Nicaragua - The Last Day

I'm Home!

I'm so thrilled to be able to write to you again from the United States. I just created http://www.flickr.com/groups/hti_nicaragua_2008/pool to hold the best of our photos. Be sure to check back every few days as members add their photos to the pool.

The total number of patients we ended up seeing was 1085. Saturday and Monday were our busiest days. That's probably because the clinic at Rene Polanco is open on those days and word got around.

Let me tell you about the patient you probably know best: Ruben Davila. Monday night he was chatting with our doctors while we were cleaning up. Turns out, his family has a history of diabetes. After a simple blood test, Ruben found out he that he too has diabetes. After he found out, there was a line of doctors waiting to lecture him on his diet and medication.

I wish I had the time to tell you about all the special people I met. Let me just focus on a few:

• Carlos & Sylvia: A couple that work at the hospital in Guatemala. I ate lunch with them Monday. What sweet hearts and hard workers for the Lord! Carlos went to Harding under the HTI scholarship. For every year in school funded by HTI, students must spend that long working for HTI in Guatemala. Carlos now runs the hospital there. I think this type of financial giving is a key to success.
  
• Jose: The engine of Rene Polanco. He organizes the kids program, the clinic, the deaf program, etc. Basically, everything. Oh, he has a full time job outside the church too.
  
• Carlos Rugama (from Momotombo): He's the preacher at a town outside of Managua. He came to help us even though his church far away was not affected by our presence. He road a bus 2 hours (each way) just to see us.
  

Let me close these set of blogs about Nicaragua by describing our last Devo Monday night. Pete asked us to talk about what the trip meant to us. Here are some common responses:

• This is my Christmas.
• Its a compulsion. I have to go.
  
• It rejuvenates my spirit.
• It makes me aware of what the other 98% of the world is like.
• This is my family.
  
• To give hope to those that have none.
  

Aye! That last one was a bit controversial. It's actually at the heart of my sentiment. You see, while materially Nicaraguans are greatly lacking, that doesn't translate into someone who is poor in spirit. I've met many Nicaraguans and Latinos in general whose faith is deeper and has been proven by fire. Who of us can say the same?

I also think hope flows both ways. HTI's mission is to show Christ's love to those in need (paraphrased). We certainly do that. What we don't do is anything that will last more than a few weeks or months. Hope that Nicaragua will turn around economically is slim. Hope that Nicaragua will have a spiritual revolution is a certainty. This hope is my great gift given to me by the Nicaraguans.


Finally, I want to say thank you to all the fantastic spiritual giants on this trip. If anything, just being with them and listening to their life of service inspires me to imitate their good works.

Adios!

Nicaragua - Day ??

Buenas Dias,

It is 4:20 in the morning on Tuesday. We're about to leave for the airport. Monday was a long and very rewarding day. Unfortunately, I didn't have time to write. By the time we finished eating and having a devotional, it was after 11 p.m.

We were back at Rene Polanco Monday. I spent the whole day translating for our dermatologist again. I've found this to be exhausting. My typical day at work involves doing stuff like what I'm doing now: typing in a quiet place. Having to talk all day long, arbitrating between two parties in 2 languages, plus all the medical stuff I don't understand in either language simply zapped the energy out of me.

Monday was largely the same as Saturday. Same type of patients, lunch, etc.

Remember the boy I mentioned Saturday that had a open bacterial infection on his skin? He came back Monday and was much improved. It was still there, but only a couple of inches in diameter instead of the 5-6 inches it was before.

I have to go soon, so I wanted to brag on our Ruben. While we were off lolygaggin at the hotel, Ruben used the opportunity to talk to the staff about his faith. He started the day we arrived and it culminated last night with a Bible study with two of the men that work here. Ruben gave their contact information to Jose and Noel (the new evangalist at Rene Polanco). We'll see were it goes. God willing, the seeds will grow to bear good fruit.

Got to go now. I'll write again soon ...

Nicaragua: Day 4

Ola!

Its halftime at the Super Bowl, so I thought I´d take a minute to write. Its been a relaxing day.

We worshiped with Rene Polanco this morning. We had a combined service where the Central and North Americans lead the service. Ruben and I lead a prayer (in Spanish) while Pete and Noel gave 2 sermons - one in English and one in Spanish.

