Ticuantepe 2002:   Mission Report | Clinic Site | The Line | Registration | Screening | Eye Exams | Dispensary | Eye Surgery | Dental | Medical | Pharmacy | Mobility | Invitation | Roster | Thank You Dinner | Rest and Recreation

Arthur Jung Photo

NEVOSH 2002 Mission Report

prepared by Juan Carlos, aka Jonathan Wasserstein, OD

Greetings to members of Northeast VOSH and all of our friends,

We have just returned from our annual mission to Central America, and below is a report of some of what we did during the last week.

On the 19th of January 2002, seventy people from around the world put their lives on hold for a week to help people who are less fortunate. Many members of the group started their commute as early as 1:30 that morning. Most of us assembled in Miami airport, and we left en masse on a flight to Managua.

Upon our arrival, we then traveled by bus to our hotel in Jinotepe, which took about an hour and a half. The members of our group that had not previously been to a third world country got an education very quickly. For the second time in three years, we stayed at the Casa Grande Hotel—a nice hotel by Central American standards. One unfortunate problem with the hotel was that they took away some of our room reservations at the last minute, forcing many of our members into triple and quadruple rooms. From what we’ve been told, occurrences like this are not uncommon. A quote sometimes heard is “Así es Nicaragua, así es mi país” which translates to “This is Nicaragua, this is my country.” Some members of the group made travel arrangements on their own, so when we had a group dinner on Saturday night, it was the first time the entire group was together. We were given some basic information about the trip from Joe England, who led the mission, and Stu Zipper, who was in Nicaragua a week before everyone else and helped put things together before our arrival. Following dinner was a long night’s sleep for most of us.

Unlike previous years, we were not sponsored by SILAIS, the local ministry of health. In addition, we did not have a local service organization as our host. Instead, both jobs were performed by the mayor’s office of Ticuantepe, the town where our clinic was held. The mayor’s name is Salvadore Ampie Perez. Normally we try to avoid affiliating ourselves with any type of political organization. However we were assured by trusted members of the major opposing political party that there would not be any partisanship related to the mission. The mayor and his staff were extremely helpful during the entire week of our stay in Nicaragua. Also aiding us were Vidal Ruiz and his wife Adilia. Vidal works for the ministry of health in La Concepción, where our mission was held two years ago, and is also a native of Ticuantepe. Adilia was instrumental in making arrangements before we arrived—and did it all despite having a baby five months before our arrival.

This year, another group joined VOSH-Northeast. This trip was the inaugural mission for VOSH-Nederland (VOSH-Netherlands in English.) For those who read my mission report from last year, you’ll know that I was teaching optometry in The Netherlands at the time of that mission, and with one of my students flew in to join everyone. When we returned, we told everyone about what we did, and decided to form our own VOSH chapter. For this year’s mission, eight Dutch students paid their own way and joined us on the mission. They acquitted themselves very well, and are planning to join us again next year. In the future they will likely have missions closer to home, but for the present they have made an excellent addition to the group.

On Sunday morning we went to the clinic site for the first time. For those who have never gone with us, we set up our clinic in a school. During the time of our missions, school is in recess, so space is not a problem. The school in Ticuantepe was sponsored by the government of Luxembourg, and was quite well kept by local standards. This was obvious as there were toilet seats in the bathrooms, which has not always been the case. The school has four buildings surrounding a central courtyard. One building held our registration area, vision screening, and dentistry in its three rooms. Another had four rooms for eye exams. A third held our eyeglass dispensary, pharmacy, and storage. The final building was where our medical practitioners worked.

It was quite necessary to use as many rooms as were available. We had eight optometrists, sixteen optometry students, five optical dispensers, ten medical examiners, five registered nurses, three dentists, a dental hygienist, four dental assistants, a cataract surgeon & an assistant, three people dispensing mobility aids, two interpreters, and fifteen clinic workers.

We put our rooms together the way we liked them—a process that took a couple of hours. Then each group (clinic workers, dentistry, medical, pharmacy, dispensing, optometry) had a meeting before we had a full group meeting. After this we went to a local facility for a group lunch. For our visit we arranged for some salsa music and a piñata. It was a fun way to start getting to know people, and ended early enough for everyone to get some much needed rest.

