There may come a time during your travels in Nicaragua when you become aware that your child has developed an uncomfortable digestive condition or you merely wonder if he might have picked up parasites somewhere because of all the adventuring that your family has been doing outside of your home country.
Look for the usual symptoms
If your child has symptoms like nausea, weakness, decreased appetite, abdominal pain and or diarrhea it will be more obvious that you need to take action to find out what is going on. However, parasites can also quietly inhabit your child’s gut without showing overt signs, but still feeding off of crucial nutrition that would otherwise be designated for your child’s growth and good health.
Go straight to the lab and get a stool test done
The only real way of knowing for sure what is going on is to have a laboratory perform a stool test. For visiting families travelling in Nicaragua it may be surprising how totally simple and straight forward a task this is. Lab tests are easy to obtain unlike any of the medical bureaucratic hurdles that are typical in developed countries.
The first thing that you are going to do is ask any Nicaraguan where a good laboratory is located (Donde esta un laboratorio bueno cerca de aqui?) and believe me they will know, because they have also been there several times. Then, mom or dad will go to the lab and pick up a stool test receptacle which will be given to you free of charge in a discreet paper bag. There is no need to bring your child with you. You can say, Necesito el vaso para un examen de heces, por favor. If you are in Granada, please see a list of recommended resources below for laboratories, doctors and pharmacies.
At home, have your child poop into the jar a large enough sample to get a lab reading, and then immediately (best within half an hour) return the sample to the lab and pay for a general stool lab exam (un examen General de Heces, $2) or the much more thorough and preferable examen de Citologia Fecal, $5. The results will be more than likely available for pickup that same day depending on the lab.
Then take your results to the doctor- don’t skip this step!
You should take your lab results and your child to the pediatrician so that a qualified doctor can look them over and do a general medical exam (no self-diagnosing or prescribing, please). The doctor will determine the right medication and dosage for the particular bug that shows up in the exam.
If there is a bacterial infection, antibiotics will be prescribed or if there are only parasites, the doctor will prescribe anti-parasite medication which is different. Some parasites are in the form of eggs or quistes and require a specific medication that can penetrate the walls of the egg to get rid of the parasite before it matures.
The prescribed treatment for an infection or for parasites is available in syrup or pills, so let your doctor know if your child has any issues taking pills. Although the syrup is sweet it still tastes terrible, so make sure to have a lollipop or something similar for your child to look forward to after they take their dosage, which is likely to occur 3 times a day for 7-10 days. The medicine does come with side effects. My son tends to feel worse until he is done taking the medicine with more nausea, less appetite and an occasional headache.
It is likely that the pediatrician will also prescribe probiotics because of the massive restructuring in intestinal balance that will occur as a result of being sick and the treatment itself. You will find that the probiotic is the most expensive medicine on your otherwise frighteningly cheap pharmacy bill (around $40 for a simple local probiotic). Do yourself a favor, and plan for this moment before it happens. Travel with your own kid’s probiotic from home (around $12 for a 90 day supply).
Keep in mind that even after finishing this round of medication, a subsequent stool test may show up positive for quite a few days if not weeks following treatment. The medicine is still lingering in their system and doing its job long after the initial dosage. If you want to retest wait two weeks and then see if their system has been cleared.
How did this happen?
You are probably wondering how your child became sick in the first place. There are a few usual breeding grounds in the parasite world but there is no really no way to know how it happened in your child’s case. There are parasites in bad drinking water (mostly from wells in the countryside not in the water that comes out of your faucet in Nicaragua). There can be also contamination on fruits and vegetables that have not been washed properly (travel with a reputable produce soap and erase the doubt).
Contamination can occur between people with little hands touching places in bathrooms or anywhere else where unclean hands have touched. This is the most difficult to prevent especially when your child is enrolled in school in Nicaragua. But the preventative measure for this is to teach your child to not only wash their hands before they eat or drink but anytime they get the chance. It is better to be obsessive about it than sick all the time.
Don’t feel badly, you’re not the only ones.
Having said that and for all that we know about parasites as residents in Nicaragua, we personally get sick a few time a year. We know when we are sick because we have the kind of digestive systems that feel the symptoms of parasites (some people never even realize they are carrying a contaminated gut around).
