Joenard's Duke-EWH Summer Institute

Week 2 & 3

June 20th, 2012 | Costa Rica, Mid-Trip |

Spanish Class

Week 2:

We were given a textbook made especially for the school and we’ve been flying through a lot of grammar topics in it. Specifically, we’ve gone through nine verb tenses (2 of which were new to me) and other useful topics such as prepositions and the various uses of estar, ser, haber, tener, and hacer. I feel like the most useful topics I’ve learned so far are the imperative tense and the condicional tenses because they allow you to make instructions and talk about hypotheticals. I utilized these concepts a lot when I had to make my presentation of a fluid pump (la bomba de fluido in Spanish) on Monday.

Week 3:

The professor switched up the routine of the class and we’re focusing more on conversation as opposed to grammar exercises. He asked us the definition of lists of verbs (answered in Spanish) that we will probably use a lot in Nicaragua and the conjugation in the simple preterite, present, and future tenses.  After that, he individually asked us questions that we have to respond with the correct tense. We then went over more grammar topics and then we do the device presentation to end the class. The pace definitely went up since the first week and it’s getting pretty hard doing this for 4 hours each day. But, I’m learning a lot and it will pay off so much in a week’s time in Nicaragua.

Instrumentation Class


Me sitting in an instrumentation lecture on infant incubators.

Week 2 & 3:

We went through 14 different devices within the last two weeks. We finished all the devices found in the OR, ICU, and ER and we have moved on to equipment found in the clinical laboratory. The quizzes we have to do at the beginning of each class have been fairly straight forward. The most interesting device we’ve gone through so far is the electrosurgery machine which our instructor, Ron, demonstrated in class by carving into a bar of soap.


Variable power supply converter we built for a lab.

For the first few labs, we went through Ohm’s law, made a simple LED flashlight, made a variable power supply converter (converts AC voltage to DC voltage), and made an incubator temperature alarm.

After these sort of hands-on labs, we transitioned into more conceptual/discussion labs. The first of these labs included an introduction to troubleshooting and exercises involving how to approach the first days of working at the hospital. I feel like this allowed  me and my partner Alex to synchronize mindsets and know how to start our work in Nicaragua.

Visit to El Hospital de San Francisco Assisi in Grecia

Starting last Friday, we split everyone in the program into two groups to visit two hospitals and take a tour of their equipment. I was in the group that visited La Hospital de San Francisco in the municipality of Grecia about 2 hours north from San Jose. It was a medium-sized hospital that seemed well maintained. Also, the connecting corridors were open and flanked by lots of greenery, a big contrast to the enclosed, white, sterile hospitals in the States. It held about 118 beds.

We were shown around by a government engineer named Susanna and an in-house engineer named Carlos. They first debriefed us about the hospital, telling us about the points I mentioned above. They also talked about the healthcare system in Costa Rica and how it’s heavily subsidized by the government. Emergency services are free even to those who have no money to afford it.

In order, they showed us around the maternity ward, men’s ward, the radiological examination rooms, the gastroenterology center, emergency rooms and clinical labs. Overall, they had a mixture of old and new equipment. In the maternity ward, the doctor that told us that their one really old ultrasound had a higher sensitivity than their other new ones. In the radiological examination rooms, Carlos boasted how their state-of-the art X-ray machine was donated by GE a year ago and was a gem of the hospital.

After the tour, Susanna and Carlos gave us an opportunity to work on four pulse-oximeters, two infant warmer lamps, and an incubator in Carlos’s workshop.

Broken pulse oximeter machine in Grecia.

Me cleaning the covers of an infant incubators.


The control circuit of the incubator.

The staff in this hospital were quite keen to let us work on their equipment. It’s just that there wasn’t really much to repair. The pulse-oximeters just needed a change of batteries, the incubator needed to be cleaned and needed some preventative maintenance, and the theater lights just needed some minor maintenance. I doubt the work would be this easy across all the hospitals in Nicaragua because they were a quite big and well-stocked hospital.

Visit to Hospital William Allen Turrialba

The next Friday we went to another hospital the same distance away from San Jose but in the opposite direction in Turrialba. When we arrived, we were split up into two groups. One group got a tour of the hospital while the other group worked on some broken aspirators they had in their workshop. The tour was very informative and Alex (my partner for Nicaragua) and I fixed the aspirator we were working on, which had a broken tube connected to the motor which created the suction.

Outside of Hospital William Allen Turrialba

Broken tube that we scraped the glue off of and sanded the broken ends of.

Inside of the aspirator.

The hole where the broken tube entered the chassis of the motor.

The tube after we reconnected it and inserted it back in the chassis.

The tray in the bottom of the aspirator that needed a new holder for the collection jar.


Final repaired aspirator.

Fun Stuff

The second weekend we went to the Volcan Arenal en La Fortuna. We climbed up a trail called Cerro Chato and went to a resort that had pools of hot water powered by the hot springs. We also had a tour throughout the area.

The third weekend we went to Manuel Antonio and enjoyed the beach and the forrest.