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2001 Mission Report by Juan Carlos

Greetings VOSH members and all others interested in what we do,

We recently returned from our annual mission to Central America. This
year, our clinic was set up in Monimbo, Nicaragua. This is a small
village in the Masaya district of Nicaragua, and is about an hour's drive
from the capital city of Managua. Our group consisted of 65 people, which
is more than we had ever gone with before.

This year, our host was the Rotary Club of Masaya, whose President is
Martha Galo Pacheco. Dr. Galo has been working with us very closely since
our first trip to Nicaragua. When we originally came to Nicaragua, Dr.
Galo was the local representative for SILAIS, the national health service,
in the town of Niquinohomo where we worked. She has since been promoted
to a position in Managua, but was still able to work with us. What makes
this even more impressive was the fact that she gave birth to a baby girl,
Angela, while we were there. Congratulations Martha and thank you for
everything you've done for us.

Ana Adilia (Anita) Sanchez Nunez has also been working with us since we've
been coming to Nicaragua. Anita is currently working with SILAIS in the
Masaya district, and has made invaluable contributions to this group over
the last four years. 

Vidal Ruiz was the SILAIS representative last year when our clinic was
based in La Concepción. He took four days off from work to work with us
again this year. Two newcomers were part of our group this year, and we
extremely helpful to us. Henry Mercado is a physician raised in New
Jersey but living and working in Nicaragua. He only makes house calls. 
Miguel Silva is an optometrist who lived for many years in Seattle but is
currently living in Masaya. For those who have never been on a mission, I
can't over-emphasize the importance of local people who assist us. 
Without them, we would get a lot less done, especially for those people
who need our help the most.

This was our most comprehensive mission ever. We had six optometrists,
nine optometry students, a well-trained dispensing staff, seven medical
examiners, more nurses than you could count, three dentists, and a full
dental team. Plus we had some people who tend not to get recognized-our
support staff, without whom everything would collapse under its own
weight.

Most of our people met in Miami to board a flight to Managua. Many of
them were met with a big surprise-me. I am currently living in the
Netherlands, and made a surprise visit to join the group this year. I do
not regret my decision in the slightest.

This group arrived in Managua on Saturday evening the 13th of January. By
the time we cleared customs and loaded the bus, it was about 8PM. At this
point the "obligatory flat tire" hit. For those who don't know, there is
inevitably some type of transportation problem that affects us at some
point in the mission. This year we got it out of the way early when our
bus wouldn't start. It took two hours to find cables to give the bus a
jump-start, which allowed us to go on our way. 

We then arrived in Granada, Nicaragua at our hotel, the Alhambra. The
Alhambra is located on the city's central square, which is present in
every city in Central America. This is the third time the group has been
to the Alhambra, which is quite nice by Central American standards. For
those who don't know Granada, it is a very charming city, with a lot to
see and do nearby. There are some people that visit Nicaragua solely to
visit Granada. One thing that I can say about the people of Granada is
that they work very hard. Some of us got up at 6AM for exercise, and the
city was already awake-shops were open, the market was bustling, garbage
was being collected, etc.

On the morning of the 14th, we met for breakfast, and then went to our
clinic site in Monimbo. As always, we set up in a school complex. 
Schools are always available for us, as January is typically a school
vacation in Central America. We had 12 rooms available to us, and all
were used. We had a room for registration, one for screening eye
patients, three rooms for eye exams, another to dispense eyeglasses, one
next to it to give out medication, three for medical examinations, another
for dental exams and one more for fitting and dispensing wheelchairs and
other ambulatory aids. One strange occurrence was the presence of rain. 
During the month of January, rain is very rare in this area.

Setting up took a few hours, and when we were finished, we were invited to
the social club of Masaya. This was a rather nice complex, which included
a swimming pool. Later that night, we all gathered in the dining room of
our hotel and had a "Get-to-know-me" dinner where our Executive Director,
Carl Sakovits, introduced everyone there--including people he had just met
for the first time-and managed to make personal comments about everyone. 

On Monday the 15th of January, while many of you in the United States had
the day off in honor of Martin Luther King, we went to work. And work we
did. We were at the clinic site before 8:30 in the morning. After a
brief setup period, we started moving along, breaking the new people in
and seeing as many patients as we could. We didn't leave the clinic site
until well after 7PM. Luckily for us the school had electricity (and
therefore lights,) otherwise we would never have been able to continue as
long as we did. 

