La Casa De Refugio

La Casa de Refugio, or in English, The House of Refuge, which means a place of shelter, protection, or safety.  La Casa de Refugio is a house right next to the government clinic in Las Salinas, which was used as a gathering place in case of emergencies.  About two years ago it was donated to FIMRC to start our Pediatric Program.  The name is only fitting, the space has become a place of safety and the new home for FIMRC.  We have spent the past two years working out of the government health post building up our connections in Las Salinas and making our name known in the community, however we were also taking up space that was needed there, using supplies that were needed there, and having our supplies unfortunately go missing at times.

After about a week of working hard cleaning and organizing with the CEO of FIMRC, Meredith, we have officially opened the Casa De Refugio.  Now, FIMRC has a home and a place to call our own, where we feel safe and where the people of the community can come and feel safe as well.  It is amazing to see the programs we are doing here expand and now with our own space we are able to be so much more productive and have space to run more programs.

We now have our own working Pediatric Clinic twice a week when the Pediatrician comes in from Rivas with our own pharmacy supplied by donations and bought medications.  Monday mornings we are continuing to run the developmental center, where we have a regular group of about 6-7 kids who have a major developmental delays.  There is one family of three children aged 6, 8, and 12 who are all in the first grade together because they keep failing.  These kids don’t know their colors, numbers, letters, or shapes, which has become the main focus of the developmental center.  We have changed the focus from early stimulation to a supplement of “school” having a set organized schedule including “circle time” as if it were a preschool.  We have seen an enormous improvement in the kids once we started with an organized time.  The kids are excited to be in “circle time,” the kids are more focused throughout the hour of the program, and the kids have improved their ability to draw, write, and color as well as remember colors, shapes, and numbers.  We focus on one color, shape, and number a month to ensure that they learn with repetition of the same thing.  As the schools here are full with 30-40 kids in one classroom, the kids with developmental delays get left behind, which is why our program is so important and will hopefully continue to be beneficial. We have also started a prenatal program, seeing as there are around 200 pregnant women all within the age group of 13-40.  We have worked on having a birthing plan, seeing as the hospital is one hour away in car and an hour and a half in bus. They had to figure out if they go into labor in the middle of the night how they would get to the hospital, what money they need to save to be able to get to the hospital, what they need to bring, etc.  We also have done different teaching sessions on what to expect in labor, nutrition and excercise during pregnancy, what to expect during your pregnancy, and warning signs of when you should go to the clinic or hospital.  We have four women that come on a regular basis and are so excited to have this group to come to and share their experiences with one another.  We have also started a teen group, which may be are largest group where teens come once a week and talk about different topics, do team building activities, and play games together.  It is great to see how we are impacting the community and how we as an organization as a whole are becoming more apart of the community. 

A place of safety, shelter, and protection.  That is exactly what we want to bring to the community and with La Casa de Refugio, we are able to provide that.  Thank you Las Salinas for letting us be apart of the community and giving us the space to do so!


“Vamos a pescar!” my friend yells at me as we throw our swimsuits on and start running for the beach. Apparently in summer (because it is summer here now) is when the fish come out, and did they ever come out. We start walking to the next beach down from where I live and have to swim across a mini river to get there. As I immersed myself in the water the smell of fish was overwhelming and I swear I could taste the fish in my mouth. We made it a across the river and what I saw next was incredible. There had to be around 30 people all with their nets and fishing rods, running into the water and running out of the water with an insane amount of fish. I watched as my friends Pila, Irnan, and the guy who watches over my house Carlos, all get prepared. Irnan whips out a hand-made hand real, Pila whips out his make-shift net and they both take off running for the ocean. In his first attempt, Pila catches around 10 fish in his net, runs to the beach, throws them down and Carlos (who is around 60 or 70 years old with missing teeth and can barely run) runs toward the fish putting them into his bag. The competitiveness among the fishing reminded me of women in a bridal shop on sale day, running franticly toward the dress (or fish) of their dreams not caring who else was there, getting it and running away with it. The day continued like this with everyone running into the water, coming out with at least 10 fish in their net, and running to the shore while someone was there to follow them and guard the fish that were caught. As the tide moved, the bunch of people moved with it, running down the side of the beach and following the birds, who also wanted to benefit from the fish and were diving down getting some food of their own. As the sun began to set and for the most part, everyone had caught more fish than it would be possible to eat, and everyone started packing up and heading home with bags full of fish. As we came across the river, the tide had come up and the current was much stronger. I jump in and start swimming across. My friend Irnan jumps in and starts swimming with the bag full of fish over his head. Pila and Carlos start swimming across with my surf-board to help, seeing as Carlos is not a strong swimmer. As they start out the current gets them and starts pulling them out to sea, they are both frantically trying to swim toward the shore but cannot fight the current. Luckily, there were three surfers around who all jump on their boards, go swimming to them and safely rescue them. Finally we are safe and headed home walking down the beach as the sun sets with our bag full of fish. I can honestly say I have never seen anything like this and to be honest I have never been a fan of fishing because in general you sit there for hours and never catch anything. This was not the case. Fishing here is action packed, highly entertaining, and quite easy as we came home with around 70 fish between Irnan, Pila, and my house-watcher Carlos. Needless to say I have been eating fish daily and cannot get enough of it!


