Las Cureñas*

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

Overview

Las Cureñas is located in the mountainous region of central Nicaragua in the department of Jinotega. The town is about 15km from the urban city of Jinotega. A typical house is made of wood. The community has access to a health centre in the neighbouring community, Las Lomas, 5km away. 71 students attend the primary multigrade school with four teachers and five classrooms. The primary school goes up to grade 6, and there is no secondary school located in Las Cureñas. If students are interested in attending secondary school, they have to attend a neighbouring community, Tomatoya, 3km away.

Currently, around 90% of eligible students are attending secondary school. In a survey that included current students and older generations, it was found that only 16.3% of people had pursued secondary education and beyond (12.5% secondary school 2.3% technical school, and 1.5% university). For a majority (63.5%) their last formal education was in primary school, and for 2.5%, pre-school. 17.8% had never had formal education. 

There are 190 people in Las Cureñas that have employment. Of these 190 who work, 134 are men and 56 are women. Most people in the community work as agricultural labourers. 53.9% of those working, work in agriculture, with 49.4% who own their property versus 4.5% who rent. The next most common occupation is day labour (20.5%) or artisan work (16.5%). The remaining are bosses, home assistants, and those who have commercial businesses. 87% of those employed consider their work to be permanent, while 9% have temporary, and 4% mixed. Mixed employment signifies working several temporary jobs. 

Prior to Las Cureñas being founded in 1867, the land was a booming sugarcane plantation. However, the land became abandoned as soon as the cash crop devastated the soil fertility for sugarcane production. The plantation owners left and as new settlers arrived, they found remnants of “cureñas,” a part of the sugar mill factory. The new settlers then decided to name their community “Las Curenas.”

Global Brigades is currently working with Water and Business Program in Las Cureñas. This Water partnership began in November 2017, and the first brigades in December 2017. Las Cureñas’s Community Bank was established on December 14, 2017, with Global Brigades’ permanent staff. Business Brigades began in March 2018.

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 improvements needed to the community health centre. Las Cureñas is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: Jinotega
Department: Jinotega

*Brigades to this community are temporarily suspended at this time

Homes : 112
Population : 528
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : No
Community Health Workers : Yes
% of Homes with Latrines : 87%
Education : Up to 6th Grade
Distance from Lodging Facility : 46 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 its 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 centre (Centro de Salud) for every municipality within the department. While they are not hospitals, health centres in the municipality are typically staffed with one doctor, and two nurses, that can attend to 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 centre. These health centres are usually staffed with only one nurse and a rotating physician. Physicians are staffed in these health centres 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 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.  

Las Cureñas has access to a health centre 5km away, in the neighbouring community of Las Lomas. Community members also will go to the health centre in San Rafael. Each of these neighbouring health centres requires a one-hour walk. To take a bus requires a 20-minute walk and a bus ride for 30 minutes that costs 30 cordobas (approximately $1USD) roundtrip. This cost is sometimes difficult for families living below the poverty line. Additionally, it is important to note that medications, supplies, and materials are often not available in these health centres 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 Las Cureñas expressed were diarrheal diseases, and respiratory infections. For adults, common illnesses are chronic diseases such as diabetes and hypertension, as well as arthritis. In a sample point study, it was found that 7% had diarrhoea in the past 3 months. 13% had stomach aches, 35% had a cough, 37% had a fever, and 7% had skin 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 Tomatoya, where community members from Las Cureñas attend Medical Brigades.

309

Volunteers*

2,362

Patient Consultations*

N/A

Vision Screenings Provided

N/A

Health Education Workshops

COMMUNITY HEALTH WORKERS

Las Cureñas has 4 Community Health Workers that are trained by the Ministry of Health monthly. 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 Las Cureñas 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. Additionally more work can be done to help encourage community members to seek out community health workers when they are ill, or in need of chronic disease management. In a Global Brigades study it was found that while 94.5% of the community is aware of the community health program, only 5% have received services from them. 

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 Las Cureñas attend Medical Brigades in the community school of Tomatoya. This location has rooms for triage, consultation, dentistry and pharmacy stations.

Las Cureñas offers strong support for 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. Las Cureñas’s community volunteers are essential for the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 617
NEARBY COMMUNITIES: LA JOYA, SARAGUASCA, TOMATOYA, LAS PILAS, LA ERMITA DE SARAGUASCA

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 centres, or even the municipality health centres. 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 Tomatoya, where community members from Las Cureñas attend Medical Brigades.

109

Patient Consultations*

72

Number of Extractions*

37

Fillings Performed*

N/A

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 Las Cureñas attend Dental Brigades in the community school of Tomatoya. The average amount of time with each patient is approximately 10-15 minutes.

Las Cureñas 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. Las Cureñas’s community volunteers are essential for the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 617
NEARBY COMMUNITIES: LA JOYA, SARAGUASCA, TOMATOYA, LAS PILAS, LA ERMITA DE SARAGUASCA

Water

Program Status

  • Planning
  • Active
  • Complete

LAS CUREÑAS WATER CHALLENGE

Before the water completion, Las Cureñas had five manual wells. All five were built by the government. The first was built in 1990 next to the school, and four others in 2005. Of these wells, 2 carried potable drinking water, while 3 pumped water that should only be used for cleaning and agriculture. The two manual pumps with potable water were treated with chlorine by community volunteers. The chlorine was delivered by the Ministry of Health every two months.

