When it rains, it pours in Nicaragua and we’re not talking metaphors here. The rainy season which was supposed to have started several months ago, is finally here. The drought is over and the average Nicaraguan is happy because the farmers are happy. Hopefully the price of beans will go back down soon. Beans are a staple for every meal in Nicaragua and they were approaching the price of meat, something that wasobviously hurting many families financially
including my host family. It’s interesting to see such dependence on the fickle weather here. I’m also happy about the rain, but it has certainly brought new challenges. I have to be careful that I’m not out on my bike somewhere when another sudden storm comes up and turns every street into a muddy river. As I am writing this, another monsoon is dumping its payload on my family’s tin roof.
The hospital has also brought new challenges, as always. This past week, I rotated in the Orthopedics area of the emergency room. All squeamishness (if I hadn’t already forced it out of me in the operating room my first couple weeks) would need to have left this week. While most of the patients treated in this area were complaining of pain in old injuries in the legs, arms, or back, several people a day would come in with some real trauma: freshly broken ankles, large cuts on their hands, a thick wire sticking out of their arm. I quickly learned how the doctors bandaged and put casts on patients with broken bones and how to identify fractures from X-rays sent to the emergency department’s one donated computer.
I also took advantage, as I usually try to do, of doctors who would come in followed by a crowd of med students to teach some literal hands-on lessons. They’d learn by watching their professor assess a patient and then they’d do the same on the next patient. I did my best to blend in with the medical student and took rapid notes as the doctors explained some important detail of anatomy or physical examinations.
One time doing this, I struck up a conversation with some of the med students. They were friendly and surprisingly good at English, wanting to practice speaking with me and learn about med school in the United States. They once again rubbed it in my face that, being sixth year med students, they’re nearly doctors while I’m still 5 years away. How old are they? The same age as me. We got past this, however, and I made a couple friends. The med students never stay in one place for long, following their schedule of two-hour blocks but this time they invited me to come with them to the big Orthopedics wing on the 4th floor. I went and got to assist with supplies as they cleaned the wounds of people in the entire wing, an even more gruesome and awesome experience. The initial shock I felt in seeing the conditions in the hospital was freshened for me a little though as we made the rounds. All the rooms were open to the outside air and crowded with patients, giving little help for the comfort, privacy, or cleanliness to these people with open wounds and long recoveries to look forward to. It is good to know that this is not something that I’ve entirely gotten used to. In between tasks as we were waiting for doctors to show, the med students would pull out study materials and teach me as they reviewed together. Eventually, they invited me to their class in the morning which I gladly attended, soaking up every bit of learning that I can.
My capstone project is forming before my eyes. My English students, the heads of each of the hospitals departments, have helped me edit a short survey that I will give to them and some of their colleagues. It addresses the health issues in the hospital and community acccording to their very knowledgeable perspectives. I’ve also heard some great input from doctors concerning the lack of technology at the hospital. One doctor criticized the government’s free healthcare, saying that if they had only charged one Cordoba (equivalent to about 4 U.S. cents) to every patient that came through the doors of the hospital, no technology or supplies would ever be lacking there. I also had the chance to see the inside of a nearby private doctor’s office when I accompanied a sick friend. At the office, they do charge about $8 for a consultation and the results were obvious. This private care physician essentially had the supplies of the entire emergency room in his small office. It was also much cleaner, faster, and even air conditioned. All these experiences are coming together to give me a picture of the state of healthcare in Leon.
With only one week left at the hospital, everything seems a little surreal. I plan to make the most of it. Oh, and here are a couple long overdue photos of me teaching my English class: