¿Y Éste? ¿Está Malo?

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.

San Juan Del Sur

Our first adventure in Nicaragua was to San Juan del Sur, a beach near the southern border of Nicaragua on the Pacific Coast. I think the majority of us wanted to catch some rays so that we might even look like we’ve been in the tropics when we come home in August rather than looking like we’ve been in workshops up to our elbows in transistors and solder. The beach is only about 80 miles away from Managua but our average transit time was about 4 hours each way.
San Juan del Sur is a small port town with a hundred small fishing boats anchored in the harbor and just as many independent hotels, bed and breakfasts, and hostels along the mountainous cove to accommodate the tourism and surfing industry. The beach is equipped with very muddy brown sand and knee-high waves (also laden with mud). But, just about 12 kilometers north, Playa Majagual boasts a light sands, prominent rock formations, fifteen foot waves, and deserted beaches.

When we first got to the beach, we went to check out the rocky point of the island. We skirted around the edge of a cliff and crossed a shallow area of water where the point breaks away from the main land. “Wouldn’t it be funny if the tide came in while we are out there?” I asked more astutely than I knew. Neel reassured us that “The tide is usually high in the morning.” Right. Let’s go. Anyways, we trekked around the point and climbed on the rock formations there. I also learned the how to raise waves with sweeping arm motions (inspired by Mickey Mouse in Fantasia). Jordan didn’t master the trick though, and found himself fighting his way back across to the mainland after the tide did indeed cut us off.

Hospital Infantil Fernando Velez Paiz

The Hospital Velez Paiz is the oldest hospital in Managua as it was the only one to stay standing after the earthquake of 1972. The second floor of the old section of the hospital is no longer in use but the majority of the hospital still bustles with activity. The hospital is primarily for children but also houses a maternity ward, a general emergency room, a burn unit, four operating rooms, and an ICU. This time of year (“winter”), there is a greatly increased need for the hospital. For example, the GI clinic typically has capacity to admit 30-40 children but currently has nearly 200 occupants. I did not feel comfortable taking a picture for you all to see but imagine two mothers with their children per crib and chairs spilling into the hallway to accommodate the rest.

At the hospital, my partner Kathleen and I work with a crazy technician who goes by Jonny but all of his friends call him “Pelon (Baldy)”. Fortunately, he has a great sense of humor. We are blessed with an air conditioned workshop and Jonny is incredibly helpful and knowledgeable. Today we fixed the pump motor and drive shaft on a nebulizer and then calibrated a sphygmomanometer and fixed the intake valve (it worked, and I showed off my 110 /85 mmHg). There is no shortage of work though; we were introduced to heaps and heaps of broken machinery. Lack of spare parts is clearly the biggest problem we’ve run into so far. The operating room theatre lights have less than half of the bulbs working and less than 1 in five are the correct wattage and intensity. One of the operating rooms only has a dome reflector light that uses a single ~25 watt energy saver bulb similar to the one lighting my room at my home stay. Let me know if anyone has access to some of these (of course I could find out makes/models)!

Managua, Nicaragua

I made it to Managua, Nicaragua bright and early Saturday morning just in time to... do nothing for the rest of the day. The pace of life is much slower here for some. For others, like Octavio my host brother, life demands near 12 hours of work per week day, a day of English and Technical training on Saturdays and work meetings on Sundays. I don´t envy him.

Our house is located in a small neighborhood called Linda Vista Norte right behind a somewhat famous bakery, La Reposteria Norma (yes, that was my address). My roomate Kathleen and I share the house with Octavio (26 years old) and his mother. The two of them seem to really enjoy having us around as they kindly gave us a tour of Managua and took us to a nice lunch at a typical Nicaraguan restaurant.

We have two dogs at hour house: old docile Canela (cinnamon) and the excitable Laisha (after actress Laisha Wilkins Pérez). While I´ll miss having children in the house, working at the children´s hospital should make up for it. An introduction to the hospital and more pictures to come...

El Terremoto

Costa Rica was just starting to feel like home and its already time to say good bye. The past four weeks have been a blur but I think i picked up a great deal of experience with the language, practical knowledge for the engineering, and had a ton of fun. After school we often played some pickup soccer or basketball in between rain storms. We often played against local guys on this court right in the middle of our residential area. They seemed particularly excited to exercise their repertoire of vulgarities in English and amiably referred to me as "Strong Man."

My only regret for the weeks here was that I didn't get to spend enough time with my host family. Last night we took some time and had some fun with the kids. Jonathan and Esteban were very excited to show off the song and dance they learned from a clown at a birthday party while Antoni was all radiant smiles as usual. They're quite a handful- especially Jonathan (wearing the dress and women's shoes). Flory calls him el terremoto (the earthquake).

City Tour

For Spanish class today, my group hit the streets of San Jose to see how the city was put together and how historical events persist in the architecture and culture of the city. San Jose was chosen as the capital city of Costa Rica for its convenient location nestled in the central valley between the coffee plantations on the west coast and the port cities of the Caribbean shoreline. As a city of government and trade, the city was built around two centers of power on the northern slope of the central valley. The commercial and economic center was based at a railroad and customs complex while the executive power was built around another locus with the courthouse and legislative buildings. Fanning out between the two centers towards the north (uphill) the upper middle to high class houses loom over well-paved streets and thick wrought iron gates. From a given street corner you might see the foreign influence on the upper classes: a German high sloping roofed house with earthy colored trim faces a bright Spanish villa and is backed by the arched and columned frontage of an Italian domicile. As you look southward, elevation and economic status decline sharply.

Costa Rica is one of the three countries in the world with no armed forces. They have been without a standing army for fifty eight years but would proudly tell you longer. As a reminder of the violence and lack of diplomacy that comes with having an army, the last functioning barracks still proudly displays bullet holes on its turret just ten blocks from the center of the city. A section of the Berlin wall serves a similar purpose poised outside of a legislative building.



The morpho is the Costa Rican national butterfly. This one at the national museum is drying its wings having recently hatched. You can just see from the picture the inside of its wings is stunning blue mirrored display.

The 4th and Patines Musica

Three of my favorite EWHers and their host mother, Rocío, baked a double layer American flag cake for the 4th of July. Funfetti cake, vanilla icing, red fruit loops, and an unconventional but intuitive inter-layer bed of sprinkles entertained and satisfied nearly the entire program. Thanks girls!

Patines Musica is your typical Costa Rican roller skating rink. A hard-floored, tin-roofed room substantially smaller than most roller skating rinks in the states (but with twice as many people) reverberated with the sounds of N’sync, Celine Dion, and Bob Sinclair. Patines also seemed to be hosting the national convention of All-Costa Rican doubles figure roller skating- some of the talent there was incredible.