2005 Mission Report

2005 Mission Report, Catarina, Nicaragua
by Jonathan Wasserstein, OD
"Juan Carlos"

Greetings members and friends of VOSH-Northeast,

Welcome to my seventh annual mission report, following the 19th annual mission under the banner of VOSH-Northeast. I hope to have a better perspective on how everything went on the mission as I retired from being mission director after last year’s trip. While my two years as the “gran jefe” were very rewarding, they were also very draining. I joke that no one person can fill my shoes—so there were two mission directors this year. Both Carl Sakovits and Joe England agreed to run this year’s mission. Carl had run the 1997-2001 missions, and Joe the 2002 mission, so there was no learning curve for the mission directors.

This year, we returned to Nicaragua for the eighth consecutive year. Catarina was the town where we set up the clinic. It is located in the middle of the mountains of southwestern Nicaragua in the Masaya district, and overlooks a lagoon called Laguna de Apoyo. There was a constant stiff breeze there, and the clinic site had undoubtedly the coolest climate of any site in my nine years of participating in VOSH-Northeast missions. In fact, many of our staff wore long pants and long sleeve shirts or jackets at the clinic, which I cannot remember happening in the past. The locals usually wear long pants, though, as in their culture shorts are usually only worn by children or during exercise. There were two minor negatives about the clinic site. One is that there was barbed wire all around, especially as you headed toward the lagoon. The other is that there were deep channels to carry water next to the walkways. It took some time to learn to negotiate these, and by the first clinic day we already had one member with a torn-up big toe and another with a skinned knee.

We stayed at the Hotel Casa Grande in Jinotepe for the fourth time. It seemed as if the place had slipped a little since our last visit in 2003, but was acceptable for the week. There was a very strong breeze through the hotel, though not as intense as at the clinic site. The wind certainly helped keep the hotel cool and comfortable at night. The clinic site was 30 minutes from the hotel by bus, and the road that we took went through the towns of Niquinohomo and Masatepe, sites of our 1998 and 1999 missions, respectively.

This year’s mission brought 63 altruistic, well-meaning, individuals from all over the United States and The Netherlands to work in multiple departments at the clinic site. That is a huge number of people, but actually was the smallest number the group has taken since our 2000 mission. We had the same clinics that we’ve had in the past—eye (including cataract surgery,) medical, dental, and mobility; but we added an additional clinic this year.

We’ve long known that deafness is a serious problem in Nicaragua, but we’ve been largely unable to do anything about it, due to lack of expertise and resources. This year, we brought an audiologist with us for the first time. Ken Startz brought with him thousands of dollars worth of high-tech diagnostic equipment, and 50 brand-new hearing aids (plus a year’s supply of batteries for each,) to diagnose and treat hearing loss. It was amazing to watch the faces of those people who received a hearing aid recover one of their senses for the first time in many years. It is very similar to the feeling that we get when we give glasses to someone who has never worn them before. If we had more hearing aids, we could have helped more people. Ken told us that if people donated used over-the-ear hearing aids (OTEs,) he’d be able to recondition them and use them for next year. So if you know of any that are available, please inform a VOSH- Northeast member, and they will see that the OTEs get to where they need to go for use on a future mission.

This year also brought about a major change to another one of our departments. In the past, we have collected used wheelchairs, reconditioned them, and brought them on our missions. This provided a great service to our patients, but was very labor intensive, and required a lot of storage space. We knew that this model was unsustainable, and it took us time before we came up with an alternative. This year, we learned about an organization called the Wheelchair Foundation. This group makes wheelchairs in its own factories specifically for use in developing countries. A relief group that makes a donation of $21,000 to the Wheelchair Foundation is given a full shipping container-load of wheelchairs—a total of 280 of them. Again, these chairs are brand-new and specifically made for developing countries, where the terrain can be particularly difficult to negotiate. They are also nicely packaged, easy to put together, available in multiple sizes, and come in a striking red color. We were able to raise the $21,000, and received the full amount of 280 wheelchairs. Very special thanks go out to Marie Rondeau and Henry Mendoza, who were able to fundraise that large amount of money for the group, the bulk of which came from the Rotary Club of Providence, RI.

