Arrival in El Sauce

So here I am in El Sauce. No wi-fi so I can´t upload pics until I´m back in Leon or someplace, but I did find an internet cafe. The group from UNC is great- very friendly. I came in with two NPs who are on faculty there, and the students have been here for two weeks already- from the schools of nursing, medicine, and public health. They are already fantasizing about what restaurants they will go to when they get back to Chapel Hill! That being said, the place we are staying, Hotel Blanco, made a really tasty lunch and dinner today.

We arrived in the late morning and I toured the clinic today- even saw my first patient! It is definitely a whole different infrastucture, from a lack of imaging to limited labs and meds. Many of the illnesses on the differential for common complaints like fever are things I have never seen before and have spent limited time studying (much of it last weekend). So my perspective is that I am going to do my best to learn from the doctors here how they practice medicine and perform that to the best of my ability. However, I have a feeling that sometimes I will be wishing I could say “let´s get a scan!” I am going in early tomorrow morning to get a better lay of the land and orientation to the supplies available. I´ll be honest- my first full day tomorrow is an intimidating prospect! It will be a different world and I am hoping to adapt my practice quickly but safely to this new environment. I will keep you updated!

My strangest ever museum experience

Hello there again-

Just wanted to get in another quick update before the work starts in the morning. Today has been a pretty chill day- no fireworks here- as I prepare to head out to El Sauce in the morning, reading a bit on malaria, etc.

So there was just one stop today- but it was a stop that I won’t soon forget.

There is a “Museum of myths and legends” which happens to be found in the same building where Somoza’s notorious Guardia Nacional imprisoned and brutally tortured their political prisoners. So the museum tour is a bit schizophrenic, with content in each room that mixes the fantastical with the truly heart-wrenching.

My experience was made even more surreal by a very sweet older gentleman who could win the title for most confused tour guide ever. He wasn’t sure on the details of all of the legends, but made sure to point out the place that the prisoners used the bathroom- in every single room.

Things start out with a display of historical figures which appear to be homemade of paper mache, then you get into the truly bizarre, as the tour guide will tell you, for example, the legend of a woman who walks around with her breasts exposed trying to lure men, while in the next breath explaining various methods of torture, which are conveniently illustrated on the walls. In any case, it is surely a can’t-be-missed, unique Leon experience.

Since I really didn’t learn much about legends, if you are interested I am including a link to another traveller’s blog; apparently she had a different tour guide.

http://www.travelpod.com/travel-blog-entries/margreet98/1/1230340200/tpod.html

Enjoy the pics- next post from El Sauce!
- Dra MV

The one on the left is supposed to be Ruben Dario. I’m not sure what the little soldier man has to do with anything…

Some of the illustrations of torture methods. I spared you the more graphic ones.

This illustrates the legend of an indigenous princess who was sealed into a cave by her conquistador boyfriend after she gave him her father’s gold. Note the incongruous illustrations in the background of daily prison life.

It was pouring while I was in the museum, and the street scene outside made me nostalgic for Charleston.

Sightseeing in Leon

Hey there everybody!

Isn’t the internet so freakin amazing??? Here I am in Leon Nicaragua blogging wirelessly and then you guys can see it immediately! Crazy stuff, right? I have to say that it is pretty cool and helpful to have the blog, being that I’m here alone. Makes me feel like I have some company

So as I mentioned, I am leaving for El Sauce (pronounced SAW-say) early tomorrow morning. So the great thing is that I had the whole weekend to get to see at least a good part of Leon. It is known in Nicaragua as a university town and a center of liberal (and sometimes Sandinista) thought. Granada is kind of known as the wealthier, conservative place. apparently this rivalry has a serious history, and Managua was chosen as the capital to help quell actual battles and stuff. I’m pretty historically imprecise at this time, but I am going to be learning more politics and history as I go along

Yesterday I had two major destinations:
1. the Cathedral
- This is the largest cathedral in Central America and the 3rd largest in all of Latin America. Ruben Dario, a poet and the most famous son of Leon, is buried here. But for me the most unique thing is that they let you walk around on the roof!!! With a guide, but for real you can walk all over the place! I had a great guide who taught me a lot of things, some of which I haven’t forgotten yet.

2. Fundacion Ortiz Gurdian
- This is a really awesome art museum. It focuses on Latin American artists, but it also has some European stuff, including some Picasso sketches. It has a large modern collection, and with the help of another really nice and informative guide I even “got” most of the contemporary stuff. It also has really pretty gardens in the patio area, which are the only part you can photograph. My favorite was a work by Faldero which combined Picasso’s Guernica and Velasquez’s Las Meninas as a juxtaposition of wartime and peacetime images of Spain. Apparently I have bad taste in art because I was unable to find it on an extensive google search.

Art lovers can see other works and get a sense the variety at their web gallery: http://www.fundacionortizgurdian.org/fundacion.es

Then I went out to dinner for Dr. Delgado and his lovely family- he is an Infectious Disease specialist who I met when he was doing a course at Duke. We went to a really great asado place (grilled pork and steak). Yum! We had a great time talking about life in general as well as medicine, as both Dr Delgado and his wife are physicians who have at times worked abroad in the US.

