2 by 4. I tried to explain log rolling to them, and we got the patient on to the board without bending her spine too much. Then they put the board and patient in a hammock and carried her out to our truck.

As we drove out of town, I wrapped some rope around the patient and the board to secure her and keep her from bouncing off. Then I tried to show her family how to hold C-spine on her head to keep her neck straight. I ended up doing it myself most of the way back to Francia because they couldn´t understand.

We took the woman into Janet´s MINSA clinic. Janet started an IV, gave her diazepam to calm her down, and inserted a urinary catheter, because the patient had not been able to urinate since the accident. Mindy got some webbing from the hill, and I took the opportunity to do a better job of patient packaging. The result still looked ridiculous, but I hoped it would hold until we reached the hospital.

It did. We carried our patient into the emergency ward. I was happy that I had kept her back straight, but knew it hadn´t been straight the whole night she spent in her home. And then when the doctor arrived, he untied the ropes and pulled my board unceremoniously out from under her - no log rolling involved. Why did I even bother, I wondered.

I felt so helpless in both these incidents. I didn´t have the words to get proper care for one patient, and I didn´t have the equipment to care for the other. I did my best, and that´s all I can do, but I stuggle to accept that truth. As an American nursing student, I have a concept of the ¨right¨ way to do medicine. Unfortunately, that way doesn´t always exist here.

You Know You´re a Student Missionary in Nicaragua When . . .

2009-01-04T16:54:00.000-08:00

your Christmas tree has an angel made of a toilet paper roll on the top.

you name the tarantula in your shower Peeping Tom.

your clinic has a possum living in it.

you have to push your truck down a hill in order to start it in order to have power to pump up the tires on your four-wheeler.

you try to stay up until midnight on New Year´s Eve, but you´re too tired to stay awake because you normally go to bed at 8:30.

candlelight dinners no longer seem romantic because the candles are necessary to see your plate.

you´ve forgotten what it´s like to be able to hear your friend´s voice over the noise of the vehicle you´re riding in.

everyday conversations are conducted in three languages at once.

the chickens come in the kitchen and you get a kick out of closing the doors and chasing them till you can catch them and hold them upsidedown by their feet.

the plane flies into the airport and someone has to shoo the horses off the runway before it can land.

you have a truck engine chained to the bottom of your porch.

a chicken walks into your dorm every day to lay an egg next to your suitcase.

you take a pan off your shelf to bake a cake and cockroaches crawl out of it.

out of 7 bicycles that your group has bought, only 3 or 4 are ridable at any given moment.

you have to take an extra pin with you to put the wheel back on your four-wheeler in case it falls off while you´re riding it.

Happy New Year

2009-01-03T20:47:00.000-08:00

This past week was a little more restful than the rest of December. After I got home from Puerto Cabezas Friday night (actually 12:30 Saturday morning), I got to crash for a few days. Finished an excellent book (Three Cups of Tea) on Saturday afternoon. Had a headache most of Sunday. I dragged myself out to visit a few patients, but spent most of my time trying to sleep in the hammock. Then Monday I was still dead tired, so I took a nap all morning.

Boring, right? Don´t worry, it gets better.

Wednesday, New Year´s Eve, Janet came to the mission hill and handed us a letter from Esperanza. It was a request for transportation for a pregnant woman there. She had gotten into a fight a few days before and the other party had battered her pretty well. Whoever it was hit her hard in the stomach. Not a good thing to have happen to a 32 weeks and 5 days pregnant mother. She had started hemorrahging and having labor pains.

Jeremy went with Janet to Esperanza to pick the woman up on the four-wheeler (which was still running at that point). Then we took the truck into Waspam. The woman was in quite a bit of pain, probably both labor pains and pain from being beat up.

Outside Waspam, we got stopped by a roadblock - the Yatama, one of Nicaragua´s political parties. No idea why they were blocking the road - that´s just something people do around here. Janet told them to get out of the way, so they did. :)

We got the pregnant lady to the hospital. I went in with her, but Jeremy went to go get gas. The doctor examined her in the labor and delivery room and said she was 7 centimeters dilated already. The doctor said the baby was still alive, but she wasn´t sure it would survive because it was so premature. They gave the mother a bed and wanted her to lie down and wait. But when she was about to get into bed, she decided it would be a better idea to go back to the labor and delivery room. :) She laid down and five minutes later the baby popped out.

It was my third time helping with a birth, and as usual I felt like I got in the way more than anything. Every birth is amazing to watch, and in this one I felt especially worried about the baby because it was so premature and so small - 3.25 pounds! He was a fighter, tho - started screaming right away, and pretty loud.

About two minutes after the birth, Jeremy walked in. He looked at the baby and said, ¨Well, that was fast.¨ :) The baby had been born about 10 minutes after we reached the hospital. If that roadblock hadn´t been cleared for us, we could have been delivering the baby in the back of the truck! Thank God we got to the hospital in time....

So that was my amazing New Year´s Eve. That night I stayed up till midnight listening to music and playing games, and the next day we took a day trip to Esperanza to swim in the beautiful Wawa River. We also took a dugout canoe up the river a little way - we put 6 people in it and then tried to paddle it up stream in a spot where the current was just a little too strong - and we shipped a bunch of water all at once and the boat sunk out from under us. It was hilarious.

Probably not the way you spent the New Year´s holiday. Nicaragua is always different. :)

Uncohesive blog post

2008-12-26T13:22:00.000-08:00

This past month has been a little on the wild side. I usually try to tell one good story here, but I don´t have one to pick this time. I´ve just been running from story to story non-stop since the last time I was online. So, here´s December in brief.

Dec. 6: take Pastor Rich to the Waspam airport. Have to argue with the people at the counter to get him on the flight he had already paid for. He ended up having to buy a new ticket.

Dec. 7: Run a mobile clinic in Miguel Bikan with Janet, the MINSA nurse.

Dec. 9: Almost get to help with a birth. I wait at the mission house for too long, and make it to the clinic 20 minutes late. Janet, Amelia, and Jenny had already taken care of it.

Dec. 10: Take a 15-yr-old pregnant girl to Waspam because she´s too high-risk to give birth in Francia.

Dec. 12-14: Help lead Vacation Bible School for Francia´s children.

Dec. 13: Take a pregnant lady to Waspam for a C-section.

