St. John Goes to Nicaragua

(For those of you interested in logistics, I am copying this post from my middle-school blog. If it seems like it's written for a younger audience, that's because it is... just thought some of you might like an explanation of exactly what we are doing.)

There are 17 of us in the group, and only one person is an optometrist. Only 3 of the 17 are Spanish-speakers. So how does it work? How do all of us work together to help 250 people get their eyes checked in one day? Here's a breakdown.

1. When we arrive in a community, people are already lined up waiting to see us. Leaders in those communities have helped spread the word ahead of time and to create a system for who will be seen first. Yesterday, the community leaders had made sure that the elderly people with the worst vision were in the front of the line so that they wouldn’t have to wait so long. The Nicaraguan people who have worked with us to make this happen have done a wonderful job. We definitely could not do this without their leadership.

2. The people in line are given a “ticket” with a number. They also fill it out with their name and age. Many of the people, especially the older people, have never had the opportunity to go to school, and some of them do not know how to read and write. One of the team members who speaks Spanish or one of our Nicaraguan leaders usually fills out the paper so that will be easier.

3. When a person enters the clinic, we test their long-distance vision. The person stands behind the line and looks at the eye chart on the wall. Since many of them don’t know the alphabet, we use the eye chart that has an E pointing in different directions. Shirley and Georgia point at the chart, and the person tells us which direction the E is pointing. If their distance vision is okay but they are over 20 years old, we send them to another area to see if they need reading glasses (see the pictures at the bottom of the post.) If they do, they get reading glasses and sunglasses.

4. If the distance vision is not good, one of us takes the person to see Mary Ann, one of our team members who knows how to operate a machine called the auto-refractor. Mary Ann asks the people to look into the light and not to move their heads. She is able to get a reading from that machine that helps the optometrist decide what kind of glasses the person needs. Mary Anne has learned to communicate very well with a few words and phrases.

5. Next, the person sees Gary, our optometrist. He uses his instruments to look at the person’s eyes and decide what kind of glasses might help. Gary does not speak Spanish at all, so LuAnn works with him to translate.

6. We ask the person to wait while we find his or her glasses. To me, this is the hardest part. We have lots and lots of glasses with us. They were donated by people in the United States when they got new glasses. These are used glasses, the Lion’s Club collects them and sorts them by prescription. Allen and Charles are very organized people and understand how the glasses are sorted. I do NOT understand it. They look through the boxes and somehow pull out a pair or two of glasses that are close to the prescription we need.

7. Next is the glasses fitting. Letha, who is a nurse in our group, is very good at this. She takes the glasses to the person and tests them for close-up vision (for reading) and then sends them to Katherine to test their distance vision. Many of these people have never worn glasses before, so it is hard for them to get used to it. Lots of the prescriptions are for bifocals, and we have to explain how to use them.

8. If the glasses don’t work, we try to find something better. If they do work, the person gets a pair of sunglasses also, and he or she is ready to go! One thing that is very sad to me is that even the people who need the glasses the most often will not wear them out of the clinic. They are afraid that they will be damaged or broken, so they put them safely in the case to protect them. I hope they will wear the glasses later, because they do need them.