Nandaime, Nicaragua January 2008

Mission Report
Clinic Site
Remote Clinics
Los Gentes
Final Dinner
Beautiful Nicaragua
Rest and Recreation
Where's Jackson?

Rocco Robilotto and a young patient.

The 2008 clinic site was in Nandaime, Nicaragua.  The optical dispensary used a computerized inventory system (REIMS) to pick the best possible prescription match from the library of donated eyewear.  This system worked well and worked very fast.  For the first year, NEVOSH included a veterinary clinic.

Name unknown, Omar, Larry Ginsberg OD, Muriel Laverty A television crew interviews Omar

Our hosts for this year were Muriel Laverty and Omar.  Without their coordination and assistance, we would not have been able to put together a successful clinic.  We greatly appreciate their efforts in making the whole experience very smooth and rewarding for the people of Nandaime.  In the photo at right, Omar is being interviewed by a Nicaraguan television station.

Mission Report
The mission report is an official record of the Clinic put together by NEVOSH.  It normally includes stories from participants of special encounters they had during the trip.

Clinic Site
The clinic site this year was a school in Nandaime, Grenada Department, Nicaragua.  It was more than adequate for our needs.  We appreciate the work of our facilitators, Muriel and Omar in scouting the location. 
A visit to a VOSH clinic for a patient includes much time spent waiting in line.  They wait in the morning outside the gates of the school.  They must again queue separately for Registration, Screening, Exam, and the optical dispensary.  If indicated, they will again need to wait in line for Dental, Medical and pharmacy services.

Registration is the first step in the NEVOSH clinic process for the patient.  They will be given a sheet of paper to carry, which has their name, age, city, and any medical or specific eye complaints .

Visual Acuity, or screening, is the step in the process that has patients looking at eye charts through one eye at a time to determine generally the state of health of their eyes.  This important step gives the optometrist a numerical indicator of eye health, such as 20/20, 20/40, or in some cases, 20/400 or even "hand motion"  which indicates that the patient is able to perceive only a hand wave in front of their eyes.

Here the patient undergoes a much more rigorous examination of ocular health.  With the use of trial lenses, the optometrists are able to zero in on the correct prescriptions for the patient for both near and far vision correction.  By swapping and rotation of non-spherical lenses in a round trial frame, correction for astigmatism is determined, both in the power of the astigmatism and the correct angle, or "axis".  At the completion of this examination, the patient carries his or her paper to the optical dispensary.  This year, the optometric students from SUNY were unable to attend and perform examinations.  This shifted a heavy load of burden onto the travelling optometrists.  The cadre of veteran VOSH ODs stepped up to the challenge and exhausted themselves to see every patient possible that came to the clinic in Nandaime.  The work that they performed was more challenging than past years, simply due to the volume that each examiner needed to see to get through the line.  Kudos to each and every OD for this monumental effort.

The optical dispensary is tasked with finding the best match to the prescription given by the optometrist.  From a large library of donated eyeglasses, the dispensary staff picks the best match possible.  This year the dispensary was aided greatly by the computerization of the library inventory under the REIMS system.  REIMS stands for Richmond Eyeglass Inventory Management System, and was developed specifically for this type of remote clinic.  Using this system, the prescription is entered into a laptop on site and the system returns the best matches from the inventory.  It is pretty slick, and can be set to prioritize the right eye, or the left eye.  If bifocals are not available in the best prescription match, it can automatically split the prescription into two pair of glasses, one for distance and the other for near vision. 

In preparation for this trip, an enormous amount of time was spent by VOSH volunteers stateside in entering the prescriptions of eyewear in the library into the system.  Among those taking on this important and seemingly endless data entry task were Larry Ginsberg OD, Jennifer Burney, Stephen Burney,  Deb Imondi,  and Sarah England.   Major Kudos are in order for those who entered the prescriptions before the mission, and especially to Stephen Burney, who was the on site expert in all thing REIMS.  For the 2008 trip, all of the plus single vision and bifocals were in the computerized inventory.  For any minus prescriptions, which are less common, we had to resort to the old method of digging through the trays of eyewear, organized by power.  At the end of the clinic, we were able to run a report, showing how many glasses were dispensed, and in what power, to ease the replenishment process.

Once again this year, the intrepid eye surgeons, Dr. Steve Grimes MD, and Dr. Charles Collins MD, made the trip and restored the sight in one eye for the most needy patients.  Over 50 Pre-Op evaluations were carried out at the clinic site by Carl Sakovits, OD, Joe England MD, and Sarah England.  Some of the patients evaluated did not to show up for the procedure, and one feisty hombre got up off the gurney and walked out of the hospital without receiving the surgery.

