Diabetic Home Visit

                              Mi Casa

Today I performed diabetic home visits, the person who runs it is an older Nicaraguan lady.  We went from house to house checking blood glucose (sugar) levels and blood pressure as well as asking about symptoms and medication compliance.  Many blood sugars were in the 400-500 levels with normal being less than 126.  Surprisingly, no one even had symptoms.  It is also difficult to find compliance here due to their diet.  Rice, tortillas, and fruit are staple foods so when we say to cut back on these foods people then ask well then what do we eat??  And honestly, there is no good answer because its difficult to buy different foods.  Also, insulin is extremely difficult to get here so metformin is the only medication given out.  For these reasons most people have poorly controlled diabetes with many complications.

The visit also gave me the opportunity to see many different houses.  The houses range from those with front doors, ceramic floors and a kitchen table to those with diet floors and no table.  Most houses are made of cement but there are some of wood and others of tarp.  Every home also has a latrine which is a hole dug deep into the ground used as a toilet, surrounded by tin walls.  Sometimes, homes will have an outdoor clay oven and many have a washing station for clothes.  An interesting sign off status is having these portraits superimposed onto some sort of background.  For example,  a baby in a queen sized bed, our two people with the background of a nyc apartment.  It looks slightly odd but people here love it.

                               Very nice home

 This is a well that many homes have in order to get water. They are working on purifying the water so many homes how have filtered water.  The tropical climate is perfect for parasite growth so those who don't have a filter (and even those with one) get parasites.  Here, everyone is advised to take anti parasites every 3 months, and the medication is cheap because its so common.  Many of the kids who come into the clinic are malnourished,not hungry, and have a night cough... All of which are signs of parasites.

The cows are coming!! Animals and humans share the roads around here.

Below is a latrine

Hasta luego!