Travel Adventures, Nicaragua style

Little Corn Island

by Tina Romenesko

The day began at 6:00 a.m. at the dock in Pearl Lagoon, which was a block away from the Green Lodge. Anne and I had always planned to take this boat and fly to Big Corn Island for part two of our adventure, and after the long bus ride a week ago, Dr. Pam’s family, Sallie, and Reva, had also opted for a boat and a flight.  Each leg would be about one hour in length compared to 10 1/12 on the bus.  Dr. Pam’s daughter Alegra had thrown up 9 times on the 10 ½ hour bus ride and they prudently decided that this would be a much better option!  It was a beautiful sunny day - and ride was gorgeous along the inter-coastal waterway.  Parrots.  Kingbirds.  Egrets.  Cormorants.  and Miles and Miles of unspoiled Carribbean coastline.   We stopped for gas at Kukra Hill, where one ambulance-load-full of women had come from, at clinic, which gave us much more perspective on their journey.

As we had heard, Blufields was a little rough - and since we had 7 hours to wait - Anne, Reva, and I opted for breakfast at the South Atlantic Hotel, upstairs.  “It’s a good spot”, whispered an ex-pat sitting on the porch. That was all the push we needed, so in we went - and they had Wi-Fi.  :)

After recollecting ourselves with the traditional breakfast of eggs sunny side up, gallo pinto, salty cheese, and wonder bread toast, we ventured down the street, rolling our suitcases behind us on the cobblestones.  We hardly looked like tourists....  Eventually we made our way to the market - which was shabby inside and out, and filled with treasures.  I had heard that there was a stall where an old woman (la viejieta) sold herbal medicines and teas from the rainforest.  After asking 2 vendors about her, the third finally sent me in the right direction.  She was tiny, wrinkled, and a little terse, as I asked about a medicine for my sun blister.  Did I say she was tiny?  Honestly, she came up to my waist at most.  I bent down to hear her answer.  “No.  Nothing for my painful “ampolla”, but how about this tea to help you sleep - it’s also good for your riňones (kidneys)?” .  She showed us roots for men’s prostates, special seeds on necklaces for children to wear if they are ill-tempered, and rosemary tea for immunity.  I opted for the kidney potion, tilo, and gave her 5 cordobas.  “Can I take our picture?”  “Sí.”  As we posed for Reva, we both smiled in recognition of the many differences in our experiences, overtly reflected in our statues.  But we had communicated across these boundaries - and I had a new tea in my backpack, from the rainforests of Nicaragua.  My kidneys will be grateful for the inquiry, I’m sure.

We arrived at La Costeňa Airlines around noon - after spending an hour in the Parque Central.  The rain had started up again - as we settled in for a long wait.  Our plane from Blufields to Big Corn was delayed because of the aguaceros (or squalls) - and even so - we took off in a driving rain.  It's only about a 20 minute flight,  but it was obvious that we wouldn’t make the last panga (boat) for Little Corn.  Enter Twyla - the owner of the Cuban restaurant on LCI (Little Corn Island).   As we landed in the 8 seater plane, she took us under her wing, shuffling us into a crowded taxi.  “The panga drivers know the flight is late - they’ll wait for us”.  Wait for her is more like it - everybody seems to know Twyla.  She is carrying a large plastic basket filled with mint for Mojitos at the restaurant.  I REALLY like this woman!  .  When we got to the port - we were hustled onto the waiting panga - guys were grabbing our bags - backpack and poof!  We were on the boat, under a big plastic tarp and we were off.  

When it rains, the passengers hold a large tarp over their heads, in unison, like a make shift roof.  Well.  The swells were pretty amazing - and all I could see was the inside of the boat and the tarp, which I was holding onto for dear life - pressing down on my head and face.  We hit a couple of big swells and I thought my stomach might end up in my lap.  I used all my yoga tool box not to barf - during the 30 minute trip - which seemed like about 30 hours.  Twyla saw my fear - and kept reassuring me from the seat behind me.  "It's okay Tina.  Hang on - we are almost there - look out - now you can see the island!"  So sweet of her to help us.  

