Bringing the Art of Nursing to La Carpio, Costa Rica

As you may know, I had the opportunity and privilege this past spring break to serve the people of La Carpio through International Service Learning, as a part of Shorter University School of Nursing‘s Global & Community Health Practicum. Even having been on several international mission trips before, this experience changed the way I perceive poverty, healthcare, and my role as a nurse.

During the first day of clinics, we went door-to-door, surveying the population and giving appointment cards to those with acute illnesses that needed our care. This served multiple purposes. Primarily, it ensured that the patients that came to our clinics were in need of treatment and could be served by the resources we had on hand. We didn’t have the means to treat every condition, so by seeking out people that we could help the most, we avoided making promises of care that we couldn’t keep. Secondly, it served as a venue to provide therapeutic communication to even those who we could not treat. We spent the same amount of time with families that we could treat as we did with those that were beyond our scope of care.

That is not to say that choosing which patients to give appointments to came without a challenge. At first, that responsibility brought some intense anxiety. We were split into small teams and given complete independence in deciding who to give appointments to. I started to ask myself how I could be sure that I made the right decisions. I had to reconcile with my faith leaving a family’s house without having given an appointment to anyone. It became good practice in faith and trust. First, we had to trust in God’s guidance and sovereignty. Relying on the Holy Spirit took a lot of weight off of our shoulders and helped us realize that all we had to do was be obedient in His direction and trust Him to care for those that we were unable to. It also provided a great opportunity to trust the nursing judgement of ourselves and each other, which we will carry with us into our practice as future nurses.

We soon felt confident in the interviewing process, but the poverty we faced that day was impossible to ignore. Even though we prepared ourselves, what we saw changed us.

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(Photo credit: Travis Lugo, BSN Student)

Poverty plagues La Carpio unlike any city I’ve visited before, domestic or abroad. Two out of three residents ended up being Nicaraguan refugees. Some were there legally, but many didn’t have documentation, and therefor had little to no access to health care. The people who did have access to running water said that it was unreliable and sometimes unclean. Many of the adults had little to no education and therefor limited employment opportunities, if that. Their homes were built with whatever materials they could find, on steep, hilly terrain, and in the flood zone of a nearby river.

Yet, their joy and gratitude for what they had was often written all over their faces. They didn’t need us to feel sorry for them or give them “a better life.” They genuinely loved their life, and just needed our time and our genuine, loving care. Charity is something they could use, for sure, especially with regards to cleaner water, but that wasn’t the role God gave us there. We were there to give them holistic, patient-centered nursing care. We had to set aside our desires to provide them with every little thing we thought they needed, and accept the work God laid out for us. Through Him, we were making a difference despite their living situations remaining the same. The healthcare system only lets local doctors spend up to 10 minutes at a time with patients, and many doctors work without nurses. Taking the time to interview them and spending an hour evaluating them brought them more joy than we can know.

I had to continuously remind myself that I was making an impact on both their physical and spiritual health, despite not being part of my idea of a typical medical mission trip. At first it was a major struggle, because I didn’t get to spend hardly any time at all praying with patients or guiding their spiritual growth. During my service in Mexico, we prayed with every single patient, but in Costa Rica the focus was more on their concerns and well-being. While in Mexico, I saw up to a hundred patients a day, ISL’s program makes appointments with about 50 people, spread across three days and two clinic sites.

It was a contrast, for sure, with what I was secretly expecting, but perhaps not a bad contrast. I think both approaches could maybe learn from the other, but I grew an appreciation for ISL as the week progressed, because of the vast amount of time I was able to spend with each patient. I discovered issues my patients were dealing with that I would not have had time for in a fast-paced, high-volume clinic. Our thorough conversations were able to identify a patient whose history of sexual child abuse accounted for most of the presenting physical symptoms and a patient whose chief complaint turned out to be less serious than an existing condition that he had no idea about.

Even when the patient’s history had little to do with their presenting symptoms, the fact that we were interested in knowing about them brought them joy. They were excited to share their life and health with us. Their spirits were lifted by the amount of time being invested in them. We assured them with smiling faces that they were going to be taken care of today, and that is spiritual care. Even if I didn’t break open a Bible.

