Get Your Gloves On

On Friday we traveled with the nurses and doctors to a health post in Northern Masaya where they were hosting a health fair. Around 8 AM, a single truck rolled into Centro de Salud ready to go. Originally, I thought just a handful of nurses and doctors would be coming with us. I was wrong. Just about every doctor, nurse, administrator, and even Jugo, our trusty janitor (and the 3 interns) hopped in or on the truck ready to roll. I rode on the back of the truck along with 12 other persons clutching onto the truck, the supplies on the back of the truck, or other people on the back of truck as we whizzed around the back roads and main highway in Masaya. The breeze was phenomenal, even though my hijab kept flapping and flying in the wind, often slapping Onyema or Garrison in the face. Now I understand why everybody here enjoys sitting on the back of trucks. If only it were legal in the States.

As usual, once we arrived to the health post I worked with the gynecologists in the women’s reproductive health room. This time, I was actually prepared for what I was going to observe: pap smears, biopsies, IVAAS, and even some mammograms to test for potential lumps in breasts. I grabbed a seat next to the stack of supplies ready to observe the day away. Little did I know that when the doctors asked me to pass pairs of gloves to them, I would be putting on a pair myself. The doctors turned to me and said, “get your gloves on”. Initially I was confused; why am I wearing gloves to sit and observe a bunch of pap smears and biopsies? I didn’t realize I’d spend the afternoon actually doing these pap smears and biopsies until the nurses handed me a metal clamp and shoved me in the direction of the woman lying on the bed in front of me. Oh god. Why didn’t I pay more attention earlier? Why am I being trusted to do this? I took a huge breath of air and stepped to the foot of the bed.

  1. Obtain metal clamp: check.
  2. Put it in and twist it sideways: check.
  3. Widen the cervix via the metal clamp: check.
  4. Apologize to the woman for any pain felt during the widening stage: check.
  5. Confuse the woman with my broken Spanglish: check.
  6. Scrape the cervix with a thin wooden utensil and swipe the collected fluids on a plastic petri dish: check.
  7. Spray and swipe the petri-dish with a formula to keep the fluids in place: check.
  8. Cautiously secure and close the petri-dish inside of a cooler to get inspected by fancy technology in the clinic later that day: check.
  9. Look confused for my next step and lose all credibility from the woman lying on the bed: check.
  10. Doctor steps in and reminds me to prepare the acid for the biopsy: check.
  11. Acid prepared, cotton balls soaked and inserted in the cervix, and countdown from 60 seconds begins: check, check, check.
  12. After letting the acid sit for 1 minute, remove cotton balls, and carefully inspect the cervix for white spots: check.
  13. Clarify that there are no white spots, inform the woman she doesn’t have HPV (Alhamdullilah!), and carefully remove the metal clamp: check, check, check.
  14. Apologize more for any pain felt during the removal process: check
  15. My first successful Pap smear and biopsy: and……check!

No women were hurt in the process…well…kind of. But that part doesn’t matter. What really matters is the experience and what I’ve learned throughout it. I finally got my hands wet with some experience in a field of medicine I would like to pursue later on. Okay, sorry, bad joke. I wore gloves. But you get my point.

Pap smears, biopsies, and even more pap smears later, the topic of discussion in the women’s reproductive health room eventually turned into (you guess it!): my hijab. I’ve found that during my time here in Nicaragua, it’s always the women who are more intrigued and fascinated with it. I smiled, and shared the ideology behind the hijab. I could tell the women were still a little perplexed when they scrunched their noses and whispered “but do you have hair?”. Entertained, I asked them if they’d like to see it. They about fell out of their seats. I closed the door and finally satiated their yearning to see just exactly what was hiding under the flowered-printed scarf of mine. After a chorus of “oooohs”,“aaaahs”, and “que bonita!”, I think they finally understood the purpose of hijab. Once again, I drew the link between modesty and hijab in Islam and Virgin Mary’s veil in Catholicism. The connection clicked. The gynecologists and nurses in that subdivision of the clinic are such sweethearts and have been nothing but supportive and informative throughout my journey in understanding the work involved with pursuing a career in women’s health.

Conducting pap smears, biopsies, feeling for lumps in the breasts of elderly women, and even verifying to the nurses and doctors that yes, I did indeed have a full head of hair…my 4th week of work in Masaya had successfully came to a close!

