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This was our 4^th day of clinic work, and the 4^th time this team has traveled out from our Fountain Blue Hotel to a new site to do a medical clinic. We’ve become quite efficient at doing the clinic set-up.

Within 15 minutes, all the big bags are brought in from the bus, the layout and available space is assessed and organized, all the medicines are unpacked and placed in their spots on a table, the intake area is established, and the process of registering and caring for the crowd is begun. Today, in the pastor’s home in San Francisco, here in the outskirts of Matagalpa, it went like clockwork.

Because of time constraints and the number of people that needed to be seen, Arlen and Clay again split apart into 2 separate stations to do the medical evaluations. Braulio has become very efficient in his interpreter duties in Arlen’s room.

By 3 PM, we had evaluated 99 people. We saw small children with respiratory infections, lots of people with back pain (no doubt it’s from all the bending and carrying and hard work that many of them do every day), and a little girl with craniosynostosis, who will most likely not ever see her head grow to a normal size or have the neurosurgery that she would have already had in the USA or Europe. Healthcare is quite connected to money down here, and most of the citizens don’t have much.

An average job here is hard work for about $3 - $8 per day. It means that some can afford electricity for a couple lights, but no television or any cars. It means a home may have a small radio, but will not enjoy any decent healthcare. As in many poor countries, a citizen may be able to be evaluated by a local doctor, but they then must pay cash for any tests the doctor orders or any medicines that are prescribed. Most have no money for that; they are just trying to live through the day and have enough food for their families to survive.

We said some rather painful good-byes, as we knew this was our last clinic day. The pastor and his family, who had opened their entire home (and the dirt street out front) to us, are very special people, and there were many hugs. Our interpreters, Braulio and Myra, hugged each of us. It is quite difficult to spend many hours during a week with such nice people, to share both joyous and sad moments with them, and then to leave them with the likelihood that these team members will never see them again.

At the same time, the reality of our circumstances was hitting us. This was it; our workdays were done. It was happiness, it was sadness, it was relief, and it was a feeling of emptiness about the uncompleted work. A group picture – including Braulio, Myra, and Francisco, our incredibly talented bus driver – was set up in the street in front of the bus.

Brenda Rose, the Missionary Ventures International “Field Coordinator” here in Nicaragua, took the photographs. She’s been such an inspiration to us, and had everything so organized before we arrived. Renea Harris, the MVI medical trip coordinator from Florida, is such an integral part of this team. This was the 2^nd year we’ve been blessed with her presence, and it’s hard to imagine how we’d do it without her. The dedication and sacrifice these 2 women put forth is nothing short of miraculous.

We headed back to the Re-Nutrition Center, the place where MVI takes in the most malnourished of the area’s children and brings them back up toward normal during a few months of time and love, and we re-visited the kids we had met just a few days before.

Angel immediately spotted Martin, and the 2 of them ran, giggled, rolled, hugged, and peek-a-booed until near exhaustion. A tiny girl who had only been at the Re-Nutrition Center for a couple weeks showed definite signs of improvement compared to just a few days ago. Whereas she had what seemed like a permanent, blank, vacant, faraway look in her eyes earlier this week when we visited, there was now a little spark, and a tiny smile crossed her lips several times. Many of the younger children clung to our team members, some falling asleep in our arms. The Nicaraguan women who work day and night with these kids are so dedicated and caring….

We left a big bag of clothing at the Re-Nutrition Center, as well as a bag of the donated stuffed animals. Maybe a new shirt and a small fuzzy bear can supplement the love of the workers here and bring more smiles to some little faces.

It was, obviously, quite difficult to leave….joy, sadness, hope, and hopelessness, all wrapped up into one. We hope our brief times there brought a little happiness to some of the kids.

On Friday, we’ll try to relax and wind down. It’s to be our official “tourist day,” and a visit to an active volcano, shopping in the Masaya Market, and a trip to a Christian-family-run coffee wholesaler business is planned. They say that the coffee grown in the mountains in Nicaragua is the best in Central America.

Anna enjoys one of the small girls at the Re-nutrition Center.	Some Nicaraguan friends join the team at the end of the day.	Mackenzie and Brenda take one of the supply bags to the bus.
Lance talks with the pastor and the pastor's son.	One elderly patient said it was the best day of her life when Noel presented her with one of the donated canes.	Pam and one Re-Nutrition Center child take a comforting rest.