Assembly of People Into Giving a Sh*t: Christmas Eve

There are many aspects of the Christmas story that are often over-looked or misinterpreted. We think of the night that Mary gave birth as a peaceful and silent night. We forget the involvement of the government. We forget the emotions of those involved.

When Mike was in college, he volunteered with a home for those with disabilities. He attended one of their plays which was the Christmas story. During the play the audience could hear one young man shout over and over “No room in the inn!” He was to play the role of the innkeeper and he was simple minded. When his part came and Joseph explained how his wife was pregnant and everyone else in Bethlehem had turned them away, the innkeeper responded, “Ah hell! You can have MY room.” Simple minded but not simple hearted.

Pregnant Mary and Joseph went to Bethlehem, a town crowded with people coming back to their home town to register with the Roman government which was an occupying force in Israel. Rome wanted to take a census, for tax purposes. The Roman Empire was not kind to those who did not follow their laws and the need for taxes was great because they had to pay their soldiers who maintained the Empire.

Joseph and Mary went from inn to inn trying to find a place to rest. I remember what it felt like to be nine months pregnant…swollen, out-of-sorts, and feeling like any moment I might pop! I cannot imagine needing a bed to just lie down and rest to discover that there were no vacancies anywhere.

And while the last innkeeper did not offer his room…he did offer them the cattle shed. A place with straw and flat surfaces…a place to rest. In the early days of the Midwest many farmers offered travelers their barns in which to rest. 

Nicaraguan Nativity painting

Mary goes into labor. The baby is coming. This part of the story is not told. Maybe because long ago, people instinctively knew what having a baby was like or maybe because it was written by men who did not understand the pain, the messiness, the fear, the exhaustion of having a baby. I do. I can imagine Joseph going out into the night to find a mid-wife to help with the birth.

I can imagine the sweat pouring off Mary’s face. Did she know to breathe and focus on something else to help? Or was she terrified, it being her first child and first birth? We know she was young…so young.

Joseph and the midwife helped Mary, giving encouragement as each contraction tightened the largest muscle in the human body to move the baby in position and then eventually through the birth canal. We have no idea how long this birth was, but there was no spinal block…no drugs given…no fetal monitor…just working, pushing, and hoping against hope that baby and Mama will survive the ordeal.

Let me tell you, with no drugs, pushing a baby out is work and it hurts. There is a huge relief when the baby comes shooting out but it is not clean. Fluid, blood and most of the times feces come out of the body before and during the actual crowning and birth of the baby. Most of the time, mothers cry out with the effort so it is neither silent or calm as everyone is doing their job to help the baby come. Midwives are encouraging and – I suspect – Joseph was lending physical support as Mary squatted…maybe?

Taken away from her home and the people she knew, Mary gave birth to her son in a barn with Joseph and a stranger (mid-wife) …we can guess. When the birth is over, the cord is cut, the baby wiped off, Mary is cleaned, the straw with fluids, placenta, and feces is removed, and Mary will have tried to feed her child.

Baby and mother trying to get the nipple in the mouth so that sucking can happen and Mary’s uterus can start contracting down again.

I am sure with all the smells of the bodily functions, the animals were disturbed, moving and making noises. This was no silent night.

But as with all births, it was holy.

Despite the Empire’s desire to lord over the Israelites, despite the lack of room or space, despite the strange land, Mary gave birth to the Son of David.

Despite wars, famine, flooding, and all kinds of disasters, women give birth…no different from Mary. It can be frightening, painful, hard work, and something that we don’t want to happen, but babies come when it is their time.

We cannot forget that human element of the Christmas story.

Mary gave birth to Jesus. Not at home. Not in a hospital. Not in an inn. Not even in the innkeeper’s room, but in the cattle shed.

That is where the King of Kings – as we Christians call Jesus – was born…in a barn. Without a home.

We must remember this when we see refugees, homeless people, and outcasts…because we are seeing Jesus when we see them.

-Kathleen

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Assembly of People Into Giving a Sh*t: Love

Our fourth Advent banner today is LOVE. It is the only banner that actually has images of people…a Haitian woman holding her baby…Madonna and Child. When we made these banners years ago, Haiti was going through an AIDS epidemic and had gone through a revolution to overthrow their family dynasty of the dictators, the Duvaliers. 

 🎜LOVE is what makes the world go round. 🎝

🎜All we need is LOVE. 🎝

🎜What the world needs now is LOVE sweet LOVE. 🎝

Songs from the ages exalt LOVE. But what is LOVE?

When many people hear the word “LOVE”, they automatically think of the romantic kind of LOVE. The LOVE that one has with a spouse or partner. Passionate LOVE. Abiding LOVE that moves with us through the years as we age. LOVE that depends on the other.

With all the Disney films for children, a spell is broken by “the kiss of one’s true LOVE.” In these movies the prince comes along and lays eyes on the beautiful princess and gives her a kiss. Poof! Spell broken

With the Pixar movies, Brave, that began to change…the spell was broken by the daughter with her true LOVE for her mother and in Frozen with the true LOVE of a sister.

Familial LOVE is another form of LOVE that we recognize as well. Deep abiding LOVE we feel for the members of our family…that feeling of warmth and attachment I have when I just think of our children.

LOVE with one’s friends. I will light up when I see our wonderful friends. We have so many dear, precious friends that my LOVE for each of them is as deep as familial LOVE. All of these types of LOVE, give us warmth in a cruel world, and fuzzy feelings of acceptance and joy.

But there is a different LOVE that may be most important of all…the LOVE we share with everyone whether we like them or not. The word LOVE in English can mean an emotional state but it also means action. The LOVE we act on.

