Doctor Saul

Saul and his Wife

Back in the spring, when I was trying to figure out what to do for the summer, one of the doctors at the med school put me in touch with a friend of his who was involved with an organization called Doctors for Global Health. I spoke to the director of the organization on the phone, and was quite interested in their community-based work. However, I chose not to work with DGH because I wouldn’t have been able to apply for Stanford funding if I did a community health project that didn’t involve research. Then, a few weeks before the end of the school year, I got an email from a fifth year medical student at BU who had spent a year volunteering with DGH in Nicaragua. He gave me the contact info of a doctor he had worked with who lived in Managua. I gave the doctor a call, and he invited me to attend a traditional Nicaraguan folkdance performance with his wife and another American medical student who was volunteering for the summer with his organization.

Turns out Saul is quite the rebel doctor. He grew up in Guatemala and was a medical student there during the Civil War of the early 1980s. Like most of the idealist university students at the time, Saul got involved in the cause of the anti-dictatorship guerillas. But when the government started killing students for their political involvement, Saul had to flee to Canada. He was just months away from finishing his medical degree. He lived for three years in Canada, and during this time he secretly returned to Guatemala in order to finish medical school. By this time the Sandanistas had come to power in Nicaragua, so Saul decided to put his medical skills to use in a country where the Socialists had emerged victorious. Except for a three year stint in the early 90s when he went to El Salvador to help the guerilla fighters, he’s been in Nicaragua ever since. And he’s devoted his life to providing medical care to the poorest of the poor. He’s now the head of a Nicaragua-based organization called APS (Atencion Primaria a Salud). APS runs health clinics and also trains health promoters to attend the medical needs of people in remote areas where there are no doctors.

"Che" picture on Saul`s Truck

I met Saul at his clinic around 5pm on Thursday evening (Carreterra Norte, from Siemens, one block up). Turns out there were some problems with his truck, but after a bit of pushing we got it to start. Then we swung by his house to pick up his wife as well as a medical student from USC who is volunteering with APS for the summer. The dance performance was in Masaya, a colonial city that’s a forty minute drive from Managua. It was quite the spectacle. Dancers in elaborate costumes and some very lively music. When we arrived it was raining hard in typical tropical fashion. But soon the rain stopped and we sat outside and watched the show. It was a fun time. They invited me to come the next day to attend a health promoter training, but I already had a meeting scheduled at the hospital, so I’m going to go with them next week. I’m looking forward to it.

A hazy picture of the dance performance

Independence Day

Sara threw a party at her apartment last night in honor of July 4th. It was an excellent July 4th, celebrated with chips and guacamole, roasted chicken, hot dog casserole, Nicaraguan beer, and a bit of Jose Cuervo. The crowd was quite diverse and included Americans, Nicaraguans, Japanese, and one Korean. The cast of characters included: William and Mario, the two informatics guys who work on the Dengue Project; Nana and Emmy, who both work at the Japanese embasy; Miyumi, daughter of a Japanese diplomat father and a Colombian mother; Robert and Justin, two American guys who run clothing factories (aka "sweatshops); Sara 2 (to distinguish her from MPH Sara), who will be starting med school at the Univeristy of Oklahoma in the fall; Two pre-med volunteers from a program that gives free medicines to needy Nicaraguans; Willy and Indira, the cute newlyweds who live next door to Sara and are both architects....

And then there was Alex. A Korean man who runs a textile factory that does embroidery. Alex knows basic Spanish vocabulary but almost no grammar. However, he didn't let his language difficulties get in the way of his telling stories. It quickly became apparent that Alex was the evening's feature entertainment.

He told us:
- about his wife who lived in Korea who he missed very much.
- that they had only been married since January
- that he had left to work in Nicaragua soon after the marriage
- that his wife would be coming to live with him in Nicaragua in August
- that he had taken up drinking out of loneliness because his wife wasn't with him.
- that he wanted children
- that he was sad he couldn't make children since his wife was far away.
- that he was exercising so he wouldn't be fat when his wife came
- that he was learning to cook so he could cook a romantic dinner for his wife.

In short, Alex was hilarious. And thus was spent a wonderful July 4th evening.

Haircut

I got a haircut this afternoon for 25 Cordobas, which is equivalent to $1.50. I had been meaning to get my hair cut before coming down to Nicaragua but was too busy. Then I had my surfing accident which left a mark on my forehead all last week. Now that my head is healed, I was ready for the haircut.

