We talked with an American physician and his para-medic wife yesterday afternoon. They have been in Nicaragua since November 2010. They came down to offer care in churches. They have enjoyed their mission and they had some incredible tales to tell.
The night prior we ate at a local restaurant and there were some pre-med students in the restaurant. By amazing coincidence they were all from Clemson University in South Carolina. I lived in SC during the nineties. I was recruited to help develop a new children's hospital and I had an academic appointment at both the University of SC and at Clemson. Clemson was my first full professorship. I introduced myself and talked with the students for awhile and they reported that they were in Nicaragua to help set up a new children's clinic in a rural village. Based on this I tracked down the clinic the next afternoon and that was how we came to meet Bill and Christie.
One incredible-to-believe story is that an individual cannot get free health care without a birth certificate. On the surface this sounds like a reasonable request. The government would like to keep records on the health of individuals. However, the clinics are obliged to actually refuse care if you do not have a birth certificate, or at least the clinic staff cannot be seen to be helping people who are not registered.
Obtaining a birth certificate might be straightforward in Managua, Rivas, or Leon, but in the rural hills there are huge obstacles. During the rainy season, from May to November, the roads are often not passable even if there were buses available. Mothers birth on their own in the villages. There are no officials present to register the birth. When a child is not registered within a few weeks of birth, the paperwork to obtain a birth certificate apparently costs $300, or half the average yearly wage of a worker! So, lots of rural families do not have birth certificates.
Bill and Christie had lots of other stories that will percolate in my mind as I consider how best to help out in this country.
I made contact with Rob, the American administrator of the new children's clinic and perhaps I can help out at this clinic in the future as well as at the Roberto Clemente clinic.
We have settled in well at the clinic. Our routine is to see 15 to 20 patients over 5 hours from 10 AM to 3 PM. In the mornings I'm up at dawn to watch birds. In the afternoon we enjoy incredible sunsets.
Montezuma Oropendola. This bird rips off the bark and eats the insects that live underneath. The bird was dropping two inch chunks of bark all around me as I took the picture.
Below are Howler Monkeys. There is a baby riding on Mom.