We were doing a slide presentation at North Anderson Community Church (Presbyterian) back in the day when we ran shelters in North Carolina. A member came up to me and said, “The way that you LOVE those people is admirable.”

Trying to be honest, I replied, “I’m sorry but I don’t LOVE many of these people.”

She then said one of the most important sentences I have ever heard, “LOVE is a verb: you show your LOVE by caring for them physically and emotionally.”

Maybe it was because I was getting the flu or maybe because we then saw the movie, Gandhi, I don’t know but that sentence has stuck with me.

Mahatma Gandhi said, “The real LOVE is to LOVE them that hate you, to LOVE your neighbor even though you distrust [them].”

True LOVE often comes with no warmth or fuzzy feelings of acceptance or joy, but instead true LOVE often comes in the face of hate and malice.

LOVE is action…what we do to and for others.

Cornell West, an American philosopher and social activist, said, “Never forget that justice is what LOVE looks like in public.”

If we believe in the Divine of LOVE…the God of LOVE…we have no other choice, but to LOVE… 

“You cannot LOVE God whom you have not seen, if you hate your neighbor whom you have seen.” (1 John 4:22b) 

“LOVE your enemies, pray for those who persecute you,” Jesus told his disciples. (Matt 5:44)

Martin Luther King, Jr., said, “LOVE is the only force capable of transforming an enemy into a friend.”

“Nothing is impossible for pure LOVE,” Gandhi said…and he would know. He held a LOVE-filled revolution and the British left India.

LOVE…a force that is powerful and right. 

What the world needs now is indeed LOVE…true LOVE.

Neighbor to neighbor.  Community to community.  Nation to nation.  All LOVING each other.  All taking actions of LOVE.

-Kathleen

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Assembly of PIGS: Joy

Today is the third Sunday of Advent and our banner has a Chinese red dragon and the character for “JOY”. It has bells on the bottom that have rusted away over the past 30 plus years and shiny sequins for the fire coming out of its mouth. I find the banner itself quite joyous. 

In this year of 2020 with its quarantines due to the dangers of the virus, we have found the year extremely boring with no break in sight.

We’ve tried to break the monotony. We tried to go away for a few days as the Jubilee House Community…to see and do something different but Hurricane Eta hit; so, we rescheduled and Hurricane Iota hit. We went back to the same old same old.

Until yesterday…and yesterday we celebrated with fanfare Becca and Paul’s daughter, Eibhlín, turning 15 years old. We had her quinceañera.

We all dressed up. A masked photographer came and took loads of photos. Eibhlín and her sister, Orla, had fancy dresses made, and bought fancy shoes. They even had fancy masks to wear. Sarah cooked a great Chinese feast. Daniel got balloons galore. Claudia and the girls’ friend Abril decorated. There were presents, speeches, music, Zoom calls and - as I have mentioned above - lots of photos. Even Samantha, the Community’s toddler, after a cool down and rest, dressed up in her fancy dress to match Eibhlín’s. 

Quinceañeras are a Latin thing and usually very big…I have issues with them by-and-large. In some ways they remind me of debutant balls…or events that announce “Here she is, ready for the picking!” Boys do not have quinceañeras, neither do they have debutant balls.

A quinceañera is also a time that the family spends way too much money. For poor Nicaraguans, they will often times go into debt to pay for the festivities. I have issues with spending too much money for frivolous things when the family might suffer…but last night taught me an important lesson…JOY is as important for the soul as bread is for the body.

Being poor is like quarantining. It is boring. You can’t afford books, outings, puzzles, games…it is the same old same old every single day. It is worse than quarantining because you sweep the same dirt floor, eat the same rice and if lucky beans, scrub the same clothes on a washboard, cook over a wood stove with the same pot…day in and day out. It is dreadfully boring, so when there is the chance for a break in that boredom…for JOY, the poor jump at the opportunity.

In 2003 we went to El Porvenir, the remote, rural coffee cooperative, with volunteer Lisa and her mother Dottie and brother Josh who were visiting. Dottie did medical consults and I handed out medicines. Lisa and Josh made balloon hats for all the kids of the cooperative. Word went out through the cooperative and kids kept coming from down below the mountain. It was the most fun I had had on top of that mountain, watching the different creations and the children’s delight in the hats. JOY was so prevalent that I was surprised a beam of happiness was not lighting up the sky. 

I have heard volunteers say “Oh! They are so happy!” wondering if the “simple life” of poverty makes one happy. What actually happens is that having new people around and dressing up for those on delegations breaks the monotony and gives people a little JOY.

JOY feeds the soul.

When we ran shelters in North Carolina in the 1980s, we laughed all the time. Mike and our late dear friend Margaret kept us in stitches. As we have aged laughter comes more slowly to us, but it is there. We understand dark humor and the need to laugh at things that most nice, white folks would find appalling. Our humor has an edge to it as does the humor of the poor. 

When Pat died Joseph and Daniel kept making jokes. While trying to be “Mama”, I fussed at them. Their response consistently was “that is how we grieve…you know this.” And I did because they grew up with us.

Laughter cleanses the soul of all the negative build up and allows JOY to break into the soul. As People Into Giving a Sh*t we must be aware that spreading JOY is as critical as spreading justice, peace and hope.

I love our Chinese dragon…our symbol of JOY…the glittering fire burning away the pain and hurt to allow the bells to ring and my soul to fly.

-Kathleen

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Future Fridays: Are Nations Not Responsible For Their Actions?

