El Trabajo Comienza!

Alas, after two weeks of cultural immersion and orientation, I have started my work at the Centro de Salud Monimbo. For my first week in the clinic, I did a different rotation each day getting to know the different staff and programs. There is a staff of 12 doctors, around the same number of nurses, an epidemiologist, and 3 women who run the lab. A large portion of the clinic’s patients are referred to the lab by the doctors they see to get tests for pregnancy, stds, different parasites, dengue, tuberculosis, and aids. In the morning, the tiny one room lab floods with people carrying their excrement samples in match boxes and plastic bags and others who are waiting to get their blood tests. Due the scarcity of materials, these blood tests consist of using capillary tubes instead of needles to transfer blood into a small glass test tubes. There are only three women who work in the lab and every day they process all kinds of tests manually for every patient who needs it. For preparing the blood samples, these brave women use their own mouths to siphon samples that potentially contain deadly diseases!
One of the programs offered by the clinic is called “Trabajo de Terreno” and provides basic health services and education to communities in rural areas surrounding Masaya that do not have the funds or means to access traditional health clinics and hospitals. For two days of my first week, I traveled with a team of doctors and nurses to different areas to discover completely impoverished communities. I met many families with several children and children’s children living under rudimentary tin shacks. Right now, the Trabajo de Terreno program is focused on decreasing mortality rates of the H1N1 flu virus, as it has been very high in recent months in Nicaragua. Pregnant women are the most susceptible, so we have been going from village to village, door to door, looking for pregnant women to vaccinate. Even after finding those who were pregnant and instructing them to come to a nearby house, where stationed doctors and nurses were giving the vaccines for free, there was a lack of attendance and we had to hunt down many women and give them the shot at their house. I can already see that these visits mean more than just administering vaccinations. Simply having contact with health professionals who are positive and encouraging reminds people about their health and to make better choices. For example, we encountered one pregnant woman who was very sick. She had seen a doctor in the recent past, but had failed to follow up with any appointments for her or for the routine vaccinations of her child. We encouraged her to come in and bring her kid and also explained to the husband the importance of these future appointments. The visits to these communities are about more than disease control, they are about disease prevention through outreach, encouragement, and education.
The lack of resources is made up for by the presence of so much hard work and so much heart. The clinic is open every day so that those that work during the week could access services on the weekend. All of the doctors here are very young because here in Nicaragua you do not need an undergraduate degree before going to medical school. Their enthusiasm, energy, and optimism are really quite inspiring.
My host family is awesome. They are artisan shoemakers who sell their work in both the local artisan market and the larger local Mercado. My room is on the top floor and has a balcony overlooking the top of the San Geronimo church. Last week was Semana Santa, work was off, so I went to the Carribean coast with two other interns from Managua. So many crazy adventures, but I must save that for another post!
adios