And the campaign begins!

2011 is a big year here in Nicaragua - it's election year.  And while we Americans may think that politics can get a bit heated at home, its nothing like the full-fledged furor that exists here.  As I mentioned before, El Sauce is predominately Sandanista, but to those who aren't Nica fluent that would need some explanation.  I will give a very brief summary as I understand it, but if you are actually interested Wikipedia has a lengthy explanation of Nica history and the politics of it all.  But here's the short of it - the US financed and supported a lengthy period of ruthless dictators that took total advanatge of the Nicaraguan people for many years (a rather common story here in Latin and South America).  Augusto Sandino was a Nica who stood up to the US government and the corrupt dictators of the time, but was subsequently killed.   Much later, his name was used to drill up popular support to overthrow the regime and the Sandinistas came to power.  Their political position is socialistic and they have done a great many things to help the poor people of the country.  Under the Sandanistas illiteracy has dropped, health standards have risen and the general welfare of the country has improved.  The current president Danieal Ortega is up for re-election and things are going to get interesting.  As with all political parties, his is not squeaky clean and the papers are currently full of allegations against his government, so we will see what will happen.  But now for the reason for bringing this up:
This past weekend was the official kick-off of the election campaign.  The elections are Nov 6 so that only leaves a little more than 2 months for campaigning, but the truth is that the last 4 years have been a campaign.  But the kick-off was a great excuse for some fun events.  Every year all the municipalities of Leon(of which El Sauce is a part) take part in a big sporting competition and this year it was in Leon and coinicided nicely with the start of the campaign.  So I got myself a spot on one of the 4 buses from El Sauce heading into Leon to discover Leon and the festivities.
The day began early - very early.  The buses were scheduled to leave at 6am and I had been encouraged to show up at 530 to make sure I got a seat so i figured 5 would be an ok time to get up and not that much earlier than the normal rising time around here.  Unfortunately the muchachos next door decided they would rather take the Katie Fitz approach and stay up all night rather than get up so early.  So around 330 sounds began to come from next door and buses heading towards the further afield towns passed through revving their engines and merrily tooting their horns.  So the day began early.  We actually left at 630 but the 1 - 1.5hr trip took more like 2.5 hours because we kept stopping randomly on the side of the road for prolonged stretches - no idea why - i was told it was so all the buses would arrive together but I am not sure how we got split up. Isat next to El Sauce's runner who talked almost constantly and of which I understood maybe half - but he did a 1hr 9 min 1/2marathon - thats quick!
Then we finally arrived and the parade started almost immediately.  Music, marching bands, super-sized dolls, trucks packed with people - and above all political propaganda.  There's a song, chants, shirts, flags - everything.  I then wandered around Leon all morning/afternoon and then returned to watch the end of the games.  Some volleyball, soccer and dances(some good, some of the high school dance group quality) all interspersed with lots of Sandanista rhetoric (who are we voting for?!?!  youth for Daniel!!  Peace, love, christianity, socialism and revolution!!!)  it was certainly something else.  We capped it all off with some litres of the Nica staple, Tona(a rather bland but refreshing cold beer that is ubiquitous - Mac you would be hating the beer world down here!) eventually boarding the buses and getting back to El Sauce at 130am.  Just in time to catch some sleep before the campaign started in El Sauce at 900am...

 That's a tall woman...

 FSLN!!! for life!!!

 They won!

 Dancing with Daniel's blessing.

La primera semana! The words part...

La primera semana!

Wow! It's hard to believe that I have now spent the first week of my year abroad here in Nicaragua. After thinking about it, wanting to do it, and then planning it for so long it seems ridiculous that it is actually happening. And it has been quite a week: arriving, figuring out where things are, seeing how the hospital works...-and then there is the whole language thing! My Spanish is certainly good enough to survive and I can carry on a conversation quite well with one or two people who are talking directly with me – and happen to be of the slower talking variety. But put a group of saucenos together or even just two and the conversation speeds up, the pronounciation drops off and my understanding plummets! But I have hope, things have gotten better – and it has only been a week.

