Second week… Success!

Wow we are about half way done here!!  Which makes me really sad L  I feel like we are all finally fitting in here and getting the hang of things.  This week was a really short working week because we had Monday off for the national holiday as the 30 year anniversary of the government revolution, and Friday was pretty much a half day because there was a procession here in Diriamba for San Sebastian, the town’s protective saint.  Every city (I think) has a protective saint, and one day each year they celebrate it with a festival and procession where they have a church service, raise the saint’s statue from the church, and carry it down the streets with a parade of dancers in crazy outfits, horses, and tons of people.  On Friday July 24, the 3 cities of Diriamba, Jinotepe and Dolores (which are all really close) each process to Jinotepe, where they meet for a huge party.  As the saints are carried through the streets, people walk with them, so the crowds get bigger and bigger.  There are horses dancing, boys in colorful caps with crazy hats topped with peacock feathers, sellers selling food, people walking with sashes as saints, the men carrying the saint statue on their shoulders, men and women dancing traditionally in traditional clothes with long flowing dresses.  But mostly tons of people!!  And then on the main highway from Diriamba to Jinotepe, the Pan American Highway, it looked like a massive Latin American tailgate!  People were all sitting under pop-up tents with piles of liquor and beer bottles everywhere and cooking food.  It was crazy!  Anyway, so Rita and I left early for lunch on Friday to see the procession, but then we went back to work afterwards because we didn’t want to miss the whole day.  But then no one was around and we didn’t have anything to do.  This actually was an incredible blessing because we started talking to the hospital receptionist Veronica, who is a super cute nice little lady.  She has been working there for 25 years and therefore knows everyone!  Key person to be friends with!  We sat at the entrance/exit of the hospital, so she would introduce us to everyone that passed.  We definitely met more people that afternoon than the whole past 2 weeks- doctors, nurses, helpers (ayudantes).  We also asked and received permission to watch a surgery in the OR next week.  We even got to hold a brand-new baby!  He was only minutes only but adorable!  The nurse cleaned him up, put clothes on him, and then let us hold him before bringing him to his mom.  So adorable!  I also asked Veronica bazillions of questions about the hospital, health care system in Nicaragua, and everything else I could think of.  She was so full of information.  Shocking bits include:  the average age to give birth in the hospital is 16! The normal number of children is up to 8!  There are 6 nuns that work at the hospital and also live there! There are no engineers, technicians, or mechanics at the hospital- just helpers/ ayudantes like Harold and Cheyo!

            Which brings me to our work this week.  Tuesday was an awful day but then Wednesday and Thursday more than made up for it as we were actually able to fix some things!  We planned on Tuesday to finish up with one of the fetal Doppler monitors that we had taken apart, cut and were resoldering a new connection.  Well it kept going back and forth between working (when it sounded beautiful with no noise!) and not working (in which there would be no noise).  It was working and then we taped the wires to protect them, and then it stoped and we haven’t got it working sense.  Sor Ligia also brought it a new Doppler that used to be the working one but then quit working.  We also tried to use the Carbon pieces that we bought last weekend in Jinotepe, but when we asked Harold who was the one who suggested them, he said that the ones we got were too small.  We also tried to figure out how the baby incubator worked since we reconnected the wire.  We used a multimeter to determine the voltage and current across 2 nodes that we saw to see if we could just add this lamp to the circuit.  Rita first measured 120 V but then after trying to measure voltage, it only measured 0.5 V.  After turning the multimeter to a different setting to see if the wire was open or short, it continuously said short which was wrong.  We then discovered that we blew a fuse in the multimeter trying to measure the 10 A current.  Now we have to go back that too!  Good thing we already had to go back.  Glad that we brought 2 multimeters.  So Tuesday we broke things rather than fixed them.  Oh except we did meet some friends!  When we were walking into the hospital Tuesday morning, we stopped to talk to a different receptionist was cross-stitching.  As we were standing there talking to her, these 2 other non-local looking guys in scrubs walk in.  We started talking in English J and found out that they are undergrad students from Canada working with about 15 others for a Canadian NGO.  These guys, Anthony and Brock, are shadowing a pediatrician in our hospital who speaks a bit of English, helping her catch babies, give shots and vitamins, and just learning.  I’m not going to lie- I’m a bit jealous when I heard that Anthony got to catch a baby when a patient had a C-section.  However, Wednesday was an awesome day!  Out Canadian friends came by to visit again with more people that we got to meet.  We also returned some of the working equipment that we had been storing in our room: 2 centrifuges, ear/eyes/throat lamps, and 1 Doppler (that we took apart but didn’t do anything to fix it).   We tried splicing together more Dopplers by mixing parts: body, speaker, transducer.  But then we gave it to Sor Ligia, the director, and she said she could not hear anything.  We then decided that all the transducers were the problems.  I cut and stripped 2 transducers in order to put them together as a good connection and a good head.  Rita also found a manual online for an infusion pump and figured out how to use it!  We then met up with the Canadians in Jinotepe for amazing Chinese food!  We also saw their “Base Camp”  where they live, it is soo luxurious… free internet, a garden, classes there, a guard, kitchen for cooking, and lots of other English speakers!  As nice as that might be every once in a while, I am so glad we are staying with a family in a homestay because we are getting the real Nicaragua- bucket showers, Spanish, and all!

            Thursday, we finished splicing the Doppler and it worked!!!  We also finished the instructions for the bedside monitor with color-coded plug-ins and everything.  We showed it to both Cheyo and Sor Ligia, and they both said it was good!!!  We are still stuck on the Defib and EKG machines.  We also asked Harold about the carbon for the centrifuge, and he said we are missing a metal plate.  Ugh!   Thursday night we stayed up and watched the Mexico- Costa Rica soccer game with my host girl.  It was great to talk to her!  I also found the scoop about the feud between Costa Rica and Nicaragua as she as rooting for Mexico over her Latin American country.  Friday morning, we finished translating and presented the Infusion Pump to Sor Ligia- complete with 3 sets of instructions including alarms.  But she didn’t want it yet.  Lots of people were cleaning out a closet near ours which was full of donated medical supplies.  Everything is donated!  Yet there are whole closets full of supplies and more equipment keeps popping up.  On Friday, Sor Ligia wheeled in another baby incubator, just to tell us that we needed to buy a new sensor.  There are many things that they show us just to get us to buy a certain part.  That got Rita and I frustrated because our purpose here was not necessarily to buy them what they want considering that is not a long-term solution.  Also, Rita and I were noticing how very few people will talk to us.  We try to say hi to the doctors and/or nurses, but they kept running away.  I don’t know if there is a cultural stigma between mechanics and doctors that prevents forming relationships.  Also, for the fact that all of the equipment and supplies are donated, they are very particular about their equipment.  Even if something is slightly off, they will not accept it and say it is broken.  When we return with equipment that is fixed, the people are not that excited and barely say thank you.  It is rather strange.  I’m thinking that it is a culture thing in that everyone just has their own jobs, and everyone does there job as expected.  People don’t say thank you very much at all.  So I guess that we are expected to fix the equipment and that is that.  But we were excited about our victories this week and the relationships that we are forming.  We hope this coming week to further those especially in order to figure out what to do for our secondary project. 

            We also formed some great relationships with the family this week.  We watched the end of the Mexico vs. Costa Rica soccer game with the daughter Eulisa    and got to talk to her a bunch.  We also are beginning to communicate better with the grandmother, and she taught me how to cook some things tonight.  I also started going to this gym across the street run by this tiny little lady in her house.  I asked to join, and then she started telling me what to do- 5 min warm-up on the bike in her kitchen, then 4 sets of 12 of all the weight exercises from squats to leg curls, leg extensions, lunges, to leg press where I was literally lying in the middle of her kitchen. She just kept taking me to more and more. She kept laughing too because I was so sweaty and bright red.  It was soo hard!  I was not expected it at all from the 5 ft Nicaraguan lady! It was fun though, and she is honestly endearing. 

            This weekend we traveled after the festival to Masaya and Granada on Saturday.  Masaya is a city with a huge, huge market full of tons of souvenir-type gifts, and because of that it was all white tourists there.  There were also kids walking around making things out of grass to sell and even these kids acting as missionaries who would come up and talk to you and then return to shove a Bible in your hand and  then return to ask for money for food.  It was very interesting.  Then Granada, which is now very touristy as many ex-pats from the US and Europe come to retire or vacation there.  It is a very old colonial town on the beach of Lake Managua, so it is beautiful! There are tons of huge churches!  We saw 2 weddings just walking around Saturday night.  It was so strange to see so many Gringos, hear English, and eat American food (we had the best burgers Saturday night).  I’m definitely going to have big time culture shock going back to Durham if this was a shock for me!  It definitely was still Nicaragua though as we had kids that came up to us in the middle of dinner begging for food, kids break dancing in the streets for money that were amazing, men juggling fire for money.  I think this would be a great place for next year to take Spanish classes as it is still Nicaragua so the students could learn Nicaraguan Spanish rather than Costa Rican and visit Nicaraguan hospitals, yet it is still more Americanized than our towns for culture customization.  Just a thought.  I loved Costa Rica but it is so different from here.  Nicaragua definitely has more culture I think.  That night we also stayed literally in a giant room with 10 bunk beds in the back of a restaurant on the main strip with an outhouse.  It was super cheap and fun but very hot and rather odd.  On Sunday, we kayaked through the 265 islands in the lake, which was beautiful and super fun!  We walked along the beach on the way there, which was nice but pretty dirty and deserted.  It was strange.  The kayaking was fun though, and we got a great deal.  Most of the people who own businesses in Granada can speak both English and Spanish as most are from Nicaragua, but lived in the states (typically Texas or California) for some time and then returned.  Interesting!

            This Monday was a kinda frustrating day at the hospital.  It was very slow day and pretty empty. We asked around for information about Casa Saria, a company that we are buying parts from, but no one was around for help.  At the end of the day, we called and the manager told us that he is sending out an engineer to get more information.  When I told him that we were engineers and knew what we needed, he did not accept that answer.  Pretty frustrating just because we don’t have unlimited funds or unlimited money, but we told him we were leaving soon and that we might not buy anything if it was too expensive.  He still wanted to send the engineer out, so we will see.  We also had to wait for Harold to return to ask about replacing the carbon in the centrifuge.  We made the pieces that we needed from aluminum foil according to Cheyo, but then when Harold came, he said you couldn’t use foil but needed real metal.  He then made the piece and properly installed the carbon.  When we tried it, it still didn’t work because the motor was been worn down so its curved.  Ugh so after 2 trips to Jinotepe to buy carbon, we couldn’t actually fix it.  We did ask Harold about his education, and he said that he studied electricity in school and just knows other stuff from his experience.  He knows what he is talking about, while I think Cheyo is more of a handyman.  Harold is currently on vacation until the end of the week, but he said that he normally works 8 to 3.  We are discovering that Nicaraguans don’t like to work and take a lot of vacation!  There is apparently a 20-day party here in Diriamba where there is no work and people come from all over- all cities in Nicaragua, US, Costa Rica, etc.  Crazy!  And each city has a festival like this but different dates so everyone can go to them all.  Our host family was telling us about this and that Nicaraguans like to party! 

            We also returned a centrifuge that was working but missing tubes.  We saw the other centrifuges that we returned last week just sitting on a table unused.  We also are still holding onto the infusion pump that we wrote instructions too because Sor Ligia doesn’t want it yet.  The hospital is rather strange.  The emergency respiratory clinic was closed today, and there were very few patients.  For example, there were only 2 children in the pediatric wing with broken arms.  Veronica said that the hospital was free and they didn’t refuse service to anyone, but our Canadian friends said that it is semi-private and that they have refused to treat some people.  I haven’t figure it out yet.  I honestly thought that there would be people lining the hallways, but it is instead hardly full.  There are many people waiting in the emergency department and the clinic across the street, so maybe those are the free parts and the others are not.  We also glued on a piece to fix a nebulizer today by cutting up a different connector.  Hopefully it will work tomorrow.  We are planning to walk around to each department and ask if they have any broken equipment or any needs or wants. We need some new projects because what we have left are at a standstill.  Anyway, we will see what this week brings.

