Amigos For Christ Brings Basic Health Care, Essential Surgery To Nicaraguan Poor

By PRISCILLA GREEAR, Staff Writer

Published: September 25, 2003

CHINANDEGA, Nicaragua—When Richard Nutt, M.D., signed up a year ago with his daughter for a mission trip to Nicaragua to give medical support to a foundation, God—or one of his Franciscan priests, anyway—had bigger plans in mind for this Demorest orthopedic surgeon.

As he was adjusting to culture shock during the first few days in the extremely poor Central American nation, he was completely surprised when the director of the Chinandega 2001 Foundation, Franciscan Father Marco Dessy, approached him and said, “How would you like to be the medical director?”

“I said I’m just a dumb orthopedic surgeon. I have no administrative experience … OK, I’ll try it,” Nutt recalled.

Now, a year later, the practicing surgeon and member of St. Mark’s Church, Clarkesville, is steering “a runaway train,” as he serves as the volunteer medical director of the Amigos for Christ organization of Buford.

Amigos works through the Chinandega Foundation to provide free medical services, as most poor can’t afford the cost of medication.

Nutt is medical supervisor of the San Martin de Porres Surgical Hospital, completed a year ago, which includes two operating and two recovery rooms.

Amigos sends international mission teams of doctors and nurses and operates a mobile medical unit that goes out to remote villages, as well as a city clinic, providing medicine and equipment.

Amigos donor and board member Pat McAleer of Mobile, Ala., funded construction of the $212,000 hospital.

“If they go to the clinic that the government provides and the doctor writes a prescription most of them don’t have the money to purchase a prescription,” Nutt said. “The medical clinic provides medicine for free … We provide them with good medical care with doctors who are really screened for their medical expertise.”

He takes “marching orders” from Amigos executive director John Bland.

Walking through the facility in late July and seeing newly installed supply shelves, Nutt said, “This is so nice. Fantástico!”

In an operating room he pointed out surgical implements and canisters of nitrous oxide and oxygen and spinal anesthesia, which must be bought locally, for general anesthesia.

And check out those lobby chairs, donated by a church pew company in Gainesville.

“There are 100 little individual items that have to be available. Everything is in the detail, getting it functional. (The purchaser) has to know what to get, how to get it,” he said. “There’s well over $1 million in this place. Where it all comes from, Lord knows.”

The members thank God that crates packed with hundreds of thousands of dollars worth of donated medical supplies from hospitals, drug companies and the Catholic Medical Mission Board keep coming. Expired or extra supplies are given away, such as $25,000 worth of orthopedic instrumentation just given to a local hospital.

But Nutt, who brought along his CD and book to study medical terms in Spanish, noted that the more that comes, the greater the need for donated supplies and equipment. The most “desperate need” is for financial contributions.

“It seems the more you do, the more there is to do. The whole operation keeps growing,” he said.

The surgeon was in Nicaragua for two weeks this summer with his wife Mary-Ann and daughters Andrea and Georgianna. He worked with an Amigos mission team from the Archdiocese of Atlanta and New Orleans that came down July 26-Aug. 3.

The mobile unit and clinic “do what a general practitioner does in the office every day,” he explained. In the hospital “we’re not trying to be an acute care hospital, but an elective surgery hospital.”

The first hospital patients arrived last spring. About120 people had eye surgeries to restore sight. Several corrective operations were performed for children born with cleft palettes. The goal is to bring down surgical teams monthly.

Chinandega resident Maria Cecilia has received care for her son Elvin, who was born with a cleft pallet, causing him difficulty eating and talking.

“He already eats more. He gets sick less; he’s gaining weight. He’s happy to talk. He didn’t talk before,” Cecilia said. “I’m happy, although I don’t have enough to eat … I feel more peace, as he’s a different child.”

There is also a dialysis clinic waiting to open, only the second in Nicaragua, when they can find needed equipment. Nutt said there are many agricultural workers in the area who have had kidney damage and whose lives could be extended 10 to15 years through dialysis.

