Archive for SarahAnne Herbert

El Quinto Dia (and Departure)

I know this post is a few days late… You can thank the ocean water for that. Alas, we had an amazing last day in Nicaragua where we helped out at a local health fair, toured around Lago Nicaragua, and made our final trip back to the capital!

At the health fair, we assisted in and observed the gynecology clinic, where we were permitted to observe Pap smears and ultrasounds, the pharmacy, where we helped package and organize prescriptions, and a few other clinics. Brenna and I also helped with the kids’ piñata, an elaborate Santa Claus piñata filled with Nicaraguan candies.

Best of all, a DJ sat outside and played music during the ENTIRE health fair, from 8am until the afternoon when we left! The fair was extremely crowded all morning, with children, men, and women all patiently waiting in long lines outside to be seen by the doctors within.

When the health fair was finally slowing down, we left for lunch, where we were greeted by our wonderful bus driver and his son and daughter! They had come to say their goodbyes and deliver some delicious homemade Nicarguan snacks called Rosquillas! It was delightful. His kids were so excited to meet us, and the Rosquillas were so tasty!

After lunch we said our goodbyes to the two wonderful doctors who accompanied us on most of our trip! It was so sad to say goodbye to them, and we hugged, laughed, and took pictures for as long as we could!

Our drive back to Managua was beautiful. We made a stop at a mountain-top town to buy souvenirs and take pictures of the beautiful Lago Nicaragua and Ometepe Island. The lake itself is made of freshwater but home to bull sharks, and the island has two volcanos, one of which is extremely active… We were told you’re allowed to hike up to the top and look down in the crater at the lava, but that you’re risking your life if do… it erupts fairly frequently.

On our drive down from the mountain town, we saw the most beautiful sunset over Ometepe, a perfect ending to our day.

We ate our last dinner in the hotel in Managua, and arose early in the morning for the flight back home.

Arriving back in the United States has been quite a culture shock… My trip has made me so much more aware of my good fortune and how much relative wealth my country has. Clean tap water, freedom from most mosquito-borne illnesses… the list is extensive and does not end there. Going Christmas shopping reminds me of all of the freedom and money we have to be materialistic… When some can’t even afford to feed their pets…

I cannot put into words how much this trip has impacted me, but I do know one thing: meeting these wonderful, loving, generous people has made me want to be a more compassionate person in my everyday life, and I’m still moved by their loving kindness and welcoming hearts. I hope I am granted the gift of one day returning to that beautiful, happy country, but for now I will hold it in a special place in my heart.

El Cuarto Dia

What a day…. This morning I woke up early, around 6am, to watch the beautiful sunrise on the beach. Pigs snored in their owner’s backyards and we witnessed a mother pig nursing her baby wilburs!!


After a breakfast of omelettes and pancakes, we piled into the bus and made our way to the nearby community called El Tambo. I was so caught off guard when we arrived… We met a few of the families, who live in a variety of homes… Most were small, one-room brick-house dwellings with tin roofs, but some were made of less sturdy materials like thin logs and sheets and open to the outside.



Chickens ran around the front yards, going inside occasionally to escape the curious visitors who were trying to catch them. A lone, skinny puppy peered shyly at us from one of the front stoops.


One of leaders of El Tambo gave us a tour of the neighborhood, introducing us to members of the community. We ended up meeting an older man who asked us for help with his eyes. Professor Kelly grabbed her pen light and examined the man’s cloudy eye… she then spent the next half hour speaking with him and attempting to arrange a way for him to get driven to the nearby health clinic.


After more community members had arrived, we gave several presentations on health promotion topics, including diabetes, hypertension, clean water, and breast exam education in the community center next door.

They were the most wonderful women, and they were so welcoming to us! They loved our presentations and thanked us for them often. A few of us got to play with their adorable children while they stayed and watched the presentations, a welcome break for them from the constant attention the playful toddlers and babies required. (We also got to watch Finding Dori with them!)


It was so obvious they appreciated the time we spent with them, and they showed their gratitude by surprising us with the most delicious meal we had experienced YET, a delicious homemade chicken dish with rice, squash, pico de gallo, and amazing sauce. They even brought us homemade star fruit juice!


We were moved (to tears) by their generosity. They showed complete strangers so much love and hospitality, and they trusted us immensely, not only with their children but with sharing their difficult stories with us.

