Here’s an article I wrote for CentralAmerica.com
Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other, as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,
And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
- Robert Frost
When I read that the nearest hospital would be 2 1/2 hours from where we would be living in San Juan del Sur, Nicaragua, I felt a tinge of unsettling fear. Being a mother of 2 young kids, I’m fully aware that a serious injury could happen at any moment.
This fear got even more real after we moved and I discovered that the way most of the houses with ocean views are built here in San Juan del Sur are with very beautiful, but unsafe patios. I practically have a heart attack each time I find myself in one of these homes with my kids. Rope railing are great for an unobstructed view, but I just can’t see the beauty through the images one of my children plummeting to their death.
It took 7 1/2 months before we got a personal look at the free medical system in Nicaragua. On my son, Titus’s, 1st birthday my daughter, Azalea, reached up into a snow cone machine and cut what looked like the tip of her finger off. There was so much blood! We found the piece of finger and put it on ice (but not directly, as a retired firefighter party guest advised us) and rushed to the clinic in town. Knowing this would be a Spanish-only situation, we brought my friend’s Nicaraguan husband who knew where the hospitals were and could speak both languages. We were told at the clinic in town that we could wait 30 minutes, but they would probably send us to the closest “city” Rivas, so we opted to just head there. We parked and our friend carried Azalea through the front door and straight to the back demanding that she be seen. Only two people were allowed in the hospital with Azalea, so my husband had to wait outside in the waiting area. The doctors looked at the piece of finger and determined that there was no bone in it and it was only the pad that she had cut off. They asked if we’d rather they sew it or bandage it. I don’t have a medical background, so why they were asking me was puzzling. We decided that with her screams of pain and intense fear, it was best to only clean it and wrap it. As her finger healed, I was so happy that this was the decision that we had made. She had cut a pretty large circle off the pad of her finger. To stitch it, the skin would have had to pucker and the healing would not have looked as even. We left the hospital in Rivas after about 20 minutes with no bill to pay. Azalea decided she wanted to go back to the birthday party where we had left all of our friends and Titus with my parents. She was such a brave girl and recovered quickly enough to even have a turn at the piñata.
Exactly 2 years later on Titus’ 3rd birthday we had a tropical storm that was connected to Hurricane Nate whip through Nicaragua. Our internet went out with the high winds and we decided to head over to the resort, Surf Ranch, down the street to see if they had internet. They use the same provider as we do, so if their’s was still up, then it was something having to do with our home system and not the company. As soon as we pulled out of our property we found a downed tree blocking the road. With little to do that day, my husband decided to go get our machete and saw to try to unblock the road. It was raining outside, so the kids and I made fun in the car while Daddy worked on the tree. (pic) Once a large piece was cut free we tied it to the car to drag it away from the road. There was one small final branch in the way, and Kharron used the machete to slice through it. Easier than expected, the machete glided right through the branch and slipped out of Kharron’s wet hand. Unluckily, it bounced off the dirt road and ricocheted back, hitting the knuckle of his thumb. I heard him shout, “I cut my thumb! I cut my thumb!” As he walked towards the car clutching his wrist. I could see drops of blood rolling off his hand. There was a small white sliver of a bone resting on top of his open knuckle wound. We have a river that wraps around our neighborhood, so when there is a lot of rain it gets high enough where we cannot leave until it goes down. Usually this is just for an hour, but in the middle of this tropical storm, it might be days until the rained stopped. Knowing we were stuck, uncharacteristically calmly went to the back of our SUV and retrieved a medical kit my mom had left us after Azalea’s finger incident. I rolled the kit out, assessing my options, and went for the gauze and medical tape, wrapping as tightly, but gently as I could.
It was 30 hours before we made it to the Rivas hospital. We had no translator this time, but hoped our years of being in the country would get us through even the medical terminology. Immediately the doctors started talking about admitting Kharron into the hospital for 3 days. The Rivas hospital is dirty and full of cats in the outside corridors. It is not someplace one wants to sleep even for 1 night, forget about 3. We started looking at other options and called Vivian Pellas, the private hospital in Managua. They would not be able to see Kharron until the next day, so we decided if the doctor was just going to do a local anesthetic, then we’d stay and have it cleaned and stitched in Rivas. If they wanted to put him under and do something more severe then we’d wait the day and go to the better hospital. The doctor ensured that he would do a local and just clean and suture it and Kharron would only have to spend one night. We agreed and I left the hospital to run home and get our own sheets, a pillow, and a change of clothes for Kharron. When I got back an hour later they told me he was still in surgery. I waited outside the door for over an hour. Finally they wheel him out in a chair with a huge bandage over his thumb. He told me that they put him under and he thought they put “clavitos” or “little nails” in it. We asked the nurse wheeling him, but couldn’t get a straight answer. Kharron started to get pretty serious about not wanting to spend the night. We asked for a prescription for the antibiotics they were going to give him and to sign him out. Reluctantly they handed over the paperwork, but refused to give us a prescription.