“We have people who have mangled legs from auto accidents that need further surgery and they have no way of doing it. Some need amputations,” he added.

Missionary Denise Miller, M.D., a general surgeon from Longmont, Colo., screened patients at clinics July 28-29 for cancer, hernia, skin lesions and other conditions for September surgeries. She said surgical appointment times would be printed in the local newspaper.

After screening 62 patients in one day, many of whom live near the Chinandega city trash dump and go to it regularly to search for food, Miller said, “These people have to be given numbers. They’ll swamp you … They’re sick. Everybody had runny noses, runny eyes, their hair was weird, was blond or red from malnutrition, bites all over, parasites.”

The patients she saw from Santa Matilde, a Chinandega residential community created by the Foundation and Amigos for Christ and a few other organizations to relocate residents from the dump, were much healthier.

There’s also a health clinic, which the mobile unit visits. Sabrina Bland, wife of the Amigos executive director and a registered nurse, trained some residents as community first aid workers. They were awarded certificates during a ceremony held during the mission trip. “One of the best ways to (control) diseases is to prevent them,” said one project leader. “They will be attentive to you. When the doctor comes they will help them.”

Atlanta missionaries also presented a play “The Bad Fly Family,” teaching children to cover latrines to prevent flies from spreading parasites.

Children at the Foundation’s Haldo Dubon School also benefited from the mobile mission, which stopped there one late July day, as workers unloaded plastic containers of everything from Pokémon vitamins to cough syrup from the back of the Land Rover and teachers escorted earnest-looking students in to see “la doctora.” After check-ups the children received a toothbrush and toothpaste.

The school is located near the dump, but children had to agree to give up scavenging through it in order to receive a free balanced meal at the school. Nevertheless, many youth complained of respiratory problems as well as ear infections, flu and diarrhea.

“We’ve seen lots of parasites, lots of grippe (flu), runny noses, a lot of people have headaches. We’ve been trying to tell everybody to make sure they wear their shoes all the time, to drink lots of water. That headache can be a sign of dehydration,” said Jennifer Pragle, a registered nurse and member of Prince of Peace Church, Buford.

She added, “It’s hard for me to make the transition from an intensive care unit to only having a stethoscope.”

As the children endure extreme poverty and many come from single mother homes, the principal said that some get depressed and some have attempted suicide. She said that teachers try to care for mental health by offering support and encouragement.

“We have had some problems with them, but they have been overcome,” she said.

And while students are urged to keep studying, she noted the discouraging reality that most in the high school’s graduating class will not be able to afford college.

The following day the medical team drove through a river and traveled pothole-filled roads to arrive at a village near the border with Honduras. Karla Brenes, M.D., feels privileged to work for Amigos on the mobile unit caring for the poor.

“They are the most needy. They need love; they suffer a lot. I like it, I feel happy with this work,” she said.

For Nutt the work is both frustrating and rewarding.

“The reward of doing it is just a simple thank you. It doesn’t even have to be said. You can just feel it … You know you are needed here,” he said. “(And) you don’t have to wade through a mountain of red tape to take care of everybody.”

Miller noted how coordinating the work involves little miracles. “You want something or the other. You don’t know how you’re going to get it and someone comes in and donates it. It’s just been so wonderful because in surgery I can go in and fix something and the problem is gone.”

She recalled a patient suffering from a hernia, who came in barely able to walk, much less work.

“I fixed him. The next day he walks in and he was on with his life. It’s like, if we don’t care for them, they’re not going to get taken care of,” she said. “I’m very impressed by the hospital here and the potential.”

Nutt joined Miller in Chinandega again in early September for surgeries.

“We just did what we had to do … Denise was unbelievable. She brought her 16 people and they did 63 cases. I did a few. Everything clicked. The equipment was made to work, the consumable supplies we used, the medicines we used. It was a real hospital. It really worked.”

Amigos for Christ, a nonprofit organization that began through Prince of Peace Church, Buford, can be reached at (770) 614-9250. The Web site is www.AmigosForChrist.org.