Day 37 6/28/13 (Day 1 at the hospital, fluorescents, working with relays, a dead hot plate, an equipment graveyard, no power, a darkened fiesta and chilling with the family)

Day 1 at the hospital was interesting. We showed up at 8:05 AM and the guard at the gate told us to wait over by the ambulance for the head of maintenance, David Diaz Marlon (as listed on the paper of our hospital contacts). It turns out that his real name is Marlon David Diaz (oops on the paper on that one). Anyways we ended up waiting for close to half an hour and met this guy nick-named “Gato” who is a chill dude that does a bunch of smaller maintenance issues around the hospital. Eventually we met Marlon and he took us on a mini tour around San Carlos in a truck (and showed us the bank, market, bus stop, Río San Juan and the beach front with a setup for a huge fiesta tonight). We then got back around like 9:15 AM and we went out with Gato to go install a couple of fluorescents in the ceiling. We took 6 lights and headed off toward the OR and the dressing room for the OR. Gato put in two new lights in the hallway and one of the changing rooms and then suited up to go in the OR (leaving us behind) and taking two more lights. Dan and I then wandered out a bit and put another light up in another hallway and called it a fix. We also waited for Gato to return and looked around a tiny bit (basically just standing in the hallway and looking around). We hadn’t really seen all that much this morning (the hospital is rather small and rather up to date it seems. Anyways one major thing I noticed was many gas canisters standing up without a chain around them or the safety head on them (ready for takeoff). There were a ton of oxygen bottles though (basically every canister we saw was an oxygen one). After the fluorescent job, we headed back to the repair shop where we’ll be working in the coming month. This is in the same room as the new generator (only 2 years old) for the hospital and basically we started with just one table and a shelf already covered in parts and old pieces and some tools. We quickly covered the table with our tools and bags and then started to dig into the old machinery piled around between two storage trailers. The two trailers are the property of SILAS (the medical administration in the area that runs many clinics in the area and the hospitals) and contain some medical equipment that we were not allowed to see. In between these two trailers was this rectangular pit (maybe 30 foot by 4 foot by 4 foot) filled with about a foot of water in the bottom. This seemed to be a place where cars could be rolled over the pit (with their wheels spanning the gap) and the stairs at the end of the pit could be used to walk beneath the car and allow servicing of the vehicle’s underside. Around this pit were piled old medical equipment such as old balances (probably around 8), several wheelchairs, two infant incubators, many feet of old electrical wiring, several air conditioners, dead examining tables and hospital screens, old covers for incubators and some other random items (microscope, electric calculator/adder/printer, surgical lamp). Most of this equipment looks completely old and caked in dust or rust and missing any sort of working condition. Dan and I started picking through some of the equipment to see if there was anything we could start working on as we had nothing to do right away. There’s a nicer wheelchair that we’re working on right now that just needs some WD-40 and some new tires. I started to work on the controls for the incubator with the most obvious issue being the relay connector that was completely cracked in half and broken (this relay connection is a plastic housing that accepts the circular arrangement of 11 pins and then slots into the base that has the wire terminals). The base was cracked and the relay had been pulled out (removing several of the wire terminals from the housing). I took the relay housing from an older incubator and epoxied the connector back together and set the piece to dry for Monday. On Monday I will re-wire the pins for the relay and then connect up the incubator controls to test the unit. Also during this time we found a hot plate missing a power cord and quite rusty from the machine dump. We saved this piece for later. Partially through taking apart the relay connector, another guy working at the hospital came over and started talking to us. He actually is called Barney and works as at hospitals as a trained technician fixing more specialized equipment like x-rays, ultrasounds, MRIs etc. We told him about what we were doing here and told him a bit about the projects we were working on (the incubator and the wheelchair). He asked if we could fix x-rays or anesthesia machines (we think we can fix minor things on anesthesia machines). Anyways by this time it was lunch time (around like 12:30 PM) (we also only were supposed to have a half day of work today for whatever reason (probably the large fiesta tonight)) and we headed off to a local house to eat some lunch (literally just a house where we sat down and had B&R and chicken and coke). After the meal Barney went off to talk to the family and then we just left without paying (don’t know if we were supposed to pay or whatnot because Barney didn’t say anything about it and the family didn’t either (think we heard something about a tab or something)). After lunch we met up with Marlon to take a tour of the hospital and saw the lab (complete with like 4 pieces of equipment), the medicine ward a bit, the main ward for ultrasounds etc, the washing and sanitization areas and kitchen area and OR (not actually inside the OR). He showed us several autoclaves that we’ll probably have to work on in some capacity (either cleaning them or trying to fix them) and showed us a huge washer that has bad and incorrectly sized tubing. There did not seem to be much of any equipment around the hospital (nowhere close to the 88 pieces listed in the inventory from last year). Anyways we returned and continued working on the different projects. We also got to see another workshop filled with old equipment (Defibs, old gas bottles strewn about, printers and old ECGs). We also started sanding off the surface rust from the hot plate and cleaning the heating element. I worked on getting a new power cord for the unit, but the cord was not grounded (-.-) but we continued anyways to test the unit. After a ton of sanding on the element and the interior case, we tried the unit (after soldering the new power cord together). The unit did not work. It would not get hot at all despite being on the hottest setting, so basically we junked the unit and called it a day (considering the heater element didn’t really even have a connection through the element). After cleaning up a bit, Dan and I headed for home at like 4 PM and watched part of the parade on the way home to the hostel where we are staying. Since then have been chilling without power and talking a tiny bit to the host family. Initial hopes for the hospital are a bit depressed as there does not seem to be all that much equipment as most of it seems to be sent to Managua to be fixed (and we haven’t seen all that much either). We’ll see on Monday though. Perhaps when we try to do our inventory or talk to the director we can find some more equipment. Also the two technicians are out of town, so we have to wait to meet them until later. We came back to the house and the power was out. Fortunately it was still light enough outside that it didn’t really matter, and we talked to the family a bit. We even went down to the docks to check out the fiesta which was hilarious without lights and people dancing onstage and this weird like marriage skit with a dude in drag and the other guy getting beat up by that dude. We got some cokes and came back and talked for a while in the dark with candles. Dinner was good (carne asado, B&R and plantains with iced tea and water). We talked about the canal a bit and the problems down here (not that many actually and the place is quite nice). We also talked about the power down here how it’s much cheaper for power and to live. Normal things. The power was supposed to come back on at 11 but it came on at 8:50 PM. Been a chill day. Watching Iron Man 1 in Spanish.