Two days later we headed to Managua for an appointment with a joint specialist. He unwrapped Kharron’s finger for the first time since his surgery and we could immediately see that it was infected. He took x-rays and noted the fracture. He performed surgery right away. Removing some of the infected skin, cutting further down to find the tendon and reattach it (that’s right, the first surgeon never attached it), and removed one of the 3 pins. We left the next day on a two week trip back to California. Kharron spent every morning re-wrapping it and making sure that the sore stayed dry. A few days after we returned to Nicaragua we went back to the doctor to get the pins taken out. We had a good laugh during this appointment as the doctor not only told us about another Gringo patient of his from San Juan del Sur, but actually showed us pictures from her arm surgery. The doctor-patient confidentiality is slightly more relaxed in Nicaragua!
Kharron saw a new physical therapist in town a few days after getting the pins removed. He still cannot bend it, but we are told that this is normal and fingers heal slow. He now has a Frankenstein finger and is forever changed by Nicaragua and Hurricane Nate.
When you hear a country offers free public healthcare, before getting getting too excited, it is important to understand what level of care is provided. In my daughter’s case, the incident was mild enough that using the national health system was sufficient and I was appreciative that even as a foreigner we were seen and cared for completely free of charge. On the reverse side I was severely disappointed by my husband’s care. After the first surgery and waking up surprised to have pins in his thumb we heard lots of stories about how that hospital is known for cutting off fingers and experimental surgeries. I feel sad for a majority of the locals who have no other choice but to use the public healthcare. How hopeless they must feel at times when receiving improper care at a dirty hospital. I quote the surgeon at Vivian Pellas who said while looking through our pictures from the Rivas hospital, “It is a shame. Cleanliness doesn’t cost anything.” One of the bacteria Kharron had was something you can only get from hospitals. Now that is sad.
We planned to arrive in Nicaragua sight unseen with a baby, a toddler, 7 suitcases, and 2 dogs. We knew that we needed to have a car immediately. Luckily, one of Kharron’s friend’s fathers, Joe already lived on the Atlantic side of Nicaragua and offered to help us get a car purchased before we moved. He seemed to know what he was talking about and convinced us to spend over our $4k budget so that we would have less problems. He advised us to spend at a minimum $10k, but that was not financially possible, so we agreed that he’d look in the $5k-$6k range.
After test driving a few SUVs he found one that needed a clutch, but he could get that fixed and all said and done it would be $6k. We agreed and wired him the money to purchase our 2007 Mitsubishi Montero. When Joe picked us up at the airport he had our car waiting for us at the hotel in Managua. It was really great to immediately have wheels and a way to get around town. We had a list of items we wanted to purchase before we moved to San Juan del Sur a week later.
Since that day, we have made many repairs on our vehicle. It turns out Mitsubishi’s have computerized engines so when something goes wrong, the mechanic needs a diagnostic computer to tell what that problem is. This is super easy in North America, but we only found one mechanic in San Juan del Sur who has that computer. The abundance of bumpy dirt roads in San Juan del Sur is rough on cars. It is common to replace bushings annually and hoses come loose often. One of our sensors needs to be cleaned every so often or our car doesn’t start. This is always fun when you have everyone loaded in the car in the morning for school.
We found a mechanic we really like, but he is located in Rivas which is 30km from San Juan del Sur, so depending on the issue, it is sometimes hard to get our car to him. Slowly we’ve been ticking off a list of fixes our car needed, but then on our way home from Matagalpa our car finally took a dive. There was a hole in a water tube that caused the engine to overheat. A nice Nicaraguan towed us the 9km to our mechanic.
Over the last 2 1/2 weeks we’ve been having our engine rebuilt and got it back yesterday. Thank you to the “collectivo” for being a cheap was to get to Rivas to pick it up. We are hoping this major rebuild will solve most of the issues and we can finally feel confident in our car.
