VOSH-Connecticut held its ninth annual eye care clinic in San Juan del Sur, Nicaragua on January 9-16, 2010. This was the twelfth year of service at this site to the San Juan del Sur area, the ninth under the auspices of VOSH-Connecticut, along with three previous missions under the auspices of VOSH-NECO. The team consisted of six Optometrists led by Dr. Matthew Blondin and included: Dr. Jerry Hardison (7th VOSH-CT mission), Dr. Brian Lynch (9th VOSH-CT mission)(CAO Legislative Liaison), Dr. Abby Quinn (8th VOSH-CT mission),  Dr. Robert Mingrone(2nd VOSH-CT mission) and Dr. Thomas Marguis(1st VOSH-CT mission).

We were joined by 8 optometry students from the University of California at Berkeley: Melissa M. Lester(Leader), Megan Lee, Raeann Murray, Caleb Poon, Yarigtnetzilem Diez, Gary Ho, Jenny Cheung and Katrina Chang. We also had 9 students from the Netherlands School of Optometry: Luuk van der Noll(Leader), Ferran van de Vecht, Aissa Kramer, Patricia van Wieringen, David Waardenburg, Tiffany Kong Tse Lam, Thies Jan Jansen, Roos Zoonjee and Hulya Erdogan, and with one rising 1st year student from the New England College of Optometry, Michael Shea(2nd VOSH-CT mission). Last year we did not have any of the students from the Netherlands School of Optometry and they were sorely missed. We were very glad to have them return with us this year, along with the Berkeley Optometry students who have been with us for every mission since the beginning in 1999. Each and every one of these students did an outstanding job, and special credit should be given to the 2 student leaders Melissa Lester and Luuk van der Noll who both did a terrific job in organizing and leading their respective student bodies.

In addition to the doctors and students, the following volunteers were included: “La Jefa” Segunda: Joyce Krinitsky (7th VOSH-CT mission), Opticians/Dispensing Dottie Byus (6th VOSH-CT mission), Mareshah Lynch (6th VOSH-CT mission), Daniel Lynch(3rd VOSH-CT Mission), Sally Lee, Editor-in-Chief, Ladies home Journal Magazine(2nd VOSH-CT mission) and her daughter Grace Lee-Niosi, Erin Tschupp and Paul Quinn, and Translators: Cecilia Suarez(Leader-5th VOSH-CT Mission) and her grand-daughter Emily Hatton(2nd VOSH-CT mission) , Orlando Sevilla(12th VOSH-CT mission), Courtney Shaw(2nd VOSH-CT mission), Fermin Gallardo-Martinez, Rachel Granetz, Luke Shoemaker and Samatha Mingrone, daughter of Dr. Robert Mingrone. We were also joined in the mission by Rose Blondin (5th VOSH-CT mission), Kevin Creed and Deanna Marguis(daughter of Dr. Thomas Marguis) who assisted as vision pre-testers and Brandon Arnieri who did a great job with video graphics and recordings for the mission. This year we did not have a separate room for vision pre-screening. All vision pre-screenings were done in the individual exam rooms, and that worked much better and were much more accurate than in years’ past. We did have a separate pre-screening room for height and weight, and that worked well also. Dr. Jerry Hardison assisted in providing preliminary help and guidance to the students, and we are very appreciative of his continuing help in this regard.

Joyce Krinitsky continues to do her outstanding job as second in command, and the mission would not be the success that it was without all of her continued help, assistance & support. The coordination of various bus transports throughout the local and southern Nicaraguan area proved extremely successful due to Joyce’s efforts, and we are extremely grateful to her in this regard. In addition to a local bus for all 4 days in and around the San Juan del Sur area, we provided bus transportation to patients from Tola, Cardenas, Rivas, Nagarote and Papaturro, as well as many of the towns surrounding the San Juan del Sur area and beyond. This year, in accordance with new MINSA rules, there was no charge to the patients to be seen. In years’ past, a small donation was asked from those who could pay, but this year everything was free for all patients.  Opticians Dottie Byus and Mareshah Lynch along with their able assistants returned once again to run the dispensary and did an excellent job as always. The dispensary part of this mission continues to be completely self-sufficient, and for that we are eternally grateful for the leadership & support of Dottie and Mareshah and their assistants. In addition, the 3,000 pairs of eyeglasses that were purchased by VOSH-CT from the Virginia Lions Club were augmented by a private donation of 400 pairs of glasses from Encore Optics obtained by Dottie Byus and another 200 pairs from Mareshah Lynch with the support from Hoya Labs. Encore Optics continues to be very generous in their donation of lenses and services to patients with special needs, for which we are all very grateful and appreciative.