A young man with a wheel barrow was waiting for us at the dock.  There are no cars on the island, so wheel barrows are used to schepp equipment to and from the hotels, as needed.  We hugged Twyla good-bye, promising to stop by her place for a mojito in the near future and headed down the path.  We wandered through farm fields, through a marsh, and trampsed alongside a couple of modest family homes, acccompanied by cows, egrets, pigs, chickens, and the ubiquitous Nica dogs.  Eventually we figured out the Little Corn Island B and B is on the OTHER side of the island!  Upon arriving we were given a much needed piňa colada and within moments had showered and were sitting down to dinner with a glass of cold white Argentinian wine.  Perfecto!  Safe and sound in our new island abode.  :)

The diving here has been phenomenal.  The reefs are some of the best I have experienced.  Period.  Purple Sea Fans in full splendor.  Colorful healthy coral.  And a wide variety of sea life.  Our dive master, Gary, is incredible - always stopping to show us huge nurse sharks, camouflouged Spanish rays, tiny drum fish, and of course the Disco Fish!  Gary is delightful in his professionalism and his vast knowledge of sea life, and he takes very good care of us!  Probably my favorite sighting was a large Hermit Crab who had taken up residence in a Conch shell.  I’d never seen a crab home of quite that magnitude.  Must be old money.....  

Diving in the morning at 9 - and then spending the rest of the day blowing off nitrogen and enjoying other aspects of the island Then back in the panga at 6:30 a.m. to head for Blufields and then the flight to Managua.  May the travel gods be with us - especially for the Managua connection!

As Anne and I were walking back from the dive shop today, we mused on the great variety of this adventure.  What a special treat.  Languages, landscapes, accomodations, people, work, rest, and activity.  From Laguna de Apoyo to the Caribbean sea - from the hard work at the clinic to a glass of white wine on the beach at dusk - its all been a grand adventure into the heart of Nicaragua.  With much gratitude.  Namaste.

I am always doing that which I can not do, in order that I may learn how to do it. - Picasso

by Tina Romenesko

As we wandered through the soggy streets toward the clinic, we were all a little sad that this is our last day.  It has been challenging, and fulfilling, and wet, and long, and filled with laughter, tears, good news, bad news, and lots of hard work.  Each of us has been challenged to do, to see, to be something that stretches our edges.  In service work, expecting the unexpected is the norm.  We only saw 30 patients today (instead of 45-50) because we needed to clean all the speculums and pack up the PINCC suitcases with equipment and supplies.  The Nicaraguan trainees also took their written tests and all agree that they have learned A LOT in the past five days.  

Today there was a cancer diagnosis, which is always a staggering reality.  This woman has four sons - the youngest is six - and she will have to go to Managua, as soon as possible, for more diagnostic tests and treatment.  She doesn’t have the money for the trip and hopes she can find help affording treatment.  Many women die because they can’t afford treatment.  Joyce and I were called in to bring her to a quiet space to process the bad news.  Joyce is our PINCC team grandmother that has spent the past two weeks walking through puddles and up and down cobblestones with her two walking sticks.  Despite having MS, Joyce has ridden on boats, walked the beach, and held many hands during our time in Pearl Lagoon.  A fierce warrior with the biggest heart I have ever known, she offered sage advice.  “Take it one step at a time.  Talk to your family - and remember its okay to ask for help.”  I held this brave woman’s hand and told her about my son that is a 21 year cancer survivor, diagnosed at age 6.  We drank apple juice, and she talked again with Dr. Sharry to ask a few more questions before taking the bus back home.

Around 2:30, Carol brought us all together, instructing us to blow up two balloons and tie them around our ankles.  Really?  Some of us were better at inflation and others at tying, and eventually we were all set for her ice breaker.  Amidst squeals and laughter, we tried to pop each others balloons, until there were only two left standing:  Jaya and the trainee, Inez.  It was a great way to release the stress of the week and come together as a group again.  Each of member of the PINCC group shared what they had learned/loved on the trip and about Nicaragua. Sally translated for those that didn’t speak Spanish and the consensus was that it was a very valuable week of learning and listening.  Many of the Nicaraguan trainees wanted to share also - expressing their gratitude and looking forward to our return in November.  PINCC will return to Pearl Lagoon every six months to check on the trainees and continue educating them in these life saving techniques.  Each visit they are progressively moved forward until they are able to perform all of the available treatments independently.  This process usually takes about 3 years and there are always new trainees with each visit, so everyone progresses at their own pace.