First week

We finished our first week at San Jose Hospital and our first weekend trip in Nicaragua to Ometepe! Both were challenges and incredible experiences! So I will begin with our work at Dirimba in the hospital. I wrote last after the first two days, so I need to fill you in on the last 3. We still have our little yellow room and lots of broken medical equipment waiting there to be fixed. Rita and I were really looking forward to Michelle coming to visit us on Wednesday afternoon to bring us our cell phone as we hoped she could answer some questions or give us some guidance on what to do. She ended up having bus trouble, so she literally just flew in and out. She said that she was worried we would not have enough to do at our little hospital. Oh boy was she wrong! She did give us great insight because we thought that most all of our machines were donated by EWH because they have a little EWH sticker on them. It turns out that that sticker just means that the machine was inventoried by EWH, not donated by. This made me feel a lot better that we were not giving the hospital bad machines- only 1 was donated. As Rita and I work in our little yellow room, Sor Ligia, the director of the hospital, will come by every now and then to bring us more broken equipment!! At least we don’t have the problem of needing to find it. The one working technician Cheyo also stops in to bring us more. Rita and I also take lots of walks around the hospital- first of course to get a break, second in the hopes of meeting people, and third to see more of the hospital. Well on Wednesday, when we were taking one of our walks, the receptionist at the front gate told us to go speak with Sor Sonia in the officina. We go up there and turns out that there is a representative from Casa Sarria, a medical supply company in Managua, that could help us get spare parts! Perfect timing! We had just written a list of the parts we need: liquid Carbon for a centrifuge (the tech Harold helped us figure that one out when we popped in from vacation the first day), lamp for the new baby incubator, transformer for a German Drager incubator, and hopefully some information about the Doppler fetal heart monitors. We just asked for prices as we have a limited budget, but hopefully we can get something that will help. The next day though, Sor Ligia brought the old baby incubator lamp with a cut cord for our reference. Hmmm… we soldered it together, but now don’t know how to connect it to the machine without the manual. They only have 1 working baby incubator and 1 phototherapy machine in the neonatal unit, so getting this to work might be a big help. And now, we have 5 fetal heart monitors that don’t work- 2 with too much noise, too hard to hear, can’t find a heart beat, and one that seems to work with a new battery. Our goal is to piece together them all to get at least 1 one more working well. I would say most of the cases in the hospitals are births, so these also are often used. The representative then came back again on Thursday to get more information about the machines. His boss spoke English, so I spoke to him on the phone. I think because we were talking in English, I assumed that we would be able to communicate, but we could not, particially because there was a baby crying in the background. But also I could not understand his questions, and he could not understand my answers. Anyway, I think we got what we needed, but I am now do not take any communication for granted. Hopefully we will get the information in the beginning of this week.

Thursday morning during one of our walks, we ran into Cheyo, the technician who is also a general maintenance guy from equipment to gardening to electrical power to water supply, and convinced him to show us around the hospital. We had already kinda wandered around considering it is not the big, but it was nice to have an official tour. Now we won’t feel self-conscious or intruding when we walk around. The hospital includes a wing each for pediatrics, maternity/ neonatal, respiratory emergencies, other emergencies, women, men, and then clinics. There were 5 clinic rooms, each with one doctor of all different specialties. Most doctors work in this public hospital in the morning from 7 to noon and then work elsewhere privately in the afternoon. There is also a working X-ray machine, with a really nice technician who was telling us about his ventilation problems as he develops the film in a closet about 1 meter by 1 meter. There are also operating rooms that we did not see however. Oh and admissions (where all the files are), kitchen, and laundry where the clothes are washed in machines and hung out to dry in the wind. The technicians have a tiny little office up above the laundry room. Rita went to ask Cheyo a question one time and found him up there rocking in his chair listening to music. We have also seen him working in the garden and actually working on a suction machine once too. He says he’s been working here 25 years. He does know what he is doing, but has a lot of responsibilities and isn’t too focused on the equipment. Harold is the head technician though and definitely knows his stuff. When he has come in to visit us in our little yellow room and we ask a question, he’ll tell us “Oh you need to check that with the multimeter” or whatever we need. I’m not sure when he comes back though from vacation. He did mention and I noticed in their workroom, that they do not have many tools. We brought 2 tool kits, a soldering iron, and 2 multimeters, which might be more than everything they have. Also, I have mentioned the best part of the tour! So we walked around to all the different parts, and Cheyo pointed out the medical equipment, which consisted of: a few nebulizers in the respiratory wing, lots of dangerously insecure oxygen tanks with breathing tubes, lots of IV bags hanging from a nail stuck into the wall, the previously mentioned X-ray machine, the previously mentioned baby incubator and phototherapy lights, 2 working centrifuges, 2 autoclaves, 3 fridges, and some poorly functioning ear/nose lights. We seriously have more equipment in our little yellow room than the rest of the hospital combined!!!! Granted we did not go into the OR or clinic rooms, which I assume have more.