When we got back, those who had energy went out for dinner in smaller
groups. I just have to share this story, which is rather typical of
things in Central America. I went with a group of seven people to a
Chinese restaurant two blocks from our hotel. We were then joined by
three other members of our group and then three more. We ordered our
meals, and were pleasantly surprised when they started serving in under an
hour. They had brought out six meals, but forgot one from our original
group of seven. When we asked, we were told that they had run out of
vegetables, along with many other things. How does a Chinese restaurant
run out of vegetables? Only in Central America.

On Tuesday the 16th, the clinic ran a little more smoothly. Everyone knew
what he or she had to do and hit the ground running. The first-timers we
no longer new people and we were able to see more people than the previous
day. We were there for about 11 hours. By this day we realized that we
had a wealth of translators. Some of them have been with us for every one
of our missions to Nicaragua. As you can probably imagine, these people
are not a luxury, but an indispensable part of the team.

On Wednesday the 17th, we again started before 8:30 AM and continued until
well after dark-sometime around 7:30 PM. I'm not exactly sure of the
time, because I was so exhausted that I couldn't keep my eyes open. Most
of the group was in the same boat. I have been on four previous missions
with this group, and I can't remember working harder than we did this
time. One unfortunate thing that was starting to happen was that there
were more people requesting examinations than we could accommodate. We
couldn't stay much later, as the group was already stretched to its
physical and mental limits. We signed people up for the next day, but it
became obvious that we couldn't see everyone-an unfortunate fact tempered
by the knowledge of the large number of people that we did see.

The last day that our clinic was open was Thursday, the 18th of January. 
I could see the signs of fatigue on our group-owing to the number of hours
(more than 12 per day, including travel) that we had been working. 
Despite everything else, we worked harder than we had before, trying to
see as many people as possible before we had to close for good. We
started closing up at around 6PM, but didn't get out until after 7PM. We
tried to bring our leftover eyeglasses to a storage site, but were told
that our bus wasn't allowed to go there. Standard procedure, but that
adds to the color of missions-not everything goes according to plan. It
is to the credit of our leaders and hosts that things have gone as well as
they have over the last four years.

Here's what many of you have been waiting for: Our final numbers for the
mission. Note that numbers are approximate, as many patients were
examined but these encounters were never recorded (luckily there is no QA
person working on the mission)

Eye examinations: 2267, of which 2021 received eyeglasses
Cataract surgeries: 25
Medical examinations: 1628
Dental examinations: 465
Wheelchairs dispensed: 41

The final number is not indicative of the number of patients seen, as
there were a number of devices (crutches, braces, etc.) that were not
recorded. The total number of ambulatory aids is probably over 100.

Upon returning to our hotel, we had a group dinner. We were all presented
with congratulatory certificates from the Rotary Clubs of Masaya,
Nicaragua, and Bristol, Rhode Island. There were quite a few thank yous,
and teary goodbyes. Everyone was congratulated on a job well done. I
personally think that the term "well done" is an understatement. This
group worked more than you could have been expected, and was pushed beyond
its limits. Those of you who went should all be extremely gratified with
what you did, and your experiences should be shared with pride.

On Friday the 19th, we all set out on some badly needed R&R. Everyone
went to the typical market, where local foods and crafts are available. 
After this some of the group went to the Pacific coast while others stayed
around Granada to explore the local sites.

I have not written about many of the sites and scenes of Granada, as I
have already discussed those in my reports from previous years. I
encourage you to read them at your convenience.

On the 21st of January, most of us boarded a plane bound for home, while
two of our physicians, Stu Zipper and Joe England stayed behind to examine
potential sites for next year. For those who are interested in hearing
about next year's trip, I encourage you to come to the reunion, the dates
and locations of that will be made available when they are determined.

As I have done each of the previous two years, I asked the members of our
group to share a personal experience from the trip. This is one of the
best ways to get the flavor of what happened. While they may not always
be happy, they do reflect some of the things that many of us will never
forget.