The rain continued to fall as we headed our separate ways, filled with appreciation, and wiser for having experienced this amazing week together.

Creole, Mestizo, or Miskito? by Tina Romenesko

Carol opened our PINCC group meeting by exclaiming “ This is the dampest PINCC first days we have ever experienced!”  The rain here comes and goes - one minute the sun is shining and the next the sky has opened up and it is raining gatos y perros.  We were without electricity for a full clinic day and for parts of the other three days which means no fans, no air conditioning, no lights, no computer back up.  You don’t realize how much you depend on electricity until you don’t have it!  

“Because this is a first visit - we all walked in completely cold,” Carol reminded us.  We didn’t have any idea what conditions would be, how the rooms would be set up, or even how much support the clinic could offer us.  The consensus is that it has been a very good couple of first days.  The trainees are beginning at ground zero as VIAA is a completely new technique to this area - so they are brand new to the idea, as are the patients.  PINCC’s main mission is to train these doctors and nurses to replace the need for return visits, which usually takes a few years and lots of training and patience from the U.S. clinicians.  The day starts and ends with classroom time - combining study (lecture, slides, etc)  and hands-on experience.  VIAA, or Visual Inspection with Acetic Acid (or vinegar)  and immediate removal of lesions with cryo (freezing) or LEEP (electrical current) allows women to be evaluated and treated in the same day, a big advantage when patients travel long distances to be seen.  On day three, women traveled from the neighboring communities of Orinoco and Tasbapounie, spending one to two hours by panga (boat) through driving rain, to get treatment.  Most spoke predominantly Creole, a few spoke only Spanish, and we BOTH had a hard time understanding each other in interviews!!  

The support team spends a lot of time educating women in hallways and private rooms to help them understand the procedure they will be receiving, what we can evaluate, and what we cannnot do.

This part of Nicaragua was never conquered by the Spanish and therefore is unique in its ethnic and racial composition.  The population is mostly Creole, but also includes the indigenous ethnic group Miskito (nothing to do with the Spanish word “mosquito” which comes from “mosca”) as well as the ubiquitous Mestizos that are a combination of many races, colors, and creeds and speak predominantly Spanish.  This diversity makes communication challenging here on many levels.  

I begin each intake asking the patient her name, figuring out how to say it correctly, and then holding her hand as I share my name and a smile.  I emphasize that clear communication is key and that it is important for us to be sure the answers are accurate.  Smiles and gestures are always helpful, like the one that seems to be universal for vaginal births - a sweeping energy with the back of the hand, down and out of the pelvic bowl (apanavayu for you yoga nerds)!  I continue to do orientations with women that have a history of abuse and am keeping a running journal of the case histories, including only their age, ethnicity, and story.  No names.  Confidentiality is a big deal here.  Carol wants me to keep a data sheet so the director of the clinic can make a case for the need for support groups and psychological counseling for women that have been victims of rape, physical abuse, and sexual abuse.  I stress how important it is for women to support women.  “Find a good girlfriend,”  I counseled a young 20 year old mother who was feeling alone and disempowered.  “Changing your life alone is really difficult - but with the support of friends, it’s always more hopeful.”  This young woman found me as she was leaving - her VIAA was clear, and she and her one year old son gave me big hugs before they left.  “ Girlfriends,” I whispered in her ear.  She kissed me on the cheek and said she’d try.  

A troubling percentage of women admitted to being victims of domestic violence, sexual assault, or rape.  One admitted that she will not get into another relationship because she has 4 daughters and doesn’t trust men, and based on her experience; she wants to protect their safety.

Each clinic day is dedicated to a different area, plus overflow from Pearl Lagoon and Haulover, the main pueblos in the area.  Day four included women from Kukra Hill, of which many were Spanish speakers, or Mestizos.  They seemed very relieved when we offered them the option of English or Spanish.  When the bus showed up - it was a sea of women that seemed overwhelming until we realized that half of them were here for ultrasounds and the other half for VIAA.  Whew.  

