Nicaragua Trip

By MIDN 2/C Margaret Jackson

In collaboration with the Center for International Nursing and the Polytechnic University of Manauga (UPOLI), our sister nursing school in Managua, Nicaragua, myself, eight nursing students from Duquesne, and two faculty members traveled to Managua for a community health nursing experience from 26 February to March 8, 2009.  During this event we worked with high risk families experiencing extreme poverty in an urban barrio (neighborhood).  We also provided care for families in the, “Centro de Salud”, the neighborhood health center, as well as in their private homes.  The work that we were involved with included health and environmental assessments, provision of care, and a great deal of health education.

Our typical day consisted of leaving our hotel around 0730 in the morning and traveling about thirty minutes to either our individual families or the Centro de Salud.  We worked in the health center throughout the morning, lending a hand where we were needed.  This meant giving shots, removing stitches, or even helping to give clean healthy water to children that were dehydrated.  The clinic was overcrowded and under resourced for the amount of people that needed to be served.  After working in the Centro de Salud, we would go to our family’s homes and visit with them.  In our first meeting we did health assessments for any problems that needed addressed.  With any findings that we made, we imputed our health plans and scheduled any necessary appointments or tests that were needed.  We had raised money several weeks in advance to establish a “Nicaraguan Health Fund.”  This fund helped us to pay for needed medical supplies, laboratory tests, procedures, and medications that are not covered by the Nicaraguan health system and are unaffordable to “our” respective Nicaraguan families. 

Alongside the health assessment, we also did environmental assessments of their surroundings.  The areas in which our families lived are heavily polluted and extremely over populated.  Their homes often consisted of three to four walls, a dirt floor, maybe a door, and a leaky corrugated tin roof.  Home improvement items were purchased to help provide a safer, more sanitary home environment.  Because the water supply is limited, and is often not always available, families collect water in barrels.  Therefore, we purchased plastic coverings for the top of these barrels for protection from disease.  The money from the fund also helped us to pay for beds and mattresses that were needed because often three to five family members would sleep in one bed.  Our $1,300 Nicaraguan fund provided us with the ability to purchase these items and more.  The students and I all collected materials before the trip such as school clothes, supplies, shoes, and books to take and distribute to the families.

An abundance of health teaching was done while we were working in Managua.  We developed health teaching activities for a preschool that included the importance of good dental hygiene, hand washing, manners, and the significance of not polluting the environment with trash.  We presented this information with the students from the Nursing School in Managua who aided us in conveying our information to the children in Spanish.  We continually presented important health information throughout the week to our families by expressing any important issues that arose from the health and environmental assessments.

Throughout the week we were able to explore the culture of Nicaragua by visiting various surrounding towns, exploring some of the devastation that remains from the 1972 earthquake, and hiked to one of the large volcanoes. We visited several public and private hospitals throughout the city of Managua.  The lack of resources, health care employees, and funding created environments that were unlike anything that is seen here at home.  There was some medical technology throughout a few of the facilities, but problems arise when the machines break and there is no money to replace them or the knowledge on how to fix them.  Therefore, the technology becomes useless and adds to the already existing clutter.  While the trip was educational and a life-changing experience, the underlying mission was to provide assistance to the families with whom we worked with, and gain a more global view on the health care system in a developing country.  We accomplished our goal and significantly impacted the lives of those family members we had the pleasure of helping.