This weekend I got the change to talk to the other students about their hospitals, and it is super interesting how different everyone’s are. Julie and Yujing in Managua have a really nice hospital with tons of equipment and a very knowledgeable staff; Benny and Jared in Rivas have a nice hospital with a good maintenance crew that know what they are doing but don’t seem to work too hard; Calvin and Will in Jinotepe have a smaller hospital but a great crew; Ali, Sharon, and Jane in Chinendaga are working at 2 hospitals: one that is really well-run but has a small budget and very little equipment, the other has tons of equipment but poor management and is really dirty. A lot of the other students are struggling to figure out their purpose in hospitals that have very competent technicians and maintenance crew- another set of hands, the attention and motivation to help, and a small budget to buy parts. Calvin and Will said that when the told the staff that they had some money to spend, the maintenance staff was so excited they held a meeting to decide what to buy and then drove them to the store in the hospital car! Our hospital seems to be so different where we are the technicians, and they are seriously giving their problems to us. We have a ECG machine and a defibrillator both from the 1970’s!

Thursday, we also worked on the opthamology machines (ear/throat lights). They had two sets and lots of extra heads that they claimed did not work. Rita and I discovered that if you take the lights out just a bit from the head, they work! One did need a new light that we replaced and taped in order to fit. We then wrote a note on the machine with instructions for if they stop working again to try that and brought one to the emergency area and one to the clinic. Exciting! Our first victory!

Friday we worked on reconstructing a working fetal Doppler with a speaker from this one, a transducer from that one, and the circuitry from another. We’ll see if its better when we test it this week. Our major project was removing a noisy connection and trying to resolder things together. It will be a long shot but really exciting if it works! We then left early to go to Jinotepe to buy liquid Carbon from the market there (and got to see Will and Calvin). We will see what this week brings. It is a short week though because Monday was a national holiday as the 30 year anniversary of the current government’s revolution to come to power, and Friday/Saturday is apparently a festival from Diriamba to Jinotepe to celebrate our city’s saints. This weekend was interesting because there were Sandinistan flags, parades, and celebrations everywhere we went and the whole weekend (a girl on our bus ride was even wearing a FLSN bracelet!), yet every person I talked to did not like the Sandinistan government. I saw FSLN signs everywhere, wall paintings with their slogan “Vamous por mas victories!” in all the cities, buses flying flags all along the road to Rivas on Saturday morning, and even lots of police in the streets. Interesting! I’m just really thankful that we were able to travel safely.

Oh and this weekend was awesome! I really just liked seeing everyone again, hearing how their week was about their work, cities, homes, families. We went to Ometepe, which is an island in Lake Managua (which is HUGE!! it looks like an ocean but is fresh water) with at least 2 volcanoes and a lagoon. Most of the group went up on Saturday and climbed one smaller volcano on Saturday to a lake on top which was a 8 hour hike! Rita and I went to a wedding of a relative of our host family on Saturday, which was interesting as it was very intimate- just the family with a lawyer in a house, which made it kinda awkward for us but still cool to see and fun as the couple was very happy that we came. So we came up on Sunday, and then met up with Julie, Yujing, and Will in a super cool hotel that they found on the beach and went swimming a bit. I was very happy! Yujing and I tried to swim to this island which looked really close but didn’t get any close the more we swam with huge waves, so we decided to use common sense and go back. Rita, Yujing, Jared, and I then stayed up that night for a while talking about life and lying on the beack looking at the stars, which was really, really enjoyable! Monday, all of us Dukies went to Punta Jesus Maria (via riding in the back of a pick-up truck) which is where all the winds around the volcano meet so the waves were coming from all directions. It was absolutely beautiful to turn around and see the volcano in the background with dark ominous clouds of a coming store and the water in all directions! Incredible! We swam out for a while, and then all of a sudden we realized we were really far out- must have been a current, and had a far way to swim. Luckily, we all made it back and caught the ferry home to San Jorge, taxis/buses/bikes to Rivas, and then home. Amazing weekend!