Day four I was able to introduce some mudras to the patients I counseled.  The first is trying to get a restraining order (which is very difficult here in Nicaragua) so I showed her Vajrapradama Mudra - the interlaced fingers reminding her of the support around her, both visible and invisible.  She connected with her breath, with her heart, with her children, and felt the protection of the shield of compassion - keeping her family safe during this time of transition and action.  I referred her to Dr. Effy and she will have to go to Bluefields to get the court action.  It is the most dangerous time for women - when they can see that the woman in taking action against him.  She is going to talk with her sister for additional support.  Again - the feeling of shame is so strong.  I keep reminding her that she is smart, strong, powerful, and deserves to be safe.  

The next mudra I taught was Trimurti to a woman that is having a lot of pain in her abdomen, wants to have a baby, and also has bad migraines at night from a busy mind.  I explained the importance of connecting positively with her reproductive organs, and also that belly breath is a good way to ground the thoughts and induce relaxation in the nervous system.  She seemed to understand what I was saying - I hope she will try it - which is the beauty of mudras.  They are free, can’t hurt, and can give hope.  

Tomorrow is dedicated to the Miskito women from Raitipura which is only about 10 minutes from Pearl Lagoon and will offer its own challenges in language and culture.  It will also be the day to see any local women that we were unable to see during the week and employees of the clinic.

Today is PINCC’s MPH Summer intern’s 26th birthday!  

Happy Birthday Reva Grimball!  

Can you think of a better way to spend your birthday than on the Caribbean coast of Nicaragua, sitting in a damp hallway, interviewing women about their knowledge and practices concerning cervical cancer?  PINCC’s summer intern, Reva Grimball. is doing just that!  Her summer project will be analyzing the data she collects to help PINCC inform others of the need for their services in areas just like Laguna de Perla.  

Reva has an undergrad degree from St Edwards University in Austin with a Major in Biology and a Minor in Spanish.  She just completed her first year in Berkely’s Graduate Master’s in Public Health program, with an emphasis on Infectious disease and vaccinology.  I quizzed her about the safety and efficacy of vaccines to which she replied that she is 100% pro-vaccine.  Her enthusiasm includes, whole heartedly, the new vaccine for the Human papillomavirus, or HPV, which is the cause of cervical cancer.  “ Cervical cancer can be prevented and is eradicable because it has no animal reservoir.  In Australia, the HPV vaccination is mandatory.”  She also emphasized the importance of vaccinating both young women and young men, as the virus is passed between the sexes with sexual contact.  Even though it is best to vaccinate before the onset of sexual activity, young people can be vaccinated up until the age of 26.  “We were able to eradicate smallpox with vaccines.  It’s time to do the same with HPV.”  

Reva said she was attracted to PINCC because of their ties with infectious disease (HPV) and women’s issues, as well as their emphasis on sustainable programs that focus on education and treatment.

We are all looking forward to Reva's birthday cake tonight at dinner! :)

PS:  Cake was delicious - from the PINK BAKERY.  Chelsea had tried to order the cake the day before and they informed her that it was dependent on the electricity (absolutely necessary for baking a cake) and the temperature (cakes cool slowly here!)  I am happy to report that the cake was enjoyed by all - with a nice round of Happy Birthday To YOU at Ulrich's Bar and Restaurant accompanied by a light Caribbean breeze!

JUNE 10, 2013 - Clinic Day One in Laguna de Perla, Nicaragua

PINCC Blog post by Tina Romenesko

The torrential rains during the night had left us without power, but the gas stove was humming as I entered the cozy kitchen of the Green Lodge.  Arlene and Wesley, our hosts,  were busy serving breakfast to the PINCC volunteers, six at a time.  Coffee, scrambled eggs with tomato and pepper, gallo pinto (of course), bread, guayaba jelly, and some of the most delicious pineapple I have ever tasted.  We were all done, and fully coffeed,  by 7:00 sharp and headed for the Clinic, where the patients were already lining the soggy and overcrowded hallways.  Some volunteers began setting up rooms while others began the interview process.  Fifty numbers had been distributed to patients, which meant we had a very full day ahead.  Many of them had come by panga (boat) from neighboring communities and represented at least 3 different ethnic groups that comprise the Pearl Lagoon region.  We weren’t sure if the interviews would be done in Spanish or English.  The people in this area speak both languages, as well as many ethnic dialects.  Our intake forms were in Spanish, but most of the interviews today were in a combination of the two.  It took me awhile to get the gist of the accent - in English.  I asked them to be patient with me as I tried to listen and spell their names and towns over the rattle of the continuing rain on the roof.  Most of us were standing in puddles or underneath roof leaks, but everyone pursued and communicated the important facts surrounding each woman’s reproductive health issues.  