 La Vida Loca

La Vida Loca

As I climbed aboard the old yellow school bus (which is used for the public bus here in Nicaragua) I couldn’t help but let out a sigh of relief. Even with the loud Spanish music, the bus workers yelling when to stop, the street venders with everything you could ever need delivered to you right on the bus, I absolutely love riding the bus and finally felt at home after two weeks of feeling like a stranger in my own country. The life in Nicaragua is different, some may think it is worse because there is less money, less education, or less work, but I think that Nicaraguans have found how to live life with pure emotions, how to be happy in the face of poverty, how to treasure your family, and how to enjoy the little things of life. Even so, the life is hard for Nicaraguans with their being a lack of education and money, people can resort to desperate measures to make ends meet or to make a better life for themselves. I have known girls of 13 to 14 years that have been given to older men to have their babies in exchange for a house, a moto, or simply money. I have known guys that have given themselves to older women with money that just want sex and companionship from younger men, and the young men give up their lives for this. I have also seen how the people here want so badly to hold on to their traditions and protect the life of Nicaraguans at the expense of others, with fights and animosity toward gringos that dates back to the war I am sure. They will carry around machetes and are always ready for a fight if the name of Nicaraguans was ever in jeopardy. And as I have said so many times, the people here also are protecting an indigenous community that has been there for generations. They are the most friendly, willing to help people I have ever met and the most genuine people as well. When I get entered into a family with such love and excitement as I have been, it is overwhelming to think that after knowing me for a day, a week, or even a month the people would drop everything to help me if I were ever in need. It is this sense of community and love that I absolutely love and that I never want to get rid of. Life does not revolve around things like it does in the states. In the states everything that is done is done for things. Eating the best food, the most organic food, having the newest mac toy, having all the best gaming systems, having the best kitchen appliance, half of which are useless and sometimes never leave the box it came in, having the most pretty decorations (that are for nothing but cost a lot of money). All of these things don’t matter in Nicaragua and it is this that I love. My life in Nicaragua hasn’t been easy all the time, cultural differences are hard to get used to and it is hard not to judge families that are using their daughters for money, or people are always trying to take advantage of me because I am white, but on the other hand, I have never been without money so I am not sure how I can judge that. Life is not easy anywhere, and every person in every place in the world has their own challenges to face and overcome, however getting back to the simple things in life that matter the most helps to you face those challenges. Needless to say I am thrilled to be back and thrilled to see what the next months may bring!


Thank You!!

“Que bueno!” Martita said as the four volunteers we have this week and I were unpacking the four suitcases full of medicine and medical supplies. As we started unpacking the piles of medicine for children and pregnant women, the cups we use daily for urine tests or for giving water to patients as they wait all day in the clinic just to be seen, the folders that are used for charts, the paper we use to print ultrasounds and end of the month reports, the pens that we seem to lose too fast, the baggies we use to put medicine in, the markers we use to make posters for teaching sessions in the school, and most importantly the formula that may save the life of two premature, very malnourished babies, Martita and I are overwhelmed with how helpful these simple donations are. It is amazing here I have learned that we in the states take for granted so many things. Honestly when we get donations in the clinic it is like Christmas and the clinic runs that much smoother when we have the supplies we need. Not only did we get the four suitcases full of medicine, but we also got eight out of ten computers that were donated to FIMRC by MySpace to go to all of the surrounding Centros de Salud. These computers will allow all the nurses not only to finish the charting they are required to do on a monthly basis faster and more efficient, but it also gives them the assets to learn new technology and improve healthcare in Nicaragua.

