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Reflections from Nicaragua: “learning about strength”

An excerpt from Ashley Balsam’s blog

Thursday, 15 April, 2010

“Sweat drips down the mothers face she fans her young child who is cuddled up on her lap, sweating as well, but clinging to the security of a familiar warm place to rest his head. The mother and child are crammed into a small room with one crib and 3 beds, all occupied by similar scenes. Our group of twelve enters the room prompting some mothers to light up with anticipation of possible departure, while others show fear and distress at the continued illness of their child. Though one would expect the depicted scene to be accompanied by a montage of complaints about the unrelenting and suffocating heat, not a single negative comment is muttered, and the mothers simply continue to use papers to move the stagnant air around their diaphoretic young ones and graciously thank us as we explain the medical plan for the day. This is rounds on the infectious disease wards in La Mascota in Nicaragua.

“While I am learning much about the unique infectious diseases here, from dengue fever to fulminant Varicella to brucellosis, I am also learning much about the nature of the people. Through desperate poverty and in the most uncomfortable of environments, in the place where self pity could reside, there is an enduring resistance and gracious strength that emanates from within the nicaraguans. I especially find that the women display an amazing indestructibility in the face of repetitive devastation from the loss of children, to unfaithful husbands, to the hardship of immense poverty, they not only stoically endure this environment, but they often glow with gratitude and happiness.

“As I try to prepare mentally for the trip, I fear that I am going to be frustrated by lack of time and resources on this missions trip. While I am very excited about our hyperbilirubinemia project, I fear that we will not be able to accomplish all that we hope to do. The neonatal jaundice teaching idea came from some research that Dr. Slusher had done on Kenya and Nigeria. She realized that neonatal jaundice was very much under recognized and was a large cause of neonatal death and disability. After teaching community workers how to build a simple phototherapy box and test/recognize signs of jaundice they were able to start to make a difference in the newborn morbidity/mortality outcome. Similarly to the situation in kenya and nigeria, there is a lack of recognition of neonatal jaundice and no current therapy is used. Many of lost pipitos had reportedly normal births and then suddenly developed hearing loss, paralysis, or CP. These children easily could have these disabilities due to sequela from kernicterus. With some simple education and implementation, we might be able to start to change these outcomes as well.

“My hopes for this missions trip fill me with excitement, but my heart is also heavy as I anticipate the burden of suffering that these children endure daily.”

Read more about Ashley Balsam.

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