1 week left…

Leaving Nicaragua and all that I love here is going to be very difficult.  But, I plan to make the very best of this last week. Nurse Martha worked with Dr. Karla and I all week and I transitioned her into the position. It was great to see her jump right in. She already has ideas of topics she wants to teach, how she wants to organize our stuff, and ways to grow the ministry. We did nutritional evaluations on the first graders at 2 of the schools. For the nutritional evaluation, we measure heights and weights of the child, calculate Body Mass Index or find where the child falls on the growth chart. We also did some home visits, hospital visits, and started the consults with Dr. Karla for some patients. She is a great fit and I am at ease knowing that Dr. Karla will have a companion and a partner in this project.

Love,

Ayla Landry

"I would rather be ashes than dust! I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry rot. I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet. The proper function of man is to live, not to exist. I shall not waste my days in trying to prolong them. I shall use my time." ~Jack London

Dr. Karla needs a nurse for when I go…

I will be leaving Nicaragua June 3^rd and cannot imagine leaving Dr. Karla alone to do this medical ministry without a nurse/companion to share it with. 

Without a nurse, Dr. Karla would not be able to do manage the large load of patient needs that we have with the 1,800 children in the NRN schools and any health education or classroom to classroom activities including the biannual anti-parasite teaching/ treatment would not be possible.  While at the schools, Dr. Karla is always busy with new consults, following up on previous consults, or an emergency comes up.  She often has to leave to see a patient at their home or go to the hospital.  I have been managing and bringing to Dr. Karla’s attention the additional needs/mini-projects at the schools.

Without a nurse, it would be impossible to have any normal/effective schedule of consults at the schools. She would always have appointments to bring patients to and attend, visits to a hospital or home, or meetings to attend.  A nurse allows Dr. Karla to manage her time and medical skills more effectively because she has someone to rely on and delegate other tasks to.

Without a nurse, the project would be much more overwhelming and stressful. With a nurse Dr. Karla could have someone to pray with and share the experiences and responsibilities with to make it much more enjoyable and fruitful.

So, we found Nurse Martha, a wonderful Nicaraguan Nurse to take my place when I leave! Then, we had her approved, and hired. The nurse’s role in this project includes but certainly are not limited to:

·        Doing basic assessments and triage for the consults with Dr. Karla

·        Completing clinical history interviews with patients and/or patient’s parents

·        Giving injections/administering medicines ordered by Dr. Karla or from outside prescriptions

·        Organizing and carrying out health education projects at the schools

·        Accept new patient concerns, questions about health from students, and phone calls while Dr. Karla  is in the middle of consults

·        Attending appointments with patients, meetings with directors or parents,  so Dr. Karla can go to the hospital or attend to emergencies or higher priority items as they come up

·        Help Dr. Karla remember patient needs/questions

·        Keep medications/supplies organized in our clinical bag and in the car (Charlie)

·        Have another clinical person to help make clinical decisions and brainstorm how to solve tricky logistical issues that come up

·        I imagine to help manage medical mission groups that come down to help the project

·        Emotional/spiritual support and companionship through all of the joyful and very sad experiences with patients and their families

Nurse Martha is a very experienced Nicaraguan Nurse that is skilled, loving and enthusiastic. She has worked with Doctor Karla before and will be a great asset and addition to the medical ministry team. This last week, I will be transitioning Nurse Martha and teaching her all about the position. The organization couldn’t have found a better doctor to be working for their medical, mission and I am so excited to see the team of Dr. Karla and Nurse Martha together in action!

Love,

Ayla Landry

“I am more interested in what I can create 
than in what I can consume, 
in what I can share
than in what I can own,
in living my own life
rather than viewing others on TV or the big screen.
I think for myself and choose my own heroes.
My goal is to be one of them.” ~Dr. Sami Sunchild

Feliz Dia de Las Madres!

May 30^th is Mother’s Day in Nicaragua! Here, Mother’s Day is a national holiday with lots of traditions, celebrations, travelling, roses, cake, and presents. If your mother is still living you wear red and if your mother has passed you wear white. My host family had a big party. My host grandparents came into town from Rio Blanco that is a 7 hour drive away. They came by bus and stayed with us for 4 days. On one of those days, all of their children and many of their grandchildren came over to our house for a party. My host mom’s sister surprised us and brought a live band. The front yard turned into a parking lot, concert stage, play ground and restaurant.  There were about 35 people over at our house! It was so much fun and definitely a great way to spend a day off of work for Mother’s Day.