Moving picture: Arthur Jung

On Monday the 21st, our clinic opened for business. Something happened on this day that had never happened in my five previous missions. The people waiting on the line gave us a round of applause. This was a very touching experience, and was repeated every day that the clinic was open. Special commendation on this day is hereby given to the medical and pharmacy groups. Patients were overbooked, and the teams did not finish until around 8PM—their day lasted more than twelve hours. In total they saw 606 patients. After we finished, I volunteered to assist in the medical clinic, as did a couple of other members of the optometry department—but only for above the waist exams. Needless to say, our offer was rejected. Speaking of the optometry department, we saw 408 patients. The dental clinic saw 150, and 11 wheelchairs were dispensed. I don’t think I’ve mentioned in the past about how valuable wheelchairs are in Nicaragua. There are a significant number of people injured during the wars that afflicted this country, as well as diabetics, accident victims, and people with birth defects. Without a wheelchair, many of these people have to be carried around everywhere.

Lunch on this day was a Nicaraguan specialty called nacatamales. These consist of a piece of chicken, a few vegetables, rice, possibly yucca, and some form of flour and steamed inside a banana leaf. These are traditionally served only on weekend mornings, but an exception was made for us. We also had fresh pineapple, which was outstanding. They’re grown right in the area where we were, and are the best I’ve ever had. We were lucky enough to get them every day.

On Tuesday the 22nd, not only did we have our main clinic, but we also had a satellite clinic. Four of us, including myself, went to a small village called La Trinidad in the Malacatoya district of Nicaragua. The trip was arranged by Donna Tabor, an American whom I don’t think I’ve mentioned in my previous reports. She was a Peace Corps worker in the city of Granada from 1996-1998, and decided to stay after her commitment was over to continue helping the people. Her help has been invaluable in the past, as she not only knows how we think, but is thoroughly ingratiated with local customs and people. She especially concentrates on helping the local street children, many of who are addicted to sniffing glue. She holds classes for them, and tries to help them to follow a better path.

Before we left Granada, where we met Donna, I was asked to examine a man who was having trouble seeing. He was 53 years old, and could barely see my fingers in front of his face. He had extremely dense cataracts, which is not necessarily uncommon in Nicaragua, but is rare in a man so young. We sent him to the clinic in Ticuantepe, and while there he was instructed to go to the hospital the next day, where he would receive cataract surgery. Luckily for him we happened to be in town—because of this chance encounter with us he went from being virtually blind to a sighted, fully functional person.

Donna accompanied us on this trip, as did her friend Gini Sheffield, also an American, both of whom translated for us. One of the aforementioned street children, a boy named Humberto, also accompanied us. He was trying to stay away from glue, and thought he might get into trouble is he was left alone. The other members of the trip included Charissa Lee, an optometry student, physician Rocco Andreozzi, and Shahin Barzin, who dispensed medications. A pickup truck took us to the town where our clinic would be. There were seven in our party, along with the driver. So according to Nicaraguan custom, there were twelve people in the truck. No one ever seems to go anywhere alone for long distances. Four other people just came along for the ride. That’s just how it is.

The road we had to take there was an adventure in its own right. It was a dirt road, which I expected. However there were huge potholes, depressions, and rocks all along the road. The driver must be extremely attentive, otherwise there will massive damage to the vehicle and potential injuries to the passengers. It took about one hour to get to our final destination. Before we reached the end, we got to a river. Instead of having a bridge, there was a ferry to shuttle vehicles across. I had never seen such a contraption, but it worked.

We got to the clinic and worked a long day under less than ideal conditions. The medical patients got no privacy, and the eye examiners had to work in daylight, which makes the exams more difficult to perform. However, we did see 84 eye patients and 73 medical patients, which made for a successful day. We are strongly considering having more of these clinics during next year’s mission.

