Travel Journal, Part Three: Medical Brigade to Pedregal

Itinerary

Day One: Travel Day (Destination – Pedregal; Travel by Boat)

Days Two and Three: Pedregal

Days Four and Five: Blue Lagoon (Travel by Horse; Return to Pedregal at the end of Day Five)

Days Six and Seven: San José (Travel by Horse; Return to Pedregal at the end of Day Seven)

Days Eight and Nine: Pondler (Travel by Boat)

Day Ten: Arenitas (Travel by Boat) and San Pablo (Travel by Horse; Return by Boat to Pearl Lagoon at End of Day)

Whereas the Wawashan River was wide and picturesque, the Pachy River was narrow, dangerously shallow, and almost completely choked in parts with fallen branches. The Pachy River was barely controlled chaos, and there we were, in the middle of it.

Storm clouds had rolled in early on the day of our departure. The plastic tarp had to be unrolled after only an hour of travel, and we didn’t emerge from underneath it until we bumped up against the muddy shore of Pondler. There, we transferred to a larger, slow moving wooden boat (think along the lines of a large canoe), and fought our way (still enveloped in dirty black tarp) up the river for four hours. Six hours after starting out, we reached Pedregal.

No one met us by the river bank to help us carry the sacks of medical supplies and belongings. Nor was there a soul to guide us to the health outpost, located about 20 minutes from the shoreline. We struck out a path, shouldering what we could, and quickly found ourselves sinking, shin- to knee-deep, in mud. Soft, sticky, odious mud. Boots filled with slime. People lost their balance and toppled over. Sandals and shoes were sucked off of feet. We were, in short, miserable.

When we had nearly reached the clinic, we were met on the trail by two young men on horseback. Laughing at our plight, they informed us that the route we’d chosen was for horses and mules. Another, drier trail was available for pedestrians. Cursing, we finished the trek and washed away the accumulated grime in the outside sink with clean bedpans we’d found. No food had been prepared for us, so we ate insufficient suppers of crackers, hung our hammocks in the clinic, and collapsed for the night.

Mud emerged as the consistent theme of this journey. Mud was ever-present; in the roads and rivers, spattered on our clothes, stuck to our boots, and occasionally in our hair. Add the sticky heat and you have a pretty good recipe for misery. Every day, we washed ourselves and our clothes, only to be covered once again by red-brown muck. Lest I lead you to believe that I spent my entire time simply obsessing over personal hygiene, however, I should speak of the work that we accomplished.

My first two days of the brigade were spent holding the final training on Plan de Parto and ECMAC with the community health workers of the Pedregal area. I can now happily report that I am half-way finished with my SPA project!  The rest of the brigade was spent in a similar fashion as that of the Pueblo Nuevo brigade: early mornings; rainy days; long, muddy horseback rides (and one terrifying trip in a dory, or cayuco – a small, incredibly unstable wooden boat); meals of beans, rice, and tortilla; meetings with the community men (made more difficult this time by the rice harvest); malaria testing; photography; bathing and washing in creeks; and long, dark nights of whining mosquitos, hair-raising trips to the latrine, and sleep in hammocks. This brigade, however, was smoother and overall more pleasant than the last. We accomplished a good deal of work, and there was a greater harmony between the team members. Oh yes, and less instances of accidents and illnesses. At the end of the ten days, I was certainly ready to return home – I longed for my bed, my shower, and my (relatively) mud-free life in Pearl Lagoon – but I wasn’t desperate to escape, as I’d felt my first time around. I’d like to believe that, with each of these brigades, I’m growing a bit; becoming a little bit tougher and more resilient. I guess I’ll have to wait and see – I have two brigades left to go…

Training, complete with pig as special guest

One of our meetings with community men

Weighing babies (they always cry)

Malaria Testing

One of the communities

The ride to Blue Lagoon

Early morning washing

One of the creeks we used to bathe and wash

A very unnerving ride down a river

The ride to San Pablo

Word of the Day: renko – lame, crippled (I learned this word after being stuck on a renko mule for a three hour journey back from a community. An unpleasant experience to say the least.)

Travel Journal, Part Two: “Living Positive” Conference and Ideas Exchange in Managua

Two days after returning from the Pueblo Nuevo medical brigade, I was forced from my home once more. Monday morning, I took the early boat to Bluefields, where I ran last minute errands for a conference I’d been helping to plan over the past few months. Although I was excited for the conference – a workshop and ideas exchange for individuals living with HIV from Bluefields, Chinandega, Masaya, and Managua – I was already exhausted and sick from the brigade. I prayed that everything would go smoothly, that we would have good traveling weather, and that I could manage to keep from infecting others with my cold.

Tuesday morning began at 4:30 AM, with a hurried bucket bath before heading down to the wharf to meet the Atlantic coast participants. Although our boat was scheduled to leave at 6 AM, the entire group had arrived by 5:45 AM. I was impressed; maybe my prayers had been answered. The trip to Rama was trouble-free; a mid-way stop along the banks of the river provided us a snack of fresh, sweet oranges. Likewise, the bus travel between Rama and Managua, and then to Pochomil Beach were pleasant and uneventful. We arrived at the Oceanside hotel and conference center at 4 PM.