If your neighbor had a tree twith a branch that hung over into your yard and over your house, and though you had asked for them to trim the branch, they had not. And if that branch cracked and fell on your roof caving in part of it, should your neighbor have to pay for the damages?

If your neighbor, avoiding garbage pick-up fees, burns their trash and during a dry spell a spark flies over to your house and catches it on fire, should your neighbor have to pay for the damage to your home?

If your neighbor keeps having huge barbecues with billowing smoke even though you have asked and asked that they be mindful of your child with asthma. And then if your child has an asthma attack breathing in said smoke, should your neighbor be responsible for the hospital bill?

Negligence and plain selfishness are easy to see on an individual level and holding people responsible on an individual level is usually a cut-and-dried solution.

But what about nations?

When nations do not limit green house gases, then are they responsible to pay for the damages of climate change to nations suffering from the changes in climate (like hurricanes, droughts, flooding, or fires) but who are not polluting nearly to the degree that wealthier nations are? 

2020 hrricane damage Caribbean coast communities, Nicaragua

Last month Nicaragua lived through two category 4 hurricanes within two weeks. TWO within TWO WEEKS!

The Nicaraguan government is committed to reducing green house gases even though Nicaraguans per capita have a low carbon footprint. The president of the Central American Bank for Economic Integration, Dante Mossi said that as of October 2020, the Nicaraguan National Program for Sustainable Electrification and Renewable Energy (PNESER) has achieved for Nicaragua a 98.33% in electricity coverage throughout the nation and 74.39% of the electricity was generated from renewable sources. Mossi went on to say…

  “Nicaragua will be the second country in Latin America to achieve 100% national coverage, which is a historic accomplishment that demonstrates the commitment of the Government to guarantee this basic right for the population…we must acknowledge and congratulate Nicaragua for obtaining approval of US $ 115 million-dollar funding from the United Nations Green Climate Fund to manage the effects of climate change. Approval of funds at this scale by the Green Climate Fund is unprecedented for the region and a clear recognition of Nicaragua's work on environmental protection, as well as
adaptation and mitigation of the effects of climate change. We have a lot to learn from the Nicaragua experience.” 

So, with Nicaragua working to do its part, should not neighbors who are having so much impact on climate change help pay for the damages created by climate change? 

And this is the rub…an individual may be held responsible, but a nation?

Why not?

Climate justice calls for action, and being held responsible when negligence and selfishness happens is a good way to ensure the action.  Being held responsible calls for atonement and funds to repair damage or reparations.  Only when climate change hits us in the pocket.. that seems to be the only effect that moves many.

-Kathleen

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Adios, 2020! Ending this Whale Poop of a Year in the Black

Well, we got word this week that the last of our adult children and the grandchildren are not coming home for Christmas in an attempt to keep us Old Farts safe and well…or as they said, “not die.” We appreciate their love and care for us, but it feels like just one more PBFTTT from 2020. What a year!

We surpassed our Giving Tuesday goal, which was luverly! Just stupendous! And those of you who helped are just wonderful and we are grateful, so grateful.

With that good news, here comes the not-so-good...

We still meet weekly and wonder where we are going to get the month’s income to do all the unsexy things that take money…and frankly we are exhausted trying to find money and asking for money and stressing out in the middle of the night about how we are going to meet this week’s payroll (as I write this, it is 3:30 AM because I couldn’t sleep). So, we are girding up our loins and asking anyway…we really want to finish this llama spit of a year in the black. 

In the words of Pres. Elect Biden... "here's the deal:"

People were amazing in raising money for the ultrasound machine, but the paper is $200/box then there is the air conditioning to keep it working, the maintenance, and the gel…not to mention the salary of the wonderful doctor, Jorge.

People were brilliant in raising money to put in dental chairs, but the supplies are about $450/month especially with no donations of dental supplies coming in the country…not to mention the salaries of dentist Julio, hygienist Lydia, and assistant Fabiola…two air conditioners and the high electric bill  as well as maintenance for running the equipment.

People were remarkable about raising money to hire the therapist, Dominga, but we have to cover the PPE for her and all the staff and supplies for her to work with patients, especially arts and crafts with the kids. 

People were superb in raising funds for the Giving Tuesday so that we can get our charts and medicines on-line, but we spend anywhere form $2,000 -3,000/month in medication costs.

People were fantastic in raising construction money but we have three builders/maintenance staff salaries...for Rogelio, Lucas, and Pedro…and then there is the money for the truck to haul materials and maintenance supplies like door knobs, screening, lighting fixtures that blow with surges in electricity, water pump replacements, waste filtration materials, and on and on it goes.

And while people are wonderful about raising money for special equipment, we have financial books to keep for our projects, our donors, both the Nicaraguan and the U.S. governments which take staff, printers, copiers, paper (blech!), phones, and cars to run in and out of banks and government offices.

All those are things that the CDCA has to pay, but who wants to fund boring stuff like that? Really?

Well, we hope you will. All those boring facets of our work mean that each year we can:

• Support 3,000 farmers through the organic agriculture cooperative with loans, phone minutes as Mike and Becca spend hours on the phone with buyers and the cooperative staff, fuel to run the vehicles to go to the sesame plant, meet with farmers as well as the wear and tear on the trucks.
• Provide health care, dental care, psychological care for thousands of people
• Provide eye exams and corrective lenses for hundreds
• Provide lab tests for thousands of people 
• Provide medicine for all those folks above
• Provide family planning for hundreds
• Provide monthly visits, labs and medicines for 143 people with chronic conditions like diabetes and hypertension
• Provide wheelchairs, crutches, walkers, beds, etc. for hundreds
• Provide public health classes to hundreds 
• Provide ultrasounds for hundreds
• Provide Personal Protective Equipment and a clean environment to slow the spread of COVID-19 and other viruses 
• Educate people to the issues of poverty and Nicaragua

Please give and help us end this donkey snot of a year in the black…and consider giving monthly in 2021 so there are continuing funds for this important work.

