thinking of Nicaragua

We've made it safely back to the US! The day before we were to fly out of Managua, I ran into some visa problems at the border of Costa Rica and Nicaragua. Jay was gracious enough to accompany me across the Costa Rica border to a Nicaraguan embassy to get another visa. Thankfully everything worked out!
I've been back to the US for a few days, but I still think of Nicaragua constantly, especially Sahsa. It's hard for me to summarize, so I wrote one more poem.

The memories of Sahsa are like the smell of earth after the rain.
I miss nature's alarm clocks: cows, dogs, crickets,
the drumbeats of thunderstorm on zinc roof.
The boy with swollen belly haunts me, he cries
fitfully, too hungry to wail.
His mother smells vaguely of urine, she talks
with one hand hiding her missing front teeth.
Stale pastries under the neon supermarket lights stare
with raisin eyes as dark as the pupils of begging children.
The flush of chlorinated toilet water gargle
'agua, agua', where is the clean drinking water for them?
From the plane, the cities of light glisten
with every passing of clouds, mimicking
the starry sky above lightless villages.
The beauty of RAAN is like the black buffaloes,
hardly blinking an eye at the truck full of gringos.
The spirit of Nicaragua is in the bachata,
blasting from crowded, yellow school buses.

*RAAN = Región Autónoma del Atlántico Norte (Northern Atlantic Autonomous Region, the region that encompasses Sahsa)

How did I spend more money in the last 4 days than the last 4 weeks...oh yea...COSTA RICA

So our endevors in Leon ended with some last bit of exploration of the city. Andrew, Jay and I took a trip to Masaya while the rest of the girls joined Sara at the beach. We also did some fun touristy stuff like visiting historic Leon, which was buried after one of the many volcanos of the country got a little upset. We also hit up th batman movie, ate at everything from Hollywood pizza to fritangas (sp?--but basically is fried everything...chicken, squash...cheese..you name it!) On our last night, we met up with Joe, Shruti and Caleb who are also in Leon. We had quite a night on the town (I suggest everyone ask Jay for a dance back in the States!) The next morning we left for San Juan del Sur...and as a group of very diverse tourists with a ton of bags strolled up to the bus stop, we were immediately ambushed with a ton of ppl and lots of different info on what to take and what would get us where. Basically, we ended up getting jipped as the bus that promised to get us to San Juan dropped us off in Rivas and we ended up having to pay again for a different bus to get us to our destination. Eventually, we made it to Mango Rosa, which was a gorgeous villa type resort, as much of a contrast as you could possibly imagine from Sahsa. After one look at the nice pool and hammock collection, we decided to stay 2 nights instead of our original one night plans. We visited the amazing beaches, Andrew and Jay tried surfing, and at night we grilled out. (The grocery shopping was left to the boys, who did a great job finding stuff, got to the checkout line only to find out they didn't take credit cards...but they still managed to bring back shrimp, fish, pineapple, veggies, and corn...probably pissing off the cashier during the process!)

After taking a taxi to the border of Nicaragua and Costa Rica, we found a bus that was supposed to take us to Arenal...unfortunately, after we paid...we found out from the driver that the bus was never supposed to go to Arenal at all! So, all of us get dropped off at the side of the road with our luggage (imagine what one word was going through our heads!) We then got a taxi, which was a truck...all our luggage went in the tina, Mia and Kamal in the front seat, April, Kristine, Jay and Andrew in the back and I was on Andrew's lap. If we weren't close enough after the 3 weeks in Sahsa, this ride finished the job!!! We finally make it to Arenal only to find out we had missed our reservations by 50 min. Thankfully, we found a hotel and restaurant owned by a Chinese lady, and Andrew/Mia used thier magic (ie Mandarin...see being multi-lingual pays off!!) to get us some nice discounts. That night we visted the hotsprings in Arenal (you can't get more touristy than 40 different pools of differing temps catering to the whims of gringos!) There was also an infamous slide that we tried out (where I came close to drowning...thanks to Kristine the rescue!) Andrew made an attempt to teach me how to swim later in the evening after said near drowning episode. The next morning we went rafting. We were supposed to go to a class 3/4 river but it rained a lot the night before and the guides didn't think it was safe. So, we drove to a river that was usually 2/3, but probably a little more because of all the extra rain water. It was an amazing experience. April and I both took little falls into the river at different points, but it was a blast.