After the service, we headed for the market in Masaya. The group goes there most years to buy suvenirs. I bought a few things, though there will be no spoilers in this blog.

Now were back at the hotel, eating Pizza Hut pizza and watching the Super Bowl. How much more American can you get?

I don't have much else to add. We'll be hosting another clinic in Rene Polanco tomorrow. Tomorrow night I'll write my final entry from Nicaragua. It'll probably be short since our flight leaves early Tuesday morning.

Until tomorrow ...

Nicaragua: Day 3

Whoohoo! We got our medicine! We got it around noon from Nicaraguan customs. It was a huge blessing. There were no fees (or bribes). Each piece of luggage of almost 50 lbs of medicine was insepcted, each baggy opened, and each bottle inspected. I learned that we could of had it last night, but 20 minutes before closing the customs people said it'd be too much work and they were going to home. Fortunately, the only medicine we didn't get back were a few tubes of sun screen somebody "confiscated" for pesonal use.


The new medicine made an immediate impact. One of the members of the church at the clinic yesterday even showed up to claim some of the prescriptions we wrote yesterday.







Overall, today was shorter but more intense. The clinic today was at Rene Polanco (the church Waterview supports). I translated for the dermatologist all day today. We saw around 40-50 patients and overall the clinic had around 300 patients. The patients we saw were less dire than yesterday. Virtually every case involved soap, cream, shampoo, and - about half the time - a shot. Yes, I saw around 20 shots today.




A couple of patients stick out:




There was a women today that had a few small "skin tags" - little places that stick out that you can barely grab hold of. She also had a large one on her groin about the size of a thumb. Since she was our last patient, the dermatolist performed a little minor surgery by cutting it off. Thankfully, he said he didn't need me for that part.




There was also a 3 year old boy. He had extreme rashes all over his body for 2 years. His ear was almost scabbed over inside it was so dry. Worse, he had an open oozing scab the size of a grapefruit in his arm pit. It radiated out and dissapated about 6 inches up his arm and 6 inches down is chest. The dermatologist thought it was special because he wanted to take a picture of it. I´ll have to ask him why tomorrow.

I found it interesting that 2 different people on separate occasions told me the same thing: some people see the doctor just to have someone to talk to that will listen to them. They come in to complain about phantom problems, but after being prescribed with a few vitamins, they walk away content. It pangs me to know that some are so starved for attention that they'll go to such extremes. Why do they choose a doctor and not the church?

Our day started with another excellent devotional. What should we pray for? James says wisdom, but that's not what you want when your short on rent, have a child in the hospital, etc. What does James have to say about the link between your prayer life and your physical & mental health?

A couple of notable conversations:



One was with a couple of the local ministers. Juan (Jose's brother), said that the goal of Rene Polanco this was was to have a church that is organized Biblically, i.e., one that has deacons and elders. He said that they have several prospects for deacons, but have realized that they actually have to find 2 elders instead of 1. That has been very difficult for them.



It made me think: a few years ago, Waterview had a "town hall" meeting on why a church of over 1,000 people couldn't find one more elder. This has some interesting implications on both churches. Small churches makeup the majority of the churches in the 'hood (brotherhood). How are they expected to follow plan laid out in 1 & 2 Timothy with such a small census? For that matter, how did the congratations Paul wrote to do it? On the other hand, why did a spiritually and resource (people and money) congregation like Waterview have so difficult a time growing new elders?

Christians all over the world struggle with the same things. We have more in common than we are unalike.


Another conversation was with one of the regulars here on the dangers of the American style of benevolence. HTI simply forbids anything that resembles give-aways, e.g., building houses, giving away stuff, money, etc. They feel it creates a culture of dependency, reinforces perceptions of Americans, creates jelousy and strife in the 'hood, and ultimately does more harm than good.



Benevolence everywhere - inside and outside the church - suffers from the same thing: well meaning people who end up being part of the problem and don't care enough to seek a solution. One interesting view I heard was that benevolence should not be seen as a outreach ministry. Instead, benevolence and evangalism should be separate. Benevolence demoralizes people and cultivates poverty instead of ending it. Perhaps the question is this: does benevolence keep more souls out of the church than it does to bring it in?



BTW - I don't have any anwers. Just questions.





