A Crash Course in Nicaraguan Healthcare

This week I ventured outside the confines of my educational focused internship to learn more about Nicaraguan Healthcare – out of necessity. Victoria and I visited Granada and the Island Ometepe this past weekend and although it was a very enjoyable time, we both returned to León with a few scrapes, bruises, and some road burn. As we only had a very limited time on the island, we talked to a few Nicaraguans and tourists about the best way to see the island – the overwhelming response was to rent a motorized scooter to visit the different culturally significant towns and the scenic, refreshing natural spring, “Ojo de Agua.” As Victoria had experience driving a motorized scooter and the island had only one road, we went right ahead and rented one for the day. Until we hit a sandy speed bump and our scooter fell over an hour into our journey, we were having a great time and really did see a lot of the island. We found sites with beautiful views of the Island’s two volcanoes and got to see the natives’ cozy, brilliantly painted homes.

Luckily we were going very slowly when the scooter swerved and fell, so the damage was a lot less severe than it could’ve been. The motorist behind us (who we later found out was an Island policeman) stopped a lot more gracefully than us to make sure we were okay and even spoke to me in English briefly before driving off. Immediately after our spill, a Nicaraguan family rushed out of their house to help us, inviting us in to use their shower to clean up our arms and legs. Helping each other, we got all of the dirt off our cuts and stopped the bleeding. I have a scrape on my foot and a road burn on my knee. Victoria is a little worse for the wear, with a matching road burn on her knee, an additional burn on her arm, and scrapes up and down her leg and arm. I was completely floored by how nice the family was and how eager they were to help us considering we were complete strangers. The whole family was involved – the elderly grandmother muttering “pobrecitas” (poor things), the little son with his eyes fixated on our wounds, the daughter around our age wincing as we cleaned them, and the two mother-figures of the house (most likely sisters) giving us advice on how to proceed. Although they had no Band-Aids in their house (or their family store), they directed us to the Health Center a little ways up the road for additional care. With no other means of transportation, we got back on the scooter in search of Band Aids.

The Health Center ended up being a lot less welcoming and helpful than our random encounter with the Nicaraguan family. I think a foreigner visiting the small island health center is a rarity, especially with very evident injuries, so we were greeted with stares from the Nicaraguans waiting to be treated. The children pressed their faces against the window into the treatment room and peered in at us. Granted, they did treat us quickly, in fact before all the other Nicaraguans waiting outside. Initially, I did feel guilty about this, as I think the fact that we were “gringas” gave us an express ticket to the front of the line. However, even in emergency rooms back home, those in need of the most immediate care get treated first, and we were the only ones with visible wounds. I wasn’t about to turn down speedy treatment even if it arose from a mixture of my privilege and the doctor’s urgency to get the foreigners out of their hair. Besides the speed, I have very little positive things to say about the Health Center. The woman only cleaned our cuts and repeatedly insisted that the center had no Band Aids or anti-infection cream to give us even though we had to drive on our scooter about an hour back to get back to our hostel and return it to the rental company. Persistent as we were, the woman reluctantly gave Victoria two Band Aids and wrapped my knee with gauze. We left without paying anything, as healthcare is free in Nicaragua, but not before two doctors tried to convince us we needed some newly discovered vaccine, which would’ve cost money.

Now that I’m back in Leon, on the hunt for large Band Aids, I realize just how rare they actually are here. Not a single pharmacy I’ve walked into has anything but small ones, apparently so insufficient for my cuts they refuse to even show me the box. I’ve had to stick with gauze instead. I can understand the perspective of the doctor at the Health Center a little bit more now. Obviously supplies are very limited and they can’t hand them out liberally. That being said, I’m surprised they didn’t simply charge us for bandages, as we were both prepared to pay if necessary. I kept asking her if there was a place nearby we could buy bandages to give her the idea I wasn’t looking to take advantage of the Health Center’s limited funds and supplies. Regardless, everyone here, from my host family to the teachers at Las Tais to the pharmacists, has strongly advised against bandaging my leg to let it dry out in the air. I don’t have much experience with this kind of injury, as I’ve previously stayed away from scooters, motorcycles, and the like. Thankfully, there are at least two pharmacies on every block and pharmacists actually serve a role fairly equivalent to doctors in the United States. You don’t need a prescription for anything and pharmacists are very knowledgeable and willing to assist anyone who walks in. Which means I spent a good deal of yesterday lifting my knee to show the pharmacists over the counter and ask their advice.
Victoria and I also consulted with a Nicaraguan doctor thanks to one of my host sister’s American husband who runs a nonprofit here. He brought us to the doctor he uses for his organization. It was a house visit and more of a favor for a friend than any official visit. She gave us some additional advice, chastised us a bit for not coming to her sooner, and confirmed the medications we were using and applying were correct. This kind of consultation isn’t common protocol here in Nicaragua – it’s normally just home treatment, advice from pharmacists, and when it gets bad, a trip to the clinic, where we’ve been told they’re quick to get out the knives. Nothing quite gives you motivation to keep a cut clean and healthy than the alternative of having the infected area scraped out with a knife in a foreign clinic. But not to worry, concerned readers, family, and friends; Victoria and I are healing and taking care of ourselves!
Everyone here has definitely taken notice of my leg and has been eager to help, even a woman in Leon’s central park where I stopped to rest after work. I wanted to clean out my cut a little bit before continuing home and she asked what I was using and recommended an additional product to help fight infection. I consulted the pharmacist before buying it and turns out it’s a spray widely used for this kind of injury. Small advice, help from well-meaning people, and a Skype session with my family made me more confident in taking care of things for myself.

Unfortunately, the cuts on my leg have also given the Nicaraguan men a little bit more material to work with when I pass them on the street. The first morning after I walked the block and a half to the bus station I got a few more kissy noises than usual and one “baby what happened to you?” from one particular man putting his English to good use, as per usual. But that aspect of Nicaraguan culture is a whole different story (stay tuned for further blog posts).

Rest assured, I’m not planning any further physical investigations into Nicaraguan Healthcare – I’ve definitely had my fill of adventures in that department. For now, I’m taking it easy, staying away from motorized bikes of all kinds, and focusing on making the most of the time remaining with my work placement.

Kerry Mullen ’16