Next day we took a jeep boat jeep trip to Monteverde, which is where I am typing right now. WE are staing at this cute hostel run by a family with the most adorable 3 kids! We took a tour of a coffee farm yesterday and explored for a bit. This morning, the girls went on a extreme canopy tour, which was 14 zip lines (up to 2250ft), a tarzan swing, and a 90 foot rappel. The tarzan swing was probably one of the scariest things I have done in my life. Some awesome pics to come tho! We leave tomorrow for managua again and will fly out around 7 am on the 30th. It feels so strange to be almost finished with this trip. It has been a brilliant experience with some great people, but despite all the fun, all of us are ready to see friends and family back in Chapel Hill. Thanks for reading up on our travels...and we'll be home soon !!!

Leon

Thanks Harneet for the summary!
Every city has its character, and since tonight is our last night in Leon, I wanted to write about it. Tomorrow we will head to San Juan del Sur for a night and then to Costa Rica.

Leon is one of the two oldest cities in Nicaragua. Cordoba, the man who founded both Granada and Leon, is named for the currency of Nicaragua. From the viewpoint of our feets, the streets of Leon is a smorgasboard of pavements- ceramic, brick, cement, some pavements are shiny from the morning washing, some are really dirty with nose boogies. Each building is made up of many different colors, depending on the whims of its habitants - lime green, adobe red, tangerine orange, etc. The city is organized in blocks, with its 16 churches as the most prominent landmarks. People will tell you directions from the cathedral and two blocks south rather than say the name of an avenue (in fact, I think many streets have no names). Foreigners, women with baskets of peeled mangoes, begger children, and professionals, uniform-wearing private school kids, all mingle together on the narrow streets. Eskimo ice cream shops are very popular, with exotic flavors such as pitalla (sp?), which is the fruit of a cactus that grows on jicaro trees. It is magenta and sweet. On the outside, it kind of looks like a softer, magenta version of a small pineapple. Yum. Although this is the rainy season in Nicaragua, these past few days in Leon has been rainless. The weather here is much more predictable than that of Sahsa, meaning it is hot, hot, hot. Walking around at 7AM could give you a good sweat. Occasionally, in between the alleys comes a cool breeze, which is almost as good as that pitalla ice cream...

And the UNC Crew makes a comeback from 40 down to kick some Sasha ASS!

Back from Sahsa!!! I apologize for the lack of entries but I’ll try to do a quick whirlwind tour of our adventures on the Atlantic coast of Nicaragua. So for those of you who don’t know about Collaborative Sahsa Health Initiative, UNAN has now committed to sending a brigade of medical students in their 6^th (last) year to Rosita and Sahsa to help increase man power in the medical infrastructure in there. So after enjoying a couple days in Leon, we met at 8 AM on June 29^th in front of the hospital to catch a yellow school bus for our 17.5 hour bus ride to Sahsa. Oh yea, I forgot to introduce DOCTOR Sara Faber (yes, she made us call her Dr. Faber the whole time…J/k Sara!), who we met the day before in Leon. She is one of two UNC med/peds residents “supervising” us medical students on this trip. After rolling our luggage through half of Leon, we arrived at the hospital and helped load the bus with the 12 other UNAN students (6 of whom you’ll meet later in the blog), the UNAN supervising physicians, Dr. Edgar Pena, our main project contact at CIDS. Highlight moments of packing the bus include Andrew and Jay being very helpful in loading countless bunk beds and then unloading them once it was determined that there wasn’t enough room for the students. As for the ride, we forded 3 rivers, dodged holes the size of your grannies panties (thank Jay for that comparison), seeing the amazing cloud forest greenery, crossing multiple mountain ranges. The 2 hour drive from Rosita to Sahsa can only be described as a Jackhammer roller coaster on a pitch black “road”. Highlight of the ride, after driving straight for probably around 6 hours, sphincters (yes ppl…think back to your anatomy!) were starting to show signs of failing so there was a request made for the driver to stop. He kindly did so on the side of the highway, were we ended up using the bathroom in the bushes as trucks passing by looked on….among the Sahsa crew, this is known as the ‘I want my mommy’ moment.

