NICARAGUA: SUNDAY BEST

Sunday Best

I arrived in Chinandega, Nicaragua yesterday, a hot Thursday in August. For anyone not familiar with the location, go south on the Pan American highway and about a hundred miles north of Managua, hang a left. That is, if you can make it that far without getting robbed or a bad case of Montezuma’s revenge. I’ve skipped the adventure and come in by aircraft. I only had a taxi trek of sixty kilometers with the friendly driver from the mission, Benito, who thankfully managed to stay awake the whole way even though I arrived at 6 AM, long before the average awakening hour of a native Nicaraguan. I’ve found it is much better for my cardiovascular system and mental health if I just don’t bother to keep my eyes open while travelling on the Pan Am highway even for short distances, regardless of the manner of conveyance--- be it bus, taxi, ambulance or pickup truck. That is just my personal list. Any jaunt down the famous 16,000 miles of highway travelled by the likes of Che Guevara and Jack Kerouac, would also note the modes of walking, motorcycle, moped, bicycle, horse cart, wheelbarrow, scooter, lawnmower, tractor, and a variety of transportation trucks varying in wheel numbers from four to eighteen. Which is also the number of people you might see on one bicycle. A single rider is an obvious waste of potential locomotive capacity. And I consider Nicaragua the land of the original triple bypass as well—you know, a car passing a truck passing a motorcycle, all at the same time on the same side of the road at speeds that might make Dale Earnhardt, Jr. jealous. And if it is in August, as it is now, driving these breakneck speeds during a monsoon. My personal favorite Pan Am sight ever was a twelve year old boy driving a team of skinny horses, one set of wagon wheels on the road and the other riding the steeply sloping shoulder. There was no seat for him. He stood straight up, the reins in his left hand and in his right, a machete cutting down the tree limbs as he travelled along at a gallop. In our culture, this might be seen as child abuse. But in Nicaragua, this young man is merely a brilliant multi-tasker, and the pride of his father. Life is plainly different here.
I spend Thursday unpacking my suitcase and supplies for the operating room at the Saint Martin de Porres Hospital where I will be working for the next ten days. I am part of a mission team who provides surgical services free of charge to the many indigent people in the area, which is at least half the population. The only poorer country in Latin America is Haiti. The average Nicaraguan makes less than a dollar a day, and there isn’t much in the way of socialized medicine. When you see the folks walking down the PanAm highway in their bare feet and ragged clothes, it does something to your heart. It makes it bigger, more open, more accessible to strangers who freely walk through it and some who even take up permanent residence there. Denise, the other surgeon and mission director who comes in from Colorado, and I come a day or two ahead of time to “get things in order.” Part of doing that is the pre-operative screening clinic which is always on Friday.
I wake up Friday morning to the sound of disagreeing geckos that populate our ceiling. “Ack. Ack. Ack. Ack.” It is more pleasant than an alarm clock, but also less predictable. The little creatures summon me out of sleep at 8 am Eastern time, but to my surprise and dismay, 6 AM in Nicaragua. And don’t think one can go back to sleep once the geckos are at it. This argument goes on for hours, sort of like a row in certain parts of the Bronx. The windows of the house are open to keep the breeze going in the late summer heat, and I hear the rain clanking on the metal roof above my head. It will be a quest getting to the Fey Y Alegria Clinic where the patients will be assembled, because the ambulance will have to maneuver the muddy, rutted backstreets.
When we arrive, there are about a hundred people, standing under sheets of plastic or sharing an umbrella with a friend, lined up into the sodden, puddled lane, all smiling at us as we get out of the back of the ambulance, “Buenos dias, doctorras.” They curtsy slightly, as though we are queens, then the mass of humanity shuffles aside, allowing us through the gates of clinic building.
It’s Friday—not really the day for your Sunday best, but here in Chinandega, they are making an exception. Everyone is freshly cleaned—no small feat when you have no shower or bathtub and, in some cases, not even running water. And each person is freshly pressed despite the fact that their clothes must be washed by hand in a river or pounded out with hauled water on a rock and hung indoors during the monsoon season to dry. They heat heavy metal irons which would be museum pieces in this country, on a fire of wood or charcoals. Even though they are poor, they dress proudly. And regardless of inferior quality or faded color or mended tears in their clothing, to me, they are all beautiful.
I know they do it for me—all this effort. Not that I have done anything to deserve it, but because the people, even in their poverty and suffering, are polite, respectful. They are giving me what little they can, even if that is collecting rain water from their roof and buying a ten cent bar of laundry soap from the market—a purchase which might comprise twenty percent of their daily earnings. Denise and I see patients all morning. We talk to dozens of longsuffering ladies with gallbladder disease, their eyes pleading with us to help them out so that they can continue to work on their small farms, cook in their outdoor kitchens, and launder clothes at the local creek. Housekeeping is an all day affair without modern conveniences. Their tasks are made unbearable at times by the nagging pain under their right rib cage that gets worse every time they eat. Then there are the working men with hernias, some of them quite large and painful, hidden away by their oversized trousers. We see an ancient grandmother with weathered nutmeg colored skin being led in by a dutiful teenage grandson in a blue school uniform. Can I help her? She has cataracts and cannot see. No, I say, but an eye team in coming in two months. I take her name and give them the location of that clinic. At noon, the ladies of the local Catholic Church appear with a lunch of chicken, rice and black beans. Denise and I look at each other. First of all, we know they cannot really afford this gift, Secondly, at home, we would never stop the clinic to get lunch while fifty or sixty patients wait, especially if some were still standing outside in spitting rain. “Por favor, doctorras,” say the church contingent, motioning toward a table in a private room across the courtyard. We do not insult their noble kindness which continues as some of the patients say in English and Spanish, “Please, eat,” or “Enjoy your meal, doctor.”
After lunch, my first patient is a thin seven year old girl with dark hair braided into long pigtails. She has a welcoming smile and a worried mother. The girl is dressed like a little ballerina, her costume a pink taffeta, ironed and even starched. She picks up her tiny skirt, twirls around with a giggle and then shows me a hernia protruding from her navel like a golf ball. The mother looks at me the way that a mom in the U.S. would peer into a pediatrician’s eyes when her child has a high fever, expecting the worse. I nod at the mom. “Si, senora, we can fix this.” Six small words, but to the mother, it is all she came here in a cloudburst to hear. She smiles broadly, tears forming in the corner of her eyes. The little girl releases her cotton candy skirt and spins around in dizzying circles. Their bill is paid in full.
The day flows on and as the last patient is ushered out the gates of the clinic, Denise and I look at the surgery schedule for the next week. Eighty cases. We rejoice, because we didn’t have to say “No” to very many people. As we pack up into the ambulance to ride back to the hospital and the mission house, suddenly, the rain stops. When we turn off the mucky side road, the sun appears along with steamy mist rising off the hot asphalt of the Pan American highway.
I’m thankful for the respite and the rays of sunshine. I look out the window of the ambulance at the small shacks that stand on the side of the road, observe the children nearly naked in the yard chasing chickens. Taking it all in, I absently twiddle with the fabric of my skirt. Did I tell you what I am wearing today? A sleeveless black and white floral dress with an empress waistline, the hem ending at midcalf. It’s one of my favorites. It travels well and doesn’t wrinkle, and I know I look good in it.
For I am the student of gracious people, and I have learned my lesson well.
They have taught me to wear my Sunday best.