La Clinica

My village


I am working with the FIMRC non profit organization (Foundation for international medical relief of children).  They have multiple locations including those in Uganda, DR, Peru, and in India.  At this specific clinic they are here full time to help give the community the medical help they need.  This includes a pediatric surgeon 2 days a week, medications too expensive to get elsewhere, any supplies, and a prenatal program.  In Nicaragua, all public healthcare is free.  Every community of around 4,000 people have a community physician, in rural communities such as the one I'm in the physician is a newly graduated medical student.  Medical school begins after high school and every new physician must do a year of service in a rural community before residency.  So basically a 22 year old with my knowledge providing all healthcare in a community with no support and the closest hospital 1.5 hours away.   They get their medical education paid for in exchange for a year of service.  Every region has a hospital that provides more services including xrays, labs,  labor and delivery and surgery with some subspecialties.  Then in Managua, the capital, they have the most technologically advanced medicine.  As I mentioned, FIMRC provides a pediatric surgeon who knows more about pediatric illnesses and has more experience than the local clinic.  Also, FIMRC and the local clinic (health post) share medications with mainly FIMRC giving meds out.  The prenatal program is awesome.  Before it started there was a high maternal mortality however it has lowered since the program began.

Today, I went on home prenatal visits.  In the community there is usually around 50 pregnant women at any time.  The prenatal visits happen once a month throughout the 9 months.  We visit their homes and talk about something different every month.  This includes symptoms, foods to avoid, getting exercise, foods to eat, and many more topics.  Then, the woman gets a handout at the end.  It's run by a Nicaraguan from the community and the women really trust her.  Here, home births are discouraged because of conditions of the home and flourishing tropical diseases.  However, because the hospital is far women are told to come to the hospital 2 weeks prior to their due date and they then sit in the hospital.  However, they need to bring their own food, sheets, and anything else they may want.  Even with these conditions, last year only 1 person delivered at home because she had no one to care for her other 5 kids and the baby died and the mom feel ill secondary to leaving the placenta in the uterus.  Also, prenatal vitamins are essential here! Many of the parasites live on green, leafy vegetables and that's where folic acid comes from thus women aren't getting them.

One more note about pregnancy in Nicaragua, most women get pregnant at an early age and also marry young and have 6\7 kids.  Pediatricians stop seeing girls after age 12\13 and tell them to see an OB/GYN because many are beginning to have kids.

Ok, until next time!

Hasta luego!