A healthcare role unique to the nurse is the opportunity (and responsibility, really) to strengthen a patient’s spirit. False hope does no good for a person, and I would never advocate that, but instilling genuine joy and a healthy hope for their future well-being works miracles. A nurse can make a patient feel like someone really cares about them and is willing to go beyond treating physical symptoms.

Although my father’s cancer diagnosis was absolutely terminal the day he found out (and deep down, we all knew it), his nurses kept his spirit up the whole time. When the doctors told us he wouldn’t make it past the weekend, he made it another month. And another month. Not because the nurses gave him the false hope that he would pull through, but they treated him like a real person. One asked him about his family and watched as his face lit up while he talked about us and showed pictures. Another used appropriate humor to get laughs out him. He not only got the best treatment available, but he was confident in the care he was receiving. The combined efforts of the doctors and nurses at Northside helped him believe he was in good hands. His body was actively destroying itself, but his spirit endured.

Solomon, one of the few men to ever be gifted by God with complete wisdom, said this about the importance of joy and spiritual care:

A joyful heart is good medicine, but a crushed spirit dries up the bones.
– Proverbs 17:22

We call this the art of nursing, and it can’t be taught by reading a book or listening to a lecture.

I chose Shorter University’s School of Nursing because of the commitment to integrating faith and profession. Our trip to Costa Rica confirmed I made the right decision. Seeing and caring for the people of La Carpio gave us a new compassion for our patients and a greater passion for our field of work.  We practiced nursing care through assessment and administering medication, but also the art of nursing through therapeutic communication and counseling. The local doctors working with ISL showed genuine interest and even eagerness in teaching us about what we encountered, and encouraged us in our own careers. Our translators, many of which were med students, proved to be a tremendous and irreplaceable aid to our work. All-in-all, it was incredible.

If I’m being honest, I went into this trip unsure of the impact I would make, but I have come out unable to ask for a better or more fruitful experience. If I ever came across another chance to work with ISL, I would definitely take it in a heartbeat!

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“Heal the sick who are there and tell them, ‘The Kingdom of God has come near to you'” – Luke 10:9

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Send Me to Costa Rica!

Every year, the junior class of Shorter University’s School of Nursing travels internationally, where faculty and nursing students provide nursing care to an under-served population through free clinics.

Next year, during Spring Break, we are traveling to Costa Rica through a program called International Service Learning (ISL). To find out more about the goals and objectives of their nursing teams, click here. To learn more about their initiatives in Costa Rica, click here.

It will be run very similar to the way my team was when I served in Los Mochis, Mexico. It was during that trip that God called me not only to healthcare, but also to missions. I cannot wait to return to the mission field abroad with newly acquired nursing skills.

Each student is responsible for roughly $3,400 to cover airfare, food, transportation, lodging, materials, and tuiton. This adds up to approximately $75,000 for our entire 22 student team. If you are willing and able, please consider supporting my fellow classmates and me financially. What you may consider a small contribution could bring us even closer to our goal and allow us to take advantage of a great opportunity.

To donate via GoFundMe or check out our fundraising progress, visit our page by clicking here, or typing http://www.gofundme.com/SUNursingMissions in your address bar. If you’d prefer to donate using PayPal directly, click here, or click on my donate button in the sidebar to the right. Sponsor me for $15 or more and I’ll send you the t-shirt we designed for our supporters!

If you decide that you are not equipped to support in that way, that’s okay too! We desperately need your prayers as well. Please pray for our team as we prepare physically, mentally, and spiritually. Pray that in all things, we may serve in the name of Jesus Christ, and He will receive all the honor and glory.

Thank you so much!

 

“Heal the sick and say to them, ‘The Kingdom of God has come near to you.'” – Jesus Christ (Luke 10:9)

 

5 Things God Taught Me in Nicaragua

As many of you probably know, Kaitlin and I returned to Nicaragua this past July to minister to and serve the people of El Bongo and Los Cedros. It was only our second time visiting, but it already felt so familiar and home-y upon arrival. God showed up in brilliant ways, and I cannot wait to share some pieces of that with you all. One thing I have discovered about blogs on the Internets in the last few years is an intense fascination with lists. I’m not sure if it is a good idea or not to contribute, but here goes: five things I learned from God in Nicaragua.