This is a little joke my husband, Kharron, and I have about what is needed to get anything done in Nicaragua. Its not always 2 stores that is needed, sometimes its only 1 store, but 2 people. The general rule is that you will not find what you need in one place by just yourself searching. You will need to speak to a local who either knows where or knows a person who can get it, but once you have it you will need to find a store that will put it together/on/fix it…
Having a “guy” seems to date back to the 1980’s when food shortages were rampant in Nicaragua, a biproduct of the Sandinista government controlling the price of most essential items. A black market or “bisnes” were created and industrious people in the busier cities hired themselves out to wait in lines for the wealthier or became “drivers” who’s sole purpose was to find what their employer was looking for. These men were and still are worth every penny. (*Blood of Brothers: Life and War in Nicaragua by Stephen Kinzer)
The first time we experienced this two-stores-and-a-person phenomenon was prior to us even moving. We had a friend who was already living in Nicaragua so we asked if he might be able to find us a car, so we didn’t have to spend our first week running around scrambling for a car. He obliged and found us an affordable 4×4 SUV. Being an American and not having residency in Nicaragua, he could not own the car himself, so he put the car title under his girlfriend’s name.
We purchased a generator at PriceSmart (equivalent of Costco) two days after we landed. We had done our research and knew that power outages were a major problem. Kharron works as a software developer and it is very important that his access to internet is uninterrupted. Once we were moved into our first home we struggled with connecting our generator to the already wired system. When a home is properly wired, once there is a power outage, you only need to switch a lever to change the power source and turn on the generator. We needed the correct cable in order to plug into this system. One weekend day the family drove around Rivas, stopping at every hardware store (ferretería) to find the correct cable with 110 plug on one end and 220/240 plug on the other. It finally became clear that we would need to buy the 220/240 at one store and the 110 and cable at another. We then hired an electrician back in San Juan del Sur to wire the parts together. In this case, it would have been much easier to hire a “guy” to do all this running around for us, returning with a completed product.
Soon after we moved and once Kharron got an office outside the home, he decided to buy a motorcycle. This way he could get to work easily without me having to get both kids in the car to take him & pick him up from his office. We do not have residency (yet) so we cannot own a motorcycle. Luckily Juanita was happy to not only walk us through all the stores in Rivas that sell motorcycles, but also put the moto Kharron selected in her name as the owner. There are several engine checks that are needed immediately after purchasing a motorcycle, for this we used Juanita’s husband, Vicente who rode the moto the 45km back to Rivas, waited while the checks were completed and returned with paperwork and receipts. All for $8.
Most recently we needed 2 new tires for our SUV. Already having made some connections, we have a “guy” we now go to for all things related to car. So we paid Happy (yes, that’s what he’s called) because he knows someone who goes to Managua and can buy decent tires at a good price. Of course Happy nor his “driver” installs tires, so we had to go to a vulcanizadora (tire repair shop) to have the purchased tires placed on our vehicle. The most popular one in San Juan del Sur seems to be Vulcanizacion “Las Pampas”.
Once you understand and embrace this process, its really beneficial. You don’t need to do anything but pay a few bucks to a knowledgeable and trusted local once they have delivered your commodity. In return, you’re helping someone make a honest living.
For the first 3 days we stayed in Managua, listening to the advice of a friend who was already living in Nica. We landed on a Saturday and our dogs weren’t scheduled to come in until Monday night. Our friend Joe reserved us a spot at Don Quijote Hotel for only $60 a night and was going to show us around the city for the next couple days. The hotel was in a convenient location, was very clean and included breakfast and delicious coffee in the morning.
Managua is like an infectious disease that slowly creeps up on you. The first day you notice its busy and a little dirty, but you’re okay with it. The next day the scenery seems a little apocalyptic and you can’t believe how crazy the drivers are. By the third day you just want to get all your errands done quickly and get out before the inevitable accident in a rotunda, or traffic ticket.
Managua is a necessary evil when living in Nicaragua. There are things harder to find outside of Managua and everything is cheaper there. The best supermarket, La Colonia is located in Managua (also in Granada and Leon), the best veterinarians, hospitals, and stores. Mechanics seem to take trips to Managua many times a week for parts.
On our last day we ran around going to get a copy of our car key made since the one the car came with was about to snap. We also went to Western Union to wire money, went to SENSA – the big hardware store owned by Ace, Kid’s Plaza looking for a twin size plastic sheet (Azalea was having some bed wetting issues), ate lunch, and managed to buy our way out of two traffic tickets which are called “multas” – translated to “fines”.
Finally we were off to paradise – Surf Tours Nicaragua, in Miramar where my friend manages.
I thought getting through customs with 7 bags and 2 kids was going to be a nightmare, especially after traveling a red-eye. It was actually very easy! There are men to help you with your luggage and you only need to pay them a couple of dollars to make them happy.
There is a VIP option which for $30 per person (and some undisclosed amount for kids) you can skip customs all together. They take you out a side door and you wait in a lounge while they stand in line and do everything for you. Not sure how this is legal. I thought we had made a reservation for this, but there was no one holding our name on a sign when we exited the plane and it wasn’t much of a hassle anyway.
All in all, not a bad experience.