At five the rooster wakes us. He crowed at three am as well. Elizabeth says the roosters in Quilali sing to the moon. We have a lovely cup of home grown coffee and get dressed. It’s time to milk the cows.

Cornejo store in Quilali
We walk past her brothers’ houses and her aunt’s house. Her father owned all this land including the highest point, but sold the other side of the street to support the family. At the end of the street, we head up the second highest vista. Here Elizabeth is building a house to have a place for more people to stay who want to help. Her house is beautiful! Massive compared to the neighbor’s, up on the hill overlooking the town and the river like a Central American castle. Two stories with a deck and huge patio. It’s not quite finished but handmade carved doors and windows are in and they are magnificent.
The electricity’s not hooked up, nor the plumbing. Elizabeth plans to pump water from the well rather than depend on the city water which is runs intermittently. Some houses have toilets like the Cornejos but must collect water when it’s available to flush them when the plumbing is off which is about half the time. Showers are more like standing baths from water collected in barrels. While there is no plumbed hot water, Elizabeth was kind enough to heat some water in an electric kettle she brought for her mother last time she came. Electronics are very expensive in this country who produces none, so she brings what she can.
After touring the outside of the house, since it’s locked, we make our way down the backside of the hill past the well, to the stable just above the river. Her father owns twelve acres at the edge of town and the cows have plenty to eat.
Señor Cornejo has hired men to help and they’re nearly done milking the eight cows when we arrive. Two calves wait outside the corral until their mothers are ready to be milked. The men let one in and it hurries to its mother. As the calf starts to nurse, one man hobbles the back legs of the cow, the other puts a rope around the calf and ties it by her head. The cow licks the calf as I make a poor attempt to milk the cow. It’s been a long time since I milked a goat and this is my first time milking a cow. After Elizabeth tries too, the man quickly finishes the job, the other man takes us up to unlock Elizabeth’s house. She’s disturbed by the large dimensions of the great room. She’s used to door to a tiny kitchen but I assure her that this large gathering space is perfect for a big open kitchen that will accommodate multiple cooks, a large dining table and sitting area for all the guests she plans to host. There are three large bedrooms downstairs and a huge loft with a deck upstairs plus three full bathrooms. She could easily sleep ten to twelve people.
Her family have all helped in this endeavor to build a house for the one who went to America. Perhaps she’ll come home someday.
After making plans for storage, stair rails, and roughly laying out the kitchen, we head back to her mother’s house. Breakfast is rice, beans, fried plantains and fresh papaya juice. Very good and filling. Magdalena, Elizabeth’s sister in law has come to cook for us. She shows me how to make cheese from the cows’ milk.

Making cheese with Magdalena
We then prepare the backpacks to be distributed at the primary school and separate clothes for Casa Materna and the hospital. We wash up and dress. By 9am we are ready to go.

getting backpacks ready for school children
Elizabeth’s sister Erika joins us. She has been instrumental at organizing all the meetings, communicating back and forth to Elizabeth where the greatest need is and making sure the donated funds are used appropriately. She even rode the bus eight hours to the big market in Managua to buy nearly 300 pairs of shoes twice! She has a bad back and the bus ride was hard on her. Her daughter Alejandra and niece Chrisiam climb in the car with us. The driver packs the truck with three huge sacks of backpacks and clothes and off we go.
First stop the Primary School. This is where Elizabeth and all her siblings and cousins went to school and now her nieces and nephews learn here too. Her oldest nephew earned the highest grades in last graduating class and next year will be attending the secondary school. The primary schools are grades 1-5 teaching children 9-13 years old. Children start school at the Kindergarten which teaches children 5-8 years old. After Christmas, Elizabeth will deliver school supplies to the Kindergarten. Today, we deliver backpacks to the poorest children with the most potential in the primary school- two from each class.
Only five children show up, and two adults. Although this is school break, some of the children cannot be here as they are up in the mountains picking coffee with their families. The school year breaks for harvest which here in Nicaragua begins in November. The next school year begins in February. Few of these children will get a break but will be working to support their families.

presenting backpacks to poorest children at the primary school
These children seem rather somber since they don’t get many presents. Most handouts come through the government and are tied to political beliefs so the families are suspicious of anything free and the children act according to what they’ve been taught. We take pictures of each presentation and ask that the children use their new supplies to write a thank you note to bring to the 4H girls. Our praise over their handwriting and artwork starts to wiggle smiles from their lips.
Each backpack is different filled by individual 4H girls, so it’s exciting to unpack them. The children begin to relax and have fun comparing their supplies and even a some gifts – small toys, bracelets, hair ties, flip flops – shoes are greatly needed with the constant rain and mud.
The word gets out that we are presenting backpacks and more parents show up. The teachers and Erika identify those families in the greatest need, but we haven’t brought enough backpacks, so I head back with the driver to get more. The house is open with the front convenience store and we’ve brought so many donations that we locked our door. Unfortunately, I can’t get it unlocked. Elizabeth’s mother tries to unlock it. The driver tries. One of the children run to get Elizabeth’s brother who cannot open it either, so he breaks the lock. Only one day here and already we’ve created drama. The family just brushes it off and by the time we get home, there’s a new lock on the door.
I return to the school with more backpacks and eight more children leave happy. All the original chosen students receive their backpacks, so it’s time to tour the school. Elizabeth reminisces with some of her old teachers through the classrooms. Last year, she presented them with white boards and they are taking good care of them.
The school is in poor shape, needing paint and repair, but we ask what the students most need and the teachers agree – a Computer Lab. We visit the space designated for the lab. It’s a separate building currently being used as storage. Elizabeth and Erika ask if the parents would be willing to build the computer desks and the teachers believe for the children, they will. So we put thirty computers on the wish list. The student teacher has already investigated the cost of each unit – $600 including all the cables and harder drives necessary to run a group of 5-6 monitors. At a grand total of $18,000, we will have to do some fundraising.
We say goodbye and head across town to the Secondary School. Here we present $50 scholarships to the top two students in each class. Ten students dressed in their uniforms greet us and a couple of parents whose children are working in the fields. Clearly the children with the most economic opportunity are doing the best in school.
These older students are very grateful for the scholarships which have come from Altruesa. The director of the secondary school is a member of Altreusa whose mission is to improve education and just this year have reached out to Nicaragua. He praises Elizabeth who humbly claims she is only a bridge. I tell the students, Elizabeth Cornejo is more than a bridge, she is an example of what they can do if they stove to do well in school, seek higher education, and follow their dreams. They will not only improve their lives but can help improve the lives of others.
After the students leave, we tour the school. It is in much worse shape than the primary school. Just to the right of the crowed administration office is the bathrooms. The septic tank is in between the two and overflows with heavy rains which occurs frequently. Funds will have to be raised for replumbing. The classrooms are in poor shape but functional. One classroom is being used as a library. Since it’s so hot and humid during the school year, the classrooms have open caged windows. The books do not last in this environment. Glass windows and a ceiling fan for circulation are needed or better yet build a library and use this classroom as it was intended. There is space on the school grounds to build. Another fundraiser is added to the list.
I explain to the director that right now we would like to help with what monies we’ve brought. I ask if the science class has a microscope. The director lights up, No, and with a microscope they could better teach biology. As a health care provider, this is close to my heart. We will figure out a way to get them a microscope.
So with the growing needs list we break for lunch. It’s been a long day and we’re only half done, so we treat her sister, the girls, and our driver at the only restaurant in town. Grilled chicken, rice and plantains. I start to order iced tea until I find out it’s sweetened. All the beverages are sweetened, sugar is even added to fresh juice. Some of Elizabeth’s relatives have diabetes and I noticed dental caries in the youngest children and missing teeth in adults.
