Three of us jumped on a little motorcycle this morning, me on the back rack and Kelly's feet hanging out to the sides to ride to the little town of La Flor, where the route up Volcano Concepcion begins. After a bit of mechanical troubles and a little extra walking (not too far thanks to the downhill coasting), we began the ascent to the mirador (lookout) of this majestic volcano mountain. I enjoyed the peace and beauty of a morning in the jungle...graceful butterflies, including the Blue Morpho, the chatter of birds in the banana groves above, the leaf cutter ants busy crossing the trail awkwardly stumbling as they carried organic material larger than themselves and I think I even found some turkey tail mushrooms. We took our time reaching the top to be greeted by beautiful blue skies and sunshine casting shadows from the clouds on the farms below. Beyond, sparking blue water of Lake Nicaragua meeting the Volcanoes across the shore. The wind was very strong and it was so much better than a high powered fan in refreshing my body and cooling my skin. A cow got friendly with me and cleaned off both of my legs with its sandpaper tongue, loving the salt from my sweat and even trying to eat my shoes. I am thankful to have received just what I needed today!
Since arriving in Nicaragua, this has been the most challenging week so far. I really enjoyed a full week of seeing patients. I find fulfillment and devotion to this work in their smiles, stories, patience with my language learning process and sincere gratitude. However, I haven’t been sleeping well and it is catching up with me. I am also still adjusting to living in a new place, with new systems and a new community.
This week I was able to take some time while seeing patients to learn some new words in Spanish. Instead of just moving on after I had explained a concept or an object that I didn't know the word for, I asked the patient what the word was in Spanish. I repeated it. They corrected me. I repeated it again and many times I asked them to spell it. I wrote the words down and later entered them into my vocab notebook. In thinking back to the near 50 conversations I had with patients this week, I remember learning cane, rash, scar, shovel, since, suppository, spit, wheezing, worn and much more that I have already forgotten but I am sure will come up again soon.
I saw many adorable kids with "el gripe," the flu. It's been going around for weeks. I remember one 3-year old boy with red cheeks and sad eyes who clearly articulated that he had a cough and fever, while most kids just stare at me while their mother does the talking. When I bend down next to the toddlers to check their throat and lungs, they have such varied reactions. Some scream fearing I am going to give them a shot because pain medicine shots are very commonly given in the hospitals here. Some little ones clamp down their mouth when I try to look inside, pulling back and throwing their head around to avoid the tongue depressor. Some just look at me curiously with wide eyes, responding "si" (yes) to every question I ask directly to them. Some twist to watch me when I put my stethoscope on their back, squirming in their mothers lap or pulling at the scope. I think I’m going to find a fun toy to distract the ones that need it. I love working with the kids. They have such vitality, many of them not slowing down regardless of how sick they are. They run around the clinic with a big smile, exploring everything while I’m explaining the treatments to their mother. Even here in a place that is poor and oppressed, the children offer hope.
I also enjoy seeing the grandmothers. These are the people that hold the families together. Many generations within a family have lived together in the same home their whole lives. The grandmothers generally walk slowly and with support of a daughter or grandchild, carefully stepping up into the clinic and shuffling into the plastic lawn chair where I often ask them to repeat their full name multiple times as I struggle to spell it correctly for our records. Their tanned and deeply wrinkled faces held in a constant smile, they begin to tell me what ails them, pointing often to their stomach, low back or other joints. Many have very few teeth so it can be difficult to understand them. I am glad they are patient as I often have to find a creative way to ask the same pertinent questions multiple times. They are so excited to see what natural medicines I have brought back from our dispensary for them, often checking to make sure I’ve covered all their ailments as I show them the little bags of pills and bottles of tinctures, explaining how they are to be used. They leave with sincere gratitude, big smiles and sometimes a kiss on my cheek.
