El Hatillo, Jinotega

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

Overview

El Hatillo is located in the mountainous region of central Nicaragua in the department of Jinotega. A typical house is made of bahareque (an earth mixture anchored with rock and sticks). The community has access to a health center in the neighboring community, Llano de la Tejera, 10km away. Within El Hatillo is a multigrade primary school. 27 students attend the primary school with two teachers and one classroom. The primary school goes up to grade 6, and there is no secondary school located in El Hatillo. Most people in the community work as agricultural laborers.

Global Brigades is currently working with the Medical and Business. Program in El Hatillo. The Medical Program has been partnering with El Hatillo since the first Medical Brigade in March 2013, and the Business Program since the induction of the community bank in September 2017. The Business Program team will continue to work with El Hatillo to monitor the community bank. Additionally, he Public Health Program was completed in December 2014, and the Water Program in June 2017. Before Global Brigades programs were implemented in El Hatillo, the top three needs expressed were: limited access to potable water, limited access to medical attention, and need fro road repairs. El Hatillo is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: Jinotega

Department: Jinotega

Homes : 34
Population : 122
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 62%
Education : Up to 6th Grade
Distance from Lodging Facility : 1 hr

Medical

Program Status

  • Planning
  • Active
  • Complete
Global Brigades pharmacist checks off medication before explaining the medication and dosage to next patient in line.

HEALTH CARE ACCESS:

Healthcare access in Nicaragua is structured by the Ministry of Health, based in the capital, Managua. From there, each of the fifteen departments has it’s own department hospital, which is overseen by the SILAIS administrations (Sistema Local de Atención Integral en Salud). At a municipality level, there is a health center (Centro de Salud) for every municipality within the department. While they are not hospitals, health centers in the municipality are typically staffed with one doctor, and two nurses, that can attend patients with chronic, communicable, or noncommunicable diseases, as well as pregnancies. They however, do not have the ability to perform surgeries. Lastly, most but not all communities have a Puesto de Salud, a smaller health center. These health centers are usually staffed with only one nurse and a rotating physician. Physicians are staffed in these health centers by Nicaragua’s Social Service. This is an initiative that requires Nicaraguan medical students to do two years of service in rural communities prior to graduating.  The physician density in Nicaragua is approximately 1,099 people for every one doctor.  According to the World Health Organization, there should be a maximum of 435 people per physician to qualify a country as having adequate access to medical attention. This density is significantly lower for the 40.6% of the population that lives in rural areas. It is for this reason that Nicaragua’s Social Service initiative brings medical students to these communities. However, access remains limited since these training physicians may be assigned to up to fifteen communities at a time.  

El Hatillo has access to a health center in the neighboring community, Llano de la Tejera, about 10km away. Even with this access, it is important to note that medications, supplies, and materials are often not available in these health centers and are dependent on government funding. There is no access to private pharmacies. Additionally, as noted above, access to trained medical professionals is limited.

During their initial communications with Global Brigades, the top three illnesses in children that El Hatillo expressed were parasites, diarrhea, and respiratory infections.  For adults, common illnesses are chronic diseases such as hypertension, diarrhea, and joint pain. Without access to trained healthcare 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.

 

66

Brigade Volunteers

1819

Patient Consultations

N/A

Pap Smears Performed

15

Health Education Workshops

COMMUNITY HEALTH WORKER:

El Hatillo has six Community Health Workers that are trained by the Ministry of Health monthly. Community Health Workers, or Brigadistas de Salud, work on a volunteer basis as advocates for healthcare within their communities. They are tasked with treating and preventing common illnesses, and some of their responsibilities include first aid, supporting and caring for pregnancies and newborns, and responding to emergency situations. They are also responsible for following up with chronic patients to ensure proper administration of medications and treatments to avoid further complications. Global Brigades is planning to establish a partnership with El Hatillo Community Health Workers and the Ministry of Health, and is looking forward to providing these Community Health Workers with blood pressure cuffs, stethoscopes, glucometers, and first aid kits, to facilitate more impactful work. The presence of these volunteers and their advocacy for health within their community contributes to the sustainability of healthcare supported by Global Brigades’ Medical Program and is one of the most impactful disease prevention strategies in rural communities.

