Changes

So here I am waiting at the international airport in Nicaragua at 5 in the morning for my flight to Belize City. The last month has been a whirlwind of meeting the replacement pilot, getting him trained, getting all my belongings packed in two 50-pound bags, and still flying emergency flights throughout the region. Before starting another assignment in another country, I really like to spend a day or two preparing myself for what is ahead. But the day before was filled with taxi rides, meetings, and hand-delivering government letters — which barely left any time for sleep, much less reflection. So the short three-hour flight from Nicaragua to Belize City will have to do.

What comes to mind are the numerous people I have met and served with throughout my time in Nicaragua. As has been true in all seven of the countries in which I have served, I am leaving an incredible group of individuals with hearts synced in one accord to helping our fellow man — especially the people from Verbo Church, kids from Casa Bernabe, and the staff at the Puerto Cabezas airport and hospital. Every person I had the privilege of working with in Nicaragua welcomed me with open arms and accepted me as part of the Puerto Cabezas community. Nicaragua will always have a place in my heart. But as the plane takes off and leaves Nicaragua behind, I start thinking about what is ahead: Belize. An entirely different kind of whirlwind transition is waiting for me the second I step on Belizean soil.

At the airport, I am greeted by fellow Wings of Hope pilot Dave Brown, who had generously postponed his departure date in order to give me a proper transition period. Immediately, Dave starts showing me around Belize City. For me, everything is different. Belize City is a more advanced, developed and busier city than any of my previous assignments. The airplane is different, as are the airstrips we fly into. Airspace can be extremely busy, especially in relation to the airspace in Nicaragua where I rarely would hear another aircraft. I start to feel a little overwhelmed with everything that will be expected of me. When, finally, some normalcy comes: the phone rings. We have a patient to pick up in one of the islands off mainland Belize.

The rush to the airport, preflight of the aircraft, meeting the flight medic, quick taxi and departure to where our patient is waiting bring back memories of the hundreds of flights I have done exactly like this. It was Congo, Tanzania, and Nicaragua all over again. After the flight, I reflect back on my first day in Belize. It started with sitting in the airport in Nicaragua with a mind full of questions and unknowns and ended with a picture that I have become more accustomed to: the sun setting behind an ambulance taking away a patient to receive proper medical care.

Countries change, aircraft change, protocols change, languages change, but the phone will always ring. It doesn’t matter where I am serving, what aircraft I am flying, or how different my living conditions are. The most important thing never changes — and that’s to always answer the call to help relieve the suffering of someone in need. 

Did you hear that?

Pop…pop…pop.  

There it is again. It isn’t incredibly loud, but very distinctive. I heard it a few minutes before, as well. 

As a pilot, any abnormal, sudden sounds while flying make the heart skip a beat. But even more so when you’re a few thousand feet above the scarce jungles of Northeastern Nicaragua. I had just departed the bush airstrip of Waspam with a pregnant lady in the midst of a premature complicated delivery. She is in my back seat with a young nurse. I take a quick glance back at my delicate passengers and give a “thumbs up.” The intermittent popping sound doesn’t seem to be bothering them, but it is definitely making me nervous. The patient seems fairly stable, so I focus all of my attention, first of all, on flying the aircraft—and, second, on finding the source of the sound.

A quick glance at my engine gauges reading normally eases my mind a little. I think, “We’re not falling out of the sky—so that’s a good thing.” My first thought is that it is an electronic problem. “Probably the avionics,” I guess. I remove my headset from my right ear, trying to isolate the source of the sound. I clearly hear it again, and not in my headset. I now focus my attention to the radios and transponder. But a quick radio check with the Puerto Cabezas control tower comes back as clear; they can also read my transponder. My next thought is an electrical failure. I can’t smell anything burning, and my amperage gauge is telling me that the alternator is charging the system fine.  But that doesn’t calm my nerves at all. Obviously, something is not right.

I begin switching on and off all of the electrical lights with my eye on the amperage gauge and circuit breaker panel. Everything that I do checks normal. I cannot seem to initiate nor stop the popping. As my frustration mounts, I begin exploring the possibility of other nonelectric causes. Maybe the stretcher is making that noise as the patient moves around? Maybe on takeoff from the bush airstrip I picked up a small branch or other object that is hitting the exterior of the airplane? A quick glance outside the aircraft and a slight jostle of stretcher doesn’t confirm those suspicions. Every pop is now an annoying reminder of the hours I will spend looking for the cause.

