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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!

Thursday, June 30, 2011

Day 22

Yesterday afternoon we worked an eventful evening shift in the hospital. We spent most of our time in the Pediatric ER and the Internal Medicine wing. All of us enjoyed working once the sun had gone down. Dr. Jihron, one of the primary doctors in charge of the ISL students, let me follow her as she went from patient to patient explaining their health problems, the treatment they will receive, and why. Several people were in the hospital with complications due to diabetes and cirrhosis of the liver. We met a 65-year old recovering alcoholic who had come to Masaya to get fluid drained out of his stomach. Looking solely at his abdomen one could mistake him for a pregnant woman. The rest of his body, especially his arms and chest, were emaciated.
Towards the end of the night we went to pediatric unit. Even though all of the kids were there with injuries, the room remained astonishingly quiet. A few kids stand out to me in particular. One boy around ten had fallen off a horse and broke his arm. He seemed too small to have been riding such a large animal without a saddle. Although he was noticeably in pain, I didn’t see him cry or complain once. A little girl around 8 years old was brought in with a leg wound. She was playing with her friends when a worker who was riding a bike somehow accidentally hit her with his machete. As she was fighting back tears, I told her she was very brave and she gave me a big smile in return. We learned that the girl and father with her weren’t even her own. They were neighbors who had seen it happen. All of the kids were so brave and calm despite their injuries. Each day I’m here I keep thinking about how much I would love to go into a pediatric sub-specialty.

As we were leaving the hospital, a man who looked around 40 years old was receiving some kind of respiratory treatment while a policeman with an AK-47 stood next to his chair. He asked one of the other students for a glass of water. It was the first time I had seen a prisoner at the hospital. It seemed so odd to all of us at the time that he wasn’t tied down or handcuffed to anything. The admitting doctors had suggested it to the police, but he deemed it unnecessary. When we returned to the hospital Wednesday morning several more police had arrived. In the middle of the night the guarding cop had briefly fallen asleep and the prisoner was able to quietly sit up and sneak out unnoticed.

We learned later in the day he was in prison for raping a young boy. We all felt creeped out and sad about the situation. We were also angry with the cop for allowing his escape. Unlike the US where our methods of tracking people are aided by technology and cameras on every corner, we all knew how easy it would be to disappear here and never be seen again.

We spent most of Wednesday helping the nurses and doctors admit patients and take vital signs. In the afternoon we saw another vaginal birth and worked in the ER. A middle aged man in critical condition was rushed in towards the end of the day with several broken ribs, a fractured hip, a punctured lung, and possible brain damage. Dr. Jihron told us he had fallen into a latrine head first after helping clean it out. Average latrine holes here are around 35 ft deep. It was the worst condition I’ve seen anyone in. He was vomiting up blood and the doctors at Masaya tried to stabilize him before they sent him to the larger hospital in Managua with more resources. Within an hour, he was loaded once again into the small Red Cross ambulance with his weeping mother and supportive brother. We haven’t learned yet if he lived or not. I hope he did.

Thursday we are taking a break from the hospital to volunteer at one of the local health fairs to teach about preventative medicine, take vital signs and conduct glucose/urine tests. We are hoping to work another evening shift in the hospital tonight.

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