Las Quebradas*

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

Overview

Las Quebradas is located in the mountainous region of northern Nicaragua in the department of Esteli. A typical house is made of adobe/ mud or wood. The community has access to a local health centre, Llano Largo which is 3 kilometres away from the community as well as a multigrade primary school. 9 students attend the primary school with 1 teacher and 2 classrooms. The primary school goes up to grade six, and there is no secondary school located in Las Quebradas. Following primary school, students have the option of attending secondary school up to grade twelve. Most people in the community work as agricultural labourers.

Global Brigades is currently working with the Business Program in Las Quebradas. In their communication with Global Brigades, the top three needs expressed was access to clean water, access to health care, and job opportunities. Las Quebradas is on the waitlist for continuing Holistic Model implementation as part of Global Brigades’ strategic plan in Nicaragua.

Municipality: La Trinidad
Department: Esteli

*Brigades to this community are temporarily suspended at this time

Homes : 26
Population : 83
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 50%
Education : Up to 6th Grade
Distance from Lodging Facility : 41 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 Quebradas has access to a health centre in the neighbouring community of Llano Largo. This neighbouring health centre 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 $ 1 USD) round trip. 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.

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 Llano Largo, where community members from Las Quebradas attend Medical Brigades.

102

Volunteers*

474

Patient Consultations*

N/A

Vision Screenings Provided*

23

Health Education Workshops*

COMMUNITY HEALTH WORKERS

Las Quebradas has 3 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 Quebradas 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 Quebras attend Medical Brigades in the community of Llano Largo. This location has rooms for triage, consultation, dentistry and pharmacy stations.

Las Quebradas 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. Las Quebrasdas community volunteers are essential for the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 266

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 Llano Largo, where community members from Las Quebradas attend Medical Brigades.

69

Patient Consultations*

39

Number of Extractions*

78

Fillings Performed*

6

Dental Education Workshops*

BRIGADE INFORMATION

Community members from Las Quebras attend Medical Brigades in the community of Llano Largo. This location has rooms for triage, consultation, dentistry and pharmacy stations.

Las Quebradas 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 organizations.

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 Quebrasdas community volunteers are essential for the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 266

Water

Program Status

  • Planning
  • Active
  • Complete

LAS QUEBRADAS’ WATER CHALLENGE

Previously, one of the only water sources for the community was a well built-in 2000. This system was manual, meaning that families had to walk to the well and carry water to their homes daily. The time and energy that was necessary in order to retrieve water caused families to sacrifice important hygiene and sanitation practices that would require more water.

*Volunteers have not been able to support this project but work has been able to be continued due to the generous support of the Merkel Foundation.

0*

Volunteers

82

Project Beneficiaries

2

Kilometers of Pipeline Installed

1320

Storage Tank Volume (gallons)

LAS QUEBRADAS WATER SOLUTION

In June 2019, a partnership between Las Quebradas,  Global Brigades Nicaragua, Alcaldía de La Trinidad, Club Rotario metropolitano de Leon and Movimiento Comunal was officially formed. Before a plan for a water system custom-designed for Las Quebradas was created, the land was first surveyed. From this land survey, it was determined that the best fit for Las Quebradas would be a mini-aqueduct served by a gravity construction system, a pump and a storage tank. The water system solution has able to provide water to flow through the distribution pipeline to every house in the community through 2 km of pipeline. This new water flow will supply the community of Las Quebradas through the projected 20-year lifespan of the project.

In addition to construction, Las Quebradas mobilized to form a CAPS (Comité de Agua Potable y Sanitación/ Water and Sanitation Committee). Over the course of three months of construction,  community members were able to construct a system that now reaches the entire community. The celebration of this system’s water inauguration was in October 2019.

Business

Program Status

  • Planning
  • Active
  • Complete

LAS QUEBRADAS’ 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 Las Quebradas, the average family income is low per household. The main form of employment in Las Quebradas 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 labouring, 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 this program’s work but continued progress has been able to be accomplished through the generous support of the Merkel Foundation.

0*

Volunteers

2

Loans Disbursed

19

Savings Accounts Opened

$275

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. 

Las Quebradas’ community bank, named Odorico de Andrea, was established in May 2018 with the support of Global Brigades. The community bank has 12 female and 4 male shareholders who meet bi-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 over time and ensure its sustainability. Global Brigades and Las Quebradas’ 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

LAS QUEBRADAS PUBLIC HEALTH CHALLENGE:

Global Brigades is working on the implementation of the Holistic Model in Las Quebradas and has not yet begun with the Public Health Program. The financing, delivery, and installation of household health infrastructure products will begin as soon as possible.

% of Homes with Latrines : 21
% of Homes with Showers : N/A
% of Homes with Washing Station : N/A
Common House Materials : Wood, Adobe

Local Reference Points

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

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