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

*Brigades to this community are temporarily suspended at this time

Homes : 175
Population : 695
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 88%
Education : Up to 6th Grade
Distance from Lodging Facility : 64 km

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

Volunteers

631

Patient Consultations

N/A

Vision Screenings Provided

20

Health Education Workshops

COMMUNITY HEALTH WORKERS

La Naranja has 3 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.

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: 663
NEARBY COMMUNITIES: SANTA ISABEL, LA REFORMA, LOS ANGELES, SAN JOSE, CERRO DE AGUA

MEDICAL/DENTAL VOLUNTEERS IN  LA NARANJA

Chapter Date # Of Volunteers
Columbia University Medical Brigade & Colgate University Medical Brigade March 2018 30

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

Patient Consultations

96

Number of Extractions

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. 

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: 663
NEARBY COMMUNITIES: SANTA ISABEL, LA REFORMA, LOS ANGELES, SAN JOSE, CERRO DE AGUA

MEDICAL/DENTAL VOLUNTEERS IN LA NARANJA

Chapter Date # Of Volunteers
Columbia University Medical Brigade & Colgate University Medical Brigade March 2018 30

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.

319

Volunteers

704

Project Beneficiaries

16

Kilometers of Pipeline Installed

9,046

Storage Tank Volume (gallons)

LA NARANJA’S 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 VOLUNTEERS IN LA NARANJA

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

Business

Program Status

  • Planning
  • Active
  • Complete

LA NARANJA’S ECONOMIC CHALLENGE 

Rural communities in Nicaragua face a number of structural obstacles when it comes to economic growth. Access to credit is limited by physical barriers in transportation and exclusion from formal financial institutions. This exclusion can be the result of a lack of financial literacy, credit history, and land titles or substantial assets consumer goods to offer as collateral. Additionally, maintaining savings is not a common practice in rural communities in Nicaragua, and when families do save, they often do not have a safe place to do so.

In La Naraja, the average family income is low per household. The main form of employment in La Naranja is agriculture, and the primary crop produced is vary based on the season. Economic growth faces additional obstacles due to the community’s dependence on agriculture and day laboring, as its inhabitants’ incomes are earned on a seasonal basis, determined by crop yields, and susceptible to external factors like drought, disease, and international market trends.

*No volunteers have been able to support in this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

0*

Volunteers

12

Loans Disbursed

71

Savings Accounts Opened

$798

Capital Invested

LA NARANJA’S MICRO-FINANCE SOLUTION 

The Business Program works to stimulate the local economy by organizing community residents around a community bank, which is entirely owned and operated by its members. Focusing on providing access to low-interest loans credit and savings for the members, its Bank Council members are tasked with growing 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 can be used by members for everything from farmers taking out loans to buy their seeds before planting, to a family taking out a loan to cover medical expenses. 

La Naranja’s  community bank, named Ahorrando para el futuro, was established February 2018 with the support of Global Brigades. The community bank has 21 female and 42 male shareholders who meet monthly along with a bank council that leads the shareholders and oversees the meetings. 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.

Additionally, Global Brigades provides matching capitalizations once these capitalizations meet established benchmarks. Global Brigades also has monthly follow-ups and training with the community bank to strengthen the bank overtime and ensure its sustainability. Global Brigades and La Naranja’s community bank are working towards being able to disburse loans, increase savings and train individuals on financial management.

Public Health

Program Status

  • Planning
  • Active
  • Complete

LA NARANJA’S 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.

*No volunteers have been able to support in this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

0*

Volunteers

69

Sanitation Units Installed

268

People Benefited with Public Health Infrastructure

N/A

Hours of Public Health Education

Local Reference Points

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

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