by Trish Krider

Our team this year includes one nurse and one doctor. Medical facilities are limited here and the one physician, Doctor Medina, handles quite a large caseload of patients.  He is well known to all of the families in the barrio and handles all the medical issues of the people in this and the surrounding areas.  Each day Janni and Rick head over to his clinic in Ruben Dario to assist in any way possible.  Whether it is in taking vital signs as patients check in or taking some of the load for seeing patients off of his plate, Dr. Medina is grateful for the assistance.  A modest structure whose “waiting room” is an open porch, patients come to his clinic for everything from illnesses, to pregnancy, to well-baby check-ups.  We have had teams work with Dr. Medina in the past doing both clinic work and home visits.  What a surprise it was for Janni when a woman with whom she had shared time in a home visit came in as patient this week!

The conditions are far from sterile, and the supplies are extremely limited and outdated, but Dr. Medina is loved and respected by his patients and provides for them to the best of his ability. One room of the clinic is the pharmacy, and although it is called the pharmacy, this does not in any way imply that the drugs that are needed will be what is available.  The supply of medicine is provided by the government.  How much of each and which type is available is based not on need, but on how many families are served by the clinic.  The pharmaceuticals are scheduled to be delivered on the first day of the month and when the supply is gone there is no replenishment until the next month’s supply is delivered.  This means that those who visit the clinic earlier in the month have a better chance of getting medications (if, of course, the medication one is seeking is one that was supplied that month).  The things we take for granted at home are true hardships here even down to the method of distribution.  Who would think that the little orange bottles that we toss when our prescriptions run out would be precious to someone?  Through our donations we were able to provide this clinic with hundreds of these bottles as there are no handy containers in which to send medications home.

You can tell that Dr. Medina truly cares for the families he serves. When asked a few years back how we could best serve his clinic, he suggested providing education to the women in the community on pregnancy, breast feeding and child care. The need for this education here is dire as the rate of 10- to 14-year-old girls having babies in Nicaragua has shot up almost 50 percent over the last decade. One in three teenagers here has a child before she turns 18 years old.

This request gave birth to what we affectionately call “The Preggo Team”. In our third year now, we spend a few hours with women, who have been personally invited by the doctor, providing a comprehensive seminar on how your body changes, what to expect, and what is normal during and after pregnancy.  Dr. Medina feels so strongly about the value of this information that, as we were ready to begin, he asked us to wait as he knew there were many more women who should be in attendance.  Rather than sit and wait and hope they arrive, he got in his car and on his phone and rounded up many more “students”.  While the women listen, the older children they bring along with them sleep in their strollers or entertain themselves with the coloring pages we provide to them.  The women seem appreciative (and sometimes apprehensive) of all the information we provide.  Janni interweaves personal stories in her talk so these women know that we understand just what they are going through.

The care with which this team puts together their presentation is evident in the details – down to the very lifelike baby doll that is used for demonstration, and the amazingly comprehensive booklet that each woman gets to take home. And although it adds a time-consuming task to the team’s work, each page is encased in a plastic sleeve as we know the kind of damp, dirt floor home in which these women likely live.  Having some protection from the elements gives this booklet a better than average chance of being around long after we have gone home.

But sometimes our medical reach goes beyond what we have planned. Yesterday on the construction site Glenn had a conversation with a Mom whose child has rheumatoid arthritis in her knee.  She shared with him that although her daughter has already had surgery, they are unable to afford the additional surgeries needed.  Today our doctor, Rick, visited the construction site as Dr. Medina’s clinic was closed.  He met this young girl and two other children with serious problems, one with scoliosis and the other with a serious heart problem. All of these children face bleak futures as the medical care they require is either too expensive or non-existent here.  While Glenn, who used to work with Shriner’s Hospital, has obtained the application forms to see if the Shriner’s can assist two of the children, both he and Rick are committed to looking for resources to assist the boy with the heart problem.  We have no doubt that God sent us to this place.  We have no doubt that God put our team and these children together.  We now put it in His hands to care for these families as we have faith that He will.


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