And just like that, the first week has already passed. What a week it was! After the first day, I was a little down, and I thought these four and a half weeks would pass by so slowly. But ever since Tuesday, it’s been pretty much none stop, and the week flew by. I don’t why Monday was so slow, but now it’s evident that that by far isn’t the norm.

On Tuesday, things picked up quite a bit. We got to work and were playing around with the Drager ventilator a little bit when another technician named Donald came into the workshop and brought a plug from a surgical suction machine that had a detached wire. It was an easy fix, so Julie soldered it back and voila! it was fixed. As if that weren’t already a huge improvement, Donald came back later and told us to come with him. A fryer in the kitchen had broken, and he wanted us to go with him to investigate. We went along and he told us what to open up and so forth. We opened the box to the main transformer and immediately Donald said, “Está quemado.” After taking out the transformer, what do ya know? Donald’s instinct was 100% right. It was burned. He had diagnosed correctly just by smell and some good ol’ experience. We took the transformer back to the shop and tested it and ended up frying it some more, haha. Fortunately, Donald and Roger determined that the transformer wasn’t actually needed. It was designed to lower 220V like you find in Europe to 110V. But the wall here in Nicaragua (and in the States) outputs 110V already, so we could bypass the transformer altogether. We continued the diagnosis for a good long while and discovered the source of the problem was another broken transformer and switches. It was fun to follow Donald in his troubleshooting process and learn from him. He’s a really nice guy and likes to smile and teach us. He kinda reminds me of a fun young grandpa, and I had a feeling he’s Christian. I saw his cross necklace the other day, so I think he is, though the cross had a loop on top. Don’t know what that means. It looked kinda Egyptian? /Shrug. Anyways, after that, the day got even better. The nurses and other hospital staff bring everything to the workshop for Roger to fix, from speakers to telephones to remote controls to all sorts of medical equipment. (And the workshop has air conditioning which is really nice considering how hot it is here.) The nurses had brought a drug infusion pump and an infant warmer while we were shadowing Donald. So we started working on the infusion pump. Turns out the keypad was worn so that the on button of one of the pumps didn’t work. The circuitry was rubbed open. Roger said they usually used a silver pencil or nail polish to draw over the circuit to close it so that the button would work again, but the pencil was really small and really expensive and they didn’t have any nail polish. At first all I heard was pencil, so I thought of graphite and thought he meant that we could use a regular pencil. So I said, yeah, carbon would conduct electricity. That made Roger’s face light up, and the he disappeared from the room. (We’ve found that he tends to do that a lot.) When he came back, he had two bottle caps, one full of graphite filings and the other full of oily varnish. My comment had given him an idea. He mixed the graphite with the varnish on a piece of paper and then bent a paper clip to use one end to paint the graphite mixture over the circuit. We left it to dry for a few minutes and afterward the infusion pump turned on with not problem! That’s my favorite repair so far. It was so ingenious! We used what we had, and it worked wonderfully.

So Tuesday really left me feeling much better and excited about what was to come. Not to mention we also met Daniel Calero, the head of the engineering department, who is also really nice, though he seems like the type who could get really serious real quick. He really likes to say “correcto,” haha. And Juan Santos, the head technician who’s on vacation until next Wednesday, also stopped in during the afternoon to say hi. We were really glad to see him and told him we’d heard a lot about him and gave him the envelope from Kathleen and AJ. He was so happy to get their letters and pictures. He seems like a really nice guy and was smiling the whole time. Can’t wait to work with him next week.

Wednesday was good too. We took a long time fixing the sides of an Air Shields Infant Warmer. Apparently the nursing staff doesn’t always know how to lower the sides (you have to raise and then pull out – sometimes they just pull) so they break often. This one was missing two sides, and the corner connectors were beyond repair. So Roger took us to the “bodega” (storeroom) to look for spare parts that we could use. We’ve discovered that a key to repairs is finding the right spare part among the old stuff that you’ve thrown out. We found a simple replacement side and connectors and returned to the workshop. We tried to drill screw holes into the metal side of the infant warmer to screw the connectors on, but the metal was really stubborn. We bought a new drill bit from the nearby hardware store, and it eventually did the job, but not before melting in the hole from the intense friction, haha. We finally installed the sides and cleaned it up with alcohol and delivered the infant warmer and the infusion pump to the neonatal unit. That seems to be the department that requires the most equipment repairs. The end of Wednesday saw us cleaning the computer chips of a NELLCOR pulse oximeter with a toothbrush. Good day.

