One great aspect of FIMRC is their community outreach. This is especially apparent in their prenatal home visits and their micro insurance program. At any given time, there are 50 pregnant women in the community and many of them are young and still children themselves. The prenatal home visits began to emphasize health during pregnancy. The program is lead by a Nicaraguan woman who is well respected within the community, and who just recently gave birth so is able to relate well to the pregnant women. Every month of pregnancy and then after the baby is born she goes house to house with a different talk each time. I have been accompanying her once a week. Here, advanced notice does not really exist. We walk from house to house and just seee who is home. Then, once there, a family member will bring out plastic lawn chairs for us to sit in either outside our on their porch. We go to the house and first she gives a pretest to determine how much the participant knows about a given topic. Then we give a talk on topics such as fetal development, complications and when it's necessary to see a doctor, nutrtion, exercise, the importance of breastfeeding and many other topics. Then the participant is given a post test to determine if the talk was helpful. After this we take her blood pressure and record her weight. Then, a baby shower is set up once a few women reach around 7 months and they are given diapers, baby clothes and blankets. I hope to be able to go to one while here! This past week we went to a few different homes. One was of a 15 year old, another an 18 year old, and a 22 year old. It is amazing to see how much they learn through the talk and encouraging as well. It's different than in the states because there are no baby books available and as I mentioned the hospital is an hour and a half away and since most people don't have cars they are sitting on a hot, crowded bus. Therefore, prevention and education are extremely important. This includes exercise, healthy eating habits and general knowledge of what is appropriate during pregnancy and what is not. The concept of prevention is also prevalent in the clinic. The young doctor, Domingo, puts every pregnant woman on aspirin because there have been studies showing it reduces the risk of pre eclampsia and here it's worth it to prevent rather than treat. As I mentioned before, all of the pregnant women go to the hospital to wait for their delivery 2 weeks before their due date. Also, if they need a c - section it is performed at 37 weeks. They will not perform vaginal birth after a c - section so all of those women get sectioned. I have more to say about the hospital in another blog!
To the left is Roxana who runs the program, and she is teaching a woman how to use a thermometer. The thermometer is mercury so it's old and should be used with caution but it's the best they have.
Another program being implemented is the micro insurance program. As I mentioned, a pediatrician comes twice a week and has appointments for the kids and then we keep all of the files at FIMRC. The new program involves going to the homes of the children who are constantly sick coming to the clinic with the same illnesses. During the home visits we observe different issues that may be causing illnesses. Some of the issues here include coal burning stoves indoors, food left out uncovered all day, drinking water straight from the well, uncovered water sources including wells and latrines, children running around without shoes on, and many other issues. The common illnesses include respiratory tract infections, urinary tract infections, parasites, ameobas, and bacterial GI infections. We then will enroll the families in an educational program about how to prevent their children from getting these illnesses and then if they come to the educational sessions and are making a sincere effort we will buy them something to enhance their home to prevent illness. So for kids with respiratory infections buying a gas stove, kids with parasites buying a water purifier and shoes and other household items.
The house I went to was actually right across from where I live. A 3 year old boy consistently has parasites and now he is extremely behind in growth and weight for his age. This is his house, the well is to the right and uncovered.
This is the indoor stove, which is coal burning and can cause respiratory infections, including pneumonia. The room it is in is open to the outside so its not quite as bad. However, it should be outside altogether.
Hopefully, with education and an emphasis on preventative medicine we can help prevent some common childhood illnesses!
Adios!
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