El Hular

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

Overview

El Hular is located in the mountainous region of central Nicaragua in the department of Matagalpa. A typical house is made of cement block. The community has access to a local health center within the community, as well as both a primary school and secondary school. 234 students attend the primary school with 13 teachers and 8 classrooms. The primary school goes up to grade 6. Following, students have the option to attend secondary school, up to grade 12. Currently, 288 students attend the secondary school with 12 teachers and 8 classrooms. Most people in the community work as agricultural laborers, and in coffee.

Global Brigades is currently working with the Medical Program in El Hular and has been since the first Medical Brigade in March 2017. In their communication with Global Brigades, the top three needs expressed were lack of latrines or properly functioning latrines, limited access to potable water, and a shortage of medication and a permanent doctor in the health center. El Hular is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: La Dalia

Department: Matagalpa

Homes : 280
Population : 1300
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 95%
Education : Up to 12th Grade
Distance from Lodging Facility : 2 hr

Medical

Program Status

  • Planning
  • Active
  • Complete

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 Hular has access to a health center within their community. 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 Hular expressed are diarrheal diseases, respiratory infections, and parasites. For adults, common illnesses are chronic diseases such as diabetes and hypertension, as well as epilepsy. 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.

95

Brigade Volunteers

3247

Patient Consultations

183

Pap Smears Performed

41

Health Education Workshops

COMMUNITY HEALTH WORKER:

El Hular has six Community Health Workers that are trained by the Ministry of Health every three months. 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 Hular 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:

Community members from El Hular attend Medical Brigades in the community health center of El Hular. This location has rooms for triage, consultation, dentistry and pharmacy stations. The average amount of patients seen per day is 361 patients.

El Hular offers strong support on Medical 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 sanitation and hygiene, chronic diseases, contraception, Women’s health, and water purification. El Hular’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 355

NEARBY COMMUNITIES: EL HULAR ABAJO, SAN RAFAEL, LA LUCHA, EL CHARCON, EL LIMONCILLO, LA ALIANZA, SAN ANTONIO, LAS NUBES #2 & #3

BRIGADE SITE: HEALTH CENTER

 

MEDICAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Tulane University March 2017 33 Texas A&M University August 2017 41
University of Victoria February 2018 28

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.

365

Patients Consultations

135

Flouride Treatments

208

Fillings Performed

31

Dental Education Workshops

BRIGADE INFORMATION:

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 Hular attend Dental Brigades in the community health center of El Hular. The average amount of patients seen per day is 41 patients, with approximately 10-15 minutes per patient.

El Hular 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 Hular’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 40

NEARBY COMMUNITIES: EL HULAR ABAJO, SAN RAFAEL, LA LUCHA, EL CHARCON, EL LIMONCILLO, LA ALIANZA, SAN ANTONIO, LAS NUBES #2 & #3

BRIGADE SITE: HEALTH CENTER

DENTAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Tulane University March 2017 33 Texas A&M University August 2017 41
University of Victoria February 2018 28

Water

Program Status

  • Planning
  • Active
  • Complete

El Hular has a gravity water system that was constructed in 2015. While the system reaches 100% of the homes, there are at times issues with the distribution of water not being sufficient, or having contaminated water.

Global Brigades is working on the implementation of the Holistic Model in El Hular but has not yet begun with the Water Program. Now in the planning phase, the financing, delivery, and installation of a water system infrastructure, or repairs to existing infrastructure will start as soon as feasible.

 

Water System : Yes
Type of Water System : Gravity
% of Homes with Access to Water : 100%
Water Council : Yes

Business

Program Status

  • Planning
  • Active
  • Complete

Global Brigades is working on the implementation of the Holistic Model in El Hular but has not yet begun with the Business Program. In the planning phase, local staff is working with community members to assess the economic needs of the community, establish a community bank, and identify micro-enterprises that can benefit from on-brigade consultations. 

Community Bank : No
Community Bank Members : None
Economic Activities : Agricultural labor, coffee
Existing Microenterprises : N/A

Public Health

Program Status

  • Planning
  • Active
  • Complete

Global Brigades is working on the implementation of the Holistic Model in El Hular but has not yet begun with the Public Health Program. Now in the planning phase, the financing, delivery, and installation of household health infrastructure products will start as soon as feasible.

% of Homes with Latrines : 95%
% of Homes with Showers : 0%
% of Homes with Washing Station : 2%
Common House Materials : Cement block

Local Reference Points

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

  • Feature