We arrived in Sahsa at 2 AM, where we were greeted with our dusty and empty dormitory, which was the former clinic of Sahsa. So the eight of us stared at the 3 cots, and 1 queen sized bed and wondered what we could create…the end result: Jay and Andrew under Andrew’s matrimonial mosquito net, Kristine on a cot with a mosquito net hanging from yarn we thumb tacked to the wall, Kamal on the floor with the boys, Mia and me sharing a bed in one room and April and Sara on cots in the other. It was quite the maze..the best part being when we all got into bed, exhausted and reflecting on the eventful experience of the last 20 hours…around 3:30 AM, a cow (who Andrew lovingly named Dood) mooed, sounding as if it was standing outside our window. The next morning we woke up promptly at 6:30 as we were told to be prepared for a meeting at 7. I believe Andrew described it best as he awoke to the sight of his matrimonial mosquito net, and said, “jay, look it’s so pretty.” From then on, the boys were known as Jotandres, forever inseparable! Sorry boys, had to put it in there.

The 7 o’clock meeting happened at about 3, and we soon realized that part of the territory of starting a new program was that ironing out details was our responsibility. We did manage to get our rooms organized, get our bunk beds assembled (big thanks to the boys for heavy labor), and get used to what we now joke as Nica time (if you’re brown, this is very similar to Indian standard time). A quick introduction to the players of the Sahsa game: the UNAN students: Farabundo, Juan, Scarlet, Claribel, Laura, Sharon, Dr. Mendez (UNAN’s supervising doc who will be working in Sahsa for a year), and Edgar Pena (our main contact for this project). All of them were absolutely amazing to us for the while trip. They spoke rather well in English (big plus for me especially since my Spanish is rather on the weak side), and were a big help both on the clinical experience end as well as being cultural bridges for us as we did our surveying.

It is probably impossible for me to put into one blog all of the strange/funny/insightful/crazy/rough/etc moments so I’m basically going to do topic headings and figure out how to best put it on paper later…sorry folks, I haven’t seen internet in 4 weeks, I’ve got 3 inboxes to clear too!

1) Clinic Stories

a. Meningitis patient that with bulging fontanel that couldn’t be transported to the hospital for hours

b. Countless pneumonia casesà want to hear abnormal lung sounds, this clinic is the place!

c. Pregnant woman giving birth, no pain meds, 6 UNAN med students, 4 of us, one VERY crowded room!

d. Pain of unknown origin for 5 years in abdominal/pelvic area and my first solo speculum examà the DOLOR patient

e. Ant in ear…or river water+ mud in ear…the first one Dx with no otoscope!

f. Machete wound to hand that had a 7 hr horse ride to get to the clinic…the same night as the knife fight wound victim that Jay and I got to practice suturing on…poor guy, his street rep was totally shot after Dr. Reuland put two lime green monkey peds band aids on the neck wound he wouldn’t let us suture!

2) Latrine/bucket bath adventures…there are pictures from the boy’s camera that will pretty much summarize that aspect.Thankfully, Dr. Dent promised us 2 toilet seats for next yr! Worst part : the GIANT roaches in the latrine at night...thus, bathroom buddies =P

3) Salsa Picante! My nickname and our saving grace for eating gallo pinto for breakfast, lunch and dinner for 3 weeks!

4) Surveying stories..bee stings, crazy rides, crossing rivers, blue santa claus with a bag of meds to give out, seeing kids with obvious medical conditions and trying to tell parents the importance of bringing them to the clinic, animals everywhere (5 cordobas to the person who finds a doorway WITHOUT poop!)

5) Game Nights! Bi-lingual Mafia and Charades! Some very funny pictures to come!