Dec. 15: Help lead a Pathfinder´s meeting in preparation for the coming camperee. Interesting, because I´ve never been a Pathfinder, and now I´m leading it in Spanish . . .

Dec. 16: Run around madly trying to find transportation to Waspam for a woman who´s had a stroke in the village of Wisconsin. Jeremy is gone, and without him to drive, we can´t take her in our truck. I am reduced to begging transportation for my patient from a truck that happens to be coming thru Francia. The driver says no. :( When Jeremy gets back, we have a birthday party for him, and I tell him to plan on driving to Waspam the next day.

Dec. 17: Coordinate getting my patient from Wisconsin to Waspam. Tell Jeremy how to take care of her - I can´t go with him because I have a health class this afternoon. Finish planning for health class. Spend a lot of time and effort and am pleased with my program - but no one shows up. Apparently it is bean planting season, and everyone is too busy to come.

Dec. 18: Clear the church yard in preparation for the Pathfinder´s weekend. This means cutting grass with a machete. It´s fun for the first half-hour. Then I start wishing the rest of the people who promised to come help actually would. They must be planting beans, too.

Dec. 19: Pathfinders arrive. Finish clearing church ground in the morning. The men who promised to help finally arrive and help. They tell me clearing ground with a machete is men´s work. :P Well, if the men aren´t around . . . I spend time in church playing Bible games and singing songs in the afternoon. In the evening I go back to the mission hill to shower, because I´m still gross from cutting grass. I´m ready to go back to town and sleep with Tekoa and the Pathfinders in the Community Center when a man comes to the hill and says they need help taking care of a burn victim in the clinic. The nurse, Janet, is gone. I rush down to the clinic to help the miwife, Amelia, clean her up. She has second degree burns on the back of her right calf, blistered, with blackened skin peeling off. Jeremy, Amelia, and I clean and put on burn cream. I tell Amelia to watch for signs of shock and give her rehydrating salts. Then I finally get to go to bed - with a bunch of hyper Pathfinders.

Dec. 20: Wake up at 5am to the first Pathfinder worship of the morning. Tekoa and I hadn´t realized this service was on the schedule. :( Jeremy and I go clean and dress our burn patient´s leg again. We have to cut off more dead skin that´s peeling up. It takes a long time, and we don´t get breakfast until 9am. After that, we head out to Santa Clara, where Jeremy, Jenny, and I are responsible for the church service. Getting on the road is challenging - we have to push-start the deuce in order to pump air into the tires of the four-wheeler and then start the four-wheeler off the deuce power. When we get back, we play more Bible games with the Pathfinders. After Jeremy and I clean burns again, we get to go to bed.

Dec. 21: 5am worship. [groan] Tekoa and I don´t get out of bed this time. Later we hear that the lady Pathfinder leader from Tasba Pain prayed in Miskito that God would forgive ¨the ones who don´t speak Miskito and are still asleep.¨ I want to tell her that the reason I´m tired is that I´ve been busy trying to save people´s lives recently . . . but I don´t bother. Jeremy and I go to clean our patient´s leg and find Janet, the nurse, back in town and there ahead of us. We´re relieved she´s taking control of the situation.
We go to the church for Pathfinder events. We haven´t been there for 5 minutes when Barney, our friend who works at the Adventist radio station in Francia Sirpi, comes and tells us that his son Sam is sick. The 14-month-old baby is vomiting and having diarrhea, which is a serious concern because he´s been delicate ever since he was born. He´s lethargic and I´m worried he´s dehydrated. We talk to Janet and another missionary nurse, Marilyn, and decide to take him to Waspam in Marilyn´s truck. The doctors take blood and stool samples to test and then try to start an IV on him. He´s tiny, he´s dehydrated, and I can´t see any veins in his arm where the doctor is fishing. Sam is terrified. It hurts to watch. They finally decide to try oral rehydrating salts first.
Jeremy and I leave Sam at the hospital and come home. We rest a little, then go to the Community Center and wait for the pathfinders to come in for the night. As they´re walking back from the church, some drunk teenagers from Francia try to pick fights with the Pathfinder boys and walk up close to the Pathfinder girls, scaring them into thinking they´re going to be molested. After we get everyone into the Center, the drunkards hang around outside setting off firecrackers and throwing rocks through our windows. It takes forever to get my girls calm enough to sleep.

Dec. 22: Worship this morning is even earlier than 5am. Tekoa and I stay in bed - we´re past caring whether we get prayed for in a pointed manner. Help get the kids off to their homes and clean up the church and Community Center. Work on sorting through our Christmas give-away bags all day. In the late afternoon, I go for my usual physical therapy with Joseas and discover that his blood pressure is through the roof - 184/106. I go get Janet and help her give him Furosemide, IV, to bring it down. Then I go help her care for the burn patient again. Throw a birthday party for Rachel in the evening.

Dec. 23: Wake up at 12:30am not feeling right. Sit near the bathroom for a few hours, then go back to bed. Wake up around 4am to throw up. Should have expected to get sick - I´ve been too stressed for too long. I go to Teekamp with everyone else to give away our Christmas bags, because I don´t want to miss out. I end up spending a lot of time in the outhouse there, but it´s worth it to see all the happy faces of people getting new clothes, shoes, soap, towels . . .

Dec. 24: Our Christmas at the mission house. Rachel spends all day cooking. I help a little, as I´m able. We eat a big dinner together and play the white elephant gift exchange game. I end up with a machete, which is exactly what I wanted for Christmas.

Dec. 25: In the morning we follow the Nicaraguan tradition of giving gifts of food on Christmas. We go to our friends´ houses with bags of cookies, and we stay and visit with them for a while. In the afternoon, we leave for Puerto Cabezas. Bridget´s parents are flying in for a visit on the 26th, and we want to be there to pick them up. On the way, we take the opportunity to jump off the suspension bridge in Sesin into the river 20 ft below. It´s fun - but by the time we get to Port, my ears hurt really bad, and I have a fever. I stay on my cot in the mission house listening to Christmas music and feeling sorry for myself while everyone else goes to internet and talks to their parents.

Dec. 26: I wake up feeling better and go spend all day (literally) on the internet.

Merry Christmas, everyone! Miss you all. My thoughts are with you, at home in the snow, as I bake in the sun here. I´m hoping for a more restful week coming up.

