Sabana de en Medio* – Global Brigades

Sabana de en Medio*

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

Overview

Sabana de en Medio is located in the mountainous region of central Nicaragua, in the department of Jinotega. A typical house is made of cement block. The community does not have a primary or secondary school located within the community. Instead, to access education, students must travel to the primary and secondary multigrade schools in Sabana Grande, 3 kilometers away. There is a health center located in a neighboring community, San Gabriel, 1.5 kilometers away. Most people in the community work as agricultural laborers.

Global Brigades in currently partnering with Sabana de en Medio 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. Public Health Brigades started in January 2018. The Water Program was completed in Sabana de en Medio in March 2017. Prior to Global Brigades partnership, the top three needs in Sabana de en Medio were: access to potable water, access to hygiene services, and a primary school located in the community. Sabana de en Medio 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 : 30
Population : 81
Water System : Yes
Community Bank : Yes
Electricity : Yes
Health Center : Yes
Community Health Workers : Yes
% of Homes with Latrines : 97%
Education : Up to 6th Grade
Distance from Lodging Facility : 44 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.  

Sabana de en Medio has access to a health center in the neighboring community, San Gabriel, 1.5 Km 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 illnesses in children that Sabana de en Medio expressed were parasites and diarrhea, acute respiratory infections, and skin allergies For adults, common illnesses arechronic diseases such as arthritis and hypertension, respiratory infections, 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 Sabana de en Medio attend Medical Brigades.

284

Volunteers*

3,339

Patient Consultations*

N/A

Vision Screenings Provided*

18

Health Education Workshops*

COMMUNITY HEALTH WORKERS

Sabana de en Medio has 2 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 Sabana de en Medio 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

Medical Brigades for Sabana de en Medio 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.

Sabana de en Medio 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. Sabana de en Medio’s community volunteers are essential the efficiency and effectiveness of Medical Brigades.

AVERAGE PATIENTS ATTENDED PER DAY: 713
NEARBY COMMUNITIES: TOMATOYA, SASLE, LAS CURENAS, SARAGUASCA, CHAGUITE GRANDE, MESA DEL OCTE, SAN GABRIEL

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 Sabana de en Medio attend Dental Brigades.

229

Patients Consultations*

174

Number of Extractions *

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 one large 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.

Sabana de en Medio 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. Sabana de en Medio’s community volunteers are essential the efficiency and effectiveness of Dental Brigades.

AVERAGE PATIENTS ATTENDED: 713
NEARBY COMMUNITIES: TOMATOYA, SASLE, LAS CURENAS, SARAGUASCA, CHAGUITE GRANDE, MESA DEL OCTE, SAN GABRIEL

Water

Program Status

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

SABANA DE EN MEDIO’S WATER CHALLENGE

Previously, one of the only water sources in the community was a river contaminated with waste and agricultural chemicals 2 kilometers away. 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.

410

Volunteers

922

Project Beneficiaries

16

Kilometres of Pipeline Installed

15,852

Storage Tank Volume (gallons)

SABANA DE EN MEDIO’S WATER SOLUTION

It was not until this past September 2016 that the project officially re-started after a partnership was formed between Sabana de en Medio 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 del 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. 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, Sabana de en Medio 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 VOLUNTEERS IN SABANA DE EN  MEDIO’S

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
University of California Los Angeles Medical Brigade December 2016 21 University of Miami Medical Brigade December 2016 34
University of Wisconsin Public Health Brigade & Ball State University Public Health Brigade January 2017 CEGEP Champlain St. Lawrence Medical Brigade January 2017 13
Virginia Tech Medical Brigade January 2017 38 Wellesley College Medical Brigade January 2017 13
University of Wisconsin Madison Medical Brigade January 2017 32 University of Texas Austin Medical Brigade January 2017 30
University of Wisconsin January 2017 32 Saint Louis University January 2017 30
University of Texas-Austin January 2017 30 Smith College Medical Brigade January 2017 22
Milwaukee School of Engineering Public Health Brigade February 2017 12 February 2017 12
Milwaukee School of Engineering Public Health Brigade February 2017 12 Raleigh North Carolina Medical Brigade March 2017 18
West Virginia University Medical Brigade March 2017 53 Marquette University Public Health Brigade March 2017 28
University of Denver Medical Brigade March 2017 35 University of Maryland Baltimore Public Health Brigade March 2017 10
RWTH Aachen University Public Health Brigade & University of Munster Public Health Brigade March 2017 16 Tulane University Medical Brigade March 2017 24

