The first of the Foundation's Cross Cultural Service Trips, this trip went to Nicaragua over Winter break 2001.
In 
many ways the construction site proved to be the most profoundly cross-cultural aspect of the program. The process of building a concrete wall from raw materials became a microcosm of human interdependency. The block-cutters may not initially have known the names of the persons shaping rebar enforcement, or have spoken the same language as those mixing cement. Yet construction team members soon realized how interdependent they needed to be in order to build a strong durable wall.
Straining to manually mix each bucket of cement, lift blocks one by one, and hand-sift shovel by shovel every ounce of sand that would fill those blocks and form the cement that bound the space between them, inevitably team members lost their inhibitions and found community. As the wall was built, barriers between people were broken. Team members from both countries found themselves sweaty, dirty, and weary at the end of each day. Yet the harder they worked, the more it rained, and the filthier they became, the more they laughed with and learned about each other. It was not uncommon for students from the different continents to sing along to music together while they shoveled and sweated. Chattering in Spanish, English, French and Swahili was a backdrop to the work as students eagerly shared and learned each other’s language.
Students, who spoke fewer than ten Spanish words and had never laid a cement block in their life before their first day of work, perhaps found the task of turning hundreds of stacked blocks and veritable hills of gravel into an actual wall a daunting task. Add to that a foreman who spoke no more than ten English words and the entire project might have appeared impossible. (Bridges to Community, it was later learned, had only planned for the team to build the wall half as high as was accomplished.) And had the team been without the URACCAN students such fears might have become realities. Yet by the second week, those same American students were asking where they could find a shovel and a bucket in Spanish to those same Nicaraguan students, who replied in English that the shovels are in the shed, "Let me get a bucket for you." Two students from different nations learned that they both wanted to work on cures for cancer, that they both had lost parents to illness, and that they both enjoyed Motown music.
Ten undergraduate students, two medical students, three physicians, and a nurse practitioner worked for two weeks to provide preventive and acute care to over 700 local patients in villages surrounding Siuna. Acute care was delivered in clinics. Within each clinic were various stations, including intake for vital signs, diagnosis and prescription of treatment by a clinician, public health education, and a pharmacy. An OB/GYN conducted Pap tests and treated patients at a local maternity facility. The team delivered preventive care in various forms. The medical team set up de-worming clinics, educated patients on hygiene in a play acted out by the team, and educated patients about their specific illnesses in the public health station within the clinics.
William Young, MD, Associate Professor of Obstetrics & Gynecology, saw patients for six days at the Casa Mujers Clinic, spent one day seeing patients and two days teaching at the Siuna Hospital. Dr. Young saw approximately 14 patients each day, most of whom were pre-screened for obstetrics and gynecology consults, and had memorable or challenging problems. The first woman Dr. Young examined probably had cervical cancer, but a biopsy was not available, and due to the Christmas holidays, he was told the Pap result would not be back until February. As women repeatedly refused cervical cancer screening due to the extra three dollar cost, the team decided to pay for them and nearly all-future patients accepted. A 16 year-old, who was pregnant at 30 weeks with her second baby, was pale, febrile and shaking with malaria. She refused hospitalization because she was needed at home, only wanted medicines, which we provided, and walked for several hours to return to her village. Twenty traditional birth attendants attended classes for two days. When asked what they took to a delivery, they all answered, "A blanket for me to sleep." They mentioned nothing else. A candle is their only source of light; a machete, their only instrument to cut umbilical cords.
An undergraduate or medical student accompanied Dr. Young, assisting him at all times, and acquiring an intimate understanding of developing world medicine with a special insight into women’s health care. The medical team concluded that Siuna presents boundless opportunities to make a difference in the lives of women through education, preventive health and basic obstetrical services, and to transform students and doctors with life-directional experiences.
Adam 
Tanney led the team in six evening reflections sessions to help participants integrate the Nicaraguan experience permanently into their lives. Some sessions bonded team members with one another through interactive team-building exercises, and others encouraged team members to reach out to another and search within themselves for questions of justice, spirituality, and ethics. Writing helped participants process their experience and fortify their commitment to life-long action.
Comments that are typical of participants’ feedback:
"This experience definitely changed my perspective on life."
"I’ve been afforded some real insights into third world health and living conditions and needs. Now I need to think more about my life and opportunities to promote third world health. I’ll certainly want to make more trips. I feel a real obligation. I hope it lasts. I believe it will."
"I’m not the same person going home as the one leaving home. The value to me personally is inexpressible at the moment. I’m grateful and enlightened."
"The trip has helped solidify my resolve for the direction I want to go with my life. It did help place a check on my materialism and bring to the forefront the Christian ideals that I claim to adhere to. I feel that I am a very humbled man returning to the States."
"This trip allowed me to see more reasons why service and love should never stop. I finally feel we are the future, I am the future of our nation and the things that we do and the decisions we make can make a difference in a places like Siuna all over the world."
The following exemplify team members’ individual transformations and commitments to action:
* Joel Wickre: Based on his experience, this pre-medical junior has gained the backing of professors to design his senior thesis around solving Siuna health issues. Joel has written a proposal for a ten-week trip to Siuna with another student researcher to analyze the possible epidemiological impact of heavy metal pollutants from the mine on the water supply and environment.
* Jasmine Gipson: This sophomore student has resolved to organize the remainder of her years at Dartmouth around cross-cultural service.
* Milton Ochieng: A native of Kenya who came to the United States a year before leaving for Nicaragua, Milton departed for Siuna a shy and quiet young man. At the conclusion of the trip, Milton was brimming with confidence and burning with energy. He had found acceptance for being himself. He had an opportunity to share his customs, culture and national welcome song at a celebration for Kenya’s independence (which coincided with the trip) in a way that had never been possible at Dartmouth. People came to know Milton for who he really was, and so they loved him for who he really was. Many team members remarked the trip would not have been the same had Milton not been a part of it. Milton now hopes to bring a cross-cultural team to his village in Kenya.
* Jenny Noon: This fourth year medical student is pursuing residency programs in pediatrics after her graduation. Jenny says there is absolutely no way she can approach medicine and her role as a human and a doctor the same way after her experience in Siuna.
* Stephanie Boone: The co-faculty sponsor and lecturer of English remarked to the team during the final reflection, "I realized I’ve been packing my suitcase, not just for this trip, but for everywhere I’ve been with a lot of things I don’t just need. When I leave tomorrow I’m going home with a lot less old things and a few new ones."
The Nicaraguan community experience may perhaps be most fairly and succinctly summarized by the words offered by Alejandra Ramirez, coordinator of the Siuna Women and Children’s Health Clinic, during a presentation at dinner on the team’s final night in Siuna. "Siuna loves you and will not forget you. We pray you will not forget us. For when you return, we will be waiting with open arms and eager hearts."
