Itinerary
Day
One: Travel Day (Destination – El Castaño/Chaca Chaca; Travel by Boat)
Days
Two and Three: El Castaño
Day
Four: Papelito (Travel by Horse)
Day
Five: Papelito/Papel (Travel by Horse)
Day
Six: Papel (Return to El Castaño by Horse)
Day
Seven: Peral (Travel by Boat)
Day
Eight: Tortuguita (Travel by Horse)
Day
Nine: El Cedro (Travel by Boat)
Day
Ten: Sawawas (Travel by Boat; Return to Pearl Lagoon at End of Day)
What does the Wawashan River look like 6
hours in?
Dark.
It was past 7 pm when we finally reached El
Castaño, the first stop on our 10 day medical brigade. We’d been traveling
since 8 AM, starting out from Pearl Lagoon with the majority of our 9 person
team, their luggage, and sack after sack of medical supplies. The trip north
across the lagoon was sunny and smooth; we stopped briefly in Marshall Point to
retrieve the 9th member of the team, then entered the Wawashan River
and made our way to Pueblo Nuevo.
The boat that would take us further up the
river was not there when we reached Pueblo Nuevo, so I had a little time to
wander about the town, purchasing last-minute supplies, and to visit the
majority of my old host family. Pueblo Nuevo is a bit like what we imagine when
we talk about the “wild, wild west”. It is a sprawling group of communities
settled by mestizo immigrants from other Nicaraguan departments in search of
land for cattle ranching. The majority of the settlements lack power and cell
phone service; none have running water. There is a rough, lawless vibe; there
is no doubt that these vaqueros would go to great lengths to defend the land
they’d claimed.
At 12 pm we set out again, crawling up the
river with a feeble 15 hp motor. The dense jungle on either bank spilled out
into the river; branches resisting the swift current’s pull; roots dipping
gently into the murky water. The first five hours of the journey had the feel
of a wildlife tour: capuchin and howler monkeys swung from tree to tree
overhead, hundreds of butterflies flitted among pale pink tissue paper flower
clusters, egrets and kingfishers inspected the waters for signs of a meal
swimming below, while more visually stunning tanagers darted in and out of the
foliage. Now and then, there were flashes of emerald green as iguanas went
skittering up the banks to hide from our approaching boat. We even saw a few
crocodiles, sunning themselves on fragile rafts of accumulated sticks.
At 5 pm, a fog descended, dimming the light
of the setting sun, and blurring the once sharp outlines of the trees. By 6 pm,
the sun had fled the sky but the moon and stars had yet to appear. Two
flashlights were all we had to guide the boat through the shallow river. The
boat increasingly connected with the flotsam bobbing along in the current, or
scraped against the rocky riverbed. All conversation had ceased; the struggling
motor was the only noise echoing through the night air.
When we finally landed in El Castaño, we
struggled up the muddy bank with our supplies, rubber boots sucked deep into
the wet clay. We were led to the one-room school, where we dropped our bags,
strung up our hammocks, and collapsed in weary relief.
We quickly settled into a pattern. Rise
with the sun. Dress, roll away hammocks, and pack personal belongings into
backpacks or plastic sacks. Gather in
one of the nearby homes for a breakfast of rice, beans, tortilla, and cheese. Set
out, either by horse or by boat, to community of the day. Arrive at worksite
(usually a school or church) and, using tables, desks, and benches, set up
stations where teams of nurses would be weighing and measuring babies;
providing vaccinations; performing PAP exams, prenatal examinations, HIV
testing, and pregnancy testing; testing for malaria; and completing medical
consultations. Work from 8 or 9 AM until mid to late afternoon, with a quick
break for a lunch of rice, beans, and cheese (when we were lucky, we would
receive chicken). Bathe, whether it be in a shower stall crudely fashioned
using sticks and plastic tarp, a wooden board wash house, or a nearby creek.
Eat a dinner of…you guessed it…rice, beans, and cheese. Hang hammocks in the
flickering light of thin church candles. Chit chat and gossip until the candle
extinguishes itself. Sleep. Lather, rinse, repeat.
Not being a nurse, my work options were
somewhat limited. My primary objective for being on the brigade was to hold a
meeting in each community with the resident men. Two of my colleagues and I
used this forum to discuss the importance of maternal child health, and what
they, as men, could do to protect and promote the health of the women in their
lives. However, it was not always possible to convene these meetings, as the
men were much more likely to be in the fields working than in our makeshift
clinic waiting for medical care. Furthermore, the meetings themselves only
required about an hour and a half of time to complete. While it was a
worthwhile project, it hardly could be said to fill my days. So I ended up
filling some of my ample free time by assisting in the weighing and measuring of
children under three years of age, malaria testing, and vaccinating dogs
against rabies. I also took along my camera to document the work being done for
the benefit of our financiers.
As one day slid into the next, the brigade
began to take a toll on us all, mentally and physically. We grew exhausted by
the constant traveling and restless, uncomfortable nights spent in hammocks. We
felt dirty from the creek water that we used to bathe and wash our clothes, and
itchy from the mosquitoes that feasted on every exposed patch of flesh. Some
grew tired of the unvarying diet of rice, beans, and cheese. Lowered immune
systems combined with exposure to the rain to leave many, including myself,
with runny noses and phlegmy, hacking coughs. One staff member fell through a
rotting step and injured her leg and arm; two nurses fell from their horses and
sustained minor bumps and bruises. Enthusiasm flagged, tempers grew short, and
petty arguments broke out.
The feeling of exasperation was universal
when we arrived in El Cedro, to be met by only two young men to help us with
our supplies. In the dusk of late evening, we dragged the sacks and thermoses
up the river bank, across the field, and to the house that would serve as our
clinic and lodgings. We were then led through the house and into the back, to
what I can only describe as the general animal containment area (to say it was
a hog pen would be too specific, as there were also four mangy dogs, cattle,
horses, a small flock of chickens, and a turkey), where we were told we would
be sleeping. There’s a first time for everything; this was my first night to be
awoken by a large pig, grunting and brushing against my hammock as he passed
by. It was not a good night.
We managed to reach the final community, but
a successful end of this brigade simply was not meant to be. We arrived to find
that our few remaining pieces of ice had melted during the night; ice that was
necessary to maintain the vaccines we’d been carrying with us since the start
of the brigade. More than half of the team was sick and/or injured, and
essentially out of commission. The final straw came when a nurse was stung in
the face by wasps that emerged, enraged, after being disturbed by the opening
of an old latrine. Tails between our legs, we got back into the boat after only
an hour in Sawawas, and headed to Pueblo Nuevo for the night. While it was
disappointing to not be able to complete all of the work as planned, I was
happy to spend a bit of unexpected bonus time with my old host family (and
catch up on some of the telenovelas). The next morning we returned to Pearl
Lagoon.
Campo
Word of the Day: Chincaca – used by many individuals living in rural areas to describe their
lower back area (“¡Ay doctor, tengo un gran dolor en la chincaca!”)