-Kathleen

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Assembly of PIGS: Peace

Today is the second Sunday of Advent and our banner has a dove and the words for PEACE in Hebrew and Arabic. When we made the banners 35 plus years ago, we had a Muslim from Morocco in our Community and it seemed appropriate to include both words on our PEACE banner since there has been so much strife in the Middle East.

The Arabic word salaam is a greeting as is the Hebrew word shalom… “PEACE be with you.” Salaam means PEACE and harmlessness, safety and protection from evil and from faults. As-Salaam is also one of the names of Allah.

Shalom means PEACE, harmony, wholeness, completeness, prosperity, welfare and tranquility. 

Both words mean so much more than the absence of war or just tranquility.

When I learned the meaning of shalom in my seminary days, it was like a light bulb going off in my head. I understood how we as a world could actually obtain PEACE. When we all live in harmony, when we give everyone wholeness and prosperity and wellness, when we make sure that we are all complete then we can truly have PEACE. Otherwise, PEACE is elusive.

There can be no PEACE without justice.

When people march in the streets because of police brutality and racial biases, this is not a law and order issue…this is a justice issue and without justice there will be no PEACE. 

Until the U.S. addresses the complaints of the Arabic nations to rule as they choose, we will have terrorism…without justice, we will have no PEACE whether we have good intelligence or not.

Until Israel addresses the issue of the subjugation of the Palestinians, there will be no PEACE in the Middle East.

We tend to put band aids on problems and hope that the bandage will stop the bleeding; we never address the wounds and injustices that so many feel. Giving food and shelter helps but not if, with the other hand, we are giving weapons trying to control the outcome.

Deciding that our best interests mean training people in terrorist tactics and setting up dictatorships around the world; then... what that really means is that those tactics will come back to haunt us. Without justice there can be no PEACE…there will be no PEACE.

We have this irrational notion that “keeping the PEACE” is the same thing as PEACE itself. It is not. PEACE cannot be “kept”, PEACE can only be made through hard, hard work and understanding. Making PEACE starts and ends with justice.

If you are hungry and poor, you have nothing to lose if you blow up a building.

If you feel constrained and oppressed, you have nothing to lose if you grab a gun and start shooting up a street.

If you are nothing but a shell from being trodden on your whole life, you have nothing to lose if you loot and burn a business.

If you have no hope of a future, you have nothing to lose in strapping on a bomb and walking into a crowded mall.

But if all you experience is justice, then you have everything to lose.

When our boys were younger, I would read the books they read so that we could discuss them. One of the series they read was the Pendragon series with a boy, Bobby, who moved through dimensions to points of cruxes in different dimensions’ societies. In the first book, The Merchant of Death, Bobby went to a dimension that had extreme classism. The wealthy had all they needed and wanted, while the poor had little and suffered under the thumbs of oppression from the wealthy. One of the leaders of the people who were so poor, finally broke down and with explosive rocks went to an event held by the wealthy to blow himself and the whole arena up.

I remember reading this and suddenly realizing that the author, D.J. MacHale, was explaining to young people in his book why suicide bombers existed. And MacHale did it so well…because - not once - did I think that the man willing to blow himself up was wrong…I could only see him as desperate.

There was no justice in that society, so there could be no PEACE.

PEACE is an individual action. When our kids were small, we had a cassette tape of PEACE music for children and one song was "I Can Make PEACE with Everyone I Meet”. Creating a world of kindness and respect, treating each other with empathy and understanding, and working daily for justice…this is how we as individuals can make PEACE.

PEACE is a community action. In your neighborhoods, towns, and cities we all need to work for justice for every single person…this is how we make PEACE.

PEACE is a nationwide action. In the world, we all need to work to ensure that everyone has their needs met, treating other nations with respect and kindness, and working to ensure there is a healthy world for today and the future ahead…this is how we make PEACE.

Without justice there can be no PEACE.

-Kathleen

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Giving Tuesday: Please Help the CDCA Raise Its Goal of $5,400 to Save in the Future

Today is Giving Tuesday, a day fostering giving to non-profits online. The CDCA’s specific project goal for today is $5,400 to set up and maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We have been posting on social media about this day. We have written blogs explaining in more detail why we chose to focus on this project and how you can help. So far, these are the blogs we have written if you want to check them out:

1. a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important.
2. a blog about how typing data electronically makes for less mistakes and more time for patient care. 
3. a blog about HOW we are able to do this now and how appreciative we are, 
4. a blog on climate change and saving paper 
5. a blog about how much space and time we will save 
6. and today I will write on the importance of statistics and a summary of why we need this service.

With Hikma Health, a non-profit organization, working to provide “Smart Care, Everywhere,” we are now able to have access to an on-line software and cloud storage area designed specifically for all our patients’ health information... their paper charts. It is true what Hikma Health says on their web page “As of now, health data management systems are not designed to support low resource settings - and need to be adaptable to these increasingly common conditions.” 

Every time we tried to think of ways to move our information to on-line storage and have all our information not on paper, all the programs available were too expensive and too detailed. Creating one that we would have to code and set up is beyond our capabilities.

HIKMA Health also say, “Under acute conditions, populations are disconnected from health care providers, and humanitarian organizations have difficulty tracking rates of disease and the amount of equipment/medications they need to order.”