Roses and “I love you” balloons are being sold on every street corner. People everywhere are getting into taxi’s with cakes in hand. Every other commercial in the TV was about Mother’s Day. Lots of red and white and music everywhere.  Mothers are really important in the Nicaraguan culture and are the head of every family. Men often leave their wives when they get pregnant and so women are left to raise and support the family. Sibilings are close and children are close to their mothers. There is no school on Mother's Day and people everywhere travel to spend time with their mother. The cemeteries are well decorated that day and homes are full of family. It is a joyful day and a wonderful holiday to remember all that mothers do for us. Thank you moms for all that you do!

Love,

Ayla Landry

“All men and women are born, live suffer and die; what distinguishes us one from another is our dreams, whether they be dreams about worldly or unworldly things, and what we do to make them come about... We do not choose to be born. We do not choose our parents. We do not choose our historical epoch, the country of our birth, or the immediate circumstances of our upbringing. We do not, most of us, choose to die; nor do we choose the time and conditions of our death. But within this realm of choicelessness, we do choose how we live.” 

~Joseph Epstein

Melinche tree

There is a tree here in Managua that is called Melinche tree. It is said to represent marriage. The tree is tall with lovely vibrant red flowers that cover it and create shade and beauty. However, in other seasons, the tree has it long striking branches with ugly dark pods hanging from it. The roots are deep and large and can overturn the earth it is buried in. The trunk is strong and holds firm throughout all seasons and grows and grows. Marriage has its happy, lovey-dovey, beautiful, flowery times as well as its challenging, difficult, and ugly dark times. The roots of marriage are love that is so strong that it can turn the world upside-down. Love grows to be strong as the trunk and a firm relationship that lives through the good times and the bad times and stands tall. Love never fails.

Love,

Ayla Landry


" A happy marriage has in it all the pleasures of friendships, all the enjoyment of the sense and reason -and indeed all the sweets of life." ~ Joseph Addison

Parties, appointments, support and cute kids!

Thursday morning started out at the Quinta again waiting for Dr. Karla to come and pick us up for the day. The plan was to check on Dayana, pick up Edwin and his mom and go with them the neurologist appointment, and go to the school to do consults.

The school was having a mother’s day celebration so we didn’t do consults…we joined the party! Red and white streamers draped across ceilings and around staircases and down the walls. Music and food and mothers with their children in every classroom. I introduced Debbie and Ryan to the special needs classroom and all my friends there. They were greeted with hugs and smiles and joy. When we walked in Dr. Karla had already joined the festivities and was striking at the piñata. I toured them around the whole school where not one room was without a party. Mother’s Day is on Monday May 30^th but since it is a national holiday and there will be no school on Monday the celebrations are today. The students were in their best clothes; dresses, high heels, collared shirts, dress shoes, sparkly bows, combed/gelled hair. The people are some of the poorest in the world…but they take pride in what they have. They wash their clothes daily and always look nice. Joy was all around and Debbie and Ryan had the chance to see some of the Latin festivities.

Dayana was still not doing well and her frail little body still functioning with machine and medicines. One of the college students from Indiana donated an inflatable pool raft and bed sheets to be given to Dayana’s mom to help her sleep. Ryan and I took turns blowing the raft up and when it was inflated Debbie, Ryan, and I brought the raft, the sheets, and some food to Dayana’s mom. She was so grateful and welcoming to our presence there in her time of suffering. Then Dr. Karla offered to pray with her and all the mothers there sleeping on that cement. They all eagerly gathered in a circle holding hands and we linked hands too. Dr. Karla started the prayer and, in true Nica form, everyone prayed their individual prayers aloud simultaneously. I closed my eyes, listened, and prayed with them. Prayers of praise and glorifying God and his power and grace. Prayers asking for healing, mercy, strength, peace, protection, blessings. Prayers of thanks. Prayers for others, for their little ones in the hospital, and for themselves. When I opened my eyes I saw that more people had come to gather and pray with us. I saw tearful eyes, and faithful hearts. We hugged with them and I could not help but feel overwhelmed by their situation.