I just wanted to write a quick thank you to all who have been supporting me and FIMRC here in Nicaragua and to let you know how appreciative we are of all the donations, prayers, and love you are sending our way. Believe me it is such an amazing help here and Martita is extremely grateful to all my friends and family as am I. I am so richly blessed to have such amazing people in my life, and I especially want to thank my parents for making all of this happen. They have the biggest hearts and I love telling people here who ask how we are getting all of these donation that it is all because my parents want to help. Thank you!

El Centro Para Desarrollo

As we were unloading Yasmil, our trusty taxi driver’s car, full of toys, books, and developmental activities I was overwhelmed with the sense of happiness and excitement for what was to come. As I have mentioned before, FIMRC has received a grant to open a developmental center for children up to age five, in the house that will one day, which is approaching sooner than I ever thought possible, be our own free-standing Pediatric clinic. The building was donated to FIMRC from the community which shows how much the community supports the work that FIMRC is doing. With this grant we are able to provide developmentally appropriate activities and games for children who otherwise have to make toys out of coins or whatever else they can find in their houses to play with. The children will have the opportunity to come to learn and play with their mother’s and be able to meet developmental milestones that they may have never met before. About a month ago, I spent the day in Managua with the new boss of FIMRC Caroline, Martita the head nurse of the clinic, and Yasmil a good friend and great taxi driver from Rivas. As we went from store to store looking at the possibilities we have and being able to buy things that were so amazing and that made Martita so excited to have this opportunity for the children of her community, I felt so great knowing the possibilities that this center brings to the community. The idea is to have mother’s come with their children and teach a handful of mothers how to do developmental assessments and play with children in an educational and developmentally appropriate way. Those of you who know me, know that children are my passion and after working at KidStreet, I have a new love for the development of children and cannot wait to be a part of this center. As we prepared for the opening day, Caroline and I went around inviting the community leaders to a meeting explaining what we will be doing with the developmental center and their excitement for the center was overwhelming. About two weeks ago, we had our opening day, which thanks to the help of the community leaders, was a hit. We displayed all of the toys that we bought in Managua for people to see, we provided fresh juice made by a local mother, and we had a cultural performance from the teenagers from the high school complete with cultural singing and dancing with typical Nicaraguan music and clothing. It was great to see how excited the community leaders were and how everyone in the community wanted to be a part of the celebration. We explained what the center was going to be, and had mother’s who were interested in being trained on developmental assessments and play sign up so that we can follow through with them and start to train them. After the meeting came the fun part. We let the children start to play with the toys, and it was incredible seeing how developmentally delayed these children were, but how eager they are to learn. We have a lot of shape games and puzzles, and seeing kids of four and five years old (and some of their mothers) unable to identify simple shapes colors, showed us how much educational play is needed here.

It is incredible the lack of education here with 10-15% of the population of the five surrounding communities of Asentamiento, Limon I, Limon II, Las Salinas, and La Virgen Morena having graduated from the one high school that serves all five of these communities and a literacy rate of around 30-40% of adults and kids. It makes sense in a community where the likelihood of having any kind of career is so limited due to that fact that families cannot afford to send their children to the University in the bigger cities that kids would rather find some way to make money, start their families early at age sixteen or seventeen, or spend their time surfing with friends. This is evident almost everyday in some interaction I have whether it is with the children that are around ten to twelve years old that live near my house who come to play and when asked to read, still sound out every word, or when asked to point out on a map where Nicaragua is, they are unable to do so, also with the parents of the children who come to see the Pediatrician who are unable to write down the name of their own children because they are unable to write/spell in general. It shows how important education is here and how there is such a lack of education. The development center will be a huge asset to the community here, giving children the tools to learn through playing and the parents the asset to learn themselves and help their children in the home by speaking and playing more with them in an educational way.

We have yet to see how successful the developmental center will be, but based on the excitement from the community we have high hopes for the potential of what it can do. Unfortunately, due to two weeks of pure rain we have not been able to fully open the center yet seeing as the rain prevents people from leaving their houses and the buses from running on occasion. Starting out we plan on having one day a week with an hour and half session to see how many children will come and how involved the mothers will be. The first day we opened no one came due to the strong rain we had. This week, we had two children who live very close come. With these kids we were able to see how happy the kids are to have toys and we are able to see how excited they are to learn. After one session it was evident that these children are eager to learn and are able to learn within one session. With one child we worked on names of shapes and colors, and by having us say colors and have the child repeat, quizzing him from time to time, the mother learned in just that short of time to do the same and took over saying what the shapes were and what colors there were having the child repeat her. It is these basic skills that mothers can use on a daily basis in their houses that will help these children learn and grow in a more developmentally appropriate way. With the developmental center, we also are working closely with the local Nicaragua governmental group of Pepitos that helps children with physical and mental disabilities. We have a few children from the local communities who are physically or mentally disabled, as well the workers from Pepitos are bringing children they work with as well doing physical therapy activities with the supplies that we have teaching the mothers what they can do to help their children in their homes. This centro para desarrollo (center for development) fell into our laps with this grant, but I think the potential for what it can do for this community is huge and as the growth and development of children is my passion I am so fortunate to be here and be a part of it.