Josefa, our administrator, does a great job of knowing what we need for our patients in the clinic. She knows what medicines to order according to what the doctors prescribe monthly (available funds allowing)…but tracing diseases is difficult for us. We just do not have the means to really follow-up as we would like. This electronic records service will make that more possible.

“Under protracted conditions, chronic illnesses get worse because they go under treated and preventable complications occur too often.”

This too, is true. Many of our patients get some medications from the government as well as our clinic. Being able to record ALL the medications they are taking will allow our doctors to plan a strategy with the patients who suffer with chronic illnesses.

This service will also provide for us - at our finger tips - what is working and what is not. Statistics. Finding out if the medications are consistently lowering diabetes or not; and if not, why not. 

It will allow us to go through patients’ files and develop not only strategies for individual patients, but also methodologies for the future of service for the clinic. It will allow us to tap into grants and provide for the Nicaraguan government accurate statistics of the diseases we are seeing for their own nationwide public health programs.

In summary, this service:

• will save the clinic money in paper, file folders, printing costs, and maintenance on the file cabinets.
• will save trees and energy…we will go greener and with climate change (two hurricanes category 4 and 5 within two weeks), Nicaragua needs our clinic to be more ecologically sound. 
• will save on space in the lobby area as well as with storage of all the files…which means better social distancing. 
• will also allow us to make fewer mistakes because everything will be typed and not hand-written. 
• will save us time which will mean more patient care. 
• and will allow us to track and keep records of diseases and patient statistics to use for better public health and grant writing as well as developing strategies for the patients. 

Dr Jorge with patients... charting by hand

This is a win-win scenario. This project is valuable to us.  We would love to be able to just spend the money for it to happen; but the CDCA is struggling to pay payroll for staff and bills as well as buying medications and sending out hurricane relief. THIS is why we need YOUR help today. Help us reach our goal of $5,400 today.

Together we can solve problems. Thank you!

- Kathleen

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Giving Tuesday: Time, Money, and Space Savings

Tomorrow is Giving Tuesday, a day fostering on-line giving to non-profits. The CDCA sets a specific project goal for that day. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and then maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We are posting on social media about Giving Tuesday and we are writing blogs explaining why we chose to focus on this project and how you can help. So far:  

1. a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important;
2. a blog about how typing data electronically makes for less mistakes and more time for patient care;
3. a blog about HOW we are able to do this now and how appreciative we are;
4. a blog on Future Friday and saving paper;
5. and today's blog about how much space, money and time we will save. 

We have seen well over 30,000 patients in our clinic …getting closer to 40,000. Files in the medical part of the clinic, dental clinic, eye glasses, and therapy areas take up a great deal of space. We have file cabinets everywhere: 

• in the lobby space,
• in a storage room,
• in the therapy room,
• in the warehouse,
• and in the vision correction room. 

Space we could use for other purposes, like:

• more social distancing inside the clinic,
• storing medical supplies and equipment,
• And more room for play in the therapy room, 

We jam files into limited space and as a result many patient charts get misfiled.  For years this has been an on-going problem…we spend so much time trying to find misfiled charts. For this Giving Tuesday, one donor gave a gift in honor of his friend, who has actually spent her visits in Nicaragua helping us refile all the files into correct numerical order. 

Bucknell Brigade students and professors have spent hours upon hours helping us find files on patients who have not been seen in the clinic in the previous five years. They pull those files and archive them to make room for newer files, and we then mark them on the computer as no longer active.   North Anderson Community Church Presbyterian volunteers have also done their fair share of standing at the file cabinets and ordering one file after another.

Filing has taken huge amounts of time, space, and money in purchasing file folders and hanging file folders. For many years we could not buy them here and so delegations would bring them down in their luggage instead of using the baggage weight for medicines. Plus we have spent money on fixing file cabinets as they break under the weight of so much paper.

With the digital on-line service we will slowly but surely remove the old files and have more space. We will not have to search and search for missing files at the start of every shift. We will not have to collate all the daily charts into the proper file and then find space for them at the end of every shift.

Time, space and money from the on-line service will save the staff of the clinic:

• time best spent with patients and developing good public health;
• space best used to maintain more social distancing;
• and money best spent on medications and supplies instead of file folders and cabinet maintenance. 

Please give this Tuesday. In the long run, the clinic will save money. 

Together we can solve problems. 

-Kathleen

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Assembly of PIGS: HOPE

I love this time of year here in Nicaragua. The rains have usually slacked off which lowers the humidity, but the land is still green with foliage. The temperatures are pleasant, the skies are blue and clear, and everyone is getting ready for festivities.

Sarah and Daniel start decorating for Christmas and adorn our house with lights and decorations. On the first Sunday of Advent, we begin hanging our Advent banners, made long ago with Brethren Church volunteers, when we were in the States running shelters. These banners are 34 years old. Sewn on the banners are the different themes for each Sunday. The first banner is HOPE and the image we chose was of Central America. 

In the 1980’s, Kathy, Sarah, Mike and I all went to Nicaragua during the Contra War. One would think that a war zone would not represent HOPE, but it did for us.

In the States we worked with the poor, the homeless, the battered, and the outcasts. These folks were taught by our U.S. society that they lived as they did due to their own bad choices…not as a result of our society’s priorities.

In Nicaragua, the people had had a revolution and had overthrown a dynasty of dictators and were now in charge of their own destinies. With the Nicaraguan citizens actively participating, the government back then was filled with HOPE for a better future. Investments in education and health care were reaching people in the most remote areas. Land reform was giving landless peasants swaths of earth on which to grow food for themselves and for others who were hungry. Local leaders in communities were given authority and resources to make real changes in their communities. It was a land of endless possibilities. HOPE was high.

