Monday, November 22, 2010

Once More Into the Breach

We’re late. Again.

Dr. Ross makes it a common joke in the van, the fact that we are always running on “Nicaragua time." This means we’re chronically late for everything, usually by at least an hour. For Americans who are used to getting where they need to be exactly when they need to be there, this can quickly grow frustrating. Flexibility is the name of the game in developing countries. Today, it’s the visit to UPOLI that holds us up. There’s a lecture for us this Monday morning that gives us a general synopsis of the current state of Nicaraguan healthcare. It’s interesting, but time-consuming nonetheless. 

Tardiness, however, works to my advantage this morning. It allows for an unforeseen reunion with a good friend of mine and many others. As I walk out to the bus for the ride to the barrio, his familiar face pops out from behind his white van. It’s our faithful UPOLI driver, Don Pedro!

I begin relaying the half dozen messages that I've been instructed to pass along to him by my classmates from my last trip. He asks about the RMU nursing students, particular Megan, who rode in the front seat with Don Pedro last year. For ten days, the two of them had attempted to cross the language barrier by coming up with some sort of code language. Don Pedro still knows all their catch phrases.

Finally we are under way toward our adopted neighborhood, the Anexo Villa Libertad barrio. The van stops outside the clinic and after brief instructions, we head out on foot. The streets of the barrio are already well baked by the sun when we begin our hike. We are going to be working in an area of the barrio that I haven't been in before. After walking a few blocks from the clinic, we have to cut off the dirt road onto a path to reach our family's homes.

The path takes us along the edge of a small ravine, overgrown with weeds and filed with the ever-present stench of rotting garbage. It's a dirty area, but there's a silver lining to be found in the abundance of foliage that blocks the sun's harsh rays. 

When the students arrive at their families' homes, there is that general sense of first-day apprehension. Some are better at hiding it than others, but every nursing student knows that feeling. You're about to enter someone else's life. You're on the verge of inviting yourself into a stranger's privacy. It's your job, yes, but it's also a privilege. From time to time, it makes all of us antsy. Today's nervousness is particularly acute, considering our patients today don't speak our language and their lives play out in tiny houses smaller than our bedrooms at home. Just looking around can easily leave you feeling overwhelmed in a foreign world...

But knowing all this, each one of them bravely stretches out their hands with a greeting and press once more into the breach. They have a job to do.

The students had the opportunities to meet their families on Friday before we left for the mountains, but it was only for a brief introduction. Today they will be spending the morning in their families' home doing assessments, conducting interviews, and providing as much education as they can. Fortunately for the nine undergraduates on this trip, we also have the added resource of six DNP students from the RMU doctorate program. On a typical trip, Dr. Ross is needed in a dozen places at once to answer questions, but this time, with these DNP students, his job is a little easier. All of them have clinical experience already, so they are able to team up with the undergrads and assess families together.

So everyone has their family assignment for the week. Everyone except me, that is. 

I'm not really functioning as a nurse this time around. For my fourth trip, the RMU ChangeALife team has tasked me with my dream job. This time, I get to be a photojournalist. My primary task is the creation of this blog you're reading. So as the students begin to delve into their family assessments, I wander from house to house with my camera, listening and watching, sometimes jotting down notes to remember later. 

In some homes, there are babies with very young mothers. In others, there are environmental hazards. As always, there are problems just about everywhere for us to address. But regardless of their issues, all of the families react the same way to our arrival. Always to my amazement, instead of hiding away suspiciously in the shadows, they take the students by the hand and lead them into their yards. They pull what furniture they have out from their dwelling so that we may all sit. They usher us into their homes in a fashion that is sadly lost on our American culture, in ways that we frankly don't deserve.

One elderly gentleman, a grandfather, catches my attention. He not only welcomes these complete strangers into his home, but also insists on cutting up oranges for his new guests. We are all too touched by his generosity to refuse them. These oranges are from his own food supply, which is already scant to begin with. His hands, worn with age, are as beautifully crafted as the ripe fruit in his hands. In an attempt to thank him for his generosity, I ask him to pose for my camera. The old man grins and stands perfectly still for me, his hands open and welcoming. 

It's the sweetest orange I've ever tasted.

I have a bit of a unique perspective, being an alumnus of this experience, and I have to smile as it all begins again for a fresh group of students. They don't quite know it yet, but for these college kids, the change is already happening.  Right under their noses, little pieces of their hearts are being stolen away by the looks of children who spy on us from the gates of small shacks. 

It probably won't hit the students for a while yet. It may not be until the end of the week, or maybe not until they return home to their own families for Thanksgiving holiday. Or perhaps it won't happen until years down the road.  But sooner or later, they are going to look back on these first few moments on that hot Monday morning they spent in Managua. And that's when they will realize something special...

...that they were in love with the people from the start.