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A Family Affair

After the León sickness affair last weekend, I’ve been very conscious about gauging my health here. Needless to say, it still needs some monitoring. I’ve had issues digesting food, so my initial thought was: I need more fiber. Nonchalantly, I mentioned to my host mom that I was having tummy troubles and politely asked if she could perhaps supply me with some green tea, fresh fruit, or anything else to get my digestive tract cleaned out. The next day I woke up to 2 plates full of chopped papayas, mangoes, watermelon, bananas, and calalas. The host grandpa urged me to down 2 bottles of Leche de Magnesia (a super pasty white mixture that tastes like toothpaste), my host nephew offered me some laxatives, my host uncle offered to take me to the hospital, and my host sister advised me to try doing sit-ups. Within two hours, the entire family (14.5 family members..including Barney, the pet squirrel) knew that I had troubles using the bathroom. The gringa’s bathroom issue cultivated into a family affair. I was flattered to have such a caring host family, but also embarrassed that my difficulty using the bathroom was the topic of discussion in the house…not just for one or two days, but for the entirety of the week. My host mom got so concerned that she took me to the doctor across the street (who runs her practice right out of her house). I left the doctors office/house with a prescription to take not 1, 2, OR 3, BUT 7 laxatives in the next hour with a bottle of Jugo de Piña (pineapple juice). Here goes nothing. After following doc’s orders, it was time to wait. I waited an hour. And then another hour. 3 more hours. 2 more on top of that. Then it was dinner time. More waiting. Bed time came, and nothing happened. I then spent the entire next afternoon giving the toilet a run for its money. I was happy the 7 laxatives worked; but also mad because I missed that day of work. I love Nicaragua….but I hate what the food is doing to my stomach. In conclusion: 7 seems to be my lucky number here.

In other news: I lost my Spanish-English dictionary the other day. I casually mentioned this to my host grandpa before I left for work that day and, once again, this turned into yet another family affair. When I returned home for lunch, my host grandpa managed to turn my lost dictionary into an eager investigation around the house during which both of my host sisters, all of the maids, and 3 employees from the snack factory stopped their day’s duties and began rampaging through the house asking everybody if they’ve seen “el diccionario de Sooofiaa!!” I’m not sure if they were so concerned because I had lost something, or because they felt that I so desperately needed my dictionary. The afternoon was filled with rapid Spanish yelling by a team of Nicaraguan women charging through the house on a mission. When a Nicaraguan woman wants something: get out of her way. Hence why the day’s work at the house was on a hiatus until the gringa was reunited with the ever-important dictionary. Rest assured, the dictionary squad found the dictionary on the kitchen table buried under a week’s worth of newspapers. Good work ladies.

The perks of living in a house with 3 generations: when you can’t poop, everybody knows, and when you lose something, everybody helps.

Drawing Connections

After spending my 3rd week with my host family, I’m beginning to think that some of them have been speaking Portuguese all along—which is explains why I just can’t understand any of them. All of the women in the house have extremely high-pitched voices and yell almost 90% of the time—not because they are angry, but just because that’s how they communicate here. I almost never understand them. I still can’t tell the difference between if they are asking me a question or just saying something to me; so in order to avoid seeming rude, I just reply with “sí, sí” to everything. Some observations about the Nicaraguan dialect:

  1. “lla” is pronounced as “ja”
  2. b’s sound like v’s
  3. v’s sound like b’s
  4. they don’t pronounce “s” at all (or a vast majority of the alphabet for that matter)
    1. Entonces becomes Entoncee
    2. Adios becomes Adioo
    3. Gracias becomes Graciaa
    4. Ustedes becomes Utede
    5. Buenas becomes Buenaa (do you get my confusion yet?)
  5. they don’t pronounce “d’s” when they are at the end of a word
    1. Verdad becomes Verdaa

None of the women in the house enunciate and when I ask them to slow down and repeat what they’ve said, they respond even faster and with a higher pitch voice. I can only imagine how much has gotten lost in translation during these 3 weeks. I feel like I would understand everybody so much easier if they all had subtitles so I could at least read what they were saying since they don’t pronounce a whopping 80% of the alphabet. What’s the point of having an alphabet if you don’t use any of it?

