Bringing the second week of working at Hospital Velez Paiz to a close, Kathleen and I have put quite a few techniques under our belts and have fixed a number of machines in high demand by the hospital. Ranging from dismantling an orthopedic surgeon’s sagittal saw to climbing on the roof to repair the hospital administration’s phone lines, we’ve seen and done quite a bit. Check out the deserted second floor of the hospital. Juanpe has 4 years of technical experience and has largely learned by teaching himself or picking up bits of information from professionals that travel through the hospital. He has worked at the hospital for 10 years and is very knowledgeable about how the place works, as he gets to see every part of it daily. He also knows all of the doctors and administrative staff very well so he is an incredible asset to us while we’re getting our feet wet. He usually works with a partner, Roger, who is out on medical leave with a broken hand (defended himself against two would-be muggers) so he is happy to have our help.
By far the most common items brought into maintenance are the nebulizers. Some of them are even broken! About half of the time though, the only fix needed is a quick two or three minute crash course for the staff on the item’s use and care. Other times, the fixes require us to manufacture tools or new mechanical parts such as corner supports for the sides of an infant warmer (arc welder) or replacement valves for a manometer. The vast majority of broken equipment comes from misuse. So much that Juan says there is a saying in Nicaragua that “La gente es un estómago; porque convierten todo en…” (The people here are a stomach; they turn everything into…). Although there is a lot of misuse of equipment such as extremely oxidized leads on things that should be kept dry, things that aren’t kept clean, and things that don’t receive the maintenance they require, I think Juan’s saying is a bit harsh. The hospital’s equipment is nearly entirely comprised of donated equipment from several different countries, with instructions in several different languages (when they are included). It’s no wonder such a simple thing as a plugging in an adapter to charge a battery is a cause for confusion. 
It's an incredible feeling when we bring an infant warmer back to the neonatal ward and they immediately put a child in, or hearing how our phototherapy lights work much more effectively than the others they have. "Vengan mañana y vean como sale el amarillo" (Come in tomorrow and see how the yellowness fades) they tell us excitedly after we hang the bilirubin lights.
