Thursday, May 28, 2020

Future Fridays: A Call to Christians

In the United States, white evangelical Christians are the bedrock of the Trump candidacy.  They see Pres. Trump as honest and morally upstanding.1   I know and love many white evangelicals and - for the life of me - I cannot see how they can focus only on one issue…abortion.  All of those whom I know and are white and call themselves evangelicals believe that abortion is considered murder and as such should not be legal.

Knowing the Bible as I do, I do understand the sanctity of life.  But for so many of them, abortion is the only Right to Life issue.  Most do not believe the facts that scientists present about climate change, which is now killing mothers with unborn babies, children, and adults…people innocent of the crime of destroying our biosphere.  Most applauded Pres. G.W. Bush when the U.S.A. waged war in Afghanistan and Iraq, again killing the unborn right along with the born, the vast majority of whom were innocents of the crime of 9/11.  And now with the coronavirus most white evangelicals think that Pres. Trump is doing a great job, while the people dying the most are of darker skin tones, the poor, and the vulnerable…the invisible ones to too many of us Whites.  

Pres. Trump, along with too many in power, lies. There are people in all areas of government, science, history, and his administration fact checking what he says.  He is not up-standing.  Donald Trump adopted the pro-life stance, when it was needed to get the Republican endorsement.2   

What are our responsibilities as Christians in all of this?  

I truly believe we are accomplices when we allow a different set of rules for the powerful than we do for the least powerful.  We are collaborators with the rich, including the ultra-rich billionaires and trillionaires,3  when we allow them to accumulate and accumulate while people are hungry and live in poverty.

Have we forgotten what we were told by our Leader, Jesus Christ?  We are to be servants to each other.  We are to take care of our earth, not abuse it.  We are to care for the poor, the oppressed, the sick, the vulnerable, the hungry.  Can we ignore these basic tenants of our faith when we enter the voting booth, as well as when we live the rest of our lives, thinking the planet, the poor, the sick, etc. are ours to exploit or to ignore?  No, we cannot.

Because when we do, then we start lagging further and further behind the One we are supposed to be following and who – I can hear shouting at me, “For the Love of your God, catch up!”  


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2Fear: Trump in the White House by Bob Woodward, published 11 September 2018 by Simon and Schuster

Tuesday, May 26, 2020

COVID-19: When is it Time to Hunker Down?

As of today the 26th of May, Nicaragua has had 885 confirmed cases of COVID-19 with 35 deaths and 370 recovered cases.1   We now have community transmission and though those are the confirmed cases, we suspect that there are many, many more.  The Nicaraguan government predicts that the next three weeks will be our peak.2

All our doctors are out sick with fevers and respiratory issues.  Our general physician and our pediatrician3 have confirmed COVID-19 cases.  Our general physician has lost 30 pounds and both are having difficulties breathing.  Our radiologist (and our main physician) is sick but has not been tested…as far as we know.

Also, among the clinic staff, both cleaners, Xiomara and Luz Marina, are out sick, as well as our health promoter, Emir. Our nurse, Isamar, and our intern nurse, Reyna are so far ok, but we worry about them all as well as the two other clinic staff members who are on permanent leave: Jessenia and Petronila; both are at high risk of death, if they get the virus.

Although we have asked our patients to go to the Ministry of Health clinics to get tested, few have.  Two of our 140 chronic care patients4  have died from unknown causes in the last week.  Respiratory issues are spreading through our poverty-stricken communities like wild fire.  All the clinic staff members have been very afraid.

As a result of all of the above, we have now told all the CDCA’s staff to shelter at home for the next three weeks, with office staff only working as possible from home. 

After June 15th, we will reevaluate…with one exception… 

This Thursday, two of our pharmacy staff, Josefa5  and Danelia, will drop-off June’s monthly medicines outside each of our chronic care patients’ homes.  Rogelio, our construction guru and all-round-wizard, will drive them around the Nueva Vida community and the rural communities in our truck.  We do feel strong obligations to our patients and our chronic care patients are the most at risk of death from COVID-19. 

We have tried to think of ways to keep our staff safe and continue to work in some areas, but we cannot.  The best place for them is to shelter at home. Even with the protective gear that we made or bought, none of it was obviously working well enough.  Besides protecting our staff, we surely do NOT want to infect our patients or others.

Our staff are dedicated to this work.  Most are making a living wage, if they live a simple lifestyle which they do; but most, also, support extended family, which means many of our staff live in poverty.  Their biggest concern has been would they get their full salaries?  

