Yamuleith Part 4

It's late and this is long but it's finally written almost two weeks after the fact. The story of Yamuleith continues but this particular account is finished.

Erika stayed Friday night (her first night at the hospital) with Yamuleith and I said I would come and relieve her for several hours on Saturday afternoon so she could go home and check on things there. We called Miguel and explained the situation to him and we all decided to go ahead and cancel our classes in Tipitapa so that I would have that time available.
Erika called and wanted us to go by her house first and pick up Yamuleith’s special air mattress that she sleeps on. It is supposed to help some with preventing the pressure wounds but I’m not convinced. Erika also wanted us to bring a plastic chair so that she would have somewhere to sit in the room and to buy another plastic water bottle for her to use there.
About an hour before we got ready to leave, it began to rain and it rained hard. As we drove in to the barrio where Erika lives, we could see that the water was rushing across one of the low places in the road. The water was emptying in to the drainage ditch by the road and it was a swirling, boiling mess. Jim stopped and we watched it for a few minutes. I immediately felt panicky…I am scared to death of water, can’t swim a lick and just the thought of going in to that rushing water almost paralyzed me with fear.
The only thing I could hear was the voice of Ron Hearst from KY3 Weather in my head…he was cautioning not to try to drive across any low water bridge area that is covered by water…let alone rushing water! But obviously, the other three cars that went around us had never heard the sage advice of Mr. Hearst. Jim patiently sat there and said quietly that he thought we would be fine. I wasn’t so sure but I finally said that we would just do it.
We got across fine…although I think I may have had a mild heart attack in the process! One of the twins met us at the house to give us the mattress and the chair. We then had to go back across the raging Rio Grande to get back out on the main road. We lived through it…obviously. But the trip to the hospital was slow going as many of the streets were flooded and those that weren’t had trash and debris that had washed in to the roads making them a giant obstacle course.
We stopped at the gas station to get a PowerAde for Yamuleith…not for the drink but for the bottle. I called Erika to let her know we were in the parking lot and she told us to come back by the ER door again. She had her son, Erik, go to a window near the ER and handed her admittance card through the window to him. He then met us at the ER waiting room (the outside area) and gave me her admittance card. He told me that I had to go through the front door and show the guard the card and then Erika should be waiting for me in the hallway. I felt like I was some sort of undercover spy having to sneak in to the hospital this way.
Jim went to park the car and wait for Erika as he was going to drive her and Erik home while I stayed with Yamuleith. There was the usual crowd of people waiting at the front door and Erik carried the chair and mattress to the door for me. I showed the guard the card and he waved me in. We started in the door and he stopped Erik and told him he couldn’t go in. So, I took the stuff from him and started through the door and the guard stopped me, telling me I couldn’t take the things in. I told him they were for a patient and he wanted to know what I was bringing in and why. Well, I thought the chair was pretty obvious but I told him the chair was so that I could have a place to sit and that the mattress was a special type of air mattress for the patient. He looked at it, touching it and lifting the edges of it and then looking at the motor. He then said, looking at me quite suspiciously, that the hospital didn’t have that kind of mattress. I told him I knew that and that is why I was bringing her mattress from home. He asked to see the admittance card again and then looked at me. I looked back.
Finally, he said that I needed to have permission to take it inside. I asked him who I needed to talk to get permission and he then said I had to have a permission slip…with the emphasis on the word for paper. Okay. I realized the game was just beginning. So, I smiled and then asked him where I could get a permission slip. He pointed to a window inside the hospital lobby. I asked if I could take the things in to the lobby with me as I didn’t want to leave them outside. It was his turn then to smile and he told me “no”. He repeated again that I needed a permission slip to take the things inside because the hospital didn’t have a mattress like that. What-ev-er!!!
I took a deep breath and told him again I didn’t want to leave those things outside while I was inside. He shrugged his shoulders as if to say…”That’s not my problem, lady.” I looked up and saw Erik walking towards the parking lot to go find Jim, and I hollered at him and had him come and stand by the chair and mattress.
Of course, this whole mini-drama was great entertainment for the crowd waiting. The guard having the gringa jumping through his hoops must have been great fodder for later conversations. I imagined that the people who had crowded around the guard and me must have looked like they were watching a tennis match as their heads would turn first toward the guard and listen to what he had to say and then in unison, they would turn towards me to hear my response.
I went to the window which was a solid piece of glass with a small circle cut out for the purpose of talking. This probably is sufficient if one speaks and understands the language extremely well. I wasn’t looking forward to trying to communicate through this little opening with the woman behind the glass. Not a problem…the lady was on the phone and apparently, wasn’t in any hurry to get off. I stood and waited…and waited…and waited. Finally, she finished her call and without raising her head to look at me, she asked what I wanted.
I started out by saying I was sorry that I didn’t speak Spanish very well and that it was difficult for me to understand but that I was told I needed to get a permission slip from her to bring in a plastic chair and a special mattress. She told me that I could bring in the chair but I couldn’t bring in the mattress because they had mattresses for the patients. I told her that this was a special mattress that was filled with air because the patient couldn’t stay on a regular mattress. She told me again that they didn’t have that kind of mattress in their hospital. Again, I said that was why I was bringing one in.
She then asked to see my admittance card. I handed it to her and she examined it very closely before giving it back to me. She wanted to know where the chair and mattress were and I pointed to the door. I told her the security guard wouldn’t let me bring them inside without the permission slip.
She got on the intercom and called for a supervisor to come to the lobby. About that time, I spied Erika down the hallway and motioned for her to come and help me. She shook her head “no” and turned and walked the other way. Great. I realized that she was afraid that they would ask for her admittance card and because I had it, she was in the hospital “illegally”. I knew I was on my own with the next level of administration.
I thought I would probably have to wait some time before the supervisor showed up but it was just a minute or so until a grumpy-faced woman appeared. She looked at me as though I was more of a threat than a nuisance. When the other lady explained to her that I wanted to bring a special mattress in to the hospital, the grumpy-faced lady looked at me and told me in a very irritated voice that they have mattresses there for the patients. I explained, yet again, that this was a special mattress and the patient needed it. She glanced around the lobby and asked where was the mattress. I motioned outside. She told me to go get it.
I went back to the door and opened it, hitting the security guard in the back. I apologized and reached for the chair and mattress. Fat chance I was going to get to bring it inside now after clobbering the guard with the door. Of course, he asked to see my permission slip and told me for the umpteenth time that I had to have a permission slip to bring the things in the hospital. I was in awe that he was still able to utter his little speech without showing any signs of irritation. I, on the other hand, was tiring of the whole rigamarole. I told him the woman at the window wanted to see the items. Of course, he didn’t believe me. I motioned for the two women to come to me and by some miracle, they complied. The guard told the women I needed to have a permission slip. I couldn’t even begin to follow what came out of the supervisor other than I knew she had an extremely impatient tone to her voice. I could identify.
The guard nodded his head and I told Erik to bring the things inside. He hesitated. I told him to get the chair and mattress and carry them inside. He quickly grabbed them and I thought for a split second that the guard wasn’t going to let him in but I think he realized that particular power game was over. The supervisor had continued to talk and her voice hadn’t softened on iota.
Erik sat the chair down in the lobby. Both women were puzzled when they saw the mattress and the pump. Obviously, they both were expecting something that looked more like a conventional mattress. The supervisor told me that the hospital didn’t have any mattresses like that. I told her I knew that and that was why I was bringing the one from the patient’s home. She asked to see my admittance card and told me that they had mattresses for their patients but they didn’t have any mattresses like that. OH, MY GOODNESS!!! This was like a cross between the movie “Groundhog Day” and the old Abbott and Costello routine of Who’s On First!!!!
I reiterated that the patient needed a special type of mattress and that it was her personal mattress. I told her that I knew the hospital had mattresses but that the patient needed this special mattress and that was the reason I had gone to her house and was bringing it to her. The supervisor and the other lady talked between themselves for a minute and finally, the first lady went back in her office and came out with the pad of coveted permission slips.
