Being able to communicate with both the patients and the doctors in Nicaragua has been quite impactful. It truly helps build connections and trust between all of us. It also allowed me to practice and improve my Spanish to help take me to my goal of being a bilingual provider. It felt quite rewarding to have a translator on hand but not having to talk through the translator and rarely needing any help translating. The week I spent in Nicaragua truly showed me how proficient my Spanish is and how I should have more confidence within my Spanish. Becoming fluent in Spanish is a very huge goal of mine that will allow me have the ability to communicate and represent more groups of people. Going to hospital appointments is hard enough, but the patient's experience is greatly impacted for the worse when they do not even have the capability to speak directly to their providers. 

One of the most impactful learning experience was the difference in practice compared to the United States. The difference between America and Nicaragua was astounding. Seeing how the doctors have to handwrite everything rather than have the ability to use a computer to type as well as the difference in sanitary conditions were quite noticeable. Some of the vets would do spays and neuters without gloves. The sharps containers were usually old coke bottles. The operating room was way less regulated. Some clinics didn’t even have bathrooms. Yet with all these difficulties the providers and the patients were always sweet and kind.

I was able to not only experience their human medical environment, but also the beauty of their veterinary clinics. The first day I shadowed a vet clinic which was funded by the HOLA program and allowed 40+ spays and neutering of animals which is helping in lowering the huge production of stray animals. I was able to place IVs into the animals, intubate them, and give them vaccines/vitamins/pain medicine shots. It was beautiful to be able to apply my phlebotomy techniques to find and stick the animal’s veins. After the vet clinic we went to an animal shelter where we then took some of the dogs to the beach. 

I shadowed two OBGYN clinics where I helped take weights, do pap smears, measure the belly of pregnant women, feel for the babies position within the womb, and find and listen to the heart rates of the babies. This was nice because I was able to apply my knowledge from shadowing a pediatrician at Denver Health (DH) in understanding topics like breastfeeding, bilirubin levels, etc. The pediatrician I shadowed at DH was also bilingual so I was able to apply Spanish terms I picked up from shadowing to understanding the clinics in Nicaragua. I was also able to observe multiple caesarean sections. It was a fantastic experience to watch being as though it takes literal seconds to get the baby out. I also observed the aftercare of the babies once they were born which was super informative. I also was educated on the fact that in Nicaragua women that do not have caesarean sections do not have the option to have an epidural. This is because the quantity of pregnancies is so high in Nicaragua that it would be too expensive to offer for every pregnancy.