Joseas

2008-12-01T11:41:00.000-08:00

As I mentioned in one of my recent blogs, I´ve been doing physical therapy with a young man named Joseas. Dawn told me about him when I first got here - how he had gone to the States for open heart surgery and hadn´t had proper care while he was recovering here, resulting in him not being able to walk. Becky and Kathilee did some exercises with him while they were here, and Dawn was hoping I would continue.

One day I went to visit Joseas with Christina. While we read and colored with him, I observed his legs. For some reason I had been thinking that he was nearly paralyzed, but I saw that I was wrong - he moved his legs easily. Jeremy helped him get to church for an afternoon presentation and reported that he could stand up if he also supported himself with his arms. I began to believe that he could walk if we just made his legs a little stronger.

I talked to Ruth and asked her to help. She had a physical therapy internship recently and will be attending Loma Linda next year for PT. We asked Becky what they had been doing for him and tried to get in contact with a physical therapist in the States. In the meantime, Ruth and I started exercises based on what she knew.

We discovered that his legs were weak from not being used in so long, and his ankles were turned in. They were stiff from disuse and wouldn´t point out like normal ankles should. Their condition was making it hard for him to balance when he stood. The first day we visited him, we asked if he could walk by himself. He stood up to show us, which scared me. I stood next to him to catch him if he started to fall. Sure enough, within three steps he fell forward onto his knees. We got his walker out for him and watched him use it. He leaned on it heavily with his hands and just shuffled his legs to move forward. We knew we were in for a lot of work.

Ruth and I started a routine - three times a week we stretched and working his legs to build muscles, and we pushed and pulled on his ankles to increase their range of motion. We also had him practice walking from time to time - we had him exaggerate bending his knees to correct the shuffling problem.

We´ve kept that routine for over a month now. Last Monday we stretched with him as usual and then brought out the walker. He was leaning heavily on it, hanging on for dear life it seemed, and we wanted him to stop. Ruth told him to let go of the walker and practice standing up straight for a minute. Slowly he let go and straightened. Then we asked him to take a step forward. Tentatively he bent one knee up and moved his foot forward. Then he stepped again. And again. We stayed with him and kept the walker in front of him in case he started falling. But he didn´t fall. He kept walking.

About halfway around the room it hit me - Joseas is walking! By himself! We´re not touching him - he has the strength to stand by himself! He can keep his balance by himself! We reached the point we had started from and suddenly Ruth realized it too. ¨Joseas!¨ she exclaimed, ¨You just walked around the whole room by yourself!¨

Tears filled my eyes and Ruth´s. We could hardly believe what we had just seen. And Joseas? He stood up straight and laughed - just laughed. It was the happiest sound I have ever heard.

Last Friday night Joseas gave his testimony in church. He walked to the front of the church independently, with Ruth and me at his side. He thanked God that he is getting better now and encouraged the church to pray and trust in God. After church, he stood up with Ruth and me to go home, and his father brought his wheelchair over to take him home. But Joseas told his dad, ¨I don´t need that. I´ll walk to the door by myself.¨ And he did.

Joseas still walks slowly. He has to have us with him in case he loses his balance. And he can´t walk far - he gets tired pretty quickly. But he can walk, and he´s going to keep walking and getting better. God has really floored me on this one. He just used two people with a spoonful of training between them to get a man out of a wheelchair and onto his feet. All I can say is, I had an AMAZING Thanksgiving. Hope you did too. :)

Random pictures

2008-11-19T20:18:00.000-08:00

In the back of the truck under a tarp to protect us from the tropical rain storm. L-R: Ruth, Tekoa, and Rachel in back; Bridget and Christina in middle; Keegan in the front.

On Nicaraguan independence day last September, our friend Gali looking all dressed up. He´s one of the kids we love to play with.

Me waiting for the Independence parade to come by.

Me and Ruth.

The pet monkey.

Why Beans and Noses don´t work well together

2008-11-19T06:56:00.000-08:00

It was a lazy Sunday morning. I was reading my Bible in the hammock, waiting for worship to start at 7. Usually we have team worship at 6:30 am, but we were all tired that day from our church conference in Tasba Pain the day before.

I was just feeling relaxed and happy when Rachel called my name around the corner. ¨Some kid is here with something wrong with his nose. Do you want to come?¨ I went to the steps and saw a young mother with a 1-year-old boy in he arms. The rest of the medical team was already there, and Jenny was trying to discover what the problem was. ¨I think she´s saying he´s got something stuck in his nose,¨ Jenny told us, ¨but she doesn´t speak Spanish very well, so I´m not sure.¨

We looked up the kid´s nose, and saw . . . something. We weren´t sure exactly what. It was dark brown and shiny, and defintely blocking his whole nose. ¨Is it a bean?¨ The mom couldn´t tell us.

So the next big question, ¨What are we supposed to do about it?¨ None of us have ever taken college classes that even mentioned how to get beans out of one-year-old noses. We found some small forceps and started telling each other, ¨Do you think these will work? Will we just push it farther back? Do you wanna do it? I don´t wanna do it.¨

Jenny and Mindy bravely decided to try. The kid immeditaely started screaming and struggling, of course, and the forceps kept slipping off the bean (or whatever it was). We were clearly making no progress.

I suggested using a syringe to try to suck it out, so we went to the clinic to try. That method was even less effective then the forceps.

We were in over our heads. Jenny and Mindy went to get Janet, the MINSA nurse. I sat in our clinic watching the kid glare at my mistrustfully from his mom´s lap.

Janet told us she had alreayd tried getting the bean out the night before, and couldn´t, which is why the mom took him to us. (Great). She knew another method to move it, though - stick cotton in the kid´s ears, hold the open nostril shut, and blow hard into his mouth. With no other exit, the air would have to go through the blocked nostril and push the bean out. So which of us wanted to blow in his mouth?

Silence.

¨OK, I´ll do it,¨ I said. (¨What am I thinking?¨ I said in my mind). So we held the kid´s ears shut, put a finger on his other nostril, and held down his legs to keep him from kicking me in the stomach. I leaned over him, took a deep breath, and dove.

There´s nothing quite like sealing your mouth around the snotty, screaming mouth of a one-year-old baby and blowing from you diaphragm. Classical singer´s training is good for something, I suppose. But it didn´t work. The stupid bean wouldn´t move. We tried for two hours, alternating me blowing and Janet trying to pull the bean out. Finally Janet said we would try later that afternoon. The kid´s nose was pretty swollen, so we gave him ibuprofen and hoped it would go down.

