I feel like my perspective on the health care we have received here is probably a little bit different than Kyle’s, as he was the patient a majority of the time (well, really all the time :) ). But I will do my best to describe what our experience was like, and how it probably differed from what many of our neighbors and friends would do here in San Nicolas.
You may know that Nicaragua has a free health care system. Most towns have a health center where you can get basic health care screenings, lab testing, talk with a doctor, and get free prescriptions. While this is a great benefit that even us, US citizens, can get these services, when you need a specialist or more intensive care you will probably have to find your way to a larger city for a public hospital or pay for private care. Our small town of 1,000 citizens has a health center in town that services the people in town, but then also a majority of the people in the surrounding smaller communities. They stay busy, for sure!
We started our health journey at our local health clinic to get a few basic blood tests. When Kyle’s cellulitis started to appear in his ankle and his ankle started to grow rapidly, the health center wasn’t quite sure what was going on, given their limited resources, and recommended that we seek more specialized care outside of San Nicolas. We had choices—go into Esteli (the next biggest town) for a larger public hospital or private hospital/clinic. Or go into Managua (a 3 hour bus ride) which also has good public hospitals and the best private hospitals in the country. We decided, with the help of our in country coordinator and with the insurance we have that we would go to Vivian Pellas Metropolitano Hospital which has some of the best doctors in the country. Very few people who live around us would have insurance and the option to go to this hospital, and would probably go to the public hospital in Esteli for more specialized care (still free).
We spend time here in San Nicolas and with our VMM co-volunteers and country-coordinator reflecting on what it means to accompany a community, and how we define solidarity in our lives and work here in Nicaragua and San Nicolas. This incident brought these discussions to life as we walked this health journey in the context of being volunteers in Nicaragua ,committed to living in solidarity with our community. It became especially evident when discussing our choices with our community here in San Nicolas.
Through these discussions, we found that there were a variety of options that people could choose here in San Nicolas.
1.) Go to the health center in town. See high levels of infection and be referred to the public hospital in Esteli.
2.) Go to the town’s natural medicine clinic and get a natural remedy consisting of plants, herbs, oils, and wait for it to heal, with regular check-ups with the natural medicine women 1 or 2 times per week (I’m not knocking this option at all, we have heard and seen some of these natural remedies work!)
3.) Or another option we heard, find a toad and rub it on the infected area. The toad will take on the infection and your fever and the frog will die. This is real! A lady and one of the bus drivers told us all about it. We even watched a youtube video about it. Crazy!!
While these are all viable options, the health center in town had already referred us out, we couldn’t speak with our natural medicine lady (who actually works out of the front of our house) until the following week, and we couldn’t find a toad! So we decided to take the bus into Managua. We are so thankful we decided to go in to Managua and to Vivian Pellas and that we had the option to do so. When all was said and done, Kyle’s infection was very resistant and started to spread into his knee . He ended up being admitted and hooked up to an IV antibiotic for about 8 days!
Skinny, but still smiling :D (Kyle lost about 25 lbs through all of this)
We received AWESOME health care at the Vivian Pellas hospital, we had very knowledgeable doctors whom we talked to in mostly Spanish, but would throw in the occasional English. The nurses and staff were very attentive and quick to answer our questions and calls. And we felt like we had a good all-around experience. While this experience has left me with some dissonance about what it means to live in solidarity and accompany our community (i.e. “How do WE get the opportunity to be insured and receive private hospital care, while our neighbors and students do not?) it has also made me really prioritize health, especially when you are so far from home and very far from your comfort zone—Spanish medical vocabulary, anyone??
So, while this process was an exercise in decision making, it also made me consider the social and economic variables that affect access to health care, what a San Nicolas family would do in our situation and has made us think about our own privilege. We feel very connected and a part of this amazing San Nicolas community, but this experience reminded us that no matter how connected we feel or how long we live in this town, we have privileges that set us apart from the people here. An important reminder, but not always an easy one.
Let me also say, that this post isn’t to knock the public health care system that the current government has worked so hard to develop and make accessible to even the most rural citizens. I think these doctors and nurses that work in the hospitals are doing an awesome job and really do provide great care for patients, we’ve seen this first hand in our health center in town. There are tons of benefits to having free, accessible health care to the 1,000+ citizens in our town, and across the country, that have very limited access to many modern conveniences. Our health situation escalated pretty quickly and we felt that moving straight into a private setting made the most sense for our situation, and we are thankful we did!
So…now we are trying to get back to 100% healthy. Kyle is still dealing with a reaction to the bacterial infection he had with something called “reactive arthritis”. This means joint inflammation and pain, still. So we wait for that to heal. We had and have some follow-up appointments with a rheumatologist. So we wait and see. And hope that he is feeling more normal very soon. If you know Kyle, you know it’s not easy for him to rest or recover at the slow pace required! So keep him in your thoughts as we try to get him back to 100%.
And thanks to everyone for all their thoughts, calls, text and emails throughout this time. I know it helped to lift Kyle’s spirits especially after spending many days in the hospital. We really, really appreciate our “tribe”! You all! :) Thank-you!
Much Love.
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