Upon arrival in Ocotal, a rural Nicaraguan village, I distinctly recall experiencing a surreal mix of smells, sounds and visions.
It was clear that I had entered a culture vastly different from my own. As the hot, stagnant air enveloped my body, I made my way through the center of town.
Surrounding me were the indigenous people of Ocotal. In celebration of a town holiday, Patronales de Ocotal, many were chanting, dancing, horse-back riding and throwing firecrackers.
Some of the street kids, caked with dirt, begged me for a few cordobas, but I fought my heart to resist giving handouts. Witnessing such poverty became an overwhelming burden.
I made my first visit to the town hospital the day after I had arrived. Ocotal's hospital was set up such that patients who lacked the resources to pay for care could receive it free of charge.
From the outside, the hospital was quite deceiving; the facility had the appearance of one of the most charming and well-kept buildings in the village.
Unfortunately, the interior told a different, much less encouraging story. The conditions within the hospital reflected a basic carelessness. I experienced shock upon witnessing the lack of organization the hospital employees seemed to perpetuate.
Contaminated syringes lay, open and unattended, on top of counters for anyone to infect themselves with. The limited supply of disposable syringes restricted the hospital to using reusable needles without proper autoclaving procedures, a danger in itself.
Despite clear hazard warnings, children lounged nearby and people placed objects including food on top of the needle disposal boxes.
Few efforts were being made to create a sterile environment for healing the sick. As water seeped out the door from the surgery unit, hospital workers diffused the contaminated fluid across the floor with brooms and mops.
Waste was swept into the beautiful, green courtyard; syringes littered the ground. At the same time as two sick girls occupied one bed, placenta stagnated in the delivery room until someone might have eventually decided to dispose of it.
Any patient or visitor could infect themselves by direct contact with body fluids that workers neglect to rid of. To complement the lack of education was an overwhelming shortage of supplies.
For example, the hospital issued only five pairs of gloves daily for the staff of each ward. This deficiency mandated the re-utilization of bloody gloves from patient to patient.
Surgical procedures and medical techniques are handled adequately by the doctors in Ocotal, but they continue to be undermined by an ignorance about infectious disease control that remains prevalent throughout the hospital.
Predominantly, the educational focus in the village must be directed toward the ancillary health-care workers. To facilitate the transition toward awareness, community education is also needed to supplement the training of health workers.
Since my return from Nicaragua, I have contacted various organizations including Americares and the American Red Cross, in search of funding and support for a project to help the hospital in Ocotal.
I estimate approximately a one year time frame to implement this special humanitarian project, with the hopes of eliciting the support of the Dartmouth community.
Ideally, I would like to coordinate a group mission for the winter of 1996; training will be provided to all those who decide to participate, and creative skills and input are needed on various levels.
The people of Ocotal respect any outside assistance in a receptive manner. Realistically, if addressed, the problems are not insurmountable.
