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Grand, Sweet Song: Nobility at a Nicaraguan Clinic
Susan M. Osborn
noble things, not dream them all day long. And so make life,
death, and the vast forever one grand, sweet song.”
— Charles Kingsley
Margie Fincham, R.N., has made the trip from West Sacramento to Rancho Santana,
Nicaragua, twice a year for the past four years. In her capacity as the health
care coordinator, she solicits and transports donations of money, supplies and
equipment from the U.S. to a nonprofit Nicaraguan clinic.
The largest state in Central America, Nicaragua is about the size of Greece and
is 11 degrees north of the equator. The flight from Houston or Miami to Managua,
the capital, takes just over three hours. Every year about 60,000 U.S. citizens
visit Nicaragua. Over 7,000 U.S. citizens reside there.
Nicaragua has been ravaged by decades of civil war, political and social instability,
lack of access to education and healthcare and natural disasters. It is the second
poorest country in the Western Hemisphere. (Haiti is the poorest.) Over 48 percent
of the population lives below the poverty line, and the majority of the poor
are female heads of households.
Rancho Santana is a three-hour drive from Managua. Spread over 1,700 acres of
rolling green hills overlooking the Pacific Ocean, this luxurious resort development
attracts investors and surfers from around the world. Outside the entrance to
this gated community is the clinic where Fincham volunteers. It is located on
land donated by the developers and built with a $50,000 donation from the Pittsburg,
Pa., Rotary Club.
In 1972, a major earthquake destroyed nearly 90 percent of Managua. Roberto Clemente
was a star right-fielder for the Pittsburgh Pirates. He was born in Puerto Rico.
Proud of his heritage, he demanded respect for Hispanic players throughout his
career. On a flight to deliver relief supplies to earthquake victims, his plane
went down. His body was never recovered. Nicaraguans consider him a national
hero and named the clinic after him.
Launched in 2004, the Roberto Clemente Santa Ana Health Clinic provides medical
care to Rancho Santana residents and employees in 41 villages. Services include
health education, primary and emergency care, and treatment for chronic health
problems endemic to this part of the world, where running water and flushing
toilets are rare.
The staff serves approximately 10,000 patients a year. Children, the elderly
and the disabled are treated at no charge. For others, fees are based on a sliding
scale and ability to pay.
Fincham first visited the clinic as a volunteer eight months after it opened.
She recalls, “Soon after I arrived, a couple invited me to have lunch with
them. After a delightful meal, I collected $500 from them for the clinic. When
I went down to the clinic the next morning, I was accepted as though I was a
member of the family. This was just amazing!”
“I found the clinic was beautiful and very small (only 1140 square feet),
but it was clean,” Fincham reports. “There were no shelves. There
was only one OB/GYN table, and part of it was broken. The other exam table was
also broken. And, because it got very hot, I bought fans for the wires hanging
from the ceiling. We had shelves made with the money from the couple I’d
Fincham recalls subsequent experiences. “One time we got down to only two
packages of sutures. What are you going to do when surfers come in with wounds
that need to be sewn up? I bought $300 worth of sutures [that] I was able to
get at a discount. The power in Nicaragua is unreliable, so an engineer friend
went through all the wiring and installed a battery back-up system. Now, we always
Volunteers from The Foundation for International Medical Relief of Children began
visiting the clinic. Now, groups of 10 to 20 come each month. When volunteers
come, they pay $500 for the opportunity. Some of that money was used to build
a small room that serves as an office and a place for staff to take lunch breaks.
Fincham is happy about the progress that has been made. She remarks, “Going
from bare bones, we now have a full-time doctor, two full-time nurses, a full-time
registered pharmacist, two administrators, a contract lab person and a contract
What plans does the clinic have for the future? Fincham replies, “A retired
hospital architect designed a second building and donated drawings. We want to
offer 24-hour emergency care and have rooms for surgery, birthing, dental, optometry
and hospice. We have the property, but we don’t have $250,000 to build
Fincham recently bought property at Rancho Santana, and she plans to live there,
“I can hardly wait until I can be there when I’m needed. I just feel
so comfortable there. My purpose is clear. I go down and see what we need, then
I find ways to provide it,” she concluded.
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