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Hadley Family Dentistry

                                                                                                                                                                                                           

Dental Mission In Nicarauga

Date: 4/28/2006

To: Our Patients

From: Steven L. Hadley, DDS

Subject: Our Mission Trip to Francia Sirpi, Nicaragua

 

I am writing this because I wanted to thank you, our patients, for supporting us and making it possible for my daughter Emily and I to go with a group of missionaries to provide health care to the Miskito Indians in Nicaragua. I especially wanted to thank my wife and partner Shari, for staying behind and making it all possible. I also wanted to thank my staff for carrying the extra burden while we were gone. Last, but not least, I wanted to thank Elisabeth, a nursing student, who helped me extract the teeth. We extracted almost 250 diseased teeth while there.

During the first part of March 2006 my daughter who is a pre-med student, and I went with a group of people on a mission trip to Nicaragua for 12 days. We went with Jeff Joiner, who is an E.R. nurse and the head of the nursing program at Union College and his daughter, also a pre-med student. Also traveling with us were twenty-two nursing students from Union College, two registered nurses from the Lincoln area and Rilla, a pre-med student at Union College. Rilla had served as a missionary in the area we were going to the previous year and is fluent in Miskito and Spanish. We met up with Craig an ER nurse from Kentucky and "Doc", a medical doctor from Georgia. Also helping us were Bob, a building contractor and his wife Ingrid.

My involvement in the mission trip started about six months ago when Jeff, who is one of my patients, asked if I would join him on a mission to care for the Miskito Indians. They live in the jungles of northeastern Nicaragua in an area called the Autonomous Zone. They are a fiercely independent group of indigenous people who no one else seems to care about. He has been going there for the last ten years and knew there was a huge need for dental care in the area.

The mission was founded in the 1970ís but at one point, political turmoil had made it impossible for Missionaries to work in the area. The Sandinistas were in control of the country during that time, and being Communists, did not like any type of religion. During the 1980ís, the Miskito Indians were subjected to genocide at the hands of the Sandanistas. The Miskito Indians reside in an area that was of strategic importance to the Nicaraguan Communist Armies. When they got in the way and refused to bend to the Communists, well, you can fill in the blanks. Many of the men fled to Honduras and joined the Contras, who were supported by the United States. That is a can of worms that I am not prepared to open for the purpose of this story. I would like to say that Uncle Sam makes mistakes at times, too.

Miskito.com, an internet website said the Miskito people "survived the genocide and continue to survive against terrible odds created by the unbridled corruption of the Nicaraguan Government and many of the local Sandinista despots who have been allowed to remain in power in Puerto Cabezas long after some democracy has been allowed on the Pacific Coast of Nicaragua."

In January I began attending class on Wednesday evenings at Union College with twenty-four third year nursing students. They had all signed up for the elective class that would prepare them for this mission trip. Since I was the first dentist to go with Jeff and his group, I was pretty much on my own as I conceptualized how and what we would need to extract teeth in an isolated area without electricity.

On March 9th we made our way to Managua after receiving numerous shots and pills for prophylaxis against most diseases in the area. We arrived late in Managua and stayed overnight at a Best Western located across the street from the airport. The next morning we moved all of our supplies and gear across the street to the airport and took the 90-minute flight to Puerto Cabezas, a city on the other side of the country in the Autonomous Zone.

We loaded all of our supplies on the missionís retired army truck referred to as "The Duce". We, thirty Americans in the back of the Duce, were quite an unusual site in Puerto Cabezas and drew a great deal of attention from the locals. With Bob driving the Duce we made the trip to Francia Sirpi in about seven hours.

The road was very rough and we were soon covered with, and choking on, the fine dust that pervaded the area. We had to go very slowly and circumnavigate potholes the entire way. It was a bone-jarring ride and, on top of that, we had to watch out for overhanging branches that would whip us in the face if we were not paying attention. During this trip I happened to sit next to Elisabeth, a nursing student at Union College, and part time LPN. We had the opportunity to talk and get to know each other during the long ride. We seemed to get along well so I asked her if she would like to help with the dental patients and she agreed to give it a try.

