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 !!!
Monday, July 28, 2008
Tuesday, July 22, 2008
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...
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 6th (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 29th 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.
Sunday, July 20, 2008
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.
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.
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