HTI splurged on an extravegant meal tonight. We ate at a stakehouse. The food was excellent. I had a tenerloin topped with a chimichuri sauce (an Argentinan pesto made from parsely, olive oil, capers, garlic, lemon, etc.). For desert, I had the tres leches. Everyone ate well.



Well, its almost 11 now. I'm going to sign off. There will be little to write about tomorrow. We're going to church, go do something touristy like go to the local market, and watch the Super Bowl (in Spanish). I'll probably write more tomorrow about today.



Until then ...

Nicaragua: Day 2

Ola!

We had a frustrating day. The 12 bags of medicine that customs confiscated were not returned. Despite 2 hours at the Ministry of Health and all afternoon chasing paperwork, they were still unwilling to release our medicine. That meant that most of the patients we saw and diagnosed today were unable to get the medicine that will make them better. That made for a lot of angry doctors and frustrated patients. Tomorrow, a group is going back to central customs office to see what we can do. Hopefully, it'll work out. Many believe this is because the new president (Ortega) likes Chavez and dislikes America. Many of us fear there's going to be "fee" associated with the return of our medicine.

Our day started with breakfast at 7. Our short devo afterwards was focused on a singular thought: Is there a connection between mental, physical, and spiritual health? Can the things we think about affect our health?

We spent most of the morning outside the Minstry of Health at a roadside food stall drinking coke and eating bananas. BTW - the bananas are really good here. You wouldn't think there's much difference in bananas, but everyone noticed that these smaller and thinner ones were sweeter and more intense.

We traveled about an hour outside of Managua to a small town called San Benito. The church there is small but strong: a common theme in Latin America. After setting up, we started seeing patients around 11.

I spent most of the day either translating for our dermatologist or helping people choose glasses. Ther dermatologist saw mostly children and a few adults. The kids all had worms, bug bites, and/or scabies. All were infected. Many had large infected blisters all over there body.

I'm proud to report that I was able to obey the Hypocratic oath: my translating did no harm. Unfortunately, the words like "scabies" or "fungus" don't really come up in my conversations with the Hispanic church. So, I had to cram a few lesser used words into my vocabulary.

Here's an excerpt from some of the more interesting answers I got for some of my questions:

Q: How long has you child had these open sores?
A: 3 years.

Q: What type of soap do you use at home?
A: I don't use soap.

Q: Can you read this line from the eye chart?
A: I can't read. (I got this same answer 4 times from mostly elderly adults.)


Small problems go unchecked and untreated. People largely self-medicate. Prescriptions drugs are sold freely here as in most of Latin America. The problem is cost. No one has money, so no one sees a doctor or buys medicine. There simply is no concept of insurance or health care. All problems are tied together: corruption, unemployment, lack of insurance, poor diet, poor sanitization, etc. No one can espape the cycle.


The church meets in a small building on a dirt road. Very common. Only the main roads are paved. Many residential streets are dirt even in a large city like Managua. Beside the church was a convenience store (pulperia), a pig, and a few chicks. The church and surrounding buildings have no running water and no electricity. The bathroom was a "whole in the ground". I won't go any further. Again, all very common.


I was fortunate to talk with many interesting people today. I'll pick on one: Carlos. Carlos is the minister at the congregation in Montotumbo located in a town named after the volcano where its located. He asked about my preference for President (they honor Bill Clinton as the man who ended their war with Honduras).

One question was particularly astute: Why does the church seem to grow in Latin America so easy and not so in the United States? His belief was that their poverty was an advantage because it kept them reliant on God. Our opulance (my word) inhibited people from thinking they need a God.

In case you don't know, Christianity is spreading in all forms in Central America. Mormons, Pentecostals, and Catholics are the main bunches, but the churches of Christ are catching up. There are more than 100 congregations her in Nicaragua consisting of around 40 or 50 members. Each year the number grows. That may seem like small potatoes in the U.S., but can you say the same thin outside the Bible belt? For example, are the number of churches doubling every decade or so in New York like they are in Africa? We have a lot to learn ...


Well, I'm back here at the hotel and its 8 o'clock and we're about to eat. Our lunch didn't come until around 3, so that's o.k. We'll spend the rest of our time at the church in Rene Polanco in Managua. The clinics Saturday and Monday will be there and we'll go to church Sunday there as well.

Until tomorrow ...