Anesthesia providers afford our plastic surgery team the freedom to treat as many patients as possible.  We have found over the years that, although the hospitals we work in down there possess the equipment necessary to provide good anesthesia, the work ethic of the Nicaraguan providers is different than ours.   While they take very good care of their patients, they are just as content treating two as they are ten.  We Americans have that inner determination to help as many patients as is humanly possible.  Having our own anesthesia providers enables us to do so.