Hospitals

Before leaving for Nicaragua, I predicted that I would visit a hospital at least once during my two-year tour. In the past two weeks* that prediction has come true – twice. Don’t worry, I’m okay.

The first time was on New Year’s Eve day. My whole family was in town visiting me for the holidays (which is why I haven’t written in so long), and I had planned a weeklong get-to-know-Nicaragua-fest for their benefit. Our trip ended in San Juan del Sur, the most popular Nicaraguan beach town, known for its spectacular surfing opportunities. I’m not sure what part of my brain had shut down that day to make it seem like a good idea to take my whole family out for a surfing lesson. But that’s what we did. Our instructor was a hottie teenage Nica surfing champion, but alas, his teaching skills were not as impressive as the many scars adorning his scalp – all surfing injuries.

After a brief beach lesson on how to stand up on the board, we were out in the water. The surf was kind of rough that day, but our instructor didn’t think it was a big deal. I was still getting the hang of holding onto my board when a wave would come by when the instructor started sending us out in turns. He would wait for a wave to come then push us out to paddle and try to catch it. My first one, I didn’t stand up on the surf board, but I did ride the wave. “Okay,” I thought, “I can get the hang of this.” I waited and watched my family members for a minute, and then headed back towards the instructor, expecting that he would wait for me to come and take my turn again.

Well, I didn’t get a second turn. As I was swimming out a big wave came. I held on to the leash of my surf board and went under the water just like I’d been taught. But when I came up, I felt something hit my head. I heard my brother, Joe, say, “Hey, Laurie, did you see that? I almost stood up on that one.” And then suddenly the instructor was next to me freaking out, pressing his hand to my forehead, and saying, “Don’t worry. It looks like it will only be two stitches.” And that’s how I ended up in the hospital the first time. Not five minutes in the water and I got whacked in the head by my brother’s surf board. Luckily, the emergency room got me in right away. I was even able to go out for New Year’s sporting three stitches covered by a band-aid right below my hairline.

My second trip to the hospital occurred yesterday. My brother – who is still staying with me – woke up feeling sick and spent the morning revisiting our dinner. When he didn’t feel better by mid-day, I started to get worried. I live two hours from any medical attention besides a small medical post (not open on Sundays), and I have spent the last six months wondering what would happen if I were to get really sick at my site. Now, thanks to my brother, I know. I gave him an anti-nauseate that didn’t seem to do much, and we boarded the bus. A bumpy two hours later, we were at the public hospital in Esteli.

The good thing about the public hospital is that it’s free. The bad thing about it is – well – almost everything else. The ER was clearly overwhelmed. While my brother tossed and turned on a bed that had clearly not been made up just for him, I tried to avoid asphyxiation from the competing odors – of food on a tray that had been sitting there for who knows how long, of hospital cleaning agents, of stale urine – that surrounded me. Finally, a nurse gave Joe a shot to stop the nausea. Once he could stand and walk around and not feel like he was going to lose his lunch, we were sent to the lab for tests.

At the lab, a little girl of about three years old was sitting behind the counter playing with lab test sheets. It soon became clear that there was only one person working at the lab presumably the little girl’s mother. This woman was responsible for all functions of the lab – giving out sample cups, receiving samples, drawing blood, and examining the samples. Given that it was just her and her three-year-old, she was actually quite efficient. After emerging with a handful of results from previous patients, she handed my brother a Gerber baby food jar and instructed him to produce a sample. Which he did, equipped with a headlamp in a bathroom with no working light and no toilet paper. Thirty minutes later we had handwritten results to bring back to the doctor. She saw us immediately, wrote out a prescription for antibiotics, and sent us on our way.

Overall, although the conditions were certainly not up to the standard of an American hospital, I must say that the experience was not as bad as it could have been. The whole thing took only four hours even though the emergency room was full of people clearly in worse shape than my brother – a guy who had been kicked by a horse, for one – and we did not pay a single córdoba for the injection, the lab exam, or the doctor’s time. We wouldn’t have even had to pay for the antibiotics if the hospital pharmacy had had them (they were out). Based on my limited experience, my assessment of Nicaragua’s medical system is that it is comprised of competent people working with very limited resources.

Okay, so not as bad as it could have been, but still not an experience I hope to repeat. Here’s to good health in 2010!


*Apologies for having taken so long to write anything. I wrote this post about two weeks ago but the internet was down when I went to post it.