Then the United States, with the help of exiled, wealthy Nicaraguans killed the HOPE as they killed Nicaraguans working for change. The CIA Handbook for the opposition…the Contras…instructed them in how to destroy the nation’s infrastructure….and how to target nurses, doctors, teachers, community leaders, etc.…and torture and murder them. Amidst all the death and fear, HOPE was slowly choked to death.

This process has happened all over Latin America, when the people actually get control of their own governments. They make changes towards socialism and the lifting up of the poor, then the U.S. with the wealthy of that nation join together to kill HOPE. The best way to break anyone is to take away their HOPE. Torturers know this. Taking away HOPE is much more effective than pain.

Political leaders know how powerful HOPE is. Pres. Obama used HOPE to ignite the Afro-American population of the United States; while Pres. Trump has used HOPE to ignite the White Supremacy Movement. Both embodied the HOPE that there would be change…HOPE is powerful.

The four Sundays of Advent highlight the four things people need to not only survive but flourish: HOPE, peace, joy and love.

HOPE helps us get up in the mornings…otherwise we stay in bed wasting away in our misery. Depressed people struggle to feel HOPE.

HOPE helps us to continue to work…hopefully for the good of our world. If we have no HOPE, then why bother?

HOPE helps us see the light at the end of the tunnel. If we have no HOPE, we can wander aimlessly.

So where do we find HOPE, when life feels so hard?

This is hard for me. I struggle with depression and struggle with HOPE. But when I look around, I see HOPE everywhere…

In Mike, who picks up his phone EVERY. SINGLE. TIME. it rings to talk to buyers, farmers, and the organic agriculture cooperative in hopes of making this year’s crops profitable for the farmers.

In a family member who struggles with mental illness but still struggles to get in control.

In my 91- year old mother, who tries her best to enjoy life to its fullest even though she is losing more and more of her hearing and eyesight while being stranded in our home.

In the passion of the youth to demonstrate and protest for racial justice and climate change.  

In the staff of the clinic, who work hard to kindly meet the needs of the patients even when the patients grump and grouse.

In the farmers, who year-after-year continue to plant while climate change messes with their crops over-and-over again.

And in the poor, who do NOT lie in bed and curl up in a ball and die.

Maybe I’m confusing stubbornness with HOPE or maybe the two are connected. We won’t give up. We won’t. Is it HOPE or stubbornness? Or does the stubbornness feed the HOPE, or is it vice versa?

You decide. Whichever it is, stubbornly hang on to that HOPE or all is lost. The torturer wins.

-Kathleen

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GivingTuesday and Future Fridays and Climate Change and...

 It all seems to roll over me in one giant growing ball of complications... we won't have many Future Fridays if we lose our trees and can't breathe... our children won't have many Future Fridays if we can't stop climate change.  Scientist say that unless we change, apparently we're going to keep having more severe weather patterns like the hurricanes that just swept over Nicaragua.  And we are creating environments that encourage the emergence of toxic pandemics, with their ongoing after-effects on the increased health needs of our patients... and with COVID-19 protocols and social distancing in place, how do we even attempt to continue to meet those needs?  And... and... and.... 

But that path of thinking is too big... the more the problems cycle around the bigger the ball keeps getting... problems too huge to wrap my head around. 

Instead...

One tiny step in the right direction: Using less paper in the Nueva Vida Clinic.  NOW.

This Giving Tuesday.  NOW.  

One attainable goal that we CAN help do, and can do it NOW. 

We can save eight trees each year starting NOW. We can create more space for patients by using less space for paper files. And we can protect our health givers and our patients in the process by switching to a digital patient record-keeping system.

We just have to get it in place... get it started... and then this ball of action can itself begin to roll and grow.  But we can not do it without your help.  We've been promised $1,350 so far.  We are a fourth of the way there.  It won't fix hurricanes.  It won't keep viruses from forming.  It isn't a magic answer.  BUT it is a real place to start, to help, to make a difference.

  https://jhc-cdca.org/givingtuesday/

Together we CAN tackle problems.

- Sarah

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Giving Tuesday: Thanksgiving

Today is Thanksgiving in the United States. It is also the day before Black Friday (a horrid tradition that has made its way down here to Nicaragua), and four days until Giving Tuesday, an opportunity to give to non-profits through social media. The CDCA sets a specific project goal for that day. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and then maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic. We are posting on social media about Giving Tuesday and I am writing blogs explaining why we chose to focus on this project and how you can help. So far:

1.  a blog about the two hurricanes hitting Nicaragua in two weeks, climate change and why going green is important. 
2. a blog about how typing data electronically makes for less mistakes and more time for patient care. 
3. and today, a blog about HOW we are able to do this now and how appreciative we are.

We are grateful this Thanksgiving Day for the Hikma Health organization, whose philosophy is "Smart Care, Everywhere".  They found our website and asked if we were interested in having an electronic patient record-keeping system for the Clinic…duh!

Through the last eight years, we have been exploring many ways to do this, but we just did not have the expertise to implement this idea of moving from paper to digital. We finally started having internet in the clinic in 2018, thanks to Philip and Lydia, who came to volunteer from London.

