International Rescue and Relief Students' training culminates in Nicaragua

“Glue the pipe together here,” he indicated with one hand, “and angle the ninety-degree elbow up, like so.” He tweaked the joint, stepped back to admire his work, and proclaimed, “That’s a finished product.”

Posed over a jumble of PVC pipes, brackets, angles, elbows, and drills, Carl Ladd resembled more of a mad scientist than an International Rescue and Relief contract instructor. The contraption at his feet seemed like a prop from some fantasy film instead of a water pump.

Ladd and the four students who assisted in assembly huddle around the pump and discuss the project—how it is both affordable and sustainable; how it connects to a filtration system to provide fresh, clean water; how it shapes the future of community development. 

They joined the other four students inside who have completed the frame for a Biosand filter, the second half of the water system. Constructed from a blue 55-gallon drum and PVC pipe, the filter is also cheap and easy to build. Connected to the pump, this system can channel water from a natural source and purify it through the sand and gravel inside the drum, which contains natural microorganisms capable of consuming pathogens and, after one year of maturity, viruses too.

If this technology is shaping the future of water sustainability, then these eight International Rescue and Relief students are shaping the future of relief work. Alongside instructors Aaron and Lauren Kent, this team will spend 89 days in Nicaragua, living, learning and lending the expertise they have spent years cultivating in Union College’s unique Bachelor of Science program.

Over the course of the semester abroad, students will learn survival skills, participate in rural clinics, and volunteer with local EMS crews, all while adapting to a foreign culture and language and taking course work in Emergency Care, Global health, Travel and Tropical Medicine and Expeditionary Leadership.

“This semester in Nicaragua is the seminal experience of IRR,” said trip leader, instructor, and Union alum Aaron Kent. “Everything they have learned over the years leads to this.” 

Kent has led the trip to Nicaragua five times and says each one is different. This unpredictability is often due to the varying number of students in attendance each trip. With eight students compared to the 16 from last year, this is the smallest group yet. 

“There are unique challenges with so few people,” said Kent, indicating the eight students huddled over the water filter. “That is your social group. That is your family. If one loses patience with another, it has to be resolved, because we will be together nearly every day for three months.” 

He assessed the group and smiled. “Social dynamics are always unpredictable.”

Until then, however, the students presented solidarity in their interactions. Juniors Zack Leyda and Josh Wahl joked about coastal survival, which they claim is less survival and more relaxation. “Sipping coconuts, getting a tan, catching some fish,” said Leyda, “it doesn’t get much better than that.”

“It’s gonna be a dream,” laughed Wahl.

“Survival is all about locating food and water,” Kent agreed, his hand straying toward the communal M&M bag. “It’s nothing but foraging. But on the coast, everything you need is right there. Food, water, shelter, it’s nice.” He paused and chuckled, “The ocean survival, however, that is the worst experience known to man.”

Kent referred to the 24 hours students spend together on a life raft in open water. “It’s nothing but rocking and seasickness,” Kent said, grimacing at the prospect.

Once the eight days of survival training are finished, students shift into the medical phase of their semester. This year, the group will be exploring a new region along the Caribbean Coast in the northwestern most part of Nicaragua. The North Atlantic Autonomous Region is one of the poorest and most undeveloped in the country. For two weeks the group will travel by boat through the dense mangrove swamps, delivering medical aid to the indigenous groups living in that territory. 

Senior Joellyn Sheehy, who will graduate this year with an emphasis in pre-medicine, is eager for the opportunities and exposure this experience will present. “I want a better understanding of what development work looks like,” said Sheehy, pausing from her drill work on the biosand filter. “And I want to learn the strategies for implementing it.”

Other students express more interest in the opportunities following the medical excursion. Newlyweds Dillon and Erica Whittaker are both eager to work with the EMS crews based out of Managua and Grenada. 

“The experience will be unlike anything in Nebraska,” said Erica, who recently quit her job as a paramedic for Midwest Medical. “There will be such a diverse range of patients and cases that one never sees in developed countries.” 