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True Joy (Tales of a Nicaraguan Missionary Journey: Part 2)

Earlier, I attempted to share my experience as a missionary in Nicaragua, only to discover how very much there is to share! I only got far enough to tell of how God got Kaitlin and I to Nicaragua, I didn’t even begin to tell of our time actually spent there. If you haven’t already read it and are interested in how God provided for our journey to Nicaragua despite great difficulties, check out my previous post.

On June 9th (2013), Kaitlin and I, along with our team members, boarded a Delta flight to Managua, Nicaragua. Before I dive any further, it’s important to know a little background information about Nicaragua and its people. Nicaragua suffers from terrible poverty, with over half of the population unemployed or underemployed, and a fourth of the country without safe drinking water. A quarter of a million children in Nicaragua are illegally employed to supplement the bare survival income of their families, and a third of all children suffer some degree of chronic malnutrition. The poor have little to no access to health care, and child mortality rates are six times worse than the United States.
Our time in Nicaragua was the first in which we had ever witnessed extreme poverty first-hand. Facing that degree of poverty was hard, but also different from what we expected. Most of the people we met with (especially those who already knew the LORD) were joyous, happy people. They may have had lives that were much simpler than ours, lacking the resources we take for granted, but they appreciated what they had and didn’t let anything affect their joy. They were normal people, just like you and I. They didn’t seem to want to be pitied or bombarded with aide. They just wanted to get to know us and let us build a relationship with their community. It didn’t take long at all for God to start teaching re-teaching me another lesson or two…
True joy doesn’t come from stuff, it only comes from Jesus. 
Alternatively, We don’t need stuff, we only need Jesus.
 
Perhaps the perfect example of this that we witnessed was an elderly woman named Santita. She was very sick the day that we met her, but still full of the joy of God. She asked us if we would let her sing to us! Of course, we said we would love that. After praying for her singing to glorify the Lord, she blessed us a song, which I was able to get a clip of:



Her love of the Lord is so evident, and we were so grateful to have met her. Despite living in poverty and facing sickness so great that she felt as though she would not live very much longer, she had reasons to sing to the Lord. Her last words in the song were prayers of “Glory to God,” and “Praise the Lord.” We were all so encouraged by her faith and love for God, and I pray that if Kaitlin and I get the chance to return next year, we will have the opportunity to visit her again. Will you join me in prayer for her? Please pray for her health, and that she would be a light in her community. Pray for her village to come closer to the Lord and be protected from illness and the Enemy.Santita was not the only one. The villages were full of wonderful people that we fell in love with. They lived simple lives, but were okay with it. I’m not talking about neglecting essential needs. These people need clean water and adequate food, and we did take time during the week to hand those essentials out and meet their needs. The book of James is clear on faith being dead without works, and that there is no sense in telling people that Jesus loves them if we were not going to love on them through meeting their needs. However, you don’t see sophisticated living structures, big fancy meals, any cars at all, gadgets/gizmos, etc. They live on the bare minimum. Their lives are simple. But, no matter what my idea of “living standards” and “comforts” were, God quickly changed my heart from an attitude that thought my purpose was to make their lives “better” to one that knew that all they really need is Jesus.

Am I making any sense? I almost felt a little envious of how simply they lived. I get so used to the noise and busyness of the United States, that being in a place away from it all was quite refreshing. I was able to feel God’s spirit so much better. I was able to sleep sounder and wake up with much more energy. My spirit desperately needed that break from the noise, and I am so grateful for it.

I think we have gotten too used to welfare culture, and it seeps into the way we look at missions. If our missions were solely based around taking resources to needy communities and giving stuff out, we would not really doing the people a service. All we would be doing would be setting up a welfare system that the people can become dependent on. Our mission host family even discouraged us from giving stuff away to the children, because none of the families want to feel like we pity them. They want to be treated like normal people. We didn’t neglect their basic needs, but didn’t focus on it the entire week. The focus was sharing the gospel, getting to know them, and praying for them.

There were several instances where the people would even give something of theirs to us, even though they had little. Kaitlin was especially touched by a girl named Kim, who gave her a bow after a church service:

I’m so glad I was able to capture that moment. For the average American, that would be a small gift. Coming from this girl who had so little, though, it was very special.