They then wrote a very detailed description of the white plastic chair and the mattress and the pump, recording every detail, and all the manufacturing info that was printed on the pump. The supervisor signed off on the permission slip and as she gave it to me, she told me that I would need to keep that permission slip as it was then the only proof that those items were mine. She said that when I took them back out of the hospital, I would have to show that slip in order to leave with them so that they would know I wasn’t stealing the items from the hospital. It took everything in me to keep from saying, “You don’t have this kind of mattress in the hospital”…but my good sense kicked in and I realized it would be counterproductive…even if it would have been funny. I mean seriously…how could I steal something from the hospital that they don’t have???
I thanked the ladies and asked if Erik could carry them for me and they said that he could but then he would need to leave….he didn’t have an admittance card! AARGHH!!! Erik and I walked down towards where I had seen Erika. She was waiting in a group of people and when we got close, she motioned for us to join her. She then took us to Yamuleith’s room. I glanced at my watch…it had been almost thirty minutes since I first tried to enter the hospital. Security companies around the world should have their employees trained at this hospital!
Yamuleith heard my voice when I walked in to her room and she smiled and said my name. I saw she was lying on a patched stained sheet and was covered with a thin hospital gown. She had two IVs going and her “pillow” consisted of a small plastic bag of water wrapped in a towel and another towel rolled up adjacent to it. It was hot in the room. The windows were open and because they had no screens, the flies were buzzing in and out. She was sharing a room with two other women, both much older. Each had someone with them. The room was small and crowded and there was just barely enough room for two people to stand between Yamuleith’s bed and her roommate, Gloria’s bed. It was noisy with everyone talking loudly and at the same time.
I went to Yamuleith’s bedside and touched her face and asked how she was. She told me she was better and then asked me if I had brought any carne asada with me. That’s a grilled meat here and Yamuleith loves it. She gets it only when the gringos come. It didn’t look as though she had been bathed yet. The bandages on her knees had been changed and her ankles rested on bags of water, similar to the one under her head. Her voice was weak.
Erika quickly gathered up her things and got ready to go. I gave her back the admittance card so she would be able to get back in to the hospital. She told me that the nurse had said that I needed to write Yamuleith’s name on the chair…I didn’t have a marker and neither did the nurse. Erika worried someone would take the chair. I assured her I wouldn’t let anyone have the chair and so she and Erik told Yamuleith good-bye and they left. I called Jim and told him to watch for them and then I began to visit with Yamuleith.
As I talked with her, I tried to take in all that I was seeing. The paint on the walls had peeled, leaving large bare areas that showed various degrees of grime. The room’s bathroom had a sink, a toilet and a shower. The shower didn’t work and seemed to be a storage area for mops and cleaning supplies. The toilet looked like it was in need of a good cleaning and there was no toilet paper. The sink’s leaky pipes emptied in to a cracked bucket which sat underneath the sink. The bathroom light was so dim that it was almost non-existent. I felt sick…somehow I knew that the private hospital would have provided much better care. I realized more than ever the chasm between those who have money and those who don’t. We were on the “don’t” side.
Yamuleith said she hadn’t slept well the night before. I’m sure she missed her own bed and I’m also sure she was in such pain that it must have been difficult. While we were talking, Yamuleith insisted I sit in the chair right by her bedside. She had a fan blowing directly on her but she asked me to turn it off as she felt cold. I felt her and she was feverish. The nurse came in and hung a third IV bag…it was her antibiotic. As she walked out, the lady who was tending to Gloria, noticed that it was leaking all over Yamuleith’s bed. She also realized that I didn’t speak Spanish very well and so at that moment, she made it her personal mission to take care of and to educate the uninformed gringa on how things worked in a government run hospital.
She went out to the nurse’s station and called the nurse back in. She looked at the IV and said that it was fine…obviously, it wasn’t as the sheet was getting soaked where the shunt part lay. Her answer was to move it off the bed. So, what that accomplished was that the antibiotic was dripping all over the floor. I wondered if Yamuleith was getting any of it at all. The nurse told me I could get the mop and clean up the floor. As I started in to the bathroom, Gloria’s friend was horrified and she quickly took the mop and mopped it up for me. I thanked her and she told me how awful the hospital and the nurses were there. I agreed but I wished she wouldn’t have said it quite so loudly...I knew Yamuleith had to have heard that.
Yamuleith and I visited. I asked her why she liked carne asada so much and she smiled. She told me when she was a little girl that her father used to fix it. She told me that she had six older brothers. I didn’t give any indication at that point that I knew about what had happened to her. I asked her if she could walk and run as a little girl and she told me she could but when she was 13, she had become very sick and that after that, she couldn’t walk anymore. She said that she was always very sick after that. She became very quiet and I could tell she was thinking about things. I stroked her face and quietly whispered to her that I was so sorry that she had had such a hard life. She whispered back, “gracias, Lynne”. She had no tears but I did.
About that time, a nurse came in with a stack of paper plates and handed me one. It had some rice with just a smidgen of chopped up beef, carrots and onions mixed in it and ½ of a boiled platano. I asked Yamuleith if she wanted to eat and she said that she did. So, I fed her, bite by bite. It was a trick to feed her as she was lying on her side. I had to turn the tablespoon that Erika had brought at such an angle that it allowed me to get the food in Yamuleith’s mouth and yet do so without dumping the rice all over the bed. After a few mishaps, I got the trick of it and Yamuleith methodically chewed each bite until it was well chewed before she swallowed. I couldn’t imagine how difficult that must be, eating every meal in such a position. Several times, I would have to stop feeding her so that I could scratch her nose for her or rub her eyes. I realized more than ever how dependent she is on others to meet her every need.
As I was feeding Yamuleith, the other lady in the room had said good-bye to her family members a little bit earlier. The doctor had come in to see her and she said that she was having trouble with her heart and breathing. He had a nurse take her blood pressure (with the old manual pump up arm band) and told her that her blood pressure was fine. The lady complained that her stomach was hurting. He had her lie down and he listened to her chest and stomach area. He said that she needed a good night’s sleep and the nurse came back in and gave her several pills. The lady finally lay down and pulled the sheet up over her face, trying to block out the overhead light and some of the noise. She was lying so still that the thought crossed my mind that she looked like a corpse. I immediately thought of that scene several days later when I found out that she had died the next day.
Yamuleith slowly drifted off to sleep. Periodically, she would wake up and call my name. I would reassure her I was still there. She would have me adjust her sheet, move her legs, get her a drink, move her head, fix her “pillow, move her arm and so on. Finally, she settled into a deep sleep. I had brought a book to read and a bottle of water. I began to read and all of a sudden, I felt like someone was watching me. I looked over at Gloria’s bed and she was sleeping and her caretaker was busy writing in a notebook. The other lady was sleeping under her sheet. I glanced at the door and there stood three women, all staring at me. I was somewhat taken aback. They didn’t budge…they continued to stare. I smiled at them and one of them returned the smile. The other two continued to stare but no one said anything. I went back to reading my book and tried to ignore the three staring women. It was a bit unnerving to say the least.
Finally, Erika came back about 4 hours later. It was almost 8:00 p.m. Yamuleith continued to sleep. I wanted to kiss her good-bye but didn’t want to disturb her. So, I quietly gathered my things and Erika walked with me out to the car. She didn’t think it was safe for me to walk outside by myself…I have to say I was glad she was with me. Although the crowd was smaller, there was still quite a gathering at the door. We said our good-byes and I got in the car.
I told Jim all about my evening and we were able to laugh about the funny things…and he let me cry about the rest. I had no idea that night that we were just taking the first steps down a very long road. It’s been two weeks since we called the ambulance to come and get Yamuleith. She continues to battle the infection that has ravaged her body. Some days look very promising…others make for restless nights. There isn’t a day that goes by that we aren’t asking God for healing.
Sometimes, I wonder how much more can she endure? How much more should she have to endure? It is so hard to imagine all that her body and spirit have been subjected to in her life. I haven’t received any answers to those questions. What I do get is a reminder that God is still in control.
I find that this walk of faith is sometimes its most difficult when it encounters those who are the most vulnerable and have been the most abused. I don’t understand so many things but I don’t think I’m supposed to...I don’t think it’s my right or my place. And honestly, how on earth could I ever question God and how He works when I hear Yamuleith praise His name? Maybe that sweet conviction will help me sleep tonight.