Although I am honored to be working here, I also welcome the weekends as a much-needed break for my mind and time to myself. Today, I was able to sleep in and spent much time reading, reflecting, praying and walking around the yard observing the many beautiful fruit trees we have. I even climbed a ladder to knock down a papaya from a tree. Not nearly as graceful as the Nicaraguans who climb barefooted and twist them off by hand, but it worked. Tomorrow I will attempt to hike volcano Concepcion again. A last minute trip to Managua canceled our last attempt. The clouds were rolling in tonight at sunset so we may have another downpour while we sleep. We are hoping for clear skies early tomorrow morning for the ascent. I will bring plenty of water, snacks and sunscreen, as the top is very exposed. I am praying for rest and rejuvenation tonight and a great hike tomorrow to start off a new week.
I've been learning a lot from children here. I love their enthusiasm for life and for anything they believe in. Today I watched for almost an hour as a young group of kids dug in the backyard for an older cousin's marbles. Martin was in Moyogalpa for the weekend and his sister and cousins had been having so much fun playing with their limited marble collection in the backyard. Then his sister, Cesia, remembered that Martin had buried a large plastic water bottle full of his marbles under the hammock in the backyard for safe keeping. He wasn't around to protect them (or lead them to correct place to dig), so Jared found a shovel and started digging where Cesia remembered seeing him stash them.
The dirt here is very hard and compact. Jared dug for a long time, slowly making progress, while the kids screamed in excitement each time they thought the sound changed, indicating he may have hit the bottle cap. Handful by handful, Cesia pulled out small scoops of the parched earth alongside the house. And the other boys waited in excitement. How wonderful it would be to have a whole bottle of shiny marbles when each of them only had their small pocket full. Soon there was a growing pile of dirt alongside the hole and the kids were growing dustier. The youngest found a coffee can and took a turn scooping out the loose dirt Jared had scraped off the dense and brittle walls of the hole. Reaching in deeper and deeper, his hair and face were full of dirt as he turned his head to the side to see me snap a photo."Tapon, tapon!" he shouted, thinking he surely had reached the cap. Cesia pushed him aside and Jared started poking around with the shovel again, trying to pry under the bottle cap to loosen it. The hard object broke free and flung out of the hole, it had only been a rock. So they kept digging. Deeper and deeper until the youngest couldn't reach the bottom any more to scoop out the loose dirt. So it was Cesia's turn again. With her head fully in the hole to reach the bottom, her cousins teasingly pretended to push her in. She threw of her sparkly pink shoes in order to jump in the hole to see if she could feel anything with her toes. When she got out, Emerson had found a metal rod and started poking the bottom of the hole. Someone yelled to quiet the crowd and they all listened in anticipation. Wait, that sounded different. Could it be the bottle? They dug some more, and more. Eventually, some of the boys got distracted by chasing each other to the ground and soon they were all in a hog pile, except Cesia. She kept digging knowing that the marbles were there and wanting to find them before Martin got home tomorrow. We were all a bit disappointed that the marbles were never found but while Cesia pushed the dirt back into the hole some of us decided we would journey down to the lake.
We ended up stopping for some fruit and snacks along the way and had fun laughing and playing in the water until the sun was nearly set. The boys mother called for them to return home and we began the slow walk up the steep hill, Cesia goofing off the whole way keeping us laughing until we parted ways at their home.
Emerson stopped at his aunt's house for a handful of sugar because the passion fruits were not quite ripe yet. He ended up sucking the sugar out of a small plastic bag the whole way home.
Los tres amigos ready to play
My role was the jungle gym and jumping platform...all was fun until the kids informed me that I had cow poop on my shirt
Cesia painted her face with the Achote seeds
At 4:30 this Wednesday evening I was thankful to be ending work at the hospital a few minutes early. It had been a pretty warm and full day of seeing patients, many of whom had waited in line most of the day and a few of whom squeezed into my schedule last minute. Maybe I would have time to walk down to the bus terminal in Moyogalpa and get on before the bus left, instead of waiting for it to come to the hospital stop. That way I'd be more likely to find a seat. Not that I can't stand in the aisle nearly cheek to cheek or pelvis to pelvis, sweating on my neighbor, like most Nicaraguans do every day, but my bulky medical bag usually whacks someone each time we all have to shimmy around to squeeze another person in either via one of the regular doors or the emergency door in the back of the bus.
