September-October 2016 | MISSION OF MERCY




Some very special and compassionate citizens of Salisbury and beyond are changing lives for the better in Central America through La Merced

Written By: Robbie Tarpley Raffish

For all of the arguing about how expensive it is, who should pay for it, and how (or whether) it should be insured, healthcare is something Americans tend to take for granted. So, four years ago, when Veronique Diriker, Ph.D., volunteered to go on a mission trip to Managua, Nicaragua, with the Salisbury-based organization La Merced, she was unprepared for what was waiting for her. “It literally changed my life,”said Diriker, who has a doctorate in organizational leadership from the University of Maryland Eastern Shore. “I could not believe it. Here [in the U.S.], we have access to everything. In Central America, so many have absolutely nothing. It completely opened my eyes.”

La Merced, which means “mercy” in Spanish, is a nonprofit organization with its roots in Salisbury’s St. Francis de Sales Catholic Church. For 15 years, beginning in the late 1990s, parishioners traveled to visit its sister church in Managua on mission trips of prayer, worship and the sharing of cultures. Nicaragua is the second-poorest nation in the Western Hemisphere, and through those trips, the group came to feel that even more could be done.

La Merced was formed in 2007 to work independently from the church in the spirit of the group’s commitment. Today, the group comprises volunteer healthcare providers, translators, business and legal professionals, engineers, contractors, educators, homemakers and medical students, all of whom come together to serve a community in tremendous need.

Headed by Peninsula Plastic Surgery’s Dr. Vincent Perrotta, who is president of the board of directors, and Tina Perrotta, the vice president and executive director, La Merced has for nearly a decade undertaken trips to Nicaragua, initially annually and now twice a year. 

Originally, the group focused on serving children with congenital and acquired deformities of the face and body. “While the Nicaraguan government provides basic medical services to its citizens, and surgery for life-threatening illnesses and injuries, there is no funding and little expertise for reconstructive surgery,” said Diriker. “This is particularly hard for the families of children with medical problems that directly affect quality of life and self-esteem, problems that often make these kids, and their families, outcasts.” 

Over the years, as the teams met more children and their families, they felt they had to acknowledge the needs of the wider community. Today, the 9- to 10-day trips bring medical care and much more to some of Managua’s poorest citizens. 

In addition to plastic and reconstructive surgery, teams led by Perrotta and Diriker deliver orthopedic surgery;
ear, nose and throat surgery; general dentistry; physical therapy; and family medicine. While not every specialty is available each trip, the organization works closely with Father Antonio Castro of Managua to bring the most needed
services and supplies for each mission.

Father Castro is a tremendous force, according to Diriker. The community served by his church includes the Marillac School, located next door, and the state-owned Roberto Clemente Clinic for Women and Children, located across the street. He and a team at the church organize the requests for medical care and support, coordinating with La Merced leadership for months before they travel to Managua.

Castro has also been developing a physical-therapy clinic for children with cerebral palsy and a vocational and tech center for children and adolescents who have little or no direction in life. On any given trip, La Merced’s volunteers may touch any and all of these locations.

Taking a deep breath, Diriker also related another stop the group makes each time it travels south: “The Dump” — literally, a municipal dump site where people make an often barely subsistence living “picking” trash.

“We usually spend at least a day there. It is both heartbreaking and a little uplifting,” Diriker said. “The people there live in terrible conditions and want for nearly everything — and we can’t make everything better in a day, a week or even a year. But that is why these surgeries and delivery of medical services are so important; they absolutely change lives, sometimes for the day and sometimes for a lifetime.”

To expand its impact, La Merced has recently partnered with UMES. Through a formal relationship, the organizations work together to seek funding and provide manpower for the medical missions.  Pharmacy students from UMES, as well as medical students from schools around the region, serve as integral parts of the La Merced team.

None of this comes cheap, however. While all team members contribute their services, they also must each raise $1,700 to cover their own travel costs. Students may apply for scholarships through a fund established in memory of Jessie Gaul, a young member of the team who passed away two years ago. In addition, medical and other provisions must be collected through donations.  

Yet, people raise the money and collect the donations because each trip brings more comfort to the ill and injured and increased support for the school. (The group recently established a scholarship program through which concerned individuals here in the U.S. can sponsor a student from the Merillac School for $100 for the entire school year, which covers a student’s tuition, uniform and books.)  

The medical-device community has been generous and supportive, as well. Local representatives from Stryker bring knee and hip implants to Managua each year, valued at approximately $2 million. Zimmer, another orthopedic supply company, was the first to provide La Merced with expensive prosthetics. Both excellent partners, La Merced hopes that each will continue to support the program in coming years. 

The organization also would like to expand its medical-service offerings into areas such as ophthalmology while growing its impact deeper into the barrio around the church. Most of the mud-and-tin dwellings there are just one- and two-room shelters; large drainage ditches carry away raw sewage; sometimes the livestock live in the homes.

Yet, these homes are often happy, with strong family traditions and customs that the La Merced teams are honored to witness. The neighborhoods are safe; violent crime is rare. These are a very spiritual people, Diriker says; they take care of each other and are grateful for the support they receive from La Merced. 

Perrotta, Diriker and their teams are currently planning the 2017 trips, one each in January and June. These next expeditions will focus on performing specialized hand surgery, knee- and hip-joint-replacement surgery, general surgery, dentistry and urgent-care medicine. They hope to expand their pharmaceutical program, add the previously mentioned ophthalmology and spend more time serving the residents of The Dump. 

In order to do this, La Merced will need to continue to raise not only money but also interest in participation with Delmarva residents who can help at home and with those who will consider traveling to Nicaragua. The organization pledges that 90 percent of all funds received in donations are applied directly to improving the lives of those served in Nicaragua, with less than 10 percent being used for La Merced’s administrative expenses.

Not every volunteer needs to be (or should be) medical. As the list of medical services to be delivered grows, administrative and clinical help are needed. Teachers are needed for training; construction professionals are needed to help with infrastructure; business people are needed to teach personal and business finance. These and other types of support are welcome. 

In fact, teaching is a vital component of the trip. American students learn about medical procedures, teamwork and cultural differences. Medical providers work with local doctors to pass on “best practices.” Nonmedical volunteers teach hygiene, finance and other skills that can be passed on to the greater community. This assures that the benefits of the program are long-term.  

And, as its website makes clear, all participants are welcome at La Merced. Paraphrasing the famous sages of the series Star Trek, “We follow the Prime Directive: We travel to Nicaragua to provide assistance and services, not to proselytize.” 

To learn more about La Merced — whether to join an upcoming mission, lend support locally or make a donation — visit


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