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Two days, Three Doctors, Three Kids and Two Hundred and Thirty Desperate Patients

The views expressed are those of the author and are not necessarily those of Scientific American.


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April 12-13 in Nicaragua

Dr. Sandoval

Dr. Sandoval

It was a rough night for the crew. The howler monkeys were trumpeting their calls later than usual, blasting away in the treetops until well past midnight. The racket, combined with temperatures in the upper nineties and one hundred percent humidity made sleeping difficult at base camp.

The surgeons had arrived the day before and I greeted them for the first time at breakfast. After my own medical intervention, I was not able to greet them as they arrived. But a day of rest had restored me and I was eager to get get breakfast finished and start treating people in the village.

The tattered chair we used to treat patients

The tattered chair we used to treat patients

We managed to muster a first class medical team to deliver aid for the next two days including Dr. Robert Fuller, Director of Emergency Medicine at the University of Connecticut Health Center, Dr. Mike Condon DDS and Dr. Paul Schonbrun, combat veteran and emergency doctor at Fort Polk, Louisiana.

As the surgical team readied their equipment and supplies, the film crew left for the village, San Juan de Nicaragua. We chose San Juan, a small jungle settlement about 100 kilometers past El Castillo on the Indian River for its accessibility – both for our team and film crew, but also for the three tribes that live throughout the Miskito Coast of Nicaragua.

A typical village house

A typical village house

San Juan is still commonly referred to by its previous names of Greytown and San Juan del Norte. San Juan del Norte was practically burned to the ground during the Contra war and then flattened by Hurricane Joan in the 1980’s. During this time the residents all be deserted the area, moving further up the river and south to Costa Rica. After the war, some residents resettled in what is now called San Juan about 10 minutes north of the original site.

The village home to about 2000 people belonging to three tribes; the Rama Indians, Creole Indians and Miskito Indians. While the history of tribe relations has been turbulent, they now live peacefully together. However, the town is segregated into tribal areas. Many more tribal people live up river, deep in the jungle in single family huts where they work as sustenance farmers.

Dr. Robert Fuller treating a child

Dr. Robert Fuller treating a child

At 7am I arrived with the film crew at the main dock. As is typical, armed Nicaraguan military troops checked our paperwork, inspected our equipment and let us in with little trouble. However, a squad of soldiers were dispatched to “supervise” us.

We made our way into the village to a small shanty surrounded by heavy iron fencing. This building was used previously for medical treatment and we determined it was ideal for our purposes. We were met by the lone doctor in the village, Dr. Sandoval who gave us a quick tour of the facilities. Essentially, there were none. But Dr. Sandoval was used to working with little resources and welcomed us as we quickly created a plan to deploy the clinic.

Team XN host Haley at the clinic

Team XN host Haley at the clinic

I radioed the rest of the team at base camp to give our location as people began lining up for treatment. They had come from miles around, mostly in handmade canoes to seek help for ailments that ran the spectrum from minor infections and dental problems to chronic conditions and emergency care. By 8am, there were at least fifty people waiting.

As the team of doctors and our young hosts arrived, it quickly became obvious that we had several challenges. Among these challenges was a lack of clean water, suitable workstations and overall, a lack of sterile supplies. By 9am, there were at least seventy five people in line.

Aerial shot of San Juan de Nicaragua

Aerial shot of San Juan de Nicaragua

The team scrambled to ready the clinic for a busy day. Twelve year old Team XN captain Enzo unpacked water purification equipment donated by Sawyer Products and prepared to supply continuous, clean water. Thirteen year old host Emma was tasked to keep the required records on patients treated and twelve year old host Haley provided support for the surgical team.

The doctors found an old, rusty dental chair in a heap outside the building and built a support using cinder blocks to raise patients to a comfortable level. Eighty percent of the patients needed dental work. Many people had severe dental problems, their teeth rotted away almost completely. With few options, the team extracted hundreds of teeth.

Team XN host Enzo pours purified water

Team XN host Enzo pours purified water

Our Costa Rican sound technician Ricardo Molina, became invaluable to the team. Fluent in Spanish, he triaged incoming patients and kept the crowd entertained for the long, hot wait for treatment as temperatures rose to 103° F. He created a ticketing system to track patients in a “first come, first serve” order.

The doctors worked at a furious pace in to move patients through without compromising safety. They split into three groups, each working different specialties. At times, all three groups were performing dental work. As one patient was released, three more showed up. It was going to be a long day.

Team XN host Emma discusses patient records with Ricardo Molina

Team XN host Emma discusses patient records with Ricardo Molina

Our team brought cases of medication, surgical instruments and supplies for the clinic. These supplies were carried on our backs for the duration of the fourteen day expedition. Dr. Sandoval was pleased for the gift. Since there is no supply chain to the village, even basic supplies and instruments were hard to come by.