We have brought Cytotechnician, Dr. Fatima Figueroa from Leon with us, which allows clinicians to perform a PAP test if the clinician feels that the view of the cervix is inadequate or incomplete.  This option gives patients the most accurate result, if there is any questionable tissue in the viewable area.  It usually takes weeks to receive PAP results - and follow through can be formidable as slides are often read off site, or even sent out of the region.  The problem today is the lack of electricity.  The microscope lights won’t be illuminating any slides until we have power.  Fatima and Sara, a medical student and pathology intern, stained 16 slides today, and hope to examine them tomorrow, but time will tell.  The power outage originated in El Rama - the regional capital - so it is imposiible to guess when we’ll be sending emails, enjoying air conditioning, or even powering microscopes.  If you see this BLOG ENTRY, we are back in business.  

I am always impressed by the volunteers willingness to do ANYTHING - and I mean ANYTHING.  No job is too menial when the team is in need.  Today I found myself doing interviews, educating clients in the hallway, donning rubber kitchen gloves and assisting Becca and Sallie in sterilizing instruments, and eventually was called upon to follow-up with clients that had been victims of abuse.  It is estimated that around 25% of women with HPV - the cause of cervical cancer - have been sexually abused before the age of 16.  The incidence of HPV rises with the age of onset of sexual activity, numbers of partners, and also the amount of stress the women endure throughout their lives.  For these reasons, our intakes include very personal and important questions that can raise difficult emotions and memories.  My role was simply to inquire, listen, and offer support and safety for them, however they needed it.  It is an honor to hold these women’s stories in confidentiality and with deep compassion.  

Seven hours later, when we break for lunch, we have seen 45 patients, performed a handful of cryos, and scheduled about half a dozen LEEPs for the end of the week when we HOPE to have power to perform them.  We have also given many women the good news that there were no abnormal cells in their cervix!  So many women came to the clinic with the C word, front and center.  They leave relieved, better educated, and empowered to improve their sexual health practices - physically and emotionally.  

PS:  Just got power!  Blog going UP!!!

Meet  Jenny – from Laguna de Perlas (blogger entry from Sallie Weissinger)

We got to Laguna de Perlas, a first-time trip for PINCC, Saturday evening shortly after sundown.  The last third of the 13-hour bus ride (note:  Sallie had come from Leon) was on unpaved roads.  At times the bus driver would come to a turn in the road, looking up to see which direction had more electrical wires going its way, and choose the route with the greater number of wires.  We let out a sigh of relief when we arrived at 7 pm.  It had been a long day, but we were here, gracias a Dios.

And why Laguna de Perlas, a place our coordinator Carol Cruickshank calls the most remote place PINCC has ever gone, including Africa?  It's because Jenny Williams, PINCC's Leon connection with the Ministry of Health, was born and raised in Laguna.  It has been her long-standing hope to bring more health resources to her region.

Jenny was one of ten children – five boys, five girls – born in “Pearl Lagoon” on the northern Atlantic coast of Nicaragua, where the Atlantic and the Caribbean merge.  Laguna de Perlas was part of a British protectorate, and the people, of mixed indigenous and African heritage, speak English and  Creole, as well as Spanish; the town seems more Jamaican than Nicaraguan, and we're in culture shock, trying to remember to say “good morning”  and “thank you” in lieu of “buenos dias”  and “gracias.”

When asked why she became a nurse, Jenny offers two main reasons- her father and mother.  When Jenny was 14, her father died at age 50 of pancreatic cancer without adequate medical care.  Her mother had to raise the 10 children on her own; Jenny doesn't know how she managed it, although she recalls several aunts in Panama helping out.  There was no family planning in those days, and her mother ended up raising many more children than she would have chosen to have.  Jenny talked movingly of a miscarriage her mother had.  Oarsmen rowed her mother, bleeding and wrapped in sheets, in a canoe to the clinic in Bluefields for 18 hours, hoping in vain to get help.

