Crisis in Nicaragua

It was one of those phone calls I dreaded receiving—a late night phone call from a team leader is usually not a good sign. That one phone call set off a chain of events that impacted our ministry in ways we could not have imagined.

Patricia "Trish" Burgess, MD

As the Director of CMDA’s Global Health Outreach (GHO), I’m responsible for the overall logistics and safety of the 40+ short-term healthcare mission teams we send around the world every year. We work closely with our national partners to balance the security needs of each team with our mission to spread the love of Christ through healthcare.


Some countries are more high-risk than others, but Nicaragua was a fairly stable location with a full-time GHO Nicaragua Director, Rolando Castillo, who we coordinate with on a regular basis. We typically send about 10 teams to Nicaragua each year, and that’s why Rolando works as our in-country director. As our full-time staff member, Rolando directs and organizes all of the details for these Nicaraguan teams while also discipling local pastors, giving us a long-term impact through these short-term teams. In fact, many of the team members return to Nicaragua again and again as they develop relationships with translators, pastors and others in the country.


On April 16, 2018, Dr. Greg Griffin arrived in Masaya City, Nicaragua with a team of 27 healthcare professionals and logistics workers. During the week, the team saw more than 1,700 patients in the clinic and many came to know the Lord.


But outside the clinic walls, the political situation in Nicaragua was deteriorating—and deteriorating quickly.


On Wednesday, April 18, protests broke out in the capital city of Managua in response to announcements from President Daniel Ortega’s administration about measures to increase social security payments, reduce pensions and repress peaceful demonstrations. Young college students and civil society organizations protested to demand a fix to the unfair laws. The government sent out police and paramilitary forces in an attempt to contain those protesting. The protests quickly turned violent, with many injured and even killed on that first day.


Rolando remembers seeing a number of young people peacefully demonstrating on the streets of the town the next day. Later that afternoon, more police officers were sent out to force the protesters to go home. In the meantime, riots broke out in other cities around the country. People began blocking roads in Managua as a sign of protest, and it began to be harder to move around some major streets.

On Friday, the situation in Managua was becoming more tumultuous as thousands of students took to the streets in protest. That day, the team left Masaya and traveled to Granada for a day of tourism, which they were able to do with no problem as the city was safe—for the time being. “Later that afternoon, the manager of a restaurant where all our teams love to eat called to warn me that there were rumors of a possible march later than afternoon in the vicinity of the restaurant and possible clashes could happen,” Rolando recalled. “And for our safety, she recommended we stay in the hotel.”


Rolando took the call seriously, so the team stayed in the hotel for the evening. That night, they heard gunshots in the distance, along with loud firecrackers. At this point, Rolando and the team leader began having serious concerns for the team’s safety, and that’s when the team leader called us late in the night.


Immediately, we began praying for the critical situation and the team’s safety. I also suggested they try to get to Managua as quickly as possible, where they would be flying out of, in case the protests worsened. The next morning, it took several phone calls from Rolando to local pastors in the area to figure out the best way to get to the hotel just outside of the airport as some of the roads were blocked. The team arrived safely and were able to fly home to the U.S. without any issues.


Later in the week, the city of Granada turned to chaos as the city hall was burned, numerous businesses were vandalized and countless numbers of looters were breaking into stores. Meanwhile, our staff in the U.S. remained in constant contact with Rolando as we assessed the continually disintegrating situation. We cancelled the trip scheduled later in April, as Rolando had concerns about keeping the team safe and the patients and interpreters being able to travel to the clinic site. However, we were hopeful we would be able to send our next two teams scheduled in May.


As the days and weeks passed, the situation became more and more dangerous as the number of protestors grew even larger, forcing major roads and cities to close. We heard more and more reports of the use of paramilitary police to control the protestors and that sniper fire killed and wound hundreds of Nicaraguans. From the news and Rolando, we learned that schools were closed or hours limited, medical personnel were punished for trying to help injured protestors, restaurants and hotels lost business and eventually closed, and families were afraid to go outside or drive on the roads. As we prayed together with Rolando for discernment and wisdom for him in Nicaragua, GHO made the difficult decision to cancel all remaining teams to Nicaragua for the rest of the year. In addition, we made no plans to schedule future teams in 2019. This was essential, yet heartbreaking, to do. They are brothers and sisters to us, and it felt like we were abandoning them in their time of need. We often talk of obedience to Christ in going on a mission trip, but there is also a lesson in obedience at a closed door.


Many of our team members serve in different locations around Nicaragua year after year and have established deep friendships with our Nicaragua team members, most of whom served as interpreters and pastors. Because of that, some of them felt we were abandoning our family in Nicaragua; however, we needed to keep the safety of our teams our primary concern.


That feeling of abandonment spurred on our GHO team members in the U.S. to try and do something—anything—to help their friends in Nicaragua who were facing food shortages and a lack of work as the nation’s economy crumbled amidst the violence. And out of that desire to continue to serve, we established the “Nicaragua Relief Fund.”