By the end of the day, we had treated well over 100 people. Ricardo told the remaining patients they would need to come back the next day for treatment. Disappointed by the long wait, but grateful for help, they thanked us and agreed to return in the morning.

The following day, we arrived at 7am and started seeing patients almost immediately. As we approached the clinic, we were greeted by a particularly articulate and friendly young man named Pablo, who thanked us, asked us where we were from and welcomed us to San Juan. We were impressed with Pablo, and Exploration Nation producer, Lou Douros turned to me and said “Wow, that guy is going to college someday.”

Ricardo quickly organized the waiting patents and his ticketing system worked flawlessly. The queue quickly filled, with patents spilling outside the fence as the Nicaraguan soldiers stood watching, AK47s slung around their backs.

I approached the soldiers handing out cold water and asked in broken Spanish if there was anything we could do for them. The commanding officer came forward and mentioned that several of his men had dental problems. One soldier cordially lifted his hat exposing a large, botfly larvae wiggling out of his head. We moved him to the front of the line.

Around 2pm, Enzo came to me looking concerned. He asked to talk to me away from the soldiers and crowd. At twelve years old, Enzo is a seasoned explorer and had noticed erratic behavior from Pablo, our young, articulate friend. Enzo said he was asking for drugs, eyeing up the film equipment and acting nervously. I confirmed this with Dr. Schonbrun.

It turns out, Pablo was an addict. His greeting and demeanor were a carefully crafted strategy to subvert our security and score a fix. As he descended into withdrawal, he could not keep up appearances and it became obvious that he was becoming a threat. What Pablo didn’t know was that most of my team were long time combat veterans in the Army and Marines. He was out of his element.

I approached him and asked him if he had a medical condition. He replied that he didn’t. I asked why he had a ticket. He nervously attempted to deflect the question and said he was saving it for a friend. I asked him to walk with me towards the gate. Ricardo, who stands well over six feet tall and Loren Gilley, a nine year combat vet followed quietly. We all reached the gate around the same time.

I told Pablo that we knew what he was doing and that we determined he posed a threat to security and he would have to leave. He became defiant. Ricardo moved a bit closer, towering over Pablo. Loren put on his “don’t screw with me” face he had perfected in Iraq and Afghanistan. I leaned in to Pablo and said “Pablo, we don’t want trouble. But we can do this the easy way or the hard way.” I nodded toward the Nicaraguan military and said “Would you rather I told them about your problem?” Pablo got the message and became very cooperative as he practically ran out the gate. The Nicaraguan military doesn’t suffer drug addicts.

After twelve hours, our team treated over one hundred patients bringing the total treated to over two hundred and thirty people. Seeing the relief of so many people made the previous two difficult weeks worth every minute. I saw a transformation in the faces of the three young hosts who found their place to contribute. They met kids just like them who had none of the comforts of America.

Over the course of the expedition we broadcast our journey to millions of other American kids to show how innovation improves lives. From sustainable farming with Dole Fresh Fruits and the reforestation project at Rios Tropicales to working with the Rama’s last shaman and surviving a harrowing night in the jungle, everything led to these last two days of relieving suffering. We literally brought innovation to people who had little to no access.

Our goal was to send a message to millions of American students that a career in the sciences directly makes life better for people everywhere. Now, we will take the hours and hours of footage and produce a series of lesson programs for elementary and middle school students to relive our expedition and apply these ideas to their own lives.

The expedition is over, but our work is only beginning. America is losing it’s place as a leader in global innovation as we struggle to produce enough science literate workers. Only know are we realizing that this problem begins earlier than previously thought, with the vast majority of students losing interest in science in middle school.

In my next installment to this series, I’ll be interviewing leaders from many of the world’s most successful companies who are meeting this challenge head on and changing how we lead young innovators to reach their potential through science, technology, engineering and mathematics.

Previously in this series:

Kids Lead Crowd-Funded Scientific Mission to Nicaragua: Science Education Is the Tide That Lifts All Boats
Exploration Nation: Expedition Central America
Exploration Nation: Expedition Central America – Day One – April 4th
Exploration Nation: Day Two – April 5
Exploration Nation: Rebuilding the Rain Forest
Exploration Nation: The Last Shaman
Exploration Nation: Life and Death in Nicaragua

Pete Monfre About the Author: Pete Monfre is a twenty five year veteran of the advertising and marketing industry serving Fortune 100 and 500 technology clients. He is also an accomplished educator, photographer, award winning musician, writer, consultant, videographer and producer. In recent years, Mr. Monfre dedicated himself to improving the future for our children and nation through engaging science education, as demonstrated by his vision and success as CEO of Enzoology Education. Follow on Twitter @petemonfre.

The views expressed are those of the author and are not necessarily those of Scientific American.





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