News from Matagalpa

From our Hospital team:
The hospital in Matagalpa is the sole major medical center for 450
thousand people scattered across many hours of travel to get to
regional clinics ...let alone the main medical center. The hospital in
general and the Peds area in particular are great studies in
contrast.... 7000 deliveries each year...in this hospital..but no system
to measure sugar in the babies....many ventilators...although some very
old...but currently no blood gas capability..at all. The pediatric
surgeon did 18 cases three days this week...but save for one
neonatologist...there are almost no other Peds specialists. The family
that spent seven days to get here....were too late...there infant had a
bili of 40 and appears to have kernicterus (brain damage)....but its
hard to get a bili also. Although they use their disposable cpap set
ups 100s of times...they seemed to be able to deliver very stable
levels of support. There are enough doctors in the hospital...there are
almost none in the rural areas.
The people continue the contrast...despite struggling conditions the
neonatologist was well versed in Cochran Data Base. The nurses often
have 8 pts..with several on vents...but were in good spirits and happy
to tell about their patients progress.
We have made some new friends and gained some good insights...soon the
work will get faster...they have asked for multiple presentations each
am at 7..then NICU 2 rounds...then NICU 1 rounds.... then PICU
rounds.... then the Peds ward....( and they are wards) 90 beds in all
for peds.
All for now..more in couple days... Sandy Rachel Selina Jeff