We gave all of the wheelchairs out over the course of the four days, thanks to the hard work of our mobility team leader and physical therapist, Beth Bagley, and her big crew. We’d love to be able to give out this number of wheelchairs again, but money will always be an issue. Anyone reading this who wants to purchase a wheelchair for use on the mission should donate $75 to our group, and we’ll make sure that it gets used to give freedom of movement to a needy person on our next mission.

Our group has developed connections over the course of the years. One of them is the wife of the president of Nicaragua. The first lady helped to make sure that the wheelchairs arrived in Nicaragua safely, and were secure until we needed them. Our connection with her is through her personal doctor, Dr. Raúl Jarquín. Dr Jarquín is also the president of the Rotary Club of Masaya, which has been our host group on and off over the last eight years. Masaya is the district of Nicaragua that we’ve spent most of our time in over the years.

I’ve discussed the work that this group has done for us before, but it definitely bears repeating. A group like ours cannot just show up in another country with no advance warning and expect to see the number of patients that we do. The Rotary Club advertises our arrival to the community, and distributes tickets for the days we will be there, staggering them so that our patients do not all arrive on the first day. They also arrange for our transportation to and from the clinic, get lunches for us, find translators, and take care of the numerous small details that pop up. As we learned in the past, an unmotivated host group can lead to a poorly attended and organized mission. We are very lucky to have the support of the Rotary Club of Masaya.

I’ve also mentioned Dr. Miguel Silva and his wife Velia before, but their support is worth mentioning again. They are both Nicaraguan citizens, who spent much of their lives in the Seattle area, where Miguel worked as a doctor of optometry. Upon retirement, they returned to Nicaragua, but continue to be very active with our group. Miguel is our liaison with the Rotary Club, and handles numerous responsibilities for us; the job of organizing the group would be much more difficult without him.

Special thanks go out to a couple of members of the group who were not on the mission. Larry Ulm and Marty Fair, both opticians and long-time members of the group, have been preparing our eyeglass library for many years. The library is a collection of 13-15 thousand pairs of eyeglasses, meticulously sorted and organized for easy use on the mission. Without their help, which unfortunately for them is mostly unseen, our work in the clinic would be far more difficult, if not impossible. Thanks guys.

Normally, the majority of the group travels to Nicaragua on a Saturday, and this year was no exception. However instead of an early afternoon arrival, most of our members (about 35) were scheduled to arrive at night, as that was the only flight available to them. Their flight was supposed to land at 8:30 PM local time, but it arrived much later due to technical problems. This group did not get to the Casa Grande hotel until one o’clock in the morning. An unfortunate way to start the trip, but this would not be the worst travel snafu experienced this week by VOSHers.

The next morning, we woke up early, packed the buses, and arrived at the clinic site to set up. We arranged the furniture as we needed it, and had our annual battles over who would use the few tables available. Tables are needed by the eyeglass dispensary to hold the glasses, by the pharmacy for all of the medicines, by the medical department for physical examination, by the optometric group to hold equipment, and by the dental group for all of their supplies. As you can tell, a great number of tables are needed, and it seems like every year there are fewer. I think we imported tables from all over Nicaragua this year for use at the clinic.

After setting everything up to our liking, each department had a meeting. This meeting is important as we inform all of the new members as to what is expected of them. The groups are also updated as to any changes from previous years, and reminded of the many nuances that are present when you work in a different environment.

We had a reservation at a restaurant at the other side of the Laguna de Apoyo for Sunday afternoon, and once setup was complete, the plan was that we would go there. Since we only had one bus on this day, it was decided that half of the group would leave Catarina early, and the bus would return later for those of us who were not yet prepared to leave. We were told that it would probably be an hour-long wait, as the roads around the lagoon were not very good. About 90 minutes after the bus left, we started to wonder if the bus was going to return. There was a trail that went to the restaurant, just past the barbed wire surrounding the school. About ten of our members decided to take matters into their own hands and walk down the mountain. When we told one of the local residents about this, he laughed heartily. He said that he did that only once, when he was a child, and that he would never do it again. Three hours after they left, these intrepid souls started arriving at the restaurant. As for the rest of us, we waited for well over two hours, until some of our people came back with vehicles to drive us there. It turns out that the bus driver didn’t want to go back. He said it was too much for his bus to take {in general, Nicaraguan bus drivers own their own vehicles.} Of course, he made this decision after telling the first group of people that he was going to get us. Needless to say, we fired him. The travel problems didn’t end here, unfortunately, but you’ll have to read on to find out more.