Life Updates...

I promise I’m trying to finish the blog on my day in the hospital with Yamuleith…but life keeps interrupting…and there are other questions that are being asked so this blog is going to be just a catch-you-up-with-other-things blog.
We were getting ready to eat lunch today and were planning on going to get some copies made of some manuals and then head on over to CINAFE...but life interrupted. Felix was vomiting and had a fever. He was complaining about his kidneys hurting and that he had low stomach pain. Jim loaded up Felix’s bike and took him home. I gave Felix 100 cord for the microbus to go to the doctor in El Crucero which would leave him a little bit in case he needed to buy meds…assuming they’re not overly expensive. So…we didn’t get to go to the copy place this afternoon and Jim ran by and checked on things at CINAFE.
He also stopped by the grocery store to get a few things. And bless his heart, he brought home a little bag that had some mini York Peppermint Patties that he found at the store! In the States, we would have no choice but to buy a bag of these if we wanted the little candies…and I could probably eat the entire bag! But here, they tear open the bag and sell the little pieces of candy individually. They do it because it’s much more affordable to buy one piece of candy than a bag. But I see it as forced portion control. Whatever the reason, sometimes I think the Nicas are way ahead of us!
Immediate news on Yamuleith…she was running a high fever and then they got that under control. She was starting to improve a little but was then diagnosed with pneumonia and anemia. She then had to have 3 units of blood. She has been diagnosed with MS and possibly lupus…another doctor has said that he’s not sure of those diagnoses. She now has started running another fever and the two “crater” type bed sores are once again getting worse…and this is happening in the hospital. Thoughts of her and her situation fill my mind almost every waking moment…and many of my dreams on my restless nights. My heart aches to have a “good” answer for her care in the days ahead. That “good” answer seems to be as elusive as a good night’s sleep.
Kenneth is also not doing as well as we had hoped he would after his last round of chemo. He is to have tests done this week on his liver and kidneys to try to determine the amount of damage that they believe the chemo has done. They already know that his heart has been damaged. His color is not good and he has dark circles under his eyes. He does not want to eat and runs a fever off and on. He has been very lethargic lately.
The doctor said that he wanted to put him on a special juice diet and to discontinue the balanced in addition to his regular meals. He also said he wanted him to quit taking the Sustagen and go back to the PediaSure. He said he wanted Kenneth to begin a daily drink regimen of a juice made of strawberries, green grapes, green apples, cherries, celery and honey. Those fruits are high in anti-oxidants and I understand that they might very well be beneficial but there are a few problems with that directive. To begin with, all those fruits have to be imported in to the country…that translates to some pretty expensive fruit juice.
We could not find cherries anywhere in this entire city. We found cherry pie filling at $6 a can and maraschino cherries at $8.80 for an institutional sized jar and that’s it. We opted for the maraschino cherries and told Danelia to rinse them well and to understand they are already sweetened and have probably lost most of their beneficial properties in the process used to make them candied.
Purchasing the other fruits was also a bit of a challenge but that was more about getting past the sticker shock. We found really small Granny Smith apples at one of the grocery stores for about $1 a piece and thankfully, the price of the celery was more normal. But grapes and strawberries were another story. We found them at several places but the quality wasn’t the best. We opted to buy them at PriceSmart. I now understand why the store is called PriceSmart…paying those prices smarted!!! Strawberries were $5.46 per pound and the grapes were $6.79 for what appeared to be about a quart sized plastic container. The honey, a local, organic honey, was about $4 for a 16 oz bottle. What we bought would be less than a week’s worth of juice and yet we couldn’t buy a larger quantity as Danelia doesn’t have a refrigerator and we knew the berries and grapes would mold. So frustrating!
But, actually, I’m glad we weren’t able to buy a large quantity of those items. Danelia told us that Kenneth doesn’t like the juice and feels sick when he drinks it. So after two weeks of that regimen, the doctor has now said he can go back to just eating more fruits and veggies. We all think that is a better plan as we feel it is a much better balanced diet and we can definitely buy more of the local fruits and veggies for the same amount we were spending on those few imported items!
The other positive in that is PriceSmart once again has PediaSure in stock and although the signage indicates it’s about $5 higher for a can with less product in it than the Sustagen, when we bought it this time, the price rang up less than $2 more! We love how God surprises us with such things!
Yesterday was Kenneth’s 10th birthday!!! When I asked him what he wanted for his birthday this year, he became very quiet and shy and would not tell me. His folks only laughed and I saw Danelia shake her head slightly as though she were telling him “no”. I told him that I only had girls and that unless he told me what he wanted, he might just end up with a new doll! That brought a smile to his face and a firm head shake of his own. We went through this several times, each time, me saying some girly item, like a new dress or perfume or nail polish. And each time, he would grin and shake his head no.
Finally, I bent down and told him to whisper in my ear what he would really like to have…he looked at his mother. She looked at me and I told her it was okay. He whispered “un bicycleta”. I looked at Danelia again and she looked embarrassed. A bicycle was one of those things that would be way beyond their means.
The “grandma” in me wanted to buy the newest and the best bicycle we could find. Jim is that occasionally needed voice of reason in our family…and he exercised his voice. So, he took Felix with him to the market on Monday morning and they found a boys bike that was in pretty good shape overall. I struggled with giving a “used” bike as a gift but knowing the difference in prices, I overcame that and hoped that Kenneth would love it anyway.
We took the bike, a cake and some groceries to the family yesterday. Kenneth was thrilled with the bike. When we arrived, Danelia was in the middle of “school” with 13 small children. There was a small piñata hanging about the wooden table that sometimes doubles as Kenneth’s bed. The children were all seated around the table and as soon as we walked in to the door, they all stood and greeted us. We were so shocked at how well –behaved and well-mannered the children were. Then I realized it was Danelia’s school kids. I will explain that in a second.
Kenneth immediately came and gave us hugs. I saw that he stole a peek outside to see if we had anything with us. The bike was in the car but he didn’t realize that. I thought I would see a look of disappointment on his face, but none appeared. He went back to sit down with the other kids. We told him to come outside with us for a minute and Jim got his bike out. It was so good to see that great smile of his. Of course, all the kids had to come see what he got. He obviously wanted to try it out but we had interrupted class time so the bike ride was going to have to wait.
Now to explain all the children…Danelia has started a Christian teaching ministry in her home for some of the at-risk neighborhood children. These are children who could easily fall between the giant cracks that exist in the education system here. Many of them are from a single parent home or from less than desirable home situations…drugs, alcohol, abuse. Some cannot afford to go to school and others are from families who just don’t send them.
Danelia feels a real burden for these little ones. She was involved in a program through her church which currently has a similar daily after-school program for their church kids. They have a four-fold area approach to teaching the kids. Each day’s teaching covers the lesson from a spiritual aspect, a cognitive aspect, a social aspect and how to apply the lesson in a physical way. They also receive a light meal each day. It’s such a great program and it is funded by an international organization but the church opened the program only to church member’s kids and would not accept any of the neighborhood kids. Danelia really struggled having to turn children away because they weren’t “members” of the church.
She has been praying about this for some time. Kenneth’s recent health set-back with the finding of the three additional tumors has prevented him from going to school. This has added to his depression. Danelia said that she believed God was leading her to start a similar type “school” in her own home. She said that Kenneth could at least continue to have some type of teaching and that it would be such a benefit to the other children.