Clear as a bell, the tower lady clears me to land. As I turn base to final, I feel my muscles tense up as the random popping follows my landing clearance. After landing, I try to calm my frustration regarding the noise. We are on the ground. My main priority now is getting the patient safely and quickly from the aircraft to the waiting ambulance. I can investigate the problem after the patient is on her way to the hospital. The transfer goes smoothly. The nurse climbs into the back of the ambulance and tells the driver, “Vamonos.” I shake her hand and thank her for the help she provided. She looks at me, smiles, and responds, “De nada, piloto.”  Her gaze then moves forward, and she blows a few bubbles from the gum she has been chewing throughout the whole flight. Pop…pop…pop.

Still so much more to do ...

It has been over a year now since Wings of Hope assigned me to Puerto Cabezas, Nicaragua. So I figure reflecting on this milestone is a good excuse to write.

I am not a very good writer, nor does it come easily for me. The hardest part of writing for me, as I am sure it is for most people, is finding the right story. It’s not that nothing happens here that warrants a story—but after you’ve been someplace a year, you become part of that place. Things that first seemed amazing, or different, become a daily part of life.

All of the 90-plus emergency medical transports that I flew last year directly transformed a life in an extraordinary way. They are all “story worthy.”

I could write about the little girl with a compound arm fracture. Not only did her arm heal completely, but she was the first patient flown from Rosita—a town of 22,000 people that now has access to air emergency services.

I  could write about the numerous pregnant women in complicated delivery or the man with a brain aneurysm. There are also the many babies with pneumonia, and the countless hours spent flying the aircraft while anxiously looking back and hoping the baby is still breathing. Then there is the pregnant girl who named her baby after me. I didn’t even fly her—just visited her after the birth, because her family from a faraway community couldn’t be there to support her.  

These images flash through my mind like a slide show from last year. But, for some reason, none seem like a fascinating story to me. I start thinking of writing about things that occur in normal life over here, apart from my work. I could write a story about learning to ride a motorcycle—while dodging cows, horses, school kids, buses and possessed taxi drivers—or the innumerable funny interactions with all of the local merchants and business owners. As before, none of my ideas are shaping up into stories. I begin to wonder why. How come everything I can think of that has occurred in the past seems just that— in the past, a distant memory? How come my mind is not recalling all of the amazing things that have happened?

I start to focus on what is on my mind and what does have my attention. It isn’t anything that has already occurred or has already been accomplished. It is what can be accomplished in the future. It is Alamikamba, a town that is an 8-10 hour car drive from Puerto Cabezas, but merely 45 minutes by air. With only a little work on the runway, and permission from the government, they, too, can have free emergency air transportation. Also consuming my mind are Kukalaia, Lapan, Raiti and Prinzalpolka—all communities that are in very similar situations to Alamikamba. All could be reached. There is still so much more to do.

Looking back on my one year here, I am filled with gratitude and joy for what has been accomplished. But the unlimited possibilities of what lie ahead are, to me, far more exciting. 

Home

A young lady is quietly awoken from a short afternoon nap. For a brief moment, she thinks she is back home in her village in Nicaragua. As her senses slowly become stronger, she realizes that she is far from home. The last week has been a whirlwind of change, fear, doubt and joy. She begins to remember the last few days. What began as a simple checkup for her pregnant sister at their village clinic, turned into the most intense day of her young life. The doctor found that her sister was showing signs of premature birth, and the baby was in a breech position. She needed an emergency C-section, and she needed it fast!

The next few hours were a blur, full of nurses and doctors preparing her sister for an emergency air evacuation with the Wings of Hope airplane. She remembers seeing the plane come in for landing as the car ambulance rushed to the airport. She smiles briefly as she thinks back to her first encounter with the pilot. He was trying to reassure her and her almost unconscious sister. His funny sounding, but steady, Spanish comforted her as she climbed into an aircraft for the first time in her life. The flight was uneventful, as her worry for her sister distracted her from the wonder of flight. A few hours later at the Puerto Cabezas hospital, her sister safely gave birth to her nephew.

But, now, as she hears her sister quietly crying beside her with her baby nestled close, the joy and relief of seeing her baby nephew born healthy, and her sister recover completely, seem a lifetime away. Her eyes slowly scan her surroundings. They are sharing a bed in a maternity house in Puerto Cabezas. The house was made for people like them: released by the hospital, but nowhere to go in a strange town with no family. In a region of a country that doesn’t have paved roads outside of a few towns, traveling is no small task. The trip home is typically 7-8 hours on a bumpy, muddy road in a hot and dusty old school bus — less than ideal conditions for a newborn baby. Making matters worse, the torrential rains have made the road home impassable. Although it wouldn’t matter anyway, as they do not have any money for the bus tickets. She feels so powerless and alone.

