Our mission is to improve the level of medical care for the people of Nicaragua through teaching of health care professionals, offering medical and surgical consultations and providing direct medical and surgical care, where needed, as well as obtaining needed medical equipment and supplies. The work is mostly performed at the Hospital Escuela Oscar Danilo Rosales Arguello (HEODRA), which is the teaching hospital of the Universidad Nacional Autonoma de Nicaragua (UNAN). This medical school is the oldest in Central America. Our current activities have been discussed above in some detail, especially now in the field of cardiology, adding to ongoing work with consultations and in obtaining appropriate, needed equipment and supplies, an array of interventional procedures in electrophysiology and in structural work (valvuloplasties, closure of atrial septal defects, and others). We offer didactic teaching (lectures) at times and our nursing colleagues are cooperating with teleconferences.