April 2004

Hailyn Nielsen • A Stranger in a Strange Land

On her winter break program to Costa Rica, Hailyn Nielsen witnessed poverty and despair—but also made new friends.

"Hiley, could you go up and do intake?” The weathered missionary, James, speaks in my general direction, avoiding eye contact and refusing to call me by the right name.

"Sure, James,” I sigh. James is our translator/guide for these two weeks in Central America. He works for International Service Learning, the program that flew 18 University of Iowa premed students to San José to spend the last half of our winter break disseminating donated medicine in rural areas of Costa Rica and Nicaragua. We wear scrubs, take medical histories, and explain antibiotic regimens in Spanish. I’m one of about four students with some presentable Spanish skills. I wipe the sweat from my forehead, grab my Spanish-English medical dictionary, and shield my eyes from the constant sun and ubiquitous dust and walk to the other tent.

"How are you holding up?” someone asks as I scoop up patient history sheets. I don’t answer. I want to say that I’m hungry, hot, and homesick, but I can’t. Wide-eyed children, crying babies, grandparents—an entire culture embraces me here. We’ve set up our clinic in the church of Los Laureles Sur. Two wooden shacks lean against each other, the services are held outside under a sheet metal roof, and stray dogs wander through without fear, searching for scraps. I’m ashamed to feel tired. The women here cook lunch and dinner for us. They give us their clean water and soap to wash our hands. I can’t stand for more than three minutes without someone bringing me a chair. They don’t serve themselves until we’ve had second helpings.

I smile. “I’m wonderful,” I say.

In an hour or so, James again redirects me to the diagnosis area, where students listen to the patients’ problems and attempt to determine the cause and appropriate course of action. One American doctor and one Nicaraguan doctor circulate among the groups, confirming or refuting diagnoses. Dr. Will, from Galena, Illinois, walks with a slight stoop, speaks with a slight lisp, and must be in his late 60s. He’s my favorite character on the trip, as he’s always teaching but always open to learn from us students as well.

"I’ve got an ‘all-see’ over here,” says Dr. Will, referring to a case of particular interest. In a mass movement of turquoise and blue, every student stops midsentence and relocates behind Dr. Will. I push my way to the front and listen.

"Now, notice the swelling and edema in the skull. How old do you think this baby is?” asks Dr. Will.

I feel uncomfortable for the skeletal woman seated next to him. All of a sudden, she’s been surrounded by students and a strange man gestures above her baby’s head. Dr. Will doesn’t even make eye contact with her. No one is translating. Why doesn’t she look worried? She just smiles.

"It looks like a newborn. It’s tiny,” someone replies.

"This woman says it’s eight months old.” Sighs and low whispers pass through the gathered crowd. The mother smiles. “So, something’s going wrong here.” Dr. Will doesn’t even know if the baby is male or female; “it,” he says. “What’s happened is that the bones of the skull have been unable to come together. The brain is surrounded by excess fluid causing all this swelling.”

I catch a glance of the baby’s face. He’s a little boy with gorgeous brown eyes. But he just stares vacantly and doesn’t appear to be in control of the motion of his arms or legs. A fly lands on his nose, and he doesn’t move. It’s as if the mother cradles a rag doll. “This baby is hydroencephalic. He’ll die within six months,” says Dr. Will. “We can’t do anything for ’em here.”

Questions erupt from the crowd of students, but I tune out the rest of the discourse. A pastor from the church who speaks English quietly leans in towards the woman as we Americans discuss her case. I know he’s telling her what Dr. Will has said. The woman doesn’t respond. The smile on her face persists. She doesn’t understand. We send her home with iron supplements for herself and vitamins for her son.

"Hiley, they need you back over there.” James gestures towards another mother with a crying baby girl.

Back to Hailyn's Index

Back to "My Life as a Student" Index