Working in the Health Center

I'm living and working in a town that's just 30 minutes north of my previous PC site, the city of Jinotega in the department of Jinotoga. San Rafael del Norte is the name of the town but it's still located in the department, think state, of Jinotega. It's 400 meters higher in altitude than Jinotega so it's a bit cooler during the day and much cooler at night. Which is great.
Courtney arranged for me to work with a dentist, the only dentist, in the health center here; Dra. Mirna.
The health center is owned, operated, and funded by the government of Nicaragua. All the services provided by the health center are free to Nicaraguans. And San Rafael just moved into a new health center, but with most of the same equipment they had at the old health center. Or in the case of Dra. Mirna, with less equipment than she had at the old health center. Apparently, the dental chair she had, which is a dental chair straight out of the 1950's, metal, does not adjust in any way possible and does not retain any of the old cushions it once had in it's day, does not fit into the new dental operatory.


The new operatory has connections for air, water, suction and all the things we associate with a dental chair but does not work with this old chair. So, for the time being, we are using a dining room table chair.



The light we had also did not make it, so we use the natural light provided by the window. And it works.
In the health center, Dra. Mirna, does extractions. And that is the only thing that is provided. Extractions. Cavity...extraction. Pain...extraction. Abscess...extraction. But, it is free of charge. Well, that is if you don't want the e-spri (spray anesthesia). This, Dra. Mirna buys and provides as a service to her patients for a small fee of 20 cords...one dollar. Also, before she sees a patient she discusses their current vaccinations. And the conversation usually goes something like this...

Dra. Mirna- Is your tetanus vaccination current?

Patient- Yes, I think I had the vaccination last year?

Dra. Mirna- You think?

Patient- Yes, I'm pretty sure it was last year?

Dra. Mirna- Okay, I'll believe you. But, if you get tetanus,
it's not my fault.

Patient- Oh. Well. I'm not really sure if it was last year or
not. But, I'm pretty sure it was in the last few
years.

Dra. Mirna- Okay.

It's a very strange conversation to have with a patient before extracted teeth. However, she does sterilize the instruments. But, are instruments are limited and they can't be sterilized after each patient, although she does scrub them with a brush and a disinfecting liquid, it's most likely a conversation born out of experience. Although I've never asked.
Dra. Mirna is interesting. At the health center, as I've said, all she provides are extractions...at the health center. However, at her home, she has a dental operatory where she provides, for a fee, fillings, crowns, dentures and most other common dental treatments. Which I find interesting. Dra. Mirna is a Sandinista...politically. However, in her private life she believes in capitalism. The two don't really go together. In the Sandinista theme song, Yankees are singled out as being the enemy of humanity and I've listened to many speeches by Mr. Ortega which blames capitalism, specifically that practiced by the U.S., as the cause of Nicaragua's problems. He even blamed the last Hurricane to hit the country on the U.S..
Interesting.