 

 

 

 

When we finally made it to the jungle and were approaching the mission we encountered a large tree, which had fallen across the road and completely blocked our way. It was very dark at this point but we were able to clear most of the tree out of the road and then drive over what we could not move. We finally reached the mission complex, it was on the outskirts of the village of Francia Sirpi. It consisted of a kitchen/dining building, dorms for visiting and current missionaries, living quarters for the missionary couple who lived there full time with their two children, the Pastorís house, some outhouses, and some cold water showers. I was surprised to see light bulbs lit up on the porch of the main building when we drove up because the electrical lines had stopped some 50 miles from the village. I found that they had solar panels and could charge batteries for limited lighting.

There was a non-functioning Satellite phone in the village but no one could get it to work so we were almost completely isolated from the outside world. They did have some kind of short-wave radio or something. I didnít check it out so I donít know for sure. In case of emergency we could have radioed the States, not that they could have done anything anyway. The nearest hospital was at least four hours away on a good day.

We began unloading all of our supplies and personal items onto the porch at this point. When we finished unloading they had food ready for us. The food there consisted of beans and rice, peanut butter and jelly sandwiches, small bananas and fresh mangos that were grown on the plantations in the area. We also ate casaba, a type of root that grew in the area which tasted kind of like potatoes, and whatever food we had brought with us. Fortunately for me, I love peanut butter and jelly sandwiches. The water had to be filtered before we could drink it because it was contaminated with parasites. I didnít have any problems from the water and as far as I know no one else did either.

After we finished eating it was apparent that Jeff, Craig and I were going to have to sleep a half-mile away in the Biblioteca next to the medical clinic in the village. I wasnít pleased with the idea of sleeping so far away from my daughter, and the mission complex, which was the closest thing I would have to home while down there, but we had no choice. Then Clint, the missionary who lived there, told us that we needed to be sure to finish taking all of our malaria pills when we got home because one of the last people who stayed in the village ended up getting malaria. I was even less pleased about staying in the village at that point.

When we were ready for bed we climbed in the Duce and drove our personal belongings to the Biblioteca. We entered through a series of locked doors with our flashlights and gear. Then we preceded to a dark, dusty, cobwebby room with three termite-riddled cots that were to be our beds. Jeff didnít want to take the top bunk because he is a big man and didnít want to break the bed and smash the guy below. I really appreciated Craig for taking the top bunk, because it was close to the rafters and a plethora of spider webs. At this point my anxiety level was extremely high. To make matters worse Craig then asked Clint "what do we do about these?" I looked at the spot where he was shining his light and there was the largest spider I have ever seen. It was not over three feet from where I had previously been standing and right by my cot. Clint immediately grabbed something and smashed the spider. I am told I jumped six feet. Clint acted like it was no big deal. Fortunately, I had extra mosquito nets for Emily and I, because it turned out that all of the others were in use up at the mission.

We finished getting the nets up and it was time to take a shower. The shower was located in the bathroom adjacent to our sleeping area. Clint took us over and showed us what appeared to me at that time to be the dankest, most forbidding bathroom I had ever seen. Remember this is just after seeing the spider. The showers were cold but you could get used to them after the initial shock. It turned out that the flush toilet in this bathroom was the only one I saw the whole time in the jungle. The rest were very vile outhouses. After showering I shook out my mattress and tucked my net in. We unscrewed a wooden window and let the breeze flow through. It cooled off very nicely at night and after getting used to the constantly crowing roosters, that ran freely with the pigs around the village, I slept very well.

The next morning we went up for breakfast and I took some playful ribbing from the girls about my initial response to seeing the spider the night before, word travels fast in the jungle. That afternoon we went for a hike into the jungle. We hiked an hour and a half to the Rio Waa Waa. Most of the hikers swam in the river. I took pictures and climbed on some volcanic rocks. When we returned from the hike we had dinner and played cards.

 

 

 

 

 

Each night I became more comfortable with our sleeping quarters and never saw another spider. My daughter told me that around the mission complex at night when she would go out to shower or use the outhouse she would see hundreds of shining little eyes in the grass. She said she checked and found out they were spiders. One of the other girls was startled one night when she went to use the outhouse and was greeted by a very large tarantula that was hiding just under the opening in the floor. Some of the other nurses informed me that they had a snake join them in the shower one evening. So it turned out that I had completely under-rated my bathroom facilities.