The Nicaraguan diet is primarily starch and sugar and very little variety. As Elizabeth’s father says: For breakfast, we eat rice and beans, for lunch, beans and rice and for dinner, rice and beans. Besides tomatoes and onions to cook the rice, very few vegetables are eaten and almost no leafy greens. Elizabeth told me that one of the biggest needs is vitamins for the children and pregnant women. No wonder, the Nicaraguan diet is not colorful enough to provide the necessary nutrients. The white rice is stripped of protein and fiber. But in this land, everything grows, Señor Cornejo says just push a seed into the earth and it’ll produce fruit in no time. This is a cultural problem, not a lack. Rice and beans are perfectly fine when you’re doing hard labor to support your family, but with modern technology and yes, in spite of the lack of first world plumbing, technology has made it’s way here – televisions, tablets, cell phones. People are not as active and storing the starch as body fat or developing diabetes, heart disease and cavities.
After my enlightening lunch, we head to the hospital.
And here we find the greatest need.
We meet first with our connection through Erika – the director of the Laboratory, who shows us the lab. I ask what the lab needs the most and he takes us to an old Olympus microscope. It’s functional but not precise enough for the doctors to accurately diagnose. I see an opportunity to kill two birds with one stone and ask if I donate a new microscope can they donate their old one to the secondary school. He explains that the microscope belongs to the government and equipment that is not used in one hospital is sent to another. I ask for his assurance that whatever we donate stays here. He takes us to the director of the hospital.
The director of the hospital explains this is the primary hospital for entire area of 79 small mountain communities & 19 neighborhoods in Quilali. Their mission is to serve families and the community but their needs are great. He agrees to meet with the rest of the staff and come up with a list of needs. Again I ask for assurance that whatever is donated stays in this hospital. As long as it is used, it will stay here, he assures us then instructs the laboratory director to give us a tour.
The hospital in Quilali would be considered a clinic in a first world country but here they deliver babies, treat emergencies, and even do surgery when there’s an anesthesiologist available. Part of the hospital is a primary care clinic treating all ages with separate rooms for general medicine, pediatrics and gynecology. Part of the hospital provides tertiary care with the most outdated equipment. The incubator doesn’t work. The blood cooler breaks down and they perform 8-10 transfusions a month. And the diagnostic machine for blood chemistry is old and very slow. Not to mention the rusted and broken beds, tables, and other equipment. But they make do.
We meet patients in the few rooms crowded with 5-6 beds. Patients recovering from surgery, hospitalized for medical issues, women in labor, patients being evaluated in the emergency room. We meet one of the doctors who takes us to see the where there is the most need. Gynecology. The ancient colposcope for the diagnosis of cervical cancer is barely functional. There’s not enough instruments for delivery and the town has a high birth rate.

examining the ancient colposcope
Time to head to Casa Materna – these place where the pregnant women stay just before and after delivery. Rocking chairs line the stoop outside of the maternity house. Very pregnant women chat and enjoy the quiet of the late afternoon. A young nurse greets us.
The director of nursing is delighted that we’ve come.
She calls the women into the gathering area and we pass out the women and children clothing. The women trade each other for more appropriate garments for older children at home. We then get the grand tour. Casa Materna supports itself by renting chairs and table cloths for events. Their focus is education of the women. Contraception is free, but getting the men to use condoms is difficult. The women prefer to come here than the hospital. The environment is warm and caring. The women seem content. Their fears relieved being cared for and close to the hospital.

Casa Materna
For the first time all day, I am really impressed. Casa Matera is fulfilling a great need; they’re self-sufficient, and the nurses are teaching the women how to take care of themselves. This is the place where DDU can affect the most women. I will be back.
Now it’s dark. We walk back to Elizabeth’s mother’s corner store and into the house. We’re served a simple meal of taro root and chaya with the fresh cheese I made this morning. Life is good.