We have come alongside Danelia to help her with some of the costs of this endeavor. She began two weeks ago with 10 students. The kids come two afternoons a week and they all crowd in to Danelia’s small little living room. Thank goodness they’re small! A pastor from another church has loaned her some little plastic stools for the children to sit on. We have supplied the kids with notebooks, Bible “fun” booklets, pens, pencils, erasers, crayons, colored pencils, glue sticks, scissors, rulers, etc.
We also supplied enough empty Pringles cans (which I had been collecting over the last 1 ½ years…I knew I was saving those for a reason!) for each child to have one and we gave Danelia a packet of colored paper so that the children could cover their cans and then decorate them. These serve as their “pencil boxes” to keep all their supplies in. Mandy had given me three fun colorful collapsible totes which I adore. God thought it was a good idea to use one to store the kids cans in…He was right.
Of course, this endeavor costs the families nothing…only the effort it takes for the children to come. Naturally, Danelia was thrilled with the kids’ supplies. She had confided earlier to me that she was afraid that the children might not come because they couldn’t afford to buy their notebooks…an expense of about a $1 per book. But she was ecstatic when we brought her a whiteboard and markers for her to use with her class. She kept thanking God for answering her prayer and then thanked us repeatedly for bringing it to her. That kind of gratitude always humble me. We are used to hearing “thank you” when we give gifts…we heard that in the States. But there is something different between the well-mannered “thank you” and the utterances which overflow from a deeply grateful heart.
Danelia has already gained three more students…she said she couldn’t turn them away. She’s a good teacher and a good woman. It’s obvious she loves these children. The meal part has not yet happened. This family has such giving and generous hearts but they don’t have the resources. So, right now, the food will have to wait. But Danelia dreams and her enthusiasm is contagious. Her dreams are quickly becoming mine.
She shared with us that she dreams of building another room on to the house so that the children have a schoolroom with space but it would be separate from their own home. She wants to make it bright and cheery and welcoming...her house is small and dark. She and Arturo have talked about where they could build it and where the doors and windows would be. She wants it to have a nice floor that would be easy to keep clean. She dreams of having a new “bathroom” (an outhouse) for the children. The fun of dreaming is that you don’t have to be realistic in your dreams and Danelia dreams big. She wants a small refrigerator, a better cook stove (she cooks over an open fire) and enough dishes so that she could provide a good meal for the children and she dreams of someday having school five days a week.
I love this woman so much. They live in a 2 room house and all four of them sleep in the same small bedroom and often in the same bed, when Kenneth is sick. There are no closets in this house…there is no need for any. Clothes are washed, ironed, folded and stacked on a box. Their kitchen is outside. She doesn’t have a sink, she has a pila, a concrete sink, which serves as the area where dishes are washed, baths are taken and clothes are cleaned. Their toilet is out back by the fence and it is an outhouse. But it is always clean.
Most people I know, and sadly, I have to include myself in what I’m about to say, would want to build a new room on to their house for their own use. Most would want new furniture, new appliances or a remodel done because they were bored or dissatisfied with what they had. Few would have such unselfish dreams. I’m so glad we know one of the few.
While talking about the folks in Tipitapa, I want to let you know that Miguel and Elizabeth have separated. I can’t say I’m surprised but we are terribly disappointed. Right now, neither want to try to reconcile and sadly, both are rejecting what God’s Word says about that. In counseling with them, I was faced with the fact that they know it, they acknowledge it, but their own selfishness and pride seem to take priority over their desire to obey Him. I am both exasperated and broken-hearted with both of them but even so, we continue to pray for repentant hearts and restoration in their relationship with the Lord and with each other. I am anxious to see if Elizabeth comes to our English class next Saturday.
And speaking about the English class…we continue to have that class with the Bible study class following. For the last couple of weeks, the church has scheduled events which have conflicted with our time, so we have had to cut the classes short. We may have to either change our class time or look for another location in the future.
This Saturday, I will also start teaching a class to Danelia’s school kids while Jim is teaching the adult Bible class. She has asked me if I would be willing to do that as she wants the children have the opportunity to study English. These kids are younger kids…most are from 5-10 years of age so it will be a “fun” class, with worksheets and coloring pages. Los Cedros taught me how much they enjoy those kinds of things and I’m so glad I kept hard copies of all those things. That will make it much easier for developing a curriculum for them.
CINAFE, the children’s home, commands most of our time and attention these days. We are there almost every day, working in one capacity or another. I continue to teach the staff English two days a week…and they are an awesome class! It has actually turned out to be my favorite class yet as they really want to learn and they put out the necessary effort to do so. We have become comfortable enough with one another now that we laugh a lot and the atmosphere is very relaxed.
Jim often uses that time to take care of the endless small repair jobs that need to be done there. You can only imagine what kinds of things a facility with 15 kids needs to have fixed…ripped screens, leaky plumbing, broken hinges, broken toilet seats, broken curtain rods, etc….right up Jim’s alley!
I continue to work with the kids but because we have been asked to temporarily take on some added responsibilities there, we have had to rework our schedules there. The last few weeks, much of our time there has been taken up with more administrative duties. We have had several staff meetings this past week and we’re working alongside the administrator to help her with some budget concerns and personnel issues.
It would be so nice to think that Christians are somehow above all the human struggles that happen in this world, but that’s not the case, is it? Lack of good communication, whether intentional or unintentional, often causes hurt and anger and creates distance. And the healing process can be very painful. But thankfully, this is a terrific group of people and I think they all desire the same thing so now, we’re just working on teaching and implementing some better communication skills and we trust God to do what we can’t.
The temperatures here have been miserable lately. I think the heat is worse this year than it was last year. We are in the mid to upper 90s every day now with the heat index usually about 10 degrees higher…and out house is a good 10 degrees higher than that! The storm clouds build every day which makes the weather oppressive. I hate to see what our electric bill is going to be as we’ve had the fans going non-stop when we’re home.
For the last couple of weeks, we have had three fans going in our bedroom…one on Jim, one on me and one on Xander. His panting was keeping us awake! We’ve even gone to bed and left the bedroom door open…this door opens up to our little back deck and usually at night, we close it, lock it, and put the Charlie bar up against it. That should give you some indication of how hot it is in our room. The picture was taken at night and we don't have very good lighting in our bedroom so I'm afraid it isn't very good but you get the idea of how much our pampered pooch loves his fan!
We actually bought two ceiling fans from some missionaries that were moving back to the States. We had planned on putting one in our bedroom and one in the living room…the two hottest rooms in the house. When Jim got ready to install them, he discovered that the light fixtures in the ceilings are held in place only by the electric wires and the sheetrock. So, we can’t even use the ceiling fans!
But there’s hope on the horizon…we had another rainstorm today! That’s the third one we’ve had here so maybe the daily rains will start sooner this year. The late afternoon storms really help to cool it off and if we could just have cooler nights, we could tolerate the hot days better.
Well, I think I’ve got you up to day with life in general. Jim and I will celebrate our 2 year anniversary here tomorrow. Two years ago, we never dreamed we would be doing what we’re doing or seeing God work as we have. Every day is different. Someone asked if it was any easier now…the fact is, life is hard for all of us, regardless of where we live. The causes here may be different but the result is the same. People suffer. And some days, that includes us. But there are also mountain-top days where we can almost see the North Pole from here. And we continue to feel privileged and blessed to be on this adventurous journey God is taking us on. And we thank you for joining us as we go!