Estoy Aprendiendo

Estoy aprendiendo, which in Spanish means that I am in the process of learning. Everyday I am learning more and more about the clinic, about the people, about the culture, about the community, and about myself. Living in different cultures allows you to fully be yourself because you have no other choice. I love that about being here. I cannot pretend to know what I don’t know, I am sure of what I do know and everything else I am learning. In the clinic, I am learning how socialized free healthcare works, how people spend an entire day waiting for healthcare at the clinic, how people are so eager to learn about their health and can take ownership in that, how people cannot always get what they need in terms of healthcare because it is free socialized healthcare, which is limited to what is supplied to us by the government. I am learning the nurses here, just like in the states, do not get paid enough for the amount of work, time, effort, and knowledge the expend in a day and how nursing in general is mandated by the government and nurses all over the world only want to deliver the best care that they can without the paperwork and regulations that might take away from that sometimes. I am learning that the nurses and doctors here are so willing to learn anything new that might help their community in some way and are willing to do what needs to be done in order to make that happen. I am learning that the community of nurses here are becoming family to me, and me encanta esta! (I love this)

I am learning that the people here are maybe some of the most amazing people I have met. I am learning that for the most part people here are eager and willing to work hard for their families and make a decent living, which luckily for this community is more possible due to the increasing tourism providing construction jobs, cleaning jobs, cooking jobs, and even jobs to young guys who just love to surf as a surf guides. I am also learning that people are who they are and as much as you want to change people the only person who can change someone is them-self. There is only so much teaching and motivating you can do but the people have to be willing to improve their lives and live a life of success. Which success here is defined in a completely different way, success is having a house and food for your family and a family to love and support, which honestly may be a better definition of success than what is generally accepted in the states. I am learning that people here generally have a past and that everyone here is connected to everyone, as it is mainly an indigenous community living here, which can lead to complicated stories, gossip, and lives. But I have also seen how people can change and even though there is a lot of mingled stories, people have learned to rise above what has happened in the past and move forward attempting to improve their lives. I have also seen people who have no desire to rise above their past and have resorted to a life of drinking and using drugs to make it through a day. Learning about people and their lives is a rewarding thing and allows me to learn so much more about the community here and how life in general is here.

I am learning about a culture, of like I have said before, some of the most amazing people and traditions I have ever experienced. For example the way that the families and loved ones of those that have passed on are embraced and loved on by the community. I have also seen a culture of intense judgement and limitations, with the culture here being mainly evangelical or catholic, most of the indigenous families are religious and with this in a small community comes big expectations for life. When people are not doing what they “should be” in the eyes of the community, the entire community knows and unfortunately there is a lot of judgement of people simply being who they are, which has been one of the hardest things for me to understand and deal with here. There are so many people here who have to hide their lives from their families and friends for fear of this judgement, and to me there is nothing good about having to hide anything in your life. Unfortunately I have seen this with both families that I have lived with and have seen different family members who maybe are not accepted by their family simply because of the hard past they have and there is little room for forgiveness or the idea of people being allowed to change.

I am learning about community in a way I never thought possible. Regardless of what double expectations and judgement there is here, there is an amazing sense of community. Since it is a small indigenous community, everyone does know everyone and is somehow related I am convinced, and would do anything to help anybody who needed it. People spend hours simply sitting outside visiting. Whenever someone needs something, the community comes together to ensure that it gets done. I have never met such generous, giving, and helpful people. And I have never felt so much a part of a community as I do, when I can walk down the street and be greeted by everyone I pass or when I can go to the bigger city of Rivas and run into people I know with huge hugs and kisses. You don’t find this kind of community in the states and this is another thing that me encanta! (I love)

I have also learned a lot about myself, having to be forced to be exactly the person I am. Being in a completely different culture speaking a completely different language, I am forced to bear it all and show my true colors. I am learning what that looks like for me and what my strengths and weaknesses are and I am learning as much as possible from those strengths and weaknesses.

