A letter from Carlos Cardenas Martinez in Nicaragua
August 15 2011
Nicaraguan Medical Volunteer Brigades—an unspeakable legacy of solidarity, hope and healing
Assuredly, I say to you, inasmuch as you did it to one of the least of these my brethren,
you did it to me. Matthew 25:31-46
In the summer of 2007, when for the first time I was invited as a PDA disaster assistance officer to come to witness and share with doctors and health workers the realities of the peasant population, their challenges in searching for health and life in abundance in a journey through Nicaraguan mountains, I was really deeply impressed by the harsh circumstances that both health care workers and their patients (and patients’ families) are forced to deal with.
The aim of my trip was exactly to know and understand the work and experience of the Medical Volunteers Brigades (MVBs) supported by the government to bring health, life and hope to the most excluded communities of the country, and how it could be an opportunity for Presbyterians to come to Nicaragua in solidarity with people suffering in different disaster scenarios caused by hurricanes, flooding, mudslides, volcano eruptions and earthquakes. At that time I understood that I could become a member of such a brigade, and I thought it really would be an exciting opportunity to overcome the pessimistic feeling I had previously had about the effectiveness of a “Quijotesque enterprise.”
Now, four years later, there is a lot of positive learning and outcomes useful to improve the work in such restricted conditions. Every three days journey planned by a brigade seems to be a perfectly synchronized “role play” with a lot of cases attended, many lives saved, and happiness and confidence returned to the humble faces of the poorest people of the Nicaraguan mountains. Now I can undoubtedly say that we are ready to recommend disaster response coordination on health issues during emergencies in engagement with these brigades.
I think an experience such as this can provide a better understanding to Medical Volunteer Brigades from abroad of the historic, political and social context of the Nicaraguan people living in these hard days of extreme poverty. We have here the local concept of a volunteer collective integrating doctors, medical specialists, nurses, medical technicians, drivers and diverse kind of helpers, all of them Nicaraguans—with the main workplaces in the public hospitals and health centers of Managua and other cities in the country—who have at least 15-20 years of experience, including those linked to the turbulent years of revolution of the 80s.
How can the volunteers have the will to give themselves in a weekend to extraordinary non-remunerated work, sharing uncomfortable conditions in exhausting travels across the country, enduring bad roads, harsh sleeping conditions and many other restrictions, and also sacrificially giving up sacred time for family, kids and personal affairs? Surely this is a practical way of incarnation in the community while living the lives of those in poverty.
This was perhaps one of the main explanations given to me by Doctor Francisco DelPalacio, one of the heroes of this newsletter. He said: “I felt the need to understand this attitude of my colleagues prior to beginning my bonding process with this collective. A wonderful outcome was to gain friends and share experiences in such passionate work for those in profound need of health services, because in essence it is practically impossible to mobilize high-level specialists from cities to work in rural areas.” This attitude of brigadistas inspired me to continue being part of the last journeys of the Medical Volunteer Brigade visiting many villages and towns in the far corners of the country. The other anonymous heroes in this story are the patients and their families overcoming many perils on their way to meet the MVB.
Dr. DelPalacio is a young specialist in gynecology and obstetrics and the current coordinator of the brigade in charge of logistics, planning and implementing the mobilization of human resources and organizing the work on the ground. He also is responsible for ensuring the well-being of the health services staff of the Dutch-Nicaraguan Hospital during the work of the MVB. He's seeking support for the Brigade and looking for fund-raising, material aid for the group in kind, such as medical assets, medicines and a transportation unit.
A quick glance into the work of some of the brigade members made me understand that this collective effort is a legacy coming from the hard days lived by Nicaraguans during the struggle and battles against dictatorships and tyrants from the early 60s until the 80s. In those years people were sensitized “to feel the pain of the humblest regardless of where they live or where they come from,” so the MVB is a legacy received from the popular struggle against injustice and power abuse. Those excluded from the benefits of public health care services are the priority of the brigades, the Health Ministry MINSA, and the current government administration, which coordinates the brigade operations closely with community leaders gathering in the Councils of Local Power (CPC).
Today, in 2011, again there shines the commitment of this group of volunteers who come to inhospitable places where minimal conditions do not exist to realize medical procedures that need special equipment or high-level specialists.
Those who are acquainted with the geography of the country they will be surprised by the list of communities and municipalities visited by the brigades, attending thousands of hopeless cases during the last two years: 45 communities in more than 20 municipalities: El Cua, Bocay, San José de las Mulas, Matiguas, Rosita, Bonanza, Boaco, Juigalpa, Rio Blanco, San Pedro del Norte, Isla de Ometepe, Matagalpa, Jalapa, to mention some of them. This has meant the extraordinary attention of at least 2,450 consultations, 1,780 small surgeries, 1,575 gyneco-obstetric interventions, etc. A brief cost-effective analysis of these outcomes by the MVB concluded that hundreds of lives were saved, many were cured, and many others received hope to continue under medical monitoring. Each case was estimated to be a comparatively very low cost, considering that surgeries practiced by the MVB in the Nicaraguan market of private health services fluctuate from around 5,000 to 15,000 US$. Costs absolutely unaffordable by the target population of those served by the MVB.
I hope to continue sharing brief stories on the MVB to put in perspective the contribution of this group to the empowerment and education of the most vulnerable groups in these places, especially on issues related to gender inequity in access to health services.
Carlos Cardenas M
The 2011 Mission Yearbook for Prayer & Study, p. 289
The 2012 Presbyterian Mission Yearbook for Prayer & Study, p. 11
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