She sees the pilot approaching their bed from a distance. In a house full of pregnant women, it’s pretty hard for him to hide. He has come by every day to check on them and give them money for food and medicine. This time, however, he comes carrying the greatest news. He had a call for another emergency to their hometown. The call came late in the afternoon, so he wasn’t able to make the flight right away. The patient is fairly stable, so he will be flying out early the next morning. He offers to take her, her sister and her nephew home the next morning on his way to pick up the patient. No bumpy, hot, dusty, day-long bus trip. No more sharing a house with 40 other pregnant women. After the most trying five days of her life, she will be going home.

The next morning, all the memories come rushing back as she sees the Wings of Hope airplane for the second time. She asks her sister if she remembers anything about the flight just a few days before. With tears in her eyes, her sister responds, “No. The only thing I remember is thinking I was dying.” As they climb into the waiting aircraft, she embraces her sister and gives a quick kiss to her new nephew. Halfway through the calm, early morning flight, the quiet hum of the aircraft’s engine begins to lull her to sleep. She smiles as she realizes that, this time, when she awakes she will again have that familiar feeling of being back home — except, this time, she will really be there.

Cost of Hope

The bike that saved the day

Hopelessness is a disease, one that completely robs the body and soul of all joy and self-worth.  It slowly creeps into your heart and starts to grow like a cancerous tumor. It makes smart people foolish, turns the active lazy, and the aspiring complacent. Hopeless people aimlessly go through life, feeling helpless and powerless to deal with whatever life throws at them. It manifests itself in many people, on different spectrums of life. However, it is always amplified during times of stress and need.

For one teenage girl from Puerto Cabezas, Nicaragua, hopelessness took hold on her way home from a trip to the hospital. She had just been diagnosed with Chikungunya, a virus that spreads through mosquito bites. Although there is no cure, medication can ease the severe fever and pain that the person endures. Her family is from a far out community and sent her to Puerto Cabezas to go to school. She lives in a one-room wooden house with her two cousins. None of them have any money to buy the medicines that help control the extreme symptoms. The nurse tells the girl that she will just have to endure the high fever and joint pains for the next five days, until her body gets rid of the virus.

She collapses on her front porch, totally exhausted from the five-minute walk from the clinic to her house. With the next five days weighing heavily on her mind, she hears her cousin talking to their neighbor. She knows that he works for Wings of Hope, flying patients from remote communities to Puerto Cabezas. A small hint of hope begins to build within her, as she hears her neighbor's motorcycle head down the street toward the pharmacy. This inkling of hope transforms into a reality as the neighbor returns with the medicine. The next few days are full of healing as her body, with the help of the medicine, fights the virus. On her way to school on day four, she excitedly tells her neighbor that she has fully recovered and is so happy to return to school.

For the neighbor, the cost of hope was only a trip to the pharmacy and two dollars worth of medicine. But for the young girl it meant everything – four days of her life being properly cared for with less suffering.

Hope is what fuels change and development. It is essential for dreams to become reality. If you don't have a desire or an expectation to do great things, those things will never be accomplished. Sometimes, the cost of hope is more than a $2 pharmacy bill. Other times, it costs nothing more than a helping hand or an understanding spirit. But with the promise of what can be accomplished by people with hope, it is an investment that the world needs to make.

A Trip to the Hospital

After I wrote this blog, I returned to the hospital. Much to my delight, the baby who was grasping for life in the ICU is on the way to a healthy recovery.

The first time you step into the hospital in Puerto Cabezas, Nicaragua, it can be quite a shock –especially if you have spent any time in a modern hospital in the modern world. But when you make three to four visits a week, you start to overlook the slightly decaying concrete walls, dirty floors, stray dogs running freely, and the many people with various diseases waiting for care. What you see, instead, is the best staffed, supplied and equipped hospital on this side of the country. The ICU may only have four beds, but the hospital has an ICU. It also has a neonatal ICU, which is where a lot of my patients end up.

“So piloto, who are you here to see today?” asks the nurse on duty. She says it with a smirk, because usually I forget the paperwork and have to explain who my patient is in my broken Spanish. Today, I actually have two patients; the first is a young pregnant girl, who was in premature birth when I flew her the day before. When my Spanish finally finds the right room, I immediately recognize her through the small door window. She doesn't see me, as I witness her and her husband holding their first child for the first time. Suddenly, she recognizes me – her face glowing with relief and pure joy – and gestures for me to come in. For a moment, I get to share in the happiness of this young family. As I scan the room, I don't have to look far to see my other patient. She's in the bed next to us.