But otherwise things are good. Life is interesting here. El Sauce is HOT – hot and sticky. And unlike being home in TN there is no relief when you walk inside, often it is even worse. And somehow, for reasons and abilities that I do not yet comprehend everyone still wears pants! Let me tell you, the last thing I want in the climate here is more clothes than absolutely necessary. And then doctors somehow manage to wear white coats as well – granted alot of them are shortsleeved – but still that is extra covering that really serves no purpose.

The pace of life here is very Latino – most people spend their days sitting and chatting with their neighbors and I am truly unsure of whether people actually have jobs or how people earn money. Interestingly, the weekends are truly no different than weekdays – shops are open and people are hanging out in the shade on the streets.

Days begin early here, people start to get moving by 530 or so in the morning although nothing officially opens until 900. I usually get to the hospital at 800 although I dont do anything till 900 – and by doing something I dont mean too much – although that is partly by choice at this point in order to get a feeling for how the hospital works and to become a bit more comfortable with the language. We then finish about 3 and have the rest of the evening to hang out, or in my case, work on my vocabulary buy some essentials or chat with some folks.

I am currently living with a nice woman named Ilean Rivera, her husband, their two children(both in their late 20s whose job/role in society/the community is largely unkown to me at this point) a granddaughter of 7 and their grandmother. They are all very nice and Ileana is more than willing to chat with me but otherwise I am kinda left to my own devices which is kinda nice but a more 'family' like atmosphere would be welcome – but again it may just be a cultural thing.

I think that's all the writing for now, but here are some photos of the hospital:

The beautiful new hospital.  It was completed in November of 2010 and replaced the old Health Center(Centro de Salud).  Unfortunately, whereas the Centro de Salud was in the middle of town the hospital is a bit outside - about 1/2 a mile or so.  Certainly gives the pedi-cabs and moto-taxis some additional work!  The hospital has a pharmacy and the ability to do blood, urine and feces tests as well as xrays.

 

 The inside - there are rarely fully closed off spaces here in El Sauce

 The exam room of the ED.

 The ED waiting room.  Just like in the states the majority of people who show up in the ED are there for non-emergencies - sore throats, runny noses, aching necks and then the even more pressing blood pressure checks and analyzing the results of blood tests and urine tests.

The ED procedure room. We examined a machete-severed achilles in this very clean room this morning...something else - somehow the machete fell from a height and got nothing but her heel.  Mala Suerte!!!!!

The hallway.  This is usually full of people.  The system works in that patients have to show up in the morning to get a number to see the doc and then wait around until they can be seen - ideally in order.  Pts start to be seen between 7 and 8am so they often show up at 6 or so to line up to get a number.

La primera semana! well some pictures...

 I have a whole entry written, but due to compatibility issues it will have to wait another day or two.  But for now some pictures of this bustling metropolis of El Sauce:

 It really is a beautiful setting with cobble-like streets, terracotta style roofing, well populated streets all surrounded by lush and green mountains/hills.  As with so much of lationamerica the pedi-cab is hugely popular!  And when it´s this hot why not?

 The nice yellow church - big and airy.  I even went to Mass!  Although I chose not to go to the 6am service...

 Went to drop in on the Hotel Blanco, a favorite of Dr. Matlins, to say hello and chat and what did I find?  Not only a group of Canadians but a Canadian named Ronan!  And the even bigger kicker - his sister´s name is Fiona!  Absolutely wild.  And his parents aren´t even Irish...

  

 El Sauce is definitely Sandinista to the core.  The house portrait is on the building across the street from my house.  Things are going to get exciting with the election coming up in November.  The whole things will kick off this coming Sunday...get excited!
And some pictures of where I am living minus the outside- those will have to come later.

 The patio where we spend alot of time in the rocking chairs seen in the background.  Would be even better if there were no mosquitos...

 My lovely room.  The fan is going to be clutch!

The ´´shower´´ and the kitchen which are conveniently located side by side.  I say convenient because we often have to fill the bidon- the big bucket- with water from the sink in order to get clean.  El Sauce has this issue that when there´s no luz, there´s no water.  And unfortunately this happens quite often.  Although given the power of the water stream from the shower head(pipe) I almost like the bucket more...

