Wednesday, March 27, 2013

Week Four: Laguna Asososca

We spent our last day with our family at the volcanic lagoon of Asososca.  Thirteen of us piled onto a pick-up truck for the one hour, forty five minute trek through the country to this secluded area.  Few tourists have access to this area and there were only a handful of locals that arrived on horse-back.  Later in the day a few tourists had made there way over with their group after volcano-boarding.

This is definitely one of the most beautiful places I have ever been to, still mostly unchanged by human hands.  The family discussed how nice it would be to have homes bordering on the steep slopes of the crater, but in my mind that is the last thing I would like to see.  I hope it stays a treasure for the locals to use in the years to come.  The water is a serene shade of green, warm and perfect.  We played catch for hours with local fruits from the shore and ate some mangoes and papaya.  As we were leaving, I was thinking how much I was going to miss everything about El Tololar and “Nica” life when I return to the cold, snow and bustle of Massachusetts.  
 "Our family" 

Week Three: Feliz Cumpleanos

On account of Semana Santa (Holy Week) Friday was our last day at the clinic. Dra. Urrutia’s birthday was the day before and the clinic staff planned for a Friday night dinner. We found out that there is a workers' bus back at 10pm, so we would be able to go instead of staying in Leon for the night or attempting another taxi disaster.  

After three weeks, I finally feel like less of an outsider and more or less a part of this close-knit group.  Despite hectic days and common issues (such as no water or no electricity on some days) there is little tension, always smiles and laughter to light up the days. It’s the way of the community, the souvenir I would most like to bring home.

Dr. Urrutia's birthday dinner

Growing up, I remember how close-knit my own community was, but as people became more mobile and filled their lives with other distractions, that life was lost.  Today, I can barely name the neighbors on my parents’ street or in my apartment building, and they know where each family in this wide-spread village live. As I sit here writing, the guys are playing cards and laughing as they do most days, watching me work away on my computer, business as usual.

Our night at the restaurant in Leon was nothing more than laughter for hours.  There was salsa dancing to the local, live Mariachi Band.  The food was fresh and amazing.  I had a whole flamed-grilled fresh fish, the best ever! The seriousness of running the Health Post in Tololar disappeared for a few hours.  Many bottles of the local beer, Tona, were had before we even got there at 6pm.  We had no idea the party started at 2pm!  I am going to miss these friends, my family away from home.

Laughter at the clinic!

The “workers' bus” home was yet another “Nica” experience.  We had no idea it would be an open truck where we were crammed in like sardines again.  We covered all of El Tololar since our stop was one of the last ones.  As we were walking home under the moonlight, I felt connection to my family’s roots, my past.  I thought of all the stories my father, who is now at the ripe age of 89, told me about when he was growing up in rural Hungary: tales of riding horses like a cowboy in the country, probably walking home under the same stars and moonlight as I was that night.

I hope that as this community improves its access to medicines, a cleaner, consistent water supply, and better nutrition, that it does not lose its other riches. 

Tuesday, March 26, 2013

Week Three: Selva Negra

We spent and amazing weekend in the jungle of Selva Negra.  The air is cool and fresh, quite the contrast from the dust and scorching heat of El Tololar.  Monica was fortunate enough to catch a glimpse of one of the worlds’ rarer birds, the Quetzal.  The hike to the summit of the mountain adjacent to our Ecolodge were somewhat difficult, but filled with lush, green foliage, bird songs and the eerie sounds of howler monkeys.  This getaway was well-worth 2.5 hours we spent standing on an over-crowded bus to get there.

View of the mountain from the lake

Elliot (can you find him? ) and a giant tree

Hot afternoons 
After visiting a few homes with questionnaires for our breastfeeding project, we were extremely overheated from walking around the village and then walking home.  Cold showers feel amazing at this time of day and no bee stings today!  As I got ready to do some laundry, I thought about how everyone should really thank their washing machines each time they are used.

 I spent 1.5 hours washing a pair of pants and a pile of socks.  My neighbor came by laughing and noting that I was slowly learning to wash Nica-style.  Another neighbor, Paula, who also works at the clinic, finished all of the family’s laundry in not much more time than this.  I find myself thinking of my mother and how she grew up in Slovakia washing her clothes the same way and it made me feel more at home. 

A cashew fruit tree

Adolescent photo project, success!!!
The photos that the six teen-agers took for quest to understand identity development and community amongst adolescents in rural Nicaragua was a success.  The photographs are stunning and our group of 6 students were inspiring and very talented individuals.  We hope to present their work at this years Family Medicine Global Health Conference and continue to work with young Nicaraguans in the future.

Monday, March 18, 2013

Week Three: Out-takes

So, this week was also the kind of thing you might see on America’s Funniest Home Videos for me.  My companions have demanded that I document each of the blunders I have encountered under these stars that are clearly not in my favor.

It started with getting stung by a bee in my armpit while drying off in the shower.  I haven’t had this pleasure since I was a kid and forgot how much it hurt!  Let’s see, I think the next thing was wearing scrubs with open bottoms while volcano-boarding.  I had volcanic ash everywhere (including "where the sun doesn’t shine") and with no running water and a bucket shower, this was hard to reverse.