We went to Janet´s house that afternoon and found her smiling. She had already got the bean out two hours before. ¨How did you do it?¨ we asked in wonder. ¨With this!¨ she said, and pulled a bobby pin out of her hair. She said it was huge - not a normal bean at all - and the kid´s nose was small. We had good reason to have trouble getting it out. It took the bobby pin to get behind it and scoop it out.

You get everything around here, I suppose. Still, that was pretty weird. I´m now the official mouth-to-mouth bean-getter-outer at the clinic, and we know to keep bobby pins on hand.

2008-11-18T13:53:00.000-08:00

Hey everyone! I was going to give you some pictures this time, but they didn´t upload properly. Sorry.

I´m busy working at MINSA. We have a new doctor there named Rachelle. She´s very nice, and I´m learning more Spanish working with her.

I´m also doing physical therapy with a young man named josias Simmora. He can´t walk and is somewhat mentally challenged, but also the happiest person I know. I love watching him get stronger and more flexible, and am longing for the day when he can walk to church by himself.

That´s all I have time for now. Keep praying! and I´ll try to get more out soon.

Change of Plans

2008-10-20T13:57:00.000-07:00

We got back from Puerto Cabeza on Wednesday night, a day late. After all the excitement that a trip to town entails, we were planning on a nice, normal last two days of our week. Problem with that is, we live in Nicaragua . . .

On Friday morning I was settled in my hammock studying Miskito and listening with one ear to Jeremy, Zephan, and Rusty testing out the hand-held radios. Payton took the four-wheeler to Santa Clara to see if she could talk to us from there. (Speaking of the four-wheeler, yes, it´s still running, but the back right wheel falls off from time to time while you´re driving it). I heard the four-wheeler come back into our driveway, and suddenly Dawn started yelling for Bridget, our picture maniac, to come quickly with her camera.

I ran out with my camera too and foud Payton unloading a baby sloth from the back of the four-wheeler. Actually she was detaching its claws from the four-wheeler rack—sloths grip hard! Payton had found the animal on the road with no mother in sight. Some kids from the village who were with her wanted to kill it, but she wouldn´t let them. She had wrapped the sloth in a shirt and brought it back so she could beg her mother to let her keep it.

We all marveled at its sharp claws and squashed-looking face. Then we wondered what to do with it. What does it eat? Will it live in a box? How will we keep the dogs from eating it? We finally put it on a post of the verandah and let it do what it wanted, which was climb . . . slowly . . . around . . . all the buildings.

After settling the sloth, I became involved in a conversation with a man who was sitting on the porch with Zephan and Jeremy talking and asking questions about what it means to be a Christian. Zephan has the best Spanish, so he was doing most of the talking. I was amazed, though, at how much I could understand and even contribute with the little Spanish I know. God gave us such a thrilling opportunity to share—the man was completely curious and open to what we were telling him about living with God.

We asked the man to stay for lunch. I helped him prepare his plate, since one of his hands doesn´t work so well after having a bullet pass through it. Right after lunch while I was trying to feed the sloth, Payton suddenly remembered that Mindy and Jenny had told her to tell me there was a lady giving birth and I should go help.

I rushed down to the house of Amelia, the village midwife. Amelia´s niece was giving birth inside. She´s just a girl, seventeen years old and bearing her first child. She´s small, too, and it seemed that she was having trouble. Mindy and Jenny told me that her water had broken several hours ago, but the baby still hadn´t come. All we could do was sit and help her through the contractions while we waited for the baby.

Mindy and Jenny decided to go eat lunch, but I stayed with the mother and tried to help Amelia, Janet, and the other ladies attend to her. Soon after Jenny and Mindy left, her contractions grew stronger. The women were holding her shoulders and knees back with each contraction, and Amelia was watching the birth canal carefully. Suddenly I heard her say, ¨Tuks! Tuks! [Push! Push!]¨ I moved to stand next to her and saw the baby´s head crowning. Amelia told me to help hold the woman´s knees back so she could catch the baby. With the next few contractions the head came out—but slowly. And then just the head was out and no more was coming. Amelia reached in around the baby´s neck and pulled off the umblilical cord. It had been wrapped around the infant´s neck, strangling her.

Amelia yelled to the mother to push, and she grabbed the suction bulb and started sucking the mucus out of the baby´s nose and mouth. I didn´t know what to do—I felt in the way and scared. So scared—because the baby´s head was blue, bluer than normal for a newborn, and I didn´t know how long it had been without oxygen. I started praying hard.

The mother delivered the rest of the baby´s body, and Janet rushed in next to me, cut the umbilical cord, and moved the baby to a blanket on the floor. She started rubbing the baby´s body, holding it between her hands and desparately massaging. Another woman brought in salt and chicken feathers and started using a feather to tickle the inside of the baby´s nose and ears. She blew into the baby´s mouth while Janet kept rubbing. Janet handed me an ampule of atropine to prepare for injection, but I didn´t know where her syringes were. So I just sat there and prayed, and watched, and FINALLY--the baby started crying. Very weakly at first, but as Janet kept rubbing, it became stronger and fuller, until it sounded right, like a healthy newborn cry.

We all relaxed. ¨Mairin [it´s a girl],¨ we told the mother, and Janet gave it the atropine and wrapped it in some clean clothes. Then the women handed it to me to hold while they cleaned up the mother. It was so tiny! I watched and listened carefully to make sure it was still breathing, and I thanked God that its face was pink now.

Jenny and Mindy showed up too late for all the excitement. :D The women asked us to name the baby, but we couldn´t decide. We said the mother should choose one of our names. :)

We walked back to the house, tired and excited. Somehow I wasn´t surprised when we found a new animal waiting at home—a kioki, I think it´s called in Miskito. There is no English word that I know of, but it´s a rodent, bigger than a rat, with sort of kangaroo legs. A man had been selling it for food, but Rachel had bought it to rescue it. I held it and thanked God for the miracle of life—animal life, new human life, and new spiritual life in my friend from earlier in the day.

So you can see from this post that no day is predictable here in Nicaragua. My plans change over and over again. I run wildly from one new situation to the next, and pray that God will prepare me for each one. It´s utter madness, but frankly, I wouldn´t change it if I could.

