By Tina Romenesko

There was definitely an energy of celebration in the air as we headed toward that hospital in the morning. Mother’s Day in Nicaragua is a national and obligatory holiday. Imagine that! Only the restaurants and stores are open and everyone is shopping for mom! As we passed the market, I saw a large table completely filled with mother´s day cakes, a yellow cake with bright white frosting and lots of red frosting roses with Felicidades a Mamá written across the top. I bet there were 50 of them, monitored by two young boys, towels in hand, swatting at the ubiquitous flies that were trying to land on these masterpieces.  

Because of the holiday, we expected our patient load to be much smaller, in fact the entire clinic was on skeleton staff except for the PINCC group.  Carol couldn´t justify an entire day off in a 5 day training so she and Jenny had  encouraged patients to come and get their cervixes examed for Mother’s day – giving themselves the gift of health.

The PINCC translator, Sallie, was needed to translate a document for Dr. Pam, so I was upgraded to translator for Karen, the Nurse Practitioner from Spokane, in a treatment room.  We saw 6 patients with various needs and there were also 3 Nicaraguan doctors in a very small room with two fans, which were duct taped to the walls.  It was my first view from the other side of the table.  I felt the pressure of accuracy as I was interpreting the results of tests and treatment plans.  I dropped out of my logical/grammatical mind and into some numinous space that seems to be able to speak medical Spanish!  Karen is a wonderful teacher and briefed me between patients so I could understand the terms I was translating!  I learned so much first hand and was able to experience the conditions these doctors and nurses work in.  We are definitely not in KANSAS anymore.  Everyone is very professional, but the rat poison on the floor, use of one hospital gown for the entire day, and placing a piece of paper towel on the exam table to provide a clean surface for each new patient are just a few examples of the limited resources they are working with on a daily basis.  Our exam table didn´t even have stirrups for the woman´s feet.  She had to hold herself in the compromising position necessary for examination, sometimes placing her foot on the doctor´s knee while they performed the inspection  More than once, I found myself leaning over a patient, coaching her to breathe, and holding her ankle at the same time to stabilize her foot on the table as she had a procedure.

We brought our donations today – which filled one entire side of the corridor.  Gloves.  Hospital gowns.  Scrubs.  Shannon is a pre-med student and also works at a clinic, so she had an entire extra suitcase filled with an amazing variety of medical supplies that she had lugged with her from South Carolina.  Each of the Nicaraguan medical staff filled a bag with medical goodies.  It was a rare treat for all of them and much appreciated.  Just about everyone in the DFW group brought something, from toothbrushes to ibuprofen and specific supplies.

Carol had predicted that it would be a half day – due to the holiday and around noon there was only one patient still waiting to be seen for a procedure.  Carol asked her to wait while we had our private Mother´s day celebration so everyone else could go home.  Jenny had purchased flowers for each of the mother´s in our group ( a Nicaraguan tradition) and our last patient was thrilled to be the first to receive a rose while sitting in the hallway in her hospital gown with the group!  The smile on her face spoke volumes!  Jenny had also brought in a Mother´s Day Cake.  just like those we had seen in the market on the way to the hospital that morning, which we all shared.  I´m sure this was one gynecological exam this last patient will never forget!

The DFW group headed for the beach around 2:30 PM, but I opted to stay back and write and do yoga.  So.  One of them will have to do the beach update!  I know they were able to take nice walks, had access to a lagoon perfect for swimming, and fresh seafood for dinner.  That sounds pretty good.

I shared dinner with Ann and Sallie from PINCC.  We had to make a reservation and put down 200 Córdobas because of the mother´s day rush.  We got there at 7 and the place was half empty but as we prepared to leave at 8:30, things were really getting going.  We shared a delicious margarita and as he brought out agua con gas and a big glass of ice I asked if the ice was made with agua purificado.  No – was the answer.  Hmmmm…..  My margarita was on the rocks……  Rocks are ice……. We all said a little prayer, and drank warm seltzer water with dinner.  Carol had explained to us the first day that the water pipes and sewer pipes run side by side in Nicaragua and are open so microbes can easily pass from one pipe to the other. That description had firmly instilled the fear of Monteczumas revenge in all of us.  We reasoned that the tequila had probably kiilled any errant bugs that might upset our intestinal tracts.

We headed for bed as soon as we got back to the hotel.  Two mother´s days for me this year.  Monteczuma wouldn´t dare take revenge on a mother on her second mother´s day.  Right?