Anyhow, I got caught up buying ginger root, chatting with the mobile blood drive representative and waiting for Carla at the post office to search through a random pile of mail for ours. Before I knew it I had walked a block too far because all the little "pulperias," small family-run convenience stores, and homes look similar…bright colored cement buildings with hole-laden cinderblocks for windows and corrugated aluminum roofs. When I looked ahead and saw a bunch of teenagers hanging out on the open basketball court, the community-gathering place, I realized I needed to turn around. Amidst all the colors, signs, people and noises of the city, I often get caught up noticing something new each time I make this walk so, needless to say, I didn't make it to the bus terminal by 5 when the bus is scheduled to leave.
Fortunately the bus will stop most anywhere so long as you make a subtle gesture like you are shooing someone away. In Nicaragua, this gesture actually means come here. When the bus stopped for me a few stores too early, I had to walk down to it because I think the hill was too steep so the driver didn't want to stop where I was standing. Surprisingly, there was still one seat left...it was worth walking the 10 minutes towards the terminal rather than waiting at the hospital bus stop where all the nurses got on, standing chests pressed up against each other and armpits in each others faces while holding the bars above the aisle.
I enjoyed this typical bus ride home from the comfort of the hard, tiny seat I was sharing on this old American school bus that has been tailored with customized art in bright and shiny paint and stickers to the Local Nica culture. Taking it all in, I smiled at the little things about this frequent experience that I have come to know, I looked around at men and women of all ages quietly enduring the bumps and quick stops as their children and tied plastic bags of things purchased in town shifted around on their laps and they press up against their sweaty neighbors. Throughout Moyogalpa, we stopped many times to pick up school kids in blue and white uniforms, working men and women and anyone who had made a trip to town today.
As always, when the bus gets full the "bus boys," as I call the teenage boys who work on the buses, are basically hanging out the back emergency door or the back side door if one is present, pushing everyone else into the crowded aisles. I don't know how the tree branches that I am constantly looking out for when I’m sitting near the window don’t hit them. They are talented. They jump on and off while the bus is still moving, quickly helping each passenger to enter and exit, all the while collecting each persons bus fare by squeezing through basically non-existent space in the aisle. They help lift up bags of cement, bikes, tires and anything folks are transporting to their destination as most Nicas use the bus for all transportation needs. What caused me to chuckle today was listening to them chastise the driver, yelling "suave" from the back of the bus with a tone that said "you idiot, slow down." This yell and bang on the metal roof was typical in every town as the "bus boys" are like passenger liaisons. They do all the communicating with the driver when someone needs to get on or off, especially when the driver misses the stop or starts driving away while people are still getting off or on in the back. Sometimes the bus stops to drop off a package at someone's home along the way or to pick up a plastic bag of who knows what from someone running out of a store. Today we slowed down so a guy could give a woman on the bus a beautiful tropical orange bird of paradise flower. When we started speeding up again, the "suave!" yell came from the back, in a tone I don't usually hear. The bus slowed again, this time to a stop. The woman jumped off and gave the guy a kiss and returned to the bus. Another whistle from the "bus boys" indicating the driver could now move forward and we were on our way.
For a while I was lost in a daydream staring out the window as the fields of corn with grazing cows and horses passed by. I enjoy seeing the countryside by bus and catching glimpses of towns, homes and family gatherings through the open doors and windows of the buildings that move by my gaze. As we passed through Esquipula today, I saw a tanned grandmother rocking in her chair by the barred window with her family gathered around in plastic lawn chairs watching television in their cement living room. We were moving pretty quickly today, as I had not seen too many herds of cattle or lone horses sauntering down the road ahead. As we neared the island's first airport, currently under construction, (it spans the main road on the island, so it will be interesting to see what happens when planes start landing here), the bus driver sped up and the "bus boys" yelled, "suave!" once again just as we flew through a giant puddle of tropical mud, possibly laden with animal feces and parasites. This time the mud only splattered up through the open window onto my arm instead of in my mouth like last time. Thankfully, I must have subconsciously remembered this dip in the road and turned away from the window when I heard the yell.
