First Impressions of Sahsa

Aside from traveling on my birthday, the flight from the US to Managua, Nicaragua was uneventful. I spent the next few days meeting with collaborators at the University of Nicaragua in Leon, and quickly ran into my first complication - due to strikes, I would not be able to do a preliminary trip to Sahsa to check out the living quarters and pilot the survey our group so diligently developed. I was crushed and worried that I wouldn't be able to properly finalize the survey and would have nothing useful to report to the other UNC students arriving in June. But, as I soon learned, plans change all the time, and by the next day the strikes had ended and we planned to fly out to a town nearby Sahsa, called Rositas.

It would be no fun if it was that simple though, right? From now on, I will employ the imagery of a roller coaster ride, because that is what this experience has been so far. In keeping with that theme - we found out that flights to Rositas were booked for the time period we needed to travel. Finally, we settled on flying into Puerto Cabezas, with a return flight out of Rositas. Hooray!

Myself, Dr. Rodolfo Peña, and another doctor from the University of Nicaragua, flew in a toy-sized plane to Puerto Cabezas (Bilwi) on the northeast coast of Nicaragua. Another loop in the rollercoaster turned out to be that La Costeña (the only national airline) purposefully did not send our luggage with us, but did not inform us of that fact. We spent a few hours in a sweaty comedor waiting for our luggage to arrive on the next flight. Thus began the adventure....

We traveled out to Sahsa in a comfortable truck, over unpaved roads with immense potholes, animal crossings, rickety bridges, and inundated streams. We passed vast areas of deforested land and after three and a half hours of spine-compressing travel, we arrived in the town of Sahsa, and met other collaborators on the project as well as UNAN medical students who were working in the clinic. The 'casa' where UNC students are supposed to stay is a sprawling property with bunk-bedded bedrooms, toilet and shower facilities, and a detached kitchen. UNAN staff have set up a surveillance system in the surrounding area, which involved numbering the houses and conducting a census in each town.

I spent the next couple days reviewing our health survey with a local representative and the UNAN doctors who have been working in Sahsa for many months. I also piloted the survey in a few of the neighborhoods in Sahsa. The pilot was successful and provided me with useful information to finalize the survey. The survey components include questions about reproductive health, pregnancies, antenatal care, vaccines, diarrhea, unintentional injury, and social networks. People were very willing to talk to me about these topics, and were very friendly in general. Sahsa and its neighboring towns are severely under-resourced, with limited health infrastructure, few teachers, poor water quality, and dirt roads that become impassible during heavy rains. I believe that UNC's and UNAN's continued involvement in supporting this region's health sector will be important for the people living here, and I look forward to moving forward with our group's work this summer.