 

The next morning we went to the main clinic in the village of Francia Sirpi and unpacked all of our medicines and supplies that we had transported with us. Clintís wife Marilyn asked if we would go through the dental supplies that the clinic had, and inventory them. So Emily, Elisabeth, and I went to the dental clinic. It turned out that the room I was sleeping in was the dental clinic in Francia Sirpi. I had noticed an old dental chair in our room the first night but, I was more worried about spiders and the chair really didnít register in my mind. The dental chair was not portable so we only got to use it that afternoon.

We went through some boxes that looked like they hadnít been touched in years, and I was very pleased to find that as far as surgical instruments were concerned, they had almost everything we would need. We sorted and inventoried everything. I supplemented their instruments with mine so that we had everything I could think of that we would need to perform oral surgery in the isolated villages where we would be going. We swept, cleaned up the cobwebs, freshened up the room, and set up to see patients in the afternoon.

The Miskito people were all very friendly and really seemed to enjoy it when we greeted them in their language by saying "Noksa." One lady tried to pay me with the local currency. I told her that I didnít want to be paid and gave it back. Jeff told me that we needed to let them pay us since it was an insult to not accept the payment. I asked Jeff how much the lady had just paid me for the three surgical extractions. He said 30 cents. They also paid us with casaba roots.

My main concern while preparing to go on the trip was how I was going to sterilize my instruments between uses. I decided that my only option was to use a "Montana Autoclave." The "Montana Autoclave" is a euphemism for bleach and water to soak and scrub the instruments in, and then a water bath to rinse them off. I checked with Jeff two and a half weeks after we returned and he said he hadnít heard of anyone with any infections due to dental treatment.

Jeff informed me of one of the goals of the mission. He said it was for the people of the area to become more self-sufficient in their health care. He said that they now have an indigenous Miskito nurse, from Francia Sirpi, who will be coming to Union College to the Nursing program to become an RN, and then she will return to the village. He also told me that they presently have an indigenous lady in medical school in the States that will be going back to Francia Sirpi to work in the clinic when she graduates.

I will never be able to thank Elisabeth and Emily enough for all of their help. Both of them were very dedicated and hard workers. Elisabeth was not bothered, in the least, by the blood or any of the maladies we encountered. Many of the surgeries were as difficult as any I had previously preformed in my 22 years as a dentist in the States.

We were able to see about four patients an hour and extract everything that came our way that couldnít be saved without doing a root canal. If it just needed a filling I pretty much refused to extract the tooth. Rilla came in very handy at these times by explaining to the patient why the tooth shouldnít be extracted. Performing a root canal would have been next to impossible under the primitive conditions we encountered there. I had an abundance of local anesthetic and made sure everyone was profoundly numb before beginning the extractions.

I learned a few phrases in Miskito so that we could find the problems and instruct the patients in order for them to cooperate. The patients had so many cavities it was hard to tell which ones were causing their immediate problem. We saw both adults and children the first day and it went well. From that day on, in every village, we had a waiting line too long to complete in the time we had available to us. We had a little bit of trouble the first day because the villagers were going out of turn and causing those whose turn it was to become upset. At that point I made Emily in charge of crowd control. She would verify that the patient was indeed next on the list. She handled this task very diplomatically.

When we finished up that afternoon we packed and got everything ready for the next day. We then headed up the hill for dinner and socializing. I was a little shell-shocked, but enjoyed the enthusiasm of the young people. That night we met a group of six high school kids from Montana. They had been staying at the mission and were doing some construction work. They were leaving the next morning. I walked back to the village with one of the kids that had played cards with us and he told me that they had taken the bus from Managua to Francia Sirpi so that they could see the country. He said it took 36 hours because their bus got stalled in a river while they were driving through and they had to wait to be towed out. I thought at that point that I was sure happy that we had flown over because the flight took 90 minutes to Puerto Cabazas and that our seven-hour ride in the Duce wasnít so bad.

We were up at 6:00 the next morning. After breakfast all 30 of us then hopped in the Duce and headed down to the clinic to pick up the necessary supplies. We were headed to a neighboring village by the name of Esperanza.

