Ironically Neuva Vida means new life; originally after Hurricane Mitch displaced roughly 1200 families in 1998, the government moved them to two cow pastures outside the city of Managua. They called it a resettlement but it has become more of a long-lasting refugee camp, a permanent sea of patchwork tin shelters built on re-used concrete pavers with roughly 12,000 people living within its borders.
We went on Sunday to visit a church plant that has been in Nueva Vida for many years. The three hour service at Verbo church had finished and an American who had been working in the community that week came up to one of our group leaders to ask if there was anyone on our team with medical experience who could come look at a young man they had been taking care of. Without hesitation, myself and another member of the team, who was a physician, agreed to take a look at the young man.
So, into the car we went while Jose-Luis dodged small craters in the road filled with probable cesspool water, turning down a smaller dirt road, gears crunching in the down shift as the car slowed to a stop. The panel to the door was ripped off and replaced by a piece of wood, the one spring in the seat where three of us were crammed had possibly become a permanent part of my anatomy. Twisting my arm out the window I grabbed the lever to the door of the car and pulled up to open it. The nurse who had been taking care of him met us outside the house, a structure of concrete pavers stacked maybe two feet off the ground, where a patchwork quilt of tin rose up to meet the patchwork tin roof.
The young man had had surgery, but in this part of the world I am told that when they recommend surgery, you, the patient, then have to go and get the supplies needed for that surgery from the local pharmacy. I don’t know if he didn’t have all of the supplies necessary, or if his health condition was just so poor he couldn’t heal, but either way, this young man was at home with a dehisced abdominal wound. To the lay person, this means the skin had split open on his belly. They said he was 23 years old and maybe 60 pounds, which would be a generous guess once we met Manuel.
He lay flat on his back, covered to his waist by a blanket, but then you could count every rib to his sternum, cheek bones razor sharp, every heart beat visible through his nearly translucent skin. Manuel occupied the only bed in the room, his mother sitting in a chair, while a nurse explained results from blood test; no HIV, but positive for TB and for lupus, oh and his hemoglobin was 5 last time it was checked (an adult male should be between 13-17). She went on to say that he looked better today though, his lips weren’t white… his lips weren’t white. I breathed the only prayer I knew at that point, Dear God.
The local nurse explained to the Manuel and his mother who we were and asked if it was okay for us to look at Manuel’s wound. He weakly nodded his head and nearly imperceptibly and said “Si”.
The gravity of the situation began to take hold though. The room was well over 110 degrees because this was a tin shelter and like 82% percent of this country they cooked their staple of food rice and beans over an open fire. There was one light but it wasn’t plugged in; electricity is an expensive commodity, used at night when the sun is down. I asked the American lady who had asked us to come check on Manuel and his situation if I could use her iPhone. She looked at me like I might be nuts for a moment but when I turned on the flash, to use as a flashlight, she understood what I was doing. I wanted to see the wound more clearly. Necessity is the mother of invention.
Merely being present in the room, seeing what this nurse from the community has been doing and encouraging them at their task was all we would do that day.
Manuel did not want a central line (a large bore semi-permanant IV used for IV nutrition, blood transfusions and sometimes even dialysis) placed. This was why he left the hospital in the first place; even in the third world you can refuse medical care. Though in his case, he may have just been faced with reality he couldn’t afford even the most basic of medical needs. His mother wasn’t physically capable of working much less of forcing her son back to the hospital.
So he lay in the half shadows of his home, a shanty by western standards, in a sea of patchwork tin roofs and fought for each heartbeat, fought for each breath, fought for existence, because it is what he had done his whole life and he knew no better. And because of that and the grace of God he did have a fighting chance.
I don’t know if Manuel has made it but I know that I listened that day, God said go and I did. We were able to come alongside the medical personal in Nueva Vida and give them the supplies that they needed. You see they were out, no more money and one more dressing change and then nothing. It didn’t feel like we did much but we did what we could and above that we were obedient to the call.
That night I revisited Psalm 40 and the last verse this time nailed me
As for me, I am poor and needy,
But the Lord takes thought for me.
You are my help and my deliverer
Do not delay, O my God