That evening had no scheduled group activities, and almost everyone was asleep very early, in preparation for the work ahead.

The next morning was Monday, traditionally the first day of the clinic. This day brought one significant problem. The wheelchairs had not yet been delivered. We were told that they were somewhere safe, and we just needed a specific person to sign for them so we could take them. Unfortunately, this person was nowhere to be found. This type of thing has happened numerous times during all of my trips to Nicaragua, and all you can say is “Así es Nicaragua, así es mi país” which translates to “This is Nicaragua, this is my country.” We found the person soon after, and everything worked out.

I know that we place a tremendous importance on what we do, have a defined schedule, and want to have everything done a certain way. This, I believe, is a very American attitude. While what we do is of no less importance to the Nicaraguan people (in fact it is probably more important,) they are not necessarily privy to our schedule, and are often more flexible in how they do things. That is my best explanation as to why there are sometimes minor snafus like this.

By two o’clock in the afternoon, the chairs arrived, and we started unpacking them. But we couldn’t start dispensing them yet. The Wheelchair Foundation has certain guidelines for their wheelchairs. For each chair that is dispensed, the donors (us) must take a photo of the recipient while that person is holding an official document from the foundation. Unfortunately, the certificates did not arrive with the wheelchairs, and we had to wait another hour for them.

While we were waiting for them, I saw a woman arrive at the clinic, and I knew she would be the first recipient. She arrived via taxi with a friend. After the cab stopped, the friend got out of the left passenger seat, folding chair in hand. The right passenger door was opened, and the folding chair was opened up directly next to the open door of the taxi. Then our patient was pushed out of the cab onto the recently unfolded chair. She had little movement in her body, and none in her legs, and was the ideal recipient of a new wheelchair. After a short wait, the certificates arrived, the woman was placed in a wheelchair, and she was able to move around on her own for the first time in a long time. This type of story (sans taxi) happily repeated itself many times over the course of the week.

This day in the clinic we saw fewer patients than any other day. We were informed that people in this area don’t like taking Mondays off from work. Supposedly, if someone doesn’t go to work on a Monday, their boss will assume they’ve been out drinking all weekend. You can’t make this stuff up.

Tuesday was a relatively uneventful day at the clinic. A group of patients from a local nursing home came to the clinic, and they received some needed care in all departments. We also brought some wheelchairs to the home for those patients who could not travel to the clinic.

That evening, we had a group dinner at the hotel, and had our first (and only) meeting with the entire group. There were welcomes, introductions, and thank yous passed out in abundance by Carl and Joe, our jefes (bosses in Spanish).

Wednesday brought the return of the first lady of Nicaragua, Mrs. Bolaños, to the clinic. She came by last year, and we showed her all around the clinic and explained what we did. This year, she did not spend nearly as much time with us, preferring instead to concentrate her time in the mobility department where the wheelchairs were distributed. Part of me thinks that she was afraid of another ambush—last year at the moment she was at the clinic Rocco Andreozzi was examining a nine-month old patient with clubfeet. While the television cameras were rolling, Rocco showed her the child and asked what she would do about it. She agreed to arrange for the baby to be operated on at a local hospital, but was definitely flustered at that moment. I think Rocco did the right thing for his patient, but I have a hunch that the first lady wanted to avoid a similar episode.

We saw an especially grateful patient in the eye clinic this day. On Monday, we examined a woman and found that she was completely blind from cataracts. While that is not unusual for us to see in and of itself, the fact that she was only 36 years old was very unusual. As many of you know, severe cataracts are generally found in patients much older. The next day, we sent her to Masaya hospital to see our cataract surgeon, Steve Grimes, where she had the cataract in her left eye removed. On Wednesday, she returned to the clinic to have the patch removed. She smiled when it was taken off, as this was the first time she could see in years. She avoided a long life of blindness by coming to see us.