We live in a culture that holds on to things. We seek more and more things to satisfy our itches and obtain comfort or happiness. A 2010 Princeton study even stated that Americans believe happiness peaks at a salary of $75,0001. Nicaraguans like Santita probably won’t see that kind of money in their entire life, but live life with a joy so complete that none can compare.
Jesus says in John 10:10 that he came so that we “may have life to the fullest.” Other versions use the phrase “live abundantly.” He also says in John 15:10, “I have told you these things so that you can have the same joy I have and so that your joy will be the fullest possible joy.”
Life and joy to the fullest does not come from things or a certain salary, but from Christ alone. I am so glad God chose such an incredible experience to reaffirm this truth in my life.

– Zack

1. Data taken from an article in Time, “Do We Need $75,000 a Year to Be Happy?” – http://www.time.com/time/magazine/article/0,9171,2019628,00.html

Tales of a Nicaraguan Missionary Journey: Part 1

Goodnight1… it’s been a while since I’ve updated this thing! Writing/blogging is something that I really enjoy, but spare-time seems to have evaded me recently. If I ever do come across free time, I like to spend it with my wife anyway, so the blog unfortunately gets shoved to the back-burner. It didn’t help that until yesterday my computer hasn’t worked reliably, either. My shift at the bakery shifted back to the early morning (5am – 1pm), and I reformatted my laptop, which worked like a charm! Long story short, I now have the time and the laptop to dust off this blog and crank out some posts**. Here goes nothing…

As the title suggests, I have done some missionary work in Nicaragua since my last update. I might as well shut this thing down if I don’t share that journey on here! God rocked my life so much that week that if it doesn’t inspire me to write, nothing will. Kaitlin and I (yes, we BOTH got to go! It was our first time as missionaries serving together. Awesome! Just awesome. Anyway, this parenthetical situation is getting a little out of hand…) served in Nicaragua during the week of June 9th, but our journey getting there began about a year earlier, when God started putting a strong yearning in our hearts to find a mission trip to go on together. Later that year, our church, West Rome Baptist, announced several mission trips taking place during the summer. We just knew God had a place on one of those trips for us. We decided together that day that we would go on one of them, but had no idea of the obstacles in store for us. This brings me to the first lesson God taught re-taught me:

If God calls you somewhere, He’ll make sure He gets you there.

In December of that year (2012), two car accidents less than two weeks apart totaled both of our cars. The second accident sent me to the hospital with a broken leg, and put me out of work for nearly three months. The driver at fault in the second accident was driving under the influence of alcohol, and had no insurance. Not only did we have to buy two cars, but also carried the responsibility of the hospital bills. He didn’t have insurance, and the uninsured motorist policy on my wife’s car did not include medical payments. We were on vacation, and lost the amount we paid in advance for the remaining three nights there. Needless to say, it was a hard situation to soak in. At this point, with all the unexpected expenditures and lost income, saving up for a $2800 mission trip seemed way way out of the picture.

However, God doesn’t really care about any “picture” we conjure up in our minds. He doesn’t see things the way we do.

Our insurance company didn’t budge on covering the medical bills. We couldn’t blame them, though. We didn’t have the coverage. If you are reading this and are unsure if your uninsured motorist policy covers medical payments, FIND OUT ASAP! It’s definitely worth the extra $20 per six months, and the percentage of people who drive without insurance is getting pretty ridiculous. In the United States, 14.29% of drivers are uninsured. That comes to about one in seven drivers! In Georgia, that percentage is about 16% and in Tennessee (where my accident took place), it spikes to 24% (ranking third in the nation!)2. Unfortunately, it is becoming more and more likely that the person who hits you on the road has no insurance, so please, I encourage you to get as much coverage as you can afford.

Our insurance company was very generous, however, in reimbursing us for our totaled vehicles and letting us use rental cars for as long as we needed. We were given more than the cars were worth, and were able to quickly use that money on new cars and medical bills. My agent even listened as I vented about the situation when it was going on, and we were able to carry a great conversation. He followed up and showed he truly cared! If anyone out there is looking for some great, affordable coverage, Liberty Mutual insurance is where it’s at! My agent is Crawford Adam. You should look him up! I don’t usually advertise or anything like that, but my insurance company took care of me when I needed it the most, and that says alot!

