El Naranjo

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

Overview

El Naranjo 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 health center within the community, as well as both a primary and secondary schools. 150 students attend the primary school with six teachers and six classrooms, while 80 attend the secondary school with six teachers and five classrooms. The primary school goes up to grade 6, and secondary to grade 12. Most people in the community work as agricultural laborers.

Global Brigades is currently working with the Business and Medical Program in this community. Prior to partnering with Global Brigades in the Medical, Dental, Public Health, and Business program, the top three needs expressed were poor conditions of latrines, insufficient access to potable water, and need of improvements to the secondary school. El Naranjo is continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: Sébaco

Department: Matagalpa

Homes : 203
Population : 976
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 70%
Education : Up to 8th Grade
Distance from Lodging Facility : 1 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 Naranjo 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 illnesses in children that El Naranjo expressed were gastric and respiratory infections. For adults, common illnesses are chronic diseases such as diabetes and hypertension, as well as arthritis. 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.

271

Brigade Volunteers

1862

Patient Consultations

N/A

Pap Smears

24

Health Education Workshops

COMMUNITY HEALTH WORKER:

El Naranjo has six Community Health Workers that are trained by the Ministry of Health three times a year. 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 Naranjo 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 Naranjo will be in two community churches located next to each other. Each church consists of one large open rooms. One church is used for triage, and consultation, while the other church is used for dentistry and pharmacy stations. The average amount of patients seen per day is 235 patients per day.

El Naranjo 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 Naranjo’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED BY DAY: 235

NEARBY COMMUNITIES: ELSALTO, JOCOMICO, EL LLANO, EL PORTILLO, ELCHILAMATE, LA PITA, LA CORNETA, SAN JOSE

BRIGADE SITE: TWO COMMUNITY CHURCHES

MEDICAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
University of California Riverside Medical June 2014 94 Saint Louis University Medical January 2015 40
Ohio State University/ University of Cincinnati Medical May 2015 44 Texas A&M University Dental January 2016 24
University of Connecticut Medical May 2016 33 College of William and Mary Medical March 2017 36

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.

741

Patients Consultations

562

Flouride Treatments

393

Fillings Performed

12

Dental Education Workshops

BRIGADE INFORMATION:

Dental Brigades uses one community church as their brigade site. The community church is suitable for brigades and running mobile clinics. It consists of one large room. Doctors send an average of 10 minutes with each patient and we are able to provide 4-5 educational workshops a day. Each brigade sees an average of 37 patients per day.

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

AVERAGE PATIENTS ATTENDED: 37

NEARBY COMMUNITIES: ELSALTO, JOCOMICO, EL LLANO, EL PORTILLO, ELCHILAMATE, LA PITA, LA CORNETA, SAN JOSE

BRIGADE SITE: COMMUNITY CHURCH

DENTAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Ohio State University/ University of Cincinnati Medical May 2015 44 Texas A&M University Dental January 2016 24
University of Connecticut Medical May 2016 33 College of William and Mary Medical March 2017 36

Water

Program Status

  • Planning
  • Active
  • Complete

A water system has not been identified as a need within El Naranjo. Upon completing Global Brigade’s Rapid Needs Assessment, it was noted that their current water system was built recently, in 2010. Nicaraguan’s government-sponsored Social Investment Fund Programme (FISE) built the gravity-pump water system, that provides water to 90% of the homes at all hours  of the day. The system operates from a drilled well from which an electric pump brings water to the highest point in the community, while those at lower elevation receive water by gravity. The operational and maintenance expenses as well as for the cost of electricity are covered by families and by a community savings fund. Service fees to run the water system are paid for per cubic meter of water (1 mt3 = 1,000 liters of water), with the cost of one cubic meter of water valued at approximately $0.40 USD On average, families consume 6 cubic meters of water each month.

Additionally, El Naranjo has a water council, known as CAPS (Comité de Agua Potable y Sanitación/ Water and Sanitation Committee). In the interest of sustainability, the six members of the CAPS had already been trained on water treatment and system maintenance, administration, and operation, so they can continue adequately managing the water system. El Naranjo has also established a monthly water fee in order to pay the CAPS for water treatment, maintenance costs, and system sustainability.

Business

Program Status

  • Planning
  • Active
  • Complete

EL NARANJO BUSINESS CHALLENGE:

Prior to Global Brigades involvement, El Naranjo 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, and beans. 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.