Live as if your were to die tomorrow. Learn as if you were to live forever.” – Ghandi.

This is my motto for life here, I am trying to live a life that I can be proud of and am trying to live everyday as if I were to die tomorrow. But I am also trying to learn as much as possible to guide me through the rest of my life, however long it may be!



Se Murio Don Juan

“Se murio Don Juan” was the text message I received on the beach Saturday afternoon and my heart sank for my host family. The father of my host Dad had a stroke about two weeks ago and was in the hospital for nine days and then was sent home. He had to have two of his fourteen children stay with him every night, in the hospital and at home because he couldn’t sleep through the night and would try to get in and out of bed. He did not improve and started to have a lot of breathing problems as well and Saturday at 3 pm se fue (he went). It was quite a contrast for me as I was having yet another amazing day on the beach surfing, taking naps in the hammock, eating coconuts straight off the tree and watermelons from the fruit truck that passes daily, but got pushed back into reality as soon as I read the message. When I heard the news I wanted to get home to my family as soon as possible, knowing that this was going to be a huge deal, I just did not expect how huge. Don Juan may have been the most respected person in Las Salinas. He raised his fourteen sons to all be a part of a construction force building the majority of hotels and gringo houses in the area, he was smart with his money and owned land all over including beach front property and mountain property that is yet to be built on, but both of which will one day help to support his family in a huge way. All of his children are the same way and if ever you ask anyone about this family and Don Juan, there is nothing but great things said. As soon as I got home, my host Dad met me in the street to ensure that I knew what happened as I gave him a hug telling him I am sorry he proceeded to tell me how and when it happened. As we walked to the house, coffee and food was being made by the family of my host mom and I was instructed to shower and eat quickly because we are all going to the house of Don Juan. I did and we headed out. It is tradition here when someone passes that there is a wake at the house complete with a viewing of the body, placing the body into the cascket, and it is typical for the family and whoever else wants, to stay up all night at the house together. I am not sure why, but it is such a great concept for everyone to join together for the whole night. As I walked with my family to the house, I got chills seeing how many people were there, hundreds of people were there. Everything closed down and the whole town of Salinas was there as well as trucks full of people from all the surrounding communities. Which is even more incredible because of the lack of technology, however all these people heard about what happened and were able to get to the house in a matter of hours. Chairs were being hauled in on trucks and benches moved around to ensure everyone had a seat. As soon as we got there, my host mom, five year old host sister, and I went to view the body. As we walked into the room, the body of Don Juan was lying on a bed with a doily covering his face. I stood back taking everything in and my host mom took Susan (the five year old) up to the body, letting her touch his hand and look at his face, allowing her to embrace a natural part of life. It was hard for me to hold back tears as I was so touched by this and how natural it is here. I feel like in the States death is such a touchy subject and I am aware that everyone deals with grief in different ways, but to have an entire community come together for an entire night to pay their respects to an amazing family and allowing children to be a part of that makes the dying process natural, which is how it should be. As the night went on, my host mom spent most of her time over two of the largest pots I have every seen making coffee for everyone there. She informed me that there were going to be three coffee breaks one at 9 pm, 12 am, and 3 am to ensure that everyone could make it through the night. The rest of the night I spent talking with most of the fourteen brothers about their father and how great a man he was and how smart he was, and how he is sleeping and resting peacefully now. Death is universal language. The sympathy that we feel for each other when there is a loss surpasses all languages and as I listened to story after story of this amazing man I felt even more a part of the family and felt extremely lucky to know such amazing people here. As the night went on and I became more and more tired, my Spanish became worse and worse and I left around 2 am with the family of my host mom. The next day, when I woke up the house was empty. I made myself some food and waited around a bit, not sure what was happening. Eventually my family came back to the house, not having slept at all, changed their clothes, brushed their teeth and we all headed back over to the house. This time, it was mainly family that was there drinking mounds of soda seeing as none of them had slept at all and will not sleep until later that night. It is amazing to me how important family is, especially in cultures like this because they all live together and are extremely close. I was watching the wife of Don Juan, having an ache in my heart for her, however as I looked around I realized how blessed she is to have such an amazing family that all live within a small community and most of the sons still live with her. So many times when someone passes in the States, they are left alone and loneliness may be the hardest part. But here, loneliness seems impossible with not only a real family surrounding you but the family of an entire community surrounding you as well. At 4 pm we all gathered at the house to take the coffin to the cemetery for the burial. As the whole community lined up to walk, the street was closed off with the amount of people there and once again I was overwhelmed with the sense of solidarity as I had my arm around my sobbing host mom I couldn’t help but feel a part of this family and community. Once we got to the cemetery, it started pouring down rain and as we were all getting drenched, it did not stop everyone from staying there, halfway listening to the preacher and halfway freaking out that we were all getting drenched. We sang a song and prayed to end the ceremony. My family returned to the house understandably exhausted and we all went to bed around 6:30pm. I am so sad for my family and for the community loosing such essential person, but I also feel fortunate that I was able to be a part of this and experience first hand the traditions here.

