Integrated and Sustainable Healthcare for a Rural Nicaraguan Community

why it's important:

This is extremely important to us because we believe access to quality health care is a basic human right that should be afforded to all human beings. This region of Nicaragua has been devastated by natural disaster, and because the federal government does not have the necessary resources to provide sustainable care, this community has suffered as a result.

The Health Outreach for Latin America (HOLA) Foundation strives to deliver health care to this community by establishing traveling acute care clinics to serve outlying communities that have little access to health care. During the week that we are in the community, we hire local physicians, travel to an outlying region, and establish an acute care center for the day. Before our arrival, the local government alerts the inhabitants of the region we are to serve, and as a result, we receive a fairly large patient flow everyday (our physicians see around 50-70 patients per day). At our acute care clinics, we provide free over-the-counter medications (such as Tylenol, Advil, Sudafed, etc.) as well as vitamin and nutritional supplements for infants, children, adults, and pregnant women. Any prescriptions the physicians write for patients we take to the city of Leon (about 30 minutes away), fill the prescriptions at local pharmacies, and then deliver the medication, at no cost to the patient. These efforts help to provide acute care for many community members that would otherwise go without care for their current ailments.

The HOLA Foundation also provides public health services for the Chacraseca community members. This encompasses providing veterinary services as well as provide public health lectures and workshops to increase the general health knowledge of the community. To serve the livestock and animal population of the community, we provide immunization, vitamin supplementation, de-worming, and surgical castration services. These services help to bolster the livestock’s health by improving their immune systems, fighting malnutrition, and preventing the spread of zoonotic diseases. Increasing the health of community’s livestock will in turn keep the community’s human population healthier, provide sustainable food sources, as well as provide sustainable capital sources. The other facet of our public health approach is providing lectures and workshops in order to increase the general health knowledge of the community. We lecture on a variety of important topics including nutrition, hygiene, and pre-natal care among others. After lecturing, we commonly play ‘Jeopardy’ like games in order to increase retention of the health information as well as promote a fun and positive atmosphere when learning about health.

While not in Nicaragua, our group fervently fund raises and plans our operations for the upcoming trip. We also keep in constant communication with non-governmental organizations that operate in the same region during other times of the year. We have also recently been able to improve our long-distance communication with the local government of Chacraseca, which is very exciting as it has allowed us to plan our operations more efficiently, and hopefully, in turn, provide better health support for the Chacraseca community members.

the plan of action:

Our current programs have made substantial impacts over the past two years. Each year we have seen 400+ patients in our acute care clinics, cared for 1000-1500 animals, and delivered public health lectures to 200+ community members. Furthermore, we have developed a positive relationship with the local government, established contacts with Nicaraguan Health Ministry physicians, as well as identified individuals willing to serve as community health leaders. All of these developments will provide a solid platform for developing sustainable solutions for the community.

However, we have recently recognized that, while there is a plethora of census health data concerning Nicaragua as a whole, there is little to no data concerning the health concerns and demographics of the region we and other organizations serve. Thus, this year, we are planning on conducting a community assessment of the region. This will be a surveyed-based assessment that will answer many questions such as: What are the most common childhood diseases? What is the maternal and under 5 mortality rate? What are the most common chronic diseases? What is the primary income source for most community members? What micronutrient deficiencies are prevalent in the region? Answers to questions such as these will help the HOLA Foundation build a picture of the community that will help us understand their health disparities as well as the root causes and resulting consequences of these disparities. Armed with this information, we plan on designing Train-the-Trainer programs for the community health leaders we have identified. A Train-the Trainer program involves our organization training a select number of community health leaders in public health lectures and workshops. Then, during our absence in the community, these community health leaders can hold lecture and workshop seminars for the local community members, allowing the fingers of our programs to extend into the community beyond our stay. Studies in other rural communities have shown that when community members take responsibility in improving the health of themselves as well as the rest of their community, the impacts of such programs have a much more sustaining effect than information delivered by foreigners (i.e. us). We hope our future Train-the-Trainer programs will have a similar effect in developing our mission of sustainable solutions.

Within the next 2 – 3 years, the HOLA Foundation, in conjunction with the Friends of Group for 60,000 (an NGO based out of New York), plan on building a clinic in the one of the most outlying regions of Chacraseca, Nuevo Amanecer. Group for 60,000 helped revive this community after Hurricane Mitch struck in 1997. They have built houses and schools in the community and are currently working on establishing a sustainable water system for the area. Once they have completed their water systems (projected completion date sometime within the next year), we plan on helping them build a permanent clinic in the area, staffed and stocked by government physicians, in order to better improve the area’s access to acute health care.

how you can get involved:

Others can help in a multitude of ways. The simplest way to help is to donate to our organization in either the form of in-kind donations or monetary. All information for donating can be found at our website www.holafoundation.org. Our organization is a 501(c)3 non-profit organization and thus, all donations are tax deductible. If anyone is interested in volunteering for our organization, they can contact our Executive Director David Baulesh at david.baulesh@holafoundation.org or our Director of Operations Nicholas Alvey at nicholas.alvey@holafoundation.org.

videos: