First thoughts on healthcare in Nica..

First whole day in the clinic!!

I totally forgot about “Nica-time” thing.  This is something that would drive most Americans I know crazy.  Por ejemplo, our family has some friends who decided to stay in Nicaragua and make a life here.  Claudia is Nica and Bob is USAmerican.  They joke was that when they were planning their wedding, they told their Nica guests that the wedding ceremony was at 4, when in fact it was at sunset.  They wanted to make sure everyone showed up on time.  Just as he and Claudia, no one showed up by 4, but came rolling in until about 6:00.  PS. The wedding the the best I have ever been to.

Clinic is the yellow building,
standing out of my home.

I was told to be at the clinic at 7:15.  My breakfast ran over and I showed up at 7:30.  Almost 100 people were waiting outside the clinic, which is right across the street from my house. Not all were patients.  Some were family members. Some were just hanging out.  I learned today that people leave their homes at 5 am to wait in line to be seen. I shuffled my way through the crowd and found the doors to the clinic to be locked.  So I waited. Only 45 more minutes though.

I got situated. Gathered my supplies. People started filtering in and I was starting to realize that I would be alone in this.  The other med student still hadn’t shown up.  Later I found out that, as expected here, her bus was 2 hours late getting her from Ometepe.  We ended up seeing 52 patients in 5 hours.

One could write a whole book on healthcare for the poor here. So much in the US is taken for granted. Privacy for one. The patient intake is completely out in the open.  Weights are yelled out across the waiting room. Reasons for visits are discussed next to your seat neighbor.  People look over the shoulder of the patient in front of them to take a peek at a chart.  When a patient goes back to see one of two doctors, it is in one big room.  One area is separated by an armoire or bookcase to allow different space for the doctors.  Towards the back of the room, an area for more intimate patient examinations is separated by bed sheets. Children are crying.  No HIPPA here. No time for it.

AC for another.  It’s hot and the air feels thick to breath.  Babes with high fevers have to endure a room with 80 people at a time that is well over 85 degrees with no circulating air.  Some people step outside to get some air but with little relief of temp.  I have the opportunity to sneak back into the pharmacy, which is only AC’ed during business hours.

Cotton balls.  The clinic has to try and cut costs wherever they can.  So instead of buying cotton balls for finger pricks, we take the stuffing out of pill bottles.  People get the bare minimum.  It’s not that big of a deal in practice, but it puts in perspective the difference between the US health care and 3^rd world health care. 

Women's care.... There is a great need, just like everywhere else.  

Obviously there are more differences.  I will write about those as time goes on.  This clinic is amazing though.  They see it all and they have to be able to handle it all with limited resources. Some things that go on here would never fly in the US. Like 90 degree waiting rooms and needles disposed of in empty clorox wipe containers. 

I am going to try and do a huge blog entry on the history and people of the clinic.  I need to do some more research.  So expect that soon. And once people get used to my presence, I will take some pics.  Right now I am the Chela, or Gringa, who can’t pronounce names and who sweats frequentemente.  One thing you have to learn FAST when you travel or live here is to have a sense of humor about yourself.  Nicas love calling each other out, and no one is exempt. 

Granada is beautiful!  I took dance class today at Carrita Feliz.  The little 4^th graders taught me some traditional moves and dances, and then they tried to teach me how to twerk...

Peace!  Hasta Manana!