Day 16 6/7/13 (A stuffed van, bribery, Rivas, sketchy microscope slides, a ferry, the American Hotel and Café and dead discos)

Today started off quite early at 5:20 AM as today was our first hospital visit on the trip. After a quick breakfast, Dan and I met the group at the school at 6:15 AM. The “bus” arrived shortly thereafter to take us to Rivas (about an hour south of Granada). The “bus” was really just a sprinter sized van with seating for 17 people max in the back with 2 spots up front for the driver and shotgun passenger. I was the first one in the van and did not feel the space crunch that shortly ensued (keep in mind that we have 23 students and Ron and Alex for a total of 25 people). We then proceeded to start cramming people into this tiny van. At one point one person was sitting on a stool and another on a 5 gallon bucket with a cushion on top! We then squeezed 12 people in a seating area meant for 8 to 9 people max. Seatbelts? Nope! The ride to Rivas after all of this wasn’t terribly exciting save for the scenery and the police stopping us. The scenery was lusciously green trees and fields with the ominous sky above (mixed with some sun). I tried to nap most of the way as I was substantially tired. I awoke to the police stopping the bus. The stop wasn’t for seatbelt checks and wasn’t for overcapacity vehicles, but rather just a routine police stop to check for 3 people in the front (as this is illegal). The police didn’t really seem to have any qualms about the horde of 24 gringos in the back, but started asking the driver for his license and registration and started badgering the driver. The driver eventually just reached in the glove box and grabbed a 100 cordoba bill and put it in with his license. We left shortly thereafter.

            We arrived in Rivas not too much later and piled out while Alex filmed the affair. After some waiting at the entrance (while Alex attempted to locate our contact in the hospital), we headed inside with the second in command of the repair shop (the main boss had chosen to head to Managua for the day). We headed through the maze-like single-floored open-air hospital to the repair shop (located in the back ironically sandwiched between the cafeteria and the morgue). The corridors to the repair shop had carts, tables, beds, cabinets and light fixtures (even a baby incubator) in various states of repair just heaped along the walls.

 

This serves to further highlight developing world hospitals and how they try to reuse as much as possible and scavenge for useable parts; unlike the US where the hospitals order primarily new parts and toss out old equipment (this strategy in developing hospitals reminds me of Hillendale a bit). The repair shop had 2 main areas: 1. A boiler, water and electricity room and 2. The small technician workspace stuffed with old units (such as defibs, ESUs (electrical surgical units), centrifuges, gas bottles, AC unit and aspirators (suction machines)). The older units were caked in dust with piles of spare parts scattered around in bins. We divided the group in half to have one half tour the hospital while the other stayed and puttered around in the shop. I stayed with the group in the shop. Alex showed us several pieces of equipment (an aspirator and centrifuge) and then we were free to poke around and take apart a centrifuge. My sub group of 5 people (Evan, Graham, Ray, Josh and I) took apart the centrifuge down to the motor and even fixture the motor in a vice. We even tried troubleshooting the motor and found two problems: 1. The motor lacked brushes and 2. A fuse on the control board was blown out. Unfortunately, we couldn’t repair it as we had neither of the parts, but we found some problems to work off of next time. Our group then toured around the hospital with the “boss” for the day (we had to put the centrifuge back together). We toured around the hospital and saw the different areas (the maternity ward, the laboratory, the medicine wing, the gynecologist room for some reason, the orthopedic wind, the x-ray section, the ICU and the regular rooms). The x-ray area was first as the “boss” wanted to show us the newest technology they had in all of the hospital which was this new computer catalog and x-ray processing and printing room (complete with a monitor, scanner and printer (actually legit new tech (only a couple years old!)). We then saw several of the x-ray rooms (with various technological levels). We then saw several ultrasound carts to check babies in the womb (again various levels of functionality) (I even noticed a nurse on Facebook). I also noticed the special rad (radiation) badges the staff were wearing (I remembered my paper on fluoroscopes that I wrote for Prof Faber at WPI). We then headed out to visit other areas such as the lab where I saw this wicked sketchy bin of microscope slides in a biohazard bin filled with blood and water O.o. We kept meeting all of the bosses of the individual areas and all of them were women (except the repair shop). We even stopped by the ICU for a bit to check out some non-functional ventilators and I was standing close to a curtain with what I think were blood stains, so I moved further away. One interesting thing I noticed was that the initials of the ICU were backwards on the door so it said UCI. I also noticed the same was done on a poster about HIV (where it said VIH) O.o. We rejoined the group and then identified a few more pieces of equipment with Ron’s help and headed off to start our weekend adventures. Mark, Evan, Kathik and I were heading for Ometepe (an island in Lake Nicaragua).

            Mark, Evan, Karthik, Alex, Ron and I grabbed on taxi to the dock in San Jorge. We again squeezed 6 people into a taxi meant (think Tuk Tuk, but worse).

 

The ferry was at 2:30 PM and we had about an hour until it arrived at San Jorge. We enjoyed a relaxed lunch (fried chicken, salad, B&R and French fries for me) before heading to the ferry. The ferry itself was a decently sized 3 leveled ship with a larger cargo space on the rear part of the boat where motor vehicles could drive on. Obviously we headed for the top deck (Mark, Evan, Karthik, Ron and I). After the 2 cars and 2 trucks piled on, we steamed out into the decently choppy Lake Nicaragua. The lake wasn’t quite choppy enough to warrant Dramamine (as I liked the waves). The top floor was the gringo floor and at one point a clown was even making balloon animals on the top deck and playing this game of hot balloon ring (hot potato with having to pass a balloon ring over one’s body from head to toe). The ferry ride was quite tranquil and only lasted about an hour (and only cost 70 cordobas).

The two volcanos of Ometepe (Concepción on the left and Maderas on the right)

After landing in Moyogalpa, Ron departed for his hotel while Mark, Evan, Karthik and I headed to this awesome place called the American Café and Hotel run by this older couple named Simone and Robert. Robert is the thinnest guy I have ever seen and must smoke at least 2 packs every day as that’s all he ever does. Simone is this little old woman with white hair like Robert’s and is from NY and makes good chocolate cake. The room was really spacious and had 3 beds, 3 fans and a private bath and was its own entity from other rooms in the courtyard area (the room had this spacious log cabin feel about it). Bob and Simone built these rooms when they bought the place 7 years ago. We dropped our stuff and headed to this local pizza restaurant where Evan and I had this epic tomato, pepperoni, salami, oregano and onion pizza for like $5 each (the room cost $12.50 a person per night). After dinner we just chilled. I asked Bob about the two clubs that were located in Moyogalpa (one was purportedly a rockin’ dance bar while the other was a disco tech). Unfortunately, the disco club had closed down (as it was right across the street almost) and hadn’t been open in months for a dance. The other place (Johnny’s or Yohnny’s Bar) was still open and Evan and I checked it out on Saturday night. The reason these places closed down is that most of the 35,000 residents are poor sustenance farmers who could hardly afford the beers there. Johnny’s was only open on Saturday nights and Sunday nights (Saturday for dancing and Sunday for cockfights). We headed to bed shortly after that as we had to get up at 5:30 AM to go hike Concepción at 7:40 AM).