Many of our team members in the U.S. donated money to the fund, along with their churches, to assist the pastors, interpreters, church members and others who had suffered the effects of the instability. In country, the cost of a basic basket of goods had increased by at least $100 since April, so lots of poor working families couldn’t afford even basic necessities to feed their families. Prior to the violence erupting, GHO sent two teams each year to help women who are victims of human trafficking, and these women and children were also going hungry.


Rolando used the money from the Nicaragua Relief Fund to buy food for these needy families. We did have to be extremely cautious while doing this because money going in and out of the country was being watched closely. We did not want to inadvertently put our Nicaraguan team members in danger if the money were to be interpreted as though we were sending support for protestors.


When the families arrived at a local church for food distribution, the local pastors gave them bags of food, plus they shared the gospel message. As time passed, more and more people came for food and to hear about the Lord. We were told they saw this gift as an offering directly from the Lord.


The Catholic Church in Nicaragua started a national dialogue between the government and the protesters to negotiate peace, but it wasn’t fruitful. Different international groups and countries like the U.S., Canada, Costa Rica and the European Union tried to push President Ortega to cease the repression, but it took months for things to finally start to settle down. Finally, most of the violence stopped in October 2018, but much damage had been done. More than 500 were killed, while thousands were imprisoned. Plus, more than 100,000 Nicaraguans fled the country out of fear or the need to search for jobs. Hundreds of companies closed due to the economic recession, and inflation continued to rise.



While we watched the situation unfold in Nicaragua from the U.S., it was easy to become discouraged. Our staff was dealing with the headaches of the logistics of cancelling multiple trips. As the doors literally shut for our teams to visit the country, we started wondering how we could continue to fulfill our mission of demonstrating the love of Jesus to the world through healthcare. But our answer was right in front of our eyes—we have a commandment to spread Jesus to the entire world, not simply Nicaragua.


So we looked up from the work and the discouragement, only to see God opening multiple doors for our teams to visit new locations around the world. If the doors to Nicaragua had not closed, we would have never seen these new opportunities for GHO, let alone walked through the open doors.


I believe God is at work in the Muslim community. He opened many doors into refugee care teams in the Middle East. We heard story after story of Jesus coming to them in dreams as we care for them in our clinics. He has opened new doors into our efforts to stop human trafficking as well. As He is showing us He is at work around the world and inviting us to join Him, He has also opened doors into more surgical teams. When I did a site visit to the Dominican Republic, we were told by a local physician that he had been praying for a surgical team to come and help his country for 18 years. God was showing us His command in Acts 1:8 to go beyond Jerusalem and Judea and in to Samaria and the ends of the earth. It was exciting! It brought hope.



We didn’t forget our beloved Nicaragua, but I believe we responded to the Lord in humble obedience. Sometimes our heart cry is felt to be ignored, but God has continued to work in Nicaragua without us. Rolando has heard amazing testimonies of the Lord’s provision. The body of Christ in Nicaragua worked together to help each other.


It’s been more than a year since that fateful phone call back in April 2018, and we are excited to announce our first GHO team returned to Nicaragua in July 2019. In fact, the Ministry of Health requested our medical teams visit certain areas that are in great need. This trip was long anticipated, and the team was extremely excited. They worked in a rural area of Nicaragua that took hours to get to, yet pastors from all over Nicaragua took long bus rides to join the team to help and serve alongside our GHO team. They all appreciated the unity of the team and the bonds as sisters and brothers in Christ reunited.


Rolando believes this time of deep sadness and pain was a lesson for his entire country, especially for the Christian community in Nicaragua. 2 Chronicles 7:14 says, “If my people, who are called by my name, will humble themselves and pray and seek my face and turn from their wicked ways, then I will hear from heaven and will forgive their sin and will heal their land.” This was a verse of encouragement for lots of churches during this time, and it brought us all to our knees imploring God for mercy.


When Rolando was able to begin meeting again with the discipleship groups he oversees, many expressed their pain and suffering but realized the Lord demands more from His people, including humble hearts and lives removed from sin. Certainly, many acknowledged that they had strayed from the Lord and that this situation made them return to their communion with God. They were also able to understand better the words of Peter in 1 Peter 5:10, “And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast.”


Rolando’s words speak for themselves about how the Lord has worked through this situation:


The Lord has been working in the lives of His people, just as the artist who perfects his painting with every single brushstroke. He built our strength in the same way as an athlete builds muscles by training every day, teaching us how to run the race to finish it. Thus, the Lord has brought us through this temporary fire, so we can become more like Him, purer in all our ways.


Also during this time, we can see His faithful hand among my family, GHO staff, translators, pastors and their families, that all of us have been kept by the Lord fulfilling the promise He said to Abraham in Genesis 15:1, ‘Do not fear…I am a shield to you; Your reward shall by very great’ (NASB).


