Grounds For Health » Nicaragua

Trip Report: Nicaragua – September 2011

Kayla Moore — Thu, 27 Oct 2011 17:26:32 +0000

Amanda, Kayla, and August with San Juan de Rio Coco coop collaborators

From Sep 21- Sep 30, 2011, Grounds for Health trained a new cohort of 11 doctors and nurses on cervical cancer screening using Visual Inspection with Acetic Acid (VIA) and Pap, and treatment of pre-cancer with cryotherapy. Of the 11 providers, nine received certification in VIA and five of those also received certification in Cryo. Two received certificates of participation only. Grounds for Health will support the trained providers as they put their new skills to use over the next several months, ensuring that they have the material and personnel resources needed to continue offering screening and treatment at their respective clinics,

During the course of the campaign, a total of 306 women were screened, 93% of whom were within the target age group of 30-55 years of age. The high percentage of women seen in the target group is one indicator of success for the promoter training conducted previously. Of the total women screened, 24% had either a positive pap, positive VIA test or both and 14% received same day treatment with cryotherapy. All (100 %) of high-grade paps were confirmed with VIA.

Smiling faces after a talk on cervical cancer while waiting to be screened

This marks the first training / campaign at our new program site, San Juan del Rio Coco in the department of Madriz, Nicaragua, where we expect to continue working for three years. The event was carried out in close collaboration with our four co-ops partners at this site, UCA San Juan, UCPCO, PRODECOOP and CORCASAN. This collaboration with local, community groups, will ensure that thousands more women receive the information and access to life-saving health services long after Grounds for Health leaves.

Highlights:

Launched new screen and treat training program and campaign in San Juan del Rio Coco, Madriz.
Established the first treatment center in the region
Co-op coordinators demonstrated impressive management and coordination skills
Co-ops and SILAIS commitment mobilize local resources to help women requiring further diagnosis and treatment

Next Steps:

Follow up on biopsy results and next steps for patients who require additional treatment
Donate cryo equipment at Hospital Primario Luis Felipe Mocado and one additional site staffed by provider trained to competency in cryotherapy
Donate biopsy punches to SILAIS Somoto
Establish schedule of supportive supervision for new provider cohort and conduct monitoring and supervision visits
Complete pilot project with SOPPEXCCA/SILAIS Jinotega and document results
Develop proposal for Master Training Program in Esteli and present proposal to PRODECOOP management during the pre-Assembly (later in 2011)
Conduct follow-up meeting with co-op coordinators to develop work plan for next phase focused on community outreach and education, including mentoring for community health promoters
Expand on the current Co-op Coordinator’s guide; develop a comprehensive resource for co-op coordinators focused on community mobilization
Work with curriculum development experts to modify the Trainer’s guide and package it for use in the Master Training Program

Making good use of readily available materials to practice Pap and VIA

Amanda & Dra. Barinia

Volunteer team

GFH preceptors and trainees

Update from Nica Campaign: VIA/Cryo Success

Justin Mool — Tue, 27 Sep 2011 14:24:26 +0000

Directly on the heels of the New York Times Article: Fighting Cervical Cancer With Vinegar and Ingenuity, Executive Director August Burns sent us a quick note:

Stats from 1st day of campaign: 66 women seen today. 16 positive for VIA 12 treated, 2 biopsies for invasive cancer, two will return tomorrow. We caught all three Pap positives with VIA confirming == as the NYT article states – it works quite well, including two Cancer in situs and 1 invasive cancer. Lives probably saved.

Pretty cool. Very tired.

love to all- A

Wonderful news! Stay tuned.

Off to San Juan del Rio Coco, Nicaragua

Kayla Moore — Wed, 21 Sep 2011 14:00:58 +0000

Next stop: Nicaragua

This past week has been a flurry of activity at the Waterbury office as Elisa helped me and August pack-up an absurdly large amount of supplies and training material into five enormous black suitcases destined for the northern highlands of Nicaragua. The fact that this will be my first trip since joining Grounds for Health as the new program manager in June heightened the usual mix of excitement and nervous anticipation leading up to Sunday’s departure.

