Nicaragua: What a Week Can Do

Many people have been asking me, “so how was your trip?” and, for the life of me, I cannot come up with a good response. I wish I could transfer my memories directly into their heads. It’s a lot to explain; it’s a lot to process.

We landed in Nicaragua at night, and boarded a small VW-esque bus, which would be our trusty mode of transportation for the week, and our mobile bedroom for our 1.5-hour bus rides to the community we would be working in at 7am each day. Since it was so dark, I had no idea what the surrounding environment was like; all I could see were the stars, which were vast and simultaneously compact, like a silver Jackson Pollack painting.

We stayed at the Global Brigade compound in a city called Esteli. It was a small complex off of the main highway that housed various brigades coming through.

Our project was to set up the first ever, functional (mobile) clinic in a small, abandoned hospital building in the rural village of La Concordia. The government had built the hospital, but didn’t stock it with medicine, making it pretty useless. This situation is a microcosm of the government’s role in health in a lot of low-income countries—it is often unhelpful.

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The abandoned hospital building that was home to our mobile clinic. Photo by: Allison Bajet

We funded local doctors and nurses to help us in the clinic (or rather, we helped them), and we brought medicine and clothing donations (thanks to all who donated, this is where your funds went!)

A key part of the core values of Global Brigades that the organization uses local and sustainable resources whenever possible. Hiring local staff, and not just bringing in foreign doctors, is essential to stimulate the local economy. Also, Global Brigades cultivates a long-term relationship with each community they visit (apparently, there is a waitlist of communities—so the organization isn’t imposing… the communities must ask for help.)

Our brigade may have only been there a week, but in a few months, another one will be back in that same community. After working with one community for a while, Global Brigades implements water projects (which is eventually taken on by members of the local community), microfinance projects, business, dental, public health… there is a long list. But each of these brigades works together to improve the health and wellbeing of the community. Global Brigades is a unique organization in a sense that it is holistic and sustainable long-term (for more information, click here).

Working with Global Brigades made me feel less guilty about my work being a band-aid covering the larger wound–the deeper-rooted issues–as there are many ethical dilemmas with short term volunteer travel. Rather, I thought of my work as the beginning of a conveyor belt that, with the help of others, would eventually piece together a larger product, or goal.

Each student was put on a rotation at different stations: triage (patient intake), shadowing a doctor (a regular physician, a physician in dentistry, or one in gynecology), filling prescriptions in our makeshift pharmacy, educating kids about dental hygiene and preforming fluoride treatments, and patient data input.

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The triage station at the entrance of the hospital. Photo by: Allison Bajet

I was on triage 2 times, which was slightly difficult because I don’t know Spanish. However, I was paired with people who knew a bit more than me, and we were able to break the language barrier in order to record each person’s symptoms. I also shadowed a doctor, and saw that a majority of cases were parasites, gastritis, hypertension, and vaginal infections. Many women had STDs because condoms are a taboo and birth control isn’t common or accepted.

This one girl who came into triage wanted to know if she was pregnant. Later, I heard that the pregnancy test came back positive, and she went dead silent, with a grave expression. She was 17. Many women have no say in sexual relations—there were countless teen pregnancies, and even more STDs.

I saw one case of severe chicken pox. Many elderly had arthritis, diabetes, and a few had cancer. All of these diseases had been unchecked and untreated for years. I saw children with severe growth stunting (which is indicative of severe, long-term malnutrition). Countless teenage girls came in holding their 2 year-old babies.

We couldn’t treat all diseases—cases like cancer were referred out to the main hospital, which was 4 hours away, in the main city. This made me feel an overwhelming sense of dread—most of the 972 people who came to see us walked for hours and hours to get to the clinic. How could they possibly get to the hospital? And if they managed, how could they pay, and would they even get to be seen by doctors? This was probably one of the heavier moments—the overburdening sense of hopelessness and grief felt by all parties that this person, someone with early stages of cancer, or a chronic case of heart disease, might die of this illness because the government neglects the healthcare system.

Mostly everyone was plagued by parasites, due to unclean drinking water (and on top of that, unclean sources were often an hour-walk away). What I didn’t realize was how clean water was so inaccessible. Later in the week, we visited a village that had started on building trenches for water piping. The community members told us that they walk 4 kilometers for water, and they only have 3 sandcastle-sized buckets of clean water a week for the entire village. For the amount of working in the intense sun (Nicaragua is close to the equator), and walking they do, I couldn’t imagine the sheer amount of dehydration they must feel daily.

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1 of the 3 buckets of water rationed out by community members for the whole community.

I also did not expect the amount of decaying teeth. Kids and adults alike came in for tooth extractions. No one owned a toothbrush. We taught the kids a song in Spanish that went over the correct way to brush teeth, and gave out toothbrushes and fluoride treatments. I felt like that was just a band-aid, until the last day, when the kids gave us hugs and sang the “cepilla los dientes” (brush your teeth) song. They had even been teaching their friends the lyrics. So in a sense, we cultivated positive health, but in all honesty, there wasn’t enough resources (tooth brushes, toothpaste, fluoride, dentists in general) to really fix the widespread dental hygiene issue.

Since malnutrition was so pervasive, the doctors prescribed vitamins for everyone; but we often ran out before the end of the day. Vitamins are so essential because it helps combat malnutrition, and the effects of malnutrition take a major toll on long-term development (within the body and the brain).

I can go on, but if you’ve made it this far, I will spare you my rambling. These anecdotes are only slices of what I experienced in Nicaragua. I’m so thankful to have gone—I met some of the kindest, most genuine people (both from the USC Global Medical team and from the communities in Nicaragua). But my heart is also heavy knowing that there is so much disease out there and not enough distribution of resources to alleviate them. My heart is heavy knowing that the children and parents I met may die of diseases that are curable in the U.S. My heart is heavy knowing that the people I met have no choice but to drink water that gives them parasites. My heart is heavy for all of the children who have to walk over 5 kilometers in the sweltering sun just to go to school. Lastly, my heart is heavy because I know that this is a problem that won’t go away anytime soon, and it isn’t limited to just Nicaragua.

Before the heaviness of my heart anchors me to my desk, I must admit that I have hope that the team of inspired students who came with me on this journey will work ceaselessly to dedicate a piece of their futures to tackle the problems we saw plaguing our counterparts in Nicaragua.

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My team mates, fighting on for the future of justice in health.
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