The Doc and nurses treated everything that they encountered with amazing grace, coordination and compassion. Unfortunately, I was so busy that I didnít get to see much of what they did. We usually set up in the villageís schoolhouse. One of the things I did notice that day was the nursing staff as they interacted with the children. I was deeply moved by the selflessness of the nurses and nursing students when treating the children infected with Scabies. They would pick up these beautiful, sweet, innocent little children whose bellies were swollen from malnourishment, worms or both, hug them and carry them to an area outside the building to bathe them in a treatment that killed the Scabies.

 

 

 

 

 

One of the other big problems facing the indigenous people is worm infestation. For these people they supplied medication to kill the worms. The medical staff also tried to educate the people so that they could avoid future infestations. The biggest hazards to their health, that they could change, were letting their pigs sleep under their houses (scabies), drinking the water without filtering it (worms), and having so many children (malnutrition). Unfortunately, in this case, they are fiercely independent and very resistant to changing their ways.

At Esperanza we were all in the same room and had a view of a cow pasture through the chain link fence that served as a window for our clinic. There usually existed a wail of crying babies surrounding us. We no longer had the use of the dental chair, so we had the patients sit in a plastic patio chair. We mainly cared for women and children at all of the clinics. The adult males had to work in the plantations surrounding the area during the day.

After lunch that day we were seeing mainly children in Esperanza. About half way through the afternoon a two-year-old child, who needed his four upper front baby teeth extracted because of severe decay, started to cry. The villagers surrounded us. They were waiting in line and watching us. When the little boy started crying hysterically it frightened the children who were next in line and watching the whole thing. We somehow managed with mamaís help to get the teeth out. The next child was understandably scared. This child was an easy situation, which if he had not just witnessed the other child crying helplessly, would have been no problem. Needless to say, he started crying the moment he sat in the chair. It was the beginning of a chain reaction. The next few children started crying the moment they sat in the chair. At that point, I told Elisabeth that we must get through our next patient without any crying or it would never stop. We were blessed with a very brave seven-year-old boy and things went very well. From that point on, I donít remember any of our dental patients crying.

 

 

 

 

 

Everyday we had to stop with people still waiting in line. We really wanted to get back to the mission before dark because the Duce broke down regularly and the headlights would go out for extended periods of time. We never did get back before dark, which happens quite suddenly around 6:00 pm. We were treated to a full moon one of the nights. On the others, before the moon came up, we were able to see the Milky Way.

The next day we went to Miguel Bikan. It was located about 45 minutes from the mission. On the way to Miguel Bikan I had the opportunity to meet another extraordinary person. His name is Jonathan. He was on the jungle hike with us the day we went to the River. He looked like he was one of the Miskito people, so I thought he was from there. He was busy looking for monkeys while we were hiking. When I finally had a chance to talk to him I was surprised at how fluently he spoke English. Much more refined than I. I found out that he was taking a break from his studies. He had finished the pre-requisites for, and had already been admitted to school in the States, to become a Physical Therapist. He was taking a year off to be a missionary at Francia Sirpi. He really enjoyed having people guess his ancestry, because he was half African American and half Japanese and looked like a Miskito Indian.

I had a little more space at the Miguel Bikan clinic. I was able to put up a barrier around my area to screen off the view, so that the patients waiting in line couldnít see the one getting treated. I also put up a sheet in the window so the children couldnít look in and harass their buddies while they were in the chair. That day went very well. The mobile clinic was able to see over 200 patients. Jeff told everyone that it was a new record number of patients seen in a day.

That night when it was time for bed I walked to our bunkhouse in the village with a missionary named Lucian. He is a nurse from Romania. He was learning English, Spanish and Miskito all at the same time. He was a very fast learner. I was still concerned about walking the half-mile from the mission to our bunkhouse by myself, so I had asked Lucian to wait and walk back with me. Lucian told me during the walk that he really wanted to find a way to get certified as a nurse in the States. I suggested that he ask Jeff for guidance. He eventually did ask, and Jeff informed him how it would be possible.

The next morning we headed for Tasba Pain, which means "good earth" in Miskito. Jeff said he thought it was the most scenic of all the villages in the area and when we arrived, I immediately agreed. There were lush green pastures and volcanic boulders strewn randomly throughout. When we arrived at the village school, we had to get permission to set up. The schools were always locked when we arrived. As we were hauling in our supplies and equipment it started to downpour. This happened almost everyday but only lasted a few minutes and then the relentless sun was back.