Hikma Health volunteer staff have been working with Sarah who works with Ligia, our dental hygienist. Ligia also understands computers and has had more available time away from dentistry for this project, because she is pregnant; she needs to be extra careful about exposure to COVID-19, and so has not been working in our dental clinic. Thanks to the two of them, information collected from clinic administrator Josefa and from me has been interpreted into understandable data language and passed onto to the coders at Hikma Health who are custom-designing an electronic record-keeping system specifically designed for the Nueva Vida Clinic! This work will ensure that we have what WE need and not what a clinic in Kenya, for example, might need. 

For this online software program to work, we need tablets and smart phones.  Thanks to Hikma Health donations we have already received some which they managed to ship through Peaceworks (NJ) and Quest for Peace (CT)…to whom we are also most grateful.

We are extremely grateful to Hikma Health for all their hard work at: 

• custom-designed coding,
• working with lay folks and older folks to develop the best program for us, 
• seeking grants to allow us to use their services free of charge for six months,
• and donating tablets and phones. 

What a gift sent to us from The Divine to our clinic! That they choose to do this work and that they found us is a wonder.

And amidst all the needs of the world with hurricanes, fires, droughts, floods, economic loss with COVID-19, we are deeply, deeply grateful that many of you would choose to help us in this endeavor. It will save us money in the long term and help us limit our effect on climate change.

Thank you because together and ONLY together can we solve problems.

-Kathleen

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Giving Tuesday: Controlling Mistakes in the Health Clinic

Giving Tuesday is in six days is Giving Tuesday, an opportunity to give through social media to non-profits. The CDCA sets a goal for that day for a specific project. Though Nicaragua has suffered with two hurricanes in two weeks, the goal we set awhile back for this year was $5,400 to set up and maintain for one year an electronic patient record-keeping system for the Nueva Vida Clinic.

We are posting on social media about Giving Tuesday and I am writing blogs explaining why we chose to focus on this project and how you can help. Yesterday, we posted a blog about the two hurricanes, climate change, and why going green is important. Today, I want to talk about typing vs. writing. 

Each time a patient comes into our clinic, this is the process Clinic staff follow, printing or writing in cursive at each step:

1. We enter the patient's name and patient number and which doctor they will see on a roster.
2. We accept payment: either a coupon earned from volunteer work, or a token 50 or 60 córdobas (equivalent of $1.43 or $1.72) which goes toward the doctor’s exam, medication, and any necessary lab work. Then we write out their name, patient number, method of payment, check off what they need, and sign the receipt, giving them carbon copies.
3. The intake nurses take a clean daily check-in sheet and write out the patient's name, patient numbers, phone numbers and vitals. 
4.  If they are a new patient, then we add a medical history sheet and a patient card with name, patient number, address and phone number. 
5. The doctor takes the daily check-in sheet and fills in their medical evaluation and the prescribed treatment. 
6.  The doctor then fills out a prescription sheet with the medication that the pharmacy will fill for the patient and instructions for taking the medication. 
7. If the patient needs laboratory tests, the doctor fills out a separate lab exam order. 
8. The doctor then tallies symptoms or conditions treated on a separate pathology form for our records. 
9. The patient takes the prescription sheet to the pharmacy where our staff write separate printed slips of paper for each medicine, including the name of the patient, the medication, how to take the medication, and what condition it is for. 
10.  Afterwards the pharmacy staff write down in a notebook what medications were handed out to be entered into a computer later on to maintain the pharmcy's inventory.

We often see about 100 patients/day and hand out about five medications per person. Can you imagine writing all that down by hand? 

The more patients the clinic sees, the sloppier the handwriting gets…and we have had many doctors and nurses who cannot write legibly at all. This means that if a doctor sees a patient who was previously seen by a different provider, they often cannot read the patient’s chart to know what their medical history is. When we hire new staff OR have visiting doctors, this is a real problem.

We have had to track down patients who have already left the clinic to refill medicine orders because there was a mistake in dosing or the medication itself when the doctor wrote it incorrectly or the prescription was not correctly interpreted in the pharmacy. Amazingly, this has happened less often than you might think.

We often have problems filing or finding paperwork because in the hurry and with the patient moving from one area of the clinic to another, their names or their patient number get written down incorrectly.

With the new electronic patient records system, everything will be entered into a Cloud-based system on tablets or phones. How will this change work at the Clinic? It will:  

• eliminate confusion while trying to fill prescriptions
• eliminate the tedious writing and mistakes 
• eliminate the confusion with patient names and numbers and will eliminate physical filing work
• eliminate the confusion of trying to understand the written data when entering it into computers 
• eliminate the duplication of medications from one doctor to another if a patient has to see a doctor other than their primary care physician 
• reduce check-in time
• reduce the charting for doctors (after getting used to the new system) and allowing for better patient care 
• and mostly allowing other doctors to actually learn what has gone on with the patient by reading clearly typed notes.

For just $5,400, you and we can not only set up the tablets needed for this system, but also cover its internet and cloud-based costs for a year…amazing!

Together we can solve problems.

- Kathleen

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Giving Tuesday: Hurricanes, Climate Change, and Doing Our Part with Your Help

A week from today is Giving Tuesday. An opportunity to give through social media for many non-governmental organizations (or non-profits). The CDCA tries to set a goal for a specific project and though Nicaragua has suffered with two hurricanes in two weeks, the goal chosen before they ever arrived was to raise $5,400, to set in place and support for a year an on-line service to get the clinic files and information away from paper printing, instead stored in the Cloud. 

We are advertising GivingTuesday with daily posts.  In addition, I will write blogs explaining why this project is extremely important and why now we can accomplish it in more detail. Today, I want to start with the two hurricanes that just hit Nicaragua in two weeks…the impact of climate change.