As in year’s past, approximately 50 local residents assisted with the clinic duties, led for the twelfth time by local doctor Dra. Rosa Elena Bello. Many of these local volunteers have been with us for all 12 years, and they all do a wonderful job, along with school principle Veronica Sanchez. A number of the volunteers have begun to learn to speak English, and that has been helpful to us and to them as well! Dra. Rosa Elena Bello continues to do a terrific job in getting and coordinating the patients for the clinic, and we continue to be very grateful for all of the help and assistance she has provided to us over the years.

In addition to the three thousand pairs of glasses were purchased by VOSH-Connecticut from the Virginia Lions Club, 3,000 pairs of sunglasses & 300 pairs of readers were purchased by VOSH-CT. This year, because of past problems with customs, these sunglasses and readers were carried down in suitcases, and all made it except for 1 suitcase that went missing after arriving at the Managua airport and has yet to be recovered. Approximately 1,200 additional pairs of readers were very generously donated by Dr. Brian Lynch and shipped down, and those did make it, however many of our other boxes of mission supplies did not. We continue to be very appreciative of the generosity and kindness of Dr. Lynch, who has donated thousands of readers at his own expense to our missions over the years.
For the past number of years, post 9/11, we had been able to send down our mission supplies through the generosity of Chris Berry and Pelican Eyes. After we had sent a shipment of 65 boxes down to Nicaragua through the Pelican Eyes at the end of September, Chris Berry unexpectedly left the country and did not return. This posed a great challenge to us in getting our boxes released in time for the mission, and in the end, and after a very large expense to VOSH-CT, we were only able to obtain 35 of the 65 boxes, many of which were partially destroyed and ransacked Fortunately, we had enough to run the mission successfully, but we will no longer be able to send anything via the container and Pelican Eyes. Jane Mirandette who has worked tirelessly with us over the years from the Villa Isabella has very graciously offered to allow us to send some of our mission supplies through her shipment with American Airlines, so we will try that for next year and hopefully that will work successfully for our mission supplies. Kathy Knight and Rosanna Obregon from the Pelican Eyes worked hours and hours on our behalf to do what they could to assist us with getting the boxes released and also helping with the over-all assistance and coordination of the mission, and we are all extremely grateful and appreciative for all that they did to help us before and during the mission. We also thank Photographer Cesar Paniamogan for once again taking and providing us with some great photographs of the mission, although this will be his last mission with us as he will be leaving Nicaragua in the spring, and my assistant Nicole Rolli for all the terrific work she continues to do with the transportation of the boxes as well as all the graphic design work for the certificates, badges, wrist bands, etc. We also are very appreciative of the coverage of our mission provided to us by Editor Kelvin Marshall and the Del Sur News www.delsurnewsonline.com .We were honored to provide services at the clinic to San Juan del Sur Mayor Jorge Sanchez Santana,  as well as many members of his staff and assistants, including Francisco Orozco, who has been helping us and Dr. Brian Lynch for many years now, and provided great translating and other services for us throughout the mission. We also provided services to San Juan del Sur Chief of Police Justo Zamora and members of his police force.
The clinic was held for the twelfth year at the Centro Escolar Enmanuel Mongalo y Rubio. It was set up Sunday, January 10, 2010 with 6 examination rooms, a pre-testing room for height and weight, dispensary & lunchroom. The clinic officially opened on Monday, January 11, 2010 at 8:00 a.m. Breakfast was provided each day by VOSH-Connecticut beginning at 7:00 a.m. Patients were seen from 8 a.m.-1 p.m., with a break for lunch provided by VOSH-Connecticut from 1:00-2:00 p.m. Clinic then resumed from 2:00-5:00 p.m. As in the past, VOSH-Connecticut provided for all expenses for both mission members and local volunteers relating to the clinic including breakfast, snack, lunch, at a cost to VOSH-CT of $1,000 for the 4 day mission. Due to the greatly increased cost of the mission, we were no longer able to provide a closing banquet, but certificates were given to all participating mission members, both local and VOSH-CT, at the end of the clinic.
Over the four-day clinic period, we saw 2,853 patients broken down as follows:
Monday          Tuesday             Wednesday            Thursday             Total
1/11/10            1/12/10                1/13/10                 1/14/10
517                    715                    736                       885                   2,853
These totals represent an increase of 176 patients over last year’s total of 2,674, and a total increase of more than 400 patients over the last two years. Because we had adequate staff this year, we were able to run 6 full exam rooms with one Optometrist and 3 students in each room, and this greatly increased our efficiency, allowing us to finish up each day prior to dark. I am hopeful that we can continue this level of staffing for future missions, as the need for our services continues to grow, along with many patients who now return year after year and see the same doctor each year.