Second Day

So Rita and I finished our first two days at the hospital!!! Wow it is hard! A big challenge is of course the language barrier. We can communicate in Spanish, but it is not easy or very comprehensive. Our biggest problem I think is not finding people we can talk to, are willing to talk, and are helpful. We met with the director of the hospital, Sor Ligia (a nun because the hospital is run by nuns), on the first day. She gave us an old room in the back hallway that was full of unused beds and nursing supplies. A lady working at the hospital brought us a plastic table and chairs. They people started bringing in broken medical equipment. Left and right! No instructions, no manuals, no explanations, no conversations or discussions! Rita and I kept thinking that we were going to meet some of the technicians or mechanics or anyone, but rather they just brought the equipment and left. One technicians, named Cheyo, brought us a lot, and we tried to talk to him. I guess he didn’t want to talk because he would just keep leaving. Around lunch time, Rita and I decided to walk around. We ran into Cheyo with another man, named Harold, who turns out is the head technician on the hospital. He knew Maura and Pia, the EWH girls who worked there last year and even had a picture of them! He was super nice, but of course he is on vacation right now. Apparently all the other technicians besides Cheyo are on vacation until next Monday at least! Yikes! Rita and I talked with Harold a bit, who then brought us more broken medical equipment. So now, we have a little room with 4 centrifuges, a defibrillator and ECG monitor, a IV fluid pump, ear/nose/throat light set, 2 sets of phototherapy lights, a baby incubator, a Doppler ultrasound, and the bedside monitor that we brought (temperature, Oxygen saturation, pulse rate, blood pressure). Hmmm and we heard some people don’t find the broken equipment until the end of the month. Rita and I were hoping to just meet people and perhaps start an inventory today. I guess they expect us to start repairing today. We started taking apart a centrifuge while we waited to meet people because they brought us that first. Well needless-to-say, since we never met anyone, we took it apart but didn’t find a problem. Hmm, well we should have checked on our own to see if it worked. We then plugged it in and it worked. We asked Cheyo about it, and he didn’t know. We then tested another one and found that it did not work. We took it apart but could only determine that the motor was broken. Discouraged we decided to go should Sor Ligia the bedside monitor that we brought. So she asked us to demonstrate for her how to use it and then asked for the manual. Hmph too bad we don’t have one. Very embarrassed, we then told her that we would find out the answers to her many questions, write a manual, and then bring it back. I felt really bad that we didn’t have everything ready for her. I understand now though why she doesn’t accept anything and everything because literally 7/12 pieces of equipment in our room were donated by EWH. I was at first really discouraged that everything that was broken was donated by us. I didn’t know if it was because the equipment we brought was poor quality or that they brought it to us since we are from EWH. Then as Rita and I were meandering around the hospital, we realized that really all the equipment that we saw in the hospital was in our room. There were some really nice new pieces of equipment in the neonatal unit, but only one was working. The other was missing some lights. We also saw some working centrifuges in the laboratory. That is all we saw! However, there is also some operating rooms, X-ray room, and ER respiratory room that we did not see. I assume there is more equipment (hopefully working) in there. The rest of the hospital contained rooms with just beds and bedside tables with some patients. It has been an interesting past few days- frustrating and challenging absolutely. It seems like they expect us to be able to fix everything. Interesting too that they did not ask us any questions- only if we had a specialty or just general! We would like to talk to some more people and find out more information about the hospital, what it needs, and about the equipment, but we haven’t found many people willing to talk to us- maybe its language or culture. I don’t know. We did have a patient come talk to us today though who knew English and works as a dentist in Arkansas! She was sooo nice. She apparently has a brother-in-law who works at the hospital and another that works in Jinotepe and knows English. She called him on her cell phone right there and gave me the phone to talk. I didn’t really know what to say, but he will be a good contact in case we get really stuck. He works for a non-profit organization installing water filters around Nicaragua- really nice and neat man it sounded like. Good connections! So Rita and I are making progress! We were also super excited today because we think we fixed a couple of pieces of equipment! We put in a new battery in the Doppler ultrasound, and it works better than before. We tried to ask around if it was good enough but didn’t get much feedback. We also investigated the ear/nose/throat light machine thing. Only 3 of the heads worked, but when we took apart the others, we found that the light bulbs worked. We then put them back in the head and they worked! No idea why! We may not be able to rewire the defibrillador but we can definitely take apart and rebuild things! We are just taking things one step at a time and trying to build relationships here. Hopefully Harold will come back and we can talk to him, we can get Cheyo to warm up to us, and maybe meet some nurses or others tomorrow. Besides that, we need to find some info on the machines perhaps online and work on writing a manual for our monitor. A lot of work to be done- good thing we are here for a month!