I have also seen the generous hand of the Lord and His provision through friends and brothers. At some point during the crisis I was quite distressed, but one of those afternoons I got a call from brother Ron Brown and Dr. Trish telling me: ‘Rolando if you and your family have to get out of Nicaragua, do not hesitate to come here. We will give you a safe place to stay while you need it.’ Those words had so much meaning, because my heart was fearful and heavy. I want to thank CMDA and GHO from the deepest part of my heart, because despite not having a single team going to Nicaragua since last April, my assistant Roy and I have gotten our monthly financial support to keep providing for our families. Praise the Lord!


Since I wasn’t going out with teams, I have been invited more to preach to other churches and spend more time preparing for discipleship sessions. It sure has been a different year, but very busy serving God and trying to bring comfort and encouragement to so many pastors and their churches that I’ve been able to meet during my years with GHO. Only Jesus Christ is the solution to the problem of sin that overwhelms humanity.






Returning to Nicaragua

by Andrew R. Schock, MSPA, PA-C


Editor’s Note: Andrew and his wife Janelle were two of the team members on the final trip to Nicaragua in 2018, and they were both on the first team back to Nicaragua in 2019.


It was around 1:30 p.m. on Thursday afternoon in April 2018. As I roamed the clinic in Pacaya, Nicaragua to check on various departments of our clinic, I noticed our interpreters all intently checking their cell phones. Clinic continued to function in usual fashion through the end of the day, when Rolando gathered us to discuss some current events that had captured the attention of our Nicaraguan partners. Protests were taking place in the more populated areas of the country, and the look of concern on Rolando’s face told us all we needed to know. We quickly wrapped up clinic, ate with haste and proceeded directly to our hotel. The streets were nearly deserted.


In the morning, the news informed us that things were stable, and we decided to head to clinic for our final day. Several team members later told me they heard explosions or gunshots during the night and didn’t sleep well. Per GHO custom, we ended clinic and proceeded to finish our trip with a day of relaxation in Grenada. There would be little relaxation this night, as the political unrest and violence dramatically worsened. Our plan changed by the next morning as there were reports of barricades and clashes, and things were continuing to worsen. Because of this Rolando led us along a more rural route back to Managua, and we arrived without any difficulty in what can only be described as providential. The next morning, we got to the airport and surprisingly took off without much difficulty.


Fast forward 15 months to July 20, 2019 as we arrived in Managua for the first GHO trip to Nicaragua since that 2018 trip. The anticipation of seeing our local friends, and co-laborers in Christ, was almost more than we could bear. While waiting for our baggage to arrive and our team to clear customs, we saw Rolando through the window, smiling at us. If you know Rolando, you know his smile can light up a room. This time I thought his face might rip in half.


The next morning as we gathered in our usual meeting location, Rolando walked in with a group of about 10 interpreters and other GHO employees. Talk about a flood of emotions! The remainder of the trip seemed to have a special feeling about it, with interpreters and team members from the U.S. forming and strengthening bonds as brothers and sisters in Christ. This close-knit unity seemed to propel us to greater love for our patients and our hosts and to greater effectiveness in our clinic and evangelism. The most dramatic development we noticed from the last 15 months was a greater depth of spiritual maturity in our Nicaraguan friends. They seemed to be more eager for fellowship and were pursuing spiritual maturity in a way we hadn’t seen in the past.


Suffering and persecution have a way of separating wheat from chaff, and their suffering the last 15 months appears to have had a very painful, but constructive, purifying effect on their souls and their walk with Jesus Christ. There was much talk prior to the trip about how important it would be for us to just be there and encourage the Nicaraguan brethren, but they turned out to be the greatest and most important ministers on our entire brigade. Shouldn’t have been surprised in the least, but I was surprised. We all were. And we are better off for having been there with them.


Get Involved

CMDA’s Global Health Outreach (GHO) is a short-term missions program that sends 40 to 50 medical, dental and surgical teams around the world each year to share the gospel and provide care to the poor. Sign up to travel on one of GHO’s short-term trips this year and join us in our efforts to transform the world. To find a trip that fits your schedule, visit


About the Author

Patricia “Trish” Burgess, MD, joined CMDA as the new Global Health Outreach Director in 2018. Trish went to the University of Georgia for her undergraduate degree where she met her husband. She took two years off before attending medical school and worked as a firefighter in Athens, Georgia during this time. She attended the Medical College of Georgia and did her residency in emergency medicine at the University of Missouri in Kansas City. Dr. Burgess felt the call to short-term missions early in her career. Her first mission trip was to Nicaragua. During this trip, she felt Him clearly telling her this was the reason He had created her, and His plans for her included continuing with short-term medical missions and leading teams. With GHO, Trish has also traveled to Cambodia, the Dominican Republic, El Salvador, Ethiopia, India, Kenya, Nicaragua, Moldova, Peru and Zambia.