Carl Sakovits said "We could only offer cataract surgery to a limited
number of patients so we had to be selective. I had the difficult job of
deciding each day who would go and who would be denied. I also had the
privilege of removing the post-operative patch and seeing the patient's
reaction. My most memorable patient was an 81 year old farmer that wept
like a baby for fifteen minutes. Like a man released from a jail term of
no fault of his own-he was free."

Peter Eudenbach remarked about the same patient, and added that "his face
was all wet, but he was all smiles, as he had not seen in years."

Steve Grimes, our cataract surgeon, was very appreciative of how hard the
local OR staff worked-they stayed over 12 hours the last day.

Fahara Mawani examined a ten year old with a very high prescription, which
had never been corrected-the next day the patient returned with nothing
but thank yous and kind words for being given sight for the first time.

Sarah England was visited by the same girl every day. Sarah taught the
girl English and was rewarded with a big hug at the end of the mission.

Nancy Baker got a first hand glimpse of third world medicine. When
informed that local children found it difficult to use asthma inhalers,
styrofoam cups were used as spacers to allow proper ingestion of the
medicine.

Bob Plass was amazed at how far some people would go for the smallest
thing. A boy came from San Juan del Sur (a good two hours by bus) needing
no more than a screw to keep his eyeglasses together. He didn't need new
glasses, just a screw. A tiny piece of metal was worth so much to him
that he used an entire day of his life to get one.

Denise O'Dwyer was amazed about how many diverse people could come
together and work so well on the mission, in addition to how the locals
appreciated every little thing she did for them.

Joe England and Al Amerigian both remarked about the same patient. She
was twelve years old but looked no older than three. She neither walked
nor talked and had to be carried everywhere. She was put in a wheelchair
that "looked like it was made for her" and no longer had to be carried
everywhere

Shahin Barzin said "The children may have been poor and impoverished but
they had hearts of gold. It was a pleasure to be accepted by their warm
little hearts. I shall remember and cherish their voices calling my name
'Show-ee' for may years to come."

Bruce Fischer examined an 82 year old man with 33 grandchildren and 50
great-grandchildren. When asked the meaning of life, the man said "I grew
up on a farm and breathed the fresh air."

Sue Seidler examined a man who had been diagnosed with diabetes. The man
had been treating himself by drinking his first urine of the day for the
last fifteen years. You can't make this stuff up.

Persephone Brown, upon leaving the clinic gave her name tag to a boy that
she had become friendly with. When she got on the bus to leave, she
started crying, as did the boy and two of his friends.

Diane Brown-King (DBK) was asked by a pregnant woman the meaning of the
name of her daughter, Persephone. After being told, the woman said she
was going to name her daughter Persephone.

Eileen Tiexiera, a nurse specializing in lactation, saw a baby that looked
severely pale and deprived. It turns out that the mother was not
breastfeeding properly. After receiving proper instruction, the mother
brought the baby back the next day looking much healthier and alert.

Larry Ginsburg gained additional motivation when he found that two of his
patients had arrived at the clinic site at 3AM waiting to see him.

Marie Rondeau was satisfied with the total experience of the trip.

Maryann England was grateful of how many local people were willing to help
their own. She was also happy that they picked up our system of
registration, which they can then use for themselves in the future.

Kate England was asked to give toothbrushes to some children. It turned
into a mob scene, and she had to be assisted by the police.

Vicky Weiss examined a four year old boy named Marvin. Marvin had one eye
that stuck out further than the other. We got an immediate CT scan, which
unfortunately showed that he had metastatic cancer that had spread to both
eyes. This is one of those unfortunate cases that we could not help very
much, and is very sad to think about. We helped a lot of people, but
couldn't help everyone.

Jean Green was working in the hospital. She remarked to the head nurse
how much she like the woman's shirt. At the end of the day-the woman gave
Jean the shirt off her back in appreciation of the work she had done.

Lynn Normand was happy to be able to interact with the children on a
personal level, despite the differences in languages.

Diane Forest was overwhelmed by the need but touched by the love and
happiness of the locals.

Leslie Vieira was assisting in surgery and remarked about a man who,
despite waiting twelve hours for surgery, was still happy just to get it
done, and jumped on the operating table to prove it.

