Travel Journal, Part One: Health Brigade to Pueblo Nuevo

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 9^th 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!”)