First day of work

Altagracia is the second town on ometepe, population about 10,000.
It has a small medical centre which houses a couple of doctors and a handful of nurses.

All secondary health care happens a boat ride away in rivas - just what one would want during a difficult labour!

So my first day I reckon I battled through seeing about 10 patients. second day I had seen 12 by lunchtime which was much better and I think the doctors a the clinic thought I may have been some use.

My spanish is barely passable to manage a consultation, but manage we did and that is not a bad starting point. So long as the problems are simple then I reckon I get to the right diagnosis. One of the ¨real¨doctors keeps an eye on me and lets me ask lots of questions.
Questions usually relate to which antibiotics they stock in the clinic. Not much is the usual answer

The problems people come with?
chest infections, urine infections, worms, pregnancy checks, machete injuries, PID, arthritis, gastritis.

Reasonalby standard GP sort of stuff - apart from the machete injuries

Today I saw a boy of 8 who had cut off the end of his finger with a machete.
A lot of the household farm work is done with machetes so injurues are reasonably common.
Another lad of 18 managed to cut his lip with a machete - wasn´t quite able to ascertain exactly how he did that.

Its been pretty difficult starting out but that was what I expected.

My spanish is getting better every day now that I am down on the island so I´m optomistic that things will be getting easier