We are committed to paying the staff’s full salaries during these uncertain times and while they are sheltering at home.  We depend on donations.  In other words, we depend on people like you to meet the budget.  Our electricity will be lower with projects on hold, as will all other bills.  But we will still need to pay staff not only their salaries, but their benefits as well. We will also need the funds to buy medicines for the chronic care patients, about $4,000 U.S. a month. 

If you are able and willing to help, please do.  We know needs are high across the world and with every little bit we receive, we promise to use to its maximum.


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1John Hopkins COVID-19 map reflects Nicaragua’s MINSA weekly update.
2The government release a 75-page document yesterday on its response.  I will write a blog on this after I wade through it.
3Both of these doctors also work for the Ministry of Health, so they could have picked up the virus there and brought it to our clinic.
4Chronic care patients mostly have diabetes and hypertension, though some have chronic obstructive pulmonary disease, Parkinson’s, HIV, and thyroid conditions.
5Also Clinic Administrator.

Thursday, May 21, 2020

Future Fridays: the Positive Side of the New Norm

As we listen to the evening’s news from the United States, COVID-19 continues to absorb most of the reporting as well as the question of “when will we get back to normal?”

We may need to rethink normalcy in our time of isolation, because it may not be what the world’s population, including all flora and fauna, need.  

Here in our CDCA work in Nicaragua, we are looking at ways to adapt to the new norm.  Wednesday we held a Zoom Live Event hosted by Megan Quinn from East Tennessee University.  Sarah did a power point presentation and about 75 people attended.  Folks joined in from all over the United States and even a dear friend from Belgium, who stayed awake to attend.  Becca and Sarah finished up the hour answering questions.

Dr. Jorge Flores, one of our clinic doctors, was going to attend with Becca translating, but he is home with fever and aches...COVID?  Maybe.  But if he had been able to attend, what a new perspective he could have brought to the 75 attendees!

Besides missing the chance to hug people and enjoy their company, the good news for the earth is that no airplane flights were required for the presentation.  No driving needed to attend the presentation, whether in Washington State, North Carolina, Iowa, Pennsylvania...well, you get the idea.  The meeting happened with technology keeping the carbon footprint low.

None of us WANT this to be the norm exclusively.  For us living in Nicaragua, we miss our children, grandchildren, siblings, parents, nieces and nephews, as well as good friends who live abroad.  In 2019, Mike and I made four trips to the States... a record for the two of us... and such a delight it was to be with family. Over our history we each usually make an annual trip north.

Our work raises a great deal more funds when one of us is talking and sharing the hopes and dreams in person.  Sarah frequently raises $40,000 each spring, and Becca over $15,000 each trip north.

But in a year or so, as we approach the possibility of a vaccine that allows safe travel for us, may we look at how to keep the carbon footprint down.  And until then, we will continue to fund-raise, spread the news, and visit virtually.  Please help as you can.


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Sunday, May 17, 2020

"What DO you do?" You Are Invited...

“What DO you do?”  You Are Invited…

Many times, when speaking in the U.S., we are asked that question.  It isn’t a question about the focus of the CDCA’s work, or not quite understanding the important reasons for working in partnership with Nicaraguan communities. Rather, the question is asked in a puzzled tone of voice reflecting acknowledgement that an 8-5pm work week probably doesn’t fit the need, and so what really is it that we do every day?

With COVID-19, the answer to that question becomes even stranger in many ways for most of us.  At our virtual Board meeting held two weeks ago, we called upon our Board to come up with fresh fundraising ideas, since our budget is strained beyond limits with no volunteers bringing donations. 

So following up on Board suggestions, several of us have spent many hours putting together a Live Event… a Zoom meeting being hosted by Megan Quinn, JHC Board member, volunteer in Nicaragua, and public health professor at East Tennessee State University.  Live from Nicaragua: Fighting Coronavirus Together, will happen this week, Wednesday May 20, starting at 5:15pm EDT.  YOU ARE INVITED to join us:  The meeting will include a presentation, followed by Q&A time including Nicaraguan Nueva Vida Health Clinic staff.

So picture in your head days spent on power point design… script writing… photo taking… editing and finalizing… all done either by communicating virtually with each other, or by standing at an acceptable social distance to talk over the back fence.  Followed by sending out hundreds of email invitations to family, friends, hosts of all our COVID-19 canceled speaking engagements, Rotary partners, etc. Plus, posting on social media. Whew!  Definitely not a routine week!

