Wednesday, November 17, 2010

Somewhere in the Middle of Nowhere


The crew looks exhausted this morning. I’m sure I look that way too, as I’m still stuck in my don’t-speak-to-me-until-there-is-coffee mode.

Last night, the second half of our journey into the Madalgalpa had made more than a few of us uncomfortable. A bit scared, even. No cars. No signs. No lights. Nothing but a long, narrow road made of loose rocks and small boulders, carved into the dense forest. At one point, we had to get out and walk alongside our weighed-down MegaBus as it spun its wheels up the slope. Dr. Ross muttered to me under his breath as we walked. “Midnight hiking through Contra territory – well, there’s a first time for everything.” I would have been nervous too, but by then, most of us were just glad to be breathing fresh air, free from the nauseating confines of the van. 

The accommodations that awaited us at the end of this barren road were much more comfortable than we anticipated. At that point, we would have slept in a tent and not cared, but instead we found a large wooden cabin, furnished with bunks and cots for our whole group. I could tell by the number of exotic sounds leaking in through the window panes that we were very far from home. Unfortunately, we were just going to have to wait until daylight for the unveiling of our new clinical setting. 

We are all still squinting and stretching as we gather in the common room for a pre-breakfast meeting. Dr. Ross wants to let us know what to expect for the day’s activities.  The first item on the agenda is a tour of the plantation. Two security guards are standing in the doorway, ready to accompany us into the fields. As we follow them out into the brisk morning air, the temperature takes everyone by surprise. The sun is not fully risen yet, but it’s still very odd to be needing a sweatshirt outdoors here. The views that surround us are spectacular, just like those majestic vistas that you’d see in an edition of National Geographic. It's pretty clear to all of us by now...


...that we are somewhere in the middle of nowhere.

The guards lead us further into the plantation, the domain of which extends up both walls of the valley. The path through the rows of coffee plants winds back and forth through tall trees that sway in the mountain breeze. It’s far from the organized Midwestern style crop fields that I had expected to find up here. 

Edgar leads the way, single file, stopping every few moments to explain another portion of the harvest process. He points across the ridge at small moving shapes moving through the crop. The workers are out there already, filling baskets with the ripe fruit of the Arabica plant. The berries must turn red before they can be taken from the plant, and the workers only receive their seven dollar daily wage if their baskets are ripe. It’s November, early in the picking season, so most clusters are still green. 


As we walk along, Edgar and the guards tell us about the farm. We are walking on the finest coffee-growing soil in all of Nicaragua. As it is explained to me, there are two major forms of the coffee plant: the Robusta and the Arabica. Robusta is grown throughout South America and Asia at much lower altitudes, about 600 meters on average. It’s far more durable, inexpensive, and easier to grow than its sister plant. The fickle Arabica, on the other hand, is susceptible to disease, must be tended carefully, and raised in shade at high altitudes of 1200 meters or more. After being picked, the berries are laid out in the sun to dry...


...then they are taken to a giant pavilion to be washed and separated, then sent down a long channel for further sorting. At the end, just before they are bagged and shipped off to Texas for roasting, the beans are finally beginning to resemble what you and I would find at the local Starbucks.


Quality takes precedence over quantity here at El Quetzel. These beans are renowned as the best you can buy in this country. And they certainly have a mighty colorful logo to market them. 


The farm has been owned and operated by the Bendana McEwan family for three generations.  The family had the land taken away when the revolution broke out. They were exiled to the United States, but after the war, the newly elected president, Violeta Chamorro, returned the farm to its owners. Frank Bendana McEwan brought his family back and went to work turning his father’s farm into the finest coffee-growing environment possible. Senor McEwan planted trees in mountain fields where there were none, and over time, the Arabica plant thrived. When he passed away, his daughter Lillian took over the farm with her older brother. She and her husband and son have driven up from Managua today to help us with the health fair. 

We are told there about eighty families who work this farm year-round. That number swells to over six hundred during the peak harvest times. Lillian’s family have built a school and a clinic for their workers, but with only one doctor visiting every other week, there is a great need for community health education. This is where Edgar’s non-for-profit organization, InterChange Works, comes into the picture. He and his team create partnerships on farms like this one to create funding for health fairs so the people can receive free treatment and education. Though we have received very little preparation for this fair, Dr. Ross and the Robert Morris group will be the backbone of the operation today. 

After our tour of the fields, we gather back at the cabin for breakfast. More rice. More beans. But at least today, the coffee is exceptional.


It’s a good thing that we have unlimited access to caffeine, because today is going to be a very long day. The agenda for the fair includes clinic time, educational sessions, and recreational activities for the children. But after eating, the crew seems energized for the day’s events, and by mid-morning, we have our supplies set up at the clinic. With a piñata overseeing the festivities, we are ready to go. 


The community turns out in droves. Before long, there are kids running everywhere in the yard between the clinic and the school. Our translators, in testament to their amazing commitment to these secluded communities, change into ridiculous costumes to portray today’s educational topics. 


That’s Juan as the Learn to Lead Lion on the right. Edgar, the Super Safety Dog, is on the left. Juan jokes with me later, “We were expecting Superman too, but he bailed on us.” 

The RMU team hits the ground running and doesn’t stop. For six hours, there is endless activity at all stations. Dr. Ross educates the men on common health issues…


…while inside, the DNP students staff the exam rooms, treating patients of all ages for ailments ranging from moles to macular degeneration.


The undergrads stay busy delivering presentations…


…and triaging patients on the veranda.


Meanwhile, outside the clinic, the children’s boundless enthusiasm is so infectious, they threaten to run our young Olympian ragged in the yard with their cat-and-mouse games of chase.


The lesson’s from today’s health fair are elementary in nature, but crucial in importance. We talk about handwashing. We demonstrate teeth brushing. We show the kids what stop-drop-and-roll is all about. In return, the lessons this isolated community teaches us are simple as well...

You’re never too old for Crayons. 


Laughing is a great form of exercise.


Sack races are only won through teamwork.


And most importantly, friendships come easy when you start them off with a smile….


….even if you're somewhere in the middle of nowhere.