As a hazy dawn breaks over Managua, Nicaragua, the litany of pain begins once again to fill the children's ward of the Fernando Vélez Paiz Hospital. In one corner a writhing 7-year-old wails continuously while a doctor removes the dressing on her right buttock. "She's lucky the bullet missed the bone, "says Dr. Ricardo Zamora, 27, as he swabs a disinfectant on the mangled mass of red muscle—the carnage caused by a single stray round during a recent shoot-out between government troops and contra guerrillas. When he finishes, he moves on to another of the ward's nine war victims, a sad-eyed 11-year-old girl whose right leg was blown off by a Sandinista mine planted near an electric-power station to discourage contra attacks. "It's often difficult to tell who's at fault," says Dr. Zamora. "Both sides are killing and wounding civilians. What's sad is that so many kids are caught in the middle. And since we don't have enough anesthetics, for them it's just a matter of pain. Every day it's a chorus of pain."
On this morning in Nicaragua's northern war zone, only hours after the U.S. House of Representatives has voted against renewed aid to the contras, Domingo Jimenéz, 14, emerges on crutches from his family's shack in Pantasma, 160 miles from Managua. After settling himself on a bench, he pulls back his right pant leg to reveal a thigh that ends in an abruptly tapered stump. A victim of a contra-planted mine, he no longer screams in pain like the youngsters at Vélez Paiz. But like most of the war's estimated 5,000 civilian amputees—many of them children—he knows he may never receive an artificial limb. Although the American embargo on trade with Nicaragua exempts the sale of medical supplies, Dr. Zamora says his country is bankrupt and cannot afford to buy prostheses. At least half the national budget goes to defense, and wounded soldiers, he is told, will be the first to receive prosthetic fittings.
Fortunately victims like Domingo are starting to receive aid from organizations such as the Red Cross and Jubilee Partners, an Atlanta-based Christian-action group whose Walk in Peace program has helped fit several hundred civilian casualties with artificial limbs. "We've got a long waiting list," says Jubilee director Don Mosely, "but we expect to help provide limbs for at least a thousand victims in the next two years."
Meanwhile Domingo waits, his head cocked, listening to the thunderous rumble of mortar shells exploding 10 miles away in the lush, green hills. "Every day I dream of walking," he says wistfully. Once Domingo pitched for a local baseball team; now he has given his glove away. The third of eight children born to Domingo Sr., a butcher, and his wife, Dora, he remembers the fateful morning more than a year ago when his father woke him at 6 a.m. and asked him to hop a ride on a truck to buy a few things in Jinotega, two hours away. "Go," he recalls his father saying, "and remember, you're my son, almost a man, so behave yourself and come right back." After lacing up his ankle-high boots, Domingo grabbed a nylon shopping bag and ran off toward the highway. A cloudless, blue sky was brightening, yet the cool, damp breeze of the tropics made him shiver.
"No! No!" shrieks Yalitza Galeano, a 4-year-old with deep wounds on both legs. While a nurse holds the hysterical child still, Dr. Zamora removes the last layers of gauze over her exposed left shin-bone. "We're not sure who shot her, but they say she was playing on the patio in front of her house when the battle started," he explains. "She caught bullets in both legs. She's having a hard time healing, poor thing. She's the nervous one and cries a lot."
Leaving the two-room shack, Domingo reached the road with time to spare before the big, wooden-sided truck trundled into view. Cheerful by nature, he smiled greetings to the other people waiting, mostly poor farm workers laden with trussed chickens or sacks of vegetables to sell in the Jinotega market. Trailing dust, the already crowded truck slowed to a stop. Domingo and several other children climbed up first and squeezed in among the other standing passengers. All told, by the time the three-ton Robur, an East German vehicle, left Pantasma, 52 people were aboard.
"I was thinking about baseball," Domingo remembers. "I was holding on to the center bar with my right hand above my head, wondering if grabbing it tight would make my pitching arm strong." In his other hand Domingo clutched the nylon bag he was to fill with rice, corn, beans and other items his father had made him memorize. Though the boy had occasionally attended school, he still could not read or write. Usually he helped his father cut and sell meat. Like many of the rural poor who have been moved to state-run cooperatives or relocation settlements, the Jimenez family had recently been brought to Pantasma (pop. 3,000) from their countryside home, ostensibly to keep them safe from contra attacks. (Critics of such relocation projects charge that the Sandinistas merely want to prevent the contras from recruiting soldiers among the peasantry.)
Seven-year-old Elda Sánchez was also standing on the crowded truck as it headed out of town. She was with her father, Amancio, 33, a Pentecostal pastor, and her aunt, Carmen Picado, 19. "I don't remember seeing them," Domingo says, "but when you're riding in the open air, people are just happy looking at the sky, up at the hills and hoping for a safe ride." As for Elda, all she remembers is holding her father's hand the moment before her world exploded and the sky went black.