Eventually around 5:30, my stop in Los Angeles was near and as I got up to exit, my bulky bag became lodged under my low seat. Pulling it, my sweaty body bumped everyone in the aisle near me and I finally made my way to the door just as the driver passed my stop. I pounded on the metal roof to catch the drivers attention. The boys yelled "suave" and I descended the stairs, likely while the bus was still moving. I'm so used to it now I can't even remember. I walked the quiet dirt road home, stepping around the palm fronds and pieces of banana trees that are being used to fill in the ruts, smiling as I passed a large pig trying to cool off in a mud puddle and a small group of men and women singing loudly in a home church service...thankful to have shared the bus ride experience with the community and thankful that tomorrow I work at the NDI clinic, which is just down the street from my home here in Los Angeles.
Yesterday afternoon, I played baseball with the local primary school kids. We played in the dirt street/intersection in our neighborhood. Before we began, we all shared scar stories. The kids gathered around as I expressed concern for a boy who had just cut his finger with a kitchen knife. All at the same time, the other kids got excited as they bragged about their own numerous scars, pulling up their clothes to show me. I found out that many scars were from machetes and falling on something. One boy who fell on a plastic tube had a circle scar between his eyes. Many stories I simply could not understand. After all they were all talking at once. I showed them my most recent scar - I couldn't remember what it was from. Eventually, after many finger wags (meaning no), the placements of first and second base were argued over and decided on (no third base as we were playing in a narrow street). A boy grabbed a bat and we all scattered about in the "field."
I was on a team of 6, mostly girls. The other team consisted of only 2 boys that were up to bat first and kept hitting home runs so I never actually got up to bat in the hour that we played. With an eye always on the ground, due to scattered animal poop, large potholes and water ruts, mud, trash and squealing piglets, we tried to stop the boys line drives. No gloves for catching of course and the field was quite narrow and long (it was a street remember) so we had to chase most of the balls that didn't hit us directly. At least we were using a tennis ball and their team had a broken bat. Our team deemed the bat so broken that we used a tree branch when we finally were up to bat. Many times the ball got lost out of bounce in the empty lot of weeds over the barbed wire fence. We'd all scatter in the field until the ball was found. The team finally asked me to play first base because I could catch and girls would squeal in delight, exchanging big smiles with me, when I tagged on of the boys out. The favorite thing to do when someone was on second base, our team would give him a chance to steal for home (remember there is no third base in this street game). So we'd take a break from someone batting. I'd become the catcher. The pitcher would become the second baseman and the two of us would throw the ball back and forth trying to tag out the runner. We would continue to do this until we got him out or he scored a run, no matter how long it took.
The game ended with us girls practicing catching infield fly- balls with a lemon as the tennis ball had been lost, possibly for good. It was a fun afternoon..reminded me of elementary school pick up games in my neighborhood back home. I wish I'd have had my camera...but then again it's nice to not feel like a tourist and just enjoy the moment. I think I'll bring a few tennis balls back to Nicaragua with me next time I come home to the states.
It was a good week here in the community of Los Angeles, Nicaragua. It began with a wet pile of cow poop on the patio outside my bedroom door and ended with a scrawny little dog jumping out in front of our moving vehicle to "do his business" in the middle of the local highway, with no regard to the possibility of losing his life. Thankfully, we swerved to miss him. I guess when you gotta go, you gotta go. It seems I've stepped in a lot of animal poop this week so it seems to be on my mind. Many animals frequent our yard, including pigs that the dogs like to chase away, an increasing number of grazing horses, chickens, the young frolicking cow that leaps around, loud and commanding blue birds with long tail feathers in the papaya trees and this morning, a big lizard with a bright yellow belly. While riding on the back of a motorcycle going into Moyogalpa, we ran into "traffic" on the rural island highway. This consisted of a farmer and his herd of cattle casually sauntering down the road while trucks, bicycles and motor bikes were trying to pass. We had to slowly navigate a path between them all while trying to keep enough speed to steer and stay upright.