View San Juan del Rio Coco in a larger map

This trip marks the official launch of a new three-year program in Madriz, Nicaragua. The program will be largely based in the municipality of San Juan del Rio Coco, where Grounds for Health has recently entered into partnership with four co-ops: UCPCO, UCA San Juan, Prodecoop and CORCASAN. Already, the four co-op coordinators at this new site have impressed us with their incredible management and organizational skills. From navigating the murky waters of local health regulations to coordinating food, housing and transportation for staff, volunteers and patients to shopping for essential supplies—this team of co-op coordinators has set the bar high for all involved, challenging us to make this program better than ever.

Working closely with our in-country staff, Barinia and Amanda, the in-country team has trained 34 community health promoters (CHPs) and has tasked them with raising awareness about the risks of cervical cancer and the importance of screening and early detection. With the CHP’s hard at work, the co-op coordinators turned their attention to hand-selecting a group of trusted doctors and nurses to attend next week’s level 1 training, which will emphasize the Single Visit Approach.

Over the next couple of weeks, GFH staff and volunteers will come together with co-op coordinators, local providers, and community health promoters to improve access to life-saving screen-and-treat services in rural communities. Check out our Facebook page and Twitter feed for up-to-the-minute updates.

Much more to come …

GFH Volunteer Awarded Scholarship

Katherine Buell — Tue, 23 Aug 2011 15:08:15 +0000

Congratulations to long-time volunteer Sylvia Estrada, who was recently honored with a scholarship from One Nurse At A Time. Sylvia, who has been volunteering with us since 2007, will use this scholarship as she travels with us in November on her 5th Grounds for Health trip to Nicaragua. It’s no surprise to us about Sylvia’s honor — she has been a steadfast, reliable volunteer that we have often looked to for facilitation, leadership, and to be a mentor to new volunteers.

Sylvia is an expert nurse, who began her training as a women’s health care nurse practitioner thirty years ago. She has completed a diploma in nursing, BSN, MSN, MS in health care management, certification in women’s health and is now in the midst of a DNP degree. All this and she still finds time to volunteer extensively abroad, where she has used her clinical skills in numerous women’s health care campaigns in Central and Latin America.

We are thrilled for you, Sylvia, and are looking forward to many more years of your dedication to Grounds for Health!

Please check out the One Nurse At A Time website for more information on this scholarship.

Note: Sylvia is not the only incredibly talented, highly-skilled volunteer we have…and we’re always looking for more. If you’re interested, visit the Volunteer Page to learn more about how you can be a part of on-the-ground campaigns to reduce the rate of cervical cancer worldwide!

Sylvia Estrada (2nd row, 2nd from left) in a group shot with newly-trained in-country doctors and nurses, GFH staff and volunteers.

From the Field: Solidarity and Bold Women in La Dalia

Katherine Buell — Tue, 09 Aug 2011 19:13:46 +0000

Amanda Eastwood has been working as a program assistant for Grounds for Health on the ground in Nicaragua since May. Recently, she travelled with the vice president of one of the co-ops Grounds for Health works with, to visit women in the co-op’s communities. The following is her account of that experience; a glimpse into some of Grounds for Health’s on-site work:

Amanda on horseback in Nicaragua

La Dalia is a small, charming town in the department of Matagalpa, Nicaragua located roughly – in terms of ‘generally speaking’ and the state of the treacherous dirt ‘highway’ leading there – two hours north of my home base in the city of Matagalpa. It is also the main site of a pilot project I currently focus most of my energies on. In collaboration with the Union of Agribusiness Cooperatives (UCA) branch in La Dalia, we’ve trained a solid force of community health promoters from the nearly twenty participating cooperative communities to return to their communities and share the lessons learned with their peers.

In the name of solidarity, a deeply rooted Nicaraguan value, co-op vice-president and inspirational figure Lucia and I have been visiting each and every of the communities to assist the promoters in sharing the good news of free cervical cancer screening services. Following the meeting, the women choose a date to all go together for their screening. Each woman receives a form with her name and other pertinent information on it to be turned in to the nurse at her appointment; a source of information that enhances the data I’m collecting at each participating health center.

