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    Nicaragua

    Overview:

    Nicaragua is the second poorest country in the Western hemisphere by most economic measures, and offers UMMS students, residents and faculty an excellent opportunity to gain experience in global health and improve their Spanish language skills, while also being part of the UMMS Family Medicine Department’s long-term effort to try to address health and poverty in Nicaragua.

    Addressing health and poverty in a developing country such as Nicaragua requires a broader approach than just looking at medical clinics and hospitals.  Therefore, partnerships are being developed in three areas:  (1) health, (2) education, and (3) jobs and economic development.

    The UMMS Family Medicine Department has been developing partnerships at these locations in Nicaragua:

    • The medical school at UNAN (Universidad Nacional Autónoma de Nicaragua) university in León
    • The HEODRA public hospital in León, which is UNAN’s teaching hospital
    • The rural communities of Tololar and El Porvenir (which are about 30 minutes by car from the city of León)
    • The Tololar health clinic (also called a “Puesto de Salud”) in the community of Tololar



    Below is an overview of our ongoing efforts in Nicaragua:                                                                              

     For a print-friendly version of this overview see the 6-page report, “UMMS Nica partnerships_v1_numbered.pdf”
    (see the bottom of this web page to view or download this document)

    1.  Health:

    Project GEMINI:  UMMS faculty and Rotarians from Massachusetts have partnered with the UNAN medical school in Nicaragua to establish a regional training center at the medical school in León that will train Nicaraguan doctors and nurses in Advanced Cardiac Life Saving (ACLS).


    Supporting the Tololar health clinic (in the rural community of Tololar):

    o     2009 (November):   Dr. Michael Chin and Dr. Anna Doubeni visit the clinic and leave some supplies

    o     2010 (January):  Dr. Michael Chin visits the clinic and delivers some supplies

    o     2010 (July):  A 3rd year UMMS student (Mitchell Li) leaves some supplies after his 4 days of visits

    o     2010 (October):  Michael Chin and Anna Doubeni visit briefly to prepare for the February 2011 trip

    Advanced Life Support in Obstetrics (ALSO) training in Nicaragua:

    o     2009:  Dr. Sara Shields, a UMMS faculty member in the family medicine department helped to teach the first ALSO course to be held in Nicaragua.

     

    o     2010 (November 29 – December 2):  Dr. Sara Shields traveled to UNAN university in León, Nicaragua to help with the second Advanced Life Support in Obstetrics (ALSO) course.

     

    §   The course was taught by six American family physicians and a Chilean perinatologist, and included several Nicaraguan instructors whom Sara's group had trained in 2009.

     

    §   The course consisted of a two-day ALSO course for nearly 40 Nicaraguan general practitioners, nurses, and obstetricians. This was followed by the one-day ALSO instructor course for 25 of the participants, and then observation of these newly instructors teaching the course to another 30 physicians and nurses.


    Understanding and supporting rural health care in the communities of Tololar and El Porvenir

    o     2005 (Summer):  Assessment of rural health in the district of León.

    §   The assessment was done by Rebecca Pike and Talia Pindyck, on behalf of The Polus Center and Rotary International.

    §   Rebecca and Talia visited several Centro de Saluds and Puesto de Saluds in the León district to administer a survey which asked doctors about the diseases they saw, what equipment they lacked, etc.

    §   For more details:  see their report, “Rural Health Report.doc”

     

    o      2006:  A group of medical students and one attending (not from UMMS) held a two-day brigade in the school in El Porvenir and saw over 170 patients.

     

    o      2007 (Fall):   Household surveys done of every home in the rural community of El Porvenir.

    §   Surveys were done by Katharine Gelber, a college graduate, on behalf of the Polus Center.

    §   For more details:  see the 15 page report, “El Porvenir_Jan 2008.pdf”

    §   For a description of each household interviewed:  see the 46 page report, “households 1-40 (Fall 2007).pdf”

        (email Dr. Michael Chin at mikechin100@hotmail if you are interested in viewing this report)

     

    o     2007 (Fall):   A 1st year UMMS medical student makes several visits to the rural community of El Porvenir to help Dr. Michael Chin with a 4-page overview of the community, and to conduct water quality testing on the drinking water wells in the community:

    §   In 2007, the nearest public drinking well was in the neighboring community 1.5 miles away.

    §   For more details:  see the 4-page overview of El Porvenir, “El Porvenir (short version) Jan 11, 2011.pdf”

        (see the bottom of this web page to view or download this document)

                     

    o     2009 (Fall):   Three faculty from UMMS do an informal assessment of dental health in El Porvenir

    §   Participants included Dr. Michael Chin, Dr. Anna Doubeni and Dr. Mariah McNamara from UMMS, and Dr. EJ Welch (a dentist from Massachusetts).



    2.  Education:

    Supporting primary education in the rural community of El Porvenir

    o     2009 (Summer):  Three UMMS medical students (between their 1st and 2nd years) help to improve the primary school by painting the exterior of the school and the playground equipment.

     

    o     2010 (January):  A UMMS adjunct faculty member (Dr. Michael Chin) delivers the school’s first computer.

     

    o     2010 (October):  A UMMS adjunct faculty member (Dr. Michael Chin) delivers the school’s second computer.


    Nicaraguan medical students come to UMMS for clinical rotations:

    o     Dr. Mick Godkin is working with UNAN to hosting Nicaraguan medical students to come to UMMS to do clinical rotations in the future.


    UMMS medical students go to Nicaragua for clinical rotation

    o     2009 (Summer):  a 5th-year UMMS medical student did a 5-week rotation in low-risk OB at the HEODRA hospital in León.

     

    §   For more details:  contact Dr. Michael Chin for more information contained in the document “rotations in León Nicaragua (6-14-10).pdf”


    UMMS residents learn and serve in Nicaragua:

    o      2009 (April):   4-week rotation in the Emergency Department at the HEODRA public hospital in León, by a pediatric UMMS resident

    §   This rotation was done by Dr. Catalina Hoyos (during her a 1st year of residency).

    §   She also held a 1-day clinic in El Porvenir using a “travel pack” of supplies that she brought from the US. 


    Spanish Language Training in Nicaragua:

    o      2009 (summer):  Three 2nd year UMMS students study Spanish in León (and do a service project in El Porvenir).

     

    o     2010 (July):  One 2nd year UMMS student (Mitchell Li) studies Spanish in León (and spends four days visiting the Tololar health clinic).

     

    §   For more details:  see his 3-page trip report, "Nicaragua trip report_Mitch Li (summer 2010).pdf "

        (see the bottom of this web page to view or download this document)



    3.  Jobs and economic development:

    Microloans for Community Health:  An adjunct UMMS faculty member (Dr. Michael Chin) helped to start a program that aims to give microloans to individuals who live in the communities of Tololar and El Porvenir, where UMMS medical students have visited.

    o     For more information:   https://sites.google.com/site/microloans4health/

      o     2010 (Fall):  The Microloans for Community Health program is launched by Wilmar Rivas (a resident of the Tololar  community), Tyler Sinclair (a Peace Corps volunteer living in Tololar), and Dr. Michael Chin.



    Other documents that may be useful:                                                                                                                    

    Structure of the US and Nicaraguan educational systems (1 page):
         §   See the document:  "educational systems of US + Nica_v2_print.pdf "
                         
    (see the bottom of this web page to view or download this document)

    Maps:
       o      Map of the 15 departments within Nicaragua:
                 
       

      o     
    Map of the León department:


         o      A map of the León municipality (which is within the León department):

     

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    Mike Chin,
    Jan 12, 2011, 7:22 PM
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    Mike Chin,
    Jan 12, 2011, 7:23 PM
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    Mike Chin,
    Jan 12, 2011, 7:47 PM
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    Mike Chin,
    Jan 12, 2011, 7:32 PM
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