Every year that NEVOSH has had an Ophthalmologist performing surgeries, many lives are greatly changed by the renovation of sight to the legally blind.  This year, 50 patients received cataract surgeries at the hospital in Masaya.  Dr. Grimes set his personal record for the number of cataract procedures completed in one day.  We do not have enough kind words in the dictionary to express the gratitude of NEVOSH and the patients involved to these intrepid surgeons, their well tuned assistants, and the operating room translators.

Carl Sakovits, OD also saw the patients after the procedure, fitting protective sunglasses and witnessing first hand the moment that they first gain vision as the bandage is temporarily removed to determine the correct prescription for eyewear.

The medical clinic this year saw patients with a wide variety of health issues.  Hearts were listened to, blood pressures were checked, and prescriptions were written for the Pharmacy to fill.  All of the staff in the Medical Clinic were returning NEVOSH veterans, including Rocco Andreozzi DO, Joe England MD, Bruce Fischer MD, Geoff Burns MD, Lee Arnold PA, Becky Sox NP, Sue Seidler NP and Lynn Normand NP.

The Pharmacy crew this year dispensed medications based on prescriptions written by the medical team.  In a change from previous years, the pharmacy crew could not bring donated medications which were within 6 months of their expiration dates.  This resulted in a dearth of available medications to dispense, but the pharmacy crew did all they could to make the best of this situation, dispensing what they had in the most appropriate and diligent manner.

The mobility clinic always changes lives in a huge way.  For the most needy patients, mobility came through with shiny red Chinese-made wheelchairs.  The wheelchairs were provided through the Wheelchair Foundation.  Patients were evaluated based on need and wheelchairs were assembled and adjusted to fit the patients.  The stock of wheelchairs was released from customs only days before the clinic was scheduled to begin.  For this small miracle, NEVOSH wishes to thank MINSA, Nicaraguan customs, Muriel and Omar and all those who strove to ensure that the wheelchairs would be available to dispense in time for the clinic.
The dental crew, headed by John Kerwin, DDS, was staffed entirely by returning veterans.  After a preliminary exam, teeth were extracted, restorations performed and the dental health of 456 Nicaraguans was improved.  Dr. Kerwin has organized a golf tournament annually to help fund NEVOSH.  Without his effort, the clinic would not have the dental chairs that have made the procedures much more comfortable for the patients, and eased the access for the Dental Crew.
Once again this year, NEVOSH was further enhanced with the presence of a licensed dietician, available to discuss diet strategies with patients.  Becky Tiexera discussed eating habits and ways to improve diet.  Common concerns included eating right with diabetes, vitamin supplements, and proper nutrition for expectant mothers.

Carolyn Grimes hosted a veterinary clinic in Grenada this year.  The clinic is one of many aid institutions founded by recently recognized citizen diplomat Donna Tabor.   Carolyn was able to scrub up and perform spay and neutering procedures, and treat walk in patients.  During her four day clinic, Carolyn treated 43 four legged patients and a dog named tripod.

Remote Clinics
In an effort to bring assistance to those who need it the most, NEVOSH set up three small remote clinics in areas where the need is greater than in Nandaime.  The recipients of care in these areas were very grateful for the care they received from the travelling doctors with NEVOSH.

Without the work of a dedicated group of translators, the 2008 NEVOSH clinic would not have been possible.  We extend our sincere thanks to the translators who worked diligently to ensure that the issues expressed by the patients in the clinic were understood by the NEVOSH doctors and clinic staff.

Beautiful Nicaragua
In case you did not know it, Nicaragua is one of the most beautiful countries on earth.  Nicaragua is blessed with volcanoes and lakes, rich soils, verdant flora and many types of unique fauna (like the freshwater shark).  The spectacular scenery of this country is truly something to behold.  This section of our website is devoted to photos depicting Nicaragua's beauty  submitted by travelling VOSH members.

Los Gentes - The People
We need a place on the site for photos of the Nicaraguan people.  The doctors enjoy meeting them and getting to know each of them a little bit.  We end up with some great photos of the children and other clinic patients in attendance, and that's what this section of is for.
2008 NEVOSH Mission to Nandaime, Nicaragua
Patient totals as reported by Kevin Somerville
Cataract Surgeries 9 12 17 12 50
Optometric 329 393 341 273 1336
Medical 380 397 373 267 1417
Dental 131 148 111 66 456
Pre-Op Evaluation 20 20 20   60
Mobility 29 30 36 36 131
Veterinary         44
TOTAL:          3,494
• Optical totals include both prescription glasses (783) and readers/sunglasses (553)
• Medical totals include those from 3 remote clinic sites
• Dental totals include both restorations and extractions
• Mobility totals include wheelchairs (93), walkers (21) and treatments (17)
• Veterinary totals include sterilizations (23), tumor removal (1) and walk-ins(20)


Group Photo 2008

Submissions of photos and stories from those who were on site are being solicited.  For more information on submission, email


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

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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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