Viva Victoria: My Reflections from the Field

After 52 trips for Mending Kids, I like to think of myself as a grassroots (and grass-fed, now that I’m vegan) leader. Most everything that helps inform my decision-making has been learned from traveling on missions, meeting kids and their parents, talking to administrators, local doctors, and sometimes heads of state - asking and lots of negotiating. For better or for worse, my degree is in globe-trotting with a minor in pollinating relationships to build a network of partnerships.
 
I found myself in Nicaragua last week, reconnecting with our local partners after a ten-year absence - on my part. This was likely our 8th visit to Hospital La Mascota. The staff and our local cardiologist-host, Dr. Ramirez were ready for our arrival. When we showed up on Easter Sunday about 7 patients and their parents were waiting for us in the reception of the cardiology building. Forgoing services to pray that their children were selected for the week of procedures to correct their congenital anomalies and give them a second chance to live a long life. The fact that this medical trip was taking place during one of the most important holidays in Christendom did not go unnoticed. We came prepared with chocolate bunnies and candy to regale the kids with and proceeded to get to know them a bit to ease the atmosphere and help them feel more comfortable with us. I won’t lie that I was concerned there were only 7 patients. We hoped to help double that amount. Dr. Ramirez assured me that we would be screening more patients for the next three days and scheduling them accordingly. Per experience, I didn’t think that was the most effective way to do this but given the holiday, public transportation was cut back and other families were coming from far away, I was reminded that I have to trust the process and hope that they all show up when asked to. 

Dr. Ramirez kept asking the nurse if Viva Victoria had arrived. She was now almost 5 months old, she was screened at the end of 2023 with instructions for her mother to return today for the mission. She wasn’t there. We finished evaluations and planned the cases for the next three days. All 7 children scheduled were good candidates and put on the cath lab calendar. Monday went smoothly with 2 cases and room to screen 4 more patients in the afternoon, who were scheduled for Wednesday and Thursday. Still, Dr. Ramirez asked if Viva Victoria had arrived. She had not. So at this point, he called the hospital’s social services and asked them to go to Masaya, find the mother, and bring her back with her baby. We returned to our hotel to prepare for the next day's procedures. The following morning we stopped by Dr. Ramirez’s office. Viva Victoria was there with her mother, a cherubic young woman who was holding her. She was 16 and younger than our oldest patient. A minor raising a kid. I asked her if anyone else had come with her to support her and she shook her head. The baby was the size of a neonate. Her lips were blue and she was clearly in discomfort. The doctors reviewed her echo and quickly greenlit her for a procedure. Dr. Ramirez instructed the mom to come back the next day and that we would be scheduling Victoria for her procedure on Thursday. Her baby did not have much time.  Wednesday rolled around, procedures went on and the mother and child had not shown up.

Once again, Dr. Ramirez called social services and the baby and mom were brought to the hospital with surgery scheduled for Friday. When we asked her why she hadn’t come back as scheduled, she simply stated that she didn’t have the money to take the bus to get there. She was alone, with no support, no diaper bag, no money, and no food.  When I delved further into her story, the answer was classic. Pregnant at 15, the father had left her and was not involved. She lived with her single mom and younger siblings in a house made of plastic walls and did not go to school, nor hold a job. We weren’t there to judge, but the scene and the struggles she faced as an individual, let alone as a teen mom in the second poorest country in Central America were pretty depressing. On Friday, before the time came to take Viva Victoria in for her procedure, we presented her mom with the consent form to allow us to treat her. The doctor went over everything and when it came time to sign, the mom shared that she couldn’t write or read. I always tell anyone who volunteers with us to remain calm and show poker-faced compassion when experiencing something that might prove shocking. We told her that signing her name would not be an issue, we would simply accept her thumbprint and a witness signature. I took a photo for good measure. The baby was crying because she was hungry and could not be breastfed because she was going to go under anesthesia. I asked her if she had a pacifier, but I already knew the answer. I found a sheet to cover the baby because the room was cold, and she didn’t have a blanket. Money or not, love is free, and it was apparent how much she had for her infant. I checked on her a short while later and gave her snacks and water reserved for the medical team. I hugged her and advised her to get some fresh air. Back in the Cath lab, Dr. Ramirez was relieved that Viva Victoria’s heart was being repaired. He doubted whether the mom understood how close she came to losing her; her stenosis was so advanced. She didn’t have another chance; she likely wouldn't have survived three more months, and no other Catheterization missions were scheduled for the near future.

On Saturday, the team packed up to return; I stayed on. I had a vacation planned in Costa Rica starting on Sunday but I kept thinking about the 16-year-old without support and a fragile baby. She was raised in a shanty home with no means, no bathroom, and no education. I didn’t want to leave without visiting her one more time, to process this and consider how to help her, even if I didn’t have all the answers. I went to a store and bought a baby blanket, a pacifier, and a teether, along with a bit of money for her to buy a meal and bus fare to go home.
 
She was surprised to see me. The baby was asleep, unswaddled, and she sat in a chair, staring at her, lamenting that she couldn’t go home yet. I explained that because she lived outside the city, the doctor was taking extra precautions for the baby's health. I tried to explain how lucky she was that everything had timed out so well for Viva Victoria. I shared how much I loved her name and how she had chosen well by naming her Long Live Victoria. 
 
I asked her what her plans were; to which she had none. I asked if she planned on sending her daughter to school; she wanted to. I suggested we look for support for her so she could attend school again, learn to read and write, and support Viva Victoria when she started learning. She smiled and nodded (I recognized the placating). I asked if she had dreams when she was young and what they were; she said she wanted to be a police officer. 

I reminded her that Viva Victoria was a survivor, and she had won the lottery when we mended her child; this had to mean something great for her. That this was a new door she could go through. Yes, the challenges were there. Yes, the road would be long, but she had the power to change things for herself and her child, for the better. I did my best to ensure she didn’t feel like I was scolding her. I gave her a parting embrace, took her information on WhatsApp, and told her I would be in touch. It’s been several days now, and I am no longer in Managua, but I still think about how this mission was mending kids’ kids.
 
May courage and determination abound, may Viva Victoria have a long life ahead. And may this all be for a reason, though the path is not yet revealed.
 
Note to self: find an organization to help baby-mom in Nicaragua.
 
- Isabelle Fox, 
Executive Director

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