As fabulous and lovely as all the women in my house are, sadly enough I cannot hold down a conversation with any of them without busting out my dictionary. I feel silly for doing so, but yet again, I need to find a way of communicating with them. Every morning during breakfast my host mom compliments my scarf and mentions how she sees it as “an art” the way I wear it. She made me promise her that before I leave, I would teach her how to wear one. I agreed. During my efforts to build bridges of understanding within my house and the rest of the community, I’ve found that the best way to explain why I wear it is by comparing Islam to Catholicism. After all: Virgin Mary covered her hair too. All of the traditional depictions of Mary that are scattered around my host family’s home and in the Catholic Churches show Mary veiled. It’s the same concept: modesty in dress and behavior. Just different holy Books written in different languages. Some of my favorite parts of this trip have been spent drawing connections between the two faiths with many of the people I’ve encountered.

As usual, the rest of Nicaragua is still pretty confused about my scarf. Last week at work, when we were introduced to the laboratory staff that runs the pap smear and biopsy samples, one of the technicians asked why I wore a scarf and I explained that it was because of my religion. She laughed, and said, “nobody is in Nicaragua watching to see if you still wear it.” I laughed back and said, “I don’t wear it because my parents told me to, I wear it because God said so.” Needless to say, I don’t think I will be invited to visit the laboratory again. And I’m completely fine with that.

My meals for the day are as follows:

Breakfast: Gallo pinto, and/or a plate of delicious fresh fruits compiled of mangoes, papayas, bananas, cantaloupe, and calalas. Cold coffee with ridiculous amounts of sugar piled in it.

Lunch/Dinner: Gallo pinto, rice and fish or chicken, hot soup, or fried plaintains. Warm juice with more ridiculous amounts of sugar piled in it.

Nothing in Nicaragua is the right temperature. The coffee is always too cold and the juice & water is always too warm. Having Gallo pinto every day 3 times a day definitely takes a toll on your body. Good thing I walk almost 4 miles to and from work everyday or else I’d be purchasing 2 plane tickets home: one for me, and one for all the weight I gained in Nicaragua.

I’m beginning to become familiar with my surroundings. Masaya is a quaint little town. I can see why so many people love it; it’s the artisan capital of Nicaragua and is well known for it’s music, culture, food, and arts.

Everyday at approx. 5:00 pm the same woman walks down my street selling tortillas. For one thing, she walks down the road with her products balanced on her head and (at the top of her lungs) calls out “TOR-TEEEEEEEEEEE-YAAAAA” at the same, high pitch. Every. Single. Day. The other day I got home from work at ~4:50, so I sat on my porch and waited for Tortilla Woman to stroll by. Low and behold, she rolled around at exactly 5:00 pm hustling to sell her “TOR-TEEEEEEEEEEE-YAAAAA”s. One day I’ll buy tortillas from her. But for now, I’m going to enjoy hearing her everyday.

7th Time is the Charm

Saturday morning we left Managua to go volcano boarding in León. I was so excited about this trip and volcano boarding because I had heard such wonderful things about the town and the experience. When we arrived at our hostel Saturday afternoon, we were told that we couldn’t go because it had already started raining for the day and that we could go Sunday morning. I was happy about this because I hadn’t been feeling very well that day and wanted to nap. For one thing, the bus ride was 1.5 hours of being jolted, jiggled, and jostled from side to side and up and down. It felt like a bad, unconstructed roller coaster ride. I decided to nap once we settled in the hostel, and woke up with my head in the toilet, regurgitating everything I had for breakfast that morning. Once I felt better, I started rehydrating myself and had a few crackers to help settle my stomach. Bad idea. Within an hour, I threw it all up again.

I sipped on some water, and was very cautious about what my next plan of action was. At this point, it was 6 pm and had been 8 hours since I last ate anything; dinner was ready. Cautiously, I put noodles and spaghetti sauce on my plate and ate dinner next to the bathrooms—ready for war. Well, the war came…and my upset stomach was the victor. At this point it had started pouring outside, and the bathrooms (being outside) began to flood. Considering I was throwing up everything I was immediately eating, I figured I had caught a parasitic water virus and demanded to go to the hospital. Luckily, the closest hospital was no more than 5 minutes away, so Garrison & Onyema (may Allah bless their hearts) took me to the hospital. Instinctively, I started to freak out about visiting the hospital in fear of how I was ever going to pay for this visit and the medicine in itself until I was reminded: healthcare in Nicaragua is free. What a concept—free healthcare for all. Lack of universal healthcare was one thing I didn’t miss about America.