About a month after the accident, our growth group3 at West Rome Baptist got together to fellowship. Ever since the accident, members from our group showered us with love. They took turns bringing us dinner, prayed for us constantly, and never stopped encouraging and caring. We didn’t think any group of fellow believers could ever match the faithfulness and love of ours, until we went to that night of fellowship. There they presented Kaitlin and me a check. It was for $2300. Yeah, that’s $2300, not $230. Two zeros! We were overwhelmed by their generosity and sacrifice. They collected money within the group without us knowing, and were able to bless us far more than they would ever know!

Not too long after that, I got a phone call that turned things around for us even more. At the time of the call, I was helping my friend Marigrace make her wedding invitations. Being out of work and bedridden drove me insane; it was a blessing every chance I got to get out of the house, and I was very grateful for her family, who not only offered to let me stay with them during the day, but picked me up and gave me a ride whenever I needed one. I was sitting at their table, taping pictures to cards, when I got a call from my wife, who told me that her boss wanted me to work at her school until I went back to my usual job. Her boss, Mrs. Shemi Kumar of the Montessori School of Rome, had been diagnosed with breast cancer a year prior and was cancer free, but still finishing up treatment. She had to leave for a while as she recovered so she hired me as her substitute. The very next day, I was grading papers and teaching anatomy to a classroom full of 4th, 5th, and 6th graders. The unexpected income was definitely an answered prayer! Sharing the commute to work with my wonderful wife was an added bonus =]. In no time at all, the doctor cleared me to go back to work, and I returned to my job at Great Harvest Bread Company. My boss was so gracious to hold my position, and I am very grateful for her for that.

Needless to say, God provided for us during our time of greatest need. We knew in our hearts that He was calling us to missions in the summer, and that He would provide for the costs of that as well. There were two trips, one to Mexico and one to Nicaragua. After days of praying, God broke our hearts for the people and nation of Nicaragua. I put in my request off from work, turned in our applications, and paid our deposit. We had NO idea how God was going to provide for the remaining $2500 balance, but we knew He would!

While I was still working at the Montessori School of Rome, Kaitlin and I were contacted by a man who we house-sat and pet-sat for last year. He wanted us to watch his house and animals for two weeks in May and offered to pay us over $1000. Is God not amazing? Our family also provided very generously for our trip, and with a little sacrifice on our part, we brought our balance to zero with weeks to spare before our flight.

Sure, there were setbacks. Major setbacks. Accidents, loss of income. Hospital bills4. I left out the part where we found out that tax increases (and increases in our income) caused us to owe over $400 in state and federal taxes this year. Also, the man didn’t tell us that one of his three horses is a mustang that takes hours to be caught and put in his stall, while another of his horses founders frequently (and did so on our watch). That last setback wasn’t financial, but it still kinda sucked. Throughout the whole journey, though, was God’s reassuring voice of promise, His unfailing shower of blessing, and His passion in our hearts for missions. He never let us go, and certainly provided for us in miraculous ways.

God always provides. Even in the face of extreme tribulation and seemingly hopeless situations, God’s promises are sure. His love never fails, never gives up, never runs out!

The LORD called us to Nicaragua, and He was faithful to get us there, despite everything the Enemy could through at us. How great is our God?

Taken of a storm coming at Fort Mountain State Park5. The view was so much more beautiful in person. It turned out to be a powerful storm, but watching it coming we couldn’t help but be reminded of the power of our Creator. Even in the midst of a storm, His greatness, power, and beauty is evident.

To be continued…

-Zack

**Blog posts subject to change. Mostly grammar corrections, which I usually make as I catch them, which can happen suddenly without notice, perhaps in the time it takes you to read this. If you see changes, do not be alarmed. You are not crazy. This has been a public service announcement.

1. Meant as an exclamation, not a greeting.

2. Insurance Research Council data from 2009. That was four years ago. I am far too lazy to find current data. Does that make me a lazy blogger? Probably.

3. Fancy word my church uses for Sunday School. We do, however, experience a ton of growth together.

4. We still haven’t seen even the tip of the iceberg of those, even 7 months later. But we know God will provide! He is so good!

5. Fort Mountain State Park is located in Georgia, not in Nicaragua. Just for the record.