That evening the group split into two groups. One went to the city of Granada to explore and to have dinner at a restaurant operated by our friend Donna Tabor. For more information about Donna and Café Los Chavalos, please see last year’s mission report.

The other group was to go directly back to the hotel. We made a brief stop along the way, and it’s lucky that we did. While riding home, a bicycle rider a hundred feet ahead of us skidded off of the paved road and onto the dirt and rock covered embankment next to it. He flew off of the bicycle, and landed on his head. He had a rather large gash on his forehead, and was bleeding, though not profusely. The only person there with anything resembling a bandage was me, so we wrapped my Mets bandana around his head. He wasn’t making too much sense, and he asked for his wife. He also started convulsing briefly. We needed to get him to a hospital, but none of us knew where it was. We flagged down a cab, and asked him how much money he wanted to take the injured man to the hospital. The cabbie requested 100 Nicaraguan cordobas ($6.) We collected the money, and as we were about to give it to him, the taxi driver rode off. A few minutes later, another cabbie came by and agreed to take the man. We pulled him into the cab (and put his bicycle into the trunk.) We hope that everything turned out okay in the end.

Thursday was the last day of the clinic. We gave away the few remaining wheelchairs and hearing aids that we had. Unfortunately, although there was a tremendous need for such things, we did not have enough to give to everyone who was in need. I am still amazed at how quickly we were able to distribute so many wheelchairs. In past years, when we brought under 100 wheelchairs, it took days to give them out. It’s a testament to the efficiency of our mobility department that they were able to dispense 280 wheelchairs in two full days and two half days.

As an aside, each wheelchair came in a box, which was about 3’x 3’x 1’ in size. We unpacked the wheelchairs as they came in, and stacked the boxes in a pile off to the side. There were people constantly requesting the boxes, but we wouldn’t distribute the boxes until the end of each clinic day, to avoid chaos. You may be wondering why there was a huge demand for cardboard boxes. I know from previous missions that many of the poorest people use them for bedding, which is very sad when you think about it. By our distributing unneeded, empty boxes, we are touching more lives than we originally realized or could have imagined.

We packed up all of our equipment that evening. In addition, we merged some of our 2004 eyeglass library with the remainder of this year’s library, which may be used as the foundation for next year’s collection. All remaining eyeglasses, medications, etc. were given to the Rotary club of Masaya for distribution within the community.

On the way back to the hotel, we saw a man waving his arms furiously and smiling profusely in our direction through the window of his home. He was wearing a patch over his left eye—he had obviously had cataract surgery earlier that day. I can imagine that he would have been much happier the next day after the patch was removed, as he would be able to see again. For those who have not spent time in the eye clinic, we only send patients for cataract surgery if they are severely visually impaired—meaning they can see no more than the big “E” on the chart. Most of the patients who receive the surgery can barely see anything more than bright lights and large objects. The difference in their lives following surgery is nothing short of amazing.

That evening, we had a celebratory dinner at our hotel with the Rotary Club. We thanked the Rotarians for all of their support, and congratulated each other on a job well done. Now, here’s the part you’ve all been waiting for—our patient counts.

	MON	TUES	WED	THUR	TOTAL
EYES	296	434	455	424	1609
MEDICAL	225	421	378	387	1411
DENTAL	64	79	92	62	297
AUDIOLOGY	26	32	27	24	109
CATARACT SURGERY					23
WHEELCHAIRS					280
PHYSICAL THERAPY					15
GRAND TOTAL					3729

This was another terrific job by our group. Everyone who attended the mission should be proud of what we accomplished.

I mentioned travel problems before, but the biggest one happened on our way home. The day most of us were scheduled to fly home, a “Nor’easter” hit the northeastern U.S. Flights were delayed and airports were closed. Almost everyone was stuck in Miami for two extra days. While that sounds nice, after more than a week in Nicaragua, most people were really looking forward to going home.

This is the end of the first part of the mission report. From hereon, there will be stories submitted by our members that will give you firsthand accounts of what really happened.

