Mission to Somotillo

The mobile medical strike team (MMST) led by CAPT Jeff Cole assembled at 7am on July 9th in the casualty receiving area onboard USNS COMFORT  Our mission- get to the remote rural town of Somotillo in northwestern Nicaragua ASAP to relieve fellow humanitarians and wreak as much positive goodness on this town over a five day period as humanly possible.  This was it.  What we had trained so hard for. 

Donning our high speed sunglasses, stethoscopes, and lifejackets we ran up the stairs to the main deck to get on the uber fast RHIB (rigid hull inflatable boat) and get quickly to shore.   “Go ahead and take a seat!”, shouted Gunnery Sergeant Roberts. “It’s going to be awhile!”  Sure enough, the strike team was foiled once more on achieving an expeditious delivery to target.  We took a seat, and some of us even laid down for a snooze on bed of lifejackets.  

After finishing three books over the past few days, I was glad I snagged a few more before leaving on the mission this morning.  I whipped out my IPod and a murder mystery by Dean Koontz and tried to stay focused on the five-day mission that awaited us.  My teammate, Dr. Mike Barretti, cursed the situation and then cursed that I was reading books.  Barretti means well, trust me. He finally has made a valiant effort to quit smoking and for that I am proud of him.  

 A few hours later we descend onto the RHIB held by a single tether line to the ship crane above.  Sure hope it doesn’t snap, I thought, while preparing to do a inverted dive and duck if it for some reason it did.   We touched down safely and were on our way.   Instantly the feeling of Navy pride returns as we are skimming the water toward shore.  Barretti is making the best “Washington Crossing the Delaware” stance he could and I snap a photo.  

This is what it must have felt like back in the day (well sort of).  Just at that moment, CAPT Sheehan leans over and informs me that the Carinto harbor that we are about to enter was mined by the United States just under three decades ago during our “clandestine” operations working against the Sandinistas.  Sure hope they are cleared now.  Wow, what a difference a few decades

 and the fall of the Soviet empire makes.  I see that Sheehan has quite a bit of knowledge on Latin American history and a penchant for political science, so I make a mental note to pick his brain over the next few days about the “true” state of affairs here in Nicaragua. 

By the time we reach shore it is 10am and we board the bus for the bumpy ride through Chinandega northward to Somotillo (about 3 miles from the Honduras border).  Wow, this is the Short Bus!  I sandwich my legs into the small seat space by the window (why did I have to pick the seat with the wheel well???) and knees jab into the back of my teammate in the seat in front of me.  Next to me sits a lady volunteer and I thank her for being a member of the team and helping on the mission.  I tell her that she should join the Navy (always recruiting J) and she tells me she doesn’t want to shoot guns and be sent to the front lines in a war zone. Really??? I begin to form an answer, but then decide it is not even worth it. Back to the book.  We pass by Chinandega, and see the sign- 60km to Somotillo.  My legs have lost feeling by this point, but I ignore it and press on.  

Off to the right hand side we catch a glimpse of an enormous volcano (it must be 10,000 feet) with steam spewing from the top.   I come to find out the name of the giant is San Cristobel and it is one of seven volcanoes that are semi-active in the country.  

By the time we reach Somotillo the Dean Koontz book is almost history, and it is just past noon.   We carefully approach the target site making sure to hit every pothole along the way, and once secure, we charge the building (Centro de Salud – Raymundo Garcia) and announce the cavalry is here!  Our fellow humanitarians, weathered and spent from their numerous days here, are overjoyed to see us.  Ready to go, the first thing we do- lunch!  Luckily the Centro de Salud (in addition to a large amount of flies) has a set of rocking chairs that instantly remind me of Cracker Barrel.  Dr. Schwartzman (heart sweat man), Dr. Arthur (fellow Duke grad), and I man the rocking chairs and ingest our MREs.  The relieved troops leave for the trek back to the ship and the new MMST sets up shop.  The area where we are seeing adult patients is full of flies, BUT it is air conditioned (when the electricity is working).  I look at the bright side.   Barretti doesn’t.

It always takes a few patients to get back in the swing of things after being back onboard the ship for a while.   The Spanish isn’t quite flowing right.   You are caught off guard by a different regional style of the medical Macarena “dolor” dance.  But eventually things get going, and you’re back in a routine again.  This town is interesting.  For one, it is definitely “el campo” (the country) and all these people are farmers, or do something related to agriculture.  Somotillo is an impoverished town with little to no infrastructure and this tells me that 1) there will be less chronic health problems due to obesity 2) there will be more rashes, allergies, GI issues, skin infections, parasites due to lack of hygiene and 3) there will be A LOT of children because there is not much else to do around here besides create them.  

 

As the afternoon progresses I am working without a translator, which I am able to do, but boy does it get tiring.  A female patient asks me if I am from Cuba, I say no, she asks me if I am from Mexico, I say no, and finally she says United States?  Yes.  Peculiar.  Later I come to find out from CAPT Sheehan that Cuba (and to some degree Mexico) have had a large impact on the medical care and medical training of the people in Nicaragua.  This woman had never seen a doctor from the United States helping (especially one that could try to speak Spanish).   

 By the end of the day I was desperately in need of a coffee, and so I ventured out into the dirt road looking for some instant café.  There were lots of roosters running about, and guys on their “Tricicletas” – that’s what they called them here for the bikes to transport people around.  I found a food stand and it was super filthy.  I surveyed the scene where the coffee was prepared and that was not as bad, so after some discussion my gut and I agreed to give it a go.   

What’s the worst that could happen?  The senora preparing the coffee invited me into her “shack” and I saw on a hammock her small baby that had recently been born eight weeks premature.  The woman begged me for some vitamin drops for the babe and to give her some extra money.  I gave her some help and returned with the drops in time to pick up my coffee.  It wasn’t that bad (and as I’m writing this no issues to speak of). 

 

We packed up shop around 4pm and boarded the buses for the long haul back to Chinandega where we would be spending the night at the Volcanoes Hotel.  Thank goodness for Dean Koontz and his easy to read murder mysteries.  Just as the killer was about to strike, BOOM! , a tire blew out on the right back wheel of the bus, and we ground to a halt.  I have never seen a tire changed so fast by the driver of a bus.  He found a rock on the side of the road, and backed up onto it (using it as a jack), and changed that tire like a NASCAR pit crewman.  Most of us used the extra time to visit the bushes on the side of the road to take care of some business. 

 We were slowed by a banana carrying truck the rest of the way, so by the time we reached the hotel the Koontz book was complete (they got married).  I gave the book to Barretti and he scoffed at first, but ended up taking it.  We’ll see if he reads it.  The Volcanoes hotel turned out to be extremely nice.  A quiet place, with view of the volcano in the backyard, and a nice bar and restaurant.  The MMST settled in for our first night ashore and did what a joint medical team does after a hard days work.   Until tomorrow…..