Yamuleith Part 3

Friday afternoon, when we arrived at the hospital, it was decided that Jim and I stay outside in the parking lot while Oliver and Erika took care of the paperwork inside. The thought was that if the Billing Office saw that there were Americans involved with Yamuleith, then the price would automatically increase. El Hospital Bautista is a private hospital and although it isn’t the one that most of the Americans prefer, I think the care and treatment there is much better than the government hospitals.
Every now and then, Oliver would come out to the car to update us on what was happening with Yamuleith. The ER doctors had taken one look at her and indicated she needed immediate care. They saw the infected pressure wounds on her backside and said that she needed surgery right away on the area to remove the diseased tissue.
They began prepping her for surgery while Oliver and Erika went to find out how much we needed to pay for the admittance fee. We were told before we arrived at the hospital that it would be between $400 and $500 to admit her and then we would have the ambulance fee on top of that. We were also told that the room charge would run about $125 per day plus we would need to pay for any testing that would be done, all medications used and the doctor’s fee. We didn’t feel like we had any other option and so we had told Oliver that we had the money to get her checked in and to pay for the ambulance and to pay for her first day there plus any meds.
We waited and waited. About 30 minutes later, Oliver called my cell phone and asked me how much money could we pay. I wasn’t sure I understood him so I repeated what we had and what we could pay then and that right then, we would pay $400 admittance fee, the ambulance fee, her first day there and any meds that were used. He told me that wasn’t what he wanted to know. He said the Admissions Office said it was going to be much more than that and wanted to know how much we could pay. I told him I didn’t know at that moment. And I asked him again, how much it was going to be. He said he would ask and he hung up.
A few minutes later, he called again. He said in a very panicky voice that we needed to start praying right then, that God would do a miracle. I became scared when I heard his voice and wondered if something had happened to Yamueleith. I asked him what was the matter and he told me again, we needed to be praying. I asked him yet again, what was wrong and he told me that the regular supervisor in that office was on vacation and so was the doctor who had seen Yamuleith there last year and that the man who was working in that office said that we needed to pay $4000 for the surgery and we would have to pay it right then or they wouldn’t perform the surgery. Oliver had told him we didn’t have that kind of money and the guy was calling his supervisor to come talk to Oliver.
We hung up and Jim and I began praying fervently, begging God to soften hearts and that they would see that Yamuleith needed their care and that they would be drawn to meet the need. We prayed and prayed…and then, Oliver came out to the car. He said that the man would not change the figure and that if Yamuleith was going to be treated there, then we had to pay the $4000 right then. I was sick. We didn’t have $4000 with us and we knew that even if we did, that it was going to be a drop in the bucket of the charges that would soon follow. I didn’t know what we were going to do.
Oliver said that the man told him we had two options. We could pay what they wanted or if we couldn’t do that, he said he could help us out by calling one of the government hospitals (El Hospital Manolo Morales) and making sure she would be accepted there. He said that they would transfer her in their ambulance so that she would get there okay and that he would talk to them to let them know what they felt like she needed to have done.
The only thing we could figure is that either Oliver or Erika felt challenged that they wanted to admit Yamuleith to a private hospital (the admissions personnel would be able to tell simply by looking at Erika and Yamuleith that they couldn’t afford such a place on their own) and possibly told them that Americans were paying the bill or else the ambulance attendants told the ER people that we were at the house and were following them to the hospital. Either way…that definitely was not a time when being an American here was a benefit.
I was afraid that our choice was not a choice. But I called Karen and Dwane on my cell phone…I’m so thankful I had enough minutes…to tell them what we had been told. We all agreed that as much as we did not want her to go to the other hospital, we knew that was really the only direction we could go. Again, I felt sick. I’ve not yet been in a public hospital here that I felt was giving the best of care or would even attain the level of a mediocre facility. There’s no doubt America’s health care has certainly colored our vision here.
Oliver said we needed to come inside then and pay the bill for the care that Yamuleith had received in the ER plus the ambulance charges. He said it was going to be $50.00. We figured that it no longer mattered if they knew we were paying the bill so we went inside with him. We waited and finally Erika got the paperwork to do the transfer. I knew she was upset and I tried to explain that we just didn’t have the money to pay that. She didn’t say much but just nodded her head. I felt so awful that she knew that Yamuleith’s care was going to suffer because we couldn’t pay what was asked. Or maybe I should say, we chose not to pay it. I think we could have but I’m not sure how rapidly or how much the bill would have grown over the following days. It was a lousy position to be in…and a lonely one.
Erika stood at the payment window and the cashier told her that it was going to be $50. I reached in my purse and handed Erika a $50 bill. She gave it to the cashier. The lady looked at Erika and then at me and back again at Erika. I had told Erika I would need a receipt for what we had paid. She told the cashier that we needed a receipt. Suddenly someone else came in to her little area and the two talked very quietly. I could see what was coming. I’ve seen it before.
The lady told Erika that the bill was going to be an additional $44. Erika told me that she needed me to pay the extra money. I took a deep breath and reached in my purse once again. As I pulled it out, I asked Erika why the bill was now $44 more. She shrugged her shoulders. I told her I thought I knew and I said it was because I was a gringa. Again she shrugged her shoulders. The attitude that American’s have unlimited resources permeates this society and a large percentage of the people here think that it is their “right” to charge us more. If that weren’t bad enough, the fact that even some of our friends have a very similar attitude upsets me even more. I paid the money and fumed.
I was furious that Yamueleith still was not receiving treatment. I was angry at the outrageous admissions fee. I was tired of the “rich American” judgments. I was seething that the bill almost doubled at the sight of white skin. And I was tired that every single thing we do here takes so much time and effort.
We finally got everything taken care of and then headed on over to the Hospital Morales. We got there about 20 minutes before the ambulance and the parking lot was full. We tried to park alongside the drive back to the ER but the Security Guard wouldn’t let us. Oliver tried to argue with him, telling him he was a doctor, but evidently, the guard was tired of arguing with people wanting to park there and he basically threatened Oliver by calling over another Security Guard.
The two guards finally said we could park in the doctor’s parking lot since Oliver was a doctor. We then had to walk out and around to the front door of the hospital. There was a small crowd gathered there and we asked Oliver why there were so many people standing outside and he said that they were waiting to go inside to see their family or friend but they didn’t have a permit so they were waiting there in hopes someone would give them one. I was trying to process that procedure in my mind as we walked on around to the back of the hospital to go to the ER area. It was a repeat of what we had seen at the front door.
When the ambulance arrived, Erika and Oliver went inside to the ER with Yamuleith. We weren’t allowed in through the iron bar doors, so we stood outside for some time and waited. It didn’t take long for me to start doing what I love to do in such places…people watch. But, it was a little difficult to do as it seemed like everyone was watching us! At first it was disconcerting but before long, I began to return the stares we were receiving with a smile. A few smiled back but most just continued to stare. That’s an uncomfortable feeling but I suppose it was a little unusual to see a couple of gringos hanging out at the ER entrance to a government run hospital, waiting for news on our loved one just like all the other folks.
There are opposing rows of concrete benches outside the ER and they were filled for the most part. Most folks sat or milled about, but there were a few who were curled up on the bench, sleeping. I wondered how long they had been there, just waiting to hear how about their loved one’s condition.
I guess I need to explain this a bit better. The hospital is a public hospital meaning it is totally supported through government funds. This also means that there is always a shortage of something…nurses, doctors, supplies, medicines…everything. The only thing that is abundant is security personnel. The hospital has rules and there is to be no deviating from the rules. Only those needing immediate treatment and one of their family members or medical personnel are allowed in to the ER. Once a patient is admitted and taken to a room, which contains as many patients as is feasibly possible, only one person can be in the room at a time.
This is controlled (theoretically) through an admittance pass system. There is only one visitor card per patient and this card contains the patient’s name and room number. This is the only way past the security guards who are stationed at the doors. You have to show the card before you can be admitted and then, again, only one person is allowed in at a time. I say this is how it is theoretically as I’ve seen patients with more than one person there to see them but because it is a government hospital, there seems to have been a stricter standard applied to Jim and me.
At one point, I had counted over 75 people waiting with us outside…most were waiting on family members but many were waiting to be seen in the ER. Some would leave and others would arrive but the numbers seemed to remain pretty constant the whole time we were there. They came on foot, by taxi, by ambulance, by bicycle and by private vehicle. Some were dropped off and others were carried in. Some looked to be in pretty good condition, others appeared to be in bad shape. All had to wait their turn for treatment…the idea of triage didn’t seem as though it was being put in to practice. I was very thankful that we had the help of the people at the Hospital Bautista to facilitate getting Yamileith admitted.
The thought occurred to me that this was such a good snapshot of what our “new and improved” health care system in the U.S. could dissolve into in the not so distant future. Socialized medicine always sounds so good in theory and of course, it appeals to those who are in need, but what we’ve seen here is far from what had been visualized and purported as an ideal system. It is a broken system that runs on empty promises and good intentions with the funding having run out long ago. Patient care suffers tremendously. I don’t have the perfect answer…but I sure don’t think this is it. I think man’s natural greed and selfishness gets in the way and interrupts such lofty plans. That’s the end of my political commentary for the moment.
While waiting, only one person actually dared to talk to us. She was a vendor trying to sell pieces of gum. She had asked us earlier to buy gum and we had told her no but she continued to ask. Since our fifteenth “No, gracias” seemed to be as firm as our first one, she finally wandered off to ask others. I had pretty much forgotten about her until sometime later, I saw her heading right over to where we were sitting and she asked us again to buy gum. I noticed, she hadn’t asked anyone around us.
Once again, I told her, “No, gracias.” Normally, I would have gone ahead and bought some gum from her but I didn’t feel comfortable bringing out money in the area we were in. It was dark and the crowd seemed to be a bit rougher than it was when we first arrived. The vendora then reached for a piece of cardboard and held it for me to read. It was in English and it was asking for money so she could buy food. She didn’t look any more impoverished than most of the other people among us. I read it and again told her no but added I was sorry that I couldn’t help her. I’m sure my voice didn’t sound sincere as I was irritated that she was targeting the gringos in the crowd.
She asked me if we had someone in the hospital or if we were waiting to go in. I told her we had a friend in the ER. She looked shocked. She then asked me where we were from. I told her we were from the U.S., but we lived here. Again, she looked shocked. I know her mind had to be racing. Gringos wait at private hospitals for their friends…not at public hospitals. She asked why we lived in Nicaragua and I told her we were missionaries and this is where God had brought us. Her expression again changed and her voice took on a tone of excitement. And I noticed the conversation all around us had ceased.
She asked if we were Christian missionaries. I replied that we were and I was reminded of just how many other “missionaries” are here. Nicaragua has an abundance of Jehovah Witnesses and Mormons who are extremely active and devoted in their efforts to recruit new members.
I thought for a second if those of us who know the Truth would only choose to be as committed to sharing the Gospel of Jesus Christ as those who are deceived are in sharing their propaganda…wow! What would our world be like? Would children like Yamuleith suffer as she has? Would the Nica people struggle as they do just to have enough beans and rice to make it through another day? Would missionaries continue to live behind concrete walls and serpentine wire? Would hearts change? Would ours?
The vendora interrupted my thoughts. She then asked if we were evangelicals. Now this can be a loaded question and can have a negative connotation or a positive one. I took my chances and just said yes, that we were. She smiled and told me that she was glad that we knew Jesus and that she would pray that He would keep us safe while there. I thanked her and off she went, asking others to buy gum.
In some respects, I felt badly that I hadn’t given her money but my own desire to keep us safe kept my cross body purse closed and firmly locked in position in front of me. As if to ease my mind, a few minutes later, I heard some noise at the little fritanga (a very small curbside type of restaurant) near the hospital. I saw the vendor, eating a plate of food and talking with some of the hospital employees. A little bit later, she was back at the ER area, once again trying to sell her gum. I was glad she had eaten and maybe I was justifying it, but I was glad I had kept my purse closed.
Oliver finally came out and told us that Yamileith was being taken to a room and that they were not going to do surgery that night but just get her settled in. He said he was going to stay there with Erika for awhile and then he would go home. Erika had brought all the necessary things with her that she would need to stay the night with Yamileith. He told us we might as well go home as we couldn’t get in to see her. He asked if I could come the next day and stay with Yamileith so that Erika could go home for awhile. I told him I would. We gave him 200 cordoba so that he and Erika could get something to eat from the fritanga and it would leave enough if Yamileith felt like eating, they could buy her something as well.
So, we left. It was almost 8:00. We were hot, tired and worried. So much had happened that day that I couldn’t even begin to process it all. We stopped and got a sandwich and went home. By that time, it was about 9:00. We called Karen and Dwane and updated them. Jim turned on the water tank and we took our showers…it felt good to stand in the shower and just let the tears flow. It was the first time that day that I had a moment alone and felt like I could do that. And flow they did.
There was a sense of relief that she was in the hospital but also a sense of unease that she wasn’t in the private hospital. I felt guilty and sick at my stomach…should we have gone ahead and gotten the money to pay the $4000 admittance fee at the Baptist Hospital? Should we not have insisted she go to the hospital at all? What kind of care was she going to receive there? Would she have been better off at home? Stories of people leaving a public hospital in worse shape than when they arrived are all too common. The questions just kept coming. And I had no answers. It was another fitful night of sleep.
Next blog, I’ll tell about my visit with Yamileith.