This day was pretty uneventful for us in the dental clinic and my daughter Emily was able to go check out what the others were doing. She relayed a story to me that I would like to share. She said she was hanging around Doc when a mother carried in a baby who was limp and unresponsive in her arms. Doc wasnít even sure that the child was still alive. Doc, bless his heart, is 74 years old and he has Parkinsonís disease. The disease makes his fingers shake too much to start an IV. So he had Kerry, a nurse from Childrenís Hospital in Omaha, attempt to start one. Emily said that it was almost impossible to find a vein, because the child was so small and very badly dehydrated. Kerry was miraculously able to find a vein and get the IV started. Doc told Kerry a little later that she had saved the babyís life. Emily had been trying to decide if she really wanted to go through all of the sacrifices that it takes to become a doctor. She said when she saw Kerry save that childís life she was sure that being a Physician was absolutely what she wanted to do with her life.

Emily had another surprise waiting for her that day. It was her birthday. She had finally turned 21. A couple of the nursing students always stayed behind to help at the clinic by the mission. That day they had taken the time to make sure Emily had a birthday cake and we had a party for her that evening. After the party I headed back to the menís bunkhouse and by this time I felt no concern whatsoever walking the half-mile alone in the dark.

The next morning we got up and headed out for the last day of clinic. It was in the village of Wisconsin. Every dental patient that day was an adult female and this was totally different than any of the other villages. I think they must have had a meeting and decided that the mothers were to go that day. It was the most challenging day for us by far. Each patient had numerous broken down fragile teeth that they wanted extracted. We spent an hour that day removing a fractured root tip with a hand bone chisel. It was a blessing that it happened on the last day because we had acquired a great deal of experience by that time.

We finally finished up the last patient and were headed back to the mission for our last night in the jungle before traveling back to Managua for shopping, sightseeing, eating at Pizza Hut, and going to the ocean. The vacation part was just around the corner and everyone was jubilant on the truck ride back until a very bad sound came from one of the back axels. Something had come loose, the back two axels where not lined up properly, and we could not proceed. Bob told us that he needed a chain and a come-along to get the axels lined up so that he could hook up the support that came loose. We decided at that time that anyone who was not able to help fix the truck should start walking back to the mission and try to make it before dark. We were well over two hours away from the mission by foot.

Bob was going to try to use the jack to push the axel back into position, but the situation looked hopeless to me. I was planning on getting everyone back to the mission, and then going back in the missionís pickup, with Clint, to take the chain to them. We walked along and the group kind of got separated. Emily and I stayed back with the interpreters and made sure there were no stragglers. It was not a bad walk except that we had to go through a village that our mobile medical clinic bypassed daily because of the drug trafficking that took place there. We got through there fine and were actually enjoying the billions of stars that were sparkling in the sky as we walked along when we came upon one of the student nurses, who had become dehydrated, and wasnít going anywhere anytime soon. We were trying to re-hydrate her when low and behold we saw a light coming. Bob had been able, I have no idea how, to line up the huge axels with a jack, get the ball back in the socket, and get going again. We jumped on and made our way back to the mission.

It turned out that it was a blessing that the Duce broke down that night instead of the next day when we had to make our flight in Puerto Cabezas. Clint had time to weld a piece on to hold the axel and we didnít have the problem the next day on the way to the airport. We ate dinner and everyone spent the evening packing.

The next morning we managed to get 30 people up at 4:00. We were loaded and on our way by 5:00. We made record time to Puerto Cabezas. It only took us about five hours. When we drove up to the airport, I noticed that big piles of dirt had been dumped in front of each gate into the airport. We asked the guard at the gate to let us in because we had a flight to catch. He waved us off and told us that the airport was closed. As we drove away I noticed that men in camouflaged outfits, holding machine guns, had surrounded the airport. We drove for a distance and then stopped so that we could decide what to do next.

Nicaragua is preparing to have elections now, and the Miskito peopleís party was not happy with the way things were going. The only way that they can protest is to shut down transportation. Initially, we had some hope that the strike would be over by the next day and we could just stay overnight somewhere in town and fly out the next day. I secretly doubted that very much. If we missed the flight the next day it would mean that we would be stuck there at least until the following Monday and that we would not make our flight out of Managua to the States.