For Dillon, this is the opportunity of a lifetime. “I’m just excited to travel,” says Whittaker. “I’ve never done anything like this.” Not only will Dillon be on foreign soil for the first time in his life, he will also be learning and practicing valuable career skills there. “I’ll get the experience I need by working with the fire crews in Managua,” he said. “That will give me an edge when I graduate.” 

Getting an edge is an important aspect for IRR students. Graduates of the program are offered such a diverse range of experiences that they are able to pursue careers in many fields. One graduate is a crisis counselor for an outdoor program. Another is an investigator of accident claims for an insurance company. Still another works for ADRA. Many pursue graduate degrees and join NGO’s working in development. 

Ladd, for example, has participated in, led, and been sponsored on water-based development projects in fifteen nations, including Sudan, China and Romania. It is because of his passion and experience that Union College brought him back to help prepare the students for their semester abroad. 

Even though they may not build a water system in Nicaragua, Ladd believes it is important for them to learn appropriate technology for sustainable development. Their careers may depend on it. 

But even greater than the technology, said Ladd, is the mentality of those implementing the technology. “I help students recognize that what most American’s view as ‘problems’ abroad are opportunities to build a relationship and lend our unique expertise.”

For more information on the IRR program check out: http://www.ucollege.edu/irr

Updates from Nicaragua

Throughout the semester, we will post updates from Joellyn Sheehy below as she sends them from Nicaragua.

Going West (Mar. 29)

It’s pretty interesting how people can change. My mother loves to remind me of how squeamish I was about germs as a child and unwilling to travel anywhere without a flush toilet. Now, while I would prefer to have some sort of enclosed latrine, let’s be honest, a crop of bushes will do just as well. I did draw the line earlier in the semester against using the side of a medium-traffic road with little cover, but had it been nighttime, I’m sure even that would have been a different story. 

The previous week we journeyed along the river Wawa to the villages of Kukalaya (“coconut water”) and Layasiksa (“black water”). We left the docks of Puerto Cabezas Monday morning for what was supposed to be a four to six-hour journey. While many boats can make it in two hours, ours was a bigger boat with more weight and consequently went much slower. Students, cooks, translators, and luggage all piled on and set off down the river.

The journey took us through a hand-dug canal and into some swampy regions. The going was pretty smooth, but the water was shallow, especially because we passed through during low tide and our boat was especially loaded down. We got stuck part of the way through the canal, but it eased up as we entered the jungle part of the swampy maze, the haunting echo of howler monkeys in the distance.

I have no idea how our drivers found their way through, and in fact they didn’t for about an hour and half when we got lost, but eventually, with the help of some nice fishermen who were only going to charge us a little bit, we arrived just after sunset. 

A group of people met us at the docks of Kukalaya, which was a little unnerving at first, because all we could discern was a crowd of ominous figures on shore. It was already nightfall and they were quiet (or maybe the boat was just loud) so we only noticed them as we pulled close to the pier and scanned it with our flashlights.   Everything was fine in the end; Ericka [Whittaker] and Josh [Wahl], our leaders of the week, met with some community leaders to set us up with a house to sleep in, a place for the cooks to sleep and work in, and a church to host the clinic in the morning. We got luggage ashore, set up sleep systems, and then more or less crashed after a feast of rice with beans. 

Clinics, kids, and hazardous swims

The next day brought one of the largest groups of patients we had seen. Our group was only a third of the size of the previous week (there were more nursing students than IRR this year along with instructors and additional volunteers), but we saw 189 patients. Adam [Neep] and I worked together for what I think was one of my more educational clinics, involving multiple pelvic exams and three stitches (my first on a real person). 

By this stage we were in a pretty good clinic routine. When we got to the church we set up the pharmacy, the women’s clinic, and triage, then settled ourselves with a translator at our respective benches. Treating mainly worms, coughs and arthritis (hard physical labor takes it toll on the joints), Adam and I took turns as leading provider to ask questions, listen to lung sounds and take blood pressures. 

