Cuatro Esquinas*

  • Overview
  • Medical
  • Dental
  • Water
  • Business
  • Public Health

Overview

Cuatro Esquinas is located in the mountainous region of central Nicaragua. The community has access to a local health center 1.5 kilometers away and a multigrade primary school with two teachers and one classroom. Most people in the community work in agricultural or as day laborers. Global Brigades completed a water system in this community in 2017. Before the Water program was implemented in Cuatro Esquinas, their top three needs expressed were: access to potable water, access to hygiene services, and a larger primary school. Currently, the Public Health program is active, with on-going brigades since March 2018.

Cuatro Esquinas is on the wait-list for continuing the Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: San Rafael del Norte
Department: Jinotega

*Brigades to this community are temporarily suspended at this time

Homes : 74
Population : 274
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 90%
Education : Up to 6th Grade
Distance from Lodging Facility : 44 km

Medical

Program Status

  • Planning
  • Active
  • Complete

HEALTH CARE ACCESS

Cuatro Esquinas is a community located in the municipality of San Rafael del Norte in the mountainous region of Jinotega. They have a local health center located in 1.5 kilometers and is periodically staffed with nurses by the Ministry of Health. The local health center has medications supplied occasionally. There is no access to private pharmacies.

Based on Global Brigades Rapid Needs Assessment the top three illnesses in children are: diarrheal diseases, acute respiratory infections, and fevers. For adults, common illnesses are chronic diseases such as diabetes, asthma and hypertension, as well as diarrheal diseases, and body pain. Without access to trained health care professionals and medications, chronic diseases can go unmanaged, leading to further health problems. Acute illnesses can also be severe and affect the quality of life.

*These statistics represent brigades in the community of Los Encuentros de San Gabriel, where community members from Cuatro Esquinas attend Medical Brigades.

284

Volunteers*

3,339

Patient Consultations*

N/A

Vision Screenings Provided*

18

Health Education Workshops*

COMMUNITY HEALTH WORKERS

Cuatro Esquinas has 2 Community Health Workers (CHWs) that are trained by the Ministry of Health and supported by Global Brigades to monitor the conditions of chronic patients. In this community, Global Brigades is establishing a partnership with the Ministry of Health and is looking forward to providing these CHWs blood pressure cuffs, stethoscopes, glucometers, and first aid kits, to facilitate more impactful work.

BRIGADE INFORMATION

Medical Brigades for Cuatro Esquinas will be in the community church in Los Encuentros de San Gabriel.  This location has one large room and backyard for triage, consultation, dentistry and pharmacy stations.

Cuatro Esquinas offers strong support on Medical Brigades from the community volunteers. One way community volunteers assist is by running intake. Intake is the very first station of the clinic and is where the community volunteers write down the patient’s name, date of birth, community, and identification number. Additionally, community volunteers manage clinic organization. They set up tables and chairs in the clinic prior to the brigade’s arrival as well as direct patients to the next medical station, once the clinic has opened for the day. Lastly, community volunteers lead adult health education sessions on sanitation and hygiene, chronic diseases, contraception, women’s health, and water purification. Cuatro Esquinas community volunteers are essential for the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 713

NEARBY COMMUNITIES: TOMATOYA, SASLE, LAS CURENAS, SARAGUASCA, CHAGUITE GRANDE, MESA DEL OCTE, SAN GABRIEL

Dental

Program Status

  • Planning
  • Active
  • Complete

DENTAL CARE ACCESS

In working closely with the medical program, the dental program provides fillings, extractions, and fluoride treatments as a standard part of medical brigades. Most community members do not have regular access to dental care due to the lack of dentists within a reasonable distance.

*These statistics represent brigades in the community of Los Encuentros de San Gabriel, where community members from Cuatro Esquinas attend Dental Brigades

229

Patient Consultations*

174

Number of Extractions*

87

Fillings Performed*

57

Dental Education Workshops*

BRIGADE INFORMATION

Dental Brigades use the community church in Los Encuentros de San Gabriel as their brigade site. The community church is suitable for brigades and running mobile clinics. Dental Brigades use space in the large one room of the community church. Dentists spend an average of 12 minutes with each patient and we are able to provide 4-5 educational workshops a day.