This just goes to show, someone can have almost nothing… Barely enough money to even feed their family, to buy building materials, or own a mode of transportation, but they still may be some of the kindest, most hospitable, welcoming people you will ever meet in your life. We all agreed-today will have an impact on us for life.

El Tercer Dia

Today we got to sleep in… For an entire extra hour!!! We packed our things, hopped in the van, and traveled to a new location at 7am- a municipality called “Tola,” a rural area outside of the city of Rivas. The scenery changed drastically from crowded streets and stores to lush forests, fields, cattle, and hundreds of wild dogs.


We made our first stop at one of the main Tola health clinics, and we received a tour from the doctor of the clinic! Divided into groups, we spent the next few hours helping out the staff. Meghan, Susan, Indira, Brandon and I provided assistance in the family health/general medicine clinic, where we were taught a lot of information about how the nurses and doctors must know everything about all of the people in their municipality!


Brenna and Amanda worked in the ER where they helped with wound care and taking vitals!

Kimberly, Katherine, Angela, Mackenzie, and Ali helped out in “Mommy and Me” where they tracked and measured growth of babies and gave immunizations.

The clinic even had a natural health department which utilized the garden outside! Katherine got to sit in on one patient’s reflexology appointment! It was very exciting, although she unfortunately did not get to receive a massage herself…

We all loved the artwork and posters throughout the clinic, which contained educational messages about proper self-examinations, nutrition, and herbal medicine! The building was so colorful- a beautiful sea-green!



When we were done working in the clinics, the director of the Tola health ministry gave us a presentation on the health statistics of the area and the vector-born disease program. We were blown away by their public health program, and we told them so!

Carlos, a peace corps volunteer in Tola, was also very excited to meet us and talk to us today! He’s originally from New York, and was really excited to see some fellow Americans. We received a different perspective on Tola and the healthcare system with his point of view.

We eventually piled back into the van and made our way to the hotel. During the drive, we were stopped by several herds of cattle. I also accidentally scared the bus driver when I shouted excitedly about baby pigs and chicks in someone’s yard. “Lo siento, senor!”

We were FLOORED when we arrived at the hotel! What a beautiful place, and right next to the ocean!


After dinner we mingled some and then took a nighttime walk on the beautiful beach. Tomorrow we wake up bright and early for another day full of work at the clinic!

El Segundo Dia

We woke up bright and early and departed for the hospital at 6:45am this morning! Rested and more comfortable with our surroundings, we entered the hospital with excitement showing on our faces! In groups of four, we spent two hours each in the emergency room, labor and delivery, and the operating room.


Brenna, Meghan, Amanda and I began our day in the OR, where Doctor Mariana Jarquin, our medical brigade advisor, and our Puerto Rican nursing instructor, Gladys, acting as an interpreter, showed us through the operating room. We donned shoe covers, hair nets, and face masks and proceeded into the OR, where we were informed five “cesarias” (C-sections) would be taking place later in the day. We were kindly invited by two surgeons to watch them perform ophthalmic surgeries. One surgery was on an older man’s left eye cataract, while the other involved the setting of a maxillofacial bone fracture on a young woman’s face.


We began with the occipital bone surgery, and observed the many scrub nurses and surgery assistants as they prepared the girl for surgery. They put her under general anesthesia, intubated her, and put her on a mechanical ventilator, all the while answering our questions as Gladys interpreted for us. We cringed at some details, which I will spare the reader from, but all in all it was a quick and successful surgery, and it absolutely fascinating to watch!


Next, we traveled to the cataract surgery room, where the surgeon allowed us to view the man’s eye under the microscope before he began his removal of the lens.


After only a short few minutes, we were beckoned by Mariana into the hallway, where she informed us we would be allowed to watch the first C-section of the morning. Excited and nervous, we entered the room, just as the surgeon was making the first cut. In just 15 minutes, the first squeal came from the body of the 8lb. baby boy as they moved him from his mother on the operating table to an incubation bed. The nurses took his thumb print and foot print, and cleaned him off. They let us join them as they moved him to another room to receive his Vitamin K shot and antibiotic eye ointment. We then joyously took turns holding him and welcoming him into the world!


We spent the rest of the day moving between the emergency room and the neonatal-ICU, helping in what small ways we could. Meghan and I assisted the one nurse in the emergency room with some much needed help preparing medications, while Brenna and Amanda helped clean and feed babies in the neonatal department.


During our transitions between departments, we spoke to the other groups and learned about their rotation experiences in the various departments. We all agreed, today had been incredible.