She is a 14-year-old girl I flew in late the day before. She had an emergency C-section with serious complications in the bush hospital. I flew her, the newborn baby and a doctor from the small town of Bonanza; there was no room for a family member to take the trip with her. I was nervous for her, because she was very scared and in a lot of pain. My heart went out to her, because she had to undergo such a traumatic experience alone. I make my way to her bed, after talking with the nurse. She says that the mother is stable, but heavily medicated. The baby, on the other hand, is struggling to hold on in the neonatal ICU. The mother’s eyes open, and she nervously nods when I ask if she remembers me. I try to offer words of encouragement and hope, but it’s hard to come up with words to say when your patient is a young mother whose child is dying next door. I do manage a smile out of her when I say that I'll come back tomorrow.

I make my way out of the hospital with my two patients, who are going through two totally different experiences, on my mind. As I pass the emergency room, I hear my name being called out over the noise of the crowd. It is the sister of another patient I flew a few weeks before. She is also pregnant and had been staying at a local maternity house until she was ready to give birth. The doctors had advised her to have the baby at the hospital, due to some anticipated complications. I spoke to her a few days ago, and she conveyed that she was extremely nervous and scared for the upcoming birth.

I step into to the examination room, where the expectant mother is sitting in a chair. I greet her, while silently wondering what my next conversation with her will be like. It is quite possible that the birth will go great, and I will again get to rejoice with another growing family. It is just as possible that I will again have to search for words of comfort and hope. But one thing is certain: Whatever is in store for this young lady, she will not experience it alone. Some patients need comfort, some need to share their joy, but all need someone there.

Something to Smile About ...

As she is leaning over one of our patients for that day, the dentist remarks to me, “Nobody likes to go the dentist.” I nod in agreement, as I look up from sterilizing the already used equipment. My gaze ends up at the slowly dwindling line of waiting patients. It's true: nobody looks like they’re enjoying themselves. A few teenage girls are nervously laughing and talking among themselves, but that will surely stop when they get closer to the front of the line. We are in a small village on the northeastern side of Nicaragua. A local dentist from the Pacific Coast and I are performing the first dental clinic that this village can remember.

We have decided to solely concentrate on extracting teeth that are causing pain. We figured that would lessen the workload some. I'm sure it did, but we are set to start on our 20^th patient, and a lot more are still waiting. We work two patients at a time to maximize the dentist’s time, since the anesthesia takes 5-10 minutes to take effect. While the dentist starts working on one patient, I call out for the next person in line. She is a little girl, maybe eight years old. She's wearing a slightly torn, but well cared for, dress. She approaches the chair timidly, but bravely. I ask for her name and gesture for her to sit down. She then says to me in a scared voice, ”I'm really afraid — and it (her tooth) really hurts.”

Immediately, my heart goes out to this brave young girl, who is making her first trip to the dentist alone. I try to reassure her by telling her the story of when I had to go to the dentist because I knocked a tooth out playing football. She laughs when I tell her it was because I ran into the field goal post. The anesthesia is now ready, and the dentist administers it. While the extraction is taking place, I hold her hand and try to distract her by pointing out things that are in her gaze. The tooth comes out fairly easily, and she gladly puts it in her pocket for a keepsake. As our numb, but happy, patient leaves for home, it dawns on me that we just experienced a great snapshot of humanitarian work. 

That snapshot is of a small dental clinic in a secluded village in one of the poorest countries in Latin America. Zoom in and you will see that the dentist is a Spanish girl who lives on the opposite coast of Nicaragua. She volunteered her time to help her fellow citizens. Zoom way, way out and you will discover that her plane ticket to the Atlantic Coast was purchased by a man from Louisiana — and some of the instruments she used were donated by an American man doing water projects around the region. At the edge of the frame and a little blurry, I see myself. And I realize that I would not be in this picture at all if not for the hundreds of Wings of Hope volunteers who sacrifice their time and money to make possible something so simple, yet so monumental, as pulling out a little girl’s tooth. As this picture takes shape in my head, my mind’s eye brings my role in all of this into focus. I do whatever is left — from flying the plane, to sterilizing the dentist’s tools, to holding the hand of a scared little girl.

Most of the people we help are just like that little girl. They are suffering, and they are afraid. They probably will never understand all the work and coordination it took to bring them relieving care. But, in reality, pulling out one little girl’s tooth takes hundreds of people around the world — most of whom will never cross paths with me or the dentist or the little girl — working together toward a common goal: to relieve the suffering of those born into extremely poor and difficult situations. 

It may take a village to raise a child, but my work has shown me that it can take a world to heal a toothache. And that is a picture that makes me smile.