Se murio Don Juan, he will be greatly missed by his family and this community.

El Centro De Salud

I have gotten requests for more information about the clinic where I work, so I thought I would share all the different projects we have and where the clinic is headed. El centro de salud is the name of the government clinic where I work. As I have mentioned before, the nurses are fantastic and even though my Spanish is slowly improving I am getting more of a feel for how the clinic is run and am able to help out wherever I can. We had a group of volunteers here from a business school who implemented an electronic medical record and converted a bunch of the daily and monthly charting the nurses have to do onto the computer. It is amazing to me how open and enthusiastic people are here to learn new things and try new things. When we changed to electronic charting in the states, there was nothing but complaints. But the nurses here understand how great it is not to have to do everything by hand and are so motivated to learn and use the electronic program. With this program FIMRC has also received a donation from MySpace of 10 new computers for our health post and 5 of the surrounding health posts to implement this same program, which is pretty amazing that in the entire region of Tola, everything will be computerized and using the same software. FIMRC has also this week received a grant to implement a developmental center, which will be implemented in the building we will one day have ready for the pediatric clinic. With this grant, we will be able to provide developmental games, toys, and activities to ensure that the children of the region are developing normally and will implement ways to help if they are not. The idea is to train locals to run the developmental center. It is also amazing that just in the last few months the government has requested that the nurses do a developmental assessment for every child they see under the age of 5. With this assessment we will be able to refer children to the developmental program and ensure that every child is meeting the required developmental milestones for their age. The added bonus to this program, is that we will be able to use the supplies for our waiting room for the pediatric clinic we will one day have. There is so much happening and I cannot wait to see how our FIMRC pediatric clinic will one day run and be a part of making that happen. In the clinic, the work I do is basically helping out where I can with my limited amount of Spanish. I am able to help in the pharmacy, which is nice as I am getting to know new medication that is used here. I am also able to help with giving birth control injections, and of course put to use my IV skills when needed. The Pediatrician comes twice a week and with him we are able to give specialized care and have seen some cases of umbilical hernias, meningitis, cleft palate, and parasites. But mainly the things we see with children is common cold and flu and parents worried about malnutrition. We are working on getting an OB/GYN doctor to come at least once a week to see the numerous pregnant ladies we have so that there can be specialized care from pregnancy though the first five years of life. Here, it is common for doctors to over prescribe medication such as amoxacilina and others, so it is extremely beneficial to have a specialized doctor to know when antibiotics are needed or when medications in general are needed and when they are not and are able to educate patients on that. Right now, my main project is working with the ambassador we have here for one month, and two volunteers we have here for two weeks. Since my overlying project is nutrition, I have been working with the volunteers on doing a charla (teaching session) for the pregnant ladies of the region mainly on the importance of nutrition. Here it is so common to put sugar and salt on everything, which can lead to so many problems. I am also leading a charla on Diabetes. Here it is almost impossible to get insulin if you have Diabetes because it is extremely expensive and nobody can afford it. Because of this the only way for people to control their Diabetes is through nutrition and exercise. None of the diabetic people check their blood sugar at home, but only when they are sick and need to come to the clinic is blood pressure or blood sugar every checked, which can lead to so many problems as well. Being here has made me learn how important preventative health care is in preventing complications of certain diseases and in preventing the development of non-communicable diseases such as high blood pressure and high cholesterol. I chose my project before coming down here to be nutrition, mainly based on the fact that 75% of the children here are malnourished. Now that I am here, I realize how important nutrition is not only for children but for almost every person here in preventing long-term diseases or complications. Needless to say, there is a lot of work here and I am so excited to be diving into helping the community, getting to know the people of the community better, helping build a report with the people of the community, and hopefully providing sustainable resources for the people of the community to help prevent diseases and improve the general health, development, and well-being of the communities of Tola.

