La Joya

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

Overview

La Joya is located in the mountainous region of central Nicaragua, in the department of Jinotega. A typical house is made of wood. The community has access to a health center in the neighboring community, Las Lomas, 6 kilometers away. Within La Joya is a multigrade primary school, with two teachers and two classrooms. Most people in the community work in agriculture or as laborers.

Global Brigades in currently partnering with La Joya for the Business, Medical, and Public Health Program. A community bank was established within the Business Program in September 2017. Global Brigades local staff continues to follow up with the bank regarding bookkeeping and financial literacy. Additionally Global Brigades continues to have Medical Brigades in a community close by, in Los Encuentros de San Gabriel. Medical Brigades started in January 2013. The Water and Public Health Programs have been completed in March 2017 and March 2018 respectively. Prior to Global Brigades partnership, the top three needs in La Joya were: access to potable water, access to hygiene services, and homes in poor condition. La Joya 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

Homes : 27
Population : 195
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : No
% of Homes with Latrines : 74%
Education : Up to 6th 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.  

La Joya has access to a health center in the neighboring community, Las Lomas, 6Km 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 La Joya expressed were diarrhea diseases, acute respiratory infections, and flu. For adults, common illnesses are chronic diseases such as hypertension, as well as gastritis, and kidney infections. 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.

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

271

Brigade Volunteers*

5315

Patient Consultations*

45

Pap Smears Performed*

35

Health Education Workshops*

COMMUNITY HEALTH WORKER:

La Joya does not have any Community Health Workers trained by the Ministry of Health. 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 the Ministry of Health, to train and provide 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 for La Joya 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. The average amount of patients seen is 242 patients per day.

La Joya 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. La Joya’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 242

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

BRIGADE SITE: COMMUNITY CHURCH

MEDICAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
CUNY Queens College January 2013 23 Vanderbilt University March 2013 38
Pennsylvania State March 2014 45 Marquette University January 2015 35
Rice University March 2015 35 University of Miami January 2016 33
Oklahoma State May 2016 47 University of Connecticut January 2018 25

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.

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

229

Patients Consultations*

370

Flouride Treatments *

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 15 minutes with each patient and we are able to provide 4-5 educational workshops a day. Each brigade sees an average of 29 patients per day.

La Joya 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. La Joya’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED: 29

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

BRIGADE SITE: COMMUNITY CHURCH

DENTAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
University of Miami January 2016 33 Oklahoma State May 2016 47
University of Connecticut January 2018 25

Water

Program Status

  • Planning
  • Active
  • Complete
Jesus Maria Tinoco Pineda, donor of the land for water system’s fresh water source

LA JOYA 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.

73

Water Brigade Volunteers

180

Meters of Piping Installed

100

%

Percentage of System Completed

193

Project Beneficiaries

WATER SOLUTION: 

It was not until this past September 2016 that the project officially re-started after a partnership was formed between La Joya 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 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 of 5,500 cubic meter capacity. 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, La Joya 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.  Before the project’s completion, a capacity test of the well was completed, and demonstrated an average of 46 gallons per minute.

WATER BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Texas A&M Medical December 2016 32 University of Dayton Medical January 2017 41

Business

Program Status

  • Planning
  • Active
  • Complete

LA JOYA ECONOMIC CHALLENGE:

Like many people in rural Nicaragua, La Joya’s residents face economic barriers, such as lack of access to traditional and secure financial services, as well as limited employment opportunities, with many working in seasonal agricultural activities. In the case of the former, geographic and educational barriers make accessing commercial banks and regional financial institutions difficult, with most community members lacking the financial literacy, assets, and collateral to participate in the system. In the case of the latter, the agricultural sector presents a limited and inconsistent source of income, with the weather, as well as limited irrigation infrastructure impacting yields and quality. Furthermore, many farmers rent land rather than own, increasing their personal investment without a reciprocating return.

8

Brigade Volunteers

22

Savings Accounts Opened

$1000.48

Capital Invested

7

Loans Disbursed

LA JOYA’S MICROFINANCE SOLUTION:

The Business Program works to stimulate the local economy by organizing community volunteers around a community bank, which is entirely owned and operated by its members. Focusing on providing access to credit and savings for their fellow community members, its Bank Council members are tasked with socializing 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 are especially beneficial for subsistence farmers, who can invest more heavily in their production with a loan, pay back the loan after the harvest, and generate an income with any excess.

La Joya’s community bank, San Jeronimo, was established in September 2017 with the support of Global Brigades. The community bank has 24 shareholders who meet in a local school bi-weekly, and a 3-person Bank Council that manages the shareholders and their funds. 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.

Global Brigades and La Joya’s community bank are working towards being able to disburse loans and train individuals on loan management and financial literacy.

Community Bank : San Jeronimo
Community Bank Members : 24
Economic Activities : Horticulture
Existing Microenterprises : Plant Nursery, Horticulture

La JOYA’S BUSINESS SOLUTION:

In addition to working with the community bank, the Business Program provides technical support and consultations to support local entrepreneurs and microenterprises. The goal is to foster the development of efficient and practical business actions, grow enterprise assets, and create local employment opportunities. During this process, interested community members receive training to increase their familiarity with business terminology, develop their business administration skills, and promote innovation and diversification in the types of business ventures they pursue.

The Business Program has started hosting Business Brigades in La Joya to study the local market and work with existing microenterprises to create the best plan forward in the community’s economic development.

BUSINESS BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
University of Utah/ University of Maryland Baltimore County Business March 2018 8

BUSINESSES CONSULTED ON BRIGADE:

Business Name Sector Owner
Chavarria Produce Horticulture Jose Agustin Chavarria
Produce Greenhouse Horticulture Rosa Herrera Altamirano

Public Health

Program Status

  • Planning
  • Active
  • Complete

LA JOYA PUBLIC HEALTH CHALLENGE:

The community faces numerous public health challenges with limited infrastructure in their homes. Only 12% of homes have concrete floors as opposed to mud or dirt floors. Furthermore, 19% 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 74% 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. La Joya is on the wait-list to partner with Global Brigades Public Health projects.

198

Brigade Volunteers

29

Sanitary units constructed

29

Households benefitted

PUBLIC HEALTH BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Carnegie Mellon University Water March 2018 9 Marquette University Public Health March 2018 26
Texas A&M University Medical March 2018 41 University of Maryland Baltimore County/ University of Denver Public Health March 2018 19
University of Denver Medical March 2018 27 State University of New York – Buffalo Medical March 2018 30
California State Polytechnic University Pomona Medical March 2018 47

Local Reference Points

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

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