Business

Program Status

  • Planning
  • Active
  • Complete

SABANA DE EN MEDIO’S BUSINESS CHALLENGE

The majority of the communityś population are agricultural laborers, working in horticulture, poultry ventures, as well as dairy ventures and small shops. As a result, the opportunities for employment and sources of income are seasonal and dependent on the  conditions of the season, with drought and plant diseases consistently presenting a threat.

24

Volunteers

11

Loans Disbursed

22

Savings Accounts Opened

$1,057

Capital Invested

SABANA DE EN MEDIO’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.

Sabana de en Medios community bank, El Progreso (The Progress), was established in partnership with Global Brigades in September 2017, with 18 initial members. Currently, El Progreso has 25 members, and a three-person Executive Committee made up of a president, treasurer, and secretary, who are tasked with leading meetings and keeping records. The members meet bi-weekly to make deposits into their savings account, contribute to capital for loans, and receive training on financial planning and management from Global Brigades Business Technicians.

SABANA DE EN MEDIO’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 Sabana de en Medio to study the local market and work with existing microenterprises to create the best plan forward in the community’s economic development. Currently, brigades are consulting dairy and poultry ventures, as well as small shopkeepers.

 

BUSINESS VOLUNTEERS IN SABANA DE EN MEDIO

 

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Carnegie Mellon University Business Brigade March 2018 16 University of Florida Business Brigade May 2018 8

Public Health

Program Status

  • Planning
  • Active
  • Complete

SABANA DE EN MEDIO’S  PUBLIC HEALTH CHALLENGE

The community faces numerous public health challenges with limited infrastructure in their homes. Only 32% of homes had 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 66% of homes had latrines, the community did not have sufficient methods of waste disposal. The river, where people bathe, is contaminated with waste and chemicals.

158

Volunteers

21

Latrines Constructed

56

People Benefited with Public Health Infrastructure

2

Hours of Public Health Education

SABANA DE EN MEDIO’S  PUBLIC HEALTH SOLUTION

The Public Health Program worked with all interested families to finance and install Sanitary Stations including a shower, latrine, handwashing station, and water storage unit. These projects allow community members to avoid preventable disease and foster improved hygiene and sanitation practices. During their time in Sabana de en Medio, Public Health volunteers conducted educational workshops, or charlas, with community members on project maintenance and various public health topics. Additionally, Global Brigades trained a Basic Sanitation Committee, a community body formed by local leaders. The committee advocates for proper hygiene and sanitation practices, monitors maintenance of  completed projects . 

To promote the sustainability of the Public Health Program’s projects, families are required to contribute a portion of the project cost. This instills a sense of ownership and encourages proper maintenance of the projects. Therefore, before the Public Health Program started its projects, the Business Program worked with the community to train an existing community bank that would allow families to finance these contributions through microcredit. Although the Public Health Program has completed all planned projects in Sabana de en Medio, loans remain available through the community bank and local masons who were contracted to complete the projects now hold the skills to perform any necessary repairs or construct new units. 

PUBLIC HEALTH VOLUNTEERS IN SABANA DE EN MEDIO

Chapter Date # Of Volunteers Chapter Date # Of Volunteers
Southern Connecticut State University Medical Brigade January 2018 18 Texas A&M University Medical Brigade January 2018 45
Marquette University Medical Brigade January 2018 63 University of San Diego Medical Brigade January 2018 34

Local Reference Points

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

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