The next two and a half days were packed with informational sessions. As so often happens with conferences, the beauty of the venue was underappreciated; we rarely left the conference room before 5 PM. Yet we managed to enjoy the beach during early morning walks, a sunset yoga and meditation session on the first full day, and a bonfire and dance party on the second night. More importantly, the participants seemed to learn a lot from the session facilitators and from one another about how to manage their disease and their general state of wellbeing – physically, mentally, emotionally, and spiritually. HIV is still a highly stigmatized disease in Nicaragua; most of the participants have to hide their status not only from strangers and coworkers, but from friends and family. This isolated, beachside venue provided a rare opportunity to openly discuss their lives and their disease. Questions were finally asked and answered, experiences were shared, and new friendships were formed.

Early on Thursday morning, we packed our belongings into the bus, ate a quick breakfast, and said our goodbyes before starting the long trip back to the other coast. An excellent, though brief, trip. And I think I managed to keep my cough to myself.

Word of the week: bienestar - wellbeing

A Very Important Message

Happy Autonomy Day to all those out on the Atlantic coast of Nicaragua!

But, much more importantly...

HAPPY BIRTHDAY to my wonderful mother!

Eat a cupcake for me in my absence :)

I wish you nothing but the best for your birthday and for the year ahead!  I love you and miss you very much.

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!”)

When does Peace Corps feel a lot like summer camp?

When it rains, monsoon-style, for days on end, one can become a bit bored. And some, who have way too much time on their hands, may resort to indulging in activities from their childhoods. Like making friendship bracelets…

Although I’m overall satisfied by my efforts, I’m happy that the rainy season is coming to a close (as much as is possible here in the tropical Pearl Lagoon).

Ch-ch-ch-ch-changes

I awoke to the crash of thunder and pounding of the rain, magnified by the corrugated zinc sheets of the roof. Fear gripped me. There was someone outside of my window. I pulled the curtain back slightly from the window to take a peek. A large, wide brown eye stared back at me. Two horses, terrified of the storm, had taken shelter on the front porch. I released the air I didn't even know I’d been holding in, took a deep breath, turned over, and fell back asleep. The next morning, the horses were gone. I could have almost written the encounter off as a dream if it wasn't for the two large piles of horse poop my host mother was angrily sweeping from the porch tiles.

It’s been a month since I've moved. My fifth residence. My fourth family (if you don’t count the staff of Hotel Brandt’s in Managua where I spent a month and a half in-between sites). My host sister from my first family here in Pearl Lagoon was sent suddenly to Pueblo Nuevo for work, taking her baby and mother with her. My new family is friendly and welcoming; the home dry and comfortable. Still, as with all moves, it has required some adjusting.

Obviously, there’s getting used to the new physical environment: I am now living in a neighborhood closer to the center of town, which means more foot traffic and more noise. My new house has a beautiful bathroom, but lacks a kitchen and sinks. Ever washed your coffee mug in the shower? My new bedroom is spacious, but I haven’t yet found a way to hang my mosquito net. Every night is a mental battle: coat myself in oily, noxious repellent, or rely on the fan to blow the blood suckers away (a not entirely reliable method, especially with our recent bout of power outages)?

More difficult (though more rewarding) are the adjustments one must make to happily and comfortably cohabit your new home. It takes time to get to know people; to understand their moods, their likes and dislikes, their ways of communicating. Even harder is finding what your place is in the family. As you all know, Peace Corps volunteers in Nicaragua must live in a host family situation for the entirety of their training and service. Is this family accustomed to having people outside of their family (much less foreigners) live with them? Are they looking for a renter/rentee relationship? Friendship? Or are they interested in “adopting” you – treating you as a sibling, child, or grandchild? And what is it that YOU want from THEM? There will be moments of confusion, awkwardness, and frustration as you work to figure one another out. Hopefully, you and your family will develop a positive relationship over time. If not, you can always look for a new place to stay…

 I was concerned about this latest move; I didn't know how much more adjusting I could take. Every move – every family I’d had to say good bye to – seemed to rip a small piece from my heart. I felt depleted, raw, inflexible. I wanted no more of this family/home stay business. I wanted my own space, where I wouldn't have to adjust. The universe, however, had other plans for me. The move date approached and no reasonable rental option had been uncovered. Instead, a well-respected teacher, upon hearing my plight, approached my health director and offered to house me. She seemed nice, and frankly I had no other option. So I packed my bags, moved into the home she shared with one of her daughters and baby granddaughter, and started adjusting again…

Which brings us to the present. I think it’s going well, and I’m keeping my fingers crossed that, with eight months to go, there are no more major adjustments to be made. And no more horses on the front porch in the middle of the night.

Word of the week: mudarse - to move