Cuatro Esquinas offers strong support on Dental Brigades from the community volunteers. One way the community volunteers, assist is by running intake. Intake is the very first station of the clinic and is where the community volunteers write down the patient’s name, date of birth, community, and identification number. Additionally, community volunteers manage clinic organization. They set up tables and chairs in the clinic prior to brigade’s arrival as well as direct patients to the next medical station, once the clinic has opened for the day. Lastly, community volunteers lead adult health education sessions on oral health and hygiene. Cuatro Esquinas’s  community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED:713

NEARBY COMMUNITIES: TOMATOYA, SASLE, LAS CURENAS, SARAGUASCA, CHAGUITE GRANDE, MESA DEL OCTE, SAN GABRIEL

 

Water

Program Status

  • Planning
  • Active
  • Complete

CUATRO ESQUINAS’ WATER CHALLENGE:

Previously, one of the only water sources of the community was a river contaminated with waste and agricultural chemicals. In the 1990’s the Municipality of San Rafael del Norte identified a mountain spring water source of good quality and quantity to build a water system off of. At the time there were no issues breaking ground on the project since the land had been fully donated by the landowner, Jesus Maria Tinoco Pineda, to the Municipality because Pineda knew the water needs that communities in the surrounding area had. Despite this promising beginning, lack of financing and a budget from the Municipality led to the project’s halt for almost 20 years.

353

Volunteers

921

Project beneficiaries

16

Kilometers of Pipeline Installed

15,852

Storage Tank Volume

CUATRO ESQUINAS’ WATER SOLUTION: 

It was not until this past September 2016 that the project officially re-started after a partnership was formed between Cuatro Esquinas and 4 other communities, Global Brigades Nicaragua, the Municipality of San Rafael del Norte, and Water for People. In order to plan a water system custom-designed for the 5 communities, the land was first surveyed by the Municipality of San Rafael del Norte. From this land survey, it was determined that the best fit would be to take water from an available spring source. Households would then be connected to a gravity system with one storage tank. A concrete water catchment was constructed to collect water from the spring mountain source. From there nine kilometers of trenches were dug with pipeline laid. The system was designed to then conduct water by gravity to the storage tank, where it would be held and treated, before flowing through sixteen kilometers of distribution pipeline to every community member’s household. This new water flow will supply the communities of Sabana de en Medio, La Joya, Cuatro Esquinas, Mesa del Ocote and San Gabriel through the projected 20-year lifespan of the project.

In addition to construction, Cuatro Esquinas mobilized to form a CAPS (Comité de Agua Potable y Sanitación/ Water and Sanitation Committee). Over the course of eight months of construction, 816 Global Brigades volunteers worked alongside the committee and community members to construct a system that now reaches 221 families and 921 beneficiaries for the 5 communities combined. Before the project’s completion, a capacity test of the well was completed, and demonstrated an average of 46 gallons per minute.

WATER VOLUNTEERS IN CUATRO ESQUINAS:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
DePaul University Public Health Brigade December 2016 23 Oakland University Medical Brigade December 2016 31
Saint Louis University Medical Brigade January 2017 30 State University of New York Binghamton Medical Brigade January 2017 37
University of Southern California Medical/Dental Brigade January 2017 38 University of Missouri Medical Brigade January 2017 34
DePaul University Medical Brigade November 2016 35 West Virginia University Public Health Brigade March 2017 15
College of William and Mary Medical Brigade March 2017 35 UNC Charlotte Medical Brigade March 2017 31
Central Michigan University Public Health Brigade & Pennsylvania State University Public Health Brigade March 2017 26 Carnegie Mellon University Water Brigade March 2017 8
University of Arizona Water Brigade March 2017 10

Business

Program Status

  • Planning
  • Active
  • Complete

CUATRO ESQUINAS’ ECONOMIC CHALLENGE 

Rural communities in Nicaragua face a number of structural obstacles when it comes to economic growth. Access to credit is limited by physical barriers in transportation and exclusion from formal financial institutions. This exclusion can be the result of a lack of financial literacy, credit history, and land titles or substantial assets consumer goods to offer as collateral. Additionally, maintaining savings is not a common practice in rural communities in Nicaragua, and when families do save, they often do not have a safe place to do so.

In Cuatro Esquinas, the average family income is low per household. The main form of employment in Anita is agriculture. Economic growth faces additional obstacles due to the community’s dependence on agriculture and day laboring, as its inhabitants’ incomes are earned on a seasonal basis, determined by crop yields, and susceptible to external factors like drought, disease, and international market trends.

