Wednesday, February 10, 2010

Scorpion

Jonathan was stung by a scorpion out at the plant while he was getting some bamboo samples together to send to the US. Everyone says that the scorpions here are not nearly as deadly as the the ones in the US and Mexico, but I had trouble getting a straight answer from anyone about what kind of danger he was in. It hurt a lot, but that was ok until he started to feel numbness in his mouth and tongue. That kind of systemic, neurological response concerned us, so we called a local doctor that had been highly recommended by some and disparaged by others. He wasn’t in, but someone in his office said - You should probably go get a shot of anti-venom. They have it at the Public Hospital.

So we headed out that way, but decided to stop at the Granada Private Hospital instead because the wait is shorter usually. They recommended a shot of hydricortisone. OK we paid 130 cords (7 dollars) in advance for the consultation with the general doctor and we paid another 130 cords for the shot.

But it didn’t help and later in the afternoon Jonathan was feeling dizzy and his legs were getting numb. So Thelma drove him from work to the public hospital - called Japones - because they donated it to Granada. I took a taxi to meet them. We went to the emergency pavillion which looked like every other building in Nicaragua - wide courtyard, tile floors and outside corridors with rooms opening off. We waited at a desk while the clerk finished his call with his friend, but then we were seen immediately by the doctor - we walked behind the desk and sat by down in a regular office across from a guy with a list and a blood pressure cuff. He took Jonathan’s blood pressure, noted his age and told him he needed a shot of anti-histamine just in case he was having an allergic reaction. (He had already taken two benadryl.) We told him about the shot at the private hospital. He said, how much did you pay over there? We told him and he said, here it’s stronger and its free. Good to know. They didn’t have any antivenom either. We decided, if the scorpions were really deadly here, they would have antivenom or would at least suggest we go look for some elsewhere.

We took the prescription for the shot and walked over to the emergency room. There were four people sort of standing in the middle of the room waiting for a attention, a doctor talking to a drug distributor at her desk and several medical personnel and two patients on gurneys. One had a busted nose and was on an IV and the other was just lounging on a dirty sheet on the gurney. He got up and left. Jonathan moved up in line and gave the nurse or whoever his prescription. He was told to sit and wait on the gurney the other patient had just vacated. The sheet was not changed. He sat down and I wondered over to watch the nurse get the syringe to make sure she took a fresh one out of the package. Which she did. She filled it up with the medicine, added a little water from the tiny package of water and then attached a line and one of those little needles that go in your vein. Then she walked over to Jonathan and put the needle on the dirty sheet. He picked it up before it could touch any germs. Then she stuck it in his vein and I had to leave so I wouldn’t faint.

I watched the other health care worker put on gloves and empty all the basins into a toilet that was over by the window. He rinsed them out with water from a faucet on the wall and stacked them up. There WAS a big bottle of Maxi-cide and he used proper technique to remove the gloves and cleaned his hands with afterward with alcohol gel. Still. I used a higher standard of sanitation to wipe noses in preschool than I have seen in hospitals in Nicaragua.

Jonathan sat around and waited to make sure he didn’t have either a strong reaction to the medicine or an increased reaction to the venom. Then we just walked out of there and took a cab home. The only bureaucracy was to write his name and age on a list. No charge.

Back at home, I am scouring web sites and trying to figure out just what kind of a scorpion it is. All the antihistamine has pretty much knocked Jonathan out, but I have to keep going to check on him to make sure he has not suffered heart or kidney failure or respiratory distress. His legs and tongue are still numb and his finger hurts.

All this has of course taken me to the place I never want to go here. What would we do if something serious happened to the kids? We would just have to high tail it to Vivian Pellas in Managua, but it is a forty minute drive at break neck speed. It is clear that there is no trauma capacity in Granada. I saw a women being wheeled on a stretcher into an ambulance. It looked like a regular mini van, donated by the government of Taiwan. Maybe there was some kind of electronic box in there, but it certainly wasn’t like an ambulance at home. I keep telling myself, its ok. There are kids all over the place here and they get along just fine without the advanced medicine we are used to in the States. What makes my kids so special? But it doesn’t really make me feel any better.

Jonathan seems fine this morning, just a little numbness left in the legs and tongue.

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