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Wednesday, July 1, 2015

MEDICOS Nicaragua 2015: Rural Life in Sabana Grande

Living in Sabana Grande + Other Thoughts

I dozed off on the bumpy bus ride with the cool outside air grazing my sticky skin. We were on an old American school bus that was turned into Nicaraguas greyhound equivalent. On the bus we were accompanied by chickens, parrots, clowns (yes, clowns. Ugh, I nearly pissed myself), and the occasional vendors that hopped on and off selling things like candy and enchiladas, to metronidazole and mysterious cure-all meds.

"Solar Centre! Muchachas!"

We sprung up from our seats collected our belongings and rushed off disoriented. We were finally at our stop, and as the bus started leaving we had a panic attack as we spotted Andrea sound asleep at a window seat. Some bus banging and yelling later, she sprinted out of there as the locals on the bus chuckled at us. As she was hands on knees recovering, I looked up at the beautiful green undulating mountains (yes, i thought of the sketchy micro Brucella video) and sprinkling of small tin roof houses. We had arrived.

A Chicken Bus (Greyhound equivalent)

We were in Sabana Grande, the region in Totogalpa where we stayed with host families, held training sessions for the Brigadistas (volunteer community health workers) and worked in rural community clinics. It was peaceful with butterflies fluttering with the cool breeze, a welcomed contrast to the hot, humid, and polluted León.

We ate our first meal at the Restaurante Solar, a restaurant that cooks with solar energy thanks to grupo fenix and the university of engineering (they've made quite an impact- read more here).
We met our host moms, and went to our homes for the next few nights. I stayed with Andrea just a stones throw from the Solar Centre with beautiful fruit trees, turkeys, chickens, a puppy, and a sweet little 2yo girl. 

View from the bedroom door

Our host families fed us breakfast and dinner and welcomed us into their homes. To summarize the things you may be wondering about: Families- variable, but imagine rural Nicaraguan families at their highest and lowest points, then insert American medical students. Houses- variable between tin roofs, mud walls, cement bricks, and anything that was available. Food- dependent on family but could be fruits, fried meat filled tortillas, pasta, eggs, soup, rice and beans. Toilet- a wooden outhouse built with a stone toilet covering a deep never ending hole. Shower- a fresh bucket of water in a little shower booth open to sky (I actually really enjoyed this). Imagine all of these things and insert lots of bugs- flies, cockroaches, beetles, and more flies. Mosquitoes? Definitely. Dengue? Yepp. Chikungunya? A ton. Trypanosoma? Oh yes, and if you find a kissing bug make sure to catch it and put it in the drop box found at your local clinic.

Uproot a bunch of med students from the city of Sacramento and plant them with different families and clinics in rural Nicaragua, and you get a ton of different reactions.

For me, this was a chance to reflect. Growing up in San Francisco, and now living in Sacramento, I forgot how much our lives are overtaken and pretty much controlled by technology and convenience. Grocery stores and hospitals are abundant. Clean water comes right to your home. There's internet everywhere. You can order something off of Amazon and get it the next day. We forget how privileged we are to have these things at our fingertips. We forget how we have manipulated the land and resources to make these things so available and convenient to access.

We forget these things, until we find ourselves at the mercy of mother nature herself. At a place where all of those man-made conveniences are far away. It's hard to describe, but in Sabana Grande we were living a life somewhere between backpacking in a valley, and a small town with limited electricity and water- a vulnerability that most of us had never experienced before.

Add to that- our work in the rural clinics. Resources were scarce yet we were seeing the worst of everything from traumas and infections to late stage chronic diseases and cancer. I heard all kinds of lung sounds, a thyroid bruit, and saw all kinds of genetic abnormalities. The sanitation (or lack thereof) was overwhelming in itself... it was just a whole different world than what we were used to.

There's just so much I can write about but then I would never post this blog. I'm sure you can ask any of us and our experiences would be completely different.

For me, this experience shook my core a bit. There were times when I felt elated and helpful, and other times when I felt frustrated and worthless. It was a humbling experience. I thought a lot about my privileges, purpose, and goals. How fragile life is, and how quickly things can change for better or worse. We also talked a lot about the One Health model, and what different expertise we would need to make a sustainable impact with locals spearheading the projects.

Even though its been almost a month since I've been back, I still think about the wonderful people I met in Nicaragua. To have the opportunity to build bonds with people from a completely different part of the world. I met an old gentleman in his nineties who said the most beautiful thing to me... when we met at his rural home he gently shook my hand, gave me a welcoming fatherly hug, stared off into the sky and said, in Spanish: 

"Do you ever look up at the sky and wonder how lucky you are to meet people from all around the world?"

Yes. I feel that way all the time.


Andrea Araujo (Translator) as we rode the back of a truck to a rural clinic

The kids gathering for talks on Nutrition and Dengue Prevention

Semi Han (MS2) doing some Health Education with the kids

BP Training with the Brigadistas

A meal at the Home Stay