Since I’m writing the report, I’m going to put my story first (executive privilege.) I saw a nine year-old boy who came in holding his mother’s hand. She told me that he could not see anything, and that he had never had his eyes checked before. After examining him, I saw that he had an extremely high prescription. During the exam, I saw his eyes light up, as he was able to see for the first time, if only a little (after all, the exam rooms are small and dark.) I then escorted him to the eyeglass dispensary, where we were able to find a pair of eyeglasses in his prescription. Then the smile came—this day was the first day he was ever able to see, and will be a turning point of his life. I took his address and will send him a new pair of glasses, as if his glasses break he will be blind again, and I don’t want that to happen to him again.

“I don’t have a specific anecdote per se, but the entire experience was extremely rewarding for me. I could not believe how happy and grateful most of the mothers were that I was examining their children even if they only left the clinic with Tylenol or children’s vitamins. I thoroughly enjoyed working in the clinic with the entire medical and pharmacy staff—everyone made me feel very welcome and at home on my first mission to Nicaragua. I look forward to seeing everyone soon.” Allison Gurey

“This was my first VOSH mission and the first time audiology was added to the mission. I could write a book about the emotions shared by bringing hearing back to the 49 people we fit with hearing aids this year as well as the sadness of the many we turned away that needed help. One story I want to relay is one about a 22 year-old beautiful deaf mute woman. She came in with her mother and daughter. Although a deaf mute since birth, I told her I wanted to test her anyway. Her mother spoke English so I gave instructions to the mother, who relayed the instructions to her granddaughter. The granddaughter then used sign language to communicate with her mother. I started the test and she actually heard a pure tone at 90 db @ 1000 Hertz. The patient was so very excited at actually hearing something... I continued with the test at the other frequencies and found she acknowledged hearing the tones at all frequencies with a PTA (pure tone average) of approximately 95-100 dbs. The bone scores followed which indicates she may very well be able to hear even though she had a profound loss. I had no high-powered hearing aids so I took a set of impressions and told her I will send a set of high-powered hearing aids to the interpreter (Stacy) who will go to her village and dispense them to her. Through my co-workers at Beltone New England, I will find a set of high-powered hearing aids and when we go back next year, I have great hopes she will come to the clinic and be able to speak with us…….. Thanks VOSH for the opportunity to do this fantastic work. See you all next year!!!!!” Ken Startz

“There were many wonderful things that happened in the medical rooms this year as there is every year. This is great but my favorite memory is how each member of medical and pharmacy helped each other without regard to ego. This spilled over to audiology, optical, dentistry and wheelchairs. People just seemed to get why we were there. It was a true team with no individual agendas. We should all be proud.” Rocco Andreozzi

“My best memory is a man of 62 years of age who's family was concerned because he had developed problems with walking due to poor balance, incontinence of urine and problems with memory all in the last two months. The Docs in Nica had done the right test i.e. a CT scan of the head but they had not picked up the diagnosis. They told him that his problems were due to a nerve pinch in his back. In fact the scans confirmed the clinical suspicion of "normal pressure hydrocephalus." This can be dramatically cured with the placement of a ventriculoperitoneal shunt. We contacted some people with Rotary and with a referral letter he was sent to a hospital in Managua. Hopefully, there they will follow through and put a shunt in this man, which is often dramatically curative. I wish we had follow-up.” Joe England

“I was with the wheel chair brigade. The wheel chairs arrived in two or three shipments. Each wheel chair came in a box, which we unloaded, stacked, and then unboxed. Unboxing was tedious. It involved breaking down the big box, the little box inside the big box, and sorting plastic from cardboard. All of this was made a hundred times more tedious by constant requests by local staff and visitors for the used boxes. In the beginning, we handed out boxes first come, first served, but we soon realized there would be a riot if we didn't orchestrate the handing out of the boxes more judiciously. Evan Pritchard devised a system which reminded me of a bouncer at a club. The box collectors would assemble at the end of the day (five o'clock was the official box distribution hour) in a single line and Evan would hand out a box and stamp the hand of the recipient. Kids would wipe off their hands and get back in line, or try to sneak up from behind. Of course, anyone who has been to a club knows all the tricks. It was not quite a Rave, but it was certainly festive. Chris Harrop, David Pritchard's student, wryly noted that it seemed at times people were happier receiving the boxes the wheel chairs came in, than the chairs themselves. The truth, however, is that nobody cried and hugged us for a box.” Ali Hocek

