This was the earliest morning for us in Nicaragua, not including our departure from Logan. We left the hostel at 6 am, traveling on a local bus for two hours to reach El Sauce. On the bus we observed one example of how poverty impacts local Nicaraguans. A boy, about nine years old, was selling tomatoes and onions to help provide for his family instead of attending school. Food for thought when you look down at the foods that color your plate and whose hands they passed through to get to yours.
The hospital here opened in the last year in response to the need for more sophisticated services in this region. Prior to this past year, the nearest hospital was Heodra in Leon. Despite having the capability to perform surgery, there is no night staff for after-hours surgery. Night trauma would require the injured individual to travel for one and a half hours for treatment. The hospital is also grossly understaffed with 51 openings in all medical specialties, nursing, technicians and social services.
El Sauce is not a small, rural community either. A point of comparison would be living in Worcester, but having to travel twice as far as Boston for care. Imagine if you were an eclemptic woman requiring a c-section and what your chances are for survival in that situation. That is the reality here.
Despite such limited resources, a growing theme on this visit is how effectively the Nicaraguans utilize these resources, and the knowledge they have. They attempt to fill in the gaps by drawing on the community and their organization skills. Maternal care here is superb. They know every last detail about the patient and family. If an expecting mother misses an appointment, someone visits her in the community to ensure that she is in good health. Knowing about this program for mothers was very uplifting and deepened my respect for the health care system in Nicaragua.