Work in the clinic went well this week. Mostly we saw the regular... kids with the flu and adults with urinary tract infections, intestinal parasites, diabetes and hypertension. I saw an interesting case at the local hospital, a teenage boy with Dengue Fever. He was immediately admitted for IV rehydration and because this condition can become severe and life-threatening, isolating him in a bed with a mosquito net as Dengue is transmitted by mosquito bites. My Spanish is slowly improving and I have had numerous requests to teach English to everyone's children. The parents really want their children to be at the top of their class and feel learning English from an American is an unsurpassable opportunity. I am going to try to get a small class started.
I am feeling pretty healthy overall. I think my stomach has finally adapted to the heat and my appetite has come back. I am looking forward to eating some of the many fruits we have on the NDI property here once they are ripe. Check out the Farming tab on this website for more on what we are growing and doing on the land. The other day I was admiring a beautiful handmade palapa structure on the land here that we use for teaching the Brigade groups that come down from the US. I thought I'd share a few photos of it.
Thanks everyone for your prayers. Please keep praying that my health remains strong (and that the small Dengue outbreak doesn't spread), that my language skills improve especially for better communication with my patients and for restful sleep. Feel free to stay in touch and share any prayer requests or what is going on in your life...the info is on the contact me tab of this website. Many thanks!
The scorpions love to live in the palm leaf roof
The view looking upwards from inside
This is the window in the roof to allow for airflow
Yet another post this weekend because I would liked to share some pictures. Today I mostly hung out with kids. It was refreshing thought I needed a break from Speaking Spanish by 3pm. Cesia (9 years old) and Martin (14 years old) took me to their grandfather's small family farm about a 15 minute walk from our neighborhood. We carefully navigated a deeply washed out dirt rut that was filled with garbage. Thankfully it wasn't raining or it would have been a small river. We found some bones that Martin thought was the skeleton of a child as the site used to be a graveyard long ago, though Orderli told us it was from a deceased dog. There were beautiful trees with many strong roots growing down from the branches, some dangling which we used to swing like Tarzan. We walked through a pasture of weeds behind the cemetery and saw a group of men from the local churches with machetes clearing the area to keep it clean and beautiful I was told. When we reached the farms, the fields were beautiful, rows of rice with a few corn plant inter-dispersed, some scattered coconut trees and edged with plantains, mango, oranges, coconut, limes and many other fruits I've already forgotten the names of. Orderli, their grandpa gets up every morning at 4:30 to begin work here. He plants the seeds he's harvested from his own field of various types of beans, wheat, rice, corn and a few other things. About 85% of the planted seeds sprout and he later harvests this food for his family. They eat a lot of gallo pinto (a mixture of lightly fried beans and rice), plantains and a corn drink called pinol. Before heading home for church, we rested in the shade of a hammock and Cesia and Martin climbed a few coconut trees. When they finally found the coconut they wanted to get for me they needed my help stabilizing Martin up in the tree who was already boosting Sesia up to the coconuts. It was hilarious. And the coconut water was delicious.
I went to church with the family and again did not understand much of what the Pastor was saying aside from the Bible verses because I had my English Bible. However, they sang and prayed fervently and were very welcoming to me. I tried a pink milk drink in a bag afterwards that was too sweet and grainy for me (corn meal) and soon after went to the lake with Cesia and her cousin Cristhel, another young girl. They laughed and talked the whole way down the trail and would have stayed for hours if I didn't emphasize that we really needed to leave mmy skin wasn't feeling burned. I threw them off my shoulder many times into the murky, almost bath water-hot water. We swam under each other's legs, smeared mud on our bodies, played tag, dug holes, sung in Spanish and danced in water. On the way home the girls strung their sandals and wet swimsuits on a stick to hold between themselves, so they wouldn't have to touch their wet stuff I guess. They goofed off the whole way, teasing the small pigs and chickens and screaming while going up into the trees when a group of cows came by.
The local school...primary (elementary) in the morning and secondary (middle school) in the afternoon.