“I used to say the age range of people we saw was "0-90". My little story involves the 114 year-old woman who was brought to me in the clinic by Sarah Chirnside. She was slumped over in her bright new red wheelchair, apparently asleep. Her daughter wanted her to be seen because she couldn't open her eyes. Upon examination, her eyes were "glued" shut due to chronic conjunctivitis. I administered some medicine, and gave the daughter instructions to continue care. The old woman responded with a nice "gracias" and was on her way.” Larry Ginsberg

“A few of us rode on the back of a flatbed truck with the luggage to La Casa Grande. We made fast friends despite the language barrier, with Ricardo and crew.... He invited us back to his home in Catarina for dinner (big surprise.....) after knowing us for about 20 minutes. When we were stuck in Miami on the way back home from the mission, we had trouble getting someone to give us directions or let us use a restroom...... We, Americans, could certainly learn a few things from the people of Nicaragua. The kindness and love shown to us and the willingness to share what little they have always touches my heart.” Sue Seidler

“The most memorable patient I saw this year was a 75 year-old lady. She had had a tracheostomy. (A tracheostomy is a hole cut into the windpipe usually done if somebody is on a respirator in the hospital for many weeks). Because of this tracheostomy, she could not utter a sound. What was remarkable to me was that despite the fact that she couldn’t speak, she could communicate so well that I understood her better than any other patient I saw this year in Nicaragua. She just had amazing way of using gestures to get her point across. It occurred to me later that it didn’t matter what language I spoke, she had broken the language barrier.” Bruce Fischer

“This was my first mission. It was an awesome experience and I met such great people. The clinic was more than I expected. The thought of the wheelchairs that were given away touches me each time I think about it. I loved dispensing glasses to the children who had never worn glasses before. The smiles I got from them were more than great!!! The blessings from the
elderly were quite cool too. I hope this will be an annual trip for me.” Linda Carpentier

“This year, I had the great opportunity to help a young man receive a hearing aid. It was late Thursday morning and as the supply of aids had dwindled to 4 or 5 remaining, Ken would have to determine whom he could best help. With input from Ken, we passed on to the rotary that they should not sell tickets for any people with hearing problems on Thursday. Ken had about 8 people returning from Wednesday and we suspected he would have some referrals from other departments. But as things go, when Kevin and arrived to begin registration, there were about a dozen people standing in line for "odio". We made the difficult decision to tell them that they could see a medical doctor, in hopes that some of the hearing problems were perhaps ear infections or impactions. People were not happy but since there would be no more hearing aids to give out, just having a hearing test would not be very helpful. It was shortly after we got all the people registered for medicina that a young mother approached with a baby and a son of about 11. I tried to explain that there were no more "odio" exams. She tried again and then began to walk away looking so sad that I just had to try to figure out if we could help at all. I asked if it was her son who had the hearing problem and she replied that it was. I asked them to wait and went to talk to Ken. At this point there were three hearing aids remaining. After looking at the people still waiting, most of them were elderly; Ken agreed that he should test this boy. Happy ending—this young man had a significant hearing loss. Ken made the decision to give him the last hearing aid. It was just wonderful to see the happiness in his mother's eyes. She gave us all big hugs. Well of course this story also has sad ending - not everyone who needed a hearing aid received one. Another problem is trying to figure out how the people who received aids will get more batteries after the years supply given to them runs out. It costs about $26 a year for a supply of batteries. This will be something some of us will be thinking about for next year. Ken says he hopes to bring at least 200 hearing aids next year. The audio department was a great addition, all you had to do was look in the eyes of people who could now hear!” Maryann England

“In Nicaragua, seldom do things go as planned, yet everything seems to work out... After losing my luggage (including important prescriptions for the pharmacy) and hiking down a mountain, because the bus refused to pick us up, one might get discouraged. Yet, because of the place we are in and the people around us, none of it seems to be upsetting. I made a woman cry because the glasses, which fit her difficult prescription ridiculously well, were unbelievably ugly. Then the next patient to sit down said it wasn’t important what her glasses looked like as long as she could see. For as much possibility there is for disaster, I wouldn’t trade my experience for the world. I am so happy and lucky to be a part of such a wonderful group of people” Whitney Catanio