6) Dr. Dent and Dr. Morgan’s visit…I believe there was a vehicle malfunction, some very full rivers, and amazement at just how much help the Sahsa community needs

7) Diarrhea…CIPRO!

8) Dr. Rick Hobbs (Med/peds resident at UNC) and Dr. Reuland join the crew…and our very scary bus ride back from Puerto Cabezas

9) And more but I’m out of time…and Andrew is the only one next to me and he’s not creative at all!!

While the score was probably Sahsa 40 and us 4 halfway through the trip, we came back strong and I think all of us would say that this experience was worth all the hardships/surprises/and psychotic break laugh moments (if you know Sara Faber, she can best demonstrate a psychotic break laugh). Being in one of the most rural and forgotten places of the world really makes you re-evaluate the resources and opportunities available to you. When we got to Sahsa, we had no electricity (a week later, it started up from 7 pm to 10 and we were in awe), the water was yellow, the clinic was lacking a thermometer and quickly running out of medications. There was a line of patients every morning and there were definitely days when patients were sent home and told to return the next day…and since Sahsa ‘s clinic covers the surrounding other communities, that may mean half a days walk/horse ride/bus ride. The houses we visited during our surveys probably survived a day on what we spend on a pack of gum. One of my personal wow moments was seeing a 14 year old with a 16 month child and I followed that up with giving a Depo shot to another young teenage girl. During surveying, Andrew and I interviewed a woman in her 40’s who had 17 pregnancies, 4 spontaneous abortions, 3 children who died before the age of 5—with 3 events happening over a span of 4 months. All of us will probably post a more thorough evaluation of thoughts and events later but we all survived, when there were definitely moments we thought we wouldn’t and I think we will make better human beings and better physicians because of it.

a really quick summary and two poems

Quite a lot has happened in the past month. Harneet´s update of our adventures on Island Ometepe seems like eons ago. Since late June, we traveled to Sahsa and spent three weeks there, living with six other UNAN medical students. It´s too much for my Internet cost to write about the entire experience at once, but in brief, we went out to the Sahsa community and many other neighboring communities for surveys. The surveys included basic identifying information like name, birthdate, occupation, level of education, what type of house it is, and pregnancy history for women between the ages of 15 to 49, and a diarrheal survey if the household had at least one incidence of diarrhea in the past month. We also marked each house on the GPS. In total, we probably have about 375 surveys completed, though the total hasn´t been thoroughly counted. We also rotated in the Centro de Salud down the street from where we lived and helped out with the other UNAN students and our two awesome UNC residents, Sara and Rick. Both the opportunities to survey and to help out at the clinic have been incredible privileges. Almost nobody turned us down for the surveys, instead, they offered us the only chairs they have or the only egg that the chicken laid. At the clinic, women with crying babies wait for hours to be seen, after walking for hours to come to the clinic. I´m sure others will write about those experiences in more detail. We´re currently in Leon, in the next few days we´ll do some data input, and then we´ll travel to Costa Rica for a few days.
Everyone is safe and sound. There was a bit of traveler´s diarrhea passing around while we were in Sahsa. First Andrew, then me, then Kamal, and maybe Harneet, but we´re all healthy now.
I´ll share two poems here, one from earlier in the trip. The second I just wrote as we finished our stay in Sahsa. Please pardon any weird symbol mistakes, I´m still trying to figure out this keyboard.

June 24, 2008
In a mango country of volcanoes and lakes,
I am only a passerby,
Riding in a rented Jeep with mis amigas,
I pass the real Nicaragüense on their school buses.
It is a country where pigs can sit on top of buses
and one can buy cheese and coconuts along the road,
where people stare at me with curiosity
and men yell out´I love you´in English, freely.

In the heart of Lago Colcibolca, Isla Ometepe lies.
The twin peaks of Concepcion and Maderas make up Ometepe.
When I see the silhouette of school children on dirt roads,
I can only think of my Chinese childhood,
for my heart is not within the center of heart of hearts,
aunque quiero.
I only watch out of the car trunk and reminisce
my own homeland and all the volcanic hearts I had left behind.