Yamuleith...Part 2

Friday morning at a little after 7:00 a.m., we got a phone call from Dr. Oliver. He said that Erika had called him the night before saying that Yamuleith’s fever had spiked and that she was very sick and needed her antibiotic. We had priced this particular antibiotic the week before just so we would have an idea of how much it cost and were shocked at the price. It ran around $90 for two weeks worth. I remember thinking I was glad we didn’t have to buy it that day…I guess I jumped the gun. No wonder Erika needed help with it. Evidently, Yamuleith has gotten to the point that the regular regimen of antibiotics just can’t handle her infections anymore.

I’m not sure why Oliver didn’t go over there then but it may have been too late in the evening to have found any pharmacies open. Anyway, he said he was going to go to a discount pharmacy and find out how much the antibiotic was so that he could come by and get some money from us. He would then go on over to their house.

About an hour later, Oliver was at our gate. Jim gave him the money, reminded him to keep the receipt and told Oliver that he wanted him to check her out thoroughly and Oliver said he would.

Jim and I were waiting for PriceSmart to open. We wanted to run by there and then on to the grocery store to buy some food for Erika and the kids. Their situation had been weighing heavily on both our minds, so when I asked Jim if we could go get some things, he quickly agreed. Normally, we would go to the market but we knew it would be really busy at that time and parking would be an issue, so we just decided to go to the stores and get what we needed so we could get on over to Erika’s house.

When we pulled up in front of the house, Erika’s 12 year old daughter, Julissa, met us at the door and quickly ushered us in. Erika gave me a quick kiss and greeting and then began telling me that Yamuleith was very sick. I stepped to the bed and noticed that once again, Yamuleith was laying face down with a pillow under her tummy. She looked so uncomfortable that I asked Erika about her position and Erika removed the small piece of material that she had draped across Yamuleith’s bottom. I saw that she had numerous large pressure sores (also known as bedsores) all over her back and backside. There were two areas that were covered with two pieces of 4x4 gauze.

Erika began to remove the tape to show me the largest one. Yamuleith’s face scrunched up in pain and she moaned. I reached out to try to soothe her and I was shocked at how hot her body was. She was burning up with fever. I asked Erika about it and she said that when Oliver came earlier, that she had started Yamuleith on her antibiotic and had just given her a pain pill not long before we arrived.

Erika continued to pull off the tape. I knew what I was about to see wasn’t going to be pleasant but I can honestly say I’ve never seen an open wound like that before in my life. I felt a wave of nausea come over me and for a second, I thought I was going to have to sit down. I hadn’t seen anything even close to that since we had visited the children’s burn ward at one of the government hospitals here a few years ago. There was no formal prayer but just a silent plea that God would keep me from reacting the way I felt.

The largest wound was between 2 and 3 inches across and was extremely deep…forming what I can only describe as a crater on her backside. The child doesn’t have an ounce of padding there and I knew the wound must be getting close to the bone. I don’t have the words to describe how horrific that place was. I have since tried to do some research on such things and what I saw is considered a Level 4 pressure wound which has the potential to be very dangerous to someone in her condition. It wasn’t bloody per se but it was just a crater of raw flesh. I am not indicating that this is what she has but the first thing that came to my mind is that must be how those with that flesh eating disease must look. It is an image I don’t think I will ever forget.

The heat, the odor of her apparently leaking colostomy bag and the sight of such a wound almost got the best of me and I really did feel queasy. I told Erika to cover it back up and asked her what Dr. Oliver had said when he saw it. She basically told me that he didn’t uncover any of the bandages but instead was more concerned about Yamuleith’s fever and pain as that was what she was complaining about.

I was furious. I have to say that I think that’s how I deal with such things when I don’t have the luxury to sit and cry my eyes out. I could feel that anger rising up inside of me. What I was seeing was unacceptable and the fact that this was what this absolutely helpless child was enduring just about pushed me to my breaking point. I think I understand very well the “fight or flight” reaction. I was scared. Yamuleith was weak, feverish and full of infection. I was afraid we might lose her. I had no choice…I had to fight…flight just wasn’t an option.

I took a deep breath and I calmly told Erika that Yamuleith needed to go to the hospital. I told her that the wound was very serious and that it was badly infected. She agreed but didn’t know what to do. She also was afraid of what would happen since she told me that Dr. Oliver hadn’t looked at the “bad place.” I told her I wasn’t sure why he didn’t but that wasn’t important right at that moment. That what was important was that we needed to get Yamuleith to the hospital that day.

Erika began telling me why it was so difficult as she had no one to stay with her other children. I listened for a minute and then told her that we were going to bring in some groceries, run home and make a phone call and that we were then going to go get Dr. Oliver and bring him back with us. It’s not that I wasn’t sympathetic to her situation…it’s that Yamuleith’s situation was the priority. Erika sensed that I was very serious and simply said, “Okay”.

Jim and I went out to the car and I did something I haven’t done since I got the call 3 ½ years ago that my mom had died…I leaned against the car and just cried out, “Oh my God…why?” Jim put his arm around me and rested his chin on top of my head. He held me for just a second and said, “Let’s get the groceries inside.” That’s exactly what I needed to hear. I do much better when a wave of emotion is about to pull me under if I have a task to focus on. I love my husband…he knows me so well.

We hurriedly carried in the groceries with Julissa’s help…25# of rice, 15# of beans, a gallon of oil, 4# of sugar, 2 bags of pinolillo (a corn drink), pasta, eggs, tomatoes, carrots, chayote, potatoes, onions, garlic, peppers, bananas, papaya, and apples. We also had bought a rotisserie chicken thinking that it would be simple then for Erika to make sure that Yamuleith would have some protein. Needless to say, Erika and her children were thrilled with that.

I think Yamuleith’s mind was somewhere else at that moment…I’m hoping it was somewhere where she was free of pain. Her voice was weak. The knots of anxiety in my throat and stomach were growing. I had been wiping her face and forehead with a wet towel. She told me she didn’t feel good. I told her I knew that. She asked me if she had a fever and I told her yes. She said she liked the cool towel on her face and I told her I was glad it was helping. She told me she was sick and I told her that yes, she was.

As usual, she said my name with each sentence. I’ve not yet figured out why she does that but I find it so special that she’s one of the few people here who does a pretty good job of pronouncing my name. I imagine her hearing skills are so honed to compensate for her blindness that she is just that much better at mimicking gringo sounds than most folks are.

Yamuleith called my name again but her voice was very soft. I bent down to just a few inches from her face and asked her what she wanted. I expected for her to tell me she wanted a drink or to be repositioned. She said, “Lynne…help me.”

That did it. The tears were going to come. I kissed her face and told her we had to leave to go get the doctor to come and help us but that we were going to help her. I put on my sunglasses so that the tears wouldn’t be so obvious to those who are blessed with the gift of vision…you might take a minute right now and thank God for your own gift of eyesight. We told Erika what we were going to do and told her to get Yamuleith’s things together for the hospital. Again, Erika told us she needed to find someone to take care of her other children. She knew Yamuleith needed to go to the hospital, she had even verbalized that to me, but I think the whole situation was just too much for her to cope with right then.