            After seeing immediate attention from a doctor and getting an injection for Lord knows what (I still don’t know what they injected me with), I was prescribed something in sloppy, Spanish doctor handwriting and headed to la Farmacía (pharmacy) next door. It was still storming outside, and the streets began flooding once again so we took a taxi back to hostel. After taking the medicine and drinking more water, I was right back to square one: the toilet. You’ve got to be kidding me. Eventually, the hostel owner found me and so kindly offered me a private room in the back with my own personal trashcan for vomiting purposes. How luxurious…my own barf bin! I accepted the offer, and moved into my private room. It was now 10 pm and I had vomited 5 times—ranging from noodles to crackers to pure water. Nothing was staying down. Rachel and Garrison went to the supermarket and picked up Sprite, packets of Alka Seltzer, laxatives, and just about anything that was intended to calm your stomach or send your food anywhere but north. I began falling in and out of consciousness: only to be met with more Duke—oops, I mean puke. Round 6. More meds, more Alka Seltzer, more water: more vomit. By the end of the night, I had hurled, upchucked, vomited—whatever you want to call it: 7 times. I gave up the thought of rehydrating and decided I wanted to sleep and dream about blueberries, my mother, a happy stomach, and air conditioning. I woke up in the morning feeling significantly better, and was able to eat a piece of bread without sprinting for a toilet, trashcan, or piece of pottery. Success! 7th time’s the charm! I must have left León with rock hard abs that weekend from all the vigorous stomach activity; P90X has nothing on Nicaragua’s parasitic water viruses.

 

Good news: By Sunday morning, I felt much better, Alhamdulillah

Bad news: I didn’t end up going volcano boarding (which is a real bummer considering out of the entire group, I was the most excited about this)

 

Good news: I got a refund for my ticket for volcano boarding!

Bad news: I owed the rest of the group so much money from buying my medicine and food intended for calming my stomach that it didn’t really matter.

 

Good news: I spent all of Sunday relaxing at the hostel and waiting for the others to get back from volcano boarding.

Bad news: During this 6 hour waiting period, I managed to check out of my private room, sneak right back into the private room in order to nap in privacy and avoid paying for 2 nights worth of stay, get walked in on by a couple who was assigned the room for the next night (and freaked them out), and have a very angry hostel owner all in a matter of a just a few hours!

 

I’m still unsure of what injection I received at the hospital, and whether I truly have a parasitic water virus…but I can say that this experience ranks as one of my top 5 worst so far. Although I’m sad about missing out on the volcano boarding trip, I am more than grateful to be back in good health…and besides, more interns are expected to arrive in Managua next week, so hopefully they will be up for some volcano boarding once they are settled in. Furthermore, I cannot stress enough how thankful I am for 1) having such wonderful friends to take care of me 2) Nicaragua’s free healthcare system and 3) ultimately, Allah for bringing me to it— and pulling me through it. This experience was nothing but a reminder that if He brings you to it, He will pull you through it. 

Call Me Maybe?

During the past 2 weeks, I’ve spent a few days in the prenatal clinic observing more pap smears, and even got to give babies vaccines (they didn’t even cry!). The remainder of my days were spent in the women’s reproductive health clinic observing more biopsies, IVAAs, and even conducting a Doppler sound on a pregnant woman in order to detect the heartbeat of her baby through her stomach. From the time I’ve spent here, I’m constantly amazed at how the doctors are able to work in these conditions. For one thing, the women’s reproductive health room is no bigger than the size of my dorm room in Ehaus last year—and mind you, this room serves as work space for 2 gynecologists: 2 desks, and a reclining chair that is used for the pap HPV testing (which consumes just about all of the space in the room). None of the clinics have fans, or even ventilation systems. So when the janitor came in to clean the floors, the potent cleaning solution he was using to clean the floors stayed in the room, and I thought I was going to get high off of the intoxicating fumes and lack of ventilation. 