Daily Musings

Life never ceases to surprise or entertain, and here in Nicaragua I get to be amused by numerous happenings throughout the day that I thought might be fun to share. My daily routine usually consists of waking up around 5:30 or 6 am to pots and pans banging in the kitchen that connects with my room and the smell of something delicious frying in a gallon of vegetable oil (which I am not going to lie, usually tastes great but I am sure my heart is not appreciating it as much). I wake up, stumble out of bed to the bathroom (which I have trained my body not to go in the middle of the night any more, I am not a fan of peeing in a pail in my room, I don’t have that great of aim). Once I have awakened, la abuela (the grandmother) of my house is there cooking, because the mom goes to work around 6 am, and calls me to eat as soon as she sees I am awake. I eat with the kids at the table during which the two pigs we have and stray dogs come in the kitchen as we shoo them away constantly. I never thought I would have to worry about pigs in the kitchen, but apparently I do all day every day. After breakfast I get ready and after spending some time on the front porch with Susan the 5 year old chatting, I head off to the clinic. On my walk to the clinic I pass chickens roaming, stray dogs and cats everywhere, more pigs everywhere eating trash off the ground, cows all around, sometimes blocking the entire road (talk about morning traffic, try getting through a herd of cows on the road), old men walking or riding their horses with cowboy hats, boots and a machete in hand, kids in uniform on their way to school walking or riding their bike with white tops and blue skirts or pants, mini trucks full of 10-20 men in the bed of the truck on their way to work, and friendly house moms greeting me as I pass. I laugh everyday on my way to work with something new that I get to experience. The other day the high school was having a beauty pageant and some of the surrounding schools came to see, I swear an entire school was packed in the bed of the smallest white truck ever, I am not sure how they all got on and how the truck was drivable, but it was. I also love passing people and the greetings I receive. I have finally learned how to differentiate between them. Sometimes, when I am passing by people I know I get an “hola” or “buenas” which are quite friendly and “buenas” is what is used when you walk into a store or into a place where you know people, it is short for “buenas dias” or “good-day.” Most of the time, passing people I receive an “adios”, which I have always found a little strange. After finding out that “adios” is what you say when you want to acknowledge someone, but not really talk to them or have any interest in that person. I love when some people try to impress the gringa walking by and they say “goood-bye” in English, it is hilarious and I think when I come back I am going to start addressing people I don’t really want to talk to or acknowledge with “good-bye.” When I make it to the clinic all is well and I work, helping out where I can, which right now is mainly in the farmacia and giving birth control injections with my lack of spanish. Hopefully I will be able to do patient intake and more nutrition education once I am able to ask questions and understand responses to help the nurses out a lot. If I have time when I get home, I try to head out surfing which always gives me a huge laugh. The path that I take to go the beach on foot is down a narrow dirt road, over and through the salt mines (which if it has been high tide or raining are completely muddy), over a river on a board laid across the river making a bridge which, when it is high tide, is a foot under muddy water with crabs and sea snakes everywhere, down another dirt path until I reach the most dreaded part. A muddy field (which is always muddy and sometimes underwater as well. As I sludge through the mud I then come to another mini river, which depending on high or low tide is thigh deep or I cannot touch and have to swim through once again muddy water with who knows what underneath me. I laugh every time because you would think there would have to be an easier way to get to the beach, but there is not, not on foot. But it is completely worth it when I make it across the muddy river to the sandy beach and the amazing crashing waves and kill hours attempting to stand up on a surf board, but mainly getting beaten by the waves and looking like a fool with some of the best surfers around the world surfing some of the best waves in the world all around me. I then have to trudge back through the mud to my house, with my family always laughing at how covered in mud I am when I return, shower and enjoy a delicious dinner. If I am lucky, we as a family watch Ojo Por Ojo, which is a soap opera type show that is on every night from 7-8 and everyone here loves it. It may be one of the worst shows I have seen with nothing of significance happening in any episode. I think the plot has stayed the same since I got here a month ago, but they love it. As we are watching Ojo Por Ojo, frogs jump into the house or the patio as we scamper to scare them away, the stupid june bugs are fluttering around like the idiots they are, sometimes the pigs come in as we shoo them away again, and there are tons of Geckos on the wall eating all the bugs. After Ojo Por Ojo, it is off to bed with the sounds of pigs snorting, horses muttering, roosters crowing as if it were a competition (yes they crow all day and night, not just in the morning), stray dogs barking, and loud spanish music playing from houses nearby.
Life here is pretty good and I have very little to complain about. Life is entertaining and having just a little part of the day that makes me smile or laugh, I am reminded of what I want to get out of my year here. As I am starting to get a better feel for the community, I am excited to start my project and do some nutrition teaching with families and in the schools. I want to learn as much as possible from this community and be able to be a voice for the people and part of a solution for improvement. We just spent the last week computerizing most of the charting at the clinic and started maybe the first electronic medical record here, which will be used not only at our health post, but with the 10 donated computers we just got last week as well, it will be used at all the health posts in the region of Tola, which is incredible! I want to have a vision and see the potential of the community. I want to work with the community in giving them the tools and resources to have a sustainable specialized health care system focusing on high risk times such as pregnancy through five years of life. I want to help implement preventative medicine and health initiatives. I want, in my year here, to become a part of the community and learn as much as I can about community development and how we can aid in community development in the region of Tola. And I want to continue to embrace life and the entertaining things I experience daily.

