Rain is pelting down on Doña Porcela's treatment room in Puerto Cabezas, the main town on Nicaragua's Northern Caribbean coast.
The room is barren except for a few plastic chairs, a wooden table and some old plastic bottles balanced precariously on timber beams.
Doña Porcela is a respected traditional healer here and the bottles are filled with her secret medicinal potions.
Her patient today is a teenage girl asleep on a piece of cardboard, serving as a mattress on the dirt floor.
"Grisi Siknis turns people into witches and they go crazy," she said.
Last year there were 65 cases of Grisi Siknis, which translates from the local Miskito language as 'crazy sickness'.
Exorcism
It behaves like a virus, sending teenager after teenager into a frenzied state followed by long periods of coma-like unconsciousness
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