Edwin and his mom had an appointment with the neurologist. When we arrived the clinic looked closed and I began to feel bad for Edwin’s mother who had travelled by bus all the way into town for the appointment carrying little Edwin in her arms. However, when Dr. Karla called the doctor, he said he was on his way. We waited and ate some snacks that Debbie was always prepared with. Edwin can swallow but not chew. Eating is hard and always occurs with coughing and a mess. In the States he would probably have a gastric feeding button, which is a little tube that has a closure outside of the body and goes directly into the stomach so formula/nutrition can be put directly in bypassing the mouth and avoiding the risk of choking and pneumonia caused by little bit of formula from the mouth getting in the lungs.   Here in Nicaragua, these gastric buttons are rarely done for lack of supplies in the hospitals and more so due to risk of infection. When the doctor arrived, the neurologist spoke with Edwin’s mother and Dr. Karla to get the story. Then he assessed Edwin who cried an awful cry that screamed of the little air that was passing to his lungs. He was rigid at times and not at others. He was being very stimulated so he did not appear to have a seizure while we were there. After the physical assessment of reflexes, eye movement/reactivity, and neurological function, Edwin’s mother quickly picked him up and cradled him in her arms until his cry faded to a sob then melted in to smiles. They then did a test called an electroencephalogram to measure his brain waves. Edwin sat I his mama’s lap while the neurologist attached many little electrodes on his scalp to pick up the electrical activity in his brain and light flashes try to trigger the abnormal/seizure brain activity. The test does not hurt at all. The brain waves were recorded and read from the computer. The neurologist concluded that Edwin is epileptic (has seizures) and that his brain waves are slow. He prescribed some medicines and a follow-up visit in a month.

We made sure Edwin would be able to get these medicines and then dropped them off at the bus stop to catch a ride back home. Then, Dr. Karla, Ryan, Debbie, and I  called it a day.

We went by my host family house and had lunch at 3:30pm since we hadn’t had a stopping point before then. Gallo pinto (traditional nica rice/beans dish) avocado, nica cheese, and fresh tortilla. We played with Gabriel and sat on the porch listening to the rain hitting the tin roof. It was a beautiful day. The rains softened, the smell of the wet earth set in, the breeze full of honeysuckle like flower swept in, and the frogs began to sing.

When stopped by the hang out with Ginny and Cecil on the way back to the hotel. I was having language troubles that day and kept mixing up English and Spanish in my head….it was silly and we laughed a lot. We ordered pizza delivery at the hotel  for a late dinner and spent quality time Debbie, Ryan, and I together before they left the next day.

The trip seemed so quick but packed with all the good stuff…love, God, new adventures, sharing life with loved ones, opening eyes, gaining perspective, friends, and laughter. I am so happy to have shared Nicaragua with Debbie and to work as nurses together was really special. Similarly, for Ryan to see more of my heart here and my passion to serve in the developing world was really good.

Love,

Ayla Landry

“Past the seeker as he prayed came the crippled and the beggar and the beaten. And seeing them...he cried, "Great God, how is it that a loving creator can see such things and yet do nothing about them?"...God said, "I did do something. I made you." ~Sufi Teaching

Sex and slavery in Nicaragua

That night back at the hotel, Ryan and I talked for a while in the chairs near the elevators. A non-Nicaraguan older man came out of the elevator with a prostitute. It really bothered me. How could a man play into that system of wrong? Where did she come from to learn that selling her body was the best way to make a living? Did she have a choice…or know there are other ways out there? Does the man have a wife and kids at home? Is he a sex addict/ a sexual tourist or just some rotten man? I wanted to punch him in the face!!!! Though there is consent from both the man and the woman…it is still wrong.

Here in Nicaragua the sex trade is a big issue along with slavery. People are sold for their labor in a factory or plantation, for their bodies at outrageous rates. And I am not just talking about adults…children too.

In the world right now there are more than 27 million people who are estimated to be in slavery…more than any other time in history. 80% of those are women and 50% are children!!!

60% of the human trafficking victims from the western hemisphere are exported from Nicaragua.  

A virgin here in Managua can be sold for as much as 750 dollars or as little as 2.50 dollars. Children are chained up by their own family and told to do house work and then sold to the man of the house by night. A friend of mine works for an organization called One By One: The Refuge Project and another friend works with an organization called House of Hope here in Nicaragua fighting against prostitution and human trafficking esp with children. They told me that in one week they found 3 girls under the age of 11 living as child prostitutes; one of which was six years old, sold to the pimp by her 9 year old big sister who also worked for the pimp for 3 dollars.