BRIGADE INFORMATION:

Medical Brigades in El Hatillo will be in the community school. This location has two rooms and a large backyard for triage, consultation, dentistry and pharmacy stations. The average amount of patients seen per day is 212 patients per day.

El Hatillo offers strong support on Medical Brigades from the community volunteers. One way the six Community Health Workers, who serve as volunteers in the mobile clinic, assist is by running intake. Intake is the very first station of the clinic and is where the community volunteers write 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 sanitation and hygiene, chronic diseases, contraception, Women’s health, and water purification. El Hatillo community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 212

NEARBY COMMUNITIES: RINCON LARGO, SITIO VIEJO, OCOTAL ESPESO, LA GALERA, EL CASTILLO, LOS CALPULES, EL TANQUE, EL HORNO, LA LIMA, LAS TRANCAS, MATASANO, SAN JOSE DE HUMURE

BRIGADE SITE: COMMUNITY SCHOOL

 

MEDICAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Pennsylvania State March 2013 39 Carnegie Mellon University March 2013 27
Loyola University January 2014 33 Syracuse University January 2014 38
Mississippi State University May 2015 26 The University of Mississippi/ University of South Florida December 2017 21

Dental

Program Status

  • Planning
  • Active
  • Complete

DENTAL CARE ACCESS:

While medical access is low, dental access is even more sparing. Dental services are not available within the community health centers, or even the municipality health centers. Instead, if a patient was needing dental care, they would be required to travel to one of the country’s fifteen department hospitals. This could be up to a 2-3 hour bus ride, with many needing to first walk or horseback ride to the bus stop.

530

Patients Consultations

347

Flouride Treatments

333

Fillings Performed

16

Dental Education Workshops

University of Mississippi/ University of South Florida Medical Brigade provide fluoride treatments in El Hatillo

Working closely with the Medical Program, the Dental Program provides fillings, extractions, and fluoride treatments as a standard part of medical brigades. Community members from El Hatillo attend Dental Brigades in the community school of El Hatillo. The average amount of patients seen per day is 37 patients, with approximately 10-15 minutes per patient.

El Hatillo offers strong support on Dental Brigades from the community volunteers. One way the 8-15 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 oral health and hygiene. El Hatillo’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED: 37

NEARBY COMMUNITIES: RINCON LARGO, SITIO VIEJO, OCOTAL ESPESO, LA GALERA, EL CASTILLO, LOS CALPULES, EL TANQUE, EL HORNO, LA LIMA, LAS TRANCAS, MATASANO, SAN JOSE DE HUMURE

BRIGADE SITE: COMMUNITY SCHOOL

DENTAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Mississippi State University May 2015 26 The University of Mississippi/ University of South Florida December 2017 21

Water

Program Status

  • Planning
  • Active
  • Complete

EL HATILLO WATER CHALLENGE:

Prior to Global Brigades involvement, El Hatillo had been using an outdated water system of 21 years in the neighboring community of Rincon Largo. This presented challenges, as Rincon Largo is located at a higher elevation and the system was not built with flow meters. With both of these factors in mind, it was easier for Rincon Largo to have access to water first, and in the amount they desired (without it being measured), while El Hatillo, being located at lower elevation for a gravity system was disadvantaged with only the water that was left over.  Often times there was not enough water between the 70 families in both Rincon Largo and El Hatillo. Because of this, 70% of those in El Hatillo reported having access to water less than 1 to 3 hours a day. In the summer time this access could be even more scarce. At its worst community members reported only having water every two days, for only a half an hour to an hour. When water was not available at the tap, it required  community members, typically women and children, to walk to rivers to receive water. This meant carrying buckets, many times over long distances if there was even water available due to a four-year drought. Additionally, the quality of the water was often not adequate for drinking.

1307

Water Brigade Volunteers

2500

Meters of Piping Installed

40

%

Percentage of System Completed

124

Project Beneficiaries

WATER SOLUTION: 

In May 2017, a partnership between El Hatillo, Global Brigades, the Municipality of Jinotega, and AVODEC was officially formed. In order to plan a water system custom-designed for El Hatillo, the land was first surveyed by a contracted AVODEC technician. 