Yummy Yucca Bammies! They are like potato latkes...shredded yucca root, eggs, garlic, onions and salt, fried in soy oil (unfortunately). I love our gas stove but it doesn't have a low setting so I didn't want to use my olive oil I brought from the states. The dragonfruit drink again with a picture of the fruit below. A passion fruit and some eggs, likely from Managua even though many of our neighbors have hens that are laying. Our 3 hens are laying one egg total every few days so we've been buying most of what we eat. Our water went out yesterday so we had to have someone come all the way from Managua to fix a blown fuse...we have a large water tank with an electric pump that fills it. It cost $75 for his time and labor and $30 for the pump fuse. I hope to spend some time relaxing in the hammock today (not just posing for this picture :)) but we'll see how long the loud boom box and advertisement vehicle strolls around our neighborhood. For those in the states, I Hope you are all having a nice fall weekend.
Dragon Fruit Juice
The water tank that supplies our home, office and yard
Our chickens...3 hens, 1 useful rooster and 1 fighting rooster (his display cage is just outside of the coup)
The main road of Ometepe...pavers are cheaper than getting the asphalt crew and equipment to the island
Another week has passed and I am so honored to be here as a part of this community. We have a wonderful woman who helps us around the house named Izela. Today she brought us 3 dragonfruits and a few limes to make the beautiful drink pictured below. I have never seen any food this deep a shade of pink. For lunch today, we made a beef, broccoli and tomato stew which was a nice change of pace from my usual rice, beans, corn tortillas and plantains.
I've really been enjoying working with Trish and Adam, the other NDI doctors, in the small community clinic here in our town of Los Angeles. Eventually, I will be seeing patients on my own 4 days a week and helping with Administrative duties and the medical brigades as well. The NDI clinic is in the pueblo of Los Angeles, on the dirt road on which I live. It is a simple structure with cement walls, an aluminum roof and wooden doors. We have movable plastic tables and chairs where we see patients in the main room and a small dispensary room with old assorted metal and plastic cabinets shelving the remnant supplements, herbs and other medical supplies mostly from previous brigades (thanks for donating!). While seeing patients, we are often visited by cats, bats, cows and many other patients eagerly hoping to put their name on the list for an appointment that day. The power frequently goes out (as does our fan and the lights) but we keep working. Sometimes it rains so hard, we can barely hear the patient and everyone just smiles and waits it out...a patient culture.
I love my walk home through our open field and my neighbors back yard containing a bunch of piglets roped to a tree and the cow that I drink milk from. Yesterday as the bottom of my scrubs were getting soaked by the wet brush that covers the field, I found some passion fruit that had fallen from a tree. I am going to have it for dessert tonight.
My view from inside the clinic while seeing patients
The Medical Dispensary
The Gyn/PAP room
The waiting area behind the clinic
This is where patients stand or sit in plastic lawn chairs, sometimes all day to see one of the doctors. Chickens, pigs and dogs roam through picking at anything alive in the dirt. Most backyards look like this...all dirt and few fruit trees with a latrine. The clinic's "bathroom" is the small wooden building in the backyard, a latrine with a hole in it. It works...even for collecting urine samples.
Here is the link to the Natural Doctors International's blog on Wordpress. I'll be blogging there on the NDI blog once a month and other NDI doctors and volunteers will as well. Already, there are some blog posts up that insightfully explain the details of daily life here in Nicaragua...some are pretty funny as well. Thanks for reading our posts!
I still will be blogging here on my website as well...I am aiming for at least once per week.
Rachelle Price, ND
I am a naturopathic family physician, a graduate of naturopathic medical school at Bastyr University in Seattle, Washington. After many years of feeling a call on my heart to pursue further education in health care to better serve in the developing world, I attended naturopathic medical school a few years after earning my Bachelor's of Science in Biology from Bethel University in St. Paul, Minnesota.
My passion is learning from and serving my community as a physician, friend and educator. I focus on helping my patients discover the root cause of illness and improve their overall mind/body/spiritual health.
I also enjoy being active outdoors, backpacking, soccer, skiing, photography, cooking, gardening and working with medicinal herbs. Living simply, sustainably and creatively are important to me as well as song, laughter, music, friends, deep discussions and growing within a supportive community...and, I love to have fun.
Please peruse this website, check out my linked in profile or email me to learn more about me and how I practice naturopathic medicine.