15

Brigade Volunteers

13

Loans Disbursed

1

Savings Accounts Opened

$13,200

Capital Invested

EL NARANJO’S MICRO-FINANCE SOLUTION:

The cooperative of El Naranjo was formed in May 2016. There are 10 elected leadership council members that manage the cooperative, consisting of 24 total members. Through the cooperative C$4,800 (approximately $160USD) is in savings for business investments and C$99,000 (approx.$3,300USD) in the Public Health Fund.  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 Naranjo’s cooperative are working towards being able to disperse loans and train individuals on loan management and financial literacy.

 

EL NARANJO’S BUSINESS SOLUTION:

In addition to loans that can be taken out to invest in already established businesses, Global Brigades has worked with El Naranjo to start one new business– a chicken cooperative. In collaboration with the cooperative, the Canadian organization, Humanos donated $10,000USD for El Naranjo to begin purchasing chickens and buildings coops. El Naranjo invested $3,200USD in order to purchase the property of the land. 

BUSINESS BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers
Humanos January 2016 9
Humanos February 2017 6

Public Health

Program Status

  • Planning
  • Active
  • Complete

EL NARANJO  PUBLIC HEALTH CHALLENGE :

Prior to Public Health Brigades, El Naranjo faced numerous public health challenges with limited infrastructure in their homes. Previously only 4% of homes have concrete floors as opposed to mud or dirt floors. Furthermore, 0% of homes have access to showers. 100% of homes had traditional stoves, which meant that the majority of homes have an over accumulation of smoke. Although 70% of homes had latrines, a majority were full and the community did not have sufficient methods of waste disposal. The river (where people bathed) was contaminated with waste and chemicals.

 

2420

Brigade Volunteers

185

Sanitary Stations Constructed

12600

Meters Squared of Concrete Floors

EL NARANJO  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 10-20% 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
Touro College of Osteopathic Medicine December 2014 12 UNC-Wilmington December 2014 11
Oakland University December 2014 35 California State University- San Bernardino December 2014 3
Pennsylvania State December 2014 14 Pennsylvania State January 2015 35
Syracuse University January 2015 38 Marquette University January 2015 72
Loyola University January 2015 24 Saint Louis University January 2015 58
University of Illinois at Chicago January 2015 13 University of Dayton January 2015 56
University of Texas Austin January 2015 40 University of New Hampshire January 2015 28
Albion College January 2015 26 Texas A&M January 2015 37
Harvard University January 2015 35 University of Munster February 2015 14
Vanderbilt University March 2015 41 Pennsylvania State University/University of Notre Dame March 2015 41
Carnegie Mellon University March 2015 41 University of Notre Dame March 2015 41
Pennsylvania State University March 2015 31 UNC Chapel Hill March 2015 30
University of Indiana/ University of Denver March 2015 25 Grinnell College March 2015 30
UC Irvine March 2015 32 Northwestern University/ Western Virginia University March 2015 34
Santa Clara University March 2015 36 Athletico April 2015 22
Southern Illinois University April 2015 25 University of Birmingham May 2015 24
Florida Atlantic University May 2015 48 University of South Florida May 2015 30
Ball State University/ University of Cincinnati May 2015 43 Florida Gulf Coast University May 2015 22
Rice University May 2015 35 Ohio State University/ University of Cincinnati May 2015 43
University of Texas- San Antonio May 2015 47 Mercy College May 2015 45
University of Colorado Boulder May 2015 21 University of Colorado Boulder May 2015 54
University of Connecticut May 2015 28 Mississippi State University/ Sherman College May 2015 52
Denison University/ University of Virginia May 2015 34 University of California Berkley/ Boston College May 2015 44
University of Missouri May 2015 33 Philadelphia University May 2015 40
University of Missouri Kansas May 2015 41 Stony Brook University May 2015 40
University of Minnesota Rochester May 2015 34 San Fransisco State University June 2015 51
Elon University June 2015 39 San Jose State University June 2015 35
Manchester University June 2015 20 University of California Davis/ California State University June 2015 42
Oregon State University June 2015 31 University of California Santa Barbara June 2015 41
California State University Bakersfield June 2015 40 Mayo Clinic July 2015 36
University of Birmingham August 2015 23 University of Texas A&M August 2015 14
CUNY Macaulay Honnors College August 2015 54 Long Island August 2015 6
Wake Forest University August 2015 7 University of Washington September 2015 44
University of Munster September 2015 13 Bayreuth University September 2015 7
Lower Columbia College September 2015 4 DePaul University December 2015 24
University of Illinois at Chicago December 2015 32 University of California- Los Angeles December 2015 49
Oakland University December 2015 55

Local Reference Points

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

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