Conditions throughout the southern Nicaraguan area and in the San Juan del Sur area in particular have not improved much if at all due to the difficult global economic situation. There continues to be an increasing level of poverty and need for all types of medical and dental care, including eye care, due to the harsh global economic picture and limited financial investments being made world-wide. There is a wind-mill farm being constructed now by European and other foreign investors on Lake Nicaragua, and that is helping to ease the energy crisis somewhat, although tourism and other service-related industries are way down from what they had been in years’ past. As in years’ past, university students under the direction of Dr. David Gullette of Simmons College provide translating services for the clinic, for which we continue to be very grateful. Last May, Dra. Rosa Elena Bello was honored with an honorary degree from Simmons College in recognition of all her work and efforts on behalf of the San Juan del Sur area and surrounding communities.
Throughout the mission, all communications were held in both English and Spanish, as in years’ past, and we wish to particularly acknowledge the assistance of once again returning mission members Cecilia Suarez and her granddaughter Emily Hatton who provided tremendous translating services throughout the mission, along with Fermin Gallardo-Martinez, Orlando Sevilla, Courtney Shaw, Rachel Granetz, Luke Shoemaker and Samantha Mingrone. Common pathologies continue to be encountered including cataracts, pterygia, glaucoma, corneal foreign bodies, toxoplasmosis, conjunctivitis, retinal disease, hypertension and some cancers. Our paid security staff returned once again, and provided excellent & safe services for all not only at the gate but at each exam room as well. Follow-up treatment facilities continue to be lacking, and while lists of names were kept of needed patient cataract surgeries, other medical conditions such as goiters, heart problems and possible carcinomas remain untreated with little or no further treatment options. We also experienced one patient who had an epileptic seizure while waiting to be seen, but again, there is limited to no follow-up treatment or drugs available to assist with the needs of the patients.
Numerous drugs were donated by Alcon Laboratories, Inc.and Allergan Pharmaceutical. These were most appreciated and used throughout the mission, however by the fourth day of the mission, we had run out of all dry eye lubricants. For next year we need to continue to try and increase our supply of these types of lubricants in order to have sufficient quantities for those patients in need. Leftover drugs were donated at the conclusion of the clinic to Dra. Rosa Elena Bello.
The number of buses provided for by VOSH-CT running throughout the area during the 4 day mission has proved critical to the on-going success of the mission, and we are very grateful for all of the help Joyce Krinitsky has provided over the years in building up this transportation success. A bus now comes each of the 4 days from San Jorge under the direction of Councilman Felix Lopez, and we have continued our relationship with the Norwalk, CT Sister Cities program under the direction of Tish Gibbs who provided a bus this year from Nagarote under the direction of Ramon Sepulveda, which all worked very well. In addition, we saw approximately 100 children over a 2 day period from the Barrio Planta Project under the direction of Dyani Makous, Founder & Director, along with Emily Calder, licensed Spanish teacher, and several of their assistants. In addition, Emily Calder’s father is currently serving as a chief nurse in Afghanistan, and she was able to converse with retired Army Major Kevin Creed who had served in Bagdad at the beginning of the war and provided great pre-testing services to us in Dr. Robert Mingrone’s clinic. Rose Blondin and Deanna Marquis also provided great pre-testing and other assistance to their Dads, along with Samantha Mingrone, who translated for her Dad all week long. Paul Quinn and Daniel Lynch provided great assistance to Dottie and Mareshah in the dispensary, as well as to their Mom and Dad, respectively.
Overall, this year’s mission went well, despite horrible weather conditions for the entire time of the mission. We experienced winds daily in excess of 40-50 mph, with constantly blowing dirt, dust, smoke and ash from the road side open trash burning. Many mission members experienced upper respiratory problems and breathing difficulties due to the harsh weather conditions. This mission continues to be successful due in large part to the fact that so many mission members have worked so often and so well together in the past, and continue to recognize service above self. We are very grateful to have the continuing support of the Berkeley optometry students who have been with us all 12 years of this mission, and without whom this ongoing mission would not be possible, along with our returning once again Netherlands optometry students, to whom we are all very grateful for joining us once again in our mission. It is also an absolute pleasure to work alongside so many caring, giving individuals, both as returning mission members and locally in San Juan del Sur, who all work together in a team spirit second to none.

