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Managua, Nicaragua
I'm participating in a month-long medical trip to Nicaragua, so I'd like to use this blog to document all of my experiences abroad and keep everyone at home in touch!

Monday, June 20, 2011

Day 13

Early this morning we headed to the Masaya Community Hospital, the government subsidized hospital that serves the people of Masaya as well as surrounding areas. Over the past two weeks I’ve gotten accustomed to jumping out of bed to throw on my scrubs and tennis shoes before venturing out for the day. For the next 15 days in the hospital, we have to wear white coats over them. Looking in the mirror for the first time, I felt excited about my future career. I also felt like an imposter, completely unworthy at this point in my life to wear one.
Pulling up to work, I had a few expectations about what I would see. After serving in the impoverished areas surround Masaya and talking with a few of the students who have worked here longer than my group, I was well aware that the public hospital would not resemble a typical hospital in the United States. It is a rather small hospital for the number of people it serves and is split into three main units- the ER, OR, and Labor and Delivery. Before exiting the van, Dr. Cerrato assigned us to smaller groups for rotations. Within each unit patients fill the open space. A few curtains separate some of the sicker patients but for the most part they are laying in beds directly adjacent to one another (no more than 3 feet apart). A number of patients with IV bags sit along one bench together and there are no private rooms.
One of the other students and I were told we would go to the Labor and Delivery wing first to watch a C-section. I learned today that after a woman’s third C-section in a public hospital in Nicaragua, the obstetrician removes her ovaries. I believe this recently instated law is aimed at limiting the growth of families living in poverty who don’t have regular access to contraception. I had noticed last week that several of the older women we treated in the clinics had anywhere from 8 to 15 children on average.

In the US we are used to hospitals that are often almost unbearably chilly at time. The first thing I noticed walking into the operating room was how hot it was without AC. Next door to the operating room was a room with around 8-10 mothers who were holding their just-born babies along with a few nurses. If there are no unusual complications during the birthing process, mothers (even those who have C-sections) are sent home with their children within a few hours, as opposed to days.
Chris and I watched the doctors and nurses prep the patient from the beginning with the insertion of the catheter and epidural. Many of the sheets and aprons the doctors wore in the OR had leftover bloodstains from previous surgeries that couldn’t be washed away– this came as another large culture shock for me. Watching the entire process less than 3 feet from the surgeon was an incredible experience! I was very impressed with all of the doctors I will be working under for the next few weeks. At the first sight of the baby’s head, he pulled the child out and passed him along to the pediatrician. He proceeded to sow the mother back up within only minutes- the entire process seemed to be astonishingly fast.
I spend the rest of the day in the ER taking patient information and vital signs. A few of the other students sat in on a prostate surgery as well as a thigh-high leg amputation of a diabetic patient. On our way back to our home this afternoon, we drove to the Masaya Volcano... It was a beautiful sight to see!

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