I hope you enjoy a small sampling of the images I captured yesterday- with my new camera (thanks mom and dad). And oh yeah, I keep forgetting, happy 4th!

In the belltower!

A view of the town’s main plaza from the roof of the cathedral

From the back of the cathedral- those are volcanoes in the distance. You can get guides and climb them, which is probably safe, as they “aren’t that active.”

The front of the Cathedral

Best street food ever- two ripe mangoes cut up in a bag for 5 colones (that is slightly less than 25 cents)

Biggest freakin papayas ever at the grocery store

At the asado place with Dr Delgado and family. I had a great time! Thanks guys!

First full day in Nica!

Hello all-
So things are starting to come together. I’ve got my bearings here in Leon (thankfully the giant cathedral in the center of town is visible from about anywhere so that helps). I am, however in new accomodations. I was reading in bed last night- yes the “princess bed”- when I saw something that I have learned to fear and hate- a BEDBUG!!!! Ewwwwwwww. OMG. I have spent hours and days trying to eradicate those hateful little creatures from first my brother’s apartment, and then my own apartment in Charleston. Successful on both counts, but man is it a pain. So the last thing that I want to on my trip is to start bringing along creepy crawly passengers in my bags! Once I saw and killed the one on my pillow and examined it for a positive ID, I looked around and found some more, one alive and some dead. At this point it is 2am. Luckily the folks there were really nice about it, found me another bed to sleep in (on a top bunk in a multi-person dorm room filled with male backpackers, but still). They had the decency to not charge me for the night, so I had the decency to remove the hostal name from my blog. Anyhow, I am now at Hotel Los Balcones- about double the price but at this point I’ll pay for bug-freeness.

Today I went to the hospital/ med school in town to meet with Dr Matute, the Dean, who is a very nice guy and even gave me his personal cell number just in case I need anything. I also met with a local public health director, Dr Pena, who is doing a huge epidemiology project in Leon as well as some rural areas of Nicaragua- this has been in development since 1991 so they have a ton of data and have gotten some interesting publications. I am going to meet up with a group of UNC students in a rural town called El Sauce on Monday and spend 2-3 weeks working with them on this and seeing patients in the local community health center. Apparently I need to read up on dengue and leptospirosis. Anyhow, the epi data collection is just getting started in El Sauce so I’ll get to see how they lay the foundation for this kind of research. I met some faculty who will be in El Sauce and it looks like it will be an amazing opportunity. We were originally supposed to go to an even more rural and remote locale called Sahsa, but apparently there are some anti-government protests going on there so they switched up the destination (did you hear that? It was my mom’s giant sigh of relief).

I also wandered about and just got oriented, snapped some photos as I did it. Photo #1: typical street scene that I snapped while buying a charger for my new cell phone (thanks David Ming!). Photo #2 is a much less health-promoting version of a SHU box post (a friend’s blog)- fried plantains and a beef sandwich. Photo #3 is what you get when you ask for a fruit juice “to go.” I kept looking for the goldfish.

- Dra MV

Bienvenidos!

Hello all! Thanks for coming to check out my blog! I am new to this whole blogging thing so all comments are welcome!

So here’s the update so far:
I arrived in Nicaragua this morning and was promptly picked up at the airport as arranged by Julio, a friend of previous Duke residents who came highly recommended (juliotoursnicaragua.com). We went from Managua (only international airport in the country) to my new temporary home of Leon, about an hour or 90 min away down a two lane highway which we occasionally shared with men on horseback herding cattle. I could see all of this out of an incredibly clean windshield, thanks to the folks who performed unsolicited windshield cleaning at almost every stoplight in Managua.

Anyhow, Leon seems like a pretty cool place- not that I saw much of it today! I seem to have inherited from my mother the inconvenient propensity to delay trip preparations to the extent that I am obliged to stay up all night prior to a major trip. Although to be fair I have just wrapped up a five and a half week stint in the NICU; that’ll keep you busy. So photo #1 is my pre-departure, “just took a shower out of mercy to my seatmates cuz I just stayed up all night packing” shot. Photo #2 is a shot of all my luggage for 2 1/2 months of Central Ameican fun (including 1/2 suitcase of medical supplies).

So when we got to Leon, Julio patiently drove me around as I looked for a decent place to stay. Didn’t take long; our second stop was a hostal, where I found a private room with attached bath, wifi, and after some negotiation included breakfast, all for about 17 bucks American peer night. Hence pic #3; with some imagination it is less a mosquito net and more a princess bed . Anyhow, no a/c but a perfectly servicable fan; and no hot water- but really who needs hot water here if you don’t have a/c?! So as you might imagine I spent the day asleep mostly- sort of like postcall but with far less mental exhaustion. Via Via has a restaurant-bar out front, so after I woke up I enjoyed my first official plate of rice and beans and then got to figuring out this whole blog thing.

That’s all the excitement so far. Tomorrow I’m planning on stopping by the hospital to drop off some paperwork and get oriented, as well as wander about town looking for a place to rent long term. Hasta luego! – Dra MV