The community volunteers then administer the chlorine tabs to treat the water every 8 days. Additionally every two or three months the Ministry of Health performed a water sample test, to ensure that the water is remaining safe for consumption. 87.5% of community members in Las Cureñas used these public water pumps. 11.5% sourced their water from the river, and 1% of the population had their own private water pump. 67% drank water that was purified, while 19% did not. 1% of the community was unsure whether their water is purified or not. 

While there was potable drinking water in Las Cureñas, there was an issue with accessibility. With water only being accessible by a manual pump, community members had to walk to obtain drinking water. A walk to the nearest pump could be up to 20 minutes on rough terrain. This was especially difficult for the elderly. The responsibility of collecting water often falls on the mother of the household and/or children. Typically an individual did a trip to the water pump 4-6 times daily, carrying 10-liter jugs. The time taken from a person’s day simply to collect water was significant. Additionally, water access became more sparse between the dry months of February to May.

1,419

Volunteers

456

Project Beneficiaries

4

Kilometers of Pipeline Installed

5,284

Storage Tank Volume (gallons)

LAS CUREÑAS WATER SOLUTION

Global Brigades began a partnership with Las Cureñas for the Water Program in November 2017, with brigades starting in December 2017.

From December 2017 to April 2018, 1,419 volunteers partnered with community members from Las Cureñas to complete 85% of the pipeline installation. Additionally, a 20-cubic meter concrete water storage tank was constructed. Once trench digging was complete, what was left was installing one submersible electric pump as well as water meters in each of the receiving homes. An electric pump was needed to carry water against gravity to homes at a higher elevation. Once the electric system was installed, it was not only a success in the community to have electricity, but it also meant that the water system could begin being pumped out to households.

The inauguration of the system was hosted on September 28th, 2018. System tests were conducted to guarantee that the water was potable and had a sufficient flow rate. Water quality results indicated the water was safe for drinking. The capacity test demonstrated 30 gallons per minute, with the 3 hp electric submersible pump. This test showed that the system was ready to supply it’s projected 101 households, totaling 470 beneficiaries, with water. In addition to construction, a water and sanitation council was trained to empower the community to manage the maintenance, repairs, and treatment of their own water system.

WATER VOLUNTEERS IN LAS CUREÑAS

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
DePaul University Medical Brigade November 2017 28 DePaul University Public Health Brigade December 2017 20
University of Mississippi Medical Brigade & University of South Florida Medical Brigade December 2017 21 Rice University Public Health Brigade December 2017 21
Emory University Public Health Brigade December 2017 16 Purdue University Medical Brigade & University of California –
Los Angeles Medical Brigade		 December 2017 33
Virginia Commonwealth University Water Brigade January 2018 18 University of Missouri Water Brigade & University of Portland Water Brigade January 2018 18
Marquette University Public Health Brigade & Texas A&M University Public Health Brigade January 2018 32 Carroll University Medical Brigade January 2018 21
Saint Louis University Medical Brigade January 2018 51 Texas A&M University Dental Brigade January 2018  18
Governors State University Public Health Brigade January 2018 22 Texas A&M University Medical Brigade January 2018 45
Wellesley College Medical Brigade January 2018 20 University of Dayton Medical Brigade January 2018 61
Virginia Commonwealth University Medical Brigade January 2018 29 Harvard University Medical Brigade January 2018 34
Boston University Water Brigade January 2018 15 Marquette University Medical Brigade January 2018 62
Boston College Medical Brigade January 2018 47 Syracuse Area Medical Brigade January 2018 6
Boston University Medical Brigade January 2018 20 Ohio College Students Medical Brigade January 2018 18
University of Victoria  Medical Brigade February 2018 38 Milwaukee School of Engineering Water Brigade February 2018 15
Northeastern University Public Health Brigade & University of Arizona Public Health Brigade & University of Virginia Public Health Brigade March 2018 30 Michigan State University Medical Brigade March 2018 35
University of Arizona Water Brigade & Pennsylvania State University Water Brigade March 2018 23 University of Toledo Medical Brigade & Stetson University Medical Brigade March 2018 42
University of Virginia Medical Brigade March 2018 23 College of William & Mary Medical March 2018 30
University of Arizona Medical Brigade & Appalachian State University Medical Brigade March 2018 33 Northeastern University Medical Brigade March 2018 33
Carnegie Mellon University Water Brigade March 2018 8 Carnegie Mellon University Public Health Brigade & University of Tennessee Public Health Brigade March 2018 24
West Virginia University Medical Brigade March 2018 61 University of Notre Dame Medical Brigade March 2018 32
 West Virginia University Public Health Brigade March 2018 19 Duke University/ University of Notre Dame Public Health Brigade March 2018 14
Yale University Medical Brigade & New York University Medical Brigade March 2018 40 Colgate University Medical Brigade & Columbia University Medical Brigade March 2018 30
Texas A&M International University Medical Brigade March 2018 41 University of Texas El Paso Medical Brigade March 2018 10
Saint Louis University Medical Brigade March 2018 15 Marquette University Public Health Brigade March 2018 26
University of Houston Dental Brigade March 2018 15 University of Maryland Baltimore County Public Health Brigade & University of Denver Public Health Brigade March 2018  19
DePaul University Medical Brigade March 2018 25 University of Maryland Baltimore County Medical Brigade March 2018  35
Tulane University Medical Brigade March 2018 27