We fixed another infant warmer missing sides on Thursday. This was the first repair that Julie and I did ourselves, so it was pretty exciting! This one didn’t require nearly as much brute force, which was nice. We learned on Tuesday that brute force is rarely required. Instead the technicians use “maña,” or “skill, cunning.” Basically, they think of ingenious ways around problems. With this infant warmer, we could just use old connections that would hold for the corners we needed. So all we needed to do was some rearranging and some screwing and cleaning and we were good to go. We fixed that up and finished putting the pulse ox together so we could bring those back to neonatal again. They were pretty happy to get their stuff back, and we even saw that the infusion pump that we fixed yesterday was already in use on a really small baby. When we tested the pulse ox my pulse was around 76 and went down to 70. It’s getting better, haha.

We also got called to the clinic on Thursday. One of the gynecology clinics needed an instrument connected to a tank of Nitrous, and they just didn’t have the tools. So we went to make the simple connection and discovered that the instrument had a dirty connection too that was making it leak and not work properly. So Roger cleaned it with a brillo brush and some windex-looking stuff. It’s amazing how many problems are solved by a simple cleaning. As we were finishing, they had already called the young lady patient in and had told her to change into a hospital gown and was already asking her to sit on the examining bed. We quickly stepped aside and let them examine her and use the tool. We had to be there in case it didn’t work and also to disconnect the Nitrous afterward. But I have to be honest, I felt a tad bit awkward even though it really wasn’t that bad at all. I mean, poor patient! Julie and I were well to the side, but to have three doctors, a nurse, and a technician watching as your have your genitals checked? Unheard of!

The clinic was full though. Lots of patients with infirmities that weren’t enough to have them stay in the hospital were waiting in the big room with rows of chairs. There were lots of kids in casts. I wish I had taken a picture. Hopefully I’ll remember to bring my camera next time we leave the workshop.

We also went to take some useful stuff out of the “bodega” as they were cleaning and organizing it to make a path today. We found some nice tubes that we used to replace the leaky ones in the Drager ventilator, which we’ve had all week. We decided to name it “Gustav” (that sounds German, right). Anyways, Gustav kept giving us problems. Julie and I complained of the Curse of Gustav. That troublemaker.

We had been expecting our coordinator Michelle at the hospital all afternoon, but she never showed up. She had said the night before on the phone that she was going to come visit and was going to bring someone from the Ministry of Health to tour the hospital. But she never showed up. When we got home, we found out from Delma that she had called in the morning after we had left and said that she had a bit of a cold and would not be coming to the hospital after all. She ended up meeting the Ministry of Health person in her office and then came over to our house to visit us and chat and give us our cell phone. It was so good to see a familiar face and to catch up!

Which brings us to today, Friday, which was definitely no less exciting than the other days! We started the day with simple things. We applied epoxy to a huge crack in a baby basin so that the neonatal unit could use it again. While we left it to dry, we examined Gustav some more to find out if there were any more leaks. We pored over him with probing fingers and a sponge full of soapy water to see if any of the tubes bubbled, but we found no more leaks. Yet sometimes the pressure would still drop slowly. In the end, the pressure stayed steady, but the maximum pressure we can get is only 50 mmHg, which is not right. We’ll see what Rob says about Gustav. El rio perhaps? Haha.

