It's been an interesting last couple of months at Skylark. National and International groups continue to experience retreats at our wonderful Centre. Some groups are made up of just men, others just women and others only youth. We even had a group that came to renew marriage vows and prepare new couples as they enter a new life in holy matrimony.

We had several groups visit us from the United States doing youth camps and a pastoral women's retreat. We also had the opportunity to host a Threefold Ministries medical team and bring medical help to communties in need close to our Centre. Our director of Operations, Mauricio Manzarez's band Kenosis played in one of the events. We look forward to the rest of the year to see how God continues to move and work in this place.+

Employee of the Trimester: Don Marcos

At the Skylark Centre, we are blessed to rely on a friendly staff ready to serve our guests with the best of attitudes. This period we are especially talking about one of our security guards at Skylark: Don Marcos Aguilar.

Don Marcos has been working for us since May 2009. He lives in San Marcos and he learned about this job opening through his pastor, who happened to be a participant in an event held at Skylark.

His pastor gave him a refence letter and a few weeks later he was on board. Don Marcos Works the day shift and he is the first person every visitor meets upon arrival at our gates. He makes sure to greet everyone with a warm welcome. Don Marcos is happily married and is a father of three. +

We are happy to announce that as of last April, we have a new member of the Skylark Retreat Centre family. His name is Guillermo Larios, a young Nicaraguan from the colonial city of León. He joined the Skylark staff as a logistics assistant, working directly with the teams visiting Skylark, making sure that all the services we offer are up to par.

You can find Guillermo walking around with cables making sure that the audio is set up properly or collecting sports equipment from departing groups. Whatever the task may be, you can count on his friendly smile to help you in whatever need you may have. Welcome to Skylark Guillermo! +

Best Start (Cont)

As well as parenting classes for the moms we also had a special Mother's Day event in May for all the moms in all parts of the program. Fifty-two moms showed up for a relaxing afternoon in the Skylark Retreat Centre. A dynamic women's pastor from a local church, Cristhian Palacios, came to talk about a mother's obligation to pray for their children, to be a good example for them, to make sure their children go to school and receive discipline, and to share the love of God with them. She also shared with the mom's that they each have the right to receive love from their children and to have their voices heard within their families. The women were encouraged by Cristhian, as was evident though their active participation and laughter during her talk. I then had a brief talk with the moms about family planning and different methods they can use to plan for having or not having more children. After the talk we had a piñata and ate some delicious fruit salad prepared by the Skylark cooking staff. The women were then invited to relax and enjoy the center; they made jewellery, painted each other's nails, and swam in the pool. It was a time of laughter, joy, and reflection of what it means to be a mother. +

Teacher Training

Best Start had the pleasure of early childhood professional, Carey Franklin, joining us in our ministry for a day of training. Carey is a long-term missionary to Nicaragua with 8 years under her belt working in teaching and early childhood development initiatives in country. We invited the pre-school teachers from the community who teach the 3 - 5 year olds to join in on the professional development opportunity. Since working with little kids is pretty fun, it made for a joyous afternoon filled with singing new songs Carey taught them as well as implementing the calendar into their daily routine. A big thanks to Carey for helping build the capacity of the teachers who implement education as a value at such a young age! †

Threefold Provides Medical Aid - 887 Individuals Seen

In June 2011, Threefold hosted its 5th and most unique medical team, that not only provided free healthcare to communities surrounding the Skylark Retreat Centre and communities in Condega, but was also full of excursions and new experiences. Four medical practitioners ran clinical areas, accompanied by one Nicaraguan doctor, and eleven medical students from Northern Ontario School of Medicine. The students and some of the practitioners participated in excursions to witness firsthand medical practice in Nicaragua. They took tours of private and public hospitals and accompanied Nicaraguan public medical professionals to remote areas to provide free medical care in partnership with one of the Canadian volunteer doctors. When we traveled north to Condega, the students were invited to get to know eleven Nicaraguan medical students from the local medical school, Universidad Catolica del Tropico Seco. They got a tour of their school and enjoyed a presentation given by one of the students. We hope that this will establish a long-term intercultural relationship between the two medical schools. The students also observed medical care in the Condega hospital and in a remote clinic in a small community in Condega.

Medical student, Patricia Lyle, discloses some thoughts on her experience: The Nicaragua trip was a fantastic opportunity that I would recommend to anyone, and not only those in the healthcare field. It really reminded me of why I wanted to become a doctor: seeing people who are in need and so thankful for care, even when we didn't always have the tools/supplies that were most suitable. It was a 'problemsolving' trip that taught me to be flexible and innovative. It was a great opportunity to be in the field, make a difference, and experience medicine.

