Best Hospital in Central America?

This is what the Nicaraguan guidebooks say about a hospital I visited last week with a group of medical students from the US (who were here for a week volunteering through Manna Project)…

“Hospital Metropolitano: The best hospital in Central America. This world class facility boasts the finest medical equipment available, Central America’s most advanced surgical center, and is known internationally for its state-of-the-art healthcare.”

As an eager, med-school-bound, health enthusiast, this kind of description gets my blood going. Basically, I couldn’t wait to see this supposedly incredible hospital- I was so excited that a hospital as advanced as this even existed in a third world country.

So you can imagine my surprise when we discovered that this world-class hospital (despite the fancy machines and expensive equipment) was for all intents and purposes, empty. There were hardly any patients in the hospital- it’s too expensive for most Nicaraguans, 50% of whom live below the poverty line. The white, clean walls of the hospital, decorated with fine Nicaraguan art, stood alone in the deserted hallways. Hotel- like patient rooms, with blue walls and large windows looking over a beautiful garden down below sat silent and vacant. Even the surgical unit, with its state-of-the-art sterilization machines, was unoccupied when we walked through for our tour. Oh, and the most common surgery in this “world-class” hospital? Boob jobs.

I couldn’t believe it. We’d just spent the entire morning working at a free clinic in the Managua City Dump. The tiny clinic (hardly impressive, but quite functional) is a three-room building with two exam rooms, a scale, two shelves and a cabinet for donated medicine (the only medicine). It was jam-packed earlier that day with men, women and children, both young and old. The medical brigade volunteering there did the best they could with the clinic’s limited resources; there was no lab for testing, only a very limited supply of donated medication and no fancy equipment for X-rays or ultrasounds. The three doctors shared one otoscope and one blood pressure cuff (that the medical students happened to bring from the States). Patients waited outside the clinic in lines to be seen. Although hectic and busy and small, the clinic was operational- but because of a lack of resources and supplies, the patients did not (could not) receive complete care. Words can’t describe how hard it is to tell the mother of an extremely sick baby that ‘sorry, we don’t have the right medication for your child. And we don't even know what your baby has because we have no way of doing any tests… maybe come back in a week.’

The morning I’d spent in the chaotic clinic in the Dump contrasted so greatly with the emptiness of this big, expensive hospital. I felt like I’d been in two different worlds. The juxtaposition of the two health care facilities still makes my head spin. Why put so much energy and money into a big, fancy hospital that nobody can afford? Especially when there’s so much potential to impact the severe poverty and disease elsewhere in Nicaragua…