One week in. Rucksack and Lonely Planet down

Trip Start Aug 07, 2008
Trip End Oct 25, 2008

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Flag of Nicaragua  ,
Thursday, August 14, 2008

Here I am again. Firstly, sorry for the lack of photos, but I havenīt been organised enough to ever have my camera & cable & enough time in an internet cafe (actually I did this morning but internet was down in the whole town), so youīll still have to imagine what itīs like rather than seeing photos.

Firstly, word has obviously spread before I even write this. I had my backpack backpack and the Lonely Planet inside stolen on teh second day of placement. Nothing particularly valuable (though quite useful, yes). I left it in the hospital in a seminar room that is normally locked and only opened up by the chief resident or a consultant. However, that day I saw the consultant take a group of students in with him so it must have been one of them. Nobody is particularly sympathetic as they have all had stuff stolen before. I now take nothing more to the hospital than I can keep in my pockets.

The placement is going well. There are lots of medical students here, including about 7 other Europeans! It seems there are 10 students per consultant, so when consultant-led things are going on (like ward rounds and endoscopy) there are about 20 people in the room! This is made worse by the fact the junior doctors just look after different rooms in the ward, not for a specific consultatn, and all come on the ward rounds too! Fortunately, consultants only work for a few hours a day in the public health system, so itīs much quieter the rest of the time.

The cleanliness of the hospital is atrocious. Paint is very old and flaky, there are big holes in the walls (some of which have electical wires coming out, some have cokroaches). Floor tiles are cracked or missing. No part of the hospital is in a better condition, not even intensive care or the operating theatre. Despite this, the medicine is more advanced than I thought it would be. They have a lot of the basic drugs, send out a lot of blood tests and refer lots of people to endoscopy of ultrasound (no CT or MRI, not even abdominal X-rays). What iīm enjoying most is the surgical emergency admissions room, which is like a cross between a casulaty department and a surgical admissions unit in Britain. They have promised a lot of hands-on experience. I have already sutured a 1-year olds scalp. It was not the best first real live case to do it on, as he was continually moving his head, even with his mother and a doctor trying to control him.

The social scene is good too. There are lots of Europeans/Americans staying here for long periods of time, either volunteering, studying Spanish or at the university. There is a kind of gringo community in the town, with popular local joint (like La Olla Quemada on Wednesdays for live latino music, very good). Itīs good to be able to escape from local life, though thereīs greater possibilties for this than I thought. I donīt go out much though, as I start in the hospital at 7am, and have to get up at 5.45! This isnīt too bad as iīm always woken up around that time anyway by the roosters in the neighbourhood and the woman who acts as the neighbourhood alarm clock, shouting "el sooooooooooool" every morning (I think people pay her for this service!). This means normal bedtime is about 9.30pm, so I feel exhausted by staying up last night until almost midnight. Today is a regional holiday (which means a half-day off), where they celebrate the time that the Virgin Mary stopped a volcano from raining ash on the city. The festivities start in half an hour - I have been promised many sweets.

So, got to go now, hope everyone is well
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