Between all the different communities who attended Threefold clinics in the Skylark Centre, in Condega, and in the remote communities where we worked

in conjunction with Nicaraguan medical professionals, the team provided healthcare to 887 individuals. The main diagnoses were upper respiratory tract infections, or gastrointestinal, genitourinary, or musculoskeletal problems.

Threefold's dentist, Dr. Blanca Mairena, accompanied the clinics and provided dental care to 66 individuals. People are identified to pass through Threefold clinics through various community leaders who organize and prioritize those most in need and arrange for them to attend. All medicines were provided free to all of the patients with counselling provided by pharmacist, Heather Logan Lane.

Heather reflects, I appreciated meeting with the medical school faculty and director of the hospital as their information provided much needed context for why and how we can best work in partnership to facilitate health care. I am pleased with the ability via a translator to educate all patients on use of their medications and what they are for as this is vital information for them to care for themselves and use medication wisely. I certainly got positive feedback from mothers and young women on receiving information about medications for their children and themselves personally. I feel this will empower them to better understand and treat their health concerns.

Peggy Hawthorn, a retired medical administrator who generously kept records of the statistics during the clinics shares:

It would be beneficial for everyone to go through this type of experience. The Nicaraguan people were so appreciative of the smallest thing we could do - so happy to get something like a toothbrush; something that we take for granted. Coming back to Canada - I was so aware of what we have and don't even realize how blessed we are. I can't wait for my next trip to Nicaragua.

We are so thankful for all the volunteers who participated in the June 2011 medical team who helped provide so much aid to communities who have limited access to healthcare. Each community whose members attended the clinics has shown immense gratitude to the medical brigade and awaits your return visit! Keep reading to learn more about Threefold's continuity of care philosophy. +

Center Page: Medical Students visit Santiago Hospital in Jinotepe, Carazo Bottom Right: Dr. Clarke in one of our remote clinics

In Pictures. . .

It Doesn`t Stop When The Team Leaves . . .

While most patients are able to receive a prognosis and medication during their consultation, some require examinations and further consultations to effectively treat their problem. Over the past month Threefold Nicaragua staff has been taking patients to their follow-up appointments and our partner doctor, Dr. Alvarez, has been giving consultations, free of charge to the patients, to interpret their exam results and monitor their progress. Other patients have had appointments with specialists such as paediatricians and cardiologists who are able to counsel them effectively.

Rosa Elena, a 36 year old single mother, attended our clinics in June and was recommended to see a cardiologist due to severe heart failure. After a few exams and visits to the cardiologist we discovered she needs a vital operation on her heart as her lungs are filling with blood due to an Atrial Septal Defect that allows blood flow between the left and right atria via the interatrial septum. Thankfully the cardiologist was able to direct us to a team of surgeons that performs free heart surgeries several times a year and will be able to save her life.

Threefold believes that all medical work should be done with continuity in order to truly provide quality medical care so that we're able to do all we can to get the needed help for people like Rosa Elena who have more complex and serious problems. For this reason we also seek medical teams to come once every two months so that those with more severe cases from the communities we serve can receive regular checkups and have their health monitored. We believe in doing this that we are making a real impact on lives and ensuring sustainable change in healthcare for those with limited access to it. If you're interested in leading a medical team please feel free to contact Ellen. +

Rosa Elena and other follow up patients getting in the Threefold Van

Looking Ahead . . .

Outside of our normal programming we have a few other exciting things coming soon:

• Threefold Ministries anticipates hosting a medical team out of Memphis, TN in partnership with St. John's United Methodist Church in September. For one week the team will be hosting clinics in both Condega and at the Skylark Retreat Centre. Along with general medicine, the team will also be providing PAP smears to 100 women and dental aid. We're anticipating their arrival with much excitement!
• Best Start in Christ will have a special "community store" for the moms in the Best Start program where they will get access to a compiled mass of donations from various groups who stay at the Skylark Centre and Threefold teams. All donations are inspected to make sure they're in good condition and sold at very low prices. The moms love it as they go home with bundles of new clothes for their children and their family as well as hygiene products and quality shoes. All proceeds go back into the program.
• Best Start in Christ Staff is planning a special night at the Skylark Centre to host the teenage girls in our community to talk about family planning and how important establishing self-worth and an education are before entering into relationships. +