July 18th, 2008
A poem for the Sahsa girls

With your wide brown eyes, you look at me,
the rare ¨chinita¨in Sahsa.
I watch you walk away in the rain,
pink flip flops splashing in the mud,
precariously balancing a basket of guajadas on top of your head,
or carrying a bundle in your childlike arms.
When I watch you wait outside of the clinic,
your eyes are blank, calmly ¨shi shi¨your crying baby.
Something changed between the fifteen year old you
and the ten year old I met at the school soccer field.
The ten year old smiles shyly when I smile
and replies ¨una doctora, como vos¨when I asked
what do you want to be when you grow up
The fifteen year old you says ¨ama de casa¨when I asked
what is your job
You grew up so fast.

Pigs on School Buses!

ok...so the last couple of days have been full of vacation and lacking internet access so let's catch all you wonderful readers up on our vacation time....and yes...the last couple of days have definitely been an incredible vacation. So last time we left off, we had overcome Mombacho (eh...give or take a few falls)...

Friday the 20th marked our last day of Spanish Language school. I tried to have my last awkward, more charades than speaking conversation with my wonderful teacher Veronica and the rest of the gang learned a lot of grammar. We finished off with Salsa classes for April and I and a visit to the cigar factory for Kamal and Kristine. (yes...think back to your anatomy and those black tarry lungs!) It was fun to dance despite the stiff legs from the hike. That evening we met up with Andrew and Dhruti (who got to Granada the night before) and had pizza and drinks with the whole gang! We got to hear about Andrew being called a chinito by a little kid (making Andrew rather mad since he was CLEARLY bigger than the kid!...I believe his exact words were..."I'm 2x your size!") Being the typical medical students, we ended our night and the late late hour of 10:30 and went back to get our beauty rest!

Saturday the 21st, April, Kristine, Kamal met up with Mia and Alicia in the central park at Granada. After picking up our luggage and giving presents/saying bye to our host families (which was so sad because they were awesome!) we had a DELICIOUS lunch by the islands formed by Mombacho volcano. I gotta say, I was surprised that my cooked fish still had a head! During dinner, we had a surprise guest...the BEE trying to STEAL my coke! I would have gotten mad, but it got stuck in the bottle so that was it for my 'better than States by far' coke! We then took a boat ride tour of the islands, followed by Alicia doing some master driving to San Juan del Sur, a little down on the coast of the Pacific. In addition to passing about 50 cars, we stopped by a roadside stand and got fresh coconuts! (They had mangoes too, but I figured that may get a little messy!) At San Jaan del Sur, we saw the little villa Alicia had reserved and it was AMAZING! The place was a secluded gated community with a private indoor and outdoor pool, beautiful 2 story floor plan, and very nice staff. We ended the night by taking a trip to the beach, followed by dinner and a dip in the pool under the stars. Mia and Kamal tried to teach me how to swim...and yea, we'll just leave the rest of that out =P

Sunday, we relaxed more at the beautiful villa and in the afternoon, got a neon orange bikini for me since I wasn't smart enough to pack a bathing suit, visited the pool and finally, drove to catch the ferry to Ometepe Island. Alicia showed off more of her driving skills trying to drive our car onto the already too full ferry! Despite some sea sickness and rain, we got there safe and sound. After finding a hostel, we met up with Dhruti and Andrew for dinner at their hostel. After some good convo, sippie cup drinks, avoidance of bugs and full tummies, we headed back to our place.