There are 109 declared brothels….some of which are frequently visited by public government officials.  Most of the brothels secretly hold little girls and boys. One secret brothel here in Managua for high government officials has 12 and 13 year old girls in high security…and my friends have not been able to get girls out of there yet. Many children see their parents in sexual abusive relationships, or in the act of prostitution since people live in little one room houses. Children learn about sex not as an act of love, but as a duty, a job, and a sacrifice.

Similarly, factory/plantation workers are forced to work against their will for little to no pay.  Workers and strong children are traded as a commodity and self esteem destruction, fear, hopelessness are cultivated at the workplace. Parents refuse to work and force their children to work and provide for their families. People are locked up, chained up, physically and mentally abused. Confidence, interests, education, love, and dignity are stripped away.

 Now, I do not know the story of the prostitute that walked out of that elevator nor of the man that bought her for the night. But I do know that love, dignity, confidence, self-value, family, healthy relationships, and justice are all things that we should strive to preserve in our own lives, in the lives of others and especially in those less fortunate and/or more vulnerable than ourselves. We are all citizens of the same world.

To learn more check out:

http://www.therefugeproject.com/innocents.htm  and/or

www.notforsalecampaign.org,

Love,

Ayla

“There are two primary choices in life; to accept conditions as they exist, or accept the responsibility for changing them.” ~Denis Waitley

Nurse Debbie and Nurse Ayla in Action!

Wednesday the optometrist came with us to the school/orphanage in los brasiles. When we arrived, I gave them a tour around the school and we saw all the cute kids in the classrooms and identified the sick kids needing to see Dr. Karla. The optometrist set up where Dr. Karla and I normally work so we were out in the cafeteria area doing the consults. We saw about 15 kids. 

Debbie and I started the consult by collecting/calculating the sick/hurting Nicaraguan children’s name, age, birthday, grade level in school, vital signs, chief complaint, height in cm, weight in kg, BMI, and general triage assessment. Then, we passed the patient on to Dr. Karla to decide plan of care. If we had the medicines needed, Ryan would distribute the medicines in little plastic bags from the prescription written by Dr. Karla. Debbie did an ear wash with little 10mL syringes full of salt water, I splinted a pinky finger to send a patient for X-Rays, we discovered a heart murmur and we were doing our nursing thing side-by-side!!!! The little moments of just the smiles exchanged and the care in Debbie’s eyes were fun to watch and be a part of. There was one little girl named Alba who took a real interest and played with the stethoscope and wanted to listen to her heart…maybe she will be a nurse one day too!

We ate lunch at the cafeteria at the orphanage and then went to visit some patients in their homes. Little Ismael, who  is 5 yrs old and was diagnosed with leukemia and then taken out of the hospital by his parents believing that God would cure their son, looked about the same as he did a week ago. He can stand leaning on a chair or his mama’s leg which is an improvement. However, his capillary refill was slow, his tongue was white, his eye socket was pale as well. His mama said he was eating okay and they were still giving him the iron supplements. We will continue to check on him and be a resource for his family. Edwin, is 4 yrs old and has cerebral palsy with frequent pneumonia. He was lying in his bed and despite his breathing and lungs being a lot clear/pneumonia-free was not very responsive. Dr. Karla and I have been suspecting that he has seizures…the kind that are not so much convulsions of the body but rather more subtle in the form of unresponsive stares, twitches, laughter, and rigidity. While we were visiting his eyes rolled back in his head and he became rigid, then his eyes would roll back and he would stare off in the distance. His mother says he has been really tired lately and doing that more often. We are going to bring him to a neurologist appointment tomorrow to check the little one out and see what’s going on with his brain.

The car (Charlie is it’s name) had a flat tire that Jose Luis fixed while we visited with Edwin and his sweet mother. Then we went off to get some Nica ceviche…Dr. Karla really likes it and wanted to share it with Debbie and Ryan. After the big bowl of ceviche, we went over to Dr. Karla’s house where Debbie got to meet Dr. Karla’s daughter, Lidia, and parents. She is 2 years old…super cute…and that particular evening expressing the terrible two part of herself. She was fussy but still fun to see kick her little ball around, walk, hold hands, and be indecisive. She was a cute little mess.

Love,

Ayla Landry

"Dreams are renewable. No matter what our age or condition, there are still untapped possibilities within us and new beauty waiting to be born." 

 ~Dale E. Turner