First week

July 22, 2009 at 2:40 am Leave a comment

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!


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Second Day Second week… Success!

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