“I was so happy to be on another VOSH mission with my old friends. I was especially glad to see my old friend, Manuel who had been an interpreter in the Farmacia on my 3 previous missions. On one of our lunch breaks Eileen & I played games with some of the kids. I was moved to tears by a 5 year-old girl who wouldn't let go of me & a little 5 month-old baby with sad eyes. Diane Forest

“My favorite patient was a 14 year old with an Rx of OD -8.75sph OS -6.00sph (editor’s translation—this patient was extremely nearsighted) and she NEVER had glasses before! I was so shocked I asked her 3 times if she was sure she never had glasses before. Larry and Greg had a good laugh at me when I asked a patient if he was "retired"... Larry said `Yeah Jane he's usually golfing in Palm Springs, but he figured he stop in and check out our clinic today.’ My best memory doesn't involve eyes...One morning as we were driving to clinic, I was looking out the window and I saw a little girl sitting outside her house in her new wheelchair!!! She was energetically waving to the bus with a huge smile on her face! It brought tears to my eyes; that will forever be etched in my memory! Jane Bucci

“Another great year in Nicaragua! The people of Nicaragua never cease to amaze me. They can teach many of us who live in the United States a thing or two on what is important in life. We have heard it time and time again; money does not buy happiness. How many times have all of us seen the many smiles on the faces of the people of Nicaragua, who have little to nothing monetarily. In my conversations I have learned that what is important to them are family and faith. I have seen time and time again people who never complain when someone is taken before them. They seem to be very selfless. In the dental clinic there was a very long line for people waiting to be seen. There was a teenager who waited for hours to have some fillings placed, and had asked that his sister be taken before him. Unfortunately we had electrical problems in the room, the lights did not work and it was getting dark and we did not feel comfortable doing procedures due to the lack of light. When he was told that he would have to come back tomorrow for treatment, he simply stated I will see you tomorrow. No argument or look of disgust when faced with a very large inconvenience. How many of us could say we would have done the same? The people of Nicaragua teach many of us lessons that are sometimes hard to learn in our country. Something that keeps me coming back year after year.” Frank Casarella

“What a beautiful mission. As usual I left my sneakers behind in Nicaragua for someone who needs them. I have many heartwarming memories/Just to share one. I cherish the memory of one of our docs with a sack full of toys handing them out to a large group of boys and girls on the last day of the mission. It was like he was Santa. Remarkably he had a toy for every child in that very long line. Wow! It was endless, like someone knew exactly how many children would be there.” Carol Peltier

“I saw a cute little boy about 12 years old sitting in his new red wheelchair. When I asked about his history, the description pretty much described spina bifida. They did not seem to have a full understanding of his issues, instead just accepted that ‘he can't walk’ and `he doesn't know when he has to pee, so he wears pampers’. He had a big smile on his face and was so psyched about his new chair. I was surprised he didn't have any problems, but then on further questioning, he did in fact have a large, deep pressure sore on his heel, probably from dragging himself around. And as is so common with spina bifida, it sounded like he had a raging UTI (urinary tract infection—ed.) It was hard for me as in the US he would have been catheterizing himself and hopefully avoiding UTIs, and would have been set up to avoid pressure problems with his skin. I was surprised the kid hadn't died of urinary sepsis. So I did what I could, put him on a whopping dose of antibiotics, dressed the foot, wrote a note to the Centro de Salud (the local public medical clinic—ed.) for follow up; and then what I hope will be the best thing I could do, talked to him and his mom about the fact that now he can get around, he needs to learn to push himself, steer his chair, transfer himself, all by himself. I figured encouraging his independence really was the one and only thing I could definitely do.” Becky Sox

