Wanda Visser, RN, spent eight days in the impoverished region of Jalapa, Nicaragua, as part of a humanitarian mission organized by Interfaith Service to Latin America (ISLA).

Visser has been a medical professional in Ada for 21 years and obtained her RN in 2003. She is in the process of obtaining her bachelors degree from Minnesota State University, Moorhead, and was introduced to ISLA by her Transcultural Nursing instructor. "I have always been curious about different cultures," said Visser. "I thought it would be a perfect opportunity to experience another culture's approach to health care."

ISLA is a non-profit organization funded by donations from organizations and private individuals. The team members are volunteer who pay their own way to make the trip. Six teams are sent to Jalapa, Nicaragua in a year. Each team consists of individuals from a variety of disciplines. Visser's team consisted of five pediatricians, one pathologist, one endocrineologist, several other physicians and RNs, a physics professor, three construction workers, and an interpreter.

The group arrived in Managua on the evening of March 10, 2006. The following morning they boarded a Ministry of Health bus to head north to Jalapa, just a few kilometers from the Honduran border. The trip took several hours and even before reaching their destination, the team saw its first patients. During a meal stop in Esteli, one of the physicians visited a 3-year-old boy who had cardiac surgery in Houston, TX, two years ago through a program facilitated by ISLA.

The trip took the team past rice paddies and fields of tobacco and coffee. Paved roads turned to cobblestone and very narrow bridges spanned deep gorges.

At Jalapa, the supplies were unloaded at the clinic, which was attached to the hospital. "As we wet up the pharmacy and the equipment we would be using, my first impression was Oh, this is the hospital . . . Yup . . . I'm in a different country alright," recalled Visser. "They didn't have sheets on the hospital beds, though they clean the mattresses between patients. All of the rooms had four or five beds."

"The family provided patient care. The nurses only did the skilled nursing duties. The government doctors were on strike the first few days we were there."  A physician's wage in Jalapa is $100 per month, a pediatric cardiologist can make $200. "The first two days in the clinic were designated for los pepitos, the developmentally and physically handicapped children of the region."

On the 16th, the ISLA team traveled to a remote mountain clinic. Word of mouth spread the news of their arrival and patients, including many children, lined up. Wherever they went, they were greeted by people from miles around. Many traveled on foot while other traveled by bicycle, horse, or oxen. Motor vehicles always had the right of way, Visser observed. Visser had a variety of duties including doing patient intakes, dispensing medication, wound care, and assisting with PAP smears. One of the goals of this mission was to perform 190 PAP smears which the University of Minnesota would process at no charge.

When not caring for patients, Visser had some time to take in the surrounding culture. Jalapa is a community of about 30.000 residents but Visser said that it really didn't feel that large. She stayed at the Hotelito #1 and stayed cool in the 90-degree temperatures with the help of a ceiling fan, bottled water, and fresh juice prepared for every meal by Mama Chunga. The nights were calm and spent on the veranda with a cool drink. "I'd watch the geckos hunt insects. I didn't see or hear any mosquitoes. That gecko is hired," Visser mused.

She noted that the parents took great pride in their children there. "We did not see one case of diaper rash." Despite the low family incomes, the children were always well dressed and clean.  "The children wore uniforms to school. The girls wore white blouses and blue skirts and Mary Jane shoes with white knee socks. The boys had white shirts and glue trousers and dark shoes. They were all very neat."

The eight days passed quickly and soon the team was headed back to the United States.  Visser plans on returning with ISLA next year and is currently collecting items such as small soaps, toothbrushes and paste, ziplock bags, shampoos, and small containers for ointments, to take with on the return trip.