So things have been really busy for me here in Nicaragua over the past couple weeks. I began working full time at a local hospital here in Jinotepe and also decided to take on a second position at a local centre for children with disabilities. My time at both jobs has been amazing so far, and each have offered very unique opportunities to learn and to serve.

So my first (and original) placement is at Santiago Regional Hospital in Jinotepe. This hospital is fairly new (about 20 years old) and is considered a secondary hospital here, meaning that we are one step above the “centre de saluds” that are found in each small town/village but one step below a major hospital, such as would be found in Managua (The capital). Here’s a shot of the outside

This hospital has been even more interesting for me because it is a teaching hospital which means that once the medical students have finished the classroom portion of their education some of them are sent here to complete a year of intership. I have gotten to know one of the interns (Cesar) and have been able to shadow him and learn from him over the past few weeks. Here’s a picture of Cesar and I

So since the interns rotate through the various departments I spent two weeks with Cesar in Pediatric Emerg and we have now switched to Obstetrics and Gynecology. In addition to getting to see patients with Cesar and learning from the supervising doctor I’ve also been allowed to attend medical classes with the interns. Usually there is one lecture in the morning with all of the interns involving a case study of a patient seen in the hospital and then there is another seminar in the afternoon, with just the five of us from pediatrics (or now Obstetrics and Gynecology), where one of the students presents on a topic assigned by the supervising doctor. It has been really interesting to learn about different topics especially ones that are particularly crucial here such as Malaria and Dengue Fever. Here’s a picture of the lecture hall which also serves as the chapel.

Nicaragua has both private and public health care. Santiago hospital provides public and free health care to the community and therefore has to make do with minimal funding from the government. And this fact is most definitely reflected in the amount of resources and supplies available to the doctors which in turn restricts the quality of medicine that is available to the patients.  Which at times I have found quite frustrating to come to terms with, there is also a strange disconnect between donations from North America and the actual needs of the hospital. For example one day while examining a child on rounds with one of the doctors he explained to me that the child had a gastrointestinal parasite. He said that that part of the diagnosis wasn’t the difficult part but that the difficulty comes in figuring out what kind of parasite it is in order to treat with the proper antibiotic. The use of the wrong antibiotic or the use of a full spectrum antibiotic can lead to super bugs and other complications so it is important to try and narrow your options. He then went on to explain to me that the hospital has the equipment to perform these important tests but that they do not have any personnel who know how to use the equipment. Poverty can be so complex and this fact becomes more and more evident to me each day as I ask more questions and become more a part of the community here. There are no simple answers and I struggle with how best I can continue to support the people here once I return to Canada, in ways that will go to the root of the problems and help improve the quality of life for the wonderful people here. Anyway that’s enough talking for tonight, I will write soon about Los Popitos (the other place that I’ve been working at) and I will post more pictures of the hospital soon as well.

God bless, Lauren