Turns out there's a barbershop just one block from the house where I'm staying. And I thought the barber did an excellent job. He used electric clippers on the back and the sides, used scissors on top, and then he shaved my sideburns and back of my head with a real razor. I was a bit concerned about disease transmission as I watched him shave someone else while I was waiting my turn. But then he showed me how he uses a brand-new razor blade for each customer to prevent the spread of SIDA (as AIDS is called in Spanish). I was impressed with this public health awareness, especially when the barber is charging so little for each haircut and the cost of new blades for each customer must erode his bottom line.

I also played Monopolio this afternoon with Alan. The game was funny because the street names were in French but the cards were in Spanish. I'd say we were about tied when a gust of wind came along and scattered our money all over the patio - thus putting an end to the game.

World Cup Drama

Yesterday afternoon around 2pm I was running some statistical tests on the dengue database when I realized that the Italy-Germany World Cup Semifinal game had started. So for a half hour I monitored the progress of the game via the internet. The first half ended with a score of 0-0, and things were shaping up for a dramatic second half. So I looked at Mario, the informatics guy, and he was thinking the same thing as me: "Vamanos!" we said to each other, and we hopped in a taxi to take us to a bar where we could watch the rest of the game.

When we got out of the taxi and walked into the bar, I noticed that it seemed eerily quiet considering there was a World Cup Semifinal Game going on. There were very few people, and it was dark inside. Then it hit me: "Ah, se fue la luz!" The power had gone out! Dejected, Mario and I decided to try elsewhere. After walking for about 10 minutes we finally found a bar with electricity, air conditioning and 2 projection TV screens! We plopped ourselves down on a couple of stools, and with a cold brewski in hand, we were soon comfortably immersed in the drama of the soccer game.

It turned out to be a classic duel. No score through the first 90 minutes, so they went into overtime. Nearly everyone in the bar was rooting for Italy, but it felt like a lost cause because the Italian team kept coming close to scoring but could never close the deal. Finally, with two minutes left before a penalty shoot out, the Italians scored and the bar went wild. Then, a minute later Italy scored again to seal the deal and secure a spot in the finals on Sunday. The dramatic conclusion made this the most exciting World Cup game that I've seen this year.

Signs of Progress

As I've noted previously (see Nicaland entry), the Gringos are coming to Nicaragua, and signs of Gringo invasion can be found in the most unlikely places:

#1. Notice the Visa Sign behind the Hammocks

#2. The sign on this "house" says it has just been sold

Joc Dog Boys

I went to the beach town of San Juan del Sur again this weekend. I tried surfing again, and this time I was fortunate not to sustain any surfing injuries. So I feel like I'm making progress.

While walking around San Juan on Friday night I came across a couple of boys with hot dog carts. There carts were right next to each other and there seemed to be a bit of a rivalry between them: according to the letters on the side of their carts, one was selling "Hot Dog," and the other was offering "Joc Doc." I thought about doing a taste test to see whether Joc Docs taste better than hot dogs, but on second thought decided that such an act could have adverse gastrointestinal consequences.

I'm surprised he's not crying!

Sitting on the Street

The main pastime in the evenings here in Nicaragua is to hang out on the sidewalk. It gets hot and stuffy inside, so people take their chairs and place them outside. I spend many an evening sitting in front of the house with Mari and her sons William and Alan as well as Mari’s brother-in-law. We sit and talk and watch the people walking past. It’s quiet here in the evenings and most of the traffic on our street is from people walking to the tienda on the corner to buy cigarettes, candy, soda or beer.

Americans build houses with backyards so families can gather in back of the house. That way children can play in a protected space and parents can barbeque out of sight of the neighbors. In Nicaragua (and Latin America in general) the paradigm is reversed: it’s rare to find a house with a backyard. Instead people gather in front of the house, in view of the neighbors. It’s much more inclusive this way.

Plus, we’ve been having power outages almost every evening for the past week. When the power goes out at night, people have no choice but to go outside because no power means no fans. And without a fan it’s nearly impossible to put up with the hot, stagnant are that’s trapped inside the house at night.

The moment the power goes, everything goes dark, and there’s a collective groan of frustration emitted by the adults of the neighborhood that’s intermingled with shrieks of excitement from the children. People grab flashlights or candles and head for the streets to pass the time and wait for the power to return. Luckily, we’ve gotten power restored within an hour or two most nights, but on night last week the power stayed off all night, and William and Alan moved their mattresses to the patio so they could sleep outside. where it’s cooler.