The end of 3rd year.

It really is a crazy thing: another year gone and another year closer to being a doctor.  Fully 3/4 MD at this point and it seems like only yesterday that I started med school.  The real give-away is when I am around non-med school people and something medical gets mentioned in very general/lay-mans terms - that's when I know I have been learning too much medicine and hanging out at the hospital for way longer than a normal human being would!  For instance, this past Saturday I played a 'hat tourny' with my sister - this is an ultimate frisbee tourny where everyone is supposed to wear a hat.  Fortunately for me, I had brought my cycling cap to protect my poor, already burnt scalp from the sun not knowing that I would need a hat otherwise.  But back to the point, we  were waiting between games and one of the guys on my team (which by the way we got shafted because we did not have a super tall guy nor a super good guy and no subs to boot!) started talking about having sciatica(which always makes me cringe when someone says they have that) and taking 4 ibuprofen a day and that it was gonna kill his liver.  I made some comments in my head and then realized it wasn't worth it and moved on, but case proven - I have learned some stuff over the last three years.
  But on to the main point of this post - what happens when 3rd year is over and specifically what happens when 3rd year ends with a teaching elective in Poland followed by a student fellow year.  So, little did I know when I decided that Rochester was the school for me, but Rochester truly is a sweet place to study medicine. The neurology department is kinda a big deal and I took full advantage this past spring by being part of the neurology teaching elective in Poland.  The doc who teaches our neuro clerkship is a big name in neurology teaching and was an integral part of starting an English language medical school in Krakow, Poland several years ago.  Now he returns every May and teaches the 3rd year neuro clerkship with the help of 10 medical students and the neuro chief residents(which for you non-med peeps are generally people in their last year of residency).  So I took full advantage of the opportunity to travel to Poland for a month with a bunch of good friends and then took another 2 weeks to do some additional travelling - definitely the way to cap off 3rd year!

Ah, that's where Poland, and more specifically Krakow, is!

And so a look at the trip in photos(mind you a small selection - between the 4 of us travelling - myself, Mac, Robin and Katie - four members of the rotating fabulous funf - we had almost 5000 pictures!):

Mac and his wonderful parents who fed us well and then drove us all the way to the Newark airport.  Fantastic people!

The crew.  And I look remarkably alive considering I almost didn't make the drive to NYC.  If you don't already know the story you will have to ask me in person - it's definitely better and person and not one that I want to post online...

We actually flew into Munich, Germany and this was the view we were greated with as we stepped off the subway.  Hello Europe!

Someone should tell them they're almost doctors...

Love me some clouds.

Cool church in the middle of the Bavarian countryside - on our way to the fairytale castle.

Bavaria is gorgeous.

This is certainly one of my favorite photo spots of the entire trip - we were on our way Neuschwanstein Castle - a fairytale castle with photos a bit further down - and I saw this church kinda sandwhiched between two roads and asked to stop so I could take some pictures - well worth the break!

And then the fairytale castle - incredible!

From the front - with Christian - the most amazing host you could ask for.  Not only put up 3 strangers (he knew Robin) for a week, but also acted as tour guide and chef!  Can't ask for anything better.

Dachau - the first of several haunting concentration camps...

Beer for breakfast!

Liter beers!

Playing some Polka at the famous Haufbrauhaus.

Munich Olympic Park - pretty cool but very funny to see what they thought was futuristic...

Glockenspiel

Then to finish of Munich with a good beer drinking excess at Fruhlingsfest - the smaller, spring version Oktoberfest.  Still, plenty of beer - lots of lederhosen, dirndls and dancing on benches(that last part may be a traveller imposed custom) but a great way to finish a phenomenal week in Germany!

So much beer!

They have a special relationship...

This guy was a beast - carrying up to 7 liters of beer in each hand!

The day may have ended up with us being escorted from a beer tent for loss of balance- but it was a fantastic day - although I don't think Mac nor I will be trying to drink 7 liters of beer in a day ever again...

So that was a brief look at Munich and for the sake of time a super long posts I think that I will have to make each city we visited - 8 in total into a separate post, but we'll see how that goes.