On the way home, we stopped off to see one of Donna’s success stories. She sent a six-year old boy named Jesus to the Mayo Clinic last year because he had a defective heart valve. They gave him a pig’s heart valve, and now he’s no longer sick, just a regular kid. Across the street from the boy’s house was a pharmacy. The sign said “Farmacia natural” so we were intrigued and went inside. It turned out to be a regular pharmacy, but the workers there were excited to see us. They asked us for help procuring supplies and teaching them the proper uses. We may go back there next year for just such a purpose.

Meanwhile, back at the main clinic, it was another busy day. The dental clinic saw a record 212 people. They never counted how many teeth they pulled, but the numbers were extremely high. The medical clinic saw 311 people. The eye clinic saw 395 patients, and eleven wheelchairs were dispensed. Later that night we had a group dinner.

On Wednesday the 23rd, the eye clinic had its busiest day. We saw 617 people there. The dental clinic was nearly as busy as the previous day, seeing 206 patients. The medical group saw 363 patients. Twenty wheelchairs were dispensed. This area of the clinic was buoyed by the arrival of Al Amerigian. For those who don’t know Al, he spends much of his time throughout the year acquiring wheelchairs and repairing them, specifically for use on this mission. Due to a paperwork snafu, he was unable to join us when we left on Saturday. Once he got everything taken care of, he took the first flight down and was able to finish the clinic with us. That takes some real dedication. Many people would not have bothered to put forth the effort that he did.

Thursday the 24th was the final day of the clinic. The eye clinic saw 530 people for the day. The dental clinic saw 127 patients. Our medical group saw 407 people, and we dispensed our last seven wheelchairs. At lunchtime, our hosts treated us to a show. After we finished seeing patients, we packed up all of our equipment and headed back to the hotel for our traditional end of mission party. While there, thanks were given to our hosts and group leaders, all of whom did a great job. Charissa Lee was given the Bob Schwartz memorial scholarship, which is named for the late founder of our group.

Our official total numbers are as follows:

Eye clinic: 2034 Dental clinic: 701 Medical clinic: 1760 Wheelchairs: 49 Cataract surgery: 25 GRAND TOTAL: 4569

Great job!!!!!!!! Remember also that we saw another 5-10% that were not officially registered, but we have no way to count them. We did not count the number of eyeglasses that we dispensed, but it is probably equal to the number of patients. Also, we will be making nine pairs of glasses in the U.S. and sending them down to Nicaragua in the next few weeks.

On Friday the 25th, we set out to explore the country for a couple of days and reflect on a job well done. Two days later most of us returned home knowing that we had made a difference. Many of us are already anticipating next year’s trip.

I feel that in order to truly get a feel for how the mission went, you have to hear it directly from all of the people who were there, not just one. To that end, below are anecdotes from most of the volunteers from this mission. Some are general, others specific. Some have a happy ending, others do not. However, each adds to the total effect of the mission.

Jenny Atwood recalls crying upon hearing the aforementioned applause when we arrived at the clinic site, as well as being told by an older lady that she’d go to heaven in thanks for receiving eyeglasses.

Cheryl Kelly told of how on the last day the entire pharmacy worn the aprons that some of the local women wear. The locals appreciated their trying to blend in. A translator said that they looked like the women that work at the market.

Bob Plass had the unenviable job of taking a lens from two different pairs of eyeglasses and making one pair that the patient required to get proper vision. When the patient got them after a rather long wait, they were most appreciative. He liked to try to treat patients like individuals despite the sheer numbers.

Tim Kennedy had the daunting task of running the dispensary. Those who know him will know that he tries to deflect credit from himself onto others. He wanted to thank Larry Ulm and Marty Fair for helping him organize a library of 14,000 pairs of eyeglasses, and the rest of the dispensing team for a job well done.

Marie Rondeau recalls an old woman that had to be carried into the clinic by her family because she was unable to walk.

Jim Donnelly remembers seeing a kid wearing a sock very high on one of his legs. It was covering a highly disfigured leg—the result of an accident. He put his leg on the table for show. The boy left in a wheelchair.

Leslie Vieira told me that a patient who had cataract surgery came back to the hospital the next day to say thank you once again. He was so happy that he could see the color of someone’s eyes again.

