From the desk and comments from Robert Craig – Esperanҫa Boardmember and Esperanҫa Traveler

Three days after surgery to correct a disfiguring cleft lip, nine year-old Gabriela broke her silence. Accompanied by an adult neighbor from her village, she walked from the pediatric ward and sat at the nurse’s station where members of Dr. Nick Retson’s volunteer surgical team huddled daily to manage surgical supplies and nurse the recovering patients’ incisions to ensure proper healing before their often long journeys home.

The shy girl who arrived five days earlier for evaluation with her hand always covering her face spoke through her interpreter who said, “Gabriela wants to know if she can give you a hug.” This is when you know that Esperanҫa transforms lives.

This February I will return to Jinotega with my wife Robin who will photograph the work of Esperanҫa and their partner AVODEC. Our mission is to help tell the stories of the people we serve through surgical missions and community development projects.

My previous trip with the volunteer surgical team was a true light, to see how everyone plays a role to create a successful mission. You have the surgical teams that dedicate their skill and time away from their offices and patients back home, responsible for bringing all surgical supplies and paying all international travel and local in-country costs. Next is the local partner, AVODEC, who provides local medical mission management. Led by Luis Lanzas, the Medical Mission Coordinator, AVODEC maintains Esperanҫa’s relationship with the hospital ensuring they are prepared to allocate the necessary facilities and extra local medical staff.

But perhaps the most important task is to find the people most in need of surgery—the kind not available to local doctors and surgeons—and bring them to the hospital. From the start of the mission surgical teams hit the ground running, and they want candidates pre-selected, ready for triage on day one, with as many surgeries as time will allow. This requires AVODEC/Esperanҫa to ensure that the people in need are there and ready to have their lives transformed by our surgeons.

The Jinotega Department (think of a “state”) is the largest of Nicaragua’s 15 departments. It stretches from the city of Jinotega on the southern end to the Honduran border and the huge Bosawas Natural Reserve which makes up almost half of this department. To find patients for the different types of surgery, Mr. Lanzas and Dr. David Quezada travel for days, by truck, by foot, and on the rivers by “cayuco”, a motorized wooden longboat, stopping to visit villages in some of the most remote parts of Central America.

This is where you find people with the most severe cleft lips and palates.  Clefts are birth defects with a strong genetic component and wide variation between different ethnic groups. Native Central Americans not only have one of the highest incidences of clefts, but also the most severe. When Luis and David reach the far edge of Jinotega district, a three day 280 km journey down Rio Coco bordering Honduras toward the North Atlantic Autonomous Region of Nicaragua, they are in an area populated by indigenous people with distinct ethnicity, language and culture. And their children suffer disproportionately from clefts.

These are the people most in need. People who subsist on farming and fishing, and may have never seen a hospital, People with limited means to travel great distances. As Dr. Retson says, “these are exactly the people I want to treat.”

On February 19 Robin and I will board our flight for Managua on our way to Jinotega. AVODEC has graciously agreed to take us on this journey to the villages to find more patients for Dr. Retson. On this upcoming mission he is bringing two dentists, who will add another valuable dimension to the work of restoring patients to good health. We may also be reunited with Gabriela and her dad in her remote village in the Miskito region.

As a board member of Esperanҫa, I am grateful for the opportunity to see how our donors contribute to the incredible team effort that has made possible over 7 surgical missions in Jinotega last year alone, transforming the lives of 265 patients and their families, and spreading goodwill from our communities in the USA as those patients return to their families, schools, and communities.