La Naranja

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

Overview

La Naranja is located in the mountainous region of central Nicaragua in the department of Jinotega. A typical house is made of cement block or wood. The community has access to a local health center 5 kilometers away,  as well as a multigrade primary school. 84 students attend the primary school with four teachers and four classrooms. The primary school goes up to grade six, and there is no secondary school located in La Naranja. Most people in the community work as agricultural laborers.

Global Brigades completed the Water Program in this community in September 2016, and has had Medical Brigades in a neighboring community (Sisle) since January 2014. When Global Brigades first entered La Naranja, the top three needs expressed were: homes in bad condition, insufficient access to potable water, and lack of access to health and hygiene services. March 2018 was the first Medical Brigade hosted within La Naranja, and the Public Health Program will begin this Summer! La Naranja 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 : 140
Population : 800
Water System : Yes
Community Bank : No
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 84%
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 Naranja has access to a health center in a neighboring community, La Reforma, 5km 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 Naranja expressed were respiratory infections, diarrhea, and fevers. For adults, common illnesses are chronic diseases such as diabetes and hypertension, as well as asthma, 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.

 

30

Brigade Volunteers*

554

Patient Consultations*

28

Pap Smears Performed*

20

Health Education Workshops*

COMMUNITY HEALTH WORKER:

La Naranja has three Community Health Workers that are 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 La Naranja 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 La Naranja attend Medical Brigades in the community church of La Naranja. This location has rooms for triage, consultation, dentistry and pharmacy stations. The average amount of patients seen per day is 185 patients.

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

 

AVERAGE PATIENTS ATTENDED PER DAY: 185

NEARBY COMMUNITIES: SANTA ISABEL, LA REFORMA, LOS ANGELES, SAN JOSE, CERRO DE AGUA

BRIGADE SITE: CHURCH

 

MEDICAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Columbia University/ Colgate University March 2018 30/td>

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. 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.

109

Patients Consultations*

129

Flouride Treatments *

92

Fillings Performed*

12

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 La Naranja attend Dental Brigades in the community church of La Naranja. The average amount of patients seen per day is 40 patients, with approximately 10-15 minutes per patient.

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

AVERAGE PATIENTS ATTENDED: 40

NEARBY COMMUNITIES: SANTA ISABEL, LA REFORMA, LOS ANGELES, SAN JOSE, CERRO DE AGUA

BRIGADE SITE: CHURCH

DENTAL BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Columbia University/ Colgate University March 2018 30/td>

Water

Program Status

  • Planning
  • Active
  • Complete

LA NARANJA WATER CHALLENGE:

Previously, one of the only water sources for the community was a system over 25 years old. This system was only available to approximately 20 of 163 families. The system had a rusted connection without water meters. Due to the lack of water meters, some in the community had an inconsistent supply that made water only available a few hours a day. Those who lived at higher elevation used water inefficiently by using potable water unnecessarily for washing and agriculture.

For families not connected to the water system, their only source of water was a natural mountain spring water source that was not protected. For these families, the spring was located far from most houses. Community members, primarily women and children, needed to walk between 300 to 1,000 meters in order to get non-potable water.

296

Water Brigade Volunteers

15000

Meters of Piping Installed

100

%

Percentage of System Completed

704

Project Beneficiaries

WATER SOLUTION: 

In May 2016, a partnership between La Naranja,  Global Brigades Nicaragua, the Municipality of San Rafael, and Water for People was officially formed. Before a plan for a water system custom-designed for La Naranja was created, the land was first surveyed by the Municipality of San Rafael. From this land survey, it was determined that the best fit for La Naranja would be a mini-aqueduct served by a gravity construction system with two storage tanks. Five water sources were identified, unified, and connected to the two storage tanks (each with 28 m3 storage capacity). Then by gravity, it was designed for the water to flow through the distribution pipeline to every house in the community. This new water flow will supply the community of La Naranja through the projected 20-year lifespan of the project.

In addition to construction, La Naranja mobilized to form a CAPS (Comité de Agua Potable y Sanitación/ Water and Sanitation Committee). Over the course of three months of construction, 296 Global Brigades volunteers worked alongside the committee and community members to construct a system that now reaches 163 families and 704 beneficiaries.  Before the project’s completion, a capacity test of the 5 springs water sources was completed, and demonstrated an average of 107 gallons per minute.The celebration of this system’s water inauguration was September 27th, 2016.

WATER BRIGADES IN THE COMMUNITY:

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Western Kentucky University August 2016 30 Rutgers University August 2016 38
Elon University August 2016 23 North Carolina State University August 2016 4
Middle Tennessee State University August 2016 48 Saint Louis University August 2016 13
University of Birmingham August 2016 18 University of Munster August 2016 10
Texas A&M University August 2016 37 University of Texas-Austin August 2016 27
Rutgers University August 2016 32 Northwestern University September 2016 16
University of Waterloo September 2016 11 University of Washington September 2016 33
SDI Munich September 2016 12

Business

Program Status

  • Planning
  • Active
  • Complete

Global Brigades is working on the implementation of the Holistic Model in La Naranja 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. 

Public Health

Program Status

  • Planning
  • Active
  • Complete

LA NARANJA PUBLIC HEALTH CHALLENGE:

The community faces numerous public health challenges with limited infrastructure in their homes. Only 5% of homes have concrete floors as opposed to mud or dirt floors. Furthermore, 12% 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 84% 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. The Public Health Program begins in La Naranja this Summer!

Local Reference Points

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

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