*No volunteers have been able to support in this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

 

0*

Volunteers

N/A

Loans Disbursed

25

Savings Accounts Opened

N/A

Capital invested

CUATRO ESQUINAS’ MICRO-FINANCE SOLUTION 

The Business Program works to stimulate the local economy by organizing community residents around a community bank, which is entirely owned and operated by its members. Focusing on providing access to low-interest loans credit and savings for the members, its Bank Council members are tasked with growing the community bank and managing the funds. The Business Program provides training and support to help strengthen these community banks and stimulate the flow of capital within the community. These financial services can be used by members for everything from farmers taking out loans to buy their seeds before planting, to a family taking out a loan to cover medical expenses. 

Cuatro Esquinas’  community bank, named La Fe, was established September 2017 with the support of Global Brigades. The community bank has 20 female and 5 male shareholders who meet bi-weekly along with a bank council that leads the shareholders and oversees the meetings. In order to pool funds together, increase the capital available to the community bank, and expand the impact of its financial services, each member contributes a monthly share or fee for which they receive a proportional amount of the bank’s dividends at the end of its fiscal year.

Additionally, Global Brigades provides matching capitalizations once these capitalizations meet established benchmarks. Global Brigades also has monthly follow-ups and trainings with the community bank to strengthen the bank overtime and ensure its sustainability. Global Brigades and Cuatro Esquinas’ community bank are working towards being able to disburse loans, increase savings and train individuals on financial management.

Public Health

Program Status

  • Planning
  • Active
  • Complete

CUATRO ESQUINAS PUBLIC HEALTH CHALLENGE:

The community faced numerous public health challenges with limited infrastructure in their homes. Only 46% of homes have concrete floors as opposed to mud or dirt floors. Furthermore, 50% of homes have access to showers. 100% of homes have traditional stoves, which means that the majority of homes have an over-accumulation of smoke. Although 70% of homes have latrines, the community does not have sufficient methods of waste disposal. The river, where people bathe, is contaminated with waste and chemicals.

242

Volunteers

36

Sanitary Stations Constructed

240

People Benefited with Public Health Infrastructure

10

Hours of Charla

CUATRO ESQUINAS PUBLIC HEALTH SOLUTION:

Between February 2018  and March 2018, the Public Health Program worked with all interested families to finance and install Sanitary Stations including a shower, latrine, handwashing station, and water storage unit. These projects allow community members to avoid preventable disease and foster improved hygiene and sanitation practices. During their time in Cuatro Esquinas, Public Health volunteers conducted educational workshops, or charlas, with community members on project maintenance and various public health topics. Additionally, Global Brigades trained a Basic Sanitation Committee, a community body formed by local leaders. The committee advocates for proper hygiene and sanitation practices, monitors maintenance of  completed projects . 

To promote the sustainability of the Public Health Program’s projects, families are required to contribute a portion of the project cost. This instills a sense of ownership and encourages proper maintenance of the projects. Therefore, before the Public Health Program started its projects, the Business Program worked with the community to train an existing community bank that would allow families to finance these contributions through microcredit. Although the Public Health Program has completed all planned projects in Cuatro Esquinas, loans remain available through the community bank and local masons who were contracted to complete the projects now hold the skills to perform any necessary repairs or construct new units. 

PUBLIC HEALTH VOLUNTEERS IN CUATRO ESQUINAS:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Milwaukee School of Engineering Water Brigade February 2018 15 Northeastern University Public Health Brigade & University of Virginia Public Health Brigade & University of Arizona Public Health Brigade March 2018 30
University of Arizona Water Brigade & Pennsylvania State University Water Brigade March 2018 23 College of William & Mary Medical Brigade March 2018 30
Carnegie Mellon University Public Health Brigade & University of Tennessee Public Health Brigade March 2018 24 Duke University Public Health Brigade & University of Notre Dame Public Health Brigade March 2018 14
West Virginia University Medical Brigade March 2018 61 Carnegie Mellon University Medical Brigade March 2018 26
University of West Virginia Public Health Brigade March 2018 19

Local Reference Points

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“Global Brigades” refers to one or more Global Brigades entities, each of which is a separate and independent legal entity; “Global Brigades, Inc.,” “Global Brigades Health and Development,” “Global Brigades UK,” “GBO Ghana,” “Asociacion Global Brigadas de Honduras,” and “Fundacion Brigadas Globales de Panama”. Global Brigades Health and Development (“Global Brigades Canada”) is a federally registered Canadian charity independent from Global Brigades Inc.

Guidestar 2021