Matt Grimes most rewarding experience was helping fit a woman that could
not walk into a wheelchair for the first time.

Ann Mason was touched by the devotion and love of family members.

Anita Patel had a patient who inquired about refractive surgery. Amazing.

Frank Siringo had a patient with a cancerous growth on his face, which he
sent to be removed immediately by our medical group.

Rocco Andreozzi, on the same note, had a patient with skin cancers all
over his body. Rocco spent 45 minutes removing the cancers, which he would
never have done at home. After he was done, he said the man looked like
he had a face lift.

Larry Jerge said, "I enjoyed the mission, enjoyed working with you and all
the others. I can't believe I met 60 total strangers, worked so hard side
by side for 4 very long days, and felt so good when we accomplished so
much. It is very difficult to explain what happens on a mission like
this. You have to experience it and realize it does change your life. I
think the Nicaraguan people have changed me more than I changed them."

Zelia (Z) Felix was touched by a woman who wanted toothbrushes, but was
too proud to take a handout. She offered oranges in a trade.

Cheryl Kelly noted something about the contrast in how people lived. They
may have been living in "cages" but they did what they could to improve
that by adding flowers and other things to make things seem better.

Shelly Ross was impressed with one woman that had 19 teeth pulled and put
up with all of the pain without complaint.

John Kerwin, our dentist, was so fed up with the screaming after four days
that he and the staff started doing the same. Four his second consecutive
mission, he had a patient run away after seeing what happened to the
previous patient.

Jama Chim was able to reassure a mother of a boy with an eye turn that she
had done nothing wrong, that she no longer needed to blame herself for her
child's problem.

Anita Pursino was touched by a boy who was so happy that he came running
up to her and gave her a banana.

Nicole Jerge had a patient that spoke English and they were able to share
photos and stories. The next day, the man returned and gave her books and
a poem based on her name.

Motryja Makarewycz saw here first patient with bacterial conjunctivitis,
or "pinkeye." She treated him and was happy that she was able to
successfully cure the first infection she saw.

Charissa Lee spent much of her time trying to avoid the dreaded finger
point. For those unfamiliar, in Nicaragua it is not considered impolite
to shake your finger at someone when meaning to say "no." This is an
obvious cultural difference, as we would never do anything like this where
we live.

Ed Greenan was translating for a man in the medical clinic who kept
rattling off vague complaints. After about 15 minutes, they got the man
to admit that he wanted to get his eyes checked, but the line for the
medical clinic was shorter.

Carol Peltier brought an old pair of sneakers to Nicaragua, planning on
leaving them there at the end of the trip. On the last day she left them
in the trash pail. When the hotel staff saw them, someone went to put
them on. They looked embarrassed when seen, but were very appreciative
when she told them that they could keep them.

Harry Eudenbach said, "The mission in general was very rewarding."

And as for me, I was talking one morning to a street kid. Most of these
kids are orphans or abandoned, and many sniff glue to get high. This
happens in kids that look no older than five. One morning I asked a boy
when the last time he had eaten was. He said it had been two days ago. I
told him I'd make him a trade. I offered him three packages of cookies
and a candy bar for his glue. He didn't even consider my offer. I
offered more, and he still declined. Unfortunately, the drug had so
engulfed him that it was more important than starving.

I hope all of you appreciate the work this group did, and will continue to
do in the future. If anyone would like to make a donation, please go to
www.nevosh.com or ask a member. I hope everyone can continue to make such
strong efforts in the future, as the world needs us.

Hasta el proximo ano,

Juan Carlos

2012 Panama & Tennessee | 2010 Nueva Esperanza | 2009 Nueva Esperanza | 2008 Nandaime | 2007 Monimbo | 2006 Nandasmo | 2005 Catarina | 2005 Mus | 2004 Nindiri | 2003 Jinotepe | 2002 Ticuantepe | 2001 Monimbo | 2000 La Concepción | 1999 Masatepe | 1998 Niquinohomo | 1997 Lake Yohoa | 1996 Jutiapa | 1995 Omoa | 1994 Vera Paz | 1993 Coatepeque | 1993 Salama | 1992 Chimeltenango | 1991 Chichicastenango | 1990 Comayagua | 1989 San Manuel | 1988 Omoa | 1987 Santa Rosa

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