Pictures

2008-10-15T07:43:00.001-07:00

A turantula we found in the clinic the first day. I thought it was dead when i took this pic, but later came back and it had moved . . .

Francia kids hanging out watching us thru the clinic door. They hung there nonstop for the first few days we were working.

Jenny and Mindy sorting thru the cockroach-dung-covered contents of the mobile clinic suitcase.

A definitely alive turantula. I took video too. :)

Jeremy, Jenny, and Mindy running a mobile clinic in Wisconsin (a village, not a state). We meant to go to Esperanza that day, but got a little lost. Oops.

Packages

2008-10-15T07:30:00.000-07:00

The other great God-thing from the broken clavicle experience was the fact that my first two packages from campus ministries arrived with Dawn just before we left to take Rusty to Waspam. Right in that moment full of fear and anxiety, I held in my hands my new Project impact Tshirt, all the Clocktowers and Ministry Matters, and, most importantly, the piece of paper signed by all my friends on registration day. It seemed that God had saved the arrival of that encouraging package until the moment when he knew I would need it most. I sat in the back of the truck wiping blood off of Rusty´s forehead every few minutes, reading the notes from my friends telling me to stay strong, that God was with me.

Never underestimate the power of those little notes CM is always asking you to write. They always bring me a huge blessing from God.

The Craziest Week in which Everything Went Right (Thanks to God)

2008-10-13T20:13:00.000-07:00

A week ago last Sunday, our missionary directors and family, Rusty, Dawn, Payton, and Keegan Zimmerman, went to Port for groceries. That night, while they were gone, we got a patient to transport. He had a broken collarbone, and we had to take him to the ¨switch¨ where the bus stops so he could get to the hospital in Waspam. He stayed overnight at our mission, and we had to pray really hard for the four-wheeler to run the next day. It´s new trick is: it´s begun to turn off randomly, sometimes while climbing a hill, but always for no good reason. As if it didn´t have enough problems.

On Wednesday night Rusty got back. The rest of his family was supposed to come later that night with the Halversons, the missionaries who run the radio station. However, the Halversons´ truck didn´t come back. So the next morning, Rusty went on the motorcycle to look for them, supposing that they had broken down on the road. On the way, he came over a hill and ran into a truck he hadn´t been able to see. The motorcycle destroyed its front half on the truck´s front tire, and Rusty flew thru the air and landed on his left shoulder. Thanks to God, another truck came along just then and brought him back to Francia.

I was on the verandah feeding the parrot when Mindy ran up yelling for Jeremy and me and looking terrified. She had been at the MINSA clinic when Rusty was brought in. We hopped on the four-wheeler and headed down. Sure enough, Rusty looked pretty bad. His shoulder was hanging way lower than any shoulder is ever supposed to go. I thought it was certainly dislocated, and maybe also had some broken bones. We decided to take him to the hospital in Waspam. The owners of the truck that had brought Rusty back offered to drive us if we would pay for gas, but, again thanks to God, the Halversons and the other Zimmermans got back just at that moment.

So we four medical people, Dawn, and Rusty went in the Halversons´ truck. We got to Waspam and went to the hospital, but they told us that the emergency doctor and the orthopedic doctor were both gone and they didn´t know when they would return. Typical Nicaraguan health care. We were walking away to find somewhere to eat and wait, but just at that moment, thanks to God, we saw a doctor we knew personally. He pulled some strings, and Rusty was seen immediately.

The X-ray showed that Rusty´s collarbone was broken, and I mean broken. It was in two very separate pieces, about three inches away from each other. The doctor in Waspam said probably surgery was necessary to repair it. For that, Rusty would have to go to Puerto Cabezas, if not Managua or the States. The next step for us then was to get ahold of the missionaries with the airplane, Clint and Marilyn, to fly Rusty to Port. We sent out a radio message for Clint, but didn´t have to wait long. In about half an hour, we heard his plane landing. You see, by ¨chance¨ Clint was already on his way to Waspam. He had been in town in the morning to drop his mother off, and the hospital had asked him to come back with his airplane because they wanted him to take another patient to Port for them. Thanks to God, he flew in at just the right time to take Rusty too.

So Rusty went to Port in the little plane and we brought Dawn back to Francia so she could catch the bus to Port the next day. She went at 6 in the morning and took her son Keegan with her. Poor kid--that day was his 11th birthday, and he had been so excited to turn 11 for so long. We hated the thought of his day being ruined, so we all got up at 5am to have a party for him. We made mac and cheese--that´s really special food here, and he loves it. He got 11 little presents from his family and a scooter from all of us. He was so happy.

After Dawn left, it was just the ten of us student missionaries with no director. We were planning for the worst scenario--that Rusty and Dawn would be in the States for a long time and we would have to function on our own. We knew that we could handle it, but it was still somewhat sobering. We had our plans worked out for getting to Port and buying food. We were planning on taking the bus to Port yesterday, because Jeremy has only driven our truck (a 1965 military deuce) once and isn´t completely comfortable with it, especially starting it. It doesn´t actually start on its own--you have to roll it down a hill or push it. Plus we just fixed the brakes, so we weren´t sure if they were working, and we had just put on a ¨new¨ radiator, which we weren´t sure would work. (At this point in my conversation with my sister, she asked politely, ¨Does anything on it work?¨ And I replied, ¨It´s actually the safest, most functional vehicle we have.¨ To which she said, ¨Awesome.¨)

Because of all these concerns, we decided that Jeremy would only drive the truck as a last resort. And then the story got interesting. :) On Sabbath, we were sitting in church and someone handed in a note from Janet, the village nurse. She wrote that there was a baby being born and that we could come help.

We figured she didn´t actually need our help, so we waited till after church and lunch, then headed to the lady´s house. The baby, a little girl (Maidin in Miskito) had already been born around 1:00. However, the mother still had a hard lump in her uterus. The placenta had already delivered, so we knew it wasn´t that. She had stopped having contractions, but she said she was in pain. All she had strength to do was lie on the floor with an IV dripping into her arm. Amelia, the midwife and Janet´s mother, told me she thought the lump might be another baby, but she wasn´t sure. I felt it, and it felt like a baby to me, and when Amelia used the Doppler, we picked up a heartbeat. It was too slow for a newborn, though, and I wondered if we could be hearing the mother´s abdominal aorta, but Janet said no.

