There are three other doctors in clinic, but only two see scheduled visits during the days, and some non-emergent walk ins. If there is an emergency then one doc is pulled by the triage nurse to see the patient and las consultas must wait. There is a lot of waiting in El Centro de Salud. The ER is staffed at night and they also make house calls in the outlying areas if needed. We went to a small house down the highway from San Juan to check on a woman who was on bed rest for the last 20 weeks of her pregnancy. Yikes.
They give steroid shots for everything. Apparently there is nothing that can’t be cured by dexamethasone and amoxicillin. We lost our thermometer somehow over that last few days, so we are doing tactile temps, which are not terribly accurate. Apparently I don’t know how to use a mercury thermometer anyway so that’s no big loss. I had to weigh a baby today using a scale that looked like it was from the 1800s. I acted as a translator for a Canadian couple who brought their two year old in to have stitches removed.
I am learning a lot about the way medicine is practiced here. Nicaragua still has a very paternalistic approach to medical treatment, which is both interesting and distressing. For the doctors everything is very black and white, there is little compromise. If you don’t give your baby Tylenol when he gets a fever he WILL have a seizure, and then he WILL have seizures for the rest of his life. Well that is definitely not true but I wonder if that is the necessary approach made by the doctors here. I wish the advice about weight loss and not drinking gallons of juice and pop were heeded as freely. But such is life no matter where you are in the world!
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