Getting treated for us has become routine. Parasites are part of the normal hazards of living in a developing country but it does require attention.
Though I dread seeing Aiden get sick, it is pretty easy and inexpensive to take care of the problem here compared to the expenses and time invested to attend to something similar in the United States (see side graphic on costs for treatment for a child here in Granada).
Within one day, we have our labs processed, analyzed by a doctor and a prescription filled to deal with it all. The only part that we have to stay on top of is to keep probiotics for adults and children on hand and order them regularly to be delivered to us here in Granada.
If you find a family member is sick in Nicaragua or maybe you just want to do a parting check as you head back home to your home country, know that you can do this process on your own in any city here in Nicaragua. But if you find yourself in Granada, please see the resources list below.
My recommended resources for Granada doctors, labs and pharmacies:
All doctors have cell phones and many respond to Whatsapp messages. You will notice that the office hours for Granada doctors are mostly in the afternoon because they generally work a turn in the hospitals during the day or attend patients in Managua in the morning.
Dr. Jose Morales (male pediatrician)
Cost for exam is $13.50, cash only. Speaks some English.
Clinica Medica El Palanque
Calle El Palanque, Frente a INIFOM
Telephone to the clinic: 2552 3120, cellular: 8847 9096
Mon – Fri 4:30 – 6:30 pm, Saturday by appointment, closed Sundays
Dra. Marisol Ruiz (female pediatrician)
Cost for exam is $15, cash only. Speaks Spanish.
Clinia Piedra Bocona
Calle La Inmaculada, del Parque Sandino 20 varas al Oeste
Telephone to the clinic: 2552 5989, cellular, 8810-8149
Mon – Fri 3:00 – 5:30 pm, Sat 9:00 – 11:00 am with previous appointment, closed Sundays. Dra. Ruiz can be at the clinic at 11:00 am during her lunch hour if prearranged by phone.
Dr. Francisco Blanco (family doctor).
Cost for exam is $16, cash only. Excellent doctor for moms and dads! Bilingual.
Clinica Piedra Bocona
Calle La Inmaculada, del Parque Sandino 20 varas al Oeste
Telephone to the clinic: 2552 5989, cell phone, 8884-7332
Mon – Fri 2:00 – 6:00 pm, Sat 9:00 – 12:00 pm, closed Sundays
Laboratorio Clinico San Sebastian (recommended for great customer service and two hour turn around)
Lic. Oscar Moran
Costado Sur Parque Sandino Contiguo al Hotel La Estacion
Telephone 2552 2278
Celular: 8471 9882
Mon – Fri 6:30 am – 5:00 pm, Sat 6:30 am – 12:00 pm, Sundays the lab is closed but will open for an emergency. Call Oscar on his cellphone (he does speak some English) and tell him that you have an emergency and he will come to the lab just for you. That is the kind of customer service that really impresses me.
Accepts credit cards.
Laboratorio de Analysis Clinico Xalteva (for short Laboratorio Xalteva)
De la Iglesia Xalteva ½ cuadra al Oeste
Telephone 2552 5656
Mon – Fri 6:00 am – 5: 00 pm, Sat 6:30 – 1:00pm, Sunday closed
Farmacias Praga: There are two locations in Granada and both accept credit cards.
Farmacia Praga Central
De la Iglesia La Merced ½ cuadra al Este
Telephone: Calle Xalteva 2552 5726
Open Mon – Sat 7:30 am – 9:30 pm. Sunday 8:00 am – 7:00 pm
Free home delivery available
Farmacia Praga Inmaculada
Calle La Inmaculada
Frente de Plaza La Inmaculada (where La Colonia supermarket is located) 1 cuadra al Oeste
Telephone: 2552 1718
Open Mon – Sat 8:00 am- 8:00 pm, Sunday 8:00 am – 1:00 pm.
Free home delivery available
Calle La Libertad, de Claro 3 cuadras al Este, Granada, Nicaragua
Telephone: 2552 6488, 2552 6996 (if anyone answers!)
Open daily 24 hours. Accepts credit cards.
This pharmacy has some pricey, imported items and some pretty stale customer service at times but it is worth mentioning because it always open. They say they have a medic on duty for a free consultation and they do offer the service of giving injections (a popular form of delivering medicine in Nicaragua), nebulization and stitches.
Home delivery available