Becky Tiexiera wrote “An older man came to registration and he was the cutest thing ever. He was telling Tara (Atwood) and I how he had been there the previous day to get his eyes checked and came back with his sunglasses. All he wanted to do was sit and talk to us—he was so excited. He kept saying how much he wished he knew English so he could really talk to us. He didn’t want to leave but we had to keep the line moving. You can tell we touched his heart—we did what we came to do.”

Maureen Corcharan talked about one of the saddest sights I’ve ever seen. A young girl was brought into our clinic in a wheelbarrow. I had my camera with me but could not bring myself to take a photo. Her limbs were warped from the shape of the wheelbarrow. Unfortunately, she came in at the end of clinic and we had no more wheelchairs to give. We will be sending her one very shortly.

Ed Greenan found it very funny that a 79 year-old woman with a long history of asthma was smoking two cigars a day.

Eileen Tiexiera is a part of one of our greatest success stories. Last year, a twenty day-old baby came into the clinic on the verge of death. She had lost weight since birth, and would have been admitted to a hospital in a more developed country. It turned out that the mother was not breastfeeding properly. Eileen showed her how to do it the right way, and two days later Baby Wendi was looking better. This year, as Eileen said, she was a “fat baby” and still breastfeeding.

Sue Seidler had the unfortunate task of telling a man that we couldn’t help his son with muscular dystrophy. Our arrival in Nicaragua gives hope to some that we can help some people that the local doctors were not able to. Unfortunately, we are not able to cure everything, and that leaves some patients upset, though normally appreciative of what we’re doing.

Tara Atwood was in registration when a woman lost consciousness due to her diabetes. Members of our medical staff arrived quickly, but there was a subsequent riot of onlookers trying to get a better look. It took a long time to regain control of the situation.

Maryann England noticed that after the commotion died down and the crowd dissipated, the woman’s young son was standing next to her, holding her leg, and crying. Once he was assured that everything was fine, he was given a toy and let out a big smile.

Lynn Normand was given hugs by three consecutive patients, and was blessed on several occasions throughout the week.

Kevin Somerville was appreciative that his translator gave him a gift in thanks at the completion of the mission. He was also blessed by a patient.

Bruce Fischer had a patient who claimed to be 115 years old. The man came in with his son who claimed to be 90. When asked the secret of old age, the man said that he wakes up with and goes to bed with G-d. The patient had arthritis and had difficulty walking, and was very upset that he was unable to work.

Ann Mason saw a 65 year-old man who rode his bicycle everywhere. Not surprisingly, he was complaining of some back and knee pain. Ann liked seeing someone that was so healthy and vital at that age despite poverty being all around.

Sarah Mason saw a 30 year-old pregnant woman with severe abdominal pains. The woman likely had a uterine infection, though we had no way to test for that. The patient was treated as such, and was urged to get a pap smear.

Dave Pritchard saw a patient who could hardly see. The patient told him that he should take a local woman home with him. When Dave informed the man that he was married, the man responded “Dos…dos” meaning “Two…two.”

Ali Hocek noted that mission meant a lot to our translators, some of them have been with us for the last five years. He saw that a lot of them were using English to speak amongst themselves, and that this was their most significant contact with native English speakers—he hopes that the mission gives them some more focus in their lives.

Rocco Andreozzi saw a man with a huge sebaceous cyst on his back. It took a lot of people to help remove it. He had someone else suture it while he watched, and this is someone that may now decide on a career in medicine.

Joe England saw a patient that was dropped off at our clinic by ambulance. He was just left at the clinic—no records, no family, nothing. The man was unable to move. It turned out that he recently had a stroke. He left the clinic in a wheelchair that we gave him.

Frank Cassarella brought shirts and shoes to give away to patients. Unfortunately, by mistake he gave away John Kerwin’s shoes. Someone out there is walking around in a nearly new pair of size 11 Rockports.

Michael Siebert saw a three year-old girl named Cynthia. She was born with cataracts in both eyes, which were subsequently removed. However, the job was not done perfectly, and she sees very little. In order to get her to see, she will require surgery. We are arranging for her to come to the United States. Michael has arranged for a surgeon in Miami to perform any necessary procedure at no charge. Vidal Ruiz will take care of a visa to get her and her mother into the U.S., where they will stay with family. VOSH will take care of transportation expenses. Hopefully, Cynthia will have a long and healthy life, and we will have helped her to enjoy it.

Dale Stine couldn’t wait to get onto the bus in the morning to get to clinic. He felt very functional and it was a gratifying experience. He felt that his was the face of hope, as he was working at registration, and he was the first person the patient would see.

Greg Rios saw the aunt of Henry Mercado, a physician from Nicaragua (but now living in the United States) who has been with us on the last two missions. She was in need of cataract surgery and asked Greg to do it, even though Greg told her that he was not a surgeon. Also, she wanted it done right there in the clinic, rather than in the local hospital.

Al Amerigian saw a boy who got a wheelchair from us two years ago at La Concepción. He was small then, and was given a chair that required someone to push him. He was much bigger now, and looking for some independence. The boy traded the chair for one that he could move on his own, and within two minutes, his mother was chasing him around the clinic.

James Friesen saw a woman who had two children, neither of whom could walk. She had a seven year-old boy with spina bifida and a three year-old girl with cerebral palsy. Both children were given wheelchairs.

Ellie Santoro was fitting wheelchairs for our patients. Unfortunately we had more children needing pediatric chairs than we had available. We were able to procure some six inch thick, eighteen inches per side square pieces of foam, which Ellie was able to cut to fit the smaller bodies of children, allowing them to fit properly in the wheelchairs. Obviously, as the children grow, the foam can be cut more, and hopefully they will be able to use the chairs for a long time.

Harry Hart had many patients that were unable to see, read, or sew for twenty years or more. He was happy to be able to give people their lives back.

Nancy Hart wasn’t feeling 100% during the mission, and was very happy with the consideration that the rest of the group gave her.

Carol Peltier writes: “At the end of the mission, a young teenager came but we had little left. I found a pair of cat earrings in my pocket which produced the biggest smile.”

Jonathan Wasserstein noted that sanitation in the area we’ve been to is not up to Western standards. Garbage collection is non-existent in most places, and locals generally burn their trash, which leaves a characteristic odor. Even in the cities, locals burn their waste in the below-ground sewer, assuming they’re available. Wise guys in Nicaragua would have no competition if they decided to enter the waste management industry.

Shahin Barzin writes: “During my trip to Malacatoya, a street boy named Humberto was accompanying us. I asked him to help me dispense medication, and he took great pride in counting & sorting the pills for me. He was happy to show me the book he was reading: the Spanish translation of “Runaway Bunny.” He said “The most beautiful thing in the world is to know how to read.” Humberto had been off glue for two weeks and was tired of living on the streets. He wanted to change…I hope that he will survive the odds.”

Bas van Merriënboer writes: “The one thing that intrigues me the most was this 50 year-old female who had a c/d ratio of 0.9/0.9 and an IOP of 35 {editor’s note: these are signs of advanced glaucoma.} I felt so sad we couldn’t help her, and that she would most probably be blind within a couple of months.”

Susan DaCruz was especially touched by a patient that she examined who came back later to show off their new glasses—both the style and the fact that they could see better.

Carolyn Grimes thought the best part of the trip was “…watching my dad extract eight cataracts in one day—giving sight to eight people who would, without my dad, not have it.”

Steve Grimes, on the other hand, thought the best part of the trip was having his daughter watch him extract an “ink-black” cataract, and then two minutes later go across the hall to watch a C-section.

Henry Mercado had a patient that took a bus for ten hours to get to our clinic. All she really wanted was for someone to listen to her.

Michele Morin had Vidal Ruiz translating for her. When a patient came in, she fought with them—the lady did not want to speak to a local, only to a gringo (white person.) This woman also just wanted someone to listen to her.

Martine Brouwer saw a three year-old patient with herpes zoster (chicken pox) all over the face and eyes. She felt bad that she was unable to help very much, and the child appeared to be very distressed.