We ended our day with a late lunch shared with the nursing directors, while Kimberly and Katherine gave incredible presentations on their knowledge of baby massage techniques, natural birth, and child birth practices in US hospitals. The Nicaraguan nurses had so many questions and were so intrigued by our perspectives!


Now we are relaxing in the hotel lobby, chatting about our experiences and waiting for the van to arrive to take us to dinner. We are famished after such a busy day!!!

Nicaragua, El Primer Dia

We pulled into the driveway at Hotel Nicarao at 11:30 last night, exhausted from finals being over and a long day of traveling! After a quick discussion of the following morning, we all stumbled into our rooms to sleep. In the early morning, we were awoken by the calls of doves outside our windows. After showers and donning our scrubs, we all made our way to the lobby for our first Nicaraguan meal!

The lobby of the hotel is open to the outside and surrounded by a beautiful patio, which looks out onto the bustling and narrow streets of the city of Rivas. Even at the early hour of 7am, many people were already walking down the streets and driving their motor bikes.

Several tables were set up in front of the large open doors to the patios, and they were decorated with crocheted table cloths and little Christmas decorations! (Which felt odd, considering it was already 80 degrees outside). We were served orange juice, deliciously strong coffee, fresh papaya and pineapple, and for the entree, something Nicaraguans call “Gallo Pinto,” a tasty meal of eggs scrambled with ham and rice and beans on the side.



Gladys and Ursula, our instructors, helped us with some last minute preparations for the day by reminding us to fill our water bottles and ironing our many wrinkled lab coats, and then we were off to the hospital!

A short drive through the narrow streets of Rivas brought us to a bright pink, one-story-tall building outside of the city, the hospital where we would be spending the next few days! We entered and were welcomed by Nicaraguan Christmas music, a wonderfully decorated tree, and a happy, smiling receptionist! My eyes were immediately drawn to the brightly colored walls and the tree-filled courtyard around the corner. Very different from our hospitals in America with white walls and windowless hallways, this hospital was open to the outside air in various places, with many large windows, colorful paintings, and music filling the rooms. Hallways between hospital sections were surrounded by courtyards, and Nicaraguan flag posters were located on every few yards of walls space. Displayed on the walls of the hallways was various information on public health issues afflicting the country: posters on Zika and Dengue fever, as well as posters supporting breast feeding and maternal health.

We all eventually made our way to the hospital conference room, and were greeted by nurse leaders, doctors, and administrators. We began introductions with a prayer led by the Director of Nursing, and then joined them in standing for the Nicaraguan National Anthem. Next, several Nicaraguan nursing students and nurses gave us presentations on their hospital research. We talked quietly amongst ourselves, excitedly commenting on the fact that they were using nursing models we also use at Emory! Discussion followed, and the American students and Nicaraguan nurses got to ask each other many questions, utilizing translators and elementary understandings of each other’s languages.


After a short reception filled with laughter, smiles, and compliments in “Spanglish,” we made our way to our various rotation assignments. We split into groups of four, spending time in the emergency room, post-op and orthopedic departments. My partner, Meghan and I helped hold down a four-year-old child while the doctor sewed up a large gash on his head. He had been playing on a table at home and fell from quite a height! His mother cried from nerves, but he didn’t even utter a whimper! We told him he was “muy bravo” (very brave), and he and his mother gave us big smiles and nods.

Walking down the halls, we spotted stray cats and dogs milling about the courtyards and near patients’ rooms. Patients were wheeled on stretchers through the open-aired hallways from one area department to another. Music played continuously and the nurses and doctors chatted and laughed with one another, often staring at us as we walked by. As the clock ticked by, the day got hotter and hotter. Unable to shed our lab coats, we suffered in the heat, noticing changes in our moods as the humidity increased. Although we may have appeared sleepy-eyed and over-heated, we merrily continued on through our day, not stopping until the clock reached 5pm.


Departing the hospital, we climbed into the gloriously air-conditioned van, and drove the five minutes back to our hotel. As motorbikes passed by us on the street, we walked back into our rooms to collapse on our beds for a brief moment before getting ready for dinner. The proceedings for the following day were decided during our dinner discussion, and it was mutually agreed upon that we learned and saw quite a lot of new things in just the past 10 hours. What an incredibly rewarding experience this has already been…. I am so amazed at how different, yet similar, nursing practice can be in two countries. We all definitely agree on one thing: we cannot wait for what tomorrow will bring!