A semester long program coordinated by Dr. Christine Rack from the University of New Mexico, Casa Xalteva Spanish school, with internships and most lectures and site visits arranged by Viva Nicaragua!
My 1st week: Clínica Forense (Forensic Clinic) Granada, Nicaragua
I am sitting in the office of Dr. Hernandez when a young man walks in. He is here for a physical exam,
evidence collection and then is on his way to prison. The doctor is to check his height, weight, blood
pressure and pulse. After this he will collect blood and DNA swabs of the mouth and urethra to send to
the lab for analyzing. Interestingly, this young male is a probable sex offender but he appears happy,
friendly and attempts to speak to me when the doctor steps out. He is a little guy and has a warm,
welcoming face. It makes me realize you can’t judge someone on the way they look or portray
themselves externally.
This is the process I observe all week. They conduct physicals, approving people’s health for prison,
conduct evidence collection on domestic violence, sexual abuse and victims of lesiones (injuries) from
fighting. Lesiones are reported to be the most common case that walks in to this office on a weekly
basis. The second and third most common cases are that of domestic violence and sexual abuse.
My 2nd week: La Oficina de Medicina Legal (The Office of Legal Medicine) in Managua, Nicaragua
My first day I find myself suited up like I am headed to the moon. I am given scrubs, shoe covers, arm guards, gloves, an apron, mask and a face shield. I enter a
small room that is freezing cold in comparison to the 94°F weather that
awaits me outside. I notice a counter with fixed specimens, one with a biohazard
waste bucket and two more kept clear for evidence collection and the recording of
personal belongings. There are two metal tables in the middle of the room, one of
which has the body of a deceased person on it. He was found in a water tank and anautopsy will be done to clarify the cause of death is drowning.
First we remove and record all clothing and personal effects. The pockets are
checked for any form of identification that could lead us to discover who this man is
so the family may be notified. Afterward the doctor approaches the
table and the external examination begins. The body is examined from head to toe for evidence of foul play. The Doctor takes photos of the face, scars and tattoos in hopes of someone recognizing something that will put a name to this lifeless face.
Afterward the body is thoroughly cleaned and specimens are collected of femoral blood, vitreous fluid, urine and subclavian blood. At this point the body has been prepped for autopsy to begin. The autopsy starts with the head, the skull cap is removed and the brain is taken out and examined. After the head, the long incision is made from the chin to the pelvis. The neck to the heart and lungs are removed in
block. Meaning rather than the removal of organs individually, they are all removed in situ, as is. Afterward the stomach is opened and I am told that it is impossible to have stomach contents in both the duodenum and stomach unless it is that of a drowning. These organs are examined and the cause of death has been found, ahogado (drowning). The body is cleaned and sewn with a fine stitch. During these two weeks I learned so much about the system of Nicaragua and how their justice and
health system operate hand in hand. Many of the doctors have studied in other countries such as the United States, Spain and Germany but tell me they come back because they feel they need to serve their people. During these two weeks I was among truly talented, successful, intelligent, humble doctors. They allowed me to observe, participate and took interest in my want to learn about their system here in Nicaragua. An experience I will truly never forget I was permitted to take part in!