We decided to go to the Adventist School in town and parked in the relative isolation of the fenced schoolyard. During this time I was informed that the reason the military was surrounding the airport was that, on the day before, there had been a riot in the town of Puerto Cabezas and a police officer had been shot and killed. While in the schoolyard, a local who wanted an opinion on what he should do about his leg, approached Doc. He had just left the hospital because they wanted to amputate his leg below the knee. Doc told him to go back and let them do it because if he didnít the Gangrene would spread further and he would lose his leg above the knee. The man wanted $20 for food so he could go to the hospital. In Nicaragua they donít feed you when you go to jail or to the hospital, your family is responsible for bringing your food. Doc felt that, after talking to the man, it would be a bad idea to give him the money. He said it would just prolong the time he spent before going to the hospital and just make his condition worse.

There was supposed to be a press conference on the radio at noon and we would find out then if we would be allowed to leave by plane that day. We waited until 1:00 pm and we still hadnít heard anything. At this point, the pastor from Francia Sirpi showed up and he, Jeff, and Rilla began trying to find a way out of there for us. We waited another hour or so and finally we heard from them. They had found a way to get out of the area affected by the transportation strike and we were to drive an hour to meet them at a place called Bum. Bum was located on the Rio Waa Waa.

There was a ferry for crossing the river. Unfortunately, the ferry was on our side of the river, so it was shut down because of the strike. Somehow Jeff and Rilla were able to talk some locals into taking us across the river in their dugouts. The dugouts were actual trees that the people had carved into canoes. We said goodbye to the Duce and packed our belongings onto the dug out canoes and all 30 of us were transported across the river. While crossing the river someone pointed out the rickety wooden tower that Rilla had to climb to get a signal for her cell phone, so that she could call us at the school. Some of us joked that she had climbed up so high so that she could call God.

On the other side of the river we were outside of the Autonomous Zone and trucks and buses were lined up and formed a long double line as far as you could see down the narrow road. Again, we were blessed to find a bus that had room for all of us and would leave immediately for Managua. Remember this is the trip the young man from Montana had informed me of had taken them 30 hours. Jeff said it would be at least a 20-hour bus ride if everything went well. It was only 280 miles, but the roads were bad and progress was slow. I had been up since 4:00 am and planned to sleep on the bus ride.

It was impossible to find a position I could sleep in. So I didnít sleep. During the night, the bus driver had to play the music painfully loud in order to stay awake. Most of the songs they played were in Spanish. They did play a mix CD of classic rock tunes a couple of times and all of us enjoyed singing along.

On the bus ride, I was again very impressed with our group of young ladies. I didnít hear one complaint about our situation. The bus ride was an opportunity for me to get to meet and talk to some of the other nursing students I hadnít met yet, which I am very thankful for. I also got to see a Cloud Forest at dawn. I donít think many of us slept much that night or the following day.

We did make it to Managua in a little less than twenty hours. Doc had to be feeling pretty rough but he had his game face on. He decided to be dropped off at the airport, and try to get out as soon as possible. It turned out that we had made the right choice when we took the bus from Puerto Cabezas, because the strike was still on when we arrived in Managua and we would have been stuck there.

I did some research on the Internet and found out that the strike was called because the Yatama political party, which represents the Miskito Indians, had lost a seat on the Supreme Council. The situation was eventually cleared up in the Miskitoís favor. Brooklyn Rivera, president of Yatama, said that the battle was over something much bigger than seats on the council, he said, "Itís a struggle for survival. With the constant immigration to the Atlantic coast by the Mestizo population we are not going to survive as a political force. The struggle is for the defense of our identity and our rights as an indigenous people." Mestizos are a people who are a mixture of Indian and Spanish or Portuguese. Even though the bus ride was long and grueling, I am happy that the Miskitoís were able to regain their seats on the council.

We went to Marleneís house in Managua. It was a beautiful house and she had a wonderful lunch all ready for us when we arrived. She served the most delicious juice I have ever tasted. Her brother is an Orthopedic Surgeon in Texas and is one the largest benefactors of the mission. Jeff said Marlene insists that his group stay at her house each time they get back from the jungle. She fed us, lined up bus transportation and safe places for us to shop and swim.