Jenny went to a school in her village run by Moravian evangelists, but for high school had to go to another town where she lived with family members.  For three years she pursued nursing training in a town called Bilwaskarma, near the Honduran border.  To complete her degree she went to Managua for mandatory public health and psychiatry courses, a move that ultimately led her to her work in Leon, where she has remained since 1975.  Had employment opportunities been available in Laguna de Perlas, however, she would have chosen to go home to work.  Following her nursing program, Jenny worked as an assistant surgical nurse and then as chief of nursing at a Leon health center.   In 1991 she returned to nursing school for two additional years to become a licensed nurse, una enfermera licenciada.  With that milestone under her nursing belt, she went the administrator route and is currently Leon's Coordinator of Women's Health for the Ministry of Health.  

Jenny's interest in the medical field is matched by several of her family members:  her older sister also became a nurse, and her nephew Dr. Wesley is a pediatrician here in Laguna and sub-director of the clinic where PINCC will spend the week working.  (Dr. Wesley's father, Jenny's brother Wesley, is a trained high school teacher and runs the lodge where we are staying.)  And Jenny's children?  Her older daughter is a lawyer, and her younger daughter has just finished her medical training to be a gynecologist.

Busy, capable, big-hearted Jenny is married to a lawyer in Leon, who shares her with an expanding family of Nicaraguan women whose lives she can alter in a way that wasn't possible in her mother's time.  Brava!

BLOGGING ENTRY - TWO.  Our time in Laguna de Apoyo was magical.  Yesterday we decided to hike the Mombacho Volcano tour - an active, but presently dormant - volcano.  Yeah.  We wondered what the heck that could mean too.  The volcano hasn’t erupted for hundreds of years, but is still steaming.  On our hike around one of the craters, we were able to experience a fumerola - an opening in the earth that shoots up sulphur infused steam!  As I turned around the guide teased me, “ Pareces aun mas joven ahora”  - or you look even younger now!  I said - I’m going back!  Fountain of youth or fumerola de la juventud?  Sounds good to me!  

Our guide, Belinda, is 23 years old and has attended the University of Leon with a major in Tourism.  She attended the public university, which is free, and is a delightful young woman with an infectious laugh and light heart.  Anne, Belinda, and I immediately connected, speaking mostly Spanish with some English peppered in when necessary, and have talked about everything from Catholicism to the role of the U.S. in Nicaraguan history to language (her boyfriend is German so she is also learning his language!) and points beyond - plus a great tour of the crater around the volcano.  We rode up the steep paved (like with pavers) road on an enormous double decker truck that felt too large and too top heavy for the roadway, but we made it, up and down without incident!  The views of Lake Nicaragua, the Isletas, and Laguna de Apoyo were amazing and helped orient me to my surroundings.  Bromeliads, orchids, butterflies.  The forest is called “ un bosque enano” or a dwarf forest as the trees are low, green, THICK and filled with vegetation.  Over 35 plant species may live on ONE TREE!  Compact greenness at every turn.

We shared a traditional lunch in Granada at a darling garden patio  restaurant.  Belinda tried to get Anne and I to try the Chicharrones (fried pig ears) but we opted for just a sampling of her Vigoron - a very typical dish with yucca, cabbage slaw and, of course, fried pig ears!  As we said goodby to Belinda, we expressed our gratitude for her willingness to share on so many levels.  Back in Managua, we met up wtih Sara, a lovely medical student from Iowa whose energy and grace will be a wonderful compliment to the PINCC team.

As the bus from Leon arrived with last week’s volunteers, Sara, Anne, and I were practicing Sun Salutations and doing Mudras on the patio in front of our hotel.  :)  The long ride, a supposed 8 hour trek across Nicaragua, headed for Laguna de Perla on the Caribbean Coast. would be an opportunity for us all to connect, reconnect, and rest.  Carol noted that this group contains more returning volunteers than any other trip she has organized.  As I found my seat at the back of the bus, I met Sharry and her daughter, Chelsea.  Sharry is an Ob/Gyn from Chippewa Falls, Wisconsin!  It seems that the Midwest is well represented on this mission.