It was an honor and a privilege for us to have Sally Lee join us once again along with her young daughter Grace, who both did a great job all week long helping Dottie and Mareshah in dispensing. Her profile of us in the June 2009 edition of Ladies Home Journal Magazine was wonderful, and both Sally and her company, the Meredith Corporation, have been very generous to VOSH-CT, both financially and in terms of their time and support. They also obtained for us a large number of baseball caps for donation to the patients at the clinic, which we were very appreciative of, however these caps never made it out of customs, so we were unable to provide them to the patients at the clinic as they had been intended for. Due to Sally’s assistance, VOSH-CT and our mission will be profiled on WFSB’s Better Connecticut with Scot Haney on Friday, February 5, 2010 at 10 a.m.

Escalating mission costs continue to present a challenge. Total mission expenditures are now close to $10,000 per mission, funded solely through volunteer donations solicited primarily by myself through the CAO, as well as through our yearly mission fees and the generosity of our close friends and Joyce’s association at Prudential Realty, who very generously donated $1,000 towards the buses for this mission. We will continue to examine ways to enhance and improve our fundraising activities, in order to ensure the ongoing viability and success of the mission. This year proved especially costly for the mission due to many costs including the fee in excess of $1,500 that had to be paid in order to get half of the boxes released, the $1,100 cost to send the boxes UPS to the container, again which only half got to the mission, the $2,000 cost for sunglasses and the $1,000 cost for food for 4 days at the mission, part of which had been subsidized in the past by the fees collected by Dr. Rosa Elena Bello and which were now no longer available due to the new MINSA rules and regulations. These expenses along with many other mission expenses including the many buses we now run for patient transport during the 4 days, plus security and other costs make fundraising a challenge in these difficult financial times, but we will continue to try and do what we can to raise the necessary funds for the mission each year.

Nicaragua continues to struggle in these difficult economic times. Progress among the people has been sporadic, and we have seen a definite surge in need over the past several years as the world-wide economy has continued to deteriorate and stagnate. We all try and do the best that we can with the limited resources available to us, and once again, as our mission came to a close, mission members came away with a great deal of self satisfaction knowing that a great many in need were helped by their generous and unselfish efforts. VOSH-CT continues to be grateful to all of those, both here and in Nicaragua, who work together as one to provide eye care to so many who otherwise would have none.