Monday was the day of physical activity. Just so we've established this, I've done more physical activity on this trip than the last 23 years of my life...COMBINED!! We started the morning with kayaking about 4 Km, starting at lake Nicaragua and going into Rio Istiam. (Yes, I don't know how to swim...let's get past this point ppl) On the way, we saw beautiful birds and... MONKEYS in a MANGO tree! The cutest family of Mono Congo (Howler Monkey). I was ready for the monkeys to throw mangoes at us but apparently Nicaraguan monkeys are more well behaved than indian monkeys. The little babies just stared at us as we stared at them (although the papa monkey was getting a little agitated with us). After coming back from this nice little exercise expedition, we all realized that we had managed to get sun burns on our legs...all except April and Alicia. Kristine is definitely the most red, but all of us are not too happy with our sunblock lotioning skills! After eating a nice lunch to recuperate, we decided to follow the advice of Andrew and Dhruti's hostel guide and take the and I QUOTE " EASY walk to the Mirador" So, all of us got geared and ready to take this easy walk which ended up being more like a tortuous hike to about 700 m of Volcano Maderas. As we got to the view point, it started raining and we realized our path was now just very slippery mud with intermittent volcanic rock. For all those med students thinking this sounds like a dramatic ER episode waiting to happen, you are correct! Dhruti and Kamal took some mud to the gluteus maximus and I took a nasty fall onto my left hip (k 2nd yrs...name possible bone injuries...GO!) So, I hobbled down with the rest of the gang as we got soaked and muddy (on the upside, people lots of money for mud baths...we only paid $5 for ours!) Next time I'm in Nicaragua, I'm visiting that guide book with a Sharpie...easy walk my @$$!! haha, j/k ;)

Tuesday the 24th we packed a 5 seater car full of Alicia (our driver), Andrew and I in the front seat, Druthi, Mia, Kamal, April and Kristine in the backseat, luggage of all in the trunk and top of car and drove the 1.5 hrs to the ferry. On the way, we stopped and asked a bus driver how he managed to get a giant pig on the top of his bus (he was probably thinking about asking us how we got ourselves in that little car!) The ferry ride was full of rain and random 80's music videos (Grease lightning, Beatles, and so on). After leaving Andrew and Dhruti to catch the minibus for leon, the rest of us made the drive to Alicia's house in Managua. We've been running errands and just chilling here for the day. Tomorrow we go to see the market in Masaya and maybe volcano number 3 before heading to Leon!

wow...that was a lot of typing but we're all caught up! And as a reward for making it through this post...enjoy the pictures below!

Adios!
Neet

I promised pictures...here they are!

Picture 1: Las Chicas at La Merced
Picture 2: Neet pretending to like her caballo, which was trying to drop her constantly!
Picture 3: The group at peak 1 of Mombacho Volcano

Volcano 4, April 0

Hola! Before I explain the title, I´ll do a quick overview of the last couple days. On Wednesday we visited Miador De Caterina, which is almost like a clif and you can see all of Granada and the nearby lake. We also got to experience the wonders of Cabillo (horse) riding. Kristine´s horse was a little older so it was lagging behind until it decided to run. April and Kamal´s horse took mini breaks to poop and my horse kept trying to eat the guide´s hand and i really thought I would fall off in the process. All in all it was a lot of fun and I got to see a Mango tree on my way there!!

Yesterday we took a day trip to Mombacho, the volcano! We went on a 4 Km hike that took about 4.5 hours. We met a few more tourists, including 2 guys here from Souther California for thier friend´s bachelor party--male friends reading this, don´t get any ideas, the poor groom has an inflamed eye from all thier surfing expeditions! As for the volcano, the inclines were definitely tough on the legs! About an hour and a half in, it started raining, making the slippery stones even more slippery. That resulted in 4 falls for April, no major injuries, even though I was ready with my first aid kit just in case! Every one had one or two minor slippery moments, but we came back in one piece! The volcano actually has a ton of vegitation, so it was like hiking through the woods more or less but with a lot more incline! Pictures to come later!

Today we have class again followed by Salsa classes! We meet up with Alicia and Mia tomorrow to go visit the islands nearby and eventually make our way up to Leon. Hope everyone is doing well in the States!

Hasta Luego,
Neet

Managua!