We ran home to get some cash to pay for the ambulance and the hospital admission, called Karen and Dwane and let them know what the situation was and what our plans were. We then ran by CINAFE to get Dr. Oliver. I told him that Yamuleith was very sick and needed to go to the hospital and that I needed him to go with us to help us with the process. I realize now that I didn’t give him an option. He chose to drive his own car which would prove to be a good decision. We then drove straight over to Yamuleith’s.

Dr. Oliver again checked her out and when I told him he needed to check the wound on her backside, he put on gloves and removed the gauze pad. His face revealed his shock. He pressed around the area to see if there was any infection coming out. Yamuleith made a little crying sound. I couldn’t bear to watch him do anymore and walked over to where Jim was sitting on the couch. He began asking Erika questions, wanting to know why she hadn’t told him how bad the wound was when he was there earlier. I think he was afraid we would be upset with him for not seeing it earlier. I already was but I was more concerned with getting Yamuleith to the hospital.

He then asked Yamuleith questions about her pain level and began moving her limbs back and forth. I was getting close to the end of my rope. That child needed care and needed it right away. I told Dr. Oliver I wanted him to call the ambulance. He told me that he wanted to “make sure of things” first. I took a deep breath and got the towel wet again. I finally was tired of trying to keep the edge out of my voice and made it very clear that I wanted him to call the ambulance right then. He called the hospital and asked for an ambulance to come right away.

Getting the ambulance to come was another issue. After the earthquake in 1972, Managua rebuilt in a haphazard manner, with lots of little block and lean-to houses. Streets no longer have street names but specific addresses are given by landmarks. That works okay if the landmark is – or was – well known, but if not, then it can become a little dicey. We waited almost an hour. Meanwhile, Yamuleith and I repeated our earlier conversation…time and time again. And each time she would say, “Lynne…help me,” my anxiety level rose another notch.

Dr. Oliver then bent over her and began to talk to her. She told him that she didn’t want to be sick and that she wanted to be able to be up so that she could go out and serve the Lord…and then, she began to praise the Lord, talking about His goodness and His mercy. Not once did she say a word about feeling sorry for herself or questioning why someone, who has a spirit that flies far above the rest of ours, should be trapped a prisoner in her own body.

Oliver broke and his tears flowed freely. Before long, he was sobbing. The living room is very small and it was impossible to not be a voyeur of this intimate moment. Later when we discussed this, Oliver told us that he couldn’t believe that Yamuleith’s desire was only to serve God. He talked about those he knows who are in perfect physical condition, have an abundance of material blessings and they do nothing but complain and want more. I think we all had faces and names fly through our minds at that moment…and if we were honest, our own would be among them.

Oliver assured her that she was serving God from her bed and that she had no idea how many hearts she was touching and lives that were being changed because of her. I saw a tear roll down Yamuleith’s face…the first I had seen. Oliver said he was at the top of the list of changed hearts. He later told us that God did something in him during that time he was talking to Yamuleith and he said his heart was changed.

We all gathered around Yamuleith’s bed and we prayed over her, asking God to strengthen her body, to heal her wounds, to give the ambulance attendants, the doctors and nurses hearts of compassion so that they would treat her gently, to protect her from unbearable pain and to make sure she received good medical care. We thanked God for His provisions and His hand of protection and we thanked Him for that sweet precious child who has captured our hearts. All of us had wet faces by the end of our prayers.

Finally, the ambulance came…almost an hour after being called. Three attendants came in and did a quick evaluation of her condition, asking Erika and Oliver questions. We moved the couch and her wheelchair so they could bring the gurney in to the house. I was afraid it wasn’t going to fit through the doorway but It did…no room to spare, but enough room to get it in. They opted to lift her using the sheet but still ended up dragging her across the mattress due to the inaccessibility to the bed. She cried out. I just cried.

I had no idea how watching all that would affect me as it did. In my life, I have seen many people experience great pain…some of those were people whom I loved quite dearly. For some reason, watching Yamuleith experience that pain was every bit as disturbing. There is just something about her vulnerability of body and her strength of spirit that have made a huge impact on me. In spite of all that she has experienced in this life, she retains a child-like innocence which is wrapped in a wisdom beyond her years.

Erika went with the ambulance (which took off like a shot, bouncing wildly over the bumpy road…I worried about how Yamuleith was doing) and we followed Oliver as they were taking her to the Hospital Bautista and we didn’t know where it was. We had to stop at the gas station as Oliver had to get gas. At that moment, my phone rang and it was Moises, one of the board members at CINAFE. He asked about what was going on with Yamuleith and so I told him. He told us to wait there and he would be there within minutes.

Evidently, he had come to Managua (he lives in El Crucero) and actually, was not far from the gas station. He was bringing us some money that had been set aside to help with Yamuleith’s care and had no idea all of this was transpiring. God is ALWAYS on time! What an answer to prayer because even though we had brought money with us, we didn’t have any small bills on us which we were afraid we would end up needing. And that’s exactly what Moises brought for us! God is so amazing…

I have to go now but I will continue in the next blog about Yamuleith and the hospital…

Quick note...

Just a quick note...
I'm sorry I haven't gotten more on Yamuleith's story posted...we've been running non-stop the last few days. She's still hospitalized and I should have more info tomorrow. I will also get the second part of her story done tomorrow...or I'm planning on it anyway.
Kenneth goes to the hospital on Wednesday for his check-up following this last round of chemo. It has hit him hard and he's not doing very well.
The children at CINAFE are facing some tough times right now...I'm not at liberty to discuss them but suffice to say, please pray for ALL of these special children...CINAFE, Kenneth and Yamuleith. We love each and every one of them. And please check back tomorrow for more on Yamuleith...I'm thinking positively.

Yamuleith - Part 1

I started this last night. I will be leaving for the hospital again in a little bit so I won't get to finish it right now but this will get you started on the story of Yamuleith.

It’s 11:45 p.m. and the heat index is still at 93 degrees. It is miserable in the house – must be a good 5 to 10 degrees hotter. You know it’s pretty nasty when you are sitting perfectly still and you still work up a good sweat!
I don’t know if it’s because of this stifling heat or the caffeine kicking in from the soda I had a couple of hours ago or whether it’s simply the constant replaying of today’s events in my mind but whatever the reason, I think sleep is going to be pretty elusive tonight . So that means it’s time for blog therapy again.
I need to give you some background on what we’re dealing with right now. Right before we flew back to the States in March, we were taken to visit a young girl named Yamuleith (pronounced Jahmulet). Karen and Dwane, who are the folks who were instrumental in getting CINAFE started, have been helping with Yamuleith’s care and as Karen was also going to be flying back to the States, she wanted to run by and check on her and Karen also wanted us to meet her. She had given us a little history on her but even so, we weren’t at all prepared for what we were about to see.
I will try to do this as accurately as I can. We’ve heard her story several times and so I’m trying to piece it together to get the whole thing right but there is still so much I’m fuzzy on. She and her family lived in Costa Rica and her mother died. Her brothers were extremely abusive and the family moved around quite a bit.

Finally, due to neighbors complaining about her situation, Yamuleith was removed from the home. She was put back in the home with the father and the brothers ended up bringing her to Nicaragua to avoid abuse charges. Somehow, they traveled back and forth to avoid the law. I’m not sure exactly what happened next.
But moving forward, about 15 months ago, she was found wrapped in a sheet which was wrapped with ropes or barbed wire – I’ve heard both and am not sure which is true – and left to die. She had not had food or water for 5 days. The doctors didn’t think she was going to live. She had suffered major abuse and malnutrition which has caused permanent damage to her body. I am truly amazed that she is still alive even tonight as I write this.
Cesar, a pastor, and his wife, Erika, had brought Yamuleith home to live with them. The pastor is the one who found her and he promised her that he would never abandon her. They are a poor family, who live in a two room house and they have four children of their own – twin boys, Erik & Eddi, ages 14, a daughter, Julissa, age 12 and little Cesar, age 3. The pastor is currently working on the east coast and is gone for 1 to 2 months at a time. Erika, sells beans to try to supplement their income.
Yamuleith is now a special needs child as a direct result of all the abuse she has suffered. She is blind, has a colostomy and a catheter. She is unbelievably thin…Jim thinks she might weigh between 60-70 lbs…and I wouldn’t be surprised if it were less. She has very little movement in her limbs or extremities. Her muscles have atrophied to the point she cannot hold herself up in her wheelchair and has to be tied in to it in order to stay upright. The wheelchair is a plastic chair that has been attached to a wheelchair frame. This is important to know as you have to keep in mind she sits on a hard surface all day. When she is in her bed, she is only able to slightly move her head and several fingers. She is totally dependent upon someone to take care of her every need. She can’t even brush off the ants that crawl across her body.