The trip passed quickly for the first 5 ½ hours - sharing stories and pre-ordered gallo pinto (Nicaraguan rice and beans),  At Ramas the road turns to dirt - a formidable task for our air conditioned micro bus, but the amazing scenery offered a much needed and appreciated distraction.  Houses on stilts, seemingly constructed from 2 X 4s, peace lillies growing like wild flowers along the road, birds of all shapes, sizes,and colors......  I put on my headphones and enjoyed the scenery with Counting Crows as the soundtrack.  However, as the sky turned to night and we were still unsure of our trajectory, everyone settled in for the longggggggggg run.  We turned into Pearl Lagoon around 7 PM, after having spent 4 ½ hours on the dirt road and covering a mere 50 km. of distance.  Dirty and hungry we headed out for a quick dinner (not!) and some more camaraderie and team building, Carol style.  

Our team consists of:  Four clinicians - Dr. Pam (and her family), Dr. Sharry, Anne and Jaya.  Four interpreters:  Sally, Patricia, Sue, and myself.  Support:  Joyce, Chelsea, Becca, and Priya.  Pathology student:  Sara  and of course our fearless leader, Carol.  

MORNING ENTRY - JUNE 7, 2013.  I just watched the sun rise over Laguna de Apoyo, accompanied by the cartoon like warble of the Urupendula birds nesting above me and the Congo monkeys howling all around me.  Pretty spectacular.  When I booked the night for Ann and I at the Apoyo Restort and Spa - it looked pretty nice - was within our price range - and that was that.  I could have never imagined that I would be sitting on the porch, front and center to a rare  natural phenomenon.  

The Urupendula is a native Nicaraguan bird that each year creates long (like 3 foot long) pendulous nests from the fronds of bananas.  A task that takes about a month.  The flock that have nested in the large Guanacaste tree in front of our villa have created over 30 nests and are continuing construction from morning to night - both inside and out.  These large dark feathered birds have long brightly colored beaks and bright yellow tails.  Both sexes build the nest, climbing in from the top to construct and to sleep at night now and eventually to lay their eggs.  The call is like something I have never heard before.  Cartoon-like.  To make the sound, they must turn upside down, on a tree branch, and flip back up, like an ancient indigenous instrument or a child’s toy.  It’s the motion that makes the noise, and it is loud!  

One of the developers of the property, Gail from Kalamazoo Michigan, says this phenomenon is a once in a life time experience.  The nests are usually scattered throughout the rainforest and these naturally shy birds tend to cease all activity when a human meanders by.  But here they are - front and center - almost within arms reach - an amazing backdrop for my evening glass of Pinot Grigio and my morning cup of coffee.  I am a lucky girl.

Ann and I met up in Houston, flew to Managua, arrived at Casa San Juan without incident.  Always a plus when traveling to Latin America.  Our driver, Edgar, arrived at 9:00 sharp and drove us to my preferred destination of Laguna de Apoyo.  I had seen the crater lake the previous year from the mirador de Catarina (lookout) and knew I needed to plunge my body into its waters.  Our resort is undergoing an amazing transformation.  The 140 villas are perched on the verdant green crater that surrounds the lake, with a pool, restaurant, spa, and even an obstacle course.  

Many of the units are in poor condition, but the new manager, Gerardo from the Netherlands, has a plan to get this place in tip top shape by January.  There are 40 owners and it is a condo/hotel set up where owners can only spend ⅓ of the year in their unit.  Our villa is amazing.  Nicely appointed, large, very traditional in decor, and remember the view?  We are the ONLY guests in this off season.  They kept calling me “ Mrs. Tina “ :)  .  I’m thinking yoga retreat in the spring of 2014?  Put it on the calendar.

We meandered down to the lake and both had a lovely swim in these sacred waters.  As I slid my body into the warm, crystal clear fluid energy of the lagoon, I released old ways of being and limiting beliefs, opening to the unlimited potential locked in my heart and soul, waiting to be released.  Soon we will be immersed in the sea of service work and our community of volunteers.  Both Anne and I are filled with gratitude for this opportunity for some personal reflection before the service work that awaits us in Laguna de Perla.  

Today we have booked a tour to Mombacho, an active volcano and national park area about 45 minutes from here.  Then back to Managua to connect with the group tomorrow morning at 7:45 a.m.  The journey has begun - and what a wonderful first step.