I arrived in Managua last night after about 12 hours of traveling. Six of those hours were spent sitting in a parked plane in Miami airport. Miami had a bad thunderstorm with lightening in the afternoon so all the ramps were closed because the lightening made it dangerous for the ramp workers. Alicia´s uncle, Julio, picked me up from the airport around 9:30 PM. I felt bad that he had to wait almost 2 hours for me to arrive.
So far I´m enjoying the trip. I woke up at 5AM this morning to the symphony of birds outside my window. The house has a ton of outdoor lounging area, including a hammock! Managua reminds me of where my grandparents live in China- people don´t drive exactly within the lanes. The city buses are recycled school buses with gigantic fume pipes in the back. Periodically, something familiar catches my eyes, like an ad for ¨sports center¨and ön the run¨gas stations.
I have to extend my Nicaraguan visa since I´m a Chinese citizen who is staying in the country for more than 30 days. I´m not quite sure how that´s going to work out. Julio called the immigration office in Managua today and they said that I´m good until July 19th, but then UNAN has to apply for an extension on my behalf. I could be wrong since my Spanish is barely passable. Keep your fingers crossed for me anyway! I´m looking forward to Alicia´s arrival tomorrow! I think we´ll meet up with the girls in Granada soon after that! Hasta luego! - Mia

ahhh...mangos!

So as Kamal said, we have been taking trips to the market and the main part of Granada everyday as part of the Language school´s activities. Yesterday we visted a museum that had paintings and sculptures from the indiginous people of the area. On the way over there, a dog (un perro) decided to come along. He followed us for like 2 blocks! Needless to say, I was not too pleased with the new addition to our tour group! There are dogs everywhere! Most of them stay to themselves so it´s not really problematic. But that particular one definitely freaked me out. We went into a bank and I was really happy to get rid of him...but when we came out, he not only found us but followed us to the next bank! boo perro! btw-- this happens the day after Francisca´s dog kept us up all night by barking for hours in the middle of the night!

I also got my first taste of trying to buy something without very indepth knowledge of the language. I have been looking for mangos since we got down here, and finally found someone selling whole mangos (since the travel clinic said unless you peel it yourself, don´t eat it!). I tried to ask how much they were but we couldn´t understand the answer, so we all thought we were getting 2 mangos for 12 cordobas....until the lady kept piling mangoes into the bag...which is when we realized we had bought 12 mangos instead! good thing i like mangos!

We visted another church today and got to climb the bell tower and take panoramic pictures of Granada. Tomorrow we visit the volcano and I´m super excited about that. Other than that, everything is going well. I am learning some spanish, but am definitely not capable of speaking with local ppl yet because they talk super fast, including the host family we stay with. Hope all of you are doing well. Hasta luego, Neet

Arrrr, We Be After Some Booty!!

Yes, that´s right folks - there are pirates in our midst!! We`ll be sure to upload pictures of these one-eyed thugs soon.
All is well here in Granada. The city is beautiful and the people are incredibly warm and welcoming. April, Harneet, Kristine and I have language school each morning starting at 8. The lessons go until noon, at which point we break to go home for lunch. We return at 2 for an activity in the city. We`ve been to the central area of the city for the past two days and it is awesome. On our first day here, we stopped by a place called ¨Chocolate¨ and enjoyed tropical drinks (made with thrice-filtered water - I love touristy areas :) ) and Fantas while surrounded by fountains, beautiful architecture, and exotic flora. We visited the local supermarket which April compared to grocery store in NYC and stocked up on essentials like Pepsi and Gatorade. On the second day, the gang went to visit a local museum while I went to see an Opthamologo (sp?). It was a dollar´s taxi ride outside of the city in a private hospital. The place seemed clean enough, and they had a water cooler of triple-filtered water for the waiting patients to drink. We got there a bit early, but the doctor came in about 40 minutes late. He came in eating an ice cream cone, but! he must have had an awesome ICM teacher b/c he washed his hands before coming near my face :). His ophthalmoscope was out of juice, so he used a room lamp and special glasses to check ouy my eyes. It was difficult communicating with him, but with charades we got our points across. All in all, I must say we are damn lucky to have all of the amazing healthcare facilities we do in the States - it´s easy to take it for granted when you don´t know anythihng different.

Alas, my time on the computer is up. I hope wherever you are, you´re doing well. Hasta luego :)!

In Granada!