We asked Janet if the mother´s condition was serious. --Sí, es seriosa! she exclaimed, and told us that the mother could die if she didn´t get to the hospital in Waspam. We went and asked Mike Halverson, the radio station missionary, if he would take her in his truck, but he said no. So Jeremy and Mindy bravely went to start our deuce.

Mindy pressed the gas pedal with one hand and the starter button with the other. Jeremy worked the clutch and the brakes. The truck rolled down the hill and started, and it turned out we did have brakes, which was good. They drove to the mother´s house. She couldn´t walk, so we had to get people to carry her. I was going to help Ruth get a mattress and blanket from our clinic, but Jeremy told me he was worried about the radiator and asked me to go get some containers for water. So I ran up to our mission house, grabbed two big jugs, and ran back. By the time I got to the truck, the mother was loaded and ready to go. At the clinic we filled the jugs with water and discovered they both had holes in them. We laid them in the truck hole-side-up to minimize leakage.

After loading up all the people in Francia who wanted a free ride to Waspam (this is a normal part of emergency patient transport), we took off. Poor Jeremy--he was pretty stressed. He really hadn´t planned on driving the truck anywhere by himself. He wanted to drive carefully, too, so the lady wouldn´t get bounced around on our rutted roads. He did an excellent job, however—he even handled it when the truck tried to stall in the middle of going up hills. We prayed hard for the engine, the radiator, the brakes, and eveything else—and, thanks to God, everything functioned!

We got to the hospital safely, got the lady in, and hugged Jeremy and told him we were proud of him. The doctors said the mother didn´t have another baby in her uterus, but they didn´t explain what the lump was. They said she had sepsis and started her on an antibiotic. We saw her settled in bed with her baby girl, whom Mindy had been holding for her on the truck, and then we drove back to Francia.

When we pulled in at Mission Hill, we heard a familiar voice call from the porch, ¨OK, Jeremy, you can breathe now!¨ We looked at each other and said, ¨No way!¨ But it really was—Dawn! She and Rusty had gotten back on the bus that afternoon. It turned out that the doctors didn´t have to do surgery. They just set the collar bone and gave him a brace. We spent that evening praising God for all the coincidences that we knew weren´t by chance. We felt so blessed that He kept us safe through everything. And we felt so blessed by our delicious homemade pizza! No cheese except Parmesan to sprinkle on after baking, but it was still amazing. I think pizza qualifies as a blessing straight from God, too.

Pictures

2008-10-13T15:53:00.000-07:00

I can´t believe it´s been a month since I posted! I have an exciting story to tell everyone, but not enough time to type it right now. I´ll either post it tomorrow or get it to you in installments through the radio mail. For now, here´s some pictures from my first two months in Nic.

at COVANIC

In the airport waiting for our plane to Puerto Cabezas

Mindy and Jenny displaying our boarding passes

Me on the plane flying into Puerto and me after our 4 hour ride from Puerto to Franica. Note the difference.

Me, Mindy, Jenny, Jeremy, Tekoa, and Christina immediately after arriving in the Managua airport

Transportation Woes

2008-09-14T14:40:00.000-07:00

For our mobile clinics, we´ve been riding the mission´s four-wheeler. We stick our suitcase full of medicine and supplies on the front, and two or three of us ride. The others of us have to ride bicycles, or sometimes a motorcycle, but those break down and get flat tires about every time we ride them. The four-wheeler isn´t in good shape either. It´s welded and duct-taped together all over, it doesn´t have brakes, and the rear axle is broken. That means that we only have drive power in the front wheels, which makes it really hard to climb hills. Every time we come to a hill, we all lean forward to put the weight on the front and cross our fingers.

Last Tuesday, we were headed to Tasba Pain to run a mobile clinic. Predictably, the motorcycle got a flat, and Jeremy had to drive it back to Francia. The three of us girls continued to Tasba Pain, where we met a very steep hill that curved sharply to the right, with deep ditches on either side. We tried to shift our weight to the front to climb up, but because of the broken rear axle, we lost momentum quickly. We tried to downshift, but ended up in neutral and started rolling down the hill backwards. We decided to steer to the bottom of the hill and try again. However, because the four-wheeler does not have brakes, we could not control our speed. It was difficult to steer with all three of us, and then a small child ran across the road. We swerved, fish-tailed on the gravel, and ran into the left-hand ditch backwards. We fell on our backs on the ground left of the four-wheeler, and it almost rolled on top of us. We had to push it off of us with our feet, and, praise God, it settled on its wheels.

I landed on top of Mindy, so I wasn´t hurt as badly as she was. :P I just have a bump on my head, a bruised and scraped left elbow, and a bruise above my left hip. Mindy has scratches acroos her whole back and she feels like she pulled a muscle in it. She also has a big skinless patch on her left elbow. Right after I finished cleaning and bandaging her scrapes, she started blacking out and feeling like she would throw up. Fortunately, she was OK after sitting still for a few minutes.

We went ahead and opened our clinic to treat people that day. After we finished, we had to get back on the four-wheeler and drive home (thank God it started again). We had no way to tell someone at the mission to come pick us up. That drive home was the worst part of the day. We were intensely afraid we were going to crash again, and Mindy and I got off and walked up at least five of the steeper hills, just to reduce the weight on the four-wheeler. We got stuck in a mud-puddle, too. All in all, a bad day.

I really wish we had better transportation here at the mission. It´s frustrating to feel like I have to risk my life just to get to the people I want to serve. Please pray that we can get something that works better--soon.

Mobile Clinic

2008-09-07T13:00:00.000-07:00

We ran our first mobile clinic last Monday in the little town of Santa Clara, about a 30 minute bike ride from Francia. I think the clinic went well, for our first time, but we felt incredibly overwhelmed. We were diagnosing and treating bronchitis, UTI's, pneumonia, roundworms, pre-eclampsia, and about a hundred kids with fever, vomiting, and diarrhea. We had to pull our books out every time to figure out what to do, and it felt like we were spending a long time on each patient. We hadn't packed
enough children's Tylenol, and Jeremy and Mindy had to go back for it. Overall, we just felt inadequate. I mean, we're CNA's--we're only licensed to take vitals and help patients bathe and use the bathroom.