“This was my very first mission, hopefully with many more to come. I am a senior OT student and was working in the mobility section where we evaluated and fit people for 280 wheelchairs in 3 1/2 days! We were extremely busy to say the least. On my second day of clinic this older woman came in desperately needing a wheelchair. Once I measured and fit her into her brand new, red wheelchair she started crying. This wonderful and very grateful woman sat there and prayed for me for at least 10 minutes in Spanish. She kept looking and pointing to the sky, placing her hands together, and holding mine. She would not let me go until she was finished praying. Tears started running down my cheeks; to know that I made such an impact in a person's life is the greatest gift anyone could ever receive! When I got home everyone asked me how Nicaragua was, but it was hard for me to find a word with so much meaning to explain exactly how I felt and what it was like. All I can say is that it truly was the best experience of my life!” Sarah Chirnside

“Although this mission held numerous memorable moments, I won't forget one great lesson I learned from my good friend Bob Plass. While in dispensing one day, I set my expensive Nautica sunglasses down on my bag, and went to work. Upon returning a couple of hours later, I discovered that my glasses were nowhere to be found. In horror, I eyed the big box of sunglasses to be dispensed right next to my bag. "BOB" I yelled, "Where are my glasses?!" Of course he replies "Well, I did find a pair on the floor, so I hooked them over the box..." And of course, as I later found out, an elderly Nicaraguan man left with my glasses. Although at first I flew into a typical tantrum over money lost, I later realized that I'm sure that man needed those sunglasses more than I...and hey, at least I have a good story to tell!” Larah Alami

“The most challenging and rewarding part of the clinic for me this year was when a mother brought her 3 daughters into the exam room, all born with congenital cataracts. Although they had surgery when they were infants, they still had very large prescriptions. After much time and effort, we were able to fit them with all with appropriate (and surprisingly stylish) glasses. The change was immediately apparent simply by looking at their smiles when they put them on. They will most likely never have normal vision, but at least now they will be able to function much better.” Rocco Robilotto

“I brought down baby clothes and handed out some clothing to a young mother and her two little girls. One was about 2 years old, barefoot and dirty, wearing a torn dress. The baby, under 6-months was also very dirty. It was obvious that they were the very poor of the poor of Nicaragua. The next day the young mother showed up at the clinic to give me a bag of oranges, some of them peeled with an artistic flare and some banana chips. At other times I received various other gifts and hugs, handshakes and the elderly telling me that I will go to heaven. It's these few occasions that make me sit back and think of how much we really are helping these people and with what little these people have, they show it in a smile, a tear or a bag of banana chips. It just makes it all worthwhile. Also my other fondest memory of this trip is that Stephen proposed to me while we were in Nicaragua. We had to bite our tongues and keep it secret, until we shared the news with our families. We're thinking of getting married in Ireland this summer, while visiting his parents. So next year my name tag will say "Jennifer Burney" and not "Jennifer Atwood".”

“A 114 year old woman, a man with left sided arm and leg amputations, an elderly woman with a diabetic foot ulcer needing an amputation, a child with extensor tone from cerebral palsy, a young man with a back injury causing paralysis from the waist down, an elderly man with one leg who arrived in a cart pulled by his brother... These were some of the many people who benefited from our new wheelchair program. As a physical therapist, giving the gift of mobility is one of my passions, and this year was an exceptional year for giving, with 280 wheelchairs (from the Wheelchair Foundation) at our disposal. Our team was able to modify and adapt wheelchairs with seatbelts, tray tables, and hip/shoulder straps as needed to provide better functional capabilities. When people ask me why I do this work, I tell them that seeing the smiles and hearing the thank yous and prayers from people who are now moving independently for the first time is enough for me!” Beth Bagley

“I've never been to such a beautiful place- people and environment alike- that is so heartbreaking at the same time” Becky Tiexiera

“My most memorable moments was watching the special needs people get one of our new wheelchairs!..... and seeing Baby Wendy again!! Eileen Tiexiera

“What a wonderful mission in such a gorgeous place/ To see Baby Wendy and family was great.” Ann Mason

-----Editor’s note—Baby Wendy is possibly our greatest success story. She came to us four or five years ago with her mother. She was 20 days old at the time, and we diagnosed her with “failure to thrive,” as she had been losing weight since birth. Eileen and the others taught the mother how to breast-feed, and now Wendy is healthy and happy—and she’s come to see us every year since.

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