Meanwhile, of course, equipping our Nueva Vida Clinic staff with PPE meant coming up with a creative cheap solution to making masks and also face shields.  And when the face shield really did work, creating a mp4 video with instructions… first in English, and then in Spanish… so you and everyone else can make them cheaply as well, perhaps out of unused materials in your office or craft supplies, as we used for our first samples.  Oh… and then posting the instructions:

English language link:

Spanish language link:

But also… time spent ...

  • thanking donors by email and figuring out how to get paper thank yous to  donors who need those… 
  • keeping the accounts up-to-date and accurate with our own office staff now spread into four isolated locations, having each carried their office computer home … 
  • staying on top of the farmers’ needs via email and phone while watching the sky for May rains…  
  • doing only absolutely essential errands… and 
  • watching coronavirus updates on the news and the John Hopkins University global map, while attempting to keep staff and their families as protected as possible.

Yes, not normal weeks even by our unorthodox standards! 

-          Sarah


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Friday, May 15, 2020

Future Fridays: What have we learned?

As places around the world start opening back up after being in lock-down from the coronavirus, we need to reflect on what we as humanity have learned… or should learn.

Here are my thoughts:

  1. Listen to scientists.  This idea that politicians, religious leaders, and anyone who can get an account on Facebook, Instagram, or Twitter know more than scientists do is nuts.  If we had listened to epidemiologists and global health organizations, we would have known for years that a pandemic was coming and could have prepared.

  2. When in crisis, listen to the experts in their fields… see above.  Also, don’t deny the facts.  China, the U.S., the Russian Federation… all played down the seriousness of the disease and had to then back-pedal to keep the virus from killing even more people.  Denying facts do not make them any less true.

    photo - Shutterstock licensed

  3. Keep calm and address the problem head on.  Our daughter-in-law, Cassie, is a family medicine physician.  She says that she is glad that Gavin Newsom is her California governor because he comes on the news regularly and calmly states the problems and the solutions they are doing in connection with COVID-19.  He doesn’t speculate.  He doesn’t throw out ideas off the top of his head.  He listens to the experts.  He is consistent in California’s approach to the virus.

  4. Pay and protect those on the front-lines, as it were, for their dangerous work.

  5. Those who are asked to give up certain “liberties” or - as I would describe them – comforts… should cooperate.  Many have given them up and too many still do not.  They isolate until they decide their “need” is greater than the common good.

    Open California beaches protest
    photo: Shutterstock licensed

  6. As the virus has spread, we see more clearly all the disparities that have always existed.  Poor people with poor health die.  Homeless people are crowded in shelters or sent to parking lots to sleep.  African-American people are dying more.  Old people, left alone in their homes or those in nursing homes, die more.  People who live paycheck-to-paycheck start to go hungry.  The people with various disabilities are often triaged to not receive critical help… and…

  7. Poor nations are screwed… they are so, so screwed.

Now let’s see if during this coronavirus crisis we have learned sufficiently to face the other crisis also now facing us… that of climate change.

Can we NOW start:

  1. Listening to scientists?

  2. Stop denying the facts?  Climate change is real.

  3. Staying calm and addressing this massive problem head on?

  4. Giving the workers the support that they need to address climate change?

  5. Realizing that our comfort is not as important as the common good for all?

  6. Addressing the disparities now before climate change starves and kills those most vulnerable?

  7. And understanding that poor countries suffer the most with climate change, can we lend aid - not military weapons - and can we support these countries instead of imposing sanctions or organizing coup d’états?

    photo: Shutterstock licensed

I pray that maybe enough of us have learned these lessons.  Maybe we can start a movement… from our homes - at least - until it’s safe to socialize again.  😊


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Tuesday, May 12, 2020

COVID-19 is here

In the past week, our Nueva Vida Clinic staff have seen more patients presenting symptoms of COVID-19.  One patient who came to the gate was quite ill and we sent him directly to the hospital, but the others had relatively mild symptoms. We are instituting a more stringent protocol to protect our staff and the patients, as well as reporting any suspected cases to the Ministry of Health.

We have installed an awning outside the clinic to check patients even before they come inside.  Our infrared thermometers that we ordered to be shipped have not arrived; in the meantime we’re using conventional thermometers.
We are asking patients more detailed symptom questions, and our nurses will be testing their blood oxygen levels with pulse oximeters…$50 each!  We will have patients smell something potent to test for loss of sense of smell, as well as checking their feet for COVID toes.