Hmmm, then there was the day to remember, I was walking to the clinic, climbing under the barbed wire fence, which is not very easy for a “gringo,” and I got caught and fell, no worries, I got to the school, sat in a chair to meet with some students over a photo project and started to feel a sense that there was more air conditioning and wind than there should be. I look down and my pants are split from zipper to knee.  I must have gotten caught on the barbed wire! I was grateful to have a bandana to put over the area while walking home because it was as if I had no pants. I walked home to change and then walked back to the clinic, difficult with such a small supply of water and in the sun and heat.

Later, we went to a lecture for Chagas disease and I got my other pants caught on the broken bus seat and hear a horrible tearing noise.  Yup, pants number two…  As if that wasn’t enough, I lost my iPhone in a taxi on the way to buy water to bring home.  It did not end there either.  I went home and got stung by a bee on my backside getting water from the well to bathe. A perfect day to go down in history; someone should have told me to stay in bed!

Week Three: Water, Water Everywhere and Not A Drop to Drink

The Tomolamos project water tower
Well, not exactly water everywhere, but portable water had been out for an entire week due to a failure in the villages water pump. There has been no water at the clinic or local school for the people of El Tololar from Sunday until Friday morning.  I have had to travel to Leon to bring in a portable water supply for myself, the advantage of being from a country where our money and labor is valued higher.

It had made me feel a bit uncomfortable, guilty for blatantly being able to have something so vital that the locals did not have access to in this heat.  I feel like I adjusted well, integrated somewhat, but I can’t stop feeling like Paris Hilton for all of the luxuries I have from being born in the USA.

On the other hand, there is so much more that they have that we don’t and you can feel it soon after stepping off of the bus in El Tololar.  They have a rich community, a sense of family that we just don’t have in our technological buster.  They play cards every night, or sports or just spend the time laughing and joking for hours on end, not minding the silly “gringoes” that have come in to play for a while. Despite clearly missing my family, friends, and poor lonely cat, I feel like I have more here without all the possessions and luxuries of home. 

Adolescent photo project
We decided to do a community project with the adolescents in El Tololar, trying to capture their identity and view of life in El Tololar. This came with mixed feelings because the teenagers chosen by the teachers did not appear to be overly excited, but later when I spoke to Adilsa, the director of schools and out house mother, she said that they were extremely  excited. Monica and I cannot await the results of their vision.

School children playing during recess at Ermita School, El Tololar.

Tuesday, March 12, 2013

Week Two

Volcano boarding
Our first week in El Tololar ended with a trip to the beach. The contrast between the dust and wind of El Tololar and the cool ocean breeze of the Pacific Coast just outside of Leon is a great one.  On Sunday, Monica, Elliot and I climbed on a pick-up truck with 18 members of the community for a one hour trek to Cerro Negro, the active volcano that covered El Tololar and surrounding villages with volcanic ash in 1999. 

We climbed this volcano, stopping to take in the scene from the summit from a four foot wide path along the rim, which still actively smokes.  From an area dedicated by an arrow, we took off down the side of the mountain, a "New York Times" list of most extreme adventures that will note be easily forgotten! More importantly, this amazing community has taken us in as their own, allowing us to avoid tour groups and see their country through their eyes.

Truck ride to volcano

On Monday, it was an unusually busy day at the clinic. Well-needed fans were being installed in each of the clinic rooms while we saw double the amount of patients as last week. The water was also out in all of El Tololar.  This is something hard to comprehend as Monica and I plan our trip to Leon to purchase water. 

The people here do not have this luxury. They will have to resort to drinking from contaminated well water if water does not flow soon. The clinic is also out of sterile gauze and we are cutting and folding 4x4’s to sterilize in Leon, instead of running to the supply room as we do back at home.  Am I too spoiled (I hope no one answers?)

Tuesday, still no water and it’s the type of heat without wind perfect for making raisins.

Making gauze

Resting near the rim of Cerro Negro

Week One: Nicaragua ("Where the Streets Have No Name")

I have just arrived in Leon. Elliot has come to meet me while Monica is off to her home stay. We planned to meet for dinner picking a restaurant that overlooks the central square. Elliot has his tourist-style map of Leon, which reminds me of the kind you get at an amusement park with tourist attractions marked and many advertisements. 

Unlike most maps, there are no street names. You must navigate counting streets, noting landmarks and anything else that may trigger a memory. Elliot and I were trying to find a restaurant overlooking the the central square and travelled in three complete circles ending up in front of the same church highly reminiscent of the "Big Ben" scene in the movie European Vacation!

In the village of El Tololar, it gets even more extreme. Currently, there is no map on file of this community although I highly doubt any of the locals ever get lost here. (Meanwhile, I can barely find my way around Worcester, MA after a year and a half living there.) What's most difficult is that there are so many dusty peanut fields that look very similar.

Even when you think you have filed away some landmark, your mind can play tricks on you. We are working in conjunction with CIDS and the health post workers to create a map by marking each house with a GPS. This will make it easier for us "outsiders" to better understand the village on a scientific level, in an effort to identify what the people may need while learning who each of them are, one at a time.

At the end of the week, I have come to find that the mornings are always my favorite time of day; it's fresh outside, the dawn light slowly getting stronger. All of the animals are excited for their breakfast and there is considerable bustle about the yard.  The roosters are definitely not the highlight as there seem to be about 50 outside my door that get their start at around 4 am, not my time to rise!

Life is simple, relaxed without the constant burden of electronics. It's frustrating to be out of touch and at the same time, refreshing to be left with just your thoughts or the company of friends. I am excited today for a weekend at the beach and the adventure of sledding down the side of Cerro Negro, a volcano that I usually only see smoking in the distance.