Medical Emergencies on a Tropical Island


A panga

One would assume that in the case of a medical emergency on Ometepe Island, where minutes count, there would be specific procedures in place..an ambulance..doctors…trained EMTs…a life flight helicopter…rescue equipment…trauma kits…latex gloves…a blood bank…even a simple first aid kit. In reality, very few of these things exist on Ometepe Island.

Imagine a medical emergency where no one understands how to administer CPR, the injured are moved without knowledge of traumatic head or internal injuries, witnesses at the scene of the accident are asked to apply pressure to a profusely bleeding wound without using latex gloves, and victims are transported to a hospital in the back of a police pickup truck. The hospital has no blood bank, no x-ray machine, no defibrillator (AED)…nothing.

Now, imagine the medical emergency happens late at night. The ferries are not running to the mainland. The only way to transport trauma victims is on an open air panga, 45 minutes to the mainland. There are no life jackets, no doctors accompanying the victims, and only flat, hard benches on a boat that can transport 12 people. If it’s raining, everyone gets wet. If the waves are high, victims are tossed and bounced off the hard benches. There are no stretchers, no backboards, no body bags, no medical supplies…nothing. The panga has seen it all…birth, death, and every macabre thing in between.

Once the victims reach the mainland, those that are still alive are taken to the Rivas hospital. If the Rivas hospital is unable to meet their needs, then they are transferred to Managua to the public hospital, Lenin Fonseca. The triage process takes hours and the care received in the public hospitals in Nicaragua is poor, primitive, and pitiful. Family members accompany their loved one into the emergency room at Lenin Fonseca. They are expected to aid in treating wounds, apply pressure for heavy bleeding, and give blood. No one is concerned about bodily fluids seeping from serious wounds, nothing is sterile, and no latex gloves are in sight. Traumatic brain injuries are misdiagnosed and often ignored.

Procedures for evacuation are the same for locals, tourists, and expats on Ometepe Island. The panga and triage system from one public hospital to another does not discriminate against race, nationality, or gender. Therefore, it is imperative to know what steps to take as an expat or a tourist visiting Ometepe Island should a medical emergency arise.

Hospital Metropolitano Vivian Pellas in Managua is a private hospital. It is the ONLY hospital that caters to foreigners, and the ONLY hospital I would recommend in the entire country.

Metropolitano Vivian Pellas Services

Emergency Medical Procedures for Vivian Pellas Hospital

1. Transportation by panga or the ferry to the mainland. To avoid the triage from one public hospital to another ( which, in one case, took 12 hours before a severely injured tourist arrived at Vivian Pellas Hospital) before you leave Ometepe Island call for the Vivian Pellas ambulance to meet you in San Jorge at the dock. Do not get into any other ambulance because they will take you to the hospital in Rivas, then to the public hospital in Managua.
Telephone for soliciting ambulance: 2255-6900 ext. 5152
If you want to request a doctor in the ambulance, it will cost $2 per km. Otherwise, they will only send a nurse to accompany the patient. The cost of an ambulance sent only to a Managua address is $85.

2. Immediately call the 24 hour nurse supervisor of Vivian Pellas Hospital.
Telephone number: 8810-7615
The nurse supervisor will need to know this information:
a. Information about the patient critical or non critical
b. They will need a credit card deposit of $600-$5,000 depending on the services they offer. Have your credit card ready and give them the necessary information.

Transportation Options Off Ometepe Island

1. If a ferry is available, take the victim on the ferry ASAP. It will take one hour to reach the mainland.
2. If you must take the medical panaga, call the police station. Below, is a list of things to have on hand in case of an emergency.
3. There are options to get a helicopter. I’m looking into this option. The cost of a helicopter to Ometepe Island is about $800 rt. However, Vivian Pellas does not have a helicopter pad, or a helicopter, so I’m not sure where they would land in Managua.

Resources for Medical Emergencies

1. Free Ebook download, Where There Is No Doctor
This is an invaluable resource for anyone living in tropical developing countries.

2. Essential Packs for emergency medical situations
Prepare a first aid kit or a trauma kit and keep it handy. This website explains the various kits and the contents that should be in each kit.

3. Keep a small bag handy that includes: information about any medicines you are taking, any allergies to medicines, blood type, credit card information, a cell phone, emergency contact numbers, some local money, a copy of your passport, and anything else that someone needs to know about you.

4. Make advanced medical directives and keep them in a safe place in your house.

Specifically for Tourists on Ometepe Island

1. Keep a small bag with all of your health information, blood type, copy of passport, emergency contact numbers, and at least one pair of latex gloves with you.

2. Contact your country Embassy in Managua immediately.  When you arrive on the island, ask for the phone number of your hostel or hotel and write it down in your emergency contact list. If you should be involved in a serious accident where you are unable to communicate, your hotel can be contacted and they, in turn can contact your Embassy.

Donations

If you are planning a trip to Ometepe Island, these donations will always be welcomed at the local hospital or through our Ometepe Expat group.

boxes of latex gloves                                  CPR mouth pieces
sterile bandages                                          stretchers/backboards
ace bandages                                               body bags ( I know…I know)
life-preserver vests                                     AED defibrillator
climbing ropes/climbing gear…for volcano rescues

You can contact me through my blog if you would like to make a donation of one or more of these items, and I will make sure it gets to the right place.

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4 thoughts on “Medical Emergencies on a Tropical Island

  1. This is good information and you should have it posted in your home and in the homes of your neighbors and at the schools. It’s good to be prepared for the unexpected, even if the subject doesn’t catch much interest among blog readers.

    Looking at a map of Ometepe Island, I realized you are at least 6 miles (10 km) from the mainland. That will take a bit of time to travel. Wikipedia says the island has about 42,000 inhabitants. With a population that size, maybe there are some retired health professionals, expats or locals working at a health facility on the island.

    I downloaded the book into my Kindle for later reading. Thank you, that may have lots of good ideas.

    • Steve, That’s a great idea to post this information in schools, hotels, homes, etc. Maybe I’ll work on a laminated poster in Spanish and English that can be placed in various locations around the island. We do have several retired expat health professionals on Ometepe Island. We held an Ometepe Expat meeting last week and came up with some ideas to help improve the evacuation system. That’s mainly why I posted the information on my blog. Thanks for your suggestions.

I'd love to read your ideas and thoughts below....

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