Buenos dias! So 3 flights and a full day of traveling later, we are safe and sound in Granada. After a wonderful dinner with Bekah, Hoss and Mia, we went and watched movies at Kamal´s place so that at max we got about an hour of sleep before we woke up at 3 am so Alicia could be wonderful and take us to the airport. The flights weren´t bad at all because we were all super excited. All of us are doing well except for Kamal who is having an allergic reaction to something. Since we are experts at diagnosing --or because we stalked a doctor at the san salvador airport and he told Kamal so--we think she is having an allergic reaction to some lysol that accidently got into her eye Saturday night. We´ve been flushing it with saline solution but if any of you medical students reading this have suggestions, let us know! We´re going to try to find her a doctor here this afternoon. Other than that, there haven´t been any problems thus far. A taxi met us at the airport from the language school and the hour drive from Managua to Granada wasn´t bad at all--reminded me a lot of India actually. Kristine and Kamal are staying with a family that lives about one block away from the family --Francisca and her husband and daughter--that April and I are staying with. Before my lesson this morning, I just looked at everyone speaking Spanish and smiled awkardly! And ofcourse used the three phrases that my wonderful travelmates had drilled into me during our flight--no habla espaniol being the most handy thus far! We´re having a great time and have access to internet at the langage school so please keep in touch!

hasto luego,
Harneet

ps--the language school has a resident gato and our host family has a perro...and those of you who know my ´love´ for animals know how I feel about that! haha. oh and our host family has a papagayo too...and I swear I heard a rooster this morning! haha =P

A little background information

Hurricane Felix

Nicaragua is among the poorest countries in Latin America and has been struggling to recover from almost three decades of armed conflict and natural disasters. Hurricane Felix, which affected the northern Atlantic Coast, is the latest in this series of setbacks. The area of Nicaragua most affected, the Región Autonoma del Atlantico Norte (RAAN), is historically isolated and underserved due to a combination of factors. No paved road connects the Atlantic and Pacific Coasts. Additionally, the two coasts are culturally and linguistically distinct. The scarcity of resources in this nation combined with the geographic isolation of the Atlantic Coast, have resulted in an especially vulnerable population. Felix, a Category 5 storm, added to this burden (September 4, 2007), affecting over 180,000 people in Nicaragua and leading to over 100 deaths. The destruction of homes, public buildings, and water facilities by Hurricane Felix has led to lasting public health issues and exacerbated disease burdens.

Collaborative Sahsa Health Initiative (CSHI)

The Collaborative Sahsa Health Initiative (CSHI) aims to use a geographic surveillance system to asses the household health care needs in the Sahsa area of Región Autonoma del Atlantico Norte (RAAN) in Nicaragua with an emphasis on the burden of diarrheal diseases. This project will complement current efforts by the University of Nicaragua, León (UNAN). During the summer, 8 UNC medical students will work in an integrated team with UNAN faculty and students and local community health workers to collect household data through developed questionnaires. Following the data collection, the Geographic Information System will allow for the integration of data into a map which can then be utilized to pinpoint disease and health patterns. Analysis with ArcGIS software will provide a foundation for the design of future interventions by UNAN, UNC, and the community. The Center for Epidemiology and Health (CIDS) within UNAN has utilized this methodology for their surveillance system in León, and thus, has extensive experience. Additional information will be collected on the existing health infrastructure through interviews with community leaders and brigadistas (health promoters). Finally, a series of public health workshops will be conducted for these local volunteer health workers on topics including malaria and water sanitation.

Welcome!

Hello, and welcome to the weblog for the Collaborative Sahsa Health Initiative! This is a group started by eight UNC students committed to the development of healthcare infrastructure, clean water programs, and other public health initiatives for the Sahsa area of the RAAN region of Nicaragua. Our project will allow us to work closely with the people in the community to get a sense of their health needs, on what sorts of development projects it would be desirable and beneficial for us to collaborate with them, and to offer workshops on basic practices for improved health. We also plan to work with the University of Nicaragua to engage medical students, faculty, and deans in providing means for improved health and welfare in this region. The members of our group are set to leave for Nicaragua throughout the month of June, some traveling or participating in Spanish immersion programs prior to the start of their work. We'll keep you updated on our travels and adventures from airports, net cafes, and any wireless hotspots we can find! For now, check out the introductory posts from the students who will be participating in the trip.