The Fast White Girl

As I am hunched over with five or six nurses and a couple doctors watching the Gringa attempting to start the IV that two other nurses have failed at, I had one thing on my mind, this girl needs an IV now so give me the flipping needle. I was able to start the IV, without even noticing my audience,  successfully and rapidly according to those watching. This week there has been a string of food poisoning incidents, with one entire family having to be hospitalized for one day. We had made some house visits to other families as well and had samples of food trying to figure out what the cause was. Today, a family of five came into the clinic very sick with food poisoning, vomiting every couple of minutes.  They had been walking to the clinic vomiting on the side of the road on their way, so needless to say it was a fairly serious problem when they arrived severely dehydrated.  The commotion happened at a very convenient time as there were around ten nurses from the surrounding health posts waiting to do a teaching session with the Doctor of  our clinic.  With numerous hands, we all got beds and cribs for the family to lie in, we all started monitoring vitals and IV’s were started for fluids. I was reminded of where I was and how supplies are scarce as we try to scrounge up enough beds and buckets to vomit in. The worst of the family was an eight year old boy who was very unresponsive opening his eyes only to vomit every couple of minutes.  We started his IV first and monitored him closely. It was my job to monitor him and we were all very concerned for him, with the doctors coming over frequently to check on him. All around me nurses are taking pulses manually, blood pressures manually, writing down everything and scrap pieces of paper.  As we are attempting to arrange a ride for the family to go to the hospital that is an hour away, the room is full of nurses, doctors, and family members.  After starting two IV’s we run out of bags of fluid for the IV’s and we send someone to get them as we continue to monitor everyone.  Once we get the fluids, two other girls get their IV’s started and we are hanging them from the ceiling, the white board, whatever is around that we can make the bag higher than they are.  IV poles are something I took for granted. As the ambulance (the private, very expensive ambulance from a nearby private clinic that I now cannot believe would charge for this) arrives, we help everyone inside and send them off. Right after this, another family arrives vomiting as well, but saying they did not eat the cake (which we later determined was the culprit). There were three in that family, and after the array of nurses and doctors had watched me start the IV, I was then the go to person to start the rest of the IV’s. It felt great to be using my nursing skills and helping as much as I could, building a report with the nurses. Today I learned a lesson of resourcefulness. Here there is not the array of medical supplies that we have, there is not the technology that we have, but whatever is needed the people here find a way to make it work.

I have seen this not only in the clinic but at my house as well. There was a fan that was broken, the plug would not work, so one night my host dad pulls out an array of plugs that have been cut and the wires are sticking out. After trying a few he finally string together the striped wires from the plug to the wires from the fan, and it works. Also, after I had bought a bottle of wine I realized I did not have a corkscrew or bottle opener. Asking my host family they did not have one either but within seconds my host dad’s brother arrives with a screw and a wrench. Putting the screw in and pulling out the cork. Ingenious. It is the same way with the kids. I do not know how the kids here are so well behaved with so little to do, but they find ways to entertain themselves. The kids in my house will sit on the porch with all the adults making a game out of throwing coins against a wall or counting the coins, or my favorite is a ring of old bottle caps that have been flattened out so that they flow around the ring. The game is you shake it up and hold the ring up so the bottle caps fall to either side, whoever has the most on their side wins. It is a great reminder that you do not need a lot to get things done or to have fun. There is no way that any child in the US could sit on the porch for hours with all the adults calmly with no complaints and with nothing to do. Today I learned a lesson in resourcefulness and I hope that I acquire this skill while I am here.  

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