Since a lack of a water source was the main issue hindering the construction of the system, a solution was for the technican to conduct a hydrogeological survey to find out where the highest likelihood was in the community to drill a well that would contain a sufficient capacity to supply water to the whole community over a minimum period of 20 years. A specialist in this field was hired to do the job using their expertise, national maps, and on-site visits to the community. Then, results were compiled in a formal document which suggested an ideal spot where a well could be drilled.

With the hydrogeological research results in hand, an assembly took place on February 27, 2017 at the community primary school. The goal was to set a plan moving forward and elect a Water Council. The job of those on the Water Counic would be to assist in the assembly of the committee, as well as lead the conversations with the land owner whose land was proposed as being the best drilling location. The community members elected five representatives: President, Vice President, Secretary, Treasurer, and a Support Member to offer support during the entire duration of the water project.

Once the drilling land site was set, it was determined that the best fit for El Hatillo would be to build a mixed gravity well with a submersible electric pump, and two storage tanks (one of 14 cubic meters, the other of 4.5). This system is currently being worked on with brigades in Nicaragua, and upon completion will have a distribution network that connects the water storage tanks to 38 families, consisting of 124 individuals, as well as the community health center, primary school, and church.  

Brigades began working on this water system on May 5, 2017

In total, the water system cost $37,200 USD. Of this, the community financially supported with 16% of the funding. Rotary Club contributed the cost of the excavation of the well at approximately 19%. AVODEC supported with 3%, and Global Brigades with 62%. Outside of these funds, the value of labor donated by each family should be recognized.

In the interest of sustainability, after the project is complete, the five members of the Water Council will be trained on water treatment and system maintenance, administration, and operation, so they can continue adequately managing the water system.  El Hatillo will also establish a monthly water fee in order to pay the Water Council for water treatment, maintenance costs, and system sustainability.

 

WATER BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Wright State April 2017 24 Oakland University April 2017 24
McMaster University April 2017 40 University of Cincinatti May 2017 11
University of South Florida May 2017 25 Florida Atlantic University May 2017 43
Pennsylvania State University May 2017 25 University of Central Florida May 2017 31
University of Utah/ Ferris State University May 2017 25 Florida Gulf Coast University May 2017 35
Indiana University May 2017 31 Emory University May 2017 20
University of Miami May 2017 14 Ball State University/ Colorado State University May 2017 36
Rutgers University/ Seton Hall May 2017 26 Middle Tennessee State University/ Bowling Green State University May 2017 29
Otterbein University/ Case Western Reserve May 2017 35 Temple University/ Columbia University May 2017 35
University of Colorado- Colorado Springs May 2017 51 University of Arizona May 2017 26
University of Texas San Antonio May 2017 43 University of Minnesota- Rochester May 2017 24
University of Kansas May 2017 14 University of Missouri May 2017 30
University of Texas Dallas May 2017 21 SUNY Stony Brook May 2017 18
University of Colorado Boulder May 2017 11 University of Minnesota- Twin Cities/ University of Pennsylvania May 2017 34
Miami University of Ohio/ Missouri Kansas City May 2017 29 SUNY Stony Brook May 2017 29
California State University Bakersfield/ SUNY New Paltz May 2017 33 Northern Arizona University May 2017 26
University of Colorado Boulder May 2017 46 University of Colorado Boulder May 2017 16
Boston College May 2017 25 CUNY Brooklyn College June 2017 21
Thomas Jefferson University June 2017 37 CEGEP Marianopolis June 2017 24
Temple University School of Medicine June 2017 28 California State University East Bay June 2017 27
Drexel University/ University of California Riverside June 2017 27 Oregon State University June 2017 33
University of California Santa Barbara June 2017 29 University of California Santa Barbara June 2017 16
University of California Davis June 2017 26 University of Los Angeles June 2017 14
University of California Riverside June 2017 40

Business

Program Status

  • Planning
  • Active
  • Complete

EL HATILLO BUSINESS CHALLENGE:

Prior to Global Brigades involvement, El Hatillo did not have access to any cooperative or community bank. Community members lacked access to financial resources within the community. The majority of community members did not have bank accounts and there were only limited informal forms of credit available. Larger financial institutions did not approve loans to community members without a fixed income, making it difficult for local micro-enterprises to grow and thrive.