Our other two clinics this week went more smoothly. It feels like we're getting a crash course in pharmacology and pathology, and our knowledge base is expanding. Pray for increasing knowledge, and pray for transportation. Next week's clinics are farther. We can't all ride the four-wheeler, but it would take 3 hours one way on the bicycles, even if the bikes weren't falling apart. We may be able to take the motorcycle for now, but we're hoping to buy a horse and cart soon--that will be a huge improvement
over technology!

Sorry if you tried the email address I posted and it didn't work. I found out it won't really work for everyone to email me there, so please send to katiebooton at gmail dot com instead. I'll still be able to check that once a month or so.

My email address at the mission

2008-08-29T13:31:00.001-07:00

Hey everyone, you can write to me in Francia at yn4rra at winlink dot org

Your email will get translated to ham radio signal, sent over to Nicaragua, and translated back into text for me to read. At least, that´s how it´s supposed to work and how it hopefully will work after we get our end of it fixed. :) It should be working within the next few days, so maybe I can write back to you too.

I forgot to mention in the last post that Dawn Zimmerman, our mission director who was hurt in that motorcycle accident, is doing very well now. She met us at the Puerto Cabezas airport with her right leg and arm wrapped in bandages, on a crutch to support the leg that had to have gravel dug out of the kneecap, and she was smiling. She´s intensely hard-core and very much in charge of and taking care of all of us SMs. The idea that I might have been trying to take care of her is laughable.

Moments from my first week in Francia

2008-08-29T12:24:00.000-07:00

Sunday, August 24,10 am
I´m in Managua´s domestic airport waiting to board my flight to Puerto Cabezas. We wait and wait and they don´t call us, and finally we realize we´ve been bumped to the next flight. We ask when it will come. The best answer we can get is ¨when our plane lands.¨ It´s a long wait. I employ the time well by getting Jeremy to teach me how to handle a hacky-sack.
Sunday, 2:15 pm
Finally in Puerto Cabezas, we get off our tiny plane and enter a deluge of rain. We run through to the tiny airport building, and one of the attendants hands us a note from the Zimmermans saying they´ll be back for us at 2pm. So . . . where are they? Then we ask where to go to pick up our luggage. The response: ¨Oh, it didn´t come on the same plane as you. It´ll be here at 8:00 tomorrow.¨ Oh. No. Most of us didn´t pack enough clothes and toiletries for this twist.
Sunday, 7pm
The Zimmermans came for us, we went shopping for bicycles, notebooks, and shampoo in the market, and now we´re at a little restaurant eating the local food—grilled chicken, cabbage-tomato-and-onion salad, plantain chips, and, of course, beans and rice. Next we plan to head out on the flatbed truck for Francia Sirpi. It should be a fun ride!
Sunday, 10pm
Two hours, five bruises, and two lungs full of exhaust fumes into, it´s not fun anymore. We´re driving on what must be the most rutted dirt road of its size in the world, and I´ve been bouncing around the bed of this truck, hitting the walls, our carry-on luggage, and bags of beans and rice. Plus, the wind carries away all my body heat by convection. I lean back into some bags and brace my knees against the truck side. The jolts kill my knees and back every two minutes, but I´m a little warmer. Two more hours of this, though? I´ll never make it. But then I look up—and the stars are glorious.
Monday, 10am
Rusty Zimmerman is talking to us about the mission and our jobs here. He´s drawing a map of the villages our mission serves. I´m wearing the same too-big, sweaty, muddy scrubs I wore yesterday, and I haven´t showered. It´s ridiculously humid, and these little black gnats are turning me into a pin-cushion. I´m also trying to adjust to the fact that I have an affectionate spider-monkey sleeping wrapped around my neck. This is a lot to take in . . .
Tuesday, 11am
Becky told me she left the clinic a little messy, but she couldn´t have prepared me for what I found. In the three months since she left, we´ve had two or three break-ins. People have thrown our equipment around looking for stuff they can sell (they usually take scrubs, for some reason). Furthermore, in the absence of human habitation, the cochroaches have moved in. A layer of cochroach poo covers rotting cardboard boxes, musty rubber rubs, and rusting metal basins stuffed full of bandages, medicine, instruments, and who knows what else. The disorganized junk covers shelves, counter space, and the floor. The worst part is, we´ve been cleaning for three hours and it still looks terrible. If I didn´t have all seven of the other SMs working with me, I would be sitting in a corner crying right now.
Tuesday, 1pm
I found Rilla Westermeyer´s old Peanut Gallery (UC student directory) in the clinic, and I´m looking through it during lunch for pictures of people I know. When I mention Rilla´s name in front of Ms. Brown, our cook, she lights up with happiness. Apparently Rilla, who came as a student missionary from Union several years ago, was a big hit in this village. She became fluent in Miskito rapidly and started a Pathfinders club for the kids. ¨All children Rilla good,¨ declares Ms. Brown. Later I´m sitting in the hammock trying to learn Jesus Loves Me in Miskito. Ms. Brown sings along, then says approvingly, ¨Maybe you be like Rilla.¨
Tuesday, 5pm
Our luggage is finally here! Dawn Zimmerman stayed in Puerto Cabezas to wait for it and brought it with her on the bus. I will never underestimate the value of a clean shirt again.
Wednesday, 5pm
We four medical SMs have been cleaning the clinic ourselves today, since the other girls have gone to the school to teach. The clinic looks so much better—we actually have clean, usable counter space now. I just finished putting all my IV´s and needles in order by gauge, and I feel so triumphant.
Wednesday, 6pm
I´m running around playing ¨Cut the Cake¨ with a swarm of Miskito children as part of evening Bible School. We just finished singing songs in English and Spanish, and 13-year-old Payton Zimmerman has been translating into Miskito for us to tell them what to do. After we finish the game, we walk home with the kids who live in our direction. I stretch the limits of my Miskito with the kids nearest me: ¨Naksa,¨ hello. ¨Nakisma,¨ how are you? ¨Ninim dia,¨ what is your name? How will I ever remember their names? They´re the most incredible conglomerations of sound I´ve ever heard. Brudilia, Ceedilia, Nesli, Kati. That last one is close enough to mine for me to remember. :) Payton tells me it means ¨moon.¨ Maybe that should be my name while I´m here.
Thursday, 4pm
Inventory of the pharmacy. All day. Typing up how many we have of what meds. Trying to figure out what the meds are for—we´re just CNA´s, after all. Some of the labels are in Spanish, and that makes it harder to look up in our drug book. Some of the meds aren´t labeled, they´re just sitting in plastic bags, and that makes it really hard. Some meds are rotting, and we have to throw them out. We´ve finished all but the bottom shelf, but we just ran out of battery on the laptop. The rest will wait till Sunday—we´re going to Waspam tomorrow. We´re going to talk to the people at the hospital about how to use our microscope to test for malaria, and we´re going to get internet.

