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Today’s forecast was for 100% chance of rain, but we awoke to sunny skies.  But even with the forecast amended to indicate rain later in the day, we splintered again into various work groups – we had work to do – work that would be accomplished with or without a cooling shower.

Two members of our team, a doctor and a pharmacist, have spent their week working at Dr. Medina’s clinic in Rubén Darío.  The clinic is not like anything you would see in the states.  The “waiting room” is an open air porch on the back of the facility with a few wooden benches on which the patients wait their turn.  The clinic serves the three surrounding barrios (neighborhoods) in which approximately 3000 people.  Dr. Medina is the primary physician for all of these people and his clinic is also a teaching clinic for the local medical school.  The modest brick structure includes a pharmacy – one simple room with minimal supplies.  We were actually pleasantly surprised to see medicine on the shelves, as there have been years when there was none.

The examining rooms offer little privacy as they are partitioned with partial walls and to say supplies are limited would be an understatement.  There is little thought to sterilization as the supplies that they do have are shared.  Unlike our experience with medical services at home, there are no gloves, no clean sleeve to place over the thermometer, no sinks in the examining rooms, and no clean white paper sheet to pull up over the examining table between patients.  The examining table itself is often not much more than a wooden table or metal table with little to no padding, and surely no little pillow for one’s comfort.   When Dr. Medina gave us a tour of his clinic, he indicated a new intake area that has been carved out of the corner of one room, but this room has yet to be used as they have not yet figured out how to connect electricity to it.  We can assume that electricity would be for lights, because it most definitely is not for computers, as those don’t exist in this clinic.  All of the records are written by hand.

But that doesn’t deter Dr. Medina from taking care of this community.  Somehow, regardless of the lack of supplies and resources, they get it done, and get it done well. Considering their lack of supplies and sanitation, our pharmacist was actually surprised at how healthy the people are here as compared to her expectations.  Perhaps this is due to their internal constitution and fortitude, or perhaps they keep going because they have to.  When you live in these conditions and need something done, you have to get up and do it.  Life is not easy here, and perhaps that, by necessity, gives them strength.  This is not to say that they are in good health.  Kidney problems are rampant here because of the lack of clean drinking water.  But they don’t lie down and complain – they keep pushing on through.

This doctor is rather like the old time country doctor, only he covers a larger territory with far more people.  There is no question that he is not only dedicated to his patients but, even if he doesn’t know each of their names, he does seem to really know each one of them.  Prescription renewal here is an arduous, labor-intensive process and chronic care medicine is filled with only a one month supply.  At one point there was some confusion regarding one patient’s prescription refill as it was nowhere in his chart.  Dr. Medina had only to look at the patient and he immediately identified and listed each of his medications.   The members of our team offered what supportive assistance they could.  Clearly spending time at a clinic like this would give any of us a new appreciation for all that we have, not only in terms of sanitary conditions and modern medical technology, but the most basic of health care needs, clean water.

Four years ago while working with a local community, an idea was born in an attempt to help them to be more self-sufficient.  What good does it do to provide a new home for a family if there is no food to eat or means by which to support themselves?  Thus began the birth of our gardening project. The thought was that if we assisted a community with tools and supplies to plant gardens, perhaps they could not only feed their families, but potentially sell the yield to provide an income for their family.

Realizing that this would take a long-term commitment and continuous assistance and guidance, we have partnered with a church in Illinois that has had success in this area.  Working through them and assisting in the financing of local support, some members of our team toured these gardens in two different communities were pleased to report that they are now beginning to see success in this endeavor.  In addition to this, an opportunity was given to two communities to raise chickens – one for the eggs and one for the meat.  Felix, who is raising the egg-laying chickens, now owns 114 chickens who are laying 105 eggs every day, and in less than a year he has almost reached our ultimate goal, self-sufficiency.

It is our prayer that perhaps one day these food producing families can sell their wares to the local organizations that feed hungry families.  This goal cannot be reached until one huge obstacle is overcome – transportation.  With no means by which to get the goods to market, there is no way to fully succeed.  Felix has a son who uses his motorcycle to deliver eggs for him.  But this has only limited success – not just because using a motorcycle for delivering eggs can be limiting, but because half the year here it is the rainy season, making it not only impractical much of the time, but impossible due to road conditions.  We pray that with continued support, hard work, and dedication we will be able to assist with a long term solution to this not un-surmountable obstacle.  We are a pretty dedicated bunch – and obstacles are slow us down, but they will not stop us from doing our best to make this dream a reality.