"I have two kids of my own," says Dr. Zamora, moving on to the bed of a listless 6-year-old girl whose legs end just below her knees. "It hurts when I think these could be my kids. "Ashe lifts the sheet from Kenia Rodriguez, she sits up without a word and rocks back on her elbows, raising her freshly healed stumps for inspection. For a moment her wide brown eyes seem to stare in wonder and curiosity at such naked disfigurement.
"All this because of a grenade," Zamora explains. "I think it killed her father and a baby brother."
Domingo Jiménez and Elda Sánchez were among 49 people either killed or wounded by the land-mine blast that blew out the entire back end of the Ro-bur and left a hole in the road four feet wide and three feet deep. "People were all over the ground screaming and crying," says Domingo, his voice trailing off. "Lots of blood."
Less than a mile away Domingo's father and mother heard the blast and instantly seemed to sense what had happened. "I was sitting outside, and Dora was cooking," he says. "We looked at each other, then I jumped up and ran out. By the time I reached him, someone had put a tourniquet around his leg, but he was so still I thought he was dead. Then he opened his eyes and said, 'Papa, let them shoot me. It's better that I die.' Later, when I heard they had cut his leg off, it broke my heart."
Elda, a delicate child whose serene expression and large, soft eyes belie the agony she endured that day and for months afterward, suffered multiple fractures in one hip and both legs. Eventually her lower right leg had to be amputated to prevent a gangrene infection from spreading. Her father, Amancio, lost most of his right leg, and her teenage aunt had both legs amputated, one above the knee and one below. "What happened to me is now a matter between myself and God," says Amancio, with no sign of bitterness. "But what happened to my daughter, Elda, I find very difficult to accept."
By late afternoon Dr. Zamora, an orthopedic resident and graduate of Nicaragua's Léon medical school, is finishing his second round through the children's ward. Long workdays and the frustration of coping with a chronic shortage of medicine have left him on the edge of exhaustion. "Would you believe we don't even have vitamin C?" he says, checking another youngster with shrapnel wounds in both legs. "We need antibiotics, bandages, synthetic skin for grafts, even plaster for making casts. But all that is just for the here and now. What really worries me are the psychological wounds these kids must live with for the rest of their lives. It's hard enough for adults to survive such trauma. Imagine what it's like for children."
As the sun drops behind the hills bordering Pantasma, Domingo finishes carving a wooden top, one of many he has made for his friends since his injury. Earlier he swam in the river. Now chicks scurry and peck among the wood chips by his single, outstretched leg. "I get tired a lot, and the swimming wakes me up," he says, catching sight of his father. The elder Domingo, who likes to boast that he is 70, though his wife says he is 65, walks with the bearing of a much younger man. "I'm not afraid of the contras," he says. "I just want them to leave us alone. I don't want enemies on either side, but what happened to my son hurts me bad. What they did is inexcusable. I can only pray to God and the Virgin Mary to see to it that he gets a new leg."
As for Elda Sánchez, she now lives 90 miles away in Matagalpa. Through Jubilee's Walk in Peace program she, her father and her aunt were brought to Atlanta, fitted with prostheses and taught to walk again. Amancio says that other, less fortunate civilian casualties, like Domingo, may also benefit from recent Red Cross and Jubilee efforts to train Nicaraguans to produce artificial limbs.
"It's difficult to verify which side is the most guilty of killing and maiming civilians," says Jubilee's Don Mosely. "Sure, the contras have committed their share of atrocities, but the Sandinistas also lay mines along the Honduran border and around potential contra targets. Either way, it's usually the innocent civilian who is least to blame."
Pedro Orozco comforts his sons, Alfredo, 10, and Bayardo, 5, while Dr. Zamora examines their shrapnel-maimed bodies. They are the last patients he will see this day, and the most pitiful. Since they arrived a week ago, victims of a contra mine that was buried near their house, they have seldom ceased screaming and moaning. Apart from the deep wounds that cover their heads, chests, hands and legs, both boys may never see again. "Kids are curious," says Zamora. "They thought the mine was buried treasure and tried to dig it up."
While the hapless Pedro, a Sumo Indian from an Atlantic coast village, anxiously caresses his sons, a nurse rushes up to whisper something briefly to Zamora. "She says a mine just blew up another truck with a whole load of civilians, "he says, shaking his head. "Seventeen people were killed, five of them children. There'll be lots of wounded, so I expect we'll be seeing the serious cases in a few days. "After a nod to Pedro, Dr. Zamora slips his clipboard under his arm and disappears into the hallway, followed by the whimpering cries of the Orozco brothers.
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