For occupation, the majority of the population are agricultural laborers that cultivate corn, beans, and sorghum. Ability to harvest these products has been significantly impacted by drought. The opportunities of employment and sources of income are seasonal and dependent on the agricultural conditions of the season.

 

6

Brigade Volunteers

22

Loans Disbursed

1

Savings Accounts Opened

$700

Capital Invested

EL HATILLO’S MICRO-FINANCE SOLUTION:

The cooperative of El Hatillo was formed in April 2016. There are 11 elected leadership council members that manage the cooperative, consisting of 33 total members. Through the cooperative C$3,300 (approximately $110USD) is in savings for business investments.  The next step will be to increase the capital and expand to not only assist those interested in starting businesses but additionally to become a local financial institution for any individual looking to take out loans. Global Brigades and El Hatillo’s cooperative are working towards being able to disperse loans and train individuals on loan management and financial literacy. 

EL HATILLO’S BUSINESS SOLUTION:

In addition to loans that can be taken out to invest in already established businesses, Global Brigades has worked with El Hatillo to start one new cooperative business– a lime tree orchard. 26 families have invested in the purchase of 400 lime trees to be planted in the community. Additionally Global Brigades contributed C$20,000 (approximately $665USD). In collaboration with the cooperative, named “Tahiti,” limes will be harvested and packaged for sale in local supermarkets. In addition, the group is undertaking a reforestation initiative to battle drought conditions in the community. This imitative will use recycled bottles to create an irrigation system.

BUSINESS BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Humanos March 2017 6

Public Health

Program Status

  • Planning
  • Active
  • Complete

EL HATILLO PUBLIC HEALTH CHALLENGE :

The community faces numerous public health challenges with limited infrastructure in their homes. 88% of homes have concrete floors as opposed to mud or dirt floors. Furthermore, 88% 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 62% 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.

1084

Brigade Volunteers

32

Sanitary Stations Constructed

2170

Meters Squared of Concrete Floors

EL HATILLO  PUBLIC HEALTH SOLUTION:

With the community having large public health needs, each family was given the opportunity to receive a sanitary station (latrine, water storage tank and shower), and concrete floors. The number of projects each family received depended on what the family desired and what they could afford. As part of our development plan, families are required to financially contribute to 10-15% of the cost of the projects to encourage ownership and buy-in.

To ensure the sustainability of the in-home infrastructure projects, the Public Health Program provides continuous follow-up in the community. It also partners with the Basic Sanitation Committee, a community body formed by local leaders which monitors the correct usage and maintenance of the new infrastructure. Clear responsibilities and powers are assigned to each member, making the beneficiaries themselves an even stronger stakeholder in the Public Health projects.

PUBLIC HEALTH BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Carroll University January 2014 37 Marquette University January 2014 69
Loyola University of Chicago January 2014 33 Saint Louis University January 2014 47
University of Dayton January 2014 43 Vanderbilt University March 2014 21
Pennsylvania State University March 2014 51 University of Texas-Austin March 2014 28
Grinnell College March 2014 18 Florida Gulf Coast University May 2014 22
University of California-Berkeley/ University of Missouri May 2014 44 Louisiana State University May 2014 24
University of Colorado-Boulder/Texas A&M University May 2014 66 University of Colorado-Boulder May 2014 13
Rutgers University May 2014 21 Temple University May 2014 12
University of Minnesota-Rochester May 2014 30 Montclaire University May 2014 16
Stony Brook University May 2014 35 University of Pennsylvania May 2014 19
Brooklyn College June 2014 28 California State University East Bay June 2014 44
Oregon State University June 2014 37 University of San Diego August 2014 28
University of Washington September 2014 36 DePaul University December 2014 16

Local Reference Points

View the map to see the closest volunteer lodging facilities, hospitals, and other relevant points of reference.

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