Nursing in the Third World

One week has passed since I have arrived in Port. I usually wake to sun drifting through my mosquito net, while our solar powered fan gentle blows the thousand mosquitos that have managed to penetrate the net in a circular motion from fan-to blood sucking-to side of net, then head to the bathroom for a refreshing cold bucket shower, as Cody prepares me a fabulous breakfast and we make plans for a delicous lunch of fresh caught shrimp, crab, or lobster. I then set off to the Casa Materna...

Having the opportunity to practice any form of medicine in a developing country is truly an enlightening experience. On the one hand I come to the Casa Materna with limited knowledge and the staff are extremely eager to teach and share not only their knowledge but their language with me. Each day I learn a new word that i get to practice with my pregnant ladies (panzonas) such as lie down (prouss) or sit down (eoos) or fish head (inska lal). There is a yound doctor from the pacific side of the country who has decided to teach me various medical practices. He has shown me how to hear a babys heartbeat with a stethescope which is no small feat on its own, but imagine that the stethescope doesnt fully fill your ears and the sounds of buzzing saws from next door mix with the drama of the telenovela being brodcast at full blast next to the clinic room, all slipping into your ears simultaneously with the doctors and nurses asking, do you hear it...now...now? I finally did...it was a miracle to hear that tiny heart (kupia) beating away! The other thing that I did for the first time was a vaginal exam to see if a woman, and then another womans cervix was dilating. for those of you reading this that are not into medicine this might seem like a strange thing...but for me it was fabulous! the docotor basically looked at me and said, have you ever done this before, and i said no, and he said, well put a glove on! That to me sums up the ease of learning in the third world...people are eager to share with me, and the reality is they dont even know who i am or if i have any credentials behind my name. this is very different from the sterile, badge on all the time hospital training i have had in the states.

But on the other hand...having just completed a year of nursing training in the US, it is too easy for me to see flaws in the nursing care. I also want to express that these nurses are extremely well trained and competent in the care that they have learned to provide...but in the US we are taught to conduct every proceudre under a shroud of sterility. How can you provide aspetic or sterile care when the floor of the clinic is concrete with dirt blossoming through cracks, when the doctors and nurses all wash their hands in the same bucket of water that sits on the table all day, and quite simply in a place where running water does not exist? The answer is that they do the best they can. But as a new nurse when i saw the nurse place the cap on a newly placed IV that she had dropped on the floor two times without cleaning it with alcohol, and when the blood trickled out the IV onto the floor and she wiped it up with a dry cotton ball with no gloves on, my little heart sank. There is still much training and learning to be done on both sides here!

On another note one of my pregnant Miskito ladies has been teaching me to crochet with the needles and yarn that were dontated to the clinic. It was so fun to see all their eyes twinkle when I brought out the bag of supplies. Now every morning when I head to the clinic I see the women sitting out front in their handcrated wooden rocking chairs, bright threads in hand, crocheting little hats and booties for thier little babies to be! Im still looking for someone who can teach us to knit!

Isabe! (Im pretty certain that one means goodbye!)