COVID toes - photo shutterstock licensed

The patients who come to our clinic tend to not tell nurses what their problems are, but save the telling for the doctors, which is a difficult cultural barrier to overcome. 

After the screening, patients who are not identified as possible COVID-19 cases will go on to see the doctors. Patients who have suspicious symptoms will be sent home with information about the virus and a bag of specific medications for symptoms, all without entering the clinic buildings.  They are also being given two cloth masks for them to wear and information on how to protect their loved ones.   

These patients are strongly encouraged to go to the public health facility which has testing capabilities to be tested and for follow up with contact tracing, as this will help protect their family and give them resources if they become severely ill.

In turn, our clinic is reporting these cases to the Ministry of Health (MINSA) with the patient’s contact information so that MINSA can follow-up. We will also be calling the patients regularly to check on them.

We are ramping up protections for the staff.  We have sent home four clinic staff members who are sick - none with suspected COVID but with regular cough and cold.  All volunteers have been sent home.  We are upgrading reusable facial masks for our staff and requiring that providers wear facial shields.  This is hard for our docs who want the patients to see their faces.

Only emergency dental care is happening now.

Our therapist is one of the staff members out sick with a cold. When she is well, she is seeing patients and they wear masks and sit 6 feet apart.  This is extremely difficult with children.

We are spending tons on...
  • Bleach and washcloths to clean.  We are fumigating three times a day and mopping more and more with bleach solution. 
  • We are spending more on appropriate cloth for masks.
  • Pulse oximeters
  • More on specific medications
  • More on sewing gowns that tie in the back to protect the front of the staff instead of lab coats
And on and on it goes.
From what our clinic staff members are seeing, community transmission may be finally happening and may hit our area hard. The government said that May would be the month this would happen…and unfortunately it seems that prediction was correct.

Please keep our staff and the patients and all the families in your thoughts and prayers.  We worry that the pandemic could be like a fire storm.


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Wednesday, May 6, 2020

What Does a Mother Need?

My mother is here in Nicaragua; she’s staying longer than her scheduled visit due to the coronavirus pandemic.  Mama is 90 years old and still is important to wellness of my soul… as many mothers are.

Kathleen and Peggy - May 2020

I can make comparisons between mothers here and what Mama was to me when I was little.  Mama lived in public housing from the time I was one until I was six years old.  She stretched every cent as far as possible.  Until I was one year old, she lived with her mother, which was not always pleasant for her.  She wanted the best for her children.

Peggy Murdock 1967 with Kathleen, Roderick, Bobby

The differences between Mama and mothers here in Nicaragua are vast, like the Pacific.  Mama had Daddy.  Many mothers here do not have the support of the child’s father.  Mama had family that could and did – at times – lend financial support.  Mama had a college degree and off-and-on had jobs to support the family, as did Daddy, who was going to college and seminary during their time of elected poverty - which is the biggest difference of all… Mama could have opted for Daddy to not go to school.

For the mothers in Nueva Vida, our clinic supplies:
  • prenatal care
  • education on mothering, labor and birth, mental health and other topics
  • home visits to make sure that before and after birth, the baby and mom are all doing well
  • a welcome-to-the-world baby bag full of helpful items for newborns
  • vitamins
  • family planning
  • support for breast-feeding through vitamins, classes, and peer groups
  • and help getting birth certificates for the mom and baby when needed.

This list just names some of the help that the clinic provides for mothers, but with COVID-19, it is hard to continue support groups, although we still encourage one-on-one peer support.  With COVID-19, fundraising for this program is difficult to say the very least… that is why for this Mother’s Day for my sweet mother who struggled hard for us, my gift to her will be a gift for all these mothers.  We ask that you do the same for your mother all from the safety of your home… an added plus.


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Tuesday, May 5, 2020


We believe strongly in doing what is right - whether it seems possible or not - and having the faith that if we do what is needed, the rest will work out...details like "how to pay for it."
We believe it is right to continue serving our patients at the Nueva Vida Clinic, and we've made necessary adjustments to keep patients and staff alike safe during COVID-19. But these adjustments are expensive. Today on #GivingTuesdayNow, let's come together to make a difference. You can help and stay updated here: Thank you for being part of our work in Nicaragua.

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