After that, Julie and I decided to get our 10am refresco. It’s usually just some juice, but it’s nice since we aren’t usually too well hydrated here in Nicaragua. Yesterday we had beet/carrot/orange which tasted kinda like V8 Splash. Today we had tamarindo, which is tangy and sweet and quite refreshing. All the fruit drinks here in Central America are delicious and refreshing. We were sitting down to take our break from the frustrations caused by Gustav and to store our friends’ cell phone numbers in our phone when the secretary Doña Magdelena from the engineering office came in looking for Roger. We said we didn’t know where he was, but she said there was an emergency with the ultrasound and asked if we could go look for him. I got really excited at this. There’s something about hearing the word “emergency” in any language that gets your adrenaline pumping. So we left with some tools in search of Roger and the ultrasound emergency. We went to the neonatal ward, but Roger wasn’t there. They directed us to ultrasound, but the ladies there said there was no problem either. Julie and I were pretty confused at this point. So we shuffled back to the engineering office to ask Doña Magdelena what was up. She called ultrasound to confirm and then searched for Roger, who happened to be in NICU. I wish he would take us when he disappears, haha. We’ll have to tell him. So we went back to ultrasound, and this time the ladies welcomed us in warmly and told us they hadn’t known that the doctors had called. We waited there for less than a minute when Roger showed up. The ultrasound machine was in use and a doctor was examining a pregnant mother-to-be, so I wondered what the problem was. When the patient had left and they ushered us in to take a look at the machine, the smell betrayed the problem. Something else had burned, and by the smell of it, burned pretty darn badly. Our noses localized the problem to the metal box encasing the power source. We had to figure out where the problem was. So we started to dismantle the machine. I’ve never seen so many screws in my life. I’m serious. There were screws everywhere. The source of the burnt smell was literally coming from the heart of a steel jungle locked together by a bagillion little screws. We tried to keep track as best we could, but we eventually lost it as we were struggling to take pieces apart and practically reverse engineer the thing. Everything was so compact and closed up. It was quite a pain. We named the machine Hans. (It was Austrian made.) Like Gustav, Hans proved to be a troublemaker. At first, we just thought maybe the machine was overheating. All we found was one circuit element that had fallen off one of the boards, presumably from the heat. But the machine was still working fine, so we didn’t think much of it. But after further examination, more screws removed, more wires pulled, and more pieces of metal taken apart, we finally go to the computer chip at the heart of the power source. We checked all the uncovered fuses, and all were fine. I thought that was pretty strange. When something burns, a fuse is usually broken somewhere. Then Roger spotted it – a row of four small black cylindrical plastic fuse cases, one of which had a hole burned into it and the two flanking it which had smoldered from the heat. The circuit board underneath was the color of caramel from the heat. I opened one of the flanking tubes to find that the fuse inside was still intact, but when I went to twist open the middle burnt one, the cylinder simply cracked in half from even the small bit of torque that I was exerting from my screwdriver. There was our problem. There was why we had come. There was what would have caught the whole machine on fire if we didn’t do something about it. A voltage surge or fluctuation must have caused the problem. Come to think of it, a similar fluctuation must have caused the burnt transformer in the kitchen fryer too. It seems to be a common problem in the developing world. So we’re going to test a voltage stabilizer in the workshop come Tuesday (since Monday is a national holiday) so that the doctors can use it with the ultrasound machine so this doesn’t happen again. We’ve also found that the key to fixing these equipment problems goes further than just a mechanical or electrical fix. It stems deeper from how the staff is using the equipment, from lowering infant warmer sides to remembering to plug the ultrasound machine into a voltage stabilizer before plugging it into the wall.

We left our tools and the ultrasound disassembled on the floor to get lunch before the kitchen closed. Julie and I seem to have befriended the kitchen staff after they saw us working in there with Donald on Tuesday, which is nice. The ladies smile at us and even gave me extra refresco and extra beets yesterday. Mmmmmm =P. We ate and chatted a bit and then returned to the nightmare of putting the machine back together again. Fortunately, Roger found two similar replacement fuses on an old circuit board that was in the workshop. We were pretty excited. Julie and I got to practice our desoldering technique as we took the fuses off the board and brought it with us to replace the bad ones.

We replaced the fuses without a hitch and proceeded to rescrew everything back together. Biggest pain in the butt…ever. It took us forever, haha. We stayed until 5:30pm today, and we usually leave by 4:00pm. But it was worth it. We had to get the ultrasound working again, or else the hospital would not have a working ultrasound in case there was an emergency over the long weekend. That prospect was frightening enough to motivate us to stay and get the job done. At one point Roger said that this kind of specialty work would be pretty expensive if they were to hire a technician from outside the hospital. But here we were, getting the job done, Roger for normal monthly pay and Julie and I for a volunteer’s pay. =) The head nurse of the ultrasound department was all smiles when she saw that we had fixed it though. We did have a handful of screws left over (oops), but the machine worked perfectly, and I even got to test it by putting the probe on my chest. On the monitor, I saw my heart beating for the very first time, a dark, hollow black mass enveloped by a pulsating white film. I even saw one of my valves. It was amazing. God is amazing. His design is perfect. No extra screws there. =)

We’ve gotten to know more and more of the hospital staff and more of the layout of the hospital this week. People are starting to recognize us and joke with us. Ivan, another technician, even brought us these little green fruits that are like a cross between a grape an orange and a lychee. It’s about the size and appearance as a grape, the color and taste of an orange, and the texture of a lychee. It’s sweet and tart and juicy. So good. They’re called mammon. They have so many fruits here that we don’t have in the States.

Okay, more to come later. It’s past midnight, and I still have to pack. We’re going to Ometepe tomorrow to meet up with our friends for the weekend. It should be nice to getaway and relax. We don’t really want to be in the capital this weekend anyways. It’s the 30 anniversary of the Sandinista Revolution, so there’ll be lots of political parades, and the Sandanistas apparantly really don’t like Americans. So I gotta go pack and sleep so I can get up early tomorrow. More to come next week! :)