Sorry about no pictures yet--I´m working on it, having trouble with my computer.

Sabbath at COVANIC

2008-08-23T18:26:00.000-07:00

Because we´re missionaries, we´re expected to help with church. We should know that, but it still surprised us when the pastor came up to us on Friday at lunch and asked which one of us wanted to preach on Sabbath. :D We weren´t sure whether he was kidding or not . . .

We managed to convince him that none of us were up to preaching, but it was a little scary for a while. We did, however, help with Sabbath School by reading en espanol from Ellen White about the activities in the New Earth. (We were practicing our parts for a few days before). And then the pastor asked for volunteers to lead songs during the baptism. No one spoke up. Ruth and I looked at each other and said, ¨Hey, we can sing.¨ So we did. We stood up front and the people told us which songs to sing, and we announced them. Of course, we didn´t know the songs, so the people in the front row actually started them. We just pretended we knew what we were singing. Still, there we were, leading songs we didn´t know in a language we don´t speak fluently. Pretty cool experience, really.

After church, the pastor asked us to help lead the youth service in the afternoon. We thought he meant we should plan the whole thing, so we spent a few hours planning songs, games, Bible verses . . . When we got there, we discovered they already had a plan and they just wanted us to jump in and help. Since only Jenny is fluent in Spanish, that´s not exactly easy for us to do. The lady in charge kept grabbing my arm and talking to me really intensely in Spanish. Sometimes I can understand when people speak Spanish to me, but I had no idea what she was saying. I kept telling her, ¨No intiendo [I don´t understand].¨ Apparently she thought if she just talked louder and faster I´d understand what she wanted. :P With Jenny´s help, she finally got me to lead songs I didn´t know again. :D

We also played Sword Drill with our Bibles (the game where you have to look up a Bible verse faster than everyone else). That´s another one that´s harder with the language barrier. Not all Bible books sounds the same in Spanish and English. :P

I´m pretty impatient with the language barrier right now. I can tell I´m getting better at Spanish, but too slowly! And when we get to Francia Sirpi, we´ll have a whole ´nother language to learn. We started last week--some of the students here speak Miskito. We spent one evening trying to learn Miskito from them by means of our limited Spanish. The dean was also tranlating for us between Spanish and English, so we were speaking three languages for about half an hour. It made my head spin. :P

I forgot to say last time--for those of you who know Josh Enevoldson, Jeremy Meyer that I´m working with is his cousin. And another SM, Christina Tozer, knows Angela Gaedke from Camp Wawona. It´s nice to have friends in common.

We fly out to Puerto Cabezas (Port) tomorrow, and then we´ll go to Francia Sirpi, where the real adventure begins. I don´t know how soon I´ll be able to post again--maybe from Port. When I post from Francia, it will be short posts with no pictures. I´ll try to get pictures on soon, but I haven´t gotten that together yet and I can only do it from Port.

Don´t let that discourage you, though--send me an email, letter, package, whatever! And keep praying--it should be crazy organizing the clinic and figuring out life in Francia. Also, it sounds like Dawn Zimmerman is hurt pretty badly--I think they had to do sugery on her knee to get the gravel out.

I miss you all! Much love from Nic :)

I can blog from Nicaragua!

2008-08-22T17:27:00.000-07:00

Ok, that sounded goofy, but I just found out, thanks to Evan Oberholster the magnificent (you´re awesome, buddy), that I can send emails to my blog and it will post them. So I don´t have to wait till we go to town to blog--i can email short blog posts from where i live via Ham radio. I´m happy about that. :)

Right now I´m still in Managua, at the Adventist academy COVANIC, using internet at the director´s house. We will fly to Puerto Cabezas on Sunday and then go to Francia Sirpi, our final destination. Because our tickets were already reserved for Sunday and the flight bookings are so tight, it was impossible for me to fly out early to take care of Dawn Zimmerman. (For those who didn´t get my email: Dawn is one of the permanent missionaries at Francia. She was in a motorcycle accident earlier this week and got badly burned. There was talk of flying me out earlier than Sunday to help take care of her, but it didn´t materialize for the above reason. They got a local nurse to take care of her, and I think she´s probably better off with someone fully trained.)

This week we´ve been at the Managua Adventist academy, COVANIC. We were supposed to have ¨teacher orientation¨ here, mostly for the SM´s who will be teaching in the school, but also for us clinic workers who will give health classes. Unfortunately, the people at the school didn´t have a good idea of what Christina Vargas wanted for us. They asked us what kind of work we would be doing and what we needed, and we had no idea. The teacher SMs don´t even have a curriculum. :( So the director´s wife showed us the basics of how to make a lesson plan on Wednesday, and then Thursday and today we sat in classes and observed. (That helped us get to know the kids better). Other than that, this has been free time for us. We´ve talked to each other, practiced our Spanish and a little Miskito with the kids and teachers, helped in the kitchen with dishes and food, and excercised. :) (Crazy American girls, running all over campus).

I think it´s been good for us to have this time to adjust and get to know each other. Last night we started having worships together, and we want to continue all nine months. And we´ll continue running. Christina is really gung-ho about excercise, and i´m wanting to be too. We´re getting the other girls into it. :)

Here´s who we SMs are:

Mindy from Southern: She´ll work in the clinic with me--she´s pre-physician´s assistant and a CNA.
Jeremy from Southern: He´ll also work in the clinic--he just finished a biochemistry degree and is going to medical school next year. He´s a CNA.
Jenny from Southern--health sciences major. She´ll help in the clinic, but she´s not a CNA.
Christina from Southern--used to be occupational therapy major, but now she´s undecided. She´ll teach high school English.
Tekoa from Southern--Social work major, will teach elementary school.
Ruth from Walla Walla--she´s going to teach science. She just finished the physical therapy pre-reqs.
Bridget from Walla Walla--just finished a two-year business degree and might go back for elementary ed. She´ĺl also teach English.

And me, the only one from Union. Feeling a little out of it, but I keep singing the school song to cheer myself up. :)

I miss you all! pray for me.

Katie