Staying Healthy

Tap water in most major cities on the Pacific coast is generally safe to drink. In cities like Granada, even the expats drink the tap water.

Always be leery of tap water in rural areas and beach towns. The rule of thumb is: if locals aren’t drinking the tap water, you shouldn’t either. And even if they are, you should think twice about it.

The tap water, albeit up to government standards, might not be up to your own gastrointestinal standards of cleanliness. Even the water in Granada has been known to cause GI problems among some expats, and the situation isn’t going to improve much in the near future (Granada built its city dump right next to the aquifer, so it’s only a matter of time before the garbage begins to leech into the drinking water).

Bottled water is always a safer bet (no matter where you are), and is readily available at most corner stores, pharmacies and restaurants throughout the country. Careful when buying the bags of water on the street in Managua. You don’t know where that water is coming from, and you can be sure it hasn’t been tested.

Be careful of ice cubes since they are sometimes made with tap water you are trying to avoid. The same goes for salads with tomatoes and lettuce, or buying fruit drinks or flavored ice in the park.

Be careful of contaminated water, in all its sneaky forms. Hepatitis A is an awful illness, from which it takes a long time to recover (take it from the author).

Don’t eat food on the street. Even though those meat kabobs in the park smell good, they are covered in bus fumes and fly­transmitted horse excrement.

Hospital Bautista is a full-service institution

Careful when eating red meat. Typhoid fever (a member of the salmonella family) is an awful illness, from which it takes a very long time to recover (take it from the author).

Wash your hands often, and wear mosquito repellant during the day. Dengue is not fun (take it from the author).

Health Care
Nicaragua’s health care system received a strong shot in the arm in May 2004, with the inauguration of Managua’s $23 million world class Hospital Metropolitano Vivian Pellas (tel. (505) 255-6900, www.metropolitano.com.ni), billed as the best private hospital in all of Central America.

Located at Kilometer 9 on the Carretera Masaya (heading toward Granada), Vivian Pellas Hospital is open 24 hours a day, an employs more than 300 of Nicaragua’s leading medical specialists (many of whom speak English) in gynecology, cardiology, orthopedics, pediatric, internal medicine, surgery, neurology, urology, anesthesiology and ophthalmology, among other specialties.

The hospital also has a modern emergency room, pain clinic, maternity ward, pharmacy and first class laboratory that can run all the same tests as a North American or European hospital, for a fraction of the cost ($3.50-$22).

Unlike overcrowded hospitals in the United States, Metropolitano Vivian Pellas is very accessible for a walk in appointment, although calling ahead is recommended.

The hospital is also easy on the wallet. Hospitalization only costs $98 a day (plus a $300 deposit), and procedures that are unaffordable for patients without health insurance in the United States are economically feasible here.

Vivian Pellas also offers “executive check-ups” for men and women, including full lab work (cholesterol, liver, stool cultures, urinalysis, etc), abdominal ultrasounds and electrocardiograms starting at $170 (for men under 40) to $400 (for women over 40), including gynecological exam and mammography.

Hospital Privado Salud Integral (tel. (505) 266-1707, www.hospitalsaludintegral.com), in Managua, also has state of the art 24 hour emergency service, with operating rooms, intensive care, clinical laboratory, and endoscopy.

Private consultations range from $21-$25 dollars, and a they have four types of rooms to chose from for hospitalization, ranging from $40 to $100/ night.

The new Japanese hospital on the outskirts of Granada

Hospital Bautista (tel; 249-7070) is Managua is a 75 year old private hospital that was the best hospital in Nicaragua until the newer clinics opened in recent years. But Bautista is still a very competent and affordable clinic, with a level of personal care that ought to shame U.S. hospitals.

An affiliate of the Baptist Health Systems of South Florida, Bautista offers all the same services of Vivian Pellas, but with a less-shiny coat of paint.

Two new $30 million hospitals are scheduled to be built in Managua in the coming years. One of them reportedly will be a world-class children’s hospital.

In Granada, the Private Hospital Cocibolca (552-2907) will work in a pinch, or Hospital Amistad Japón Nicaragua (552­7049) in a real pinch best healthcare in Nicaragua is located in the capital. The further away you get from Managua, the more rustic the health services.

Recommended Doctors In Granada:
Dr. Francisco Blanco (Speaks some English)*General practice, surgery Clinica de Especialidades Piedra Bocona, on Calle Libertad Tel. (505) 552-5989.

Dr. Pedro Iglesias *General Medicine, Surgery Frente a la Farmacia los Angeles, Calle Aravesada Tel. (505) 552-4179 For full, extensive listing of U.S. Embassy recommended doctors in Managua, visit webpage: http://www. usembassy.state.gov /managua/wwwhcon14.html

Dental Care
The cost of dental work is affordable in Nicaragua, and it is easy to find dentists who can perform routine cleanings and cavity work.

For more complicated procedures, Centro Integral de Especialidades Dentales (270-3054) in Colonial los Robles in Managua offers a wide range of orthodontry and cosmetic surgery. Managua’s Clinica Medico Dental (266-1553) also offers dental surgery.

U.S. Embassy-recommended Dentist List:
Dr. Manuel I. Calderón Office Phone/Fax: 265-1613 Clinica: 2:30-6:30 pm, M-F Address: South Hwy Km 6 1⁄2
Cell Phone: 077-81486. E-mail: NoDoctor@tmx.com.ni
English: Fair

Pharmacies
Pharmacies (farmacias) are located on virtually every other corner in most major cities, and generally carry adequate supplies of most commonly use medicines at the least expensive prices (overall) in Central America.

Most of the brand name medicines you are used to North America or Europe will go by their generic or scientific name here. But most medicines and antibiotics are widely available and usually don’t cost more than $10-20 for a prescription.

Cosmetic Surgery
Nicaragua is neither Rio or Caracas. Cosmetic surgery here is usually limited to corrective procedures (ie. cleft palate) or skin grafts for burn victims.

Nicaragua’s only plastic surgery school, the UNAN in León, has existed for 10 years with the support of the University of Wisconsin. But in the last decade, the school has only graduated four plastic surgeons.

A full-service Nicaraguan Pharmacy

For cosmetic plastic surgery, Saint Dominic Clinic (277-1959) in Managua has with several foreign trained doctors who specialize in liposuction and breast, stomach and face work.

Before going under the knife, here are several things to consider: (1) Ask the U.S. Embassy for a list of certified plastic surgeons. (2) Also check with the Colegio de Médicos (the local equivalent of the A.M.A.) to see if a particular doctor is a real plastic surgeon. (3) Ask a local family doctor for a recommendation of a good plastic surgeon. (4) Talk with former patients of the doctor of your choice before you make a decision. Find out if they are pleased with the results of their surgery.