We didnít get to go to the church like we had planned because we were traveling in the bus. I had really looked forward to going to the church because it was located on an island out in Lake Nicaragua. Lake Nicaragua is the eighth largest body of fresh water in the world. I love water and really wanted to experience the lake. Jeff and others told me that there were fresh water sharks in the lake, but I thought they were pulling my leg because they enjoyed doing that quite frequently.

I did check and Lake Nicaragua is the only fresh water lake, in the world, to have both Tuna and Sharks. At one time it was part of the Pacific Ocean, but volcanic activity divided it off and it became a fresh water lake. The Tuna and Sharks adapted to the fresh water and remain there today. We went to a Pizza Hut that night and things felt pretty normal again. I was pretty tired at this point and went to sleep easily. I awoke a 3:00 am after getting five hours of sleep. I had so many ideas running through my head that I decided to start writing this story. I wrote until everyone got up.

We had a wonderful breakfast at Marleneís and then the girls got to go shopping. We went to the market that the locals go to and all of the girls seemed to be in "seventh heaven" as they shopped and shopped. Emily and I got beautiful handmade rocking chairs at this market. Then we went to a more upscale mall and hung out there for a while. I was able to find something special for my wife and son at the second mall. When we were finally done shopping we took off for the beach. It was a black sand beach because of all of the volcanic activity in the area. The girls played in the water and on the beach for hours. The waves were swelling to about six feet and were very exciting to play in. I hadnít slept much so I just sat in the shade and contemplated my interactions with the people of Managua.

While on the beach I was feeling uneasy about the way that the people of Managua interacted with me. They seemed very unfriendly and wouldnít even respond when I greeted them in Spanish. They just shook their heads "No." I now think I know the reason for their behavior toward me. We were Americans and stuck out like sore thumbs. I did more research on the Internet and found out that the Communists are making a comeback. I think that the people there were afraid to be seen talking to me because they couldnít trust anyone and didnít want to be seen talking to an American. In my research I read of thousands of Nicaraguans who have recently disappeared or have been murdered. It is a very tough situation down there. Nicaragua is the second poorest nation in the hemisphere.

We watched the sun set into the Pacific Ocean and then headed back to Marleneís to get some sleep and get ready to leave for home the next morning at 4:00. I wasnít able to sleep that night either. So I wrote more and packed. I have never gone three days with five hours of sleep. If anyone had told me that I would feel basically fine after that amount of sleep I wouldnít have believed them. I discovered when I got home that the anti-malaria pill that I was taking causes insomnia. I had just taken my weekly pill the day that we arrived at Managua on the bus.

At 4:00 the next morning, after not sleeping all night, I started kicking Jeffís bed and telling him it was time to get up. He was less than pleased with me and showed me that his clock said 3:59. Jeff is pretty easy going and was soon his usual happy go lucky self. We took our de-worming medicine before we left for the airport. Jeff had informed us before we left for the trip that we would get worms and must take it. Then we checked to be sure everyone had their passport. We made our way to the airport and took off without incident.

The UNMC mission students had been held up a day getting out of Managua and we all ended up on the same airplane. As we made our approach to Houston we were informed by the captain that we would have to circle the airport for a while due to a storm. Then, he came on and said we had been diverted to New Orleans. At this point I didnít care. We were in the USA. Then he came back on and said we had been cleared to land but it would be bumpy. We all cheered.

When we got to Houston we had to go through customs and immigration. Unfortunately, one of the students who was from Canada had forgotten to bring her visa. So she was detained in immigration for a couple of hours. We were very lucky because they held our plane for us until she cleared things up. She felt bad but it wasnít her fault and we all knew it. We were just relieved and happy she was back with us. We finally boarded the plane to Omaha.

We arrived in Omaha to find out that a snowstorm was pounding the area and that the Interstate was closed at Lincoln. We really wanted to get home so we piled in the vans and headed for Lincoln. It was a slippery ride and we barely made it back to Union College. We helped each other dig our cars out and then headed to our homes and loved ones.

I am very thankful for the opportunity to go on this trip. It turned out to be one of the most rewarding experiences of my life. I now know what they mean when they say, "it is better to give than to receive." I have lots of pictures and you are all welcome to stop in and look at them.

 

It is great to be home.

 

 

Steven L. Hadley, DDS

                                                                                                                

 

                                                                                                                  

 

 

 

 

 

 

 

 

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