International Medical Relief (IMR) was quick to respond to this disaster due to there already being a medical mission trip planned in January. IMR has been the exclusive humanitarian provider of medical care to this region for a decade, and now the Nicaraguan government and communities along the San Juan River are asking for our assistance to help the communities we know so well. Winds topping 120mph, rain, flash flooding, and landslides overwhelmed the riverfront communities where our team will be working, forcing many from their homes and leaving the land in ruin. Emergency medical clinics were set up in order to treat different conditions. IMR typically sees skin infections following hurricanes, and we expect that local doctors will begin to identify those in the coming weeks as residents return to their homes to try and rebuild their lives. Our team anticipates providing extensive wound care and treating fungal infections people receive from coming into contact with damaged property and land. Local clean water sources are also threatened as floodwaters seep into water supplies, which will likely cause widespread infectious disease outbreaks. Apart from infections, the CDC anticipates diarrhea, stomach issues, and upper respiratory diseases could potentially be on the rise for next couple of months. The winds stirred up mold and contaminants from the ground, and the local hospital is reporting seeing a large number of patients with asthma, emphysema, and bronchitis. People who had electricity lost power, which compromised their food supply and will likely lead to more digestive complications.