In a way, I imagine our work in Nicaragua will be like climbing Volcano Concepcion, a 5283 ft high volcano located on the island of Ometepe. I had the ambitious plan of hiking up this volcano, which was a predicted 8 hr hike for a fit individual. About two hours into the strenuous, rocky, and mostly 45+ degree incline trek, I had a moment of panic that I would have to quit. Every muscle ached, every step was torturous; I was physically, emotionally and mentally spent.

However, what kept me going was something my Spanish teacher had told me. It was the simple phrase "poco a poco" which means little by little. So, with this mantra repeating in my head, I slowly willed myself to take one step at a time. Eventually, miraculously, I did it. I made it to the top! What's more, I conquered the trip down, sliding through muddy terrain, skiing down the gravelly path alongside the volcano and climbing over large rocks. I was exhausted, but proud and exhilarated of my accomplishment.

This is exactly how I imagine the next few years in Nicaragua will be. I am setting out on the journey with high hopes and large goals. One week into my cultural immersion, I have witnessed resilience and creativity in the people of Nicaragua. Although it is a poor resource country with a lot of barriers to care, the healthcare system they have in place demonstrates the beautiful role of community in caring for the sick, the disabled and the vulnerable populations. It has been a humbling experience so far. The people here have a lot of heart. They tackle each problem with a strength and tenacity that is very admirable.

It is a wonder to see how much the health posts and health centers, the places for primary care and public health epidemiology mapping, are able to do with so little. And what's more, it is an amazing thing to see how proud the providers are of all they have accomplished and their future plans for improvement. With an open heart and mind, and taking it little by little, we can overcome unimaginable obstacles.