Marie Alzi thought the group’s teamwork was great, especially when the lines of patients got very long. She was happy to not only do eye exams, but also work in dispensing where she could see the final results of the exams.

Rocco Robilotto had a nine year-old boy as a patient. The patient had significant trouble seeing due to a high prescription. After the boy got glasses, his mother blessed everyone profusely.


Patrick Creevan, after pulling six teeth from the mouth of a two year old, had his fingers bitten. Since most of the boy’s teeth were out, it was less a bite than a gumming.

Charissa Lee most remembers the trip to the off-site clinic, especially the dusty, bumpy truck ride and cleaning off all of the dirt later. She also diagnosed a patient with glaucoma and referred her for treatment—the woman would have been blind if not for being examined on that day.

Long Tran was invited to the home of one of our translators, along with a few others from the group. He remarked how little these people have (at least in terms of material possessions) but that they were extremely gracious and happy with what they had. He appreciated seeing how they lived.

Jackson Lau saw a man who had a lot of trouble seeing far away because he did not have adequate eyeglasses. Jackson understands that eyeglasses are something most of us take for granted, but this man never had the opportunity to acquire them until we arrived, and was quite grateful.

Arthur Jung saw a 59 year-old man with advanced glaucoma. He told the patient about it, and the patient was relieved that he had a reason for his vision loss. Arthur found it refreshing that the man had a reaction different from the self-pity of many people back home when they find out the same thing.

Hernando Alfonso saw a 59 year-old woman with a severe case of diabetes. She was in a wheelchair, and was no longer able to see, both problems a result of the disease. She came in with nothing but hope, but unfortunately we could not help her.

Stu Zipper, while searching for a site for next year’s mission, was flagged down by a local person. This man claimed to have a 90 year-old grandmother who had broken her leg six months before, and had not left her bed since. Stu offered to help, and then drove a truck to her home and brought her to the clinic. She was given a wheelchair and some independence again.

Lee Arnold found that she could connect better with her patients now that she is speaking Spanish better.

Diane Forest was very proud of the great teamwork everyone in the pharmacy had.

Alinda Oudijk saw a patient who was so happy that she could see again that she came back bearing flowers in thanks.

Mariëlle Bas saw a nineteen year-old girl with an eye turn. She was very concerned with the cosmetic appearance, and asked if there was anything we could do. When told we could not help her, the patient became very sad.

Susan van der Veen saw a patient who was unable to see very much due to severe cataracts. He kept walking up to the eye chart from his seat to prove that he could see something. As an aside, Nicaraguans are very proud people, and this is just an individual example of that spirit.

Marga Goris saw a seven year-old patient who had a cataract in one eye since birth. This eye was unable to see much, but the other eye was normal. She had to tell the patient that we would not be able to help, but still gave her a pair of glasses with impact-resistant lenses to protect her good eye.

Monique van Veen saw a small boy who had very poor vision on account of shaking eyes (a condition called nystagmus) and severe nearsightedness. She brought the boy to the eyeglass dispensary herself and was able to find glasses that enabled him to see more clearly.

Iemkje Donkers saw a patient who had lost an eye and ear in an accident. The patient needed glasses, but we had a difficult time fitting them, as there was no ear to rest them on. We finally were able to concoct something that worked.

These are just some of the things that happened on the mission. Even if you were there, you couldn’t experience everything. Hopefully this report will allow those of you who were there to get a more full effect of what we did. For those who did not go on the mission, it is my hope that this report allows you to share in the experience. For more information or to help us on future missions, please visit http://www.nevosh.com.

Here’s looking forward to more successful missions in the future.

Hasta proximo año,

Juan Carlos

Ticuantepe 2002:   Mission Report | Clinic Site | The Line | Registration | Screening | Eye Exams | Dispensary | Eye Surgery | Dental | Medical | Pharmacy | Mobility | Invitation | Roster | Thank You Dinner | Rest and Recreation

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

Contribute to NEVOSH | NEVOSH Home

Copyright © 1987-2012 Northeast VOSH, Volunteer Optometric Services to Humanity, a not-for-profit organization, or our suppliers.  Contact webmaster@nevosh.com for reproduction permission.