Nicaragua produces less emissions than much of the world (in 2016…0.9 metric tons per capita, to the U.S. of A.’s 15.5 tons per capita). Yet with climate change, Nicaragua is at high risk as one of the areas most effected. As a global response to the ever-increasing temperatures and storms, we – as the CDCA – need to do our part.

Right now, we use up about 50,000 paper copies a year for the clinic: daily sheets on each patient exam; rosters for the patient loads; lab exam tests and results; daily tallying sheets for all the different services; patient history sheets; and then other miscellaneous forms. Putting all of this on tablets and phones and storing it in the Cloud will annually save the paper weight from about eight trees (8 inches in diameter and 45 feet high) a year in the paper alone. 

Eight trees saved will produce 1,300 pounds of oxygen in a year and will absorb 13 tons of carbon per year. That is more than what 14.5 people in Nicaragua create in one year.

When one adds in the process of making paper by using water to make pulp, the energy to create the paper and the energy to wrap and ship the paper…one ream of paper creates 4.59 lbs. carbon dioxide…so with this new system we are saving 459 lbs. of carbon/year going into the atmosphere (that is 0.23 tons/year). Plus one ream of paper uses 15,000 gallons of water so we will be saving 150,000 gallons of water in paper alone!

Every bit helps. Nicaragua is watching closely as another low pressure in the Atlantic is forming…if it does it will be Hurricane Kappa, the 31st hurricane of 2020 (it looks like it will not…thank God!). If it does its path is headed to Nicaragua.

Remember Nicaragua is the second poorest country in the hemisphere and although the government is doing a wonderful job, there is little money and the need is great (300,000 people need food; one-third of the population lives in poverty; and 70% of the population works in agriculture. Bean crops…a substantial food source…have been hit hard as well as other crops.

Doing our part to limit climate change is a must…and with your help we can.

Together problems can be solved.

- Kathleen

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Assembly of PIGS: Giving Thanks

photo Shutterstock licensed

Thursday is Thanksgiving and although with COVID-19 we are keeping to just having our intentional Community together for the meal, it is a day to give thanks. I love Thanksgiving. I love that we stop for half a day to be together, cook, eat, and drink. We sit and listen to Alice’s Restaurant, and though this year we will have no volunteers to whom to explain the song, we will listen, sing, and laugh. That song and time has become holy to us in the Community.

Every Monday, we, the Community, gather to worship. Our worship is loose and flowing; but two things we do faithfully are to start by bringing good things that happened the week before into our circle, and end with bringing people who need our thoughts and prayers into our circle. Lately, it is hard for us to think about good things. I asked Mama the other week, “Do YOU have anything good to bring into the circle?”

“What? Besides the old stuff?” she said shaking her head.

“Bring in the old stuff, Mama.”

“Well, we have food and a house and we are living.”

Sometimes these days, that is all I THINK we have, but we have so much more:

1. We have each other in our Community, and though at times we feel isolated, we still have each other (I can’t wait to be able to hug again!).

2. We do have our basic needs met and have been able to meet the basic needs of the CDCA…though how... a miracle?  Well, I believe, God is helping this work through so many.

3. We have people who pray for us and this work which – I believe - helps with number 2.

4. We have volunteers stateside like Steve selling coffee and being the CDCA’s lawyer, Sue depositing donations, Tracy and Racheal being our legal address, board members helping in various ways, Jessica writing checks, Joseph and Alex dealing with sending paper mail for us, Coury and Cassie dealing with mail for us and the list goes on and on.

5. We have volunteers in Nicaragua like Lila working on legal stuff for us, health promoter volunteers working with the clinic, Dominga working extra hours to provide more therapy sessions, volunteers in the clinic learning and providing care, Steve helping us navigate the future, Neil working with Daniel on social media, and again the list goes on and on.

6. We have a great staff who are there when they are needed both personally and professionally.

7. Though shaky and achy some days, we all have our health.

8. We who have living parents and siblings are fortunate that they all love and care for us.

9. We who have children are fortunate to have children that love and support us.

10. We who have grandchildren are fortunate to have the most adorable and smartest ones in the world 😉

11. We have the greatest friends who make us laugh and who hug us (or will) when we cry.

12. In other words, we have a whole host of people who have our backs.

So why is it so hard to think of good things?

Sometimes we feel so swamped by the bad things…like recently, two hurricanes in two weeks and looking at crop failures…we forget the good.

Two people in my life are great at saying “thank you” and praising people consistently: Sarah and my dear friend, Donna. I’m horrid. I think it, but the words do not come out of my mouth enough.

I used to pick up our boys from school and tell them “good job” about grades they got or something that happened, but the traffic would be heavy and with watching that motorcycle driver trying to kill himself with our car… that would be it. The boys would get home and tell Sarah who would hoot and holler at their successes.

I frequently start to write a letter to someone and will think, “now how would Donna express this?” and my letters would be much better and kinder.

It is not only good to give thanks to The Divine or the universe or whatever you consider that is greater than yourself, but to also give thanks to others for all they do. Lift up the people you encounter. Lift up your family members. Lift up those with whom you work. 

Samantha, our granddaughter is two, and has a will of her own. We have been trying to teach her to say “please” and “thank you” in either language and unless she really wants something, she ignores us…but when I consistently say, “thank you for the frog, thank you for the doll, thank you for the bear, etc.” as she piles high her toys in my arms; then, when I hand them back to her she will say “thank you.”

Thankfulness expressed is contagious…as contagious as COVID-19. I’m going to try and make it a habit… the goodness…not the virus.

Happy Thanksgiving!!!

-Kathleen

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