It would be easy to think that she wouldn’t be able to communicate very well but that is not true. She is a very smart young girl and she loves having visitors. When she’s feeling “good”, she wants to talk and loves to talk about the food she likes to eat…the food that the gringos bring when they visit.
Karen and Dwane have done a wonderful job of helping the family with Yamuleith’s care which is no small feat considering they are in Ohio most of the time these days. And Yamuleith requires a lot of care. They had met her last year through some other folks when she had been hospitalized for malnutrition and they have invested themselves and their resources to help with her care.
Okay, so we met Yamuleith that Saturday night in March with Karen. Her story touched my heart but her sweet spirit and lack of self-pity, stole it. Once again, I thought how we came here to share the gospel, to demonstrate the love of the Lord and to minister to the needy. Once again, God turned the tables. Yamuleith did all those things for us.
Karen asked the family if it would be okay for us to stop by on occasion and check to see how Yamuleith was doing. She assured them that we were good people. You know…that’s a funny thing to hear about yourself…someone having to vouch for your character. It’s actually pretty humbling from both perspectives - that someone might be suspicious of our motives and that someone else had to vouch for us. The pastor and his wife cordially said it would be fine. We didn’t stay long that night but it was long enough to know that this young lady was very unique.
The next day, we went to PriceSmart to buy two cans of Sustagen for Karen to give to the family as she was going to run by once more before she left. We all agreed Yamuleith needed better nutrition and thought this might be one way to help supplement her diet while we were gone. She was also supposed to be having more fruits and vegetables added to her diet but we all had our suspicions that probably wasn’t happening much.
Karen had to leave to return to the States two days later – Monday, March 8th. The date is important. We took Karen to the airport and we assured her that we would check on Yamuleith when we returned from the States. She also said that she was going to have Dr. Oliver from CINAFE check on her while we were gone and that she had suggested that he go twice a week.
We flew to the States the following morning and didn’t return until April 1st. Due to the problems we had with our car, we weren’t able to get out until Monday. Tuesday, we took Dr. Oliver with us and we went to check on Yamuleith. I was shocked at how much thinner she looked. I didn’t think that was even possible. We visited briefly with the family and Yamuleith and then left.
We are in frequent communication with Karen and Dwane – thanks to Skype – and so I mentioned to Karen that I thought Yamuleith looked even thinner. We exchanged pictures that we each had taken of Yamuleith and Karen also thought that she was noticeably thinner. The picture on the left was one that Karen took several months ago. The one that we took last week is on the right. She was in a lot of pain that day but what I want you to see is how thin her arms and legs are. And look at her shoulders and chest...every bone is visible.

We continued to make frequent visits, if not every day, then every other day, often taking a medical supply of some sort or a food item for Yamuleith. We were always well received but my concern continued to grow. We began to see more and more gauze pads decorating her body. They were covering oozing sores.
We were to find out that due to schedule conflict and a leg injury, Dr. Oliver had only been to see Yamuleith a couple of times while we were gone. We found out that she was out of some of her supplies that are used to facilitate her care so we purchased those things and took Dr. Oliver to see her again.
Now here is where my American mindset kicks in…if there’s a problem, we need to “fix” it. And in my mind, there was a problem. I noticed that the rest of the family seemed to be very healthy, several even overweight by Nica standards. I also noticed that there didn’t seem to be a lot of attention being paid to Yamuleith unless we mentioned something about her need, like wanting a drink of water, needing to be readjusted, etc. She seemed to be deteriorating right before our eyes.
If that weren’t enough of a concern, I found ants crawling on her, often onto her open sores. I felt sick at my stomach the first time I saw that. I brushed them off. I tried to rationalize the fact that Nica houses are open and of course, there are ants. And they crawl over every surface possible. The problem is that this was happening to someone who couldn’t brush them off herself, who couldn’t even defend herself from their possible bites. The next day when we returned, small tiny ants were crawling on her as she lay in bed. I began brushing them off again and noticed there were lots of them crawling all over her sheets by the headboard.
I told Erika there were more ants. My voice had to betray my disgust and repulsion. She explained to me that because we (Oliver) didn’t bring the more expensive colostomy bags, that the seal wasn’t tight against her skin and that the ants, as well as flies, were being drawn to the odor. I then asked about what kind of supplies that they needed so that we could get her taken care of so that leakage and odor were no longer a problem.
My immediate thought was that she was being neglected. I was reminded that I don’t see all that goes on nor do I know what it’s like to live in conditions like that. That’s true. But I couldn’t shake my unease. I wanted to make this foster family the bad guys…I wanted to be able to point a finger and shake it, shaming someone, whoever…whoever had been responsible for what Yamuleith was having to endure.
The pastor and Dr. Oliver began to talk about Yamuleith. Oliver speaks very good English so he was translating for us for which I was very thankful. Although I understood much of what was being said, Oliver was able to fill in the details which were crucial in this instance. Without rehashing much of her background, the pastor also said that they had other people (gringos) come who wanted to help with her care but they only would help for awhile.
He said that there was a “missionary” who had come and raised funds locally and in the U.S. to help Yamuleith but ended up taking the money for himself. Pastor Cesar said that he and his family were then accused of taking the money and misusing the funds for themselves. He vehemently denied that. He said that he promised Yamuleith when they found her 15 months ago that he would never abandon her and that they had endured shame and poverty ever since. He said that it is easy for others to be critical of their situation when they are not the ones having to live their life. I immediately felt ashamed for my skepticism. He also told us that in order to bring in better money that he was now working on the Atlantic Coast and was gone for 1 to 2 months at a time. This of course, leaves the burden of care on Erika…who is also busy trying to take care of her own children. While he is gone, she is dependent upon the sale of cooked beans from her house.
Pastor Cesar then pounded the final nail in my shame box. He said that he and Erika knew that we had the spirit of the Lord on us and that we were always welcome in their home at any time, day or night. This was a much more sincere offer than the first time he had welcomed us. He said that he could tell that we had sincere affection and concern for Yamuleith and that we had demonstrated great respect for his family. He said that there had been many big fancy cars pull up in front of his house but our car was the one which always brought help and hope.
He then told us that their dream is that someday, they would like to be able to build a separate room for Yamuleith. He would want a “sealed” room with air conditioning so that they could keep out the ants, flies, dust and humidity. He said she would do much better and that her sores would heal.

I want to tell you that I was on his side 100% at that moment but I don’t think I was. When I am skeptical of something or someone, I have to admit it runs pretty deep…which is so funny when I think about it because I have been accused in the past of jumping into situations before knowing the whole story. I just kept asking God for wisdom and compassion and that He would reveal truth to me.
I know I was pretty quiet that day on the way home. I told Jim that I was wrestling back and forth with my feelings about the family. One minute, I was frustrated and skeptical and the next minute, I felt so badly that they were struggling like they were. I could not nor can I yet, imagine what it is like to be responsible for someone who requires such extensive care. It is so easy to cast dispersions upon those who don’t measure up to our own expectations…it’s even easier when there’s someone like Yamuleith involved. But I know I can’t cast those stones unless I’m willing to take Yamuleith as my own and to be prepared to devote my own 24 hours a day/7 days a week to her. Physically, I can’t do that. Morally, I can’t do that. She’s not mine to take.
So…what do we do here? Do we just let her waste away? What’s the answer? Do we just praise this family for their sacrifice and continue to see ants crawl over the every-increasing bed sores? Do we test our very young relationship with this family by suggesting that she needs better care and then risk offending them to the point we are not allowed to see Yamuleith again? Where is the balance we need in this situation? Is the ever-coveted “relationship-building” process worth more than Yamuleith’s well-being?
Children like Yamuleith are the ones who fall between the cracks. They’re the messy ones…the ones who cause us to find that it is so much easier to be busy than it is to help; the ones who are uncomfortable to be around; the ones whose unimaginable circumstances interrupt our own comfortableness; the ones who shine a bright glaring light on our “religiosity”.
Oh, it would be so much easier to just drop food off, just drop meds off, smile and drive away. But now, now we can’t do that. Not now. Somehow, we have made some sort of unknown and undefined commitment. By brushing ants off this child’s skin-and-bone body, by wiping her oh-so-feverish brow, by holding her bent and twisted fingers and by answering her pleas for help, it is sealed. We are officially involved. Painfully, tearfully, exhaustingly involved. I will finish this later.