My favorite patients are usually the kids. Generally, people are not direly sick in the clinics, so you can smile and joke with the children. It’s hard to take vital signs of the little-little ones since they burst out crying whenever a giant white person comes towards them with a thermometer. Sometimes with a little coaxing they’re okay (either that or their parents just hold their arm down over the thermometer and let them wail). Adults can be harder to read. They often list off a hundred different problems but don’t really look sick at all. Others will only mention something in passing that seems like a big deal. Maybe they’re not really sick at all and are just coming to get medications, but we treat regardless. It could be that they don’t have a fever or pain now, but they might in the next month when there isn’t any clinic.

The next day we weren’t allowed to have clinic in the church anymore. The pastor was happy for us to use the building to see villagers, but the other church leaders didn’t think it was appropriate so we transferred to the town’s government clinic. It was a little smaller and farther away from our house, but in the end it worked better. The nurse had absconded to Puerto Cabezas for about a month, which is apparently a problem with many village medical providers (apparently they have to travel there every month for medications and supplies and sometimes just don't come back for long periods of time), so we had free reign over the facilities. 

Josh and Hoover, one of the translators, had traveled to Layasiksa the previous evening, encouraging as many as possible to come to the clinic in Kukalaya the following day. We had a good mixture of people from both villages that day, and could even draw medications from the government’s supply for what we didn’t have. Aaron and I worked together with Isabel, our wonderful translator, and I gave a lot of shots in the butt (I’m just in this degree program for the glamour, really). 

We cruised through that clinic, rotating groups out for lunch, and finishing in the early afternoon. Everyone was hot and sticky, so Dr. Caldera suggested we drive the boat out a little way and go swimming. There was talk about alligators and piranhas, but we didn’t see either of them, a little sadly, and had a relatively normal frolic in the sun and silty water. Hoover suggested the water probably wasn’t the cleanest, so I was persuaded to take another shower when we got back.

Night Life

Our bathroom and shower huts were about 15 meters from our house and I think they were used by the community. I never did figure out whose house we stayed in or whose stuff we were using. The water well was nearby, so all our amenities were close at hand. I had an informal, silent lesson from a little girl one night about how to draw up water. I got there right before her, but figured I would let the professional have at it first. She expertly filled her little bucket while I watched and waited, taking mental notes. When it was my turn, I was a tad slow, but eventually got the job done. She watched me the whole time, which was a little unnerving, and then closed the well up and walked back ahead of me as I struggled with my full bucket. Granted, hers was maybe half the size of mine, but she was only about seven and wielded the bucket around professionally...I’ll work out when I get back.

At night the grass field between our house and the latrines would fill up with giant bullfrogs (or maybe just normal-sized, but they seemed pretty big to me) so that you’d have to be careful not to crush a frog, which was always a good time in bathroom emergencies. I was following a frog around one evening (as you do, well, at least we did. You’d be sitting on the porch and see a headlamp inching across the grass and could pretty much assume they were following a frog) when suddenly a child appeared out of the dark.

“Ninam dia (what is your name?)?” he asked me. I answered and repeated the question back, proud of myself to know what he had said. He told me his name and then asked “an mani brisma (how old are you)?”

“Cut it out kid,” I thought, “that was the only other phrase I knew! Now I've got nothing.” I gave him my age and repeated the question back, trying to think of some other Miskito word so I could add to the conversation. Well, “tutni yamni” I said, using the wrong greeting as I walked away. Oh well, I tried.

Medical excursions and language barriers

That Thursday we walked out to Layasiksa, the neighboring town about an hour away. We set up in their government clinic also, except the nurse was around and was an active member of the community. She had made a list of house calls for us to make, mainly bedridden elderly, and was preparing to go give vaccinations.