Lucia, a mother, spouse, university student and coffee/community building/health promoting professional is an absolute warrior. At the ripe age of 23, she has taught me a thing or 500 about rural farming life, grass roots community development, leadership, getting the job done with strength and grace, and finally, generosity and friendship. Over the course of our last month spending two or three work days a week together forging the wilderness and the long held fears and taboos around reproductive health, she has proven to be one of the strongest links in my chain and one of my greatest sources of friendship and inspiration.

To provide a snippet of context, Nicaragua fought a civil war in the 1980’s where not only men but women and youth alike participated in the gruesome realities of battle in order to survive and progress as a nation and society. This important layer of recent history is still very present in every day sites, events and culture of the Nicaraguan people. I’ve been daily inspired by the inner strength of the women in these communities. While many rural farming women I’ve worked with previously in other places and cultures are timid and very slow to warm up to me, many of the women in these small villages have confidently spoken up in our community meetings with questions, comments, opinions and ideas. They are spunky and bold, blowing me away during each cooperative visit. While my days in La Dalia often begin for me with catching the two hour 6 a.m. bus followed by an hour and a half walk or horseback ride into the mountain communities and eventually end returning home, muddy, sweaty and exhausted around 6 or 7 PM, they are, without a doubt, my favorite.

Women in La Dalia

Quick Words from Mexico and Nicaragua

Elisa Vandervort — Thu, 04 Aug 2011 18:23:17 +0000

La Comon's incredible co-op coordinator Cecy, GFH Program Assistant Rachel, GFH trained Nurse and La Comon member Teresa

Two of our co-op partners in Chiapas, Mexico are creating small clinic spaces in their coop offices for continuing their work with GFH and perhaps other primary health care needs of their membership and community. Wow, no?

La Comon Yaj Nop Tic in La Concordia will inaugurate their clinic on August 15th! They are equipped for SVA. Cool! The plan is to have Dra. Lupita there twice a month (doing supportive supervision) and another wonderful family doctor who we have trained will be there twice a month also. Basically each Friday.

And today–we just got word from CESMACH in Jaltenango that they are moving things around in their coop office to create a space there for a similar purpose. Pretty amazing and exciting developments as each of these co-ops takes their work with us on CX CA screening and positions themselves to move it to another level.

CESMACH's amazing co-op coordinator Silvia

CESMACH Logo

La Comon Logo

Summer 2011 Update: Nicaragua

Elisa Vandervort — Wed, 20 Jul 2011 15:54:08 +0000

Proud new trainees, GFH trainers and amazing support team from SOPPEXCCA and CECOCAFEN

Grounds for Health field staff in Nicaragua just completed a series of trainings of nine new doctors and nurses in the region of Jinotega. The trainings were located in the small towns of Wiwili and El Cua where there is a sizable membership of our partner cooperatives CECOCAFEN and SOPPEXCCA.

Over six days of clinical training, 284 women were screened for cervical cancer. La Fundación Española and the Ministry of Health in the department of Jinotega made a special training request to Grounds for Health to conduct these trainings. Four additional screening and treatment centers are now equipped with cryotherapy equipment AND they are fully trained. This expands cervical cancer prevention with visual inspection with acetic acid (VIA) and treatment with crotherapy to four additional municipalities in Jinotega Region.

This expansion of services creates the potential to reach many more rural women with cervical prevention services and directly supports the Nicaraguan Ministry of Health implements VIA and cryotherapy into existing health services. Congratulations to the newly certified doctors and nurses of Jinotega and also GFH’s in-country Program Coordinator, Dra. Barinia Osejo and Program Assistant, Amanda Eastwood, MPH.

GFH Field Staff, Dra. Barinia Osejo and Amanda Eastwood, MPH

Nurse Durdane counseling a client about cervical cancer screening

Yurit Zeledon works with our partner cooperative CECOCAFEN and coordinates the work of GFH locally within the cooperative and member communities

Dr. Mcklien counseling a woman about her cervical cancer screening

Mexico and Nicaragua Program Updates

Elisa Vandervort — Tue, 31 May 2011 20:45:10 +0000

GFH Intern, Rachel Ballester, RN

I’m happy to report that the past two months have been wonderfully full and successful in terms of our program trainings in Mexico and Nicaragua.

