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The Poor Pay the Price

Marcia Ehinger, MD, a native Californian, is a retired pediatrician and genetic specialist. She is the California Writers Club Sacramento Branch newsletter content editor.

What do you do when disaster is about to strike? Hoard supplies? Hunker down? Wait. Afterwards, you go outside to survey the damage. If you are lucky, you may get help to rebuild and survive.

Now, in addition to extreme weather events, we also are dealing with a global pandemic. In India recently, the healthcare system was unable to deal with the sheer numbers of people needing hospitalization and intensive care, and the resulting deaths. The United States, in particular the state of California, responded by sending thousands of ventilators, millions of masks, and countless other supplies. However, those desperately needed items sat and waited for processing in customs.

Such news takes me back to the summer I spent in Nicaragua. My mother had met a family who worked at a busy hospital and school complex in a rather remote, underserved part of the country. Since I wanted to be a doctor, she encouraged me to visit and help out.

Shortly before I left, I received messages from nursing students asking for fashion magazines, notes from the doctor's children requesting peanut butter, and small packages in the mail which contained tiny pieces of medical equipment. Apparently, if Nicaraguans purchased products from abroad, or gifts were sent by relatives and friends, the items usually disappeared to provide sustenance or income for the customs workers or those higher up in the government. If they went through processing, a customs duty equal to the value of the object was charged to the recipient. So, when personal packages or medical supplies actually arrived, they had to be paid for all over again, which generally made them unaffordable.

I packed a few clothes and toiletries, but also squished peanut butter into REI backpacking containers, and pulled lipsticks out of their housing and pushed tiny tonometers inside. I asked the airline if I could take a large box of magazines and coloring books to children and nurses at a hospital. The airline agreed to ship them free of charge.

After arriving at the capital of Managua, I transferred to the domestic airline. La Nica made a circle trip around the country each day, from west to east coast, and back. The airliner was an old cargo plane with folding chairs bolted to floor. The crew consisted of a pilot, co-pilot and uniformed flight attendant, who brought each passenger an animal cracker and a Dixie cup of fruit juice during the trip.

Medical care at the hospital was modern, with limits. There was always electricity in the morning, maybe in the afternoon. Surgery was performed early in the day, and the washing machines cleaned the bed linens, which were hung to dry on the bushes outside or up in the attic, if it was raining. It rains quite a bit in the tropics, so nearly all the buildings sat on stilts or piers.

A few weeks after I arrived, we received a radio warning of an approaching hurricane, coming from the east. We knew it would be a big one when the fearless La Nica pilots turned their plane around and went back to Managua instead of landing on our airstrip. Within a few hours, the wind was howling outside and blowing the rain sideways. Tree limbs snapped off with loud cracks, and flew through the air. The chickens that lived under the houses were brought inside or swept away.

The next morning, we heard about the coastal flooding and destruction. The Big Bad Wolf had been busy blowing down those houses made of sticks. Buildings near the water had been swept away; those farther inland had lost their roofs. The radio announcer said that U.S. aid was on the way: tents, vehicles, blankets, food.

However, more than a week went by and nothing had been received. "Where is it?" was on everyone's lips. The older folks in the area recalled past experiences of goods never arriving, and government officials with stores full of supplies.

That Sunday, the congregation of the coastal church met outdoors under a huge blue tarp. Most of the church was gone. The pastor appealed to his poor community, "Brothers and sisters, remember those who have nothing left after the storm. If you have a second shirt, if your family has an extra blanket, if you have more than one pot to cook with, please bring it to my house after the service."

He knew where real help came from -- God, and his community. When he got home from church, the front room of his house was piled high with donations.

~ Marcia Ehinger




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