Adios y Hola

So I just got the airport 2 hours earlier and there is free wireless!!!  Yeah it is so nice to use my own computer!   Yes, so it is a transition weekend- leaving Costa Rica and coming into Nicaragua.  I am actually really sad to leave my family here and the country too.  My family was a mom and her two daughters, one in university and one who was 10 years old and adorable!  She gave me a “I love you” card when I left   I really liked the family and house.  It was small compared to others where the whole extended family lived together (another had 18 people!)  which was really fun because then we really got to know the family and practice our espanol as well!  The country of Costa Rica is wonderful too!  SOOOOO beautiful.  San Jose is in a valley, so everywhere you look there are these bright, colorful houses against the green landscape.  Gorgeous!  The people are generally friendly too.  The food was also good- lots of pineapple, mango, and papaya.  Me gusta!  We definitely lived in the capital city, which was a pretty big city and similar to other American cities in terms of lots of young people, very international, pretty dirty, crowded, lively.  It was interesting living and studying here in this city and then travelling to the smaller towns on the weekends.  I’m not going to lie, I don’t think I’m a city girl.  The weekend trips were amazing!  I loved doing all these fun activities outdoors!  Last weekend we went to La Fortuna and Volan Arenal.  About 8 of us did the same hike up the crater lake!  I think that was my favorite thing too!  Some of us swam all the way across which was so eerie because in the middle, you can’t see anything!  We were literally swimming in a cloud!

In terms of culture, I was surprised here when talking to the family by the large amount of infidelity among the men that has left many families as solely female and many very young single mothers.  Most of our host families did not have fathers, especially among young people and the generation right above us.  Similarly with that, PDA is not frowned upon in public places such as the mall or bus stops.  Family is also super important to them as most extended families still live together or close by.  My host family all lived on the same street, even the divorced father and his parents.  The children don’t leave the house until marriage, so even when going to university, they live at home.  Our host girl lived at home and went to university only 3 days a week.  I do like how important family is and the respect of elders.  I wonder if this will be similar or different in Nicaragua. I am going to a small town of about 33,000 people which I sincerely look forward to just as a difference from here.

Classes here have been good but I’m not sure how useful.  Spanish definitely, medical instruments, we will see!  I have learned so much Spanish- 3 different tenses and sooo much vocabulary.  I hope that I will be able to at least get my point across within conversations.  I am by no means comfortable, but I am sure that next month I will be practice all that I have learned and hopefully won’t have to think so much. Our lab consisted mostly of taking apart medical equipment that we brought, which was very interesting but perhaps not super educational. I am so worried that when we show up at the hospital next week, we won’t have a clue what we are doing.   I am without a doubt much better prepared than when I left, so that is really all I can ask for!  I really look forward to hopefully giving back and helping people though!  I think this last month I gained a lot more than I gave, so I hope this month I will be able to give more.

The hospitals that we visited here in Costa Rica were really nice.  They were very equipped in terms of medical equipment with X-rays, ECGs, ORs, ERs.  We went to one hospital in San Ramon and another in Tirialba.  All of the staff that we met (mostly technicians, mechanics) were very knowledge and took great pride in their hospital.  The one in San Ramon even had a butterfly garden and made their own compost! The staff gave us tours of the hospital and even explained the medical system in Costa Rica as it is mostly public and government controlled under the social security system.  I am glad that we visited though so we could see what some hospitals looked like in different countries.  It will be interesting how different Nicaragua is from this too.

The other students on this trip have been absolutely amazing!  Everyone is so incredible- interesting, intelligent and so caring!  I am really going to miss them, having so many people to talk to and travel with.  I hope that everyone in Nicaragua can travel together on the weekends.  I’m really going to miss everyone in Honduras though and I worry about their safety.  It is going to be hard to go from having 26 other students around to just Rita and I, but I hope that it will give us more opportunity to interact with the community then instead of each other.  I look forward to Diriamba and seeing another place, another culture, another family, and another hospital.  I’ll write soon!  Hopefully others will join on and we can hear from them too!