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Mission to the Center of Central America

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Mission to the Center of Central America

Dental Missions, Rancho Santa Fe, California, United States
Corresponding author: Ronald E. Fritz, Dental Missions, Rancho Santa Fe, California, United States. E-mail:
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Connecting North and South America are seven countries, each unique in its own way, running more eastward than southward, from the southern border of Mexico. In the middle of this chain of countries known as Central America, lies roughly triangular shaped Nicaragua, destination for a large group of 59 dental students, dentists, nurses, and auxiliary personnel.

Nicaragua, which translates “land of volcanoes and lakes,” is the largest and least populated of these countries, with <6 million people. It is also the second poorest country in the western hemisphere, after Haiti in the Caribbean, and the poorest on the continent, with 70% of the people surviving on <USD2 per day. Independence from Spain was declared in 1821, and in spite of its tumultuous history of dictatorships, revolution, civil war, natural disasters, and economic collapse, Nicas are happy and optimistic people, friendly, and warm. The secondary language of the indigenous people is Miskito, money is the Córdoba (US dollar is widely used), 1400 animal species abound, there are over 2 million cell phones, 12% of roads are paved, and the voting age is 16. The national dish is “Gallo Pinto” (speckled rooster): In a region so obsessed by rice and beans, it is hard to believe that anyone claims to have invented the process of mixing the two, the result of which is known in Nicaragua (and Costa Rica) as Gallo Pinto. This national dish is comfortably eaten at morning, noon, or evening meals. The national drink is “Macua,” made of guava and citrus juices. And the “Chichi,” or “Chichi Bruja,” is a bright pink fermented corn beverage.

Nicaragua’s civil unrest has had a reputation for some time, but a ceasefire went into effect 20 years ago. Even though the country has its share of challenges, with jobs scarce, the economy poor, and the politicians questionable (a fact of life shared with many other countries, unfortunately!), it is today a safe and peaceful country. And for some of us as we strolled a lovely plaza or gazed down toward Granada and Lake Nicaragua (Lago Cocibolca) from high up on Mombacho Volcano, we felt we were living a dream.

At one point in the 1850’s, the conservatives in Granada, and the liberal party to the north in Leon, each wanted their city to be the capital of Nicaragua, resulting in civil war. To resolve this, a compromise was reached to end their contentious internal rivalry, and the small, proud indigenous fishing village on the shores of Lago Xolotlán (Lake Managua) between the two, was finally named as the capital of Nicaragua. This city of 1.5 million can probably best be described as disorganized and disjointed, a scattered, disheveled urban sprawl with no center, looking like a bomb hit it: That bomb was a massive earthquake in 1972. Rebuilding on the shifting tectonic nightmare was decided as pointless, leaving today’s capital city a ghost town, surrounded by dispersed, anonymous neighborhoods, pockmarked with craters, and crisscrossed with streets that lack character as much as they lack names. Addresses are not given as a street and number, but rather as a few descriptive lines of where it is in relation to a landmark, business, or other reference point.

The dental group arrived into this environment to become involved in a mission project to better the oral health in five separate areas. The sponsors were Loma Linda University and Foundation for Worldwide Health, of which Mark Carpenter DDS (LLU ’80), Tom Rogers DDS MPH (LLU ’83), and Henry Mercado DDS (LLU ’77) are directors. When Dr. Carpenter visited Nicaragua in 1999 to do some electrical repair and maintenance, he noticed the serious need the children had with oral disease. The result is formation of their foundation and now its June 11 dental mission trip to Nicaragua. One off-shoot is Nathan’s Project to provide handicapped children needed dental treatment under general anesthesia. Dr. Mercado’s son, Nathan, who had Down’s syndrome, unfortunately passed away at the age of 23, several years ago. Nathan’s name and spirit live on to provide important help for other Down’s syndrome children.

One group of the five lived and worked a couple of hours west of Managua in Leon. Other groups went to San Marcos, Acahualinca, Catholic University (UNICA) School of Dentistry, and Hospital Metropolitano Vivian Pellas. Providing dentistry with portable units and modified adjustable aluminum lounge chairs was intense and back breaking. At UNICA, the Dean, Lorenzo Muñoz, MD, DDS, PhD, originally from Cuba, arranged a mirrored clinic for his third year students (of a 5-year curriculum), to work side by side with our students, often mixing in and working on “the other side of the aisle.”

Students’ attitudes really blossomed as relatively sophisticated dentistry was lovingly provided for these beautiful children.

Why would people travel to Central America, incur expenses, provide free care, struggle with foreign language, food, and culture? Where there is the potential to help others, the golden rule prevails. Service to others in need is not only an obligation, but an opportunity and a distinct privilege, as well.

One of Dr. Mercado’s young patients from a previous year, handed him a note in a home-made envelope. He opened it to read: Thank you, Doctor for your attention to my teeth. Thanks be to you and to my God, my Eternal Father. My teeth don’t hurt anymore. I love all the new friends I made there, including you. The magic happens when, in our attempts to give to needy Nicas, we end up looking back and realizing we have actually received more than we have given. A spiritual blessing is the deep sense of unselfish gratitude at being trusted with relieving the suffering and pain of others.

“Inasmuch as you have done it unto one of the least of these. You have done it unto Me.”

Loma Linda University and UNICA dental students who worked together, pose for a final farewell photo: An international collaboration with international rewards!

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