Business

Program Status

  • Planning
  • Active
  • Complete

LAS CUREÑAS’ 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 consumer goods to offer as collateral. In Las Cureñas, 24% reported access to credit. Additionally, maintaining savings is not a common practice in rural communities in Nicaragua, where only 18.5% of community members in Las Cureñas personally own or have a family member with a savings account. 

In Las Cureñas, the average family income is estimated to be $2,239 Cordobas per month, which is approximately $72 USD per household. The main form of employment in Las Cureñas is agricultural labour, and the primary crops produced are beans, corn, lettuce, cabbage, and coffee. 53.9% of those working, work in agriculture, with 49.4% who own their property versus 4.5% who rent. The next most common occupation is day labour (20.5%) or artisan work (16.5%). The remaining are bosses, home assistants, and those who have commercial businesses. 87% of those employed consider their work to be permanent, while 9% have temporary, and 4% mixed. Mixed employment signifies working several temporary jobs. There are 190 people in Las Cureñas that have employment. Of these 190 who work, 134 are men and 56 are women. 

Economic growth faces additional obstacles due to the community’s dependence on agriculture, as its inhabitants’ incomes are earned on a seasonal basis, determined by crop yields, and susceptible to external factors like drought and plant disease.

Global Brigades began working with the Business Program in Las Cureñas when the community bank was established on December 14, 2017. Business Brigades then began in the following March.

26

Volunteers

125

Loans Disbursed

9

Accounts Opened

$2,460

Capital Invested

LAS CUREÑAS’ 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 credit and savings for the 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 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. 

Las Cureñas’s community bank, named El Esfuerzo, was established December 2017 with the support of Global Brigades. The community bank has 32 females and 39 males shareholders who meet in Las Cureñas’s Primary school bi-weekly on Thursdays, and a 3- person Bank Council (President, Secretary, and Treasurer) 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 and Las Cureñas’s community bank are working towards being able to disburse loans, increase savings and train individuals on financial management

LAS CUREÑAS’  BUSINESS SOLUTION

In addition to working with the community bank, the Business Program provides strategic training to existing micro-enterprises. The goal is to better integrate isolated communities into the local economy and facilitate growth. During this process, interested community members receive training to increase their familiarity with business concepts, develop their administration skills, and promote innovation and diversify their goods and services.

Currently, there is potential for expanding the capacity of existing micro-enterprises. Las Cureñas has a strong culture of artisan pottery, as it is a craft that has been passed down for many generations. Since the mid-1990s a women’s cooperative has been creating and selling the signature pottery made in this region

Additionally, Global Brigades is partnering with two other existing businesses, a barber shop microenterprise and a horticulture farm. The barber has been cutting hair for 15 years, much of it without electricity. Initially, he offered cuts with the basic style, since his only tool was a comb, scissors, a wooden chair and a mirror in the back of his house protected with a plastic roof. But now, with access to electricity, he has begun to improve his style with the use of an electric razor and a wider space in the corridor of his house. Despite these limitations, Jairo recognizes this microenterprise as an important source of income for his family

The horticulture farm is owned by another family that grows cabbage, lettuce, beets, celery, and basic grains. Business brigades will work with the farm on mapping, accounting, and business planning.

BUSINESS VOLUNTEERS IN LAS CUREÑAS

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Vanderbilt University Business Brigade March 2018 12 Deloitte 3C International Business Brigade April 2018 30
Ball State University Business Brigade May 2018 8

Public Health

Program Status

  • Planning
  • Active
  • Complete

LAS CUREÑAS PUBLIC HEALTH CHALLENGE

According to Global Brigades Baseline Survey in Las Cureñas, 46.5% have latrines in good condition. Of the 53.5% in poor condition, 5.8% can no longer even be used. For showering/bathing, 62% bathe in the river or with buckets by the public water pump. 18% bathe outside of the home, 4% inside the home and 2% bathe in a neighbor’s shower. Having inadequate access to public health products is a threat to sanitation, privacy, and safety. 

*Continued progress has been able to be made due to the generous support of the Merkel Foundation.

0*

Volunteers

59

Sanitation Units Installed

314

People Benefited with Public Health Infrastructure

N/A

Hours of Public Health Education

LAS CUREÑAS PUBLIC HEALTH SOLUTION

Global Brigades is working on the implementation of the Holistic Model in Las Cureñas and has completed with the Public Health Program. The work has been carried out only with local masons and community members. 

Local Reference Points

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

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