Many of the people who work here think that we are solely here to buy them things for the clinic—which is frustrating, and completely wrong. Jugo, the janitor, keeps asking us to buy him a mop dryer. I feel bad because a mop dryer would really make the clinic look better, but at the same time we aren’t dollar signs. We are here to conduct a public health project for the community—not serve as the clinic’s sugar daddies. He is so passionate about this mop dryer though….

We are still well on our way with planning and developing our public health project for the community, which I will fill you guys in on later once we get details ironed out, insha Allah (God willing!) 

In other news, last week we took a day trip to Laguna de Apoyo (a beautiful reserve in Masaya, and also the cleanest lake to swim in Nicaragua!) The bus ride took about 30 minutes; as usual, the bus was jam-packed. A 6-year-old boy got on the bus clenching 2 chickens upside down by their legs as they wildly tried escaping the threshold of his hands. Someone who tried getting on this same bus had a bike & the bus driver told him there was no room for his bike on the bus; so he climbed on top of the roof of the bus with his bike and held on for his dear life. Talk about perseverance.

When we finally arrived to Laguna de Apoyo, we walked downhill for ~3 miles, and finally hit the water! The water was CRYSTAL CLEAR. I jumped in the water and swam out to the middle of the lake and took a look under the water and could clearly see my toes and hands…that’s how clear the water was! After an afternoon of swimming, enjoying the beautiful scenery, and munching on some fruit from our friend Angel, we decided to head home before the storms came. Mistake #1.

We had missed the last bus back to Masaya, and luckily enough so did Angel (the old man who gave us the fruit). Angel was fishing at the Laguna with his son and grandson. Angel was a genius. His son was a creep. And his grandson was adorable. Angel knew everything about the ecology of Nicaragua and kindly waited with us for a taxi to take all 6 of us home. Mistake #2. After an hour of waiting, we finally found a taxi that agreed to take us to Masaya. Angel’s son (Ivan) stared at me the entire taxi ride home. He was nice, until he gave us his phone number and (hold your breath) told us to “call me, maybe?”. Carly Rae Jepson would be so proud.

After avoiding eye contact with Ivan and pretending to know absolutely 0 Spanish to deter his efforts in making conversation, Ivan began mouthing the word “bonita” to me. Yes, Ivan. How romantic. Every girl wants strangers mouthing “bonita” to them. I’ve never wanted to throw myself out of a moving vehicle so much before.

The taxi decided that dropping us off at a random intersection was what we wanted. Mistake #3. The others weren’t happy. I was ecstatic; anything to get me away from Ivan the Creep. We parted ways with Angel and his entourage and started walking home. Within a span of 5 minutes, the sky turned black…and hell was upon us. You know a monsoon is about to hit when even the natives begin running for cover. We stayed calm and tried to gauge how far away home was….4 miles? 5 miles? Nope. Time to panic. The streets immediately began to flood and before I knew it we were running down the streets of Masaya dodging taxis, abandoned bicycles, and miscellaneous garbage floating down the flooded roads all the while laughing hysterically. We sprinted 6 blocks, 7 blocks, 8 blocks. This felt like 11th grade cross country season all over again. Left turn. Right turn. San Jeronimo church was straight ahead. Alas, my house was in sight. My entire host family was at the door watching the storm and began laughing when they saw me sprinting home completely soaked from the monsoon. I’m not sure if they were laughing at the fact I got caught in the storm or at the fact that I was laughing uncontrollably about the series of events. Just as I reached my humble abode to seek a shower, the power went out. Yep, power outage. Friends and family, we have officially entered the rainy season. Nonetheless, life in Masaya keeps me entertained.

PS: I tried using my umbrella to shield the storm, but the wind was so strong that it inverted my umbrella….hereby making it useless.

PPS: I found a lizard in my bed a few nights ago. We played hide and go seek for ~30 minutes until I finally caught it and killed it. He was a champ.

Muéstrame los dientes!

Throughout my time in Nicaragua thus far, if there is one thing I’ve noticed: kids don’t smile with their teeth. They often grin, but are shy to show their teeth. This is a young girl who lives a few houses down from me and my progress with making her show the world her beautiful teeth. After many photos and my pestering her to “muéstrame los dientes!” (show me your teeth!), I finally convinced her to proudly show her teeth.

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