The leaders divided us into three groups and we went out with the doctors and nurse to give vaccines and pay visits. Dillon [Whittaker] and I went with Dr. Caldera and Brenna, a physician assistant from North Dakota and provider over our clinics for two weeks, to visit several older ladies. The first was a tiny woman in her eighties who had a hip-femur fracture and was never treated. She lay on the floor and winced as Caldera examined her ill-healed joint, breathing rapidly as her asthma prevented deep breaths. There wasn’t much we could do for the joint, but we gave her some medicine for the pain and asthma. She was a sweet little lady and spoke in Miskito as her granddaughter translated into Spanish. The younger woman told her we didn’t understand, but she still looked deeply into our faces as she spoke to us, making me wish that I could ask something deeper than just “how old are you?”

The other house calls were cases of joint pain, female problems, and a bad case of bed sores. We did what we could and then headed back to the clinic, where long lines of people were queuing up. Aaron [Kent] was running triage by himself (indicative of his advanced skills in Miskito) and I joined Josh as a provider group, overseen by Caldera. We’d lost most of the morning trekking around the village, but settled into our group and quickly got to work. There didn’t seem to be as many worm cases in this village, and we discussed afterwards the significance of having a very active nurse in the community.

Saying goodbye

We hiked back to Kukalaya that evening and prepared our things to leave early the next morning. This time we wanted to hit high tide, so we planned to leave around 2 a.m. An elderly lady Dr. Caldera had visited earlier passed away while we were gone, so the family held a vigil at their house. They rang a bell several times and played instruments and sang through the night so that when we got up, the community was still paying homage. It was nice to see people stand together at such a time. Elderly people in Western countries so often are left alone, as are their family when they do pass on. It was nice to see people support one another and grieve together.

Missing our target by a few minutes, we left shore at around 2:20 a.m. Leaving at night presented a few problems in and of itself (we’d gotten lost coming in during the day time, the cover of night doesn’t tend to help that process). But with Josh’s high-powered flashlight that could practically illuminate Saturn, we got through okay. We rested up the remainder of the day and Saturday, packaging medications on Sunday while half the group taught CPR at the airport.

Monday we had our last village clinic, travelling some four hours to Awastigni, on the way to Tronquera. We left early, around 5 a.m., and were tossed around on the bus before arriving at the remote town. The language skills of the villagers were a lot more heterogeneous than in some of our past clinics. The town was mainly Mayagna (which apparently shares roots with Miskito), but many also spoke Miskito, Spanish, and even English. After a little bit of concern about whether we’d be able to communicate through our Miskito/Spanish translators, everything worked out fine. We did a house visit for a 20-year old boy who had been suffering from a fever and dehydration. Ericka and I gave him an IV and after a hefty dose of acetaminophen, he looked a lot better. Word had it that he was even walking around by the time we left that afternoon.

We got back late from the clinic and slept in the next day. I traveled with Ericka, Dillon, Zach [Leyda], and Aaron that afternoon to the airport to teach first aid, and everyone else taught CPR once again at the orphanage. Wednesday was our last clinic day. This clinic was specifically for the staff at Verbo, their families, and the children at the orphanage. It was fun to chat a little more with some of the familiar faces, but a little disturbing also to treat the ladies who do our laundry for joint pain related to their work. It made me realize that we are not exempt from contributing to this cycle of degenerating health. (I'm not negating that they need jobs and should be working, the whole situation just seemed rather ironic.)

Brenna, Ren [Kent], and I left Puerto Cabezas on Thursday—Brenna to go home and Ren and I to attend a meeting in Managua before the rest of the group arrived. While I was glad to think that I would get to see my family soon and then go home, it was sad to drive away from Verbo knowing that I may never go back. I had a wonderful time and met some amazing people, but another chapter is ending that has been very educational and fun. We have three more weeks left in country and then only a few more until graduation.

I don’t mind moving on to do new things, I just wish sometimes it didn’t have to include so many goodbyes.

 

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