The brief update on Mexico is that our recent Level 1 Campaign and Training (April 2011) was a great success. There we are partnering with 4 cooperatives now. In addition to CESMACH, we are also working with Finca Triunfo Verde, Ramal Santa Cruz and La Comon Yaj Nop Tic. We hired a part-time medical coordinator at this site in February 2011: Dr. Lupita Jovel. She has also been joined by Rachel Ballester, RN who joined our team as a program assistant at this site also in February 2011. Together they have been a dynamic duo, and are bringing the quality and depth of work at this site to a whole new level.

One week ago, I returned from two weeks in Nicaragua where I was working with our colleague Dra. Barinia Osejo. A fabulous trip, with back to back trainings and clinical activities. Prior to my arrival, Executive Director August Burns was also in Nicaragua for one week, meeting with our key local Ministry of Health and coffee cooperative stakeholders in Jinotega, Matagalpa and Madriz. Our new colleague Kayla Moore also joined us for 10 days, getting her first taste of the work of GFH on the ground.

During those two weeks of training activities, we screened 345 women with a mix of visual inspection and Paps (which will be processed through the usual channels). Again many of the women whom we saw had never been screened prior. When possible, we try to arrange our clinical activities in a rural setting closer to where the coop’s membership lives.

The first activity we led was a Level 2 training for doctors and nurses from the Department of Matagalpa whom we trained in November 2010. This group is comprised of incredibly strong doctors and nurses who have continued to use their skills in VIA and Cryotherapy. For this first week we were also joined by two GFH volunteers, Grace Mishkin, NP (first trip) and Sarah Morgan, MD (second trip) both of whom were essential and superb addition to our training team. Together we tested a new Level 2 Refresher Didactic Training and provided screening services for women affiliated with CORWAS, a base cooperative of CECOCAFEN. The vast majority of women seen had never been screened prior for cervical cancer.

We often heard from the women that they felt that finally the cooperative was taking them into consideration as women: “Pues por fin, nos estan tomando en cuenta.”

CECOCAFEN co-op coordinator Yuritt Zeledon w/ Lucy, who helped with training

During the second week, Barinia and I facilitated the clinical training of 5 doctors and nurses in the Department of Jinotega—all of whom pertain to key CECOCAFEN and SOPPEXCCA communities (El Cua and Wiwili).

This was a small, intimate and efficient training that again took place over 3 days. In that time we saw 158 women and certified 4 of the providers in VIA and Cryotherapy. The fifth provider works for the Ministry of Health in Jinotega and oversees the cervical and breast cancer screening programs for that region.

Barinia has undertaken a careful strategy to deepen the work in Matagalpa where we have a current partnership with CECOCAFEN while also taking steps to strengthen capacity and better ensure sustainability in Jinotega, where our formal partnership with SOPPEXCCA has ended. Meanwhile, Barinia is laying the groundwork for our next project in San Juan del Rio Coco. The trainings of the health promoters and técnicos are well underway and we will have our first Level 1 Training of doctors and nurses at this new site in late September 2011.

To help make all of this possible, we now have a program assistant in Nicaragua. Barinia is thrilled about the arrival of Amanda Eastwood, MPH. Amanda will be working with Barinia at this site for the next 6 months—and helping with all aspects of program management and implementation. We anticipate that their synergy will be impressive. Stay tuned!

Community Health Promoters: In Her Own Words

Justin Mool — Wed, 28 Jul 2010 16:58:48 +0000

Nicaragua Photos – Courtesy: Adam Pesce

Justin Mool — Thu, 27 May 2010 19:15:16 +0000

During May’s trip to Nicaragua, Adam Pesce of Reunion Island Coffee and First Drop Canada tagged along with our crew to document the program with professional photographs. He certainly got some amazing shots. Here is a small sampling of the hundreds he took. Also: we’ll update with captions soon. Adam rushed these over to us before his Grounds for Health fundraiser this evening. (Thanks for all your support/help, Adam!